bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene Expression Profile of the Hypothalamus in DNP‐KLH Immunized Mice Following Electroacupuncture Stimulation
Authors: Kim Sun Kwang , Kim Jeungshin , Ko Eunjung , Kim Hyunseong , Hwang Deok-Sang , Lee Sanghoon , Baek Yonghyeon , Min Byung-Il , Nam Sangsoo , Bae Hyunsu
Published: February 2010

Clinical evidence indicates that electroacupuncture (EA) is effective for allergic disorder. Recent animal studies have shown that EA treatment reduces levels of IgE and Th2 cytokines in BALB/c mice immunized with 2,4‐dinitrophenylated keyhole limpet protein (DNP‐KLH). The hypothalamus, a brain center of the neural‐immune system, is known to be activated by EA stimulation. This study was performed to identify and characterize the differentially expressed genes in the hypothalamus of DNP‐KLH immunized mice that were stimulated with EA or only restrained. To this aim, we conducted a microarray analysis to evaluate the global gene expression profiles, using the hypothalamic RNA samples taken from three groups of mice: (i) normal control group (no treatments); (ii) IMH group (DNP‐KLH immunization + restraint); and (iii) IMEA group (immunization + EA stimulation). The microarray analysis revealed that total 39 genes were altered in their expression levels by EA treatment. Ten genes, including T‐cell receptor alpha variable region family 13 subfamily 1 (Tcra‐V13.1), heat shock protein 1B (Hspa1b) and 2′–5′ oligoadenylate synthetase 1F (Oas1f), were up‐regulated in the IMEA group when compared with the IMH group. In contrast, 29 genes, including decay accelerating factor 2 (Daf2), NAD(P)H dehydrogenase, quinone 1 (Nqo1) and programmed cell death 1 ligand 2 (Pdcd1lg2) were down‐regulated in the IMEA group as compared with the IMH group. These results suggest that EA treatment can modulate immune response in DNP‐KLH immunized mice by regulating expression levels of genes that are associated with innate immune, cellular defense and/or other kinds of immune system in the hypothalamus.
Streptomyces hyderabadensis sp. nov., an actinomycete isolated from soil
Authors: Reddy T. V. K. , Mahmood Shaik , Paris Laskaris , Reddy Y. Harish Kumar , Wellington E. M. H. , Idris M. Mohammed
Published: February 2010

A novel actinomycete, designated strain OU-40T, was isolated from farm soil collected from the Hyderabad region of Andhra Pradesh, southern India. The strain was found to have morphological and chemotaxonomic characteristics typical of species of the genusStreptomyces. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain OU-40Tbelonged to the genusStreptomyces, and was related most closely toStreptomyces pactumNBRC 13433T(99.0 % sequence similarity),Streptomyces olivaceusNBRC 12805T(99.0 %) andStreptomyces parvulusNBRC 13193T(98.8 %). Strain OU-40Tcould be distinguished from the type strains of its closest phylogenetic relatives based on levels of DNA–DNA relatedness and comparison of morphological and phenotypic data. It is therefore concluded that strain OU-40Trepresents a novel species of the genusStreptomyces, for which the nameStreptomyces hyderabadensissp. nov. is proposed. The type strain is OU-40T(=CCTCC AA 209024T=PCM 2692T).
Genotypic detection and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a regional hospital in central Taiwan
Authors: Lin Chin-Fu , Hsu Shih-Kuang , Chen Chao-Hsien , Huang Jr-Rung , Lo Hsueh-Hsia
Published: February 2010

This study was conducted to detect the genes encoding extended-spectrumβ-lactamases (ESBLs) and determine the epidemiological relatedness of 69Escherichia coliand 33Klebsiella pneumoniaeisolates collected from a regional hospital in central Taiwan, mostly from inpatients (E. coli87.0 %;K. pneumoniae88.0 %). The phenotypes of these isolates were examined according to the combination disc method recommended by the Clinical and Laboratory Standards Institute. Most of the ESBL-producingE. coliandK. pneumoniaeisolates (98.6 % and 97 %, respectively) could be detected using cefotaxime discs with and without clavulanate. Genotyping was performed by PCR with type-specific primers. CTX-M-14 type (53.6 %) was the most prevalent ESBL amongE. coliisolates while SHV type (57.6 %) was the most dominant amongK. pneumoniaeisolates. SixE. coliand threeK. pneumoniaeisolates did not carry genes encoding ESBLs of types TEM, SHV, CTX-M-3, CTX-M-14, CMY-2 and DHA-1. The co-existence of two or more kinds of ESBL in a single isolate was common, occurring in 40.6 % and 72.7 % ofE. coliandK. pneumoniaeisolates, respectively. PFGE analysis revealed that ESBL producers isolated in this setting were genetically divergent.
Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients
Authors: Mesquita Rafael T. , Ziegler Ângela P. , Hiramoto Roberto M. , Vidal Jose E. , Pereira-Chioccola Vera L.
Published: February 2010

Cerebral toxoplasmosis is the most common cerebral mass lesion in AIDS patients in Brazil, and results in high mortality and morbidity, despite free access to HAART (highly active antiretroviral treatment). Molecular diagnosis based on conventional PCR (cnPCR) or real-time quantitative PCR (qrtPCR) has been indispensable for definitive diagnosis. We report here the evaluation of qrtPCR with blood and cerebrospinal fluid (CSF) samples from AIDS patients in Brazil. This prospective study was conducted for 2 years, analysing DNA samples extracted from 149 AIDS patients (98 blood and 51 CSF samples) with confirmed clinical and radiological diagnosis. The laboratory diagnosis included cnPCR (with the B22/B23 primer set) and indirect immunofluorescence (IF). For qrtPCR, two primer sets were simultaneously designed based on described genes and using a 6-carboxyfluorescein dye-labelled TaqMan MGB (minor groove binder) probe. One was B1Tg, which amplified a sequence from the B1 gene. The other was the RETg, which amplified a PCR product of the 529 bp sequence. The overall cnPCR and qrtPCR results were: positive results were observed in 33.6 % (50) patients. The sensitivities were 98 % for cnPCR (B22/B23), and 86 and 98 % for qrtPCR (B1Tg and RETg, respectively). Negative reactions were observed in 66.4 % patients. The specificities were 97 % for cnPCR and qrtPCR (B1Tg), and 88.8 % for RETg. These data show that RETg PCR is highly sensitive as it amplifies a repeat region with many copies; however, its specificity is lower than the other markers. However, B1Tg PCR had good specificity, but lower sensitivity. Among the patients, 20 had blood and CSF collected simultaneously. Thus, their results permitted us to analyse and compare molecular, serological and clinical diagnosis for a better understanding of the different scenarios of laboratorial and clinical diagnosis. For nine patients with confirmed cerebral toxoplasmosis diagnosis, four scenarios were observed: (i) and (ii) negative molecular diagnosis for CSF and positive for blood with variable IF titres for the sera and CSF (negative or positive); (iii) positive molecular diagnosis with CSF and negative with blood; and (iv) positive molecular diagnosis in both samples. In the latter two situations, normally the IF titres in sera and CSF are variable. Other opportunistic infections were shown in 11 patients. Despite the IF titres in sera and CSF being variable, all of them had negative molecular diagnosis for both samples. qrtPCR allows for a rapid identification of Toxoplasma gondii DNA in patient samples; in a minority of cases discrepancies occur with the cnPCR.
The antimicrobial compound reuterin (3-hydroxypropionaldehyde) induces oxidative stress via interaction with thiol groups
Authors: Schaefer Laura , Auchtung Thomas A. , Hermans Karley E. , Whitehead Daniel , Borhan Babak , Britton Robert A.
Published: February 2010

Reuterin is an antimicrobial compound produced by Lactobacillus reuteri, and has been proposed to mediate, in part, the probiotic health benefits ascribed to this micro-organism. Despite 20 years of investigation, the mechanism of action by which reuterin exerts its antimicrobial effects has remained elusive. Here we provide evidence that reuterin induces oxidative stress in cells, most likely by modifying thiol groups in proteins and small molecules. Escherichia coli cells subjected to sublethal levels of reuterin expressed a set of genes that overlapped with the set of genes composing the OxyR regulon, which senses and responds to various forms of oxidative stress. E. coli cells mutated for oxyR were more sensitive to reuterin compared with wild-type cells, further supporting a role for reuterin in exerting oxidative stress. The addition of cysteine to E. coli or Clostridium difficile growth media prior to exposure to reuterin suppressed the antimicrobial effect of reuterin on these bacteria. Interestingly, interaction with E. coli stimulated reuterin production or secretion by L. reuteri, indicating that contact with other microbes in the gut increases reuterin output. Thus, reuterin inhibits bacterial growth by modifying thiol groups, which indicates that reuterin negatively affects a large number of cellular targets.
Novel insertion and deletion mutants of RpoB that render Mycobacterium smegmatis RNA polymerase resistant to rifampicin-mediated inhibition of transcription
Authors: Malshetty Vidyasagar , Kurthkoti Krishna , China Arnab , Mallick Bratati , Yamunadevi Subburaj , Sang Pau Biak , Srinivasan Narayanaswamy , Nagaraja Valakunja , Varshney Umesh
Published: February 2010

The startling increase in the occurrence of rifampicin (Rif) resistance in the clinical isolates ofMycobacterium tuberculosisworldwide is posing a serious concern to tuberculosis management. The majority of Rif resistance in bacteria arises from mutations in the RpoB subunit of the RNA polymerase. We isolatedM. smegmatisstrains harbouring either an insertion (6 aa) or a deletion (10 aa) in their RpoB proteins. Although these strains showed a compromised fitness for growth in 7H9 Middlebrook medium, their resistance to Rif was remarkably high. The attenuated growth of the strains correlated with decreased specific activities of the RNA polymerases from the mutants. While the RNA polymerases from the parent or a mutant strain (harbouring a frequently occurring mutation, H442Y, in RpoB) were susceptible to Rif-mediated inhibition of transcription from calf thymus DNA, those from the insertion and deletion mutants were essentially refractory to such inhibition. Three-dimensional structure modelling revealed that the RpoB amino acids that interact with Rif are either deleted or unable to interact with Rif due to their unsuitable spatial positioning in these mutants. We discuss possible uses of the RpoB mutants in studying transcriptional regulation in mycobacteria and as potential targets for drug design.
The effect of rituximab on humoral and cell mediated immunity and infection in the treatment of autoimmune diseases
Authors: Cooper Nichola , Arnold Donald M.
Published: February 2010

Depletion of B lymphocytes using the anti‐CD20 monoclonal antibody rituximab has wide‐spread use in the treatment of patients with autoimmune disorders. As haematopoietic progenitor cells and only a fraction of differentiated plasma express CD20, the effect of rituximab on immune function appears to be minimal. However, hypogammagobulinaemia can occur with repeated doses and emerging data from large studies suggest a subtle increase in the risk of infection. Reactivation of latent JC virus, resulting in progressive multifocal leucoencephalopathy, and hepatitis B virus, resulting in hepatoxicity, have been documented in patients receiving rituximab; although confounding effects of concomitant immunosuppressive therapies and immune dysregulation due to the underlying disease make causal associations of infections problematic. This review discusses the efficacy of B cell depletion therapy in the treatment of autoimmune diseases, the effect of B cell depletion on infection and immunity including the role of the B cell in autoimmunity, and identifies areas of controversy.
Competence of Polish primary‐care doctors in the pharmacological treatment of hypertension
Authors: Windak Adam , Gryglewska Barbara , Tomasik Tomasz , Narkiewicz Krzysztof , John Yaphe , Grodzicki Tomasz
Published: February 2010

Rationale, aims and objectives  Compliance with treatment guidelines for hypertension is variable. This study assessed the competence of Polish general practitioners in compliance with hypertension treatment guidelines, and doctor and patient characteristics associated with compliance.

Methods  The study was conducted on a random sample of Polish primary‐care doctors working in clinics contracted by the national health insurance funds. Doctors completed a questionnaire consisting of eight case vignettes describing patients with elevated blood pressure. The cases differed on three variables relating to the level of blood pressure, the presence or absence of diabetes mellitus, and the presence or absence of other risk factors. Doctors were asked to give their treatment decision for each case. Demographic data and details of the doctor's practice were also collected. Treatment decisions were tabulated, and associations between doctor and patient characteristics and treatments were assessed.

Results  One hundred twenty‐five doctors (65% response rate) completed the questionnaire. Compliance with treatment guidelines was judged to be 51%. Poor compliance with guidelines was noted for patients with diabetes mellitus. The level of blood pressure was the strongest predictor of drug treatment. Angiotensin‐converting enzyme inhibitors were the most frequently prescribed medications. Appropriate decisions were associated with practice in large cities.

Conclusions  Compliance with hypertension treatment guidelines was judged to be poor in this study of a sample of Polish primary‐care doctors using case vignettes to test competence. Additional emphasis on hypertension guidelines in training doctors is needed, especially for diabetic patients and for doctors outside urban centres.
Key interventions and outcomes in joint arthroplasty clinical pathways: a systematic review
Authors: Van Herck Pieter , Vanhaecht Kris , Deneckere Svin , Bellemans Johan , Panella Massimiliano , Barbieri Antonietta , Sermeus Walter
Published: February 2010

Rationale, aims and objectives  Clinical pathways are globally used to improve quality and efficiency of care. Total joint arthroplasty patients are one of the primary target groups for clinical pathway development. Despite the worldwide use of clinical pathways, it is unclear which key interventions multidisciplinary teams select as pathway components, which outcomes they measures and what the effect of this complex intervention is. This literature study is aimed at three research questions: (1) What are the key interventions used in joint arthroplasty clinical pathways? (2) Which outcome measures are used? (3) What are the effects of a joint arthroplasty clinical pathway?

Method  Systematic literature review using a multiple reviewer approach. Five electronic databases were searched comprehensively. Reference lists were screened. Experts were consulted. After application of inclusion and exclusion criteria and critical appraisal, 34 of the 4055 publications were included.

Results  Joint arthroplasty clinical pathways address pre‐admission education, pre‐admission exercises, pre‐admission assessment and testing, admission and surgical procedure, postoperative rehabilitation, minimal manipulation, symptoms management, thrombosis prophylaxis, discharge management, primary caregiver involvement, home‐based physiotherapy and continuous follow‐up. An overview of target dimensions and corresponding indicators is provided. Clinical pathways for joint arthroplasty could improve process and financial outcomes. The effects on clinical outcome are mixed. Evidence on team and service outcome is lacking.

Conclusions  A set of key interventions and outcome measures is available to support joint arthroplasty clinical pathways. Team and service outcomes should be further addressed in practice and research. Meta‐analysis on the outcome indicators should be performed. Future studies should more rigorously comply with existing reporting standards.
Errors in completion of referrals among older urban adults in ambulatory care
Authors: Weiner Michael , Perkins Anthony J. , Callahan Christopher M.
Published: February 2010

Rationale, aims and objectives  Clinical care often requires referrals, but many referrals never result in completed evaluations. We determined the extent to which referral‐based consultations were completed in a US medical institution. Factors associated with completion were identified.

Method  In a cross‐sectional analysis, we analysed billing records and electronic and paper‐based medical records for patients aged 65 years or older receiving health care between July 2000 and June 2002 in an integrated, urban, tax‐supported medical institution on an academic campus. All referrals in ambulatory care, scheduling of consultation within 180 days, and completion were assessed. We conducted a multivariate survival analysis to identify factors associated with completion.

Results  We identified 6785 patients with encounters. Mean age was 72 years, and, of the participants, 66% were women, 55% were African‐American and 32% were Medicaid eligible. Of the 81% with at least one primary‐care visit in ambulatory care, 63% had at least one referral. About 8% of referrals required multiple orders before an appointment was scheduled. Among 7819 orders for specialty consultation in ambulatory care, 71% led to appointments, and 70% of appointments were kept (completed = 0.71*0.70 or 50%). Scheduling of consultations varied (12% to 90%) by specialty. Medicare, singular orders, location of referral and lack of hospitalization were independently significantly associated with scheduling of appointments.

Conclusions  Among older adults studied, half of medical specialty referrals were not completed. Multiple process errors, including missing information, misguided referrals and faulty communications, likely contribute to these results. Information systems offer important opportunities to improve the referrals process.
The impact of record‐linkage bias in the Cox model
Authors: Baldi Ileana , Ponti Antonio , Zanetti Roberto , Ciccone Giovannino , Merletti Franco , Gregori Dario
Published: February 2010

Rationale, aims and objectives Record linkage (RL) has become increasingly useful in health care administration, demographic studies, provision of health statistics and medical research. Linkage failure may occur when databases are affected by missing or inaccurate information. In particular, if the subsets of those who are not linked are not representative of the original population, the results obtained from linked data may be biased. This paper discusses the impact of incomplete RL on survival analysis.

Methods In our study we assess by simulations the potential impact of such bias, that we will refer to as RL, on the effect of the covariates in the Cox regression model. We also evaluate the RL bias introduced by an incomplete linkage procedure on the analysis of survival in a cohort of patients with breast cancer.

Results Our simulation study shows that the relative bias of the factors, which the linking probability depends on, reaches the threshold of 20%, and is never less than 5%. The bias observed in the simulation for a comparable scenario is consistent with the actual one estimated from the breast cancer records.

Conclusions Incomplete RL is rarely explicitly taken into account in the models for survival analysis. This study indicates that such a practice is potentially leading to inefficient and biased results, in particular in presence of medium or small sample sizes.
Chaperone policy in accident and emergency departments: a national survey
Authors: Loizides Sofronis , Kallis Andreas , Oswal Ashwini , Georgiou Panayiotis , Kallis George , Gavalas Manolis
Published: February 2010

Background  Medico‐legal societies and the General Medical Council have been urging a greater use of chaperones during intimate examinations. However, research into the use of chaperones has been limited only to general practice. The objectives of this national survey were to find out: (1) whether formal chaperone policy exists in accident and emergency (A&E) departments; (2) the frequency of chaperone use; and (3) clinical applications.

Methods  A simple questionnaire was submitted to the lead clinicians/clinical directors of 460 A&E departments in the UK. The departments were identified through the British Association of Accident and Emergency Medicine Directory. The completed questionnaires were either posted or faxed back to our department.

Results  In total, 270 of 460 forms were returned (58.7%), of which only 246 were useable. Although 81.71% of A&E lead clinicians/clinical directors believe that formal policies are needed, only 3.65% of the departments have a formal policy. The highest percentage of chaperone use was observed for male doctors examining female patients (91.46%), while the lowest percentage was observed for male doctors examining male patients (7.32%). Worryingly, 25.61% reported incidents of complaints regarding inappropriate examination by doctors.

Conclusion  We have demonstrated deficiencies in chaperone use and have identified specific factors that render A&E departments particularly vulnerable to allegations of inappropriate practice. We believe that policies should be designed and implemented focusing on the specific needs of A&E departments to counteract the rising numbers of medico‐legal cases, thus safeguarding patient care and protecting the health providers.
Sensitivity of clinical assessments of sagittal head posture
Authors: Gadotti Inae Caroline , Biasotto‐Gonzalez Daniela Aparecida
Published: February 2010

Rationale, aims and objectives  Historically, clinicians visually evaluate posture using anatomical landmarks. Advances in technology made digital photographs now feasible to use in clinical practice. Photogrammetry may increase the reliability of the assessment of postural changes. However, differences between visually estimated and photogrammetric recorded changes in posture need to be tested. The objective of this study was to evaluate the sensitivity of visual assessments of changes in head posture in the sagittal plane in relation to photogrammetric recorded data.

Methods  The head posture of 29 female subjects in a sagittal plane was assessed visually and photogrammetrically. The visual assessment of head posture was conducted using a postural grid with a plumb for checking the alignment. The patients were classified as having forward head posture (FHP), slight FHP or no FHP. Photogrammetry of head posture was performed using the Alcimage software® (Alcimar B. Soares, Uberlândia, MG, Brasil). Three reference points were used to measure the head posture angle: mentus, external auditory meatus and manubrium. The visually classified groups were compared in relation to the photogrammetric angles using one‐way anova.

Results  A significant difference was found between the FHP and no FHP groups (P = 0.001), and between the FHP and slight FHP groups (P = 0.002). However, no significant difference was found between the slight FHP and no FHP groups.

Conclusions  Visual assessments of sagittal head posture were sensitive to detect differences between no FHP and FHP groups, but were not sensitive to detect differences between no FHP and slight FHP groups. Head posture photogrammetry is recommended to quantitatively detect less evident differences in head posture.
Using propensity score‐based weighting in the evaluation of health management programme effectiveness
Authors: Linden Ariel , Adams John L.
Published: February 2010

When the randomized controlled trial is unfeasible, programme evaluators attempt to emulate the randomization process in observational studies by creating a control group that is essentially equivalent to the treatment group on known characteristics and trust that the remaining unknown characteristics are inconsequential and will not bias the results. In recent years, adjustment procedures based on the propensity score, such as matching and subclassification, have become increasingly popular. A new technique that has particular appeal for evaluating health management programmes uses the propensity score to create a weight based on the subject's inverse probability of receiving treatment. This weighting mechanism removes imbalances of pre‐intervention characteristics between treated and non‐treated individuals, and is then used within a regression framework to provide unbiased estimates of treatment effects. This paper presents a non‐technical introduction of this technique by illustrating its implementation with data from a recent study estimating the impact of a motivational interviewing‐based health coaching on patient activation measure scores in a chronically ill group of individuals. Because of its relative simplicity and tremendous utility, propensity‐score weighting adjustment should be considered as an alternative procedure for use with observational data to evaluate health management programme effectiveness.
Motivational interviewing‐based health coaching as a chronic care intervention
Authors: Linden Ariel , Butterworth Susan W. , Prochaska James O.
Published: February 2010

Objective  To evaluate the impact of motivational interviewing‐based health coaching on a chronically ill group of participants compared with non‐participants. Specifically, measures that could be directly attributed to a health coaching intervention on chronic illness were assessed.

Design  Quasi‐experimental study design.

Setting  A large medical university in the north‐west United States.

Methods  One hundred and six chronically ill programme participants completed a health risk survey instrument prior to enrolment and again at approximately 8 months. Outcomes were compared with 230 chronically ill non‐participants who completed the survey twice over a similar time frame. Inverse probability of treatment weights were used in conjunction with the propensity score to correct for selection bias.

Results  Compared with non‐participants, programme participants improved their self‐efficacy (P = 0.01), patient activation (P = 0.02), lifestyle change score (P = 0.01) and perceived health status (P = 0.03). Fewer participants increased their stages of change risk over time than non‐participants (P < 0.01), and more participants decreased their stages of change risk over time than non‐participants (P = 0.03).

Conclusion  These results support motivational interviewing‐based health coaching as an effective chronic care management intervention in impacting outcome measures that could also serve well as a proxy in the absence of other clinical or cost indices.
A comparative epizootiologic study of the two fish‐pathogenic serovars of Vibrio vulnificus biotype 2
Authors: Fouz B , Llorens A , Valiente E , Amaro C
Published: February 2010

Vibrio vulnificus biotype 2 is subdivided into two main serovars, serovar E, able to infect fish and humans, and serovar A, only virulent for fish. Serovar E emerged in 1976 as the causative agent of a haemorrhagic septicaemia (warm‐water vibriosis) affecting eels cultured in brackish water. Serovar A emerged in 2000 in freshwater‐cultured eels vaccinated against serovar E, causing warm‐water vibriosis with fish showing a haemorrhagic intestine as the main differential sign. The aim of the present work was to compare the disease caused by both serovars in terms of transmission routes, portals of entry and host range. Results of bath, patch‐contact and oral‐anal challenges demonstrated that both serovars spread through water and infect healthy eels, serovar A entering mainly by the anus and serovar E by the gills. The course of the disease under laboratory conditions was similar for both serovars in terms of transmission and dependence of degree of virulence on water parameters (temperature and salinity). However, the decrease in degree of virulence in fresh water was significantly greater in serovar E than in serovar A. Finally, both serovars proved pathogenic for tilapia, sea bass and rainbow trout, but not for sea bream, with significant differences in degree of virulence only in rainbow trout. In conclusion, serovar A seems to represent a new antigenic form of V. vulnificus biotype 2 with an unusual portal of entry and is better adapted to fresh water than serovar E.
Dietary compliance and life style of children with coeliac disease
Authors: Roma E. , Roubani A. , Kolia E. , Panayiotou J. , Zellos A. , Syriopoulou V. P.
Published: February 2010

Background:  Coeliac disease (CD) is common and requires a permanent strict gluten‐free diet (GFD). However, data concerning how the situation is experienced by children are limited. The present study aimed to investigate the compliance with a GFD and the impact of CD and GFD on the lifestyle of patients and their families, together with proposed recommendations for improvement of quality of life.

Methods:  Children with biopsy confirmed CD were recruited consecutively from the outpatient gastroenterology clinic. Participants were evaluated by a special questionnaire for compliance with the GFD, patients’ knowledge about CD, and the well‐being and lifestyle of children and their families. Comparisons between discrete variables were performed by a chi‐square test.

Results:  Seventy‐three children of median age 9.4 (interquartile range = 5–14.5) years were evaluated. Compliance to diet was reported by 58%. Reasons for noncompliance were: poor palatability (32%), dining outside home (17%), poor availability of products (11%), and asymptomatic disease diagnosed by screening (11%). The acceptance of the GFD was reported as good in 65%, whereas avoidance of travelling and restaurants was stated by 17% and 46% of families, respectively. Most families experienced difficulties detecting gluten from the food label. Proposed factors for improvement of quality of life were: better labelling of gluten‐containing ingredients (76%) and more gluten‐free (GF) foods in supermarkets (58%) and restaurants (42%).

Conclusions:  Children with CD have low compliance with the GFD. Better education about the disease, the availability of GF products, and appropriate food labelling could improve compliance and quality of life.
Expression of (Pro)renin Receptor in the Human Brain and Pituitary, and Co‐localisation with Arginine Vasopressin and Oxytocin in the Hypothalamus
Authors: Takahashi K. , Hiraishi K. , Hirose T. , Kato I. , Yamamoto H. , Shoji I. , Shibasaki A. , Kaneko K . , Satoh F. , Totsune K.
Published: February 2010

(Pro)renin receptor [(P)RR], a specific receptor for renin and prorenin, is a 350 amino acid protein with a single transmembrane domain. In the present study, the expression of (P)RR in the human brain and pituitary, and its co‐localisation with arginine vasopressin and oxytocin in the human hypothalamus were studied by quantitative reverse transcriptase polymerase chain reaction (RT‐PCR) and immunocytochemistry. Human brain and pituitary tissues were obtained at autopsy from the subjects without neurological or endocrinological disorders. The antiserum against (P)RR was raised in a rabbit by injecting the peptide fragment of human (P)RR corresponding to 224–237 amino acids conjugated with bovine serum albumin. Quantitative RT‐PCR showed that (P)RR mRNA was widely expressed in every region of brain examined and pituitary, with the highest expression levels found in the pituitary and frontal lobe. Immunocytochemistry showed that (P)RR was expressed in the paraventricular and supraoptic nuclei of human hypothalami, and in anterior pituitary cells. Immunostaining of serial sections showed that (P)RR was co‐localised with arginine vasopressin and oxytocin in the magnocellular neurones of the paraventricular and supraoptic nuclei. The preabsorption of the antibody by the antigen peptide abolished the immunostaining of (P)RR in the human hypothalamus. The present study has shown that (P)RR mRNA is widely expressed in the human brain and pituitary, consistent with the hypothesis that (P)RR is related to the various brain functions, such as cognitive function and brain development. Co‐localisation of (P)RR with vasopressin in the hypothalamus raised the possibility that (P)RR may be related to the central control of water–electrolyte metabolism and blood pressure.
Differential Response of Southern US Rice (Oryza sativa L.) Cultivars to Ultraviolet‐B Radiation
Authors: Mohammed A. R. , Tarpley L.
Published: February 2010

Elevated ultraviolet‐B (UV‐B; between 290 and 320 nm) radiation, because of depletion of the stratospheric ozone layer, is one of the major environmental factors influencing plant metabolic processes and yield. The southern US rice cultivars contribute greatly towards US rice production, but the effects of elevated UV‐B radiation on these cultivars are not well known. The objective of this study was to determine the effects of elevated UV‐B radiation on leaf photosynthetic rate (Pn), membrane stability, pollen viability, phenolic concentration and yield of eight commercially popular southern US rice cultivars (five inbred cultivars and three hybrids). Plants were grown in a temperature‐controlled greenhouse in Beaumont, TX, USA, and were exposed to UV‐B radiation of 0, 8 or 16 kJ m−2 day−1 for 90 days. For most of the cultivars, plants grown under 8 or 16 kJ UV‐B radiation showed significant decreases in Pn, membrane stability, pollen viability, and yield compared with the plants grown under an UV‐B‐free environment, whereas there was a significant increase in leaf phenolic concentration under 16 kJ UV‐B radiation. The hybrid ‘Clearfield XL729’ performed best among the selected southern US rice cultivars under 16 kJ UV‐B radiation.
Capsule endoscopy in small bowel tumors: A multicenter Korean study
Authors: Cheung Dae Young , Lee In‐Seok , Chang Dong Kyung , Kim Jin Oh , Cheon Jae Hee , Jang Byung Ik , Kim Yong‐Sik , Park Cheol Hee , Lee Kwang Jae , Shim Ki‐Nam , Ryu Ji‐Kon , Do Jae‐Hyuk , Moon Jeong‐Seop , Ye Byong Duk , Kim Kyung‐Jo , Lim Yun Jeong , Choi Myung‐Gyu , Chun Hoon‐Jai
Published: February 2010

Background and Aim:  Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions in a variety of clinical conditions, but studies concerning the practical impact of CE on small bowel tumors are still scarce, especially in the Asian population. The aim of this study was to evaluate the diagnostic and therapeutic impact of CE in the field of small bowel tumors.

Methods:  CE records consecutively pooled from the beginning of use of CE in Korea, October 2001 until April 2008, in 14 centers throughout Korea were reviewed. Clinical information and CE video images of small bowel tumors were analyzed.

Results:  A total of 1332 cases undergoing CE were reviewed with all clinical indications. Small bowel tumors were diagnosed with CE in 57 (4.3%) of 1332 patients. The tumors were malignant in 33 cases, and included three adenocarcinomas, eight lymphomas, 20 gastrointestinal stromal tumors, and two metastatic cancers. The most frequent indications for CE in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were identified exclusively by CE (diagnostic impact = 30/57), and they were smaller in size (mean, range: 14.3 mm, 2–35 mm) compared to the other tumors detected in radiological studies (48.7 mm, 10–110 mm). Seven patients underwent surgical resection (therapeutic impact = 7/57).

Conclusion:  CE effectively identifies small bowel tumors that are undetectable by conventional radiological studies (diagnostic impact = 52.6%) and can critically change the therapeutic course (therapeutic impact = 12.3%).
Phylogenetic diversity and metagenomics of candidate division OP3
Authors: Glöckner Jana , Kube Michael , Shrestha Pravin Malla , Weber Marc , Glöckner Frank Oliver , Reinhardt Richard , Liesack Werner
Published: February 2010

Except for environmental 16S rRNA gene sequences, no information is available for members of the candidate division OP3. These bacteria appear to thrive in anoxic environments, such as marine sediments, hypersaline deep sea, freshwater lakes, aquifers, flooded paddy soils and methanogenic bioreactors. The 16S rRNA phylogeny suggests that OP3 belongs to the Planctomycetes/Verrucomicrobia/Chlamydiae (PVC) superphylum. Metagenomic fosmid libraries were constructed from flooded paddy soil and screened for 16S rRNA gene‐containing fragments affiliated with the PVC superphylum. The screening of 63 000 clones resulted in 23 assay‐positive fosmids, of which three clones were affiliated with OP3. The 16S rRNA gene sequence divergence between the fragments OP3/1, OP3/2 and OP3/3 ranges from 18% to 25%, indicating that they belong to different OP3 subdivisions. The 23S rRNA phylogeny confirmed the membership of OP3 in the PVC superphylum. Sequencing the OP3 fragments resulted in a total of 105 kb of genomic information and 90 ORFs, of which 47 could be assigned a putative function and 11 were conserved hypothetical. Using BLASTP searches, a high proportion of ORFs had best matches to homologues from Deltaproteobacteria, rather than to those of members of the PVC superphylum. On the fragment OP3/3, a cluster of nine ORFs was predicted to encode the bacterial NADH dehydrogenase I. Given the high proportion of homologues present in deltaproteobacteria and anoxic conditions in the natural environment of OP3 bacteria, the detection of NADH dehydrogenase I may suggest an anaerobic respiration mode. Oligonucleotide frequencies calculated for OP3/1, OP3/2 and OP/3 show high intraphylum correlations. This novel sequence information could therefore be used to identify OP3‐related fragments in large metagenomic data sets using marker gene‐independent procedures in the future. In addition to the OP3 fragments, a single metagenomic fragment affiliated with the candidate division BRC1 was obtained and analysed.
Questioning the wisdom of tubeless percutaneous nephrolithotomy (PCNL): a prospective randomized controlled study of early tube removal vs tubeless PCNL
Authors: Mishra Shashikant , Sabnis Ravindra B. , Kurien Abraham , Ganpule Arvind , Muthu Veeramani , Desai Mahesh
Published: February 2010

Study Type – Therapy (RCT) Level of Evidence 1b

OBJECTIVE

To establish the efficacy of early removal of a nephrostomy tube after percutaneous nephrolithotomy (PCNL), to challenge

the wisdom of tubeless PCNL, as we hypothesized that it would result in a shorter hospital stay, comparable benefit and safety, while maintaining the option of check nephroscopy ensuring far superior stone clearance.

PATIENTS AND METHODS

In all, 22 patients were prospectively randomized equally into two groups, group 1 (early nephrostomy removal) or group 2 (tubeless) during a 1‐month study period. Inclusion criteria for the study were: a simple stone of <3 cm, no significant bleeding, no perforation, single‐tract access and ‘on‐table’ complete stone clearance. In group 1, a 20 F nephrostomy, 6 F retrograde ureteric catheter and a Foley catheter were used, while in group 2 only a 6 F retrograde ureteric catheter and Foley catheter were placed at the end of the procedure. Computed tomography (CT) with no contrast medium was done on the first morning after surgery before removing all catheters/tubes, and patients discharged subsequently. The variables assessed were stone clearance, hospital stay, analgesic requirement, postoperative complications and auxiliary procedures.

RESULTS

The mean (sd) stone bulk was similar between the groups, at 2737 (946.9) and 2934.2 (2090.7) µL, respectively. Despite an on‐table complete clearance, clearance assessed by CT was nine of 11 vs eight of 11 in groups 1 and 2, respectively. CT showed a 6 mm stone in one patient in group 1, while the remaining patients had stones of <4 mm. The mean (sd) analgesic requirement, haemoglobin decrease, urine leak and hospital stay in the two groups were 72.7 (51.8) vs 68.2 (46.2) mg of tramadol (P= 0.25), 1.6 (0.7) vs 1.6 (0.9) g/dL (P= 0.39), 13.9 (6.3) vs 7.1 (14.2) h (P= 0.018) and 72.8 (2.1) vs 70.2 (18.5) h (P= 0.09), respectively. Complications noted were early haematuria in none vs three (P= 0.21), urinoma none vs one, and fever in two vs one, respectively; one patient in group 1 required a check nephroscopy for a residual fragment. Overall clearance including re‐treatment was 10/11 vs eight of 11 (P= 0.009), respectively.

CONCLUSION

Early tube removal after PCNL results in an equivalent analgesic requirement, decrease in haemoglobin and hospital stay as tubeless PCNL. It has a significantly lower incidence of early haematuria, better clearance rates and preserves the option of check nephroscopy. It can be considered as an accepted standard of care, with the preserved advantages of tubeless PCNL.
The Contribution of Women on Boards of Directors: Going beyond the Surface
Authors: Nielsen Sabina , Huse Morten
Published: February 2010

Manuscript Type:Empirical

Research Question/Issue:The increased attention to women on corporate boards presents new challenges to governance research. In this paper we go beyond demography and open the “black box” of board behavior by drawing upon theories of gender differences and group effectiveness.

Research Findings/Insights:A unique survey of 201 Norwegian firms is used. The findings suggest that the ratio of women directors is positively associated with board strategic control. In addition, we find that the positive effects of women directors on board effectiveness are mediated through increased board development activities and through decreased level of conflict. However, our results show no evidence for a positive association between women directors and open debate. Nonetheless, open debate enhances board's strategic and operational control.

Theoretical/Academic Implications:Recognizing the limitations of traditional governance theories to explain the role and contributions of women on corporate boards, this paper draws upon group effectiveness and gender differences theories to shed some light on whether and how women make a difference to board effectiveness in strategic and operational control.

Practitioner/Policy Implications:Women's ability to make a contribution to the board may be attributable to their different leadership styles. The presence of women on corporate boards seems to increase board effectiveness through reducing the level of conflict and ensuring high quality of board development activities.
The (non) use of prioritisation protocols by surgeons
Authors: Dew Kevin , Stubbe Maria , Macdonald Lindsay , Dowell Anthony , Plumridge Elizabeth
Published: February 2010

Priority setting and rationing is a dominant feature of contemporary health policy. In New Zealand, clinical priority assessment criteria (CPAC) tools have been developed to make access to elective surgery more equitable and efficient. Research was undertaken to identify how surgeons used these tools in the consultation. Forty‐seven consultations with 15 different surgeons have to date been video‐ and audio‐recorded. There were no instances where CPAC tools were explicitly used in the consultation. Drawing on the methodology of conversation analysis and the concept of news delivery as developed by Maynard, this paper argues that the delivery of diagnoses and treatment plans can usefully be seen in part as the delivery of bad or good news. Using three case studies to illustrate the argument, it is suggested that the interactional work required in the delivery of such news challenges the ability of clinicians to use protocols such as CPAC. The analysis sheds light on important consultation processes that need to be more carefully considered when designing interventions to influence clinician behaviour. In order to influence the behaviour of clinicians to achieve policy goals, greater attention needs to be paid to the interactional demands of the consultation process.
The Magnitude and Extent of Cheating and Response Distortion Effects on Unproctored Internet‐Based Tests of Cognitive Ability and Personality
Authors: Arthur Winfred , Glaze Ryan M. , Villado Anton J. , Taylor Jason E.
Published: February 2010

The use of unproctored internet‐based testing (UIT) for employee selection is quite widespread. Although this mode of testing has advantages over onsite testing, researchers and practitioners continue to be concerned about potential malfeasance (e.g., cheating and response distortion) under high‐stakes conditions. Therefore, the primary objective of the present study was to investigate the magnitude and extent of high‐ and low‐stakes retest effects on the scores of a UIT speeded cognitive ability test and two UIT personality measures. These data permitted inferences about the magnitude and extent of malfeasant responding. The study objectives were accomplished by implementing two within‐subjects design studies (Study 1N=296; Study 2N=318) in which test takers first completed the tests as job applicants (high‐stakes) or incumbents (low‐stakes) then as research participants (low‐stakes). For the speeded cognitive ability measure, the pattern of test score differences was more consonant with a psychometric practice effect than a malfeasance explanation. This result is likely due to the speeded nature of the test. And for the UIT personality measures, the pattern of higher high‐stakes scores compared with lower low‐stakes scores is similar to those reported for proctored tests in the extant literature. Thus, our results indicate that the use of a UIT administration does not uniquely threaten personality measures in terms of elevated scores under high‐stakes testing that are higher than those observed for proctored tests in the extant literature.
What do People Want from their Jobs? The Big Five, core self‐evaluations and work motivation
Authors: Bipp Tanja
Published: February 2010

If people are differentially motivated on the basis of individual differences, this implies important practical consequences with respect to staffing decisions and the selection of the right motivational techniques for managers. In two different samples (students facing graduation vs full‐time employees), the relationships between personality traits and the preference for job characteristics concerning either extrinsic (job environment) or intrinsic job features (work itself) were investigated. Two personality traits [openness to experience and core self‐evaluations (CSE)] were consistently found to be positively related to the preference concerning work characteristics, and CSE showed incremental validity with regard to intrinsic work motivation factors (e.g., experienced meaningfulness, autonomy). Furthermore, age was differentially linked to those job characteristics. The results are discussed with regards to the optimal Person–Job Fit and the practical utility of the personality constructs.
Does Image Matter to Different Job Applicants? The influences of corporate image and applicant individual differences on organizational attractiveness
Authors: Tsai Wei‐Chi , Yang Irene Wen‐Fen
Published: February 2010

This research examined both the effects of various corporate image dimensions on organizational attractiveness and the moderating effects of applicant individual difference variables on the aforementioned relationships. Two studies were conducted for this research, which involved 40 bank samples and 360 student participants (Study 1) and 538 employee–student mixed samples (Study 2). By implementing different research designs, samples, and industry targets in the two studies, we found that corporate product image, corporate citizenship image, and corporate credibility image were important antecedents to organizational attractiveness. One of the proposed applicant individual difference variables, environmental sensitivity, was found to moderate the relationship between corporate citizenship image and organizational attractiveness.