bluuebunny/crossref_metadata_2025 huggingface dataset:
A vignette study to examine health care professionals' attitudes towards patient involvement in error prevention
Authors: Schwappach David L. B. , Frank Olga , Davis Rachel E.
Published: May 2012

Background  Various authorities recommend the participation of patients in promoting patient safety, but little is known about health care professionals' (HCPs') attitudes towards patients' involvement in safety‐related behaviours.

Objective  To investigate how HCPs evaluate patients' behaviours and HCP responses to patient involvement in the behaviour, relative to different aspects of the patient, the involved HCP and the potential error.

Design  Cross‐sectional fractional factorial survey with seven factors embedded in two error scenarios (missed hand hygiene, medication error). Each survey included two randomized vignettes that described the potential error, a patient's reaction to that error and the HCP response to the patient.

Setting  Twelve hospitals in Switzerland.

Participants  A total of 1141 HCPs (response rate 45%).

Measurements  Approval of patients' behaviour, HCP response to the patient, anticipated effects on the patient–HCP relationship, HCPs' support for being asked the question, affective response to the vignettes. Outcomes were measured on 7‐point scales.

Results  Approval of patients' safety‐related interventions was generally high and largely affected by patients' behaviour and correct identification of error. Anticipated effects on the patient–HCP relationship were much less positive, little correlated with approval of patients' behaviour and were mainly determined by the HCP response to intervening patients. HCPs expressed more favourable attitudes towards patients intervening about a medication error than about hand sanitation.

Conclusions  This study provides the first insights into predictors of HCPs' attitudes towards patient engagement in safety. Future research is however required to assess the generalizability of the findings into practice before training can be designed to address critical issues.
Trends and variations in infant mortality among 47 prefectures in Japan
Authors: Mishina Hiroki , Hilton Joan F. , Takayama John I.
Published: May 2012

Objectives  To determine IMR trends and regional variations among 47 prefectures in Japan and to identify associated population‐based factors.

Methods  We conducted an ecological study of infant mortality rate (IMR) by analyzing publicly available data from the Ministry of Health, Labour and Welfare of Japan. Outcome measure for trend is the IMR for each of 47 prefectures from 1999 to 2007; for variation, IMRs for 2006 and 2007 in each prefecture were averaged. We considered as covariates prefecture‐level variables related to public health, socio‐economic status, clinical services and health care facilities. We conducted multivariate statistical analyses to determine covariates most strongly associated with both 1999–2007 IMR trends and 2006–2007 IMR.

Results  The mean IMR decreased from 3.42 deaths per 1000 live births (range 2.1 to 5.1) in 1999 to 2.54 (range 1.5 to 4.4) in 2007; reductions were greater in prefectures with higher concentrations of public health nurses (PHNs) and nurses. In 2006–2007, nine prefectures had IMRs ≤ 2.25; eight had IMRs ≥ 3.0. When low‐, moderate‐ and high‐IMR prefectures were compared, per capita PHNs, maternal education, centralized water supply and household income were identified as significant covariates.

Conclusions  Both national and prefecture‐level IMR in Japan decreased from 1999 to 2007; however, the degree of reduction varied by prefecture. Given that more nurses and PHNs per capita were associated with greater IMR reductions from 1999 to 2007 and more PHNs with lower 2006–2007 IMRs, distribution of preventive health services may play a major role in reducing regional disparities in IMR.
Is it time to abandon paper? The use of emails and the Internet for health services research – a cost‐effectiveness and qualitative study
Authors: Hunter Jennifer , Corcoran Katherine , Leeder Stephen , Phelps Kerryn
Published: May 2012

Rationale  A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient‐reported outcomes.

Methods  Semi‐structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated.

Results  Compared with postal invitations, email invitations offered a cost‐effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well‐designed and user‐friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet.

Conclusion  Researchers should consider using email invitations as a cost‐effective first‐line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates.
Utility of the gagging problem assessment questionnaire in assessing patient sensitivity to dental treatments
Authors: AKARSLAN Z. Z. , BIÇER A. Z. Y.
Published: May 2012

Summary  Although the Gagging Problem Assessment Questionnaire (GPA) can be used to identify patients with gag reflex, it does not provide information about patient sensitivity to dental procedures. The aim of this study was to assess the utility of GPA in determining patient sensitivity (i.e. gag reflex) in response to intra‐oral radiography and impression‐taking procedures. The study included 95 patients (65 women; mean age, 44·2 ± 13·4 years) undergoing dental treatment at a Turkish dental school. Patients completed the patient section of the GPA before their dental examination. An observing dentist monitored and scored the gag reflex of patients during each step of intra‐oral radiographic examination and impression taking. The overall sensitivity of the patient to the entire process was also recorded. Descriptive statistics, one‐way analysis of variance and the Tukey’s test were used for statistical analysis. Patients with GPA scores of 1·00–1·74 did not show any gagging or displayed only mild discomfort during the procedures. Patients with GPA scores of 1·75–3·24 showed moderate gagging, which was managed with prophylactic and suppressive precautions. Patients with GPA scores of 3·25–4·00 were unable to complete the procedures because of gagging. Differences (all P < 0·001) were found between the three groups for the observed responses of patients during radiography (F, 203·343), impression (F, 175·035) and radiography + impression procedures (F, 228·319), with no significant difference between women and men. In conclusion, GPA may be helpful for the prediction of patient sensitivity to dental treatments.
Multiple Alternaria species groups are associated with leaf blotch and fruit spot diseases of apple in Australia
Authors: Harteveld D. O. C. , Akinsanmi O. A. , Drenth A.
Published: May 2012

Leaf blotch and fruit spot of apple caused by Alternaria species occur in apple orchards in Australia. However, there is no information on the identity of the pathogens and whether one or more Alternaria species cause both diseases in Australia. Using DNA sequencing and morphological and cultural characteristics of 51 isolates obtained from apple leaves and fruit with symptoms in Australia, Alternaria species groups associated with leaf blotch and fruit spot of apples were identified. Sequences of Alternaria allergen a1 and endopolygalacturonase gene regions revealed that multiple Alternaria species groups are associated with both diseases. Phylogenetic analysis of concatenated sequences of the two genes resulted in four clades representing A. arborescens and A. arborescens‐like isolates in clade 1, A. tenuissima/A. mali isolates in clade 2, A. alternata/A. tenuissima intermediate isolates in clade 3 and A. longipes and A. longipes‐like isolates in clade 4. The clades formed using sequence information were supported by colony characteristics and sporulation patterns. The source of the isolates in each clade included both the leaf blotch variant and the fruit spot variant of the disease. Alternaria arborescens‐like isolates were the most prevalent (47%) and occurred in all six states of Australia, while A. alternata/A. tenuissima intermediate isolates (14%) and A. tenuissima/A. mali isolates (6%) occurred mostly in Queensland and New South Wales, respectively. Implications of multiple Alternaria species groups on apples in Australia are discussed.
Detrital chromian spinels from beach placers of Andaman Islands, India: A perspective view of petrological characteristics and variations of the Andaman ophiolite
Authors: GHOSH BISWAJIT , MORISHITA TOMOAKI , BHATTA KOYEL
Published: May 2012

Along the east coast of the Andaman Islands, abundant detrital chromian spinels frequently occur in black sands at the confluence of streams meeting the Andaman Sea. The mineral chemistry of these detrital chromian spinels has been used in reconstructing the evolutionary history of the Andaman ophiolite. The chromian spinels show wide variation in compositional parameters such as Cr# [= Cr/(Cr + A1) atomic ratio] (0.13–0.91), Mg# [= Mg/(Mg + Fe2+) atomic ratio] (0.23–0.76), and TiO2 (<0.05–3.9 wt%). The YFe3+[= 100Fe3+/(Cr + A1 + Fe3+) atomic ratio] is remarkably low (usually <10 except for south Andaman). The ranges of chemical composition of chromian spinels are different in each locality. The spinel compositions show very depleted signatures over the entire island, which suggests that all massifs in the Andaman ophiolite were affected under island‐arc conditions. Although the degree of depletion varies in different parts of the island, a directional change in composition of the detrital chromian spinels from south to north is evident. Towards the north the detrital chromian spinels point to less‐depleted source rocks in contrast to relatively more depleted towards the south. The possibilities to explain this directional change are critically discussed in the context of the evolution of Andaman ophiolite.
NG2 and NG2‐positive cells delineate focal cerebral infarct demarcation in rats
Authors: Claus Helene L. , Walberer Maureen , Simard Marie L. , Emig Beata , Muesken Sophia M. , Rueger Maria A. , Fink Gereon R. , Schroeter Michael
Published: May 2012

Focal cerebral ischemia induces cellular responses that may result in secondary tissue damage. We recently demonstrated multi‐facetted spatial and temporal patterns of neuroinflammation by multimodal imaging. In the present study, we especially focus on the separation of vital and necrotic tissue, which enabled us to define a demarcation zone. Focal cerebral ischemia was induced via macrosphere embolization of the middle cerebral artery in Wistar rats. Subsequent cellular processes were investigated immunohistochemically from 3 to 56 days after onset of ischemia. We detected several infarct subareas: a necrotic infarct core and its margin adjacent to a nerve/glial antigen 2 (NG2)+ zone delineating it from a vital peri‐infarct zone. Initially transition from necrotic to vital tissue was gradual; later on necrosis was precisely separated from vital tissue by a narrow NG2+ belt that was devoid of astrocytes, oligodendrocytes or neurons. Within this demarcation zone NG2+ cells associate with ionized calcium binding adaptor molecule 1 (Iba1) but not with GFAP, neuronal nuclear antigen (NeuN) or 2′, 3′‐cyclic nucleotide 3′‐phosphodiesterase (CNPase). During further infarct maturation NG2 seemed to be positioned in the extracellular matrix (ECM) of the demarcation zone, whereas Iba1+ cells invaded the necrotic infarct core and GFAP+ cells built a gliotic containing belt between the lesion and NeuN+ unaffected tissue. Overall, our data suggested that NG2 proteoglycan expression and secretion hallmarked demarcation as a process that actively separated necrosis from vital tissue and therefore decisively impacts secondary neurodegeneration after ischemic stroke.
Atypical FTLD‐FUS associated with ALS‐TDP: A case report
Authors: Kobayashi Zen , Arai Tetsuaki , Yokota Osamu , Tsuchiya Kuniaki , Hosokawa Masato , Oshima Kenichi , Niizato Kazuhiro , Akiyama Haruhiko , Mizusawa Hidehiro
Published: May 2012

A 30‐year‐old Japanese woman without relevant family history presented with a behavioral abnormality followed by motor weakness about 14 years later. The patient died at age 45. Post mortem examination revealed degeneration of the frontal and temporal lobes, as well as lower motor neurons in the brainstem and spinal cord. These features were reported previously as being consistent with a diagnosis of frontotemporal lobar degeneration (FTLD) with amyotrophic lateral sclerosis (ALS). In the present study, we show abundant fused in sarcoma (FUS)‐positive dystrophic neurites but only a few neuronal cytoplasmic inclusions in the frontal and temporal cortices. TAR DNA‐binding protein 43 (TDP‐43)‐positive inclusions were absent in the cerebrum. However, TDP‐43‐positive inclusions were present in the lower motor neurons of the brainstem and spinal cord. To our knowledge, this is the first report of a case in which FTLD‐FUS pathology is of a dystrophic neurites‐predominant type and FTLD‐FUS is associated with ALS‐TDP.
Lipidized glioblastoma: Pathological and molecular characteristics
Authors: Singh Amitabh David , Iftinca Mircea , Easaw Jacob C.
Published: May 2012

We report a rare case of a 33‐year‐old man with a lipidized glioblastoma multiforme (GBM) in the right posterior frontal region. Histologically the tumor had all the typical features of a GBM but with the rare observation of lipidized differentiation. There were multiple mitoses, extensive vascular proliferation, focal necrosis and the tumor cells had abundant xanthomatous cytoplasm and marked nuclear pleomorphism. The tumor showed immunoreactivity with GFAP. The O6– methylguanine methyltransferase (MGMT) promoter was methylated and there were no isocitrate dehydrogenase (IDH)1 and IDH2 mutations. To the best of our knowledge, this is the first time MGMT promoter status and IDH mutation assessment have been reported in a case of lipidized GBM.
Reproductive isolation vs. interbreeding betweenGagea lutea(L.) Ker Gawl. andG. pratensis(Pers.) Dumort. (Liliaceae) and their putative hybrids in Mecklenburg‐Western Pomerania (Germany)
Authors: PFEIFFER TANJA , HARTER DAVID E.V. , FORMELLA NOREEN , SCHNITTLER MARTIN
Published: May 2012

Mecklenburg‐Western Pomerania is the main range of two hybridogeneousGageataxa,G. megapolitanaHenker andG. pomeranicaRuthe, which have the same two parental species,G. lutea(L.) Ker. Gawl. andG. pratensis(Pers.) Dumort. We assessed the degree of reproductive isolation vs. interbreeding between these taxa using data from field observations, crossing experiments and pollen characteristics for nine hybrid, fourG. luteaand fiveG. pratensispopulations. Pollen viability was highest in 6x G. luteaand lowest inG. pratensis(most probably 5x), with intermediate figures for the studied hybrids (5x–7x). Despite the assumed anorthoploid states, sexual reproduction (though sometimes very rare) was recorded for all populations in the field and/or in experiments. The crossing experiments revealed that all taxa are also able to hybridize. However, there were differences in the directions (i.e. role as maternal vs. paternal parent) as well as the success of the crossings: the primary hybridizationG. lutea x G. pratensisresulted in more seeds than the reverse combination (17.5 vs. 3.3%), but the seed set was highest in backcrosses of the hybrids withG. luteapollen (41.2%). These differences can be explained by overlap of flowering times, and reduced fertilities due to ploidy levels. The study showed that the taxa of theG. lutea‐pratensishybrid complex are not yet reproductively isolated but can interbreed and will generate hybrids of higher ranks, forming a hybrid swarm, most probably leading to introgression via backcrosses withG. lutea.
Mechanisms of reproductive isolation of interspecific hybridization between Trillium camschatcense and T. tschonoskii (Melanthiaceae)
Authors: ISHIZAKI SATOMI , ABE TAMAYO , OHARA MASASHI
Published: May 2012

Reproductive isolation plays a significant role in the prevention of gene flow between different plant species. Isolation factors can vary, acting either pre‐ or postzygotically. Trillium camschatcense and T. tschonoskii are herbaceous perennials which frequently grow together in Hokkaido, Japan. Natural hybrid formation, T. × hagae, between these species is common, and occurs asymmetrically with T. camschatcense as the maternal parent and T. tschonoskii as the paternal. Here, we examined the efficiency of each reproductive isolation factor to clarify which factor was responsible for the frequency and asymmetry of the hybridization. We found that prezygotic barriers, self fertilization and conspecific pollen precedence, are major isolation factors in both parental species, and that T. tschonoskii as a maternal parent has more effective prezygotic barriers than T. camschatcense. In addition, hybrids with T. tschonoskii as the maternal parent were not observed to reach the flowering stage. We concluded that prezygotic isolation factors in the both species act as main barriers to prevent natural hybridization, and that asymmetry of the isolating barriers between these species would promote T. camschatcense as the maternal parent of the hybrids.
Isolated bifid rib: Clinical and radiological findings in children
Authors: Kaneko Hiroshi , Kitoh Hiroshi , Mabuchi Akiyoshi , Mishima Kenichi , Matsushita Masaki , Ishiguro Naoki
Published: May 2012

Background:  Bifid rib is usually asymptomatic but sometimes occurs associated with other pathological conditions. The aim of this study was to investigate clinical and radiological characteristics in children with bifid rib.

Methods:  Nine children with the diagnosis of bifid rib between 2005 and 2010 were reviewed. Chest radiography and computed tomography (CT) were performed in all patients, and 3‐D images were additionally reconstructed in six patients.

Results:  Five girls and four boys with a mean age at presentation of 4.2 years had various types of unilateral bifid rib. Seven patients complained of a chest wall mass, whereas two patients whose costal abnormalities were incidentally detected on chest radiography were asymptomatic. Bifid ribs were confirmed on plain radiographs in six patients, while the other three patients were finally diagnosed on reconstruction 3D‐CT. One patient with a flared rib on a radiograph showed bifurcation of the costal cartilage on 3D‐CT. The other two patients with upper rib abnormalities on radiography had downward extension of the cervical or first rib articulating with the upper branch of the bifid first or second rib, respectively.

Conclusion:  Reconstruction 3D‐CT can demonstrate complicated thoracic abnormalities in patients with atypical appearance of the rib on plain radiographs. An isolated bifid rib may require no further intervention.
Influence of outdoor NO2 exposure on asthma in childhood: Meta‐analysis
Authors: Takenoue Yukiko , Kaneko Tetsuji , miyamae Takako , Mori Masaaki , Yokota Shumpei
Published: May 2012

Background:  It has long been assumed that the development of childhood asthma is related to exposure to environmental chemicals, but it has thus far not been possible to unequivocally establish this suspected relationship using individual studies. Moreover, studies of children have been scanty and unreliable due to the large diversity of research environments and subject cohorts. The aim of the current study was to clarify this relationship for one factor by means of a meta‐analysis of studies investigating the influence of NO2 exposure on symptomatology of childhood asthma.

Methods:  Two electronic databases (MEDLINE and EMBASE) were searched for literature on relationships between environmental chemical exposure and development of childhood asthma using the MeSH terms ‘nitrogen dioxide’ and ‘asthma’. This was done according to the MOOSE guidelines for meta‐analyses of observational studies.

Results:  A total of 130 papers were retrieved, of which 12 met the selection criteria. These papers described observational studies from seven countries. Study subjects were 97 932 ordinary children aged 0–18 years. Using random model analysis, the odds ratio (OR) for asthma development due to an increment of 10 p.p.b. NO2 was 1.135 with a 95% confidence interval [CI] of 1.031–1.251 (P= 0.01), while the OR for wheezing symptoms was 1.052 with a 95%CI of 1.020–1.085 (P= 0.001). It is therefore evident that NO2 exposure does influence the development of asthma in ordinary children.

Conclusions:  Exposure to NO2 in the air significantly influences the development of childhood asthma and symptoms of wheezing.
Chronic care model for the management of depression: Synthesis of barriers to, and facilitators of, success
Authors: Holm Anne Lise , Severinsson Elisabeth
Published: May 2012

Depression is a socially‐ and physically‐disabling condition. The Chronic Care Model (CCM) was developed to promote better management of long‐term conditions, such as depression, in primary care settings. The aim of the study was to identify barriers to, and facilitators of, success when implementing the CCM for the management of depression in primary care. A systematic search was conducted in electronic databases from January 2005 to December 2011. Thirteen articles met the inclusion criteria and were reviewed by means of a thematic analysis. The barriers were categorized under two themes: lack of organizational, administrative, and professional ability to change and implement the components of the CCM; and lack of clarity pertaining to the responsibility inherent in the role of care manager (often a nurse) when it comes to promoting the patient's self‐management ability. In terms of the facilitators of success, two themes emerged: leadership support and vision, and redesigning the delivery system. When shaping an environment for organizational change, leadership and professionals must work towards a common goal and vision. Such processes require a care manager with a clear role and responsibilities in order for the health‐care system to meet the needs of the person with depression.
Feasibility study of paclitaxel plus carboplatin in patients with endometrial cancer: A Japan Kanto Tumor Board study (JKTB trial)
Authors: Yamada Kyosuke , Tanabe Hiroshi , Imai Manami , Jobo Toshiko , Kudo Kazuya , Fujiwara Hiroyuki , Nagata Chie , Furuya Kenichi , Suzuki Mitsuaki , Ochiai Kazunori , Tanaka Tadao , Yasuda Makoto
Published: May 2012

Aim:  The optimal chemotherapy regimen for patients with endometrial cancer has not been established. We assessed the feasibility of paclitaxel plus carboplatin (TC) for postoperative chemotherapy in patients with endometrial cancer.

Material and Methods:  Patients with newly diagnosed endometrial cancer received TC (paclitaxel 180 mg/m2, carboplatin AUC6 mg/mL/min) every three weeks. Treatment was continued until disease progression or completion of six cycles. Toxicities were evaluated every cycle according to NCI‐CTCAE version 3.0.

Results:  Sixty patients were registered from December 2005 through November 2006. Forty‐four of 60 (73.3%) cases completed all of the planned six cycles. Grades 3 and 4 hematologic toxicities were observed as follows: leukopenia (61.7%), neutropenia (95.0%), anemia (21.7%), and thrombocytopenia (5.0%). There were six patients who dropped out from the protocol by neutropenia. Grade 3 non‐hematologic toxicities were observed as follows: nausea (3.3%), vomiting (1.7%), neuropathy (5.0%), myalgia (6.7%) and constipation (1.7%). No grade 4 non‐hematologic toxicity was observed.

Conclusion:  This TC regimen is feasible for endometrial cancer patients.
Remote effects of intermittent theta burst stimulation of the human pharyngeal motor system
Authors: Mistry Satish , Michou Emilia , Rothwell John , Hamdy Shaheen
Published: May 2012

Intermittent theta burst stimulation (iTBS) is a novel, non‐invasive form of brain stimulation capable of facilitating excitability of the human primary motor cortex with therapeutic potential in the treatment of neurological conditions, such as multiple sclerosis. The objectives of this study were to evaluate the effects of iTBS on cortical properties in the human pharyngeal motor system. Transcranial magnetic stimulation (TMS)‐evoked pharyngeal motor responses were recorded via a swallowed intra‐luminal catheter and used to assess motor cortical pathways to the pharynx in both hemispheres before and for up to 90 min after iTBS in 15 healthy adults (nine male/six female, 22–59 years old). Active/sham iTBS comprised 600 intermittent repetitive TMS pulses, delivered in a double‐blind pseudo‐randomised order over each hemisphere on separate days at least 1 week apart. Abductor pollicis brevis (APB) recordings were used as control. Hemispheric interventional data were compared with sham using repeated‐measures anova. iTBS was delivered at an average intensity of 43 ± 1% of stimulator output. Compared with sham, iTBS to the hemisphere with stronger pharyngeal projections induced increased responses only in the contralateral weaker projection 60–90 min post‐iTBS (maximum 54 ± 19%, P ≤ 0.007), with no change in stronger hemisphere responses. By contrast, iTBS to weaker projections had no significant effects (P = 0.39) on either hemisphere. APB responses similarly did not change significantly (P = 0.78) across all study arms. We conclude that iTBS can induce remote changes in corticobulbar excitability. While further studies will clarify the extent of these changes, iTBS holds promise as a potential treatment for dysphagia after unilateral brain damage.
Global patterns in the impact of marine herbivores on benthic primary producers
Authors: Poore Alistair G. B. , Campbell Alexandra H. , Coleman Ross A. , Edgar Graham J. , Jormalainen Veijo , Reynolds Pamela L. , Sotka Erik E. , Stachowicz John J. , Taylor Richard B. , Vanderklift Mathew A. , Emmett Duffy J.
Published: May 2012

Despite the importance of consumers in structuring communities, and the widespread assumption that consumption is strongest at low latitudes, empirical tests for global scale patterns in the magnitude of consumer impacts are limited. In marine systems, the long tradition of experimentally excluding herbivores in their natural environments allows consumer impacts to be quantified on global scales using consistent methodology. We present a quantitative synthesis of 613 marine herbivore exclusion experiments to test the influence of consumer traits, producer traits and the environment on the strength of herbivore impacts on benthic producers. Across the globe, marine herbivores profoundly reduced producer abundance (by 68% on average), with strongest effects in rocky intertidal habitats and the weakest effects on habitats dominated by vascular plants. Unexpectedly, we found little or no influence of latitude or mean annual water temperature. Instead, herbivore impacts differed most consistently among producer taxonomic and morphological groups. Our results show that grazing impacts on plant abundance are better predicted by producer traits than by large‐scale variation in habitat or mean temperature, and that there is a previously unrecognised degree of phylogenetic conservatism in producer susceptibility to consumption.
The latitudinal gradient in dispersal constraints: ecological specialisation drives diversification in tropical birds
Authors: Salisbury Claire L. , Seddon Nathalie , Cooney Christopher R. , Tobias Joseph A.
Published: May 2012

Physiological and behavioural constraints arising from ecological specialisation are proposed to limit gene flow and promote diversification in tropical lineages. In this study, we use phylogenetic analyses to test this idea in 739 Amazonian bird species. We show that patterns of species and subspecies richness are best predicted by a suite of avian specialisms common in tropical avifaunas but rare in the temperate zone. However, this only applied to niche traits associated with dispersal limitation rather than vagility. These findings are consistent with the view that diversity is promoted by more finely partitioned niches, although not simply by coevolutionary adaptation and niche packing as is often assumed. Instead, they suggest that diversification is driven by dispersal constraints, and that niches characterised by these constraints are biased towards tropical systems. We conclude that specialised tropical niches reduce the likelihood of dispersal across barriers, thereby increasing allopatric diversification and contributing to the latitudinal diversity gradient.
Interplay of RsbM and RsbK controls the σB activity of Bacillus cereus
Authors: Chen Lei‐Chin , Chen Jung‐Chi , Shu Jwu‐Ching , Chen Chien‐Yen , Chen Ssu‐Ching , Chen Shu‐Hwa , Lin Chun‐Yen , Lu Chi‐Yu , Chen Chien‐Cheng
Published: May 2012

The alternative transcription factor σB of Bacillus cereus controls the expression of a number of genes that respond to environmental stress. Four proteins encoded in the sigB gene cluster, including RsbV, RsbW, RsbY (RsbU) and RsbK, are known to be essential in the σB‐mediated stress response. In the context of stress, the hybrid sensor kinase RsbK is thought to phosphorylate the response regulator RsbY, a PP2C serine phosphatase, leading to the dephosphorylation of the phosphorylated RsbV. The unphosphorylated RsbV then sequesters the σB antagonist, RsbW, ultimately liberating σB. The gene arrangement reveals an open reading frame, bc1007, flanked immediately downstream by rsbK within the sigB gene cluster. However, little is known about the function of bc1007. In this study, the deletion of bc1007 resulted in high constitutive σB expression independent of environmental stimuli, indicating that bc1007 plays a role in σB regulation. A bacterial two‐hybrid analysis demonstrated that BC1007 interacts directly with RsbK, and autoradiographic studies revealed a specific C14‐methyl transfer from the radiolabelled S‐adenosylmethionine to RsbK when RsbK was incubated with purified BC1007. Our data suggest that BC1007 (RsbM) negatively regulates σB activity by methylating RsbK. Additionally, mutagenic substitution was employed to modify 12 predicted methylation residues in RsbK. Certain RsbK mutants were able to rescue σB activation in a rsbK‐deleted bacterial strain, but RsbKE439A failed to activate σB, and RsbKE446A only moderately induced σB. These results suggest that Glu439 is the preferred methylation site and that Glu446 is potentially a minor methylation site. Gene arrays of the rsbK orthologues and the neighbouring rsbM orthologues are found in a wide range of bacteria. The regulation of sigma factors through metylation of RsbK‐like sensor kinases appears to be widespread in the microbial world.
Impact of family history of gastric cancer on colorectal neoplasias in young Japanese
Authors: Hata K. , Shinozaki M. , Toyoshima O. , Toyoshima A. , Matsumoto S. , Saisho T. , Tsurita G.
Published: May 2012

Aim  The aim of this study was to elucidate risk factors for the development of colorectal neoplasia in the young population. In particular, we focused on the family history of gastric cancer.

Method  Young Japanese subjects aged 30–49 years old who underwent colonoscopy for the first time from August 2007 to August 2008 were included in this study. A total of 300 unselected consecutive patients (mean age 40.5 years) were eligible for analysis, and family history of colorectal cancer and gastric cancer, sex, age, body mass index, positivity of faecal occult blood test and the presence of symptoms were evaluated. Risk factors for developing colorectal adenoma and/or carcinoma were assessed.

Results  Colorectal neoplasias were detected in 83 (27.7%) cases. Two were found to have invasive carcinoma. Univariate and multivariate analyses revealed that family history of gastric cancer (OR 2.09, 95% CI 1.12–3.92, P = 0.02) was an independent risk factor for the development of colorectal neoplasia, as well as male sex (OR 1.89, 95% CI 1.10–3.27, P = 0.02), older age (OR 2.05, 95% CI 1.18–3.55, P = 0.01) and positive faecal occult blood test (OR 1.99, 95% CI 1.14–3.48, P = 0.02).

Conclusion  In the young population under 50 years of age, a family history of gastric cancer is an independent risk factor for the development of colorectal neoplasia.
Quality of life and sexual function 1 year after laparoscopic rectosigmoid resection for endometriosis
Authors: Kössi J. , Setälä M. , Mäkinen J. , Härkki P. , Luostarinen M.
Published: May 2012

Aim  Endometriosis is relatively common condition in fertile women and may affect the alimentary tract. Laparoscopic rectosigmoid resection for endometriosis has been found to be both feasible and safe. The aim of the present study was to prospectively evaluate the quality of life and sexual function of patients who have undergone rectosigmoid resection for endometriosis.

Method  All patients undergoing rectal or sigmoid resection for endometriosis in two specialist hospitals were prospectively recruited in the study. Details regarding demography, endometriosis‐related symptoms, procedure and postoperative recovery were collected. One year after the operation patients were sent a postal questionnaire asking about endometriosis‐related symptoms, quality of life and sexual functioning. The 15D Questionnaire and McCoy Female Sexuality Questionnaire were used for this purpose.

Results  A total of 26 patients responded to the 15D questionnaire. Endometriosis‐related bowel symptoms decreased significantly after the operation. The responses showed improvements in the overall score and scores for five different dimensions (usual activities, P = 0.04; discomfort and symptoms, P < 0.001; distress, P  < 0.001; vitality, P < 0.001; sexual activity, P < 0.001). Sexual satisfaction was greater 1 year after the operation (P = 0.01). Sexual problems and partner satisfaction scores had not changed significantly.

Conclusion  Laparoscopic rectal and sigmoid resection for endometriosis significantly reduce endometriosis‐related symptoms and improve quality of life and sexual well‐being.
Phacoemulsification and +14 diopter intraocular lens placement in a Saddlebred foal
Authors: Harrington Jay T. , McMullen Richard J. , Clode Alison B. , Gilger Brian C.
Published: May 2012

A 2‐month‐old, 110‐kg Saddlebred filly presented for evaluation of bilateral cataracts. A hypermature cataract in the left eye (OS) and an incipient nuclear cataract in the right eye (OD) were diagnosed. Electroretinography and ocular ultrasound revealed no contraindications for surgical removal of the cataractous lens OS. Phacoemulsification and implantation of a +14 diopter (D) intraocular lens (IOL) OS were performed at 4 months of age without complication, with the exception of a partial iridectomy performed on a small iris section that prolapsed through the corneal incision. Complete ophthalmic examinations, including ocular ultrasound and streak retinoscopy, were performed 1, 2, 6 weeks, 4 months, 1, and 2 years postoperatively. Diffuse corneal edema and a superficial corneal ulcer developed OS during the early postoperative period and resolved without complication. Dyscoria was identified owing to anterior synechia of the dorsomedial iris at the incision site. Two years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes (OU). The IOL remained centrally positioned within the capsule, with mild anterior tilting of the superior portion of the IOL and mild fibrosis of the lens capsule. The postoperative net refractive error was +0.31 D OS. Based on this report, a +14 D IOL may be the appropriate choice following lens extraction in a foal to achieve refraction near emmetropia at maturity. To our knowledge, this is the first report of phacoemulsification and IOL implantation in a foal with long‐term follow‐up.
Dacryops of the lacrimal gland in a dog
Authors: Delgado Esmeralda
Published: May 2012

A case of congenital lacrimal cyst or dacryops of the lacrimal gland in an 8‐month‐old Neapolitan Mastiff dog is reported. The dog presented with a swelling dorsolateral to the left globe, which had been present since birth. In addition, hyperplasia and prolapse of the superficial gland of the left nictitating membrane, and bilateral macropalpebral fissure and ‘diamond eye’ conformation were apparent. On manual eversion of the upper eyelid, a subconjunctival mass was visible that was translucent and pink and affected the upper conjunctival fornix. B‐mode ultrasonography revealed the presence of an echolucent thin‐walled cystic structure measuring 15 by 12 mm and containing an echodense border and a distended tubular fluid‐filled structure that extended posteriorly. A viscous and transparent fluid was aspirated from the lesion. Surgery was performed to excise the lesion, reposition the nictitans gland, and correct the morphology of the palpebral fissure. Histopathology confirmed the mass to be a cyst and distended duct of the lacrimal gland. Although tear secretion was compromised, resection of the cyst was curative.
Open non‐microsurgical, laparoscopic or open microsurgical varicocelectomy for male infertility: a meta‐analysis of randomized controlled trials
Authors: Ding Hui , Tian Junqiang , Du Wan , Zhang Liyuan , Wang Hanzhang , Wang Zhiping
Published: May 2012

Study Type – Therapy (systematic review)

Level of Evidence 1a

What's known on the subject? and What does the study add?

There are several surgical techniques for the treatment of varicocele in infertile men, including open non‐microsurgical, laparoscopic and microsurgical varicocelectomy. It is currently unclear, however, which is the most beneficial method for patients.

The present meta‐analysis found that microsurgical varicocelectomy is the most effective and least morbid method among the three varicocelectomy techniques for treating varicocele in infertile men.

OBJECTIVE

To compare various techniques of open non‐microsurgical, laparoscopic or microsurgical varicocelectomy procedures to describe the best method for treating varicocele in infertile men.

PATIENTS AND METHODS

We searched PubMed, Embase, the Cochrane Library, the Institute for Scientific Information (ISI) – Science Citation Index and the Chinese Biomedicine Literature Database up to June 2011. Only randomized controlled trials (RCTs) were included in the present study.

The outcome measures assessed were pregnancy rate (primary), the incidence of recurrent varicocele, time to return to work, the incidence of postoperative hydrocele and operation duration (secondary).

Two authors independently assessed the study quality and extracted data. All data were analysed using Review Manager (version 5.0).

RESULTS

The present study included four randomized controlled trials comprising 1,015 patients in total.

At the follow‐up endpoints, patients who had undergone microsurgery showed a significant advantage over those who had undergone open varicocelectomy in terms of pregnancy rate (odds ratio [OR]= 1.63, 95% confidence interval [CI]: 1.19–2.23].

There was no significant difference between laparoscopic and open varicocelectomy (OR = 1.11, 95% CI: 0.65–1.88) or between microsurgery and laparoscopic varicocelectomy (OR = 1.37, 95% CI: 0.84–2.24).

The incidences of recurrent varicocele and postoperative hydrocele were significantly lower after microsurgery than after laparoscopic or open varicocelectomy.

The time to return to work after microsurgery and laparoscopic varicocelectomy was significantly shorter than that after open varicocelectomy.

The operation duration of microsurgical varicocelectomy was longer than that of laparoscopic or open varicocelectomy.

CONCLUSIONS

Current evidence indicates that microsurgical varicocelectomy is the most effective and least morbid method among the three varicocelectomy techniques for treating varicocele in infertile men.

More high‐quality, multicentre, long‐term RCTs are required to verify the findings.
Impact of smoking status at diagnosis on disease recurrence and death in upper tract urothelial carcinoma
Authors: Ehdaie Behfar , Furberg Helena , Zabor Emily Craig , Ostroff Jamie S. , Shariat Shahrokh F. , Bochner Bernard H. , Coleman Jonathan A. , Dalbagni Guido
Published: May 2012

What's known on the subject? and What does the study add?

Cigarette smoking is the leading cause of urothelial carcinoma; however, the impact of smoking on outcomes after surgery for upper tract urothelial carcinoma is unknown. One study suggests that patients with a smoking history have an increased risk of recurrence in the bladder compared with never smokers but these patients did not differ with respect to time to pelvic recurrence or distant metastasis.

We subdivided smokers into current and former smokers and performed multivariate analyses that showed that smoking status was not an independent predictor of recurrence when traditional prognostic factors were taken into account. In addition, competing risks analyses showed that although current smoking did not increase the risk of recurrence, it imparted a significant risk of dying compared with former and never smoking.

Objective

To evaluate the impact of smoking exposure on oncological outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

Materials and Methods

Patient and disease characteristics from 288 patients with UTUC treated with RNU between 1995 and 2008 were collected from a prospectively maintained database at the Memorial Sloan‐Kettering Cancer Center.

Disease recurrence was defined as distant metastases, or local failure in the operative site or regional nodes.

Factors associated with recurrence and death were determined.

Results

The prevalence of current, former and never smoking at diagnosis was 19.1%, 55.2%, and 25.7%, respectively.

71.0% of patients reported a ≥20 pack‐year smoking history.

With a median follow‐up of 4.02 years, disease recurrence occurred in 27% (n = 79) of patients and 41% (n = 117) died during follow‐up.

While age at diagnosis, American Society of Anesthesiologists score, advanced stage, nodal involvement and high grade adversely affected recurrence‐free survival, smoking status was not associated with risk of recurrence or death in multivariate analysis (P = 0.60).

Multivariate competing risks regression showed that current smokers faced a significantly higher risk of death than never smokers (hazard ratio 3.64, 95% confidence interval 1.59–8.34).

Conclusions

While smoking status at diagnosis and cumulative smoking exposure were not associated with UTUC recurrence, our findings highlight the substantial risk of death in patients with UTUC who are active smokers.

Treatment plans to promote smoking cessation are recommended for these patients.
Who Deserves Help? Evolutionary Psychology, Social Emotions, and Public Opinion about Welfare
Authors: Petersen Michael Bang , Sznycer Daniel , Cosmides Leda , Tooby John
Published: May 2012

Evidence suggests that our foraging ancestors engaged in the small‐scale equivalent of social insurance as an essential tool of survival and evolved a sophisticated psychology of social exchange (involving the social emotions of compassion and anger) to regulate mutual assistance. Here, we hypothesize that political support for modern welfare policies are shaped by these evolved mental programs. In particular, the compassionate motivation to share with needy nonfamily could not have evolved without defenses against opportunists inclined to take without contributing. Cognitively, such parasitic strategies can be identified by the intentional avoidance of productive effort. When detected, this pattern should trigger anger and down‐regulate support for assistance. We tested predictions derived from these hypotheses in four studies in two cultures, showing that subjects' perceptions of recipients' effort to find work drive welfare opinions; that such perceptions (and not related perceptions) regulate compassion and anger (and not related emotions); that the effects of perceptions of recipients' effort on opinions about welfare are mediated by anger and compassion, independently of political ideology; and that these emotions not only influence the content of welfare opinions but also how easily they are formed.
TACIT COLLUSION WITH QUANTITY‐MATCHING PUNISHMENTS IN A HOMOGENEOUS MARKET*
Authors: LU YUANZHU
Published: May 2012

Tacit collusion with quantity‐matching punishments in a homogeneous market is investigated. The findings are the following: (i) tacit collusion can arise with quantity‐matching punishments in a homogeneous market, (ii) the monopoly quantity cannot be supported by quantity‐matching punishment strategy, and (iii) compared with Nash‐reversion punishments, collusion is no easier to sustain, but not necessarily harder. The results are compared with those in Lu and Wright (International Journal of Industrial Organization, Vol. 28 (2010), pp. 298–306) with price‐matching punishments. A linear demand example is provided to illustrate the theory.
TO MERGE OR TO LICENSE: IMPLICATIONS OF INFORMATION SHARING FOR OPTIMAL MERGER POLICY*
Authors: SHIEH SHIOU , HUANG CHI‐FEI , CHEN HSIAO‐CHI
Published: May 2012

We investigate the antitrust authority's optimal merger policy in a duopoly model with cost asymmetry and asymmetric information regarding uncertain demand. Technology can be transferred either through a merger or a license, while market information is shared only through a merger. We show that the optimal merger policy differs under Cournot and Bertrand competition. If firms compete in Bertrand fashion, then mergers should never be allowed. If firms compete in Cournot fashion, then mergers are permitted if market volatility is high or if volatility is in the intermediate range and the size of innovations is large enough.
DOES BANNING PRICE DISCRIMINATION PROMOTE ENTRY AND INCREASE WELFARE? A MODEL OF DIFFERENTIATED‐PRODUCT DUOPOLY WITH ASYMMETRIC MARKETS*
Authors: JORGE SÍLVIA FERREIRA , PIRES CESALTINA PACHECO
Published: May 2012

In this paper we investigate the impact of firms' pricing policies upon entry and welfare under duopoly price competition and product differentiation. We consider a model where an incumbent serves two distinct and independent geographical markets and an entrant may enter in one of the markets. Our results show that discriminatory pricing may be either more, less or equally favorable to entry than uniform pricing. The welfare effect of banning price discrimination is also ambiguous. However, the case for banning price discrimination is much weaker than under monopoly. Interestingly, discriminatory pricing may yield higher welfare even when entry occurs only under uniform pricing.