bluuebunny/crossref_metadata_2025 huggingface dataset:
Nuclear quadrupole double resonance spectrometer with magnetic property measurement system direct current superconducting quantum interference device detector and automatic tuning
Authors: Shroyer Mark H. , Day Edmund P.
Published: May 2011

A new nuclear quadrupole double resonance spectrometer based on a commercial superconducting quantum interference device (SQUID) setup (a Magnetic Property Measurement System (MPMS) from Quantum Design) is described. The experiment involves the indirect detection of pure quadrupole resonances (PQR) of a dilute spin system via the direct SQUID detected NMR of an abundant spin system. The experiment is conducted at low (3–20 K) temperatures and the magnetic field is cycled between a high (5.5 T) polarizing field, to an intermediate (0.1 T) detection field, to zero field where the sample is irradiated with a modulated search RF and back to the detection field. Loss of the NMR signal indicates the detection of a PQR. The RF circuit used for both the NMR and zero field irradiation is digitally controlled. Use of the External Device Control allows for the complete automation of the system. Test measurements on diphenyl ether are in good agreement with previously reported results. Pure 17O quadrupole resonances were detected for spin systems with concentrations as low as 120 μM.
An extended hybrid magnetohydrodynamics gyrokinetic model for numerical simulation of shear Alfvén waves in burning plasmas
Authors: Wang X. , Briguglio S. , Chen L. , Di Troia C. , Fogaccia G. , Vlad G. , Zonca F.
Published: May 2011

Adopting the theoretical framework for the generalized fishbonelike dispersion relation, an extended hybrid magnetohydrodynamics gyrokinetic simulation model has been derived analytically by taking into account both thermal ion compressibility and diamagnetic effects in addition to energetic particle kinetic behaviors. The extended model has been used for implementing an extended version of hybrid magnetohydrodynamics gyrokinetic code (XHMGC) to study thermal ion kinetic effects on Alfvénic modes driven by energetic particles, such as kinetic beta induced Alfvén eigenmodes in tokamak fusion plasmas. The XHMGC nonlinear model can be used to address a number of problems, where kinetic treatments of both thermal and supra-thermal plasma components are necessary, as theoretically predicted, or where it is desirable to investigate the phenomena connected with the presence of two supra-thermal particle species with different radial profiles and velocity space distributions.
Ion diode performance on a positive polarity inductive voltage adder with layered magnetically insulated transmission line flow
Authors: Hinshelwood D. D. , Ottinger P. F. , Schumer J. W. , Allen R. J. , Apruzese J. P. , Commisso R. J. , Cooperstein G. , Jackson S. L. , Murphy D. P. , Phipps D. , Swanekamp S. B. , Weber B. V. , Young F. C.
Published: May 2011

A pinch-reflex ion diode is fielded on the pulsed-power machine Mercury (R. J. Allen, et al., 15th IEEE Intl. Pulsed Power Conf., Monterey, CA, 2005, p. 339), which has an inductive voltage adder (IVA) architecture and a magnetically insulated transmission line (MITL). Mercury is operated in positive polarity resulting in layered MITL flow as emitted electrons are born at a different potential in each of the adder cavities. The usual method for estimating the voltage by measuring the bound current in the cathode and anode of the MITL is not accurate with layered flow, and the interaction of the MITL flow with a pinched-beam ion diode load has not been studied previously. Other methods for determining the diode voltage are applied, ion diode performance is experimentally characterized and evaluated, and circuit and particle-in-cell (PIC) simulations are performed. Results indicate that the ion diode couples efficiently to the machine operating at a diode voltage of about 3.5 MV and a total current of about 325 kA, with an ion current of about 70 kA of which about 60 kA is proton current. It is also found that the layered flow impedance of the MITL is about half the vacuum impedance.
Design and construct of a new detector for gas chromatography based on continuous negative corona discharge
Authors: Ghahfarokhi M. Sharifian , Khayamian T.
Published: May 2011

In this work, a new detector was designed and constructed based on negative corona discharge. This detector can be used separately or as a detector in gas chromatography. The detector and chromatographic variables including cell temperature, gas flow rates, voltage between the two electrodes, and column temperature were optimized. Chloroform was used as a test compound to evaluate the performance of the detector. The detection limit of chloroform was obtained 0.78 ng/ml and its dynamic range was over the range of 2–840 ng/ml. The relative standard detection was about 6% for the limit of quantification. This detector is able to be used as an alternative for analysis of compounds containing electronegative elements.
Paramagnetic Pb-type interface defects in thermal (110)Si/SiO2
Authors: Keunen K. , Stesmans A. , Afanas’ev V. V.
Published: May 2011

A multifrequency electron spin resonance (ESR) study on thermal (110)Si/SiO2 as a function of oxidation temperature Tox (200–1125 °C) reveals an unexpectedly high density of Pb-type interface centers, which variant, based on pertinent ESR properties, is typified as Pb0(110). In terms of Pb(0) center density, the (110) face is found to be the worst of all three low index Si interfaces, i.e., [Pb0(100)]<[Pb(111)]<[Pb0(110)], over the range Tox<∼900 °C. Unlike previous belief, the density of prevailing Pb(0) centers over the low index Si/SiO2 interfaces is not found to scale with Si surface areal atom density nor available Si bond density; an alternative criterion is suggested.
Effect of temperature on elastic properties of alkaline earth oxides (AEO)
Authors: Gupta Seema , Goyal S. C.
Published: May 2011

A simple and straightforward theoretical model is developed to investigate the elastic properties of alkaline earth oxides under the effect of temperature as well as pressure. The calculation are performed with the help of high pressure-high temperature equation of state (EOS) based on thermodynamic analysis. The anharmonic term arising due to thermal expansion, has been taken into account in the expansion of logarithmic series of the thermodynamic data. The results obtained for alkaline earth oxides are discussed and compared with experimental data under the effect of high temperature at zero pressure. The results are found to be in good agreement with available experimental results and thus may be helpful in analyzing the other's experimental results.
Resonant wideband polarizer with single silicon layer
Authors: Lee Kyu J. , Curzan James , Shokooh-Saremi Mehrdad , Magnusson Robert
Published: May 2011

We present the design, fabrication, and characterization of a guided-mode resonance polarizer operating in the telecommunication band. This polarizer consists of a single one-dimensional silicon grating layer and a glass substrate. The device is designed using inverse mathematical methods and fabricated by thin-film deposition, holographic-interference patterning, and etching. The fabricated polarizer has high transmittance for transverse-magnetic polarization and low transmittance for transverse-electric polarization over a ∼200 nm wavelength range. Its experimental extinction ratio is ∼670:1 at a central wavelength λc=1563 nm. Experimental and theoretical results are in good agreement.
X-ray reflectance studies of interface in ion beam sputtered CoFeB/MgO bilayers
Authors: Raju M. , Chaudhary Sujeet , Pandya D. K.
Published: May 2011

This letter reports specular and diffuse x-ray reflectance studies of the interface in the ion beam sputtered CoFeB(∼5–8 nm)/MgO(∼2–5 nm) bilayers. The study reveals the specific roles of oxygen ion energy, substrate temperature, and reactive gas ambient on controlling the interface width in the bilayers. Depending on oxidation-method employed for MgO growth the interface width varies between 0.51 and 0.20 nm. Energy of assist ions (≤50 eV) plays a key role compared to the growth temperature in determining the sharpness of the interface. The bottom grown CoFeB exhibited significant increase in coercivity (HC), which also depends on MgO-growth process.
A system for imaging the regulatory noncoding Xist RNA in living mouse embryonic stem cells
Authors: Ng Karen , Daigle Nathalie , Bancaud Aurélien , Ohhata Tatsuya , Humphreys Peter , Walker Rachael , Ellenberg Jan , Wutz Anton
Published: May 2011

In mammals, silencing of one of the two X chromosomes in female cells compensates for the different number of X chromosomes between the sexes. The noncoding Xist RNA initiates X chromosome inactivation. Xist spreads from its transcription site over the X chromosome territory and triggers the formation of a repressive chromatin domain. To understand localization of Xist over one X chromosome we aimed to develop a system for investigating Xist in living cells. Here we report successful visualization of transgenically expressed MS2‑tagged Xist in mouse embryonic stem cells. Imaging of Xist during an entire cell cycle shows that Xist spreads from a single point to a steady state when the chromosome is covered with a constant amount of Xist. Photobleaching experiments of the established Xist cluster indicate that chromosome‑bound Xist is dynamic and turns over on the fully Xist covered chromosome. It appears that in interphase the loss of bound Xist and newly produced Xist are in equilibrium. We also show that the turnover of bound Xist requires transcription, and Xist binding becomes stable when transcription is inhibited. Our data reveal a strategy for visualizing Xist and indicate that spreading over the chromosome might involve dynamic binding and displacement.
Axonal filopodial asymmetry induced by synaptic target
Authors: Li Pan P. , Chen Cheng , Lee Chi-Wai , Madhavan Raghavan , Peng H. Benjamin
Published: May 2011

During vertebrate neuromuscular junction (NMJ) assembly, motor axons and their muscle targets exchange short-range signals that regulate the subsequent steps of presynaptic and postsynaptic specialization. We report here that this interaction is in part mediated by axonal filopodia extended preferentially by cultured Xenopus spinal neurons toward their muscle targets. Immunoblotting and labeling experiments showed that basic fibroblast growth factor (bFGF) was expressed by muscle and associated with the cell surface, and treatment of cultured spinal neurons with recombinant bFGF nearly doubled the normal density of filopodia in neurites. This effect of bFGF was abolished by SU5402, a selective inhibitor of FGF-receptor 1 (FGFR1), and forced expression of wild-type or dominant-negative FGFR1 in neurons enhanced or suppressed the assembly of filopodia, respectively. Significantly, in nerve–muscle cocultures, knocking down bFGF in muscle decreased both the asymmetric extension of filopodia by axons toward muscle and the assembly of NMJs. In addition, neurons expressing dominant-negative FGFR1 less effectively triggered the aggregation of muscle acetylcholine receptors at innervation sites than did control neurons. These results suggest that bFGF activation of neuronal FGFR1 generates filopodial processes in neurons that promote nerve–muscle interaction and facilitate NMJ establishment.
A Pre‐Post Retrospective Study of Patients With Cystic Fibrosis and Gastrostomy Tubes
Authors: Best Chad , Brearley Ann , Gaillard Philippe , Regelmann Warren , Billings Joanne , Dunitz Jordan , Phillips James , Holme Bonnie , Schwarzenberg Sarah J.
Published: May 2011

Objectives:

The aim of the study was to assess the efficacy of gastrostomy tube (GT) placement on improving nutritional status and pulmonary function in patients with cystic fibrosis (CF).

Patients and Methods:

Data were collected from the Minnesota Cystic Fibrosis Database. Subjects with at least 5 percent‐predicted forced expiratory volume in 1 second (ppFEV1) and 1 BMI percentile (pBMI) measurements before and after GT placement were included. Median pBMI values were compared 2 years before and 1, 2, and 4 years after GT placement using a signed rank test. Longitudinal mixed model analysis was used to assess the effect of GT placement on ppFEV1. To assess the effect of ppFEV1 at GT placement on efficacy, the estimated ppFEV1 change was regressed against the ppFEV1 level at placement.

Results:

Forty‐six subjects with CF who met entry criteria were identified. Mean estimated step changes in ppFEV1 at placement for men, women, boys, and girls were 2.16% (P = 0.52), 0.43% (P = 0.92), 0.99% (P = 0.65), and −0.91% (P = 0.74), respectively. Mean estimated slope changes of ppFEV1 after GT placement were 5.01% (P = 0.02), 4.48% (P = 0.07), 1.49% (P = 0.23), and 4.02% (P = 0.01) per year for men, women, boys, and girls, respectively. Median change in pBMI in the second year after GT placement was 13.3% (P ⩽ 0.0001). Estimated coefficients for the effect of ppFEV1 level at placement on the ppFEV1 step and slope change were −0.041 (P = 0.28) and −0.005 (P = 0.84), respectively.

Conclusions:

GT placement in patients with CF results in significant improvement in both pBMI and ppFEV1, except in women. The change in lung function after GT placement is not dependent on the level of lung function at placement.
Gut–Bone Interactions and Implications for the Child With Chronic Gastrointestinal Disease
Authors: Klein Gordon L.
Published: May 2011

Bone is not simply a framework on which to hang viscera and connective tissue; it is also a dynamic interactive organ system with roles in immunoregulation, adipogenesis, and vascular calcification, among others. Bone is intimately affected by chronic disease, including gastrointestinal disease. The mechanisms for bone loss in conditions such as inflammatory bowel disease, celiac disease, and cystic fibrosis are discussed with regard to the role of the inflammatory response. Furthermore, we raise the issue of effects of inflammation on both intestinal and renal calcium and phosphate transport, although the ways in which these actions affect bone are not explained and require further research. The stress response, a prominent feature following burn injury, is also elucidated and its relation to gastrointestinal disease is examined. We then discuss the importance of knowing the mechanism of bone loss to determine proper prevention and treatment for the bone loss in specific gastrointestinal conditions.
How dogs lap: ingestion and intraoral transport in
Canis familiaris
Authors: Crompton A. W. , Musinsky Catherine
Published: May 2011

It has recently been suggested that the mechanism for lifting liquid from a bowl into the oral cavity during lapping is fundamentally different in cats and dogs: cats use adhesion of liquid to the tongue tip while dogs ‘scoop’ with their backwardly curled tongue. High-speed light videos and X-ray videos show that on the contrary, both cats and dogs use the mechanism of adhesion. Liquid is transported through the oral cavity to the oesophagus, against gravity, on the surface of the tongue as it is drawn upwards, then a tight contact between the tongue surface and palatal rugae traps liquid and prevents its falling out as the tongue is protruded. At least three cycles are needed for intraoral transport of liquid in the dog.
Great flights by great snipes: long and fast non-stop migration over benign habitats
Authors: Klaassen Raymond H. G. , Alerstam Thomas , Carlsson Peter , Fox James W. , Lindström Åke
Published: May 2011

Migratory land birds perform extreme endurance flights when crossing ecological barriers, such as deserts, oceans and ice-caps. When travelling over benign areas, birds are expected to migrate by shorter flight steps, since carrying the heavy fuel loads needed for long non-stop flights comes at considerable cost. Here, we show that great snipes
Gallinago media
made long and fast non-stop flights (4300–6800 km in 48–96 h), not only over deserts and seas but also over wide areas of suitable habitats, which represents a previously unknown migration strategy among land birds. Furthermore, the great snipes achieved very high ground speeds (15–27 m s
−1
), which was not an effect of strong tailwind support, and we know of no other animal that travels this rapidly over such a long distance. Our results demonstrate that some migratory birds are prepared to accept extreme costs of strenuous exercise and large fuel loads, even when stopover sites are available along the route and there is little tailwind assistance. A strategy of storing a lot of energy before departure, even if migration is over benign habitats, may be advantageous owing to differential conditions of fuel deposition, predation or infection risk along the migration route.
Different behavioural responses to anthropogenic noise by two closely related passerine birds
Authors: Francis Clinton D. , Ortega Catherine P. , Cruz Alexander
Published: May 2011

Anthropogenic noise, now common to many landscapes, can impair acoustic communication for many species, yet some birds compensate for masking by noise by altering their songs. The phylogenetic distribution of these noise-dependent signal adjustments is uncertain, and it is not known whether closely related species respond similarly to noise. Here, we investigated the influence of noise on habitat occupancy rates and vocal frequency in two congeneric vireos with similar song features. Noise exposure did not influence occupancy rates for either species, yet song features of both changed, albeit in different ways. With increases in noise levels, plumbeous vireos (
Vireo plumbeus
) sang shorter songs with higher minimum frequencies. By contrast, grey vireos (
Vireo vicinior
) sang longer songs with higher maximum frequencies. These findings support the notion that vocal plasticity may help some species occupy noisy areas, but because there were no commonalities among the signal changes exhibited by these closely related birds, it may be difficult to predict how diverse species may modify their signals in an increasingly noisy world.
Sequence-based evidence for major histocompatibility complex-disassortative mating in a colonial seabird
Authors: Juola Frans A. , Dearborn Donald C.
Published: May 2011

The major histocompatibility complex (MHC) is a polymorphic gene family associated with immune defence, and it can play a role in mate choice. Under the genetic compatibility hypothesis, females choose mates that differ genetically from their own MHC genotypes, avoiding inbreeding and/or enhancing the immunocompetence of their offspring. We tested this hypothesis of disassortative mating based on MHC genotypes in a population of great frigatebirds (Fregata minor) by sequencing the second exon of MHC class II B. Extensive haploid cloning yielded two to four alleles per individual, suggesting the amplification of two genes. MHC similarity between mates was not significantly different between pairs that did (n= 4) or did not (n= 42) exhibit extra-pair paternity. Comparing all 46 mated pairs to a distribution based on randomized re-pairings, we observed the following (i): no evidence for mate choice based on maximal or intermediate levels of MHC allele sharing (ii), significantly disassortative mating based on similarity of MHC amino acid sequences, and (iii) no evidence for mate choice based on microsatellite alleles, as measured by either allele sharing or similarity in allele size. This suggests that females choose mates that differ genetically from themselves at MHC loci, but not as an inbreeding-avoidance mechanism.
K+ Transport by the OsHKT2;4 Transporter from Rice with Atypical Na+ Transport Properties and Competition in Permeation of K+ over Mg2+ and Ca2+ Ions
Authors: Horie Tomoaki , Brodsky Dennis E. , Costa Alex , Kaneko Toshiyuki , Lo Schiavo Fiorella , Katsuhara Maki , Schroeder Julian I.
Published: May 2011

Members of class II of the HKT transporters, which have thus far only been isolated from grasses, were found to mediate Na+-K+ cotransport and at high Na+ concentrations preferred Na+-selective transport, depending on the ionic conditions. But the physiological functions of this K+-transporting class II of HKT transporters remain unknown in plants, with the exception of the unique class II Na+ transporter OsHKT2;1. The genetically tractable rice (Oryza sativa; background Nipponbare) possesses two predicted K+-transporting class II HKT transporter genes, OsHKT2;3 and OsHKT2;4. In this study, we have characterized the ion selectivity of the class II rice HKT transporter OsHKT2;4 in yeast and Xenopus laevis oocytes. OsHKT2;4 rescued the growth defect of a K+ uptake-deficient yeast mutant. Green fluorescent protein-OsHKT2;4 is targeted to the plasma membrane in transgenic plant cells. OsHKT2;4-expressing oocytes exhibited strong K+ permeability. Interestingly, however, K+ influx in OsHKT2;4-expressing oocytes did not require stimulation by extracellular Na+, in contrast to other class II HKT transporters. Furthermore, OsHKT2;4-mediated currents exhibited permeabilities to both Mg2+ and Ca2+ in the absence of competing K+ ions. Comparative analyses of Ca2+ and Mg2+ permeabilities in several HKT transporters, including Arabidopsis thaliana HKT1;1 (AtHKT1;1), Triticum aestivum HKT2;1 (TaHKT2;1), OsHKT2;1, OsHKT2;2, and OsHKT2;4, revealed that only OsHKT2;4 and to a lesser degree TaHKT2;1 mediate Mg2+ transport. Interestingly, cation competition analyses demonstrate that the selectivity of both of these class II HKT transporters for K+ is dominant over divalent cations, suggesting that Mg2+ and Ca2+ transport via OsHKT2;4 may be small and would depend on competing K+ concentrations in plants.
Expression of SLCO1B3 is associated with intratumoral cholestasis and CTNNB1 mutations in hepatocellular carcinoma
Authors: Sekine Shigeki , Ogawa Reiko , Ojima Hidenori , Kanai Yae
Published: May 2011

Recent studies have shown that intratumoral cholestasis is a hallmark of CTNNB1 mutations in hepatocellular carcinomas (HCC). Here, we analyzed the expressions of genes involved in bile acid and bilirubin metabolism and their correlation with the mutational status of CTNNB1 in a series of HCC. The expressions of CYP7A1 and CYP27A1, which encode rate‐limiting enzymes in bile acid synthesis, were unaltered or only marginally increased in CTNNB1‐mutated HCC compared with those in HCC with wild‐type CTNNB1. Among the genes involved in bile acid and bilirubin transport, the expression of SLCO1B3 was significantly elevated in HCC with CTNNB1 mutations, whereas the expression of ABCC4 was elevated in HCC with wild‐type CTNNB1. Immunohistochemistry confirmed the frequent expression of SLCO1B3 in CTNNB1‐mutated HCC at the protein level, but not in most HCC with wild‐type CTNNB1. Immunohistochemistry for MRP4 (encoded by ABCC4) partly agreed with ABCC4 expression, but most cases did not express detectable levels of MRP4. Notably, all HCC with bile accumulation, including those without CTNNB1 mutations, expressed SLCO1B3, suggesting that SLCO1B3 expression, rather than CTNNB1 mutation, is the critical determinant of intratumoral cholestasis. As SLCO1B3 is involved in the uptake of a number of chemotherapeutic and diagnostic agents, SLCO1B3 expression and the status of CTNNB1 mutation might need to be considered in the drug delivery to HCC. (Cancer Sci 2011; 102: 1742–1747)
Access to alcohol outlets and harmful alcohol consumption: a multi‐level study in Melbourne, Australia
Authors: Kavanagh Anne M. , Kelly Mary T. , Krnjacki Lauren , Thornton Lukar , Jolley Damien , Subramanian S. V. , Turrell Gavin , Bentley Rebecca J.
Published: May 2011

Aims  To assess the association between access to off‐premises alcohol outlets and harmful alcohol consumption.

Design, setting and participants  Multi‐level study of 2334 adults aged 18–75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne.

Measurements  Alcohol outlet density was defined as the number of outlets within a 1‐km road network of respondents' homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi‐level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short‐term harm at least weekly and monthly; drinking at levels associated with long‐term harm and frequency of consumption.

Findings  Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short‐term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04–1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short‐term harm was when there were eight or more outlets (short‐term harm weekly: OR 2.36, 95% CI 1.22–4.54 and short‐term harm monthly: OR 1.80, 95% CI 1.07–3.04). We found no evidence to support an association between proximity and harmful alcohol consumption.

Conclusions  The number of off‐premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off‐premises alcohol outlets could reduce levels of harmful alcohol consumption.
Platelet transfusions for patients with haematological malignancies: who needs them?
Authors: Estcourt Lise J. , Stanworth S. J. , Murphy M. F.
Published: May 2011

The goal of platelet transfusions is to prevent severe and life‐threatening bleeding in patients with thrombocytopenia. This aim needs to be balanced against the risks associated with platelet transfusions as well as the challenge of maintaining an adequate supply. This review summarizes the recent evidence regarding the clinical use of platelet transfusions in haematology patients, concentrating on the topics that still continue to provoke debate. These include the optimal dose for platelet transfusions and the relative safety of a ‘therapeutic only’ platelet transfusion strategy compared to the use of prophylactic platelet transfusions. The type of platelet product has been the subject of two recent systematic reviews. The results of these reviews will be discussed as well as their implications for current practice.
Effect of ultrasound transmission gel on ultrasound‐guided fine needle aspiration cytological specimens of thyroid
Authors: Lalzad A. , Ristitsch D. , Downey W. , Little A. F. , Schneider‐Kolsky M. E.
Published: May 2011

A. Lalzad, D. Ristitsch, W. Downey, A. F. Little and M. E. Schneider‐Kolsky  Effect of ultrasound transmission gel on ultrasound‐guided fine needle aspiration cytological specimens of thyroid

Objective:  To investigate prospectively the diagnostic impact of ultrasound coupling gel on thyroid specimens obtained under ultrasound guidance.

Methods:  Patients presenting for ultrasound‐guided fine needle aspiration (USG‐FNA) of the thyroid were invited to participate in the study. Four specimens per nodule were collected: two using chlorhexdine wash and two using sterile, colourless ultrasound gel as couplant according to routine protocol. All slides were analysed in a blinded fashion by two senior cytologists for the presence or absence of ultrasound gel‐induced artefacts. The presence of gel‐induced artefacts between the two groups was analyzed using Pearson’s chi‐square test. Kappa statistics were used to measure the inter‐rater agreement between the cytologists.

Results:  Twenty thyroid nodules comprising 80 specimen slides were collected. On slides collected with gel, cytological artefacts were detected in 60–65% of cases compared with 10–15% of cases without gel (P < 0.001). The inter‐rater agreement between the two observers was very good (κ = 0.84). Two of the 14 patients required repeat FNA due to non‐diagnostic cytology results caused by inadequate sampling and gel‐induced artefacts.

Conclusions:  Clinical cytopathologists, radiologists and sonographers should be aware of the potential for ultrasound gel to cause significant artefacts on cytological specimens. Our findings suggest that staff involved in USG‐FNA cytology should remove the gel carefully before taking the aspirate.
Depressive symptoms predict mortality in elderly subjects with chronic heart failure
Authors: Testa Gianluca , Cacciatore Francesco , Galizia Gianluigi , Della‐Morte David , Mazzella Francesca , Gargiulo Gaetano , Langellotto Assunta , Raucci Carolina , Ferrara Nicola , Rengo Franco , Abete Pasquale
Published: May 2011

Eur J Clin Invest 2011; 41 (12): 1310–1317

Background  Chronic heart failure (CHF) is characterized by a high mortality in the elderly. Moreover, depression status is also related to poor prognosis in advancing age. Thus, we sought to determine whether depressive status predicts long‐term mortality in subject with or without CHF.

Methods and results  Long‐term mortality after 12‐year follow‐up in 125 elderly subjects with CHF and 1143 elderly subjects without CHF was studied. Depression was evaluated using the Geriatric Depression Scale (GDS), and all subjects were stratified in tertiles according to GDS score (0–10, 11–20 and 21–30). With increasing GDS score, long‐term mortality at the end of follow‐up increased from 43·4% to 72·0% in subjects without (P < 0·001) and from 52·6% to 83·9% in subjects with (P < 0·007) CHF. In multivariate analysis, GDS appeared to be predictive of long‐term mortality in the absence (Hazard ratio = 1·01; confidence interval 95% 1·00–1·05; P = 0·04) and, even more, in the presence of CHF (Hazard ratio = 1·08; confidence interval 95% 1·01–1·15; P < 0·01).

Conclusions  Depression symptoms predict long‐term mortality in elderly subjects without and, even more, with CHF. Thus, depression can be considered a strong predictor of death in CHF elderly subjects.
Predominant role of obesity/insulin resistance in oxidative stress development
Authors: D’Archivio Massimo , Annuzzi Giovanni , Varì Rosaria , Filesi Carmelina , Giacco Rosalba , Scazzocchio Beatrice , Santangelo Carmela , Giovannini Claudio , Rivellese Angela A. , Masella Roberta
Published: May 2011

Eur J Clin Invest 2012; 42 (1): 70–78

Background  Hyperlipidaemia, hyperglycaemia and hyperinsulinaemia, hallmarks of the postprandial state, have been also associated with increased oxidative stress and lipoprotein oxidation contributing to vascular injury and atherosclerosis. However, the specific links among metabolic disorders, postprandial state, insulin resistance and oxidative stress are still to be clarified. This study aimed at investigating the individual role played by obesity, insulin resistance and type 2 diabetes in the occurrence of fasting and postprandial oxidative stress.

Design  Biomarkers of oxidative stress [F2‐isoprostanes and circulating oxidized low‐density lipoproteins (LDL)], LDL oxidability (conjugated diene kinetic, thiobarbituric acid reactive substances (TBARs) formation and electronegativity increase) and antioxidant vitamins (β‐carotene, α‐tocopherol and retinol) were evaluated at fasting and 6 h after a standard fat‐rich meal in 10 obese diabetic (ObD), 11 obese and 11 normal‐weight control men. Insulin sensitivity was evaluated by euglycaemic hyperinsulinaemic clamp.

Results  ObD and obese subjects, characterized by a similar level of adiposity and insulin resistance, showed higher urinary F2‐isoprostanes and circulating oxidized LDL, an increased susceptibility to oxidation of plasma LDL (lower lag phase, higher TBARs formation, and higher relative electrophoretic mobility), and lower plasma content of β‐carotene and retinol than control subjects, both at fasting and after the test meal.

Conclusions  Obesity and insulin resistance, more than type 2 diabetes, play the most relevant role in oxidative stress development. The correction of obesity and insulin resistance might be a useful strategy in counteracting systemic oxidative stress.
Testicular biopsy for early cancer detection – objectives, technique and controversies
Authors: Dieckmann K.‐P. , Kulejewski M. , Heinemann V. , Loy V.
Published: May 2011

This review highlights the usefulness of testicular biopsy for early detection of testicular germ cell tumour (GCT). GCT develops through a precursor stage, called testicular intraepithelial neoplasia (TIN; also called intratubular germ cell neoplasia or carcinoma in situ, CIS), which is present many years before invasive malignancy occurs. TIN/CIS is safely detected histologically. TIN is usually widely but non‐randomly distributed within the testicle, thus, a biopsy of 3 mm size usually indicates the presence of TIN. Surgically, testicular biopsy should be performed at the cranial pole. Two‐site biopsies provide an 18% diagnostic yield over single biopsy. Surgical complications occur in about 2.8%, most of which are managed conservatively. Serial scrotal imaging studies after biopsies revealed significant early changes. Eighteen months thereafter, less than 5% of cases have changes detectable. False‐negative biopsies are extremely rare. Biopsy also provides information regarding spermatogenesis. In case of diagnosis of TIN, orchiectomy is rarely required. Low‐dose radiotherapy eradicates TIN. In conclusion, testicular biopsy is useful in patients with unilateral GCT to explore the opposite testis, and in patients with retroperitoneal GCT to look for occult testicular primary. Further candidates for biopsy are selected patients with sonographic testicular microlithiasis. Despite its usefulness, the procedure has been implemented in clinical routine only in few countries thus far.
Predictors of exercise frequency in breast cancer survivors in Taiwan
Authors: Hsu Hsin‐Tien , Dodd Marylin J , Guo Su‐Er , Lee Kathryn A , Hwang Shiow‐Li , Lai Yu‐Hung
Published: May 2011

Aim.  To apply social cognitive theory to elucidate factors that motivate change in exercise frequency in breast cancer survivors during the six months after completing cancer treatment.

Background.  Exercise is now a well‐recognised quality‐of‐life intervention in breast cancer survivors. However, only regular exercise yields long‐term benefits. Motivations for exercise have not been analysed in Taiwan patients with cancer.

Design.  A prospective, longitudinal and repeated measures design was used.

Methods.  A convenience sample of 196 breast cancer survivors was recruited from hospitals in metropolitan areas of north and south Taiwan. Study participants were allowed to select their preferred exercised activities. Exercise behaviour and other factors were then recorded using various standardised instruments. Medical charts were also reviewed. Data were analysed by a linear mixed model and by hierarchical multiple regression equations.

Results.  Exercise frequency significantly changed over time. Explained variance in exercise frequency change was modest. Baseline exercise frequency was the best significant predictor of exercise frequency during the six‐month study. The study also identified possible age‐related differences in the effect of social support on exercise. The effect of social support for exercise on exercise frequency was apparently larger in older subjects, especially those over 40 years old, than in younger subjects. Mental health, exercise barriers and exercise outcome expectancy significantly contributed to change in exercise frequency during the six‐month study.

Conclusions.  The analytical results revealed several ways to increase exercise frequency in breast cancer survivors: (1) encourage exercise as early as possible; (2) improve health status and provide social support for exercise, especially in women aged 40 years or older; (3) reduce exercise barriers and promote mental health; (4) reinforce self‐efficacy and positive expectations of exercise outcomes and (5) provide strategies for minimising fatigue in early stages of rehabilitation.

Relevance to clinical practice.  Social cognitive theory provides a useful framework for understanding the motivation to exercise in breast cancer survivors.
Prospective observational study of postoperative epidural analgesia for major abdominal surgery
Authors: Duncan Fiona
Published: May 2011

Aims.  To describe the incidence and intensity of pain, hypotension and other epidural‐related side‐effects after major abdominal surgery and to identify factors associated with effective epidural analgesia.

Background.  Evidence exists that up to 30% of patients with epidural analgesia still experience severe pain in clinical practice. When epidurals produce good pain relief, potentially harmful side effects can result.

Methods.  Data were collected prospectively from 480 consecutive general surgical patients in a large District General Hospital in the UK.

Results.  Fifty‐six per cent of patients were hypotensive on day one. Low pain scores were found to be a predicator for postoperative hypotension. Severe pain was associated with emergency patients, male gender, the absence of hypotension and an epidural that did not continue until planned removal. Significantly lower mean pain scores were found in patients who were 70 years of age and over. No correlation exists between chronic pain before surgery and the level of postoperative pain.

Conclusion.  This study contributes to the epidural versus standard analgesia debate by describing the population in whom epidurals are used and identifies factors associated with both the success and failure of the technique in everyday practice. The Audit Commission has proposed a standard whereby less than 5% of patients should suffer severe pain following surgery. This may prove to be an unrealistic goal with currently available techniques.

Relevance to clinical practice.  As it is ward nursing staff who are primarily responsible for monitoring the effectiveness of the technique, it is important for nursing professionals to know the potential risks of postoperative epidural analgesia to be able to respond appropriately. The important measurements of an optimum acute pain assessment have been identified, based on the study results, allowing the development of a national acute pain registry to inform future practice.
Agreement between child and parent reports of 10‐ to 12‐year‐old children’s meal pattern and intake of snack foods
Authors: Persson Osowski C. , Fjellström C. , Olsson U. , Göranzon H.
Published: May 2011

Background:  Dietary assessment in children is associated with misreporting, which is a problem with both child and parent reports. Therefore, it is of interest to study how children and parents report children’s eating, respectively, although comparative studies are rare. The aim of the present article was to study the meal patterns and intake of certain snack foods of 10‐ to 12‐year‐old children as reported by the children and their parents, respectively, and to determine whether there was agreement between the child and parent reports. An additional aim was to study what factors might influence rater agreement.

Methods:  School children aged 10–12 years and their parents were given parallel questionnaires regarding the children’s meal pattern. Matched pairs (n = 147) were analysed for agreement. Descriptive statistics were used to study all variables. Rater agreement and whether agreement depends on the age and the sex of the child, the sex of the parent and household type were analysed using ordinal regression models. Correlations between the child and parent assessments were estimated as polychoric correlations.

Results:  There was a general agreement between child and parent reports, except with respect to sweets and chocolate, where children reported less frequent consumption than the parents did (P = 0.0001). The sex of the child was a significant factor regarding consumption of in‐between meals (P = 0.0001) and soft drinks (P = 0.01). Most children had breakfast, school lunch and dinner every day, whereas it was less common to report daily consumption of in‐between meals.

Conclusions:  There was a general agreement between children’s and parents’ reports, and most children were reported to have a regular meal pattern.
Neighbourhood socio‐economic characteristics and the risk of preterm birth for migrant and non‐migrant women: a study in a French district
Authors: Zeitlin Jennifer , Combier Evelyne , Levaillant Marc , Lasbeur Linda , Pilkington Hugo , Charreire Helene , Rivera Lucile
Published: May 2011

Zeitlin J, Combier E, Levaillant M, Lasbeur L, Pilkington H, Charreire H, Rivera L. Neighbourhood socio‐economic characteristics and the risk of preterm birth for migrant and non‐migrant women: a study in a French district. Paediatric and Perinatal Epidemiology 2011; 25: 347–356.

Neighbourhood‐level deprivation is associated with preterm birth; preterm birth rates are also higher for some, but not all migrant groups. We studied the impact of neighbourhood characteristics (a deprivation score and the proportion of foreign‐born residents) on singleton preterm birth in the French district of Seine‐Saint‐Denis for women born in France, North Africa, sub‐Saharan Africa and other countries. Multilevel logistic regression models were adjusted for maternal demographic and health care characteristics. For women born in France, the preterm birth rate rose with neighbourhood deprivation quintile (3.8% in the first to 5.7% in the fifth, adjusted odds ratio: 1.40 [95% confidence interval 1.14, 1.72]) and with increasing proportions of foreign‐born residents. Preterm birth rates were not higher in more deprived neighbourhoods for women born outside of France and were lower in neighbourhoods with more foreign‐born residents; in multilevel models, the inverse association with deprivation remained significant for women from sub‐Saharan Africa. Area‐based deprivation measures should be used with caution in populations with large numbers of migrants. These results raise questions about the health benefits of clustering for migrant communities as well as the negative consequences of acculturation.
Consumers’ interpretation and use of comparative information on the quality of health care: the effect of presentation approaches
Authors: Damman Olga C. , Hendriks Michelle , Rademakers Jany , Spreeuwenberg Peter , Delnoij Diana M. J. , Groenewegen Peter P.
Published: May 2011

Background  Public reports about health‐care quality have not been effectively used by consumers thus far. A possible explanation is inadequate presentation of the information.

Objective  To assess which presentation features contribute to consumers’ correct interpretation and effective use of comparative health‐care quality information and to examine the influence of consumer characteristics.

Design  Fictitious Consumer Quality Index (CQI) data on home care quality were used to construct experimental presentation formats of comparative information. These formats were selected using conjoint analysis methodology. We used multilevel regression analysis to investigate the effects of presenting bar charts and star ratings, ordering of the data, type of stars, number of stars and inclusion of a global rating.

Setting and participants  Data were collected during 2 weeks of online questioning of 438 members of an online access panel.

Results  Both presentation features and consumer characteristics (age and education) significantly affected consumers’ responses. Formats using combinations of bar charts and stars, three stars, an alphabetical ordering of providers and no inclusion of a global rating supported consumers. The effects of the presentation features differed across the outcome variables.

Conclusions  Comparative information on the quality of home care is complex for consumers. Although our findings derive from an experimental situation, they provide several suggestions for optimizing the information on the Internet. More research is needed to further unravel the effects of presentation formats on consumer decision making in health care.
Close to the bench as well as at the bedside: involving service users in all phases of translational research
Authors: Callard Felicity , Rose Diana , Wykes Til
Published: May 2011

Aim  The paper aims to develop a model of translational research in which service user and other stakeholder involvement are central to each phase.

Background  ‘Translational’ is the current medical buzzword: translational research has been termed ‘bench to bedside’ research and promises to fast‐track biomedical advances in the service of patient benefit. Models usually conceive of translational research as a ‘pipeline’ that is divided into phases: the early phase is characterized as the province of basic scientists and laboratory‐based clinical researchers; the later phases focus on the implementation, dissemination and diffusion of health applications. If service user involvement is mentioned, it is usually restricted to these later phases.

Methods  The paper critically reviews existing literature on translational research and medicine. The authors develop a theoretical argument that addresses why a reconceptualization of translational research is required on scientific, ethical and pragmatic grounds.

Results  The authors reconceptualize the model of translational research as an interlocking loop rather than as a pipeline, one in which service user and other stakeholder involvement feed into each of its elements. The authors demonstrate that for the ‘interlocking loop’ model of translational research to be materialized in practice will require changes in how health research is structured and organized.

Conclusion  The authors demonstrate the scientific, ethical and pragmatic benefits of involving service users in every phase of translational research. The authors’ reconceptualized model of translational research contributes to theoretical and policy debates regarding both translational research and service user involvement.
Peer education for advance care planning: volunteers’ perspectives on training and community engagement activities
Authors: Seymour Jane E. , Almack Kathryn , Kennedy Sheila , Froggatt Katherine
Published: May 2011

Background  Peer education by volunteers may aid attitudinal change, but there is little understanding of factors assisting the preparation of peer educators. This study contributes to conceptual understandings of how volunteers may be prepared to work as peer educators by drawing on an evaluation of a training programme for peer education for advance care planning (ACP).

Objectives  To report on volunteers’ perspectives on the peer education training programme, their feelings about assuming the role of volunteer peer educators and the community engagement activities with which they engaged during the year after training. To examine broader implications for peer education.

Design  Participatory action research employing mixed methods of data collection.

Participants  Twenty‐four older volunteers and eight health and social care staff.

Data collection methods  Evaluative data were gathered from information provided during and at the end of training, a follow‐up survey 4 months post‐training; interviews and focus groups 6 and 12 months post‐training.

Findings  Volunteers’ personal aims ranged from working within their communities to using what they had learnt within their own families. The personal impact of peer education was considerable. Two‐thirds of volunteers reported community peer education activities 1 year after the training. Those who identified strongly with a community group had the most success.

Conclusion  We reflect on the extent to which the programme aided the development of ‘critical consciousness’ among the volunteers: a key factor in successful peer education programmes. More research is needed about the impact on uptake of ACP in communities.