bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between mutation frequency and replication strategy in positive-sense single-stranded RNA viruses
Authors: Thébaud Gaël , Chadœuf Joël , Morelli Marco J. , McCauley John W. , Haydon Daniel T.
Published: November 2009

For positive-sense single-stranded RNA virus genomes, there is a trade-off between the mutually exclusive tasks of transcription, translation and encapsidation. The replication strategy that maximizes the intracellular growth rate of the virus requires iterative genome transcription from positive to negative, and back to positive sense. However, RNA viruses experience high mutation rates, and the proportion of genomes with lethal mutations increases with the number of replication cycles. Thus, intracellular mutant frequency will depend on the replication strategy. Introducing apparently realistic mutation rates into a model of viral replication demonstrates that strategies that maximize viral growth rate could result in an average of 26 mutations per genome by the time plausible numbers of positive strands have been generated, and that virus viability could be as low as 0.1 per cent. At high mutation rates or when a high proportion of mutations are deleterious, the optimal strategy shifts towards synthesizing more negative strands per positive strand, and
in extremis
towards a ‘stamping-machine’ replication mode where all the encapsidated genomes come from only two transcriptional steps. We conclude that if viral mutation rates are as high as current estimates suggest, either mutation frequency must be considerably higher than generally anticipated and the proportion of viable viruses produced extremely small, or replication strategies cannot be optimized to maximize viral growth rate. Mechanistic models linking mutation frequency to replication mechanisms coupled with data generated through new deep-sequencing technologies could play an important role in improving the estimates of viral mutation rate.
Resonating feathers produce courtship song
Authors: Bostwick Kimberly S. , Elias Damian O. , Mason Andrew , Montealegre-Z Fernando
Published: November 2009

Male Club-winged Manakins,Machaeropterus deliciosus(Aves: Pipridae), produce a sustained tonal sound with specialized wing feathers. The fundamental frequency of the sound produced in nature is approximately 1500 Hz and is hypothesized to result from excitation of resonance in the feathers' hypertrophied shafts. We used laser Doppler vibrometry to determine the resonant properties of male Club-winged Manakin's wing feathers, as well as those of two unspecialized manakin species. The modified wing feathers exhibit a response peak near 1500 Hz, and unusually highQ-values (a measure of resonant tuning) for biological objects (Qup to 27). The unmodified wing feathers of the Club-winged Manakin do not exhibit strong resonant properties when measured in isolation. However, when measured still attached to the modified feathers (nine feathers held adjacent by an intact ligament), they resonate together as a unit near 1500 Hz, and the wing produces a second harmonic of similar or greater amplitude than the fundamental. The feathers of the control species also exhibit resonant peaks around 1500 Hz, but these are significantly weaker, the wing does not resonate as a unit and no harmonics are produced. These results lend critical support to the resonant stridulation hypothesis of sound production inM. deliciosus.
Genetic analyses of historic and modern marbled murrelets suggest decoupling of migration and gene flow after habitat fragmentation
Authors: Peery M. Zachariah , Hall Laurie A. , Sellas Anna , Beissinger Steven R. , Moritz Craig , Bérubé Martine , Raphael Martin G. , Nelson S. Kim , Golightly Richard T. , McFarlane-Tranquilla Laura , Newman Scott , Palsbøll Per J.
Published: November 2009

The dispersal of individuals among fragmented populations is generally thought to prevent genetic and demographic isolation, and ultimately reduce extinction risk. In this study, we show that a century of reduction in coastal old-growth forests, as well as a number of other environmental factors, has probably resulted in the genetic divergence of marbled murrelets (Brachyramphus marmoratus) in central California, despite the fact that 7 per cent of modern-sampled murrelets in this population were classified as migrants using genetic assignment tests. Genetic differentiation appears to persist because individuals dispersing from northern populations contributed relatively few young to the central California population, as indicated by the fact that migrants were much less likely to be members of parent–offspring pairs than residents (10.5% versus 45.4%). Moreover, a recent 1.4 per cent annual increase in the proportion of migrants in central California, without appreciable reproduction, may have masked an underlying decline in the resident population without resulting in demographic rescue. Our results emphasize the need to understand the behaviour of migrants and the extent to which they contribute offspring in order to determine whether dispersal results in gene flow and prevents declines in resident populations.
Wide-field motion tuning in nocturnal hawkmoths
Authors: Theobald Jamie C. , Warrant Eric J. , O'Carroll David C.
Published: November 2009

Nocturnal hawkmoths are known for impressive visually guided behaviours in dim light, such as hovering while feeding from nectar-bearing flowers. This requires tight visual feedback to estimate and counter relative motion. Discrimination of low velocities, as required for stable hovering flight, is fundamentally limited by spatial resolution, yet in the evolution of eyes for nocturnal vision, maintenance of high spatial acuity compromises absolute sensitivity. To investigate these trade-offs, we compared responses of wide-field motion-sensitive neurons in three species of hawkmoth:Manduca sexta(a crepuscular hoverer),Deilephila elpenor(a fully nocturnal hoverer) andAcherontia atropos(a fully nocturnal hawkmoth that does not hover as it feeds uniquely from honey in bees' nests). We show that despite smaller eyes, the motion pathway ofD. elpenoris tuned to higher spatial frequencies and lower temporal frequencies thanA. atropos, consistent withD. elpenor's need to detect low velocities for hovering.Acherontia atropos, however, presumably evolved low-light sensitivity without sacrificing temporal acuity.Manduca sexta, active at higher light levels, is tuned to the highest spatial frequencies of the three and temporal frequencies comparable withA. atropos. This yields similar tuning to low velocities as inD. elpenor, but with the advantage of shorter neural delays in processing motion.
CD44+ slow‐cycling tumor cell expansion is triggered by cooperative actions of Wnt and prostaglandin E2 in gastric tumorigenesis
Authors: Ishimoto Takatsugu , Oshima Hiroko , Oshima Masanobu , Kai Kazuharu , Torii Ryota , Masuko Takashi , Baba Hideo , Saya Hideyuki , Nagano Osamu
Published: November 2009

(Cancer Sci 2010; 101: 673–678)

Similar to normal tissue stem cells, cancer stem cells (CSCs) are thought to be quiescent or slow‐cycling and, thereby, insensitive to chemo‐ and radiotherapies. CD44, a cell surface component that interacts with the extracellular matrix, has been found to be highly expressed in CSCs of several solid tumors. However, the relevancy between CD44+ cells and slow‐cycling cells and the underlying mechanisms for the emergence of CD44+ CSCs during tumorigenesis have not been elucidated. Here we show that a gastric gland residing at the squamo‐columnar junction (SCJ) in normal mouse stomach contains CD44+ stem cell‐like slow‐cycling cells and that this characteristic CD44+ gland was expanded by prostaglandin E2 (PGE2) and Wnt signaling in K19‐Wnt1/C2mE mouse, a genetic mouse model for gastric tumorigenesis. The analysis of three transgenic mouse lines, K19‐Wnt1, K19‐C2mE and K19‐Wnt1/C2mE, revealed that the expansion of CD44+ SCJ cells is triggered by PGE2‐mediated signaling and is prominently enhanced by the addition of Wnt activation. Furthermore, each expanded CD44+ gland in gastric tumor of K19‐Wnt1/C2mE mouse contains a few BrdU label‐retaining quiescent or slow‐cycling cells, suggesting that the CD44+ SCJ cells in normal mouse are candidates for the cell‐of‐origin of gastric CSCs. These observations suggest that PGE2‐mediated inflammatory signaling and Wnt signaling cooperatively trigger the expansion of CD44+ slow‐cycling stem‐like cells in SCJ, leading to development of lethal gastric tumors in mice.
Bmi‐1 gene is upregulated in early‐stage hepatocellular carcinoma and correlates with ATP‐binding cassette transporter B1 expression
Authors: Effendi Kathryn , Mori Taisuke , Komuta Mina , Masugi Yohei , Du Wenlin , Sakamoto Michiie
Published: November 2009

(Cancer Sci 2010; 101: 666–672)

Overexpression of “stemness gene”Bmi‐1 has been identified in some solid tumors. We investigated Bmi‐1 expression in hepatocellular carcinoma (HCC) and ATP‐binding cassette transporter B1 (ABCB1) as a new potential target for Bmi‐1. Bmi‐1 was highly expressed in HCC cell lines and the most well differentiated cell line, KIM‐1, showed the highest expression. Immunohistochemical, immunocytochemical, and immunoelectron microscopic analysis showed the Bmi‐1 protein as having a high intensity of small dots within the nucleus which reflected concentrated sites of Bmi‐1 repressive activity. Clear “dot‐pattern” staining was observed in 24 of 37 (65%) well differentiated HCC (including 13 of 21 early nodules [62%]), in 32 of 71 (45%) moderately differentiated HCC, and 7 of 14 (50%) poorly differentiated HCC. A similar expression was not observed in non‐cancerous background regions. High Bmi‐1 expression was observed in the early and well differentiated HCC. Furthermore, overexpression and suppression of Bmi‐1 was followed by a respective increase and decrease in ABCB1 expression. As with Bmi‐1, high ABCB1 expression was also observed in the early and well differentiated HCC. A strong correlation between ABCB1 and Bmi‐1 mRNA expression was seen in HCC cell lines and clinical samples (Pearson’s correlation coefficient 0.95 and 0.90, respectively). The Bmi‐1 gene is upregulated in HCC, and in particular is highly expressed in early and well differentiated HCC. The fact that this expression correlated with that of ABCB1 suggests a new regulation target for Bmi‐1, and gives new insight into early hepatocarcinogenesis mechanisms and potential targets for future HCC treatment.
A review on the vascular features of the hyperimmunoglobulin E syndrome
Authors: Yavuz H , Chee R
Published: November 2009

Autosomal recessive, autosomal dominant and the sporadic forms of hyperimmunoglobulin E syndrome (HIES) are multi-system disorders. Although HIES patients may present with cold abscesses, the vascular features of HIES are not well recognized. The objective of this review is to characterize the nature and spectrum of vascular abnormalities in HIES patients. Vascular abnormalities in HIES patients were reviewed with Medline and Google Scholar-based searches. In brief, the searches combined terms related to HIES with the terms related to vasculature. Furthermore, reference lists from the original studies and review papers identified were screened. There were vascular abnormalities in 25 patients with HIES. These abnormalities were identified as aneurysms (coronary, aortic, carotid and cerebral), pseudoaneurysms, congenital patent ductus venosus, superior vena cava syndrome, vasculitides, vascular ectasia, thrombosis and others. They may be congenital or acquired, in the veins and arteries, affecting both sexes. These abnormalities can be seen in all subtypes of HIES. They could be also fatal in children and adults. Limited pathological investigations revealed the presence of vasculitis. Three of the patients were found to have overlap diseases. In this review, the spectrum of vascular abnormalities in HIES are documented and discussed in detail for the first time. They highlight a previously under-recognized and potentially devastating complication of these disorders. These vascular abnormalities constitute one of the major clinical characteristics in HIES. The presence of hypereosinophilia, vasculitis and defective angiogenesis in HIES may contribute to the formation of vascular abnormalities in HIES.
Differential effects of glucocorticoids in the establishment and maintenance of endotoxin tolerance
Authors: Rearte B , Landoni V , Laborde E , Fernández G , Isturiz M
Published: November 2009

Gram-negative infections can result in endotoxic shock, which is the most common cause of death in intensive care units. Most of the undesirable effects in sepsis and septic shock have been ascribed to lipopolysaccharide (LPS), a normal constituent of the bacterial wall. The response to LPS involves rapid secretion of proinflammatory cytokines [tumour necrosis factor-α, interleukin (IL)-1, IL-6, IL-8, interferon-γ] and the concomitant induction of anti-inflammatory mediators such as IL-10 and transforming growth factor-β and glucocorticoids (GC), which render the host temporarily refractory to subsequent lethal doses of LPS challenge in a process known as LPS or endotoxin tolerance. Although protective from the development of sepsis or systemic inflammation, endotoxin tolerance has also been pointed out as the principal cause of the non-specific immunosuppression described in these patients. In this report we demonstrate, using a mouse model, that while the maintenance of tolerance is dependent upon GC, the establishment of tolerance by LPS could be inhibited by dexamethasone (Dex), a synthetic GC. Conversely, we demonstrated that mifepristone (RU486), a known GC receptor antagonist, was capable of inducing a transient and reversible disruption of endotoxin tolerance, also permitting partial restoration of the humoral immune response in LPS tolerant/immunosuppressed mice. These results are encouraging for the management of immunosuppression in sepsis and/or non-infectious shock, and deserve further investigation in the future.
The acute effect of smoking in healthy and asthmatic smokers
Authors: Papaioannou A. I. , Koutsokera A. , Tanou K. , Kiropoulos T. S. , Tsilioni I. , Oikonomidi S. , Liadaki K. , Pournaras S. , Gourgoulianis K. I. , Kostikas K.
Published: November 2009

Eur J Clin Invest 2010; 40 (2): 103–109

Background  Acute exposure to cigarette smoke is related to airway and systemic inflammation and oxidative stress. Little is known about the acute effect of cigarette smoking in smoking asthmatics. The aim of this study was to evaluate the acute effect of smoking in airway and systemic inflammation and oxidative stress in normal smokers and patients with properly treated well‐controlled persistent asthma.

Materials and methods  Ten normal smokers and 10 smokers with moderate persistent asthma controlled with LABA and ICS were recruited. Subjects refrained from smoking for at least 12 h prior to their inclusion. We compared the effects of smoking of two cigarettes on airway obstruction, airway inflammation and oxidative stress [by measuring fraction of exhaled nitric oxide (FeNO), plus pH and 8‐isoprostane in exhaled breath condensate (EBC)] before and 30, 90 and 180 min after smoking. Furthermore, we evaluated systemic oxidative stress, C‐reactive protein (CRP) and serum amyloid A (SAA) and urine leukotriene E4 (LTE4) before and 180 min after smoking.

Results  No differences were observed in EBC pH and 8‐isoprostane, FeNO and systemic oxidative stress between the groups at baseline. In asthmatics, EBC pH decreased 30 min and EBC 8‐isoprostane increased 90 min after smoking (P = 0·039 and P = 0·029 respectively), which was not evident in smoking controls. Serum oxidative stress increased only in asthmatic smokers at 180 min (P = 0·001). No differences were observed in SAA, CRP and urine LTE4 levels before and after smoking.

Conclusion  Acute smoking has more deleterious effects in well‐controlled properly treated asthmatic smokers compared with matched normal smokers.
The importance of surrogate habitats in lowland river floodplains for fish community composition
Authors: RYŠAVÁ‐NOVÁKOVÁ M. , ONDRAČKOVÁ M. , JURAJDA P.
Published: November 2009

Abstract  Floodplain borrow pits created during dike construction for flood protection along regulated lowland rivers are suggested as convenient surrogate habitats for fish communities where natural floodplain features have been lost. Fish community structure and reproduction success in three borrow pits located in the channelised floodplain of the River Dyje, Czech Republic were studied over 3 years. Short‐term floods supported the spawning of phytophilic and phyto‐lithophilic species; batch spawners capitalised on late summer flood conditions. The highest species richness of 0+ juvenile fishes occurred at sites with extended periods of flooding, at least for 2 months. Flooded vegetation was inhabited mainly by juvenile cyprinids, while 0+ percids were distributed evenly along the littoral zone. Shoreline remained bare even during higher water levels before complete inundation because of the steep banks, and therefore fish were not able to benefit from higher water levels. Borrow pits appear to function as a substitute habitat for fish and their reproduction, but only if they are properly constructed with shallow areas providing appropriate nursing conditions for 0+ fish growth and survival.
Growth and viability of hatchery‐reared Argyrosomus japonicus released into open and semi‐closed systems
Authors: TAYLOR M. D. , FIELDER D. S. , SUTHERS I. M.
Published: November 2009

Abstract  Hatchery‐reared Argyrosomus japonicus (Temminck & Schlegel) were released into estuaries of varying habitat between 1996 and 2004, and growth and recruitment to the fishery evaluated. Fish stocked earlier in summer had significantly faster growth rates (P < 0.01), and post‐stocking mortality ranged from 1.1% to 11.7% within 7 day post‐release. Argyrosomus japonicus stocked in the Georges River in 2003 and 2004 yielded fishery independent recapture rates up to 0.2%. For A. japonicus stocked in Smith’s Lake in 1997 and 2004, growth rates, timing of recaptures and increases in commercial catches suggested recruitment to the fishery by 18 months. The 1997 stocking led to a 30‐fold increase in A. japonicus catch, but stocking was not financially viable, with a cost:benefit ratio of 2.1. Small, shallow coastal lagoons may represent experimental units for refining stocking strategies, but are not optimal for A. japonicus. The potential for density‐dependent effects, and complex relationships between growth, habitat and mortality, highlighted the need for a thorough understanding of species – system interactions. Pilot releases can contribute to this understanding, particularly assessment of habitat requirements, and season, site and size‐of‐release.
Cellular components of probiotics control Yersinia ruckeri infection in rainbow trout, Oncorhynchus mykiss (Walbaum)
Authors: Abbass A , Sharifuzzaman S M , Austin B
Published: November 2009

Subcellular components of the probiotics Aeromonas sobria GC2 and Bacillus subtilis JB‐1, when administered to rainbow trout, Oncorhynchus mykiss, conferred protection against a new biogroup of Yersinia ruckeri. Thus, intraperitoneal or intramuscular injection of rainbow trout with cell wall proteins (CWPs), outer membrane proteins (OMPs), lipopolysaccharides (LPS), whole cell proteins (WCPs) and live cells followed by challenge on day 8 with Y. ruckeri led to 80–100% survival compared with 10% survival in the controls. Sodium dodecyl sulphate‐polyacrylamide gel electrophoresis (SDS‐PAGE) profiles of WCPs and OMPs from GC2 had 10 and 5 variable protein bands in comparison to 11 and 5 bands in the WCPs and CWPs from JB‐1. Proteomic analyses were employed following SDS‐PAGE to categorize one dominant protein of 104.7 kDa from the CWPs of JB‐1 and equated it with ‘Bacillus spp. endoglucanase’ with a Mascot score >69. These results point to the potential of using cellular components of probiotics for protection of fish against bacterial diseases.
A sensitive FRET probe assay for the selective detection of Mycobacterium marinum in fish
Authors: Salati F , Meloni M , Fenza A , Angelucci G , Colorni A , Orrù G
Published: November 2009

Mycobacterium marinum is the causative agent of mycobacteriosis in wild and cultured fish and of atypical infection in humans. For the diagnosis of M. marinum, cultural and traditional polymerase chain reaction (PCR) methods are currently used. However, these protocols, although able to discriminate within Mycobacterium spp., have proved to be time‐consuming or difficult to carry out. For this reason, the aim of this study was to obtain a rapid and specific diagnostic tool to quantify fish Mycobacterium spp. or to discriminate M. marinum from other mycobacteria. A primary PCR amplification with SYBR Green had a detection limit (dl) of 102Mycobacterium DNA copies with a log‐linear quantification range up to 104 (R2 = 0.99). The second PCR using FRET probes, flanking a region containing species specific nucleotide variations, was designed and validated with synthetic erp gene fragments corresponding to different mycobacterial species, different whole mycobacteria suspensions, experimentally infected fish tissues, tissues from experimentally infected fish, and samples of cultured fish. The results show that the FRET probes demonstrate a high specificity as the melting curve analysis allowed efficient discrimination of M. marinum from Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium pseudoshottsii, Mycobacterium shottsii and Mycobacterium ulcerans. The kidney is the organ with the strongest detection signal and using fish tissues the method has a mean sensitivity of 50 DNA copies/PCR.
Complete sequencing of Tunisian redspotted grouper nervous necrosis virus betanodavirus capsid gene and RNA‐dependent RNA polymerase gene
Authors: Chérif N , Gagné N , Groman D , Kibenge F , Iwamoto T , Yason C , Hammami S
Published: November 2009

Finfish nodaviruses (betanodaviruses) can cause highly destructive infections in numerous species of farmed marine fish larvae and juveniles worldwide. The betanodavirus genome consists of two single‐stranded positive‐sense RNA molecules (RNA1 and RNA2). The virus can be classified into four genotypes based on the partial sequences of the coat protein (CP) gene (T2 and T4 regions). Currently, genomic sequence information for RNA1 regions of RNA2 outside of T2 and T4 is less well documented. This study reports on the characterization of the full RNA2 sequence of a Tunisian betanodavirus with a length of 1433 nt, containing a 339 amino acid open‐reading frame encoding the CP, and typing to the redspotted grouper nervous necrosis virus Ia genotype following phylogenetic analysis. The homology of the capsid protein to other betanodaviruses or alphanodaviruses was compared. In addition, a full length RNA1 sequence of 3104 nt encoding a 982 amino acid RNA‐dependent RNA polymerase was obtained.
A comparative molecular study of the presence of “Candidatus arthromitus” in the digestive system of rainbow trout, Oncorhynchus mykiss (Walbaum), healthy and affected with rainbow trout gastroenteritis
Authors: Del‐Pozo J , Turnbull J , Ferguson H , Crumlish M
Published: November 2009

Observations were made using histopathological techniques in conjunction with a nested polymerase chain reaction (PCR) protocol for the specific detection of “Candidatus arthromitus” on DNA extracted from wax‐embedded tissues and fresh digestive contents of rainbow trout. Samples positive for “Candidatus arthromitus” DNA included fish with rainbow trout gastroenteritis (RTGE), clinically normal cohabiting fish, and apparently healthy controls from RTGE positive and RTGE negative sites. The results obtained from the PCR were confirmed by nucleotide sequencing. “Candidatus arthromitus” DNA was found in distal intestine as well as in sections of pyloric caeca, suggesting that both these locations are appropriate for molecular detection of “Candidatus arthromitus” DNA in trout. Furthermore, rainbow trout fry distal intestinal samples from two different hatcheries where RTGE had not been reported were also positive. Differences in “Candidatus arthromitus” DNA detection between paraffin wax‐embedded and fresh digestive content samples from the same fish suggested that it may be predominantly epithelium‐associated in healthy trout. Parallel histopathological observations indicated that pyloric caeca are the preferred site for visualizing segmented filamentous bacteria (SFB) in trout with RTGE. The results of this study showed that the presence of SFB was not invariably associated with clinical disease and that more information is required to understand the role of these organisms.
The incidence and temporal patterning of insomnia: a pilot study
Authors: PERLIS MICHAEL L. , SWINKELS CINDY M. , GEHRMAN PHILIP R. , PIGEON WILFRED R. , MATTESON‐RUSBY SARA E. , JUNGQUIST CARLA R.
Published: November 2009

To date very little research has been conducted on night‐to‐night variability in the incidence of insomnia. It is unclear from prior research whether subjects with primary insomnia (PI) exhibit good sleep (or better than average sleep) on some interval basis. In the present study, pilot data are provided on: (1) the frequency with which ‘good sleep’ occurs in subjects with PI; and (2) whether these events occur in a non‐random manner. Ten subjects with PI participated in this ‘naturalistic’ study. All subjects completed daily sleep diaries for a minimum of 20 days. None of the subjects received treatment for their insomnia during the monitoring period. The night‐to‐night data were evaluated by typing each night’s sleep as ‘Good’ or ‘Bad’, and then by determining the number of bad nights that occurred prior to a good night for each subject. Good and bad nights were typed in two ways: (1) using a ≥85% cut‐off and (2) using a better than the individual’s mean sleep efficiency (idiographic cut‐off). Subjects exhibited good sleep on between 29% (>85% criteria) and 55% (idiographic criteria) of the nights evaluated. The temporal patterning analysis (based on an idiographic cut‐off) revealed that better than average sleep most frequently occurred (>89% of instances) following one to three nights of poor sleep. These data suggest that insomnia severity may be mediated/moderated by sleep homeostasis and that the homeostat, or input to the homeostat, may be abnormal in patients with PI.
A cohort study of the prevalence of sleep problems in adults with intellectual disabilities
Authors: BOYLE AINSLIE , MELVILLE CRAIG A. , MORRISON JILL , ALLAN LINDA , SMILEY ELITA , ESPIE COLIN A. , COOPER SALLY‐ANN
Published: November 2009

Previous studies of the prevalence of sleep problems in adults with intellectual disabilities (ID) are affected by small, potentially biased samples and other limitations. This study aims to determine the prevalence and associations of sleep problems in the adult population with ID. The 4‐week period prevalence of sleep problems was determined in a cross‐sectional study of all adults with ID in a defined geographical area. Sleep problems were identified using the Psychiatric Assessment Scale for Adults with Developmental Disabilities (PAS‐ADD) checklist and categorized as initial insomnia, early morning wakening and broken sleep. A fourth, composite, variable of significant sleep problem was also derived. Of the 1023 adults with ID who participated, 9.2% had experienced a significant sleep problem, during the 1‐month period. Individuals with a significant sleep problem are more likely to have mental ill‐health [odds ratio (OR) = 5.53, 95% confidence interval (CI) 3.52–8.69], problem behaviours (OR = 2.06, 95% CI: 1.25–3.41) and respiratory disease (OR = 2.03, 95% CI: 1.27–3.26). There is a positive association between visual impairment and initial insomnia (OR = 1.91, 95% CI: 1.21–3.04). Although a diagnosis of epilepsy is not associated with sleep problems, the finding that individuals taking antiepileptic medication are more likely to experience broken sleep (OR = 1.73, 95% CI: 1.13–2.66) suggests that medication side effects may impact on sleep of individuals with ID. The results suggest that there is a need to further examine the relationship between sleep problems and co‐morbid health problems, which would inform the development of interventions, and trials of their efficacy.
Room for improvement: nurses' and physicians' views of a post‐operative pain management program
Authors: HARTOG C. S. , ROTHAUG J. , GOETTERMANN A. , ZIMMER A. , MEISSNER W.
Published: November 2009

Background: The practice of post‐operative pain therapy continues to be a problem. We conducted a survey among nurses and physicians about their views of an established post‐operative pain management program.

Methods: A questionnaire was sent to all nurses and physicians of nine surgical wards (general, trauma, cardio‐thoracic and oromaxillofacial surgery and gynecology). Questions were developed from qualitative interviews with staff. Patient data were derived from a post‐operative pain registry.

Results: Seventy‐eight physicians and nurses answered; the overall response rate was 23%. Post‐operative pain therapy had high personal priority on an 11‐point numeric rating scale (mean 9.08±1.27 standard deviation), but the success of pain management on the ward was rated as 7.32±1.37. Staff rating of success tended to correspond with patients' actual pain ratings. Knowledge of pain therapy was assessed as 6.85±1.82; nurses consistently rated levels higher than physicians. Staff over‐ or underestimated the painfulness of typical procedures and females rated procedures as more painful than men. There was considerable confusion about responsibilities and duties. 10.7% of staff perceived time delays exceeding 6 h between a request for acute pain services (APS) consultation and administration of medication to the patient. Invited comments suggested improvement in personnel education, team coordination, communication with patients and speed of action to increase the quality of pain therapy.

Conclusion: Despite staff's high personal priority and well‐established APS and pain management program, post‐operative pain therapy still leaves room for improvement. Considerable confusion about responsibilities and duties underlines the importance of better organizational approaches.
Mapping of resistance against Barley mild mosaic virus‐Teik (BaMMV) – an rym5 resistance breaking strain of BaMMV – in the Taiwanese barley (Hordeum vulgare) cultivar ‘Taihoku A’
Authors: Humbroich K. , Jaiser H. , Schiemann A. , Devaux P. , Jacobi A. , Cselenyi L. , Habekuss A. , Friedt W. , Ordon F.
Published: November 2009

With 1 figure

The Taiwanese barley (Hordeum vulgare L.) cultivar ‘Taihoku A’, which has been described as resistant to Barley mild mosaic virus (BaMMV), Barley yellow mosaic virus (BaYMV) and BaYMV‐2, contains the BaMMV resistance gene rym13 located on chromosome 4HL. Furthermore, ‘Taihoku A’ shows resistance to the newly detected virus strain BaMMV‐Teik, which is able to overcome the resistance gene rym5. By analysing a set of 154 DH‐lines of the cross ‘Taihoku A’ x ‘Plaisant’ it turned out that resistance to BaMMV‐Teik is inherited in a monogenic manner, the gene located on chromosome 4HL. Resistance to BaMMV‐Teik is also encoded by rym13 or an additional gene being closer linked to rym13 than 0.65 centiMorgan (cM). Using bulked segregant analysis employing Simple sequence repeats (SSRs) and Amplified fragment length polymorphisms (AFLPs), a map comprising 39.1 cM was constructed with the closest marker linked to the BaMMV/BaMMV‐Teik resistance at a distance of 1 cM. Respective markers are useful tools to introduce resistance to BaMMV‐Teik into adapted breeding lines carrying other resistance genes, which are not effective against all BaMMV/BaYMV strains known in Europe, e.g. rym4, rym5.
Retirement: What will you do? A narrative inquiry of occupation‐based planning for retirement: Implications for practice
Authors: Hewitt Alana , Howie Linsey , Feldman Susan
Published: November 2009

Aim:  To examine, using a retrospective narrative study, the factors influencing four older people’s decision to plan for the activities they would undertake once retired, the planning process undertaken and their subsequent experience of retirement.

Method:  Semi‐structured interviews were conducted to examine the factors influencing older people’s decision to commence pre‐retirement planning, the planning process undertaken and their experience of retirement. In keeping with narrative inquiry, paradigmatic‐type narrative analysis led to the development of categories and subsequent themes to reveal the participants’ experiences of these issues.

Results:  Three themes: environmental influences, the planning process and retirement experiences: the outcome of planning, were derived from the participants’ narratives. Overall, retirement activities that were continued or initiated led to a positive experience even when these planned activities were temporarily interrupted or altered. Planning for future years in retirement and older age also continued.

Conclusion:  Occupational therapists have a unique understanding of the centrality of occupation to health and wellbeing. Thus occupational therapists are well‐positioned to assist people identify, plan and engage in meaningful occupations outside work in retirement.
Epithelial–mesenchymal transition in human lungs with usual interstitial pneumonia: Quantitative immunohistochemistry
Authors: Harada Taishi , Nabeshima Kazuki , Hamasaki Makoto , Uesugi Noriko , Watanabe Kentaro , Iwasaki Hiroshi
Published: November 2009

Fibroblastic foci, a major histological feature of usual interstitial pneumonia (UIP), play a critical role in the development of UIP. The mechanisms involved in the formation of these foci, however, including cellular origin, remain unclear. Recent in vitro and animal studies suggested epithelial–mesenchymal transition (EMT) of alveolar epithelial cells during pulmonary fibrogenesis. The aim of the present study was to investigate the presence of EMT in patients with UIP on quantitative immunohistochemistry using pathological tissue sections. The study subjects were 13 patients with UIP pattern among 52 patients with interstitial pneumonia who underwent lung biopsy. Alveolar epithelial cells overlying fibroblastic foci expressed epithelial markers less frequently and mesenchymal markers more frequently compared with those in non‐diseased control lung tissues (n= 10). Moreover, double immunostaining showed that some epithelial cells stained for both epithelial and mesenchymal markers. Furthermore, significantly higher numbers of epithelial marker‐positive fibroblastic cells were found in fibroblastic foci in UIP as well as in other non‐UIP fibrosing diseases than in control lung tissues. The results showed that some epithelial cells overlying fibroblastic foci lose the epithelial phenotype and gain the mesenchymal phenotype, and that some fibroblastic cells in fibroblastic foci originate from epithelial cells. But this EMT may not be specific for UIP.
Minimal deviation mucinous adenocarcinoma (‘adenoma malignum’) of the uterine corpus
Authors: Abiko Kaoru , Baba Tsukasa , Ogawa Madoka , Mikami Yoshiki , Koyama Takashi , Mandai Masaki , Konishi Ikuo
Published: November 2009

Primary mucinous adenocarcinomas of the uterine corpus are typically low grade and frequently associated with endometrial hyperplasia and/or ordinary endometrioid adenocarcinoma, but may appear as a heterogeneous group of neoplasms. A case is described of a 56‐year‐old postmenopausal woman who presented with mucinous vaginal discharge. Imaging demonstrated thickened myometrium due to adenomyosis. Serum CA19‐9 levels were elevated to 486 U/mL. Microscopic examination of hysterectomy specimens indicated highly differentiated mucinous adenocarcinoma diffusely infiltrating the portion of adenomyosis of the corpus. In some areas endometrial glands of adenomyosis were replaced by benign‐looking mucinous metaplasia. The uterine cervix showed no abnormalities. HIK1083 and MUC6 immunohistochemistry indicated a gastric phenotype of the tumor, as seen in cases of prototypical minimal deviation adenocarcinoma (MDA) of the cervix. In summary, mucinous endometrial adenocarcinoma rarely shows features similar to MDA of the cervix. This case provokes a discussion on diagnostic and management strategy, and histogenesis of mucinous neoplasm of the endometrium.
Concurrent xanthogranulomatous orchiepididymitis and seminoma in the same testis
Authors: Val‐Bernal J. Fernando , González‐Márquez Pilar , Ramos‐Barseló Enrique , Portillo José Antonio
Published: November 2009

Xanthogranulomatous orchiepididymitis (XGO) is a rare inflammatory and destructive disease of the testis that may simulate testicular malignancy. To the authors' knowledge only 19 cases of XGO have been previously reported. Herein is reported the case of a 52‐year‐old man with XGO who presented with a left testicular mass and pyogenic discharge from the scrotum. Ultrasound examination indicated heterogeneous testicular areas suggestive of neoplasia. Testicular tumor markers were normal. Orchidectomy was performed and histopathology showed XGO and a concurrent, occult typical seminoma. As far as the authors know the coincidence of these two lesions has not been documented previously. XGO may mimic testicular malignancy and may coexist with it. Pathologists should be aware of this concurrence of lesions to avoid potential misdiagnosis. Wide sampling of the orchidectomy specimens with XGO is mandatory to exclude an occult seminoma.
Transumbilical single‐port laparoscopic partial nephrectomy in a pig model
Authors: Boylu Ugur , Oommen Mathew , Thomas Raju , Lee Benjamin R.
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

To determine the feasibility, instrumentation, and learning curve for single‐port laparoscopic partial nephrectomy (SPLPN) in a pig model.

MATERIALS AND METHODS

Ten transumbilical SPLPN were performed using the R‐Port (Advanced Surgical Concepts, Wicklow, Ireland) multi‐instrument port, a 5‐mm flexible laparoscope (Olympus Surgical, Orangeburg, NY, USA), and custom‐engineered articulating needle drivers, graspers, and scissors (Cambridge Endo, Framingham, MA, USA). After general anaesthesia, the pig was placed in the flank position. After umbilical placement of the R‐Port, Gerota’s fascia was incised and hilar dissection performed with the newly engineered articulating instruments. Either the upper or lower pole of the kidney was scored and excised after placing a bulldog clamp on the renal pedicle. The bolsters were prepared with absorbable haemostat, placed at the site of excision, and secured with polyglactin sutures.

RESULTS

A fascial incision of ≥2.5 cm should be made to allow adequate room for passing the instruments. Also, use of the 5 mm flexible laparoscope minimizes instrument crowding and allows for optimal visualization. The mean (sd, range) time for hilum dissection was 12.2 (4.3, 7–20) min, while that for total excision was 9.8 (1.7, 8–12) min. Modified suturing techniques were developed to achieve reconstruction in a small working space. Specialized instrumentation is essential for a successful SPLPN with no need for an additional port for triangulation. The mean duration of intracorporeal suturing was 27.7 min (declining from 40 to 15 min). The total ischaemia time decreased from 50 min in the first case to 27 min in the last (mean 37.4 min). The mean estimated blood loss was 81.1 (31.7, 50–150) mL.

CONCLUSIONS

SPLPN is technically feasible but further refinement of instrumentation and techniques is needed to decrease the ischaemia time and optimize the procedure.
Medical management of acute urolithiasis in one American academic emergency room
Authors: Kaplon Daniel M. , Sterrett Samuel , Nakada Stephen Y.
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

To determine the implementation of medical expulsive therapy (MET) for ureterolithiasis in one tertiary‐care emergency room (ER); referral patterns in the surgical and metabolic follow‐up of ureterolithiasis were also assessed.

PATIENTS AND METHODS

In this retrospective review we identified 556 patients with ureterolithiasis in the ER at our centre between 2005 and 2007. Of these, 131 patients met inclusion criteria, including first‐time stone formers and no urological visit within the previous 5 years. ER records were reviewed and telephone interviews conducted to determine if MET was used, if the patient was referred to a urologist, if surgery was ultimately required, and if there was ultimately a metabolic evaluation.

RESULTS

The mean (range) stone size was 4.2  (2–10) mm. Ten patients were admitted directly from the ER and 121 were discharged home. Of the 121 discharged patients, 48 (40%) were prescribed MET. In all, 46 patients received tamsulosin 0.4 mg and two received doxazosin 2 mg; no patient was prescribed steroids. The mean size of passed stones was statistically significantly lower than that of stones that did not pass (P < 0.05). Patients prescribed MET had a 23% chance of needing surgery, vs 32% in those not prescribed MET (P < 0.05). Seventy‐one (61%) patients were followed up by a urologist, 27 (23%) by a primary‐care physician, and eight (7%) had no further follow‐up. Ultimately, 31 (23%) patients had a metabolic evaluation and it was abnormal in 29 (95%).

CONCLUSIONS

In this single‐institution ER experience, 40% of patients with symptomatic ureterolithiasis were treated with MET on discharge from the ER. Our data also show that only patients referred to a urologist received a metabolic evaluation. This is notable given that the vast majority of those evaluated were found to have a correctable abnormality.
A randomized trial of photoselective vaporization of the prostate using the 80‐W potassium‐titanyl‐phosphate laser vs transurethral prostatectomy, with a 1‐year follow‐up
Authors: Bouchier‐Hayes David M. , Van Appledorn Scott , Bugeja Pat , Crowe Helen , Challacombe Ben , Costello Anthony J.
Published: November 2009

Study Type – Therapy (RCT) Level of Evidence 2b

OBJECTIVE

To compare the potassium‐titanyl‐phosphate GreenlightTM 80‐W laser ablation system for photovaporization of the prostate (PVP; Laserscope, San Jose, CA, USA) with transurethral resection of the prostate (TURP), as many technologies have been proposed as equivalent or superior to TURP without gaining widespread acceptance, due to lack of data from randomized trials.

PATIENTS AND METHODS

In all, 120 patients were randomized to undergo either TURP or PVP after a full urological evaluation, which was repeated at 1, 3, 6 and 12 months after surgery. Irrigation use, duration of catheterization (DOC), length of hospital stay (LOS), blood loss, cost and operative time were also assessed.

RESULTS

Both groups showed a significant increase in mean (sd) maximum urinary flow rate from baseline (P < 0.05); in the TURP group from 8.9 (3.0) to 19.4 (8.7) mL/s (154%), and in the PVP group from 8.8 (2.5) to 18.6 (8.2) mL/s (136%). The International Prostate Symptom Score (IPSS) decreased from 25.4 (5.7) to 10.9 (9.4) in the TURP group (53%), and from 25.3 (5.9) to 8.9 (7.6) in the PVP group (61%). The trends were similar for the bother and Quality of Life scores. There was no difference in sexual function as measured by Baseline Sexual Function Questionnaires. The DOC was significantly less in the PVP than the TURP group (P < 0.001), with a mean (range) of 13 (0–24) h vs 44.7 (6–192) h. The situation was similar for LOS (P < 0.001), with a mean (range) of 1.09 (1–2) and 3.6 (3–9) days in the PVP and TURP groups, respectively. Adverse events and complications were less frequent in the PVP group. Costs were also 22% less in the PVP group.

CONCLUSIONS

This trial shows that PVP is an effective technique when compared to TURP, producing equivalent improvements in flow rates and IPSS with the advantages of markedly reduced LOS, DOC and adverse events. A long‐term follow‐up is being undertaken to ensure durability of these results.
Penoscrotal plication as a uniform approach to reconstruction of penile curvature
Authors: Dugi Daniel D. , Morey Allen F.
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

To present our 4‐year experience of using a minimally invasive technique, penoscrotal plication (PSP), as a uniform treatment for men with debilitating penile curvature resulting from Peyronie’s disease.

PATIENTS AND METHODS

In 48 men (median age 58.7 years) with penile curvature the penis was reconstructed by imbricating the tunica albuginea opposite the curvature with multiple nonabsorbable sutures. All patients, regardless of the degree or direction of curvature, were approached through a small penoscrotal incision made without degloving the penis. Detailed measurements of penile shaft angle and stretched penile length were recorded and analysed before and after reconstruction, and the numbers of sutures required for correction were documented.

RESULTS

Nearly all patients had dorsal and/or lateral deformities that were easily corrected via a ventral penoscrotal incision. The median (range) degree of correction was 28 (18–55)° and number of sutures used was 6 (4–17). Stretched penile length measurements before and after plication showed no significant difference. A single PSP procedure was successful in 45/48 (93%) patients; two were dissatisfied with the correction, one having repeat plication and the other a penile prosthesis; one other required a suture release for pain.

CONCLUSIONS

PSP is safe and effective and should be considered even for cases with severe or biplanar curvature.
Definition and preoperative predictors of persistently elevated prostate‐specific antigen after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database
Authors: Moreira Daniel M. , Presti Joseph C. , Aronson William J. , Terris Martha K. , Kane Christopher J. , Amling Christopher L. , Freedland Stephen J.
Published: November 2009

Study Type – Prognosis (inception cohort) Level of Evidence 1b

OBJECTIVES

To define a level of persistently elevated prostate‐specific antigen (PSA) after radical prostatectomy (RP) that equates with high‐risk for disease progression, and to identify preoperative predictors of PSA persistence among men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database.

PATIENTS AND METHODS

A total of 901 men treated with RP between 2001 and 2008 were separated into groups based upon PSA nadir within 6 months after RP. We explored the association between nadir groups and time to biochemical recurrence (BCR) using multivariate Cox proportional hazards and determined the preoperative predictors of PSA persistence using logistic regression.

RESULTS

Relative to men with undetectable PSA levels, those with a PSA nadir of 0.03 (hazard ratio [HR] 3.88, P < 0.001), 0.04 (HR 4.87, P < 0.001), 0.05–0.09 (HR 12.69, P < 0.001), 0.1–0.19 (HR 13.17, P < 0.001), and 0.2 ng/mL (HR 13.23, P < 0.001) were at increased risk of BCR while men with a nadir of 0.01 (HR 1.36, P = 0.400) and 0.02 (HR 1.64, P = 0.180) were not. Using the PSA persistence definition of a PSA nadir ≥0.03 ng/mL, 230 men (26%) had persistence. The independent preoperative predictors of PSA persistence were higher body mass index (BMI, P = 0.002), pathological Gleason score (relative to 2–6: 4 + 3–10, P = 0.001) and preoperative PSA level (P < 0.001).

CONCLUSIONS

Men with a PSA nadir ≥0.03 ng/mL after RP were at higher risk for BCR. Using a PSA persistence definition of a PSA nadir ≥0.03 ng/mL, persistence was predicted by known factors associated with aggressive disease (tumour grade, PSA level and BMI). Validation of the present definition in different populations using later end‐points remains necessary to assess its prognostic usefulness.