bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamics of bone turnover markers in patients with heart failure and following haemodynamic improvement through ventricular assist device implantation
Authors: Wu Christina , Kato Tomoko S. , Pronschinske Katherine , Qiu Sylvia , Naka Yoshifumi , Takayama Hiroo , Schulze‐Späte Ulrike , Cremers Serge , Shane Elizabeth , Mancini Donna , Schulze P. Christian
Published: September 2012

Aims

Abnormal bone metabolism and progressive demineralization have been described in patients with heart failure (HF). We hypothesized that mechanical unloading through implantation of a ventricular assist device (VAD) with subsequent haemodynamic improvement would correct abnormal bone metabolism in patients with advanced HF.

Methods and results

Serum was collected from 14 controls, 20 patients with moderate HF, 34 patients with advanced HF undergoing VAD implantation, and 34 patients at the time of VAD explantation (mean duration: 169 ± 125 days). Bone metabolism markers were measured using enzyme‐linked immunosorption assay (ELISA) or chemiluminescence immunoassay (CLIA). Compared with controls, HF patients showed increased parathyroid hormone (PTH: 42 ± 19 vs. 117 ± 117 pg/mL in HF; P < 0.02) with decreased 25‐hydroxyvitamin D [25(OH)D: 29 ± 14 vs. 21 ± 11 ng/mL in HF; P = 0.05]. While procollagen‐1 N‐terminal peptide (P1NP) and osteocalcin were similar, cross‐linked C‐ and N‐telopeptides of type I collagen (CTX and NTX) were both higher in HF (NTX: 14 ± 6 vs. 20 ± 11 ng/mL; P < 0.05; CTX: 0.35 ± 0.13 vs. 1.05 ± 0.78 ng/mL; P < 0.01 for controls and HF, respectively). P1NP increased markedly after VAD implantation (49 ± 37 vs. 121 ± 62 ng/mL; P < 0.0001), with a mild decrease in CTX and NTX levels indicating a shift towards anabolic bone formation. Serum PTH correlated with estimated glomerular filtration rate (r = –0.245, P < 0.05).

Conclusion

Patients with advanced HF are characterized by increased levels of biochemical markers of bone resorption potentially as a result of secondary hyperparathyroidism and uncoupling of bone remodelling. Haemodynamic improvement and mechanical unloading after VAD implantation lead to correction of bone metabolism and increased levels of anabolic bone formation markers.
A Comprehensive Survey of Soft Wheat Grain Quality in U.S. Germplasm
Authors: Kiszonas Alecia M. , Fuerst E. Patrick , Morris Craig F.
Published: September 2012

Wheat (Triticum aestivum L.) quality is dependent upon both genetic and environmental factors, which work in concert to produce specific grain, milling, flour, and baking characteristics. This study surveyed all of the 132 soft wheat varieties (cultivars and advanced breeding lines) grown in the U.S. regional nursery system, which encompassed the three main soft wheat producing regions of the United States (eastern and southern soft red winter and western soft white). The quality parameters included test weight, kernel hardness, weight, and diameter, wheat and flour protein, polyphenol oxidase, break flour yield, flour yield, flour ash, milling score, flour swelling volume, flour SDS sedimentation volume, solvent retention capacity (SRC) for water, sodium carbonate, sucrose, and lactic acid, Rapid Visco Analyzer peak pasting viscosity, and cookie diameter. High levels of variation were observed among varieties, regions, and specific environments, with environment being in general a much greater source of variation than varieties. Variety was observed to have a relatively stronger influence on wheat quality in the western nurseries, compared with the eastern and southern regions, where location effects had a stronger impact on overall wheat quality. The greater influence of variety was particularly notable for kernel hardness in the western nurseries. Kernel hardness also varied considerably as a result of environment. For the two soft red winter wheat nurseries, the western U.S. environment produced substantially harder kernels (37–40) compared with the same varieties grown in eastern U.S. locations (15–20). Intertrait quality relationships were observed to be unique to the specific nursery and germplasm in which they were studied, and these relationships were not consistent across nurseries. Nevertheless, on average, soft wheat quality was fairly similar across the United States, indicating that breeding and testing models have been successful in achieving a relatively uniform target for quality. However, many traits showed high levels of variability among varieties, suggesting that a greater level of selection for end‐use quality would benefit end users by increasing consistency and reducing variability. The often large role of environment (location) in quality indicates that end users must be assiduous in their origination and grain procurement. Clearly, “nursery mean” quality does not reflect the potential that can be obtained, as reflected by a few exceptional soft wheat varieties.
Gibberellin 20-Oxidase Gene OsGA20ox3 Regulates Plant Stature and Disease Development in Rice
Authors: Qin Xue , Liu Jun Hua , Zhao Wen Sheng , Chen Xu Jun , Guo Ze Jian , Peng You Liang
Published: September 2012

Gibberellin (GA) 20-oxidase (GA20ox) catalyses consecutive steps of oxidation in the late part of the GA biosynthetic pathway. A T-DNA insertion mutant (17S-14) in rice, with an elongated phenotype, was isolated. Analysis of the flanking sequences of the T-DNA insertion site revealed that an incomplete T-DNA integration resulted in enhanced constitutively expression of downstream OsGA20ox3 in the mutant. The accumulation of bioactive GA1 and GA4 were increased in the mutant in comparison with the wild-type plant. Transgenic plants overexpressing OsGA20ox3 showed phenotypes similar to those of the 17S-14 mutant, and the RNA interference (RNAi) lines that had decreased OsGA20ox3 expression exhibited a semidwarf phenotype. Expression of OsGA20ox3 was detected in the leaves and roots of young seedlings, immature panicles, anthers, and pollens, based on β-glucuronidase (GUS) activity staining in transgenic plants expressing the OsGA20ox3 promoter fused to the GUS gene. The OsGA20ox3 RNAi lines showed enhanced resistance against rice pathogens Magnaporthe oryzae (causing rice blast) and Xanthomonas oryzae pv. oryzae (causing bacterial blight) and increased expression of defense-related genes. Conversely, OsGA20ox3-overexpressing plants were more susceptible to these pathogens comparing with the wild-type plants. The susceptibility of wild-type plants to X. oryzae pv. oryzae was increased by exogenous application of GA3 and decreased by S-3307 treatment. Together, the results provide direct evidence for a critical role of OsGA20ox3 in regulating not only plant stature but also disease resistance in rice.
The dynamics of adapting, unregulated populations and a modified fundamental theorem
Authors: O'Dwyer James P.
Published: September 2012

A population in a novel environment will accumulate adaptive mutations over time, and the dynamics of this process depend on the underlying fitness landscape: the fitness of and mutational distance between possible genotypes in the population. Despite its fundamental importance for understanding the evolution of a population, inferring this landscape from empirical data has been problematic. We develop a theoretical framework to describe the adaptation of a stochastic, asexual, unregulated, polymorphic population undergoing beneficial, neutral and deleterious mutations on a correlated fitness landscape. We generate quantitative predictions for the change in the mean fitness and within-population variance in fitness over time, and find a simple, analytical relationship between the distribution of fitness effects arising from a single mutation, and the change in mean population fitness over time: a variant of Fisher's ‘fundamental theorem’ which explicitly depends on the form of the landscape. Our framework can therefore be thought of in three ways: (i) as a set of theoretical predictions for adaptation in an exponentially growing phase, with applications in pathogen populations, tumours or other unregulated populations; (ii) as an analytically tractable problem to potentially guide theoretical analysis of regulated populations; and (iii) as a basis for developing empirical methods to infer general features of a fitness landscape.
Results of clot waveform analysis and thrombin generation test for a plasma‐derived factor VIIa and X mixture (MC710) in haemophilia patients with inhibitors—phase I trial: 2nd report
Authors: Shirahata A. , Fukutake K. , Mimaya J. , Takamatsu J. , Shima M. , Hanabusa H. , Takedani H. , Takashima Y. , Matsushita T. , Tawa A. , Higasa S. , Takata N. , Sakai M. , Kawakami K. , Ohashi Y. , Saito H.
Published: September 2012

We reported the results of a clinical pharmacological study of MC710 (a mixture of plasma‐derived FVIIa and FX) in haemophilia patients with inhibitors during a non‐haemorrhagic state. This report provides the results of a clot waveform analysis (CWA) and thrombin generation test (TGT) using blood samples obtained in this study. CWA and TGT were conducted using blood samples obtained from a pharmacokinetic and pharmacodynamic study in which MC710 (five dose rates: 20, 40, 80, 100 and 120 μg kg−1) was compared with NovoSeven (120 μg kg−1) and FEIBA (two dose rates: 50 and 75 U kg−1) as control drugs in 11 haemophilia patients with inhibitors without haemorrhagic symptoms. CWA showed that MC710 provided significantly greater improvement than the control drugs in activated partial thromboplastin time (APTT) at 80 μg kg−1; maximum clot velocity and maximum clot acceleration were more enhanced by MC710 than by control drugs. TGT revealed that MC710 significantly shortened the initiation time of thrombin generation in comparison to FEIBA and induced greater thrombin generation potency than NovoSeven. It was not clear whether or not MC710 caused significant dose‐dependent changes in the two measurements; however, differences between MC710 and the control drugs were clarified. MC710 was confirmed to have superior coagulation activity and thrombin productivity and is expected to have superior bypassing activity.
Regression curves of brain metastases after gamma knife irradiation: Difference by tumor and patient characteristics
Authors: Kosaki Katsura , Shibamoto Yuta , Hirai Tatsuo , Hatano Manabu , Tomita Natsuo , Kobayashi Tatsuya , Mori Yoshimasa
Published: September 2012

Regression curves and local control rates of brain metastases after gamma knife treatment were evaluated to investigate differences in tumor response to radiation. A total of 203 metastases were serially evaluated using contrast‐enhanced MRI (or computed tomography) at 1, 2, 3, 4.5 and 6 months after a 20‐Gy dose. Differences were evaluated in regression curves and control rates between tumors ≥10 mm and tumors <10 mm in mean diameter, among three major histological subtypes of lung cancer, among adenocarcinomas of the lung, breast and colorectum, and between tumors in patients with above and below median hemoglobin levels. Smaller tumors shrank faster and yielded better control rates than larger tumors. Metastases from small cell and squamous cell carcinomas of the lung shrank faster than those from lung adenocarcinoma, but 6‐month control rates were not different. Breast adenocarcinomas tended to shrink faster than lung adenocarcinomas, but the control rates were not different among adenocarcinomas of the lung, breast and colorectum. Tumors in patients with higher hemoglobin levels tended to shrink faster but the control rates were not different. Small cell and squamous cell carcinomas of the lung regress more rapidly than adenocarcinomas, although local control rates might not differ significantly.
Post‐glacial dispersal, rather than in situ glacial survival, best explains the disjunct distribution of the Lusitanian plant species Daboecia cantabrica (Ericaceae)
Authors: Beatty Gemma E. , Provan Jim
Published: September 2012

Aim

The distribution of the Lusitanian flora and fauna, species which are found only in southern and western Ireland and in northern Spain and Portugal but which are absent from intervening countries, represents one of the classic conundrums of biogeography. The aim of the present study was to determine whether the distribution of the Lusitanian plant species Daboecia cantabrica was due to persistence in separate Irish and Iberian refugia, or has resulted from post‐glacial recolonization followed by subsequent extinction of intervening populations.

Location

Northern Spain and Co. Galway, western Ireland.

Methods

Palaeodistribution modelling using Maxent was employed to identify putative refugial areas for D. cantabrica at the Last Glacial Maximum (LGM). Phylogeographical analysis of samples from 64 locations in Ireland and Spain were carried out using a chloroplast marker (atpB–rbcL), the nuclear ITS region, and an anonymous nuclear single‐copy locus.

Results

The palaeodistribution model indicated areas with a high probability of survival for D. cantabrica at the LGM off the western coast of Galicia in Spain, and in the Bay of Biscay. Spanish populations exhibited substantially higher genetic diversity than Irish populations at all three loci, as well as geographical structuring of haplotypes within Spain consistent with divergence in separate refugia. Spanish populations also exhibited far more endemic haplotypes. Divergence time between Irish and Spanish populations associated with the putative Biscay refugium was estimated as 3.333–32 ka.

Main conclusions

Our data indicate persistence by D. cantabrica throughout the LGM in two separate southern refugia: one in western Galicia and one in the area off the coast of western France which now lies in the Bay of Biscay. Spain was recolonized from both refugia, whilst Ireland was most likely recolonized from the Biscay refugium. On the balance of evidence across the three marker types and the palaeodistribution modelling, our findings do not support the idea of in situ survival of D. cantabrica in Ireland, contrary to earlier suggestions. The fact that we cannot conclusively rule out the existence of a small, more northerly refugium, however, highlights the need for further analysis of Lusitanian plant species.
Conflict in medical teams: opportunity or danger?
Authors: Greer Lindred L , Saygi Ozum , Aaldering Hillie , de Dreu Carsten K W
Published: September 2012

Medical Education 2012: 46: 935–942

Objectives  Intragroup conflicts often occur when people are called upon to collaborate in the accomplishment of a task. For example, when surgeons and nurses work together during an operation, conflicts may emerge because of differences in functional understanding. Whether these conflicts are beneficial or detrimental to team outcomes has been the source of much debate. From one perspective, a conflict that stems from differences in members’ functional understanding may enhance team members’ understanding and performance of the task at hand. By contrast, such a conflict may cause hostility, emotionality and distraction from actual task accomplishment.

Methods  This study reviews findings on the relationships between intragroup conflict and team outcomes, discusses potential conflict resolution strategies for intragroup conflicts and explores how these link to the field of medical education.

Results  Three primary types of conflict have been distinguished, involving, respectively, task‐, process‐ and relationship‐associated conflict. Both process conflict, or conflict about the logistics of task accomplishment, and relationship conflict, or conflict about interpersonal incompatibilities, have been shown to detract from effective team functioning. Task conflict, or conflict about the content of the task itself, is also generally negative for team functioning, but under certain conditions its negative effects may be minimised. For example, when teams can clearly separate task issues from relationship issues, task conflicts are less destructive for team outcomes. However, achieving such a separation in practice, and thereby realising the benefits of task conflict, is quite difficult to achieve.

Conclusions  Intragroup conflicts pose a challenge to effective team functioning. In the education of medical professionals, effective training in conflict management skills and their application to specific team conflict dynamics, such as with reference to how to resolve task as opposed to relationship conflict, is critical.
Medical misconduct in Hong Kong: implications for medical education around the world
Authors: Chan Zenobia C Y
Published: September 2012

Medical Education 2012: 46: 1009–1016

Context  Medical educators emphasise responses to medical misconduct, but little is known about medical misconduct and its implications for medical education. This article investigates the nature of medical malpractice in Hong Kong and offers guidance for the inclusion of a curriculum to prevent the occurrence of medical misconduct in medical education around the world.

Methods  A comprehensive review of judgements made by the Medical Council of Hong Kong during the period from July 2008 to December 2010 was conducted. Each of the 40 cases of inquiry related to medical misconduct were summarised and analysed according to 14 factors.

Results  Of the 40 cases, nearly half involved only one or two charges. The Council found the defendants guilty of professional misconduct on 148 of 169 charges, and ordered the following four types of penalty: removal order, suspension, warning letter, and reprimand. Cases are grouped into three categories involving: improper documentation, inappropriate management or prescription of drugs, and failure to interact appropriately with patients. The relevant ethical codes or legislation for each category are illustrated.

Conclusions  Various types of medical misconduct unquestionably caused suffering to the patients involved, their families and society. Hence, it is crucial for medical educators to teach students about the importance of medical ethics and the prevention of misconduct.
The cost of copy number in a selfish genetic element: the 2‐μm plasmid of Saccharomyces cerevisiae
Authors: Harrison E. , Koufopanou V. , Burt A. , MacLean R. C.
Published: September 2012

Many autonomously replicating genetic elements exist as multiple copies within the cell. The copy number of these elements is often assumed to have important fitness consequences for both element and host, yet the forces shaping its evolution are not well understood. The 2 μm is a multicopy plasmid of Saccharomyces yeasts, encoding just four genes that are solely involved in plasmid replication. One simple model for the fitness relationship between yeasts and 2 μm is that plasmid copy number evolves as a trade‐off between selection for increased vertical transmission, favouring high copy number, and selection for decreased virulence, favouring low copy number. To test this model, we experimentally manipulated the copy number of the plasmid and directly measured the fitness cost, in terms of growth rate reduction, associated with high plasmid copy number. We find that the fitness burden imposed by the 2 μm increases with plasmid copy number, such that each copy imposes a fitness burden of 0.17% (± 0.008%), greatly exceeding the cost expected for it to be stably maintained in yeast populations. Our results demonstrate the crucial importance of copy number in the evolution of yeast per 2 μm associations and pave the way for future studies examining how selection can shape the cost of multicopy elements.
Improving chronic lung disease management in rural and remote Australia: The Breathe Easy Walk Easy programme
Authors: JOHNSTON CATHERINE L. , MAXWELL LYNDAL J. , BOYLE EILEEN , MAGUIRE GRAEME P. , ALISON JENNIFER A.
Published: September 2012

Background and objective:  To evaluate the impact of a chronic lung disease management training programme, Breathe Easy Walk Easy (BEWE), for rural and remote health‐care practitioners.

Methods:  Quasi‐experimental, before and after repeated measures design. Health‐care practitioners (n = 33) from various professional backgrounds who attended the BEWE training workshop were eligible to participate. Breathe Easy Walk Easy, an interactive educational programme, consisted of a training workshop, access to online resources, provision of community awareness‐raising materials and ongoing telephone/email support. Participant confidence, knowledge and attitudes were assessed via anonymous questionnaire before, immediately after and at 3 and 12 months following the BEWE workshop. At 12 months, local provision of pulmonary rehabilitation services and patient outcome data (6‐min walk test results before and after pulmonary rehabilitation) were also recorded.

Results:  Measured knowledge (score out of 19) improved significantly after the workshop (mean difference 7.6 correct answers, 95% confidence interval: 5.8–9.3). Participants' self‐rated confidence and knowledge also increased. At 12‐month follow up, three locally run pulmonary rehabilitation programmes had been established. For completing patients, there was a significant increase in 6‐min walk distance following rehabilitation of 48 m (95% confidence interval: 18–70 m).

Conclusions:  The BEWE programme increased rural and remote health‐care practitioner knowledge and confidence in delivering management for people living with chronic lung disease and facilitated the establishment of effective pulmonary rehabilitation programmes in regional and remote Australian settings where access to such programmes is limited.
Two‐year evaluation of the MiniArc in obese versus non‐obese patients for treatment of stress urinary incontinence
Authors: Moore Robert D , De Ridder Dirk , Kennelly Michael J
Published: September 2012

Objectives

Obesity is a well‐established risk factor of stress urinary incontinence, which affects up to 35% of adult women worldwide. We evaluated whether there is a difference in outcomes with MiniArc sling for treatment of stress incontinence in obese women versus non‐obese women at 24 months.

Methods

A 2‐year subanalysis of obese (body mass index >30 kg/m2) versus non‐obese patients enrolled into a multicenter, prospective study evaluating the effectiveness of MiniArc sling was carried out. Qualitative (Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7) and quantitative measurements, including the cough stress test, were carried out. Secondary outcome measures included procedure time, estimated blood loss, length of stay, perioperative complications, Wong–Baker Faces Pain Scale and adverse events.

Results

Of 188 patients, 62 were obese. The mean procedure time, blood loss and length of stay were no different between groups. Obese patients reported significantly more pain immediately postoperatively (2 vs 1, Wong–Baker, P = 0.042), but there was no difference at postoperative day 7. There was no difference in objective cure using the cough stress test (81% obese vs 86% non‐obese; P = 0.449). Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7 median scores showed no difference between groups in improvement (P = 0.126 and P = 0.087, respectively). No serious device‐related complications were reported in either group.

Conclusions

The MiniArc sling represents a safe and effective treatment option for both obese and non‐obese patients with stress incontinence. Comparable outcomes at 2 years can be obtained in terms of cure rates using the cough stress test or questionnaires, as well as complication rates.
Mycobacterium ulcerans infection: evolution in clinical management
Authors: Simpson Candice , O'Brien Daniel P. , McDonald Anthony , Callan Peter
Published: September 2012

Mycobacterium ulcerans causes significant morbidity in various endemic locations in Australia and West Africa. The commonest presentation is as a necrotic ulcer often with surrounding subcutaneous necrosis and oedema, which can cause significant morbidity, deformity and functional impairment. Traditional treatment was wide excision and debridement with grafting or flap reconstructions further adding to morbidity and with high recurrence rates. Following publication of clinical studies where antibiotics were shown to be effective, treatment has moved towards combination management with systemic antibiotics and limited surgery involving mainly debridement of the ulcers. Identification of the ‘paradoxical’ immune‐reconstitution syndrome has also impacted upon the extent of excision required. This paper will present the evolution in clinical management of M. ulcerans cases on the Bellarine Peninsula, Victoria, Australia.
A Renewed Social Democracy for an ‘Age of Internationalism’: An Interpretivist Account of New Labour's Foreign Policy
Authors: Atkins Judi
Published: September 2012

This article employs an interpretive approach to explore New Labour's use of social scientific theories in developing its foreign policy. After situating New Labour in the broad tradition of social democracy, it outlines the beliefs that most social democrats shared about the values of internationalism, international community and moral leadership. Taking these concepts in turn, the article then considers how New Labour modified their content in response to issues raised by ‘New Times’. In so doing, it problematizes New Labour's responses by revealing that they drew on ideas taken from complex interdependence theory, communitarianism and democratic peace theory respectively. The article then examines how these theories, in conjunction with the reformulation of its foreign policy, influenced New Labour's transformation of the three values, before concluding with a brief examination of the dilemmas arising from this process.
Peer Network Overlap in Twin, Sibling, and Friend Dyads
Authors: McGuire Shirley , Segal Nancy L.
Published: September 2012

Research suggests that sibling–peer connections are important for understanding adolescent problem behaviors. Using a novel behavioral genetic design, the current study investigated peer network overlap in 300 child–child pairs (aged 7–13 years) in 5 dyad types: monozygotic (MZ), dizygotic twins, full siblings (FSs), friend pairs, and virtual twins (i.e., same‐aged, genetically unrelated siblings). Genetic relatedness, sex composition, and age differences contributed to peer overlap in sibling dyads. MZ twins showed the highest overlap (82%), opposite‐sex FS pairs showed the lowest overlap (27%), and friend pairs (48%) were close to the mean (53%). Social contact variables and self‐reported relationship intimacy predicted additional variance in peer overlap. The roles of genotype–environment correlational and shared environmental processes in the sibling–peer connections are discussed.
Silicon nutrition increases grain yield, which, in turn, exerts a feed‐forward stimulation of photosynthetic rates via enhanced mesophyll conductance and alters primary metabolism in rice
Authors: Detmann Kelly C. , Araújo Wagner L. , Martins Samuel C. V. , Sanglard Lílian M. V. P. , Reis Josimar V. , Detmann Edenio , Rodrigues Fabrício Á. , Nunes‐Nesi Adriano , Fernie Alisdair R. , DaMatta Fábio M.
Published: September 2012

Silicon (Si) is not considered to be an essential element for higher plants and is believed to have no effect on primary metabolism in unstressed plants. In rice (Oryza sativa), Si nutrition improves grain production; however, no attempt has been made to elucidate the physiological mechanisms underlying such responses.

Here, we assessed crop yield and combined advanced gas exchange analysis with carbon isotope labelling and metabolic profiling to measure the effects of Si nutrition on rice photosynthesis, together with the associated metabolic changes, by comparing wild‐type rice with the low‐Si rice mutant lsi1 under unstressed conditions.

Si improved the harvest index, paralleling an increase in nitrogen use efficiency. Higher crop yields associated with Si nutrition exerted a feed‐forward effect on photosynthesis which was fundamentally associated with increased mesophyll conductance. By contrast, Si nutrition did not affect photosynthetic gas exchange during the vegetative growth phase or in de‐grained plants. In addition, Si nutrition altered primary metabolism by stimulating amino acid remobilization.

Our results indicate a stimulation of the source capacity, coupled with increased sink demand, in Si‐treated plants; therefore, we identify Si nutrition as an important target in attempts to improve the agronomic yield of rice.
Is chemotherapy dose intensity adequate in breast cancer management in the Australian healthcare setting: A retrospective analysis
Authors: Bae Susie , Yeung Yvonne , Ng Say , Craike Melinda , Livingston Patricia M , Chirgwin Jacquie
Published: September 2012

Aim

To determine the adequacy of chemotherapy received dose intensity (RDI) in breast cancer treatment in a general population and to identify factors that influence RDI.

Methods

A retrospective analysis of breast cancer patients who commenced a course of i.v. chemotherapy in 2008 was undertaken. Data were collected on patient and tumor characteristics, chemotherapy regimen, dose (including delays, reductions and the reasons for these), granulocyte colony‐stimulating factor (G‐CSF) use and febrile neutropenia incidence. RDI was calculated using the planned and actual dose received and time taken. A level of ≥85% RDI was considered acceptable for treatment given with curative intent.

Results

In all, 131 patients (aged 28 to 77 years) received chemotherapy in adjuvant (n = 76, 58%), neoadjuvant (n = 11, 8%) and metastatic settings (n = 44, 34%). RDI did not reach 85% for 12% adjuvant, 36% neoadjuvant and 34% metastatic cases (χ2 = 10.55, P = 0.005). Overall, 43% of patients received G‐CSF.

Conclusion

Acceptable chemotherapy RDI was delivered for most patients in the adjuvant setting but not in the neoadjuvant setting. G‐CSF treatment contributed to the optimization of dose intensity in the adjuvant setting only. Dose intensity in the metastatic setting was considered satisfactory where quality of life is the primary focus. Other factors can be modified to improve RDI.
Differing Associations of White Matter Lesions and Lacunar Infarction with Retinal Microvascular Signs
Authors: Liew Gerald , Baker Michelle L. , Wong Tien Y. , Hand Peter J. , Wang Jie Jin , Mitchell Paul , De Silva Deidre A. , Wong Meng-Cheong , Rochtchina Elena , Lindley Richard I. , Wardlaw Joanna M. , Hankey Graeme J. ,   the Multi-Centre Retinal Stroke Study Group
Published: September 2012

Background

White matter lesions (WML) and lacunar infarcts (LI) are believed to have microvascular etiologies but the exact microvascular changes occurring in each is unclear. Aim Using the retina as a proxy, we assessed retinal microvascular changes in WML and LI.

Methods

We prospectively recruited 1211 acute stroke patients. Four subgroups were identified from neuroimaging: WML alone, LI alone, both WML and LI, neither WML nor LI. Masked retinal photographs identified retinopathy and retinal arteriolar wall signs and measured retinal vascular caliber.

Results

Compared with 448 controls with neither WML nor LI, 384 patients with only WML were more likely to have retinopathy [odds ratio (OR) 1·5, 95% confidence interval (CI) 1·1 to 2·1] and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·1 to 2·3); 200 patients with only LI were more likely to have arteriolar narrowing (OR 1·6, 95% CI 1·1 to 2·3) and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·0 to 2·4); and 179 patients with both WML and LI were more likely to have arteriovenous nicking (OR 1·7, 95% CI 1·1 to 2·6), enhanced arteriolar light reflex (OR 2·0, 95% CI 1·3 to 3·2) and wider venules (OR 2·3, 95% CI 1·4 to 3·6). All analyses were adjusted for age, gender, study site and cardiovascular risk factors.

Conclusion

Both WML and LI were associated with retinal microvascular signs, supporting a microvascular etiology. Differing patterns of association suggest different mechanisms may predominate, e.g. greater endothelial permeability in WML, and ischemia associated with arteriolar wall disease in LI.
SOURCE ROCK POTENTIAL OF ORGANIC‐RICH SHALES IN THE TERTIARY BHUBAN AND BOKA BIL FORMATIONS, BENGAL BASIN, BANGLADESH
Authors: Farhaduzzaman Md. , Abdullah Wan Hasiah , Islam Md. Aminul , Pearson M.J.
Published: September 2012

Sandstones in the Miocene Bhuban and Lower Pliocene Boka Bil Formations contain all of the hydrocarbons so far discovered in the Bengal Basin, Bangladesh. Organic‐rich shale intervals in these formations have source rock potential and are the focus of the present study which is based on an analysis of 36 core samples from wells in eight gasfields in the eastern Bengal Basin. Kerogen facies and thermal maturity of these shales were studied using standard organic geochemical and organic petrographic techniques.

Organic matter is dominated by Type III kerogen with lesser amounts of Type II. TOC is 0.16–0.90 wt % (Bhuban Formation) and 0.15–0.55 wt % (Boka Bil Formation) and extractable organic matter (EOM) is 132–2814 ppm and 235–1458 ppm, respectively. The hydrogen index is 20–181 mg HC/g TOC in the Bhuban shales and 35–282 mg HC/ g TOC in the Boka Bil shales. Vitrinite was the dominant maceral group observed followed by liptinite and inertinite. Gas chromatographic parameters including the C/S ratio, n‐alkane CPI, Pr/Ph ratio, hopane Ts/Tm ratio and sterane distribution suggest that the organic matter in both formations is mainly derived from terrestrial sources deposited in conditions which alternated between oxic and sub‐oxic. The geochemical and petrographic results suggest that the shales analysed can be ranked as poor to fair gas‐prone source rocks. The maturity of the samples varies, and vitrinite reflectance ranges from 0.48 to 0.76 %VRr. Geochemical parameters support a maturity range from just pre‐ oil window to mid‐ oil window.
Identification and Quantification of Oligodendrocyte Precursor Cells in Multiple System Atrophy, Progressive Supranuclear Palsy and Parkinson's Disease
Authors: Ahmed Zeshan , Asi Yasmine T. , Lees Andrew J. , Revesz Tamas , Holton Janice L.
Published: September 2012

Multiple system atrophy is a neurodegenerative disorder characterized pathologically by abnormal accumulations of α‐synuclein in the cytoplasm of oligodendrocytes, which are termed glial cytoplasmic inclusions (GCIs). Oligodendrocytes are responsible for myelinating axons and providing neurotrophic support, but in MSA, myelin loss, axonal loss and gliosis are consistent features suggesting that GCIs play a central role in disease pathogenesis. Oligodendroglial, myelin and axonal degeneration are also features of multiple sclerosis (MS) in which recent studies have highlighted the robust remyelination capacity of the central nervous system (CNS). The cells responsible for remyelination are called oligodendroglial precursor cells (OPCs). In this study, we investigated the role of OPCs in the pathogenesis of MSA and progressive supranuclear palsy (PSP), a neurodegenerative disease in which neuropathological changes include oligodendroglial inclusions composed of microtubule‐associated protein tau. Despite the lability of OPC‐specific antigens, we successfully identified OPCs and demonstrated that tau and α‐synuclein do not accumulate in OPCs. We also showed that the density of OPCs was increased in a white matter region of the MSA brain, which is also severely affected by GCIs and myelin degeneration. These findings raise the possibility that OPCs could be available to repair disease‐associated damage in MSA, consistent with their biological function.
Peer victimization and school disaffection: Exploring the moderation effect of social support and the mediation effect of depression
Authors: Galand Benoît , Hospel Virginie
Published: September 2012

Background

Peer victimization is associated with increased internalizing problems and reduced school adjustment. Research into the main effect and the buffering effect of social support on these internalizing problems has produced inconsistent findings, and none has tested the buffering effect of social support on school adjustment. Moreover, recent studies have underlined the importance of taking various sources of social support into account.

Aims

This study aims to test the relationships between peer victimization and school disaffection, the moderation effect of parental, peer and teacher social support, and the mediation effect of depression.

Sample

Four hundred seventh and eighth graders participated in this study.

Method

Students filled out a questionnaire assessing peer victimization, depression, academic self‐efficacy, school disaffection, and perceived social support from parents, peers, and teachers.

Results

Peer victimization was negatively associated with self‐efficacy and positively associated with school disaffection. Regression analyses showed a main negative effect of social support (especially teacher support) on depression and school disaffection and a positive effect on self‐efficacy. No significant interactions emerged between victimization and social support or between sources of social support. Path analyses indicated that the effects of victimization on self‐efficacy and school disaffection were fully mediated by depression, but that the effects of social support are partially independent of depression. Multigroup analyses indicated that these relationships were parallel among boys and girls.

Conclusions

The results of this study are consistent with the main effect model of social support. They also highlight the importance of teacher support for school adjustment.
Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study
Authors: Reme Silje Endresen , Archer Nicola , Chalder Trudie
Published: September 2012

Objectives

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a serious condition characterized by debilitating but unexplained fatigue. Treatment alternatives are few, and especially so for young people. The aetiology of CFS/ME is still unclear and controversial, but rehabilitative interventions seem so far most promising. The Lightning Process is a 3‐day training programme that has recently become available, but no outcome studies have yet been published. It is a non‐medical training programme that combines concepts from Neuro‐Linguistic Programming, Life Coaching and Osteopathy. The aim of this study was to explore the experiences of young people with CFS/ME after they had undergone the Lightning Process.

Design

Qualitative research study.

Methods

Semi‐structured interviews were conducted with an opportunistic sample recruited through open advertisements of nine young people, aged 14–26, who had undergone the treatment, and three of their parents. Inductive thematic analysis was used to evaluate the content of the interviews.

Results

Mostly positive experiences were reported of the Lightning Process. Two reported dissatisfaction and no improvement, while seven were satisfied and were much improved. Particular helpful aspects were the theoretical rationale, practical exercises, and the technique they learned. Less helpful aspects were the intensity and short duration of the treatment with little follow‐up, the secrecy surrounding it, and feelings of being blamed if the treatment did not work.

Conclusions

As this is the first report of young people's experiences with the Lightning Process, it will be important to consider the helpful and unhelpful treatment components for future refinement of interventions for CFS/ME.

Statement of contribution

What is already known on this subject? Treatment alternatives for people with CFS/ME are few, especially for young people. The Lightning Process is a popular treatment programme that has recently become available, but no studies involving the treatment have yet been published. Feelings of blame or dismissal in CFS/ME patients lead to withdrawal or disengagement from professionals.

What does this study add? The Lightning Process for young people with CFS/ME encompasses many positive aspects, particularly the practical aspects of the treatment programme. The more extreme position taken by the Lightning Process in denying the limitations of the illness seem to produce divergent results in various young people; some found it liberating and therapeutic, whilst others did not respond well to it and were left feeling guilty and blamed.
Four‐year‐olds' beliefs about how others regard males and females
Authors: Halim May Ling , Ruble Diane N. , Tamis‐LeMonda Catherine S.
Published: September 2012

Children's awareness of how others evaluate their gender could influence their behaviours and well‐being, yet little is known about when this awareness develops and what influences its emergence. The current study investigated culturally diverse 4‐year‐olds' (N = 240) public regard for gender groups and whether exposure to factors that convey status and highlight gender influenced it. Children were asked whether most people thought (i) girls or boys, and (ii) women or men, were better. Overall, children thought others more positively evaluated their own gender. However more TV exposure and, among girls only, more traditional parental division of housework predicted children stating that others thought boys were better, suggesting more awareness of greater male status. Children's public regard was distinct from their personal attitudes.
APPLYING NEPALI ETHNOPSYCHOLOGY TO PSYCHOTHERAPY FOR THE TREATMENT OF MENTAL ILLNESS AND PREVENTION OF SUICIDE AMONG BHUTANESE REFUGEES
Authors: Kohrt Brandon A. , Maharjan Sujen M. , Timsina Damber , Griffith James L.
Published: September 2012

Addressing mental health needs of 100,000 ethnic Nepali Bhutanese refugees relocated from Nepal is a new challenge for mental health clinicians in the receiving countries. A limitation of current services is the lack of knowledge about cultural understandings of mental health. Ethnopsychology is the study of emotions, suffering, the self, and social relationships from a cultural perspective. Nepali ethnopsychology can be used to develop and adapt mental health interventions for refugees. We discuss applying ethnopsychology to provide safe and effective mental healthcare for Bhutanese refugees, including cultural adaptation of cognitive behavior therapy, interpersonal therapy, and dialectical behavior therapy. Psychological interventions are proposed for the high rates of suicide among Bhutanese refugees. The contribution of ethnopsychology to applied anthropology and the growing field of neuroanthropology are discussed.
An evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland
Authors: Naughton Corina , Drennan Jonathan , Hyde Abbey , Allen Deirdre , O'Boyle Kathleen , Felle Patrick , Butler Michelle
Published: September 2012

Aim

To evaluate the clinical appropriateness and safety of nurse and midwife prescribing practice.

Background

The number of countries introducing nurse and midwife prescribing is increasing; however, concerns over patient safety remain.

Design

A multi‐site documentation evaluation was conducted using purposeful and random sampling. The sample included 142 patients' records and 208 medications prescribed by 25 Registered Nurse Prescribers.

Methods

Data were extracted from patient and prescription records between March–May 2009. Two expert reviewers applied the modified Medication Appropriate Index tool (8 criteria) to each drug. The percentage of appropriate or inappropriate responses for each criterion was reported. Reviewer concordance was measured using the Cohen's kappa statistic (inter‐rater reliability).

Results

Nurse or midwife prescribers from eight hospitals working in seventeen different areas of practice were included. The reviewers judged that 95–96% of medicines prescribed were indicated and effective for the diagnosed condition. Criteria relating to dosage, directions, drug–drugs or disease–condition interaction, and duplication of therapy were judged appropriate in 87–92% of prescriptions. Duration of therapy received the lowest value at 76%. Overall, reviewers indicated that between 69 (reviewer 2)−80% (reviewer 1) of prescribing decisions met all eight criteria.

Conclusion

The majority of nurse and midwife prescribing decisions were deemed safe and clinically appropriate. However, risk of inappropriate prescribing with the potential for drug errors was detected. Continuing education and evaluation of prescribing practice, especially related to drug and condition interactions, is required to maximize appropriate and safe prescribing.
A discussion of HIV/AIDS family interventions: implications for family‐focused nursing practice
Authors: Eustace Rosemary W.
Published: September 2012

Aim

This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care.

Background

Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual‐level HIV prevention, HIV/AIDS family‐focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention.

Data sources

The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were ‘nurse’, or ‘nursing’, ‘HIV/AIDS’, ‘family interventions’, ‘family support’ and ‘family education’, and/or ‘family subsystems’.

Discussion

The process of theorizing about ‘family interventions’ and ‘HIV/AIDS‐family interventions’ is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective.

Conclusion

Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS‐FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family‐focused approaches.
Averaging underwater noise levels for environmental assessment of shipping
Authors: Merchant Nathan D. , Blondel Philippe , Dakin D. Tom , Dorocicz John
Published: September 2012

Rising underwater noise levels from shipping have raised concerns regarding chronic impacts to marine fauna. However, there is a lack of consensus over how to average local shipping noise levels for environmental impact assessment. This paper addresses this issue using 110 days of continuous data recorded in the Strait of Georgia, Canada. Probability densities of ∼107 1-s samples in selected 1/3 octave bands were approximately stationary across one-month subsamples. Median and mode levels varied with averaging time. Mean sound pressure levels averaged in linear space, though susceptible to strong bias from outliers, are most relevant to cumulative impact assessment metrics.
Reversal of Disease-Related Pathologies in the Fragile X Mouse Model by Selective Activation of GABA
B
Receptors with Arbaclofen
Authors: Henderson Christina , Wijetunge Lasani , Kinoshita Mika Nakamoto , Shumway Matthew , Hammond Rebecca S. , Postma Friso R. , Brynczka Christopher , Rush Roger , Thomas Alexia , Paylor Richard , Warren Stephen T. , Vanderklish Peter W. , Kind Peter C. , Carpenter Randall L. , Bear Mark F. , Healy Aileen M.
Published: September 2012

Pharmacological activation of the GABA
B
receptor with arbaclofen in a mouse model of fragile X syndrome corrects neuronal defects associated with the disease.
Tuberculosis Screening Method in Question
Authors: Barnabas Ruanne
Published: September 2012

Antiretroviral therapy results in poor sensitivity of tuberculosis screening.
Fruit Flies Create a Buzz About Hearing
Authors: Bettegowda Chetan
Published: September 2012

Studies in
Drosophila
highlight new genes that may play a role in hereditary hearing loss in humans.