bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated BIS and Entropy values after sugammadex or neostigmine: an electroencephalographic or electromyographic phenomenon?
Authors: AHO A. J. , KAMATA K. , YLI‐HANKALA A. , LYYTIKÄINEN L.‐P. , KULKAS A. , JÄNTTI V.
Published: January 2012

Background

Sugammadex is designed to antagonize neuromuscular blockade (NMB) induced by rocuronium or vecuronium. In clinical practice, we have noticed a rise in the numerical values of bispectral index (BIS) and Entropy, two electroencephalogram (EEG) – based depth of anesthesia monitors, during the reversal of the NMB with sugammadex. The aim of this prospective, randomized, double‐blind study was to test this impression and to compare the effects of sugammadex and neostigmine on the BIS and Entropy values during the reversal of the NMB.

Methods

Thirty patients undergoing gynecological operations were studied. Patients were anesthetized with target‐controlled infusions of propofol and remifentanil, and rocuronium was used to induce NMB. After operation, during light propofol‐remifentanil anesthesia, NMB was antagonized with sugammadex or neostigmine. During the following 5 min, the numerical values of BIS, BIS electromyographic (BIS EMG) and Entropy were recorded on a laptop computer, as well as the biosignal recorded by the Entropy strip. The Entropy biosignal was studied off‐line both in time and frequency domain to see if NMB reversal causes changes in EEG.

Results

In some patients, administration of sugammadex or neostigmine caused a significant rise in the numerical values of BIS, BIS EMG and Entropy. This phenomenon was most likely caused by increased electromyographic (EMG) activity. The administration of sugammadex or neostigmine appeared to have only minimal effect on EEG.

Conclusion

The EMG contamination of EEG causes BIS and Entropy values to rise during reversal of rocuronium‐induced NMB in light propofol‐remifentanil anesthesia.
Nutrient and metal analyses of Chinese herbal products marketed for veterinary use
Authors: Shmalberg J. , Hill R. C. , Scott K. C.
Published: January 2012

Many Chinese herbs and herbal mixtures are fed to domestic animals for their reputed medicinal properties. These herbs could contribute to the intake of essential nutrients and toxic metals, but their composition is mostly unknown. The purpose of this study was to measure major nutrient (crude protein, crude fat, carbohydrate, fibre) and mineral (Ca, P, Mg, K, Na, Fe, Zn, Cu, Mn, Mo, S, Al, Cd, Ni, Pb) concentrations in samples of fourteen combination formulas labelled for veterinary use and commonly administered to horses and dogs. Three single herbs, Bupleurum chinense, Curcuma zedoaria and Astragalus membranaceus, each obtained from several sources, and Yunnan Baiyao, a proprietary hemostatic mixture, were also analysed. Proximate analyses and some mineral concentrations differed (p < 0.05) among single herbs, and high concentrations of several minerals were detected in some herbal combinations. Those containing the highest concentrations [g/kg dry matter (DM)] of calcium (92.4), iron (2.6) and manganese (0.28) could provide >38%, 142% and 96%, respectively, of recommended allowances in adult dogs, and >13%, 122% and 2%, respectively, of maintenance requirements in horses, at the maximum labelled dose assuming complete availability. Concentrations of cadmium, nickel and lead were below published oral tolerance levels. Aluminium concentrations (median 380, maximum 920 mg/kg DM) were higher than has been previously reported in Chinese herbs. These nutrient analyses suggest that herbal combinations marketed to veterinarians, when fed at the maximal labelled dose, are unlikely to produce clinically relevant changes in the dietary intake of essential nutrients. However, small amounts of non‐essential contaminant minerals are present in some formulas, and further research is necessary to understand the significance of this finding.
Oxidative stress, anti‐oxidant therapies and chronic kidney disease
Authors: SMALL DAVID M , COOMBES JEFF S , BENNETT NIGEL , JOHNSON DAVID W , GOBE GLENDA C
Published: January 2012

Chronic kidney disease (CKD) is a common and serious problem that adversely affects human health, limits longevity and increases costs to health‐care systems worldwide. Its increasing incidence cannot be fully explained by traditional risk factors. Oxidative stress is prevalent in CKD patients and is considered to be an important pathogenic mechanism. Oxidative stress develops from an imbalance between free radical production often increased through dysfunctional mitochondria formed with increasing age, type 2 diabetes mellitus, inflammation, and reduced anti‐oxidant defences. Perturbations in cellular oxidant handling influence downstream cellular signalling and, in the kidney, promote renal cell apoptosis and senescence, decreased regenerative ability of cells, and fibrosis. These factors have a stochastic deleterious effect on kidney function. The majority of studies investigating anti‐oxidant treatments in CKD patients show a reduction in oxidative stress and many show improved renal function. Despite heterogeneity in the oxidative stress levels in the CKD population, there has been little effort to measure patient oxidative stress levels before the use of any anti‐oxidants therapies to optimize outcome. This review describes the development of oxidative stress, how it can be measured, the involvement of mitochondrial dysfunction and the molecular pathways that are altered, the role of oxidative stress in CKD pathogenesis and an update on the amelioration of CKD using anti‐oxidant therapies.
Encapsulated papillary thyroid carcinoma, follicular variant: A misnomer
Authors: Kakudo Kennichi , Bai Yanhua , Liu Zhiyan , Ozaki Takashi
Published: January 2012

Papillary thyroid carcinoma (PTC) has long been diagnosed based on its unique nuclear features (PTC‐N); however, significant observer discrepancies have been reported in the diagnosis of encapsulated follicular patterned lesions (EnFPLs), because the threshold of PTC‐N is subjective. An equivocal PTC‐N may often occur in non‐invasive EnFPLs and benign/malignant disagreements often create serious problems for patients' treatment. This review collects recent publications focusing on the so‐called encapsulated follicular variant of papillary thyroid carcinoma (EnFVPTC) and tries to emphasize problems in the histopathological diagnosis of this spectrum of tumors, which covers encapsulated common‐type PTC (EncPTC), EnFVPTC, well‐differentiated tumor of uncertain malignant potential (WDT‐UMP), follicular adenoma (FA) with equivocal PTC‐N and minimally invasive follicular carcinoma (mFTC). We propose that EnFVPTC and other EnFPLs with equivocal PTC‐N should be classified into a unified category of borderline malignancy, such as well‐differentiated tumor of uncertain behavior (WDT‐UB), based on their homogeneous excellent outcome. It is suggested that the unified nomenclature of these lesions may be helpful to reduce significant observer disagreements in diagnosis, because complete agreement in the diagnosis of an EncPTC, EnFVPTC or FA by all pathologists may be not possible for this problematic group of tumors. In conclusion, a malignant diagnosis of EnFVPTC should not be used to cover this spectrum of tumors until uncertainty about the nature of this lesion is settled, whether it is benign, precancerous or malignant.
Global histone modification pattern associated with recurrence and disease‐free survival in non‐small cell lung cancer patients
Authors: Song Joon Seon , Kim Yong Seok , Kim Dong Kwan , Park Sung il , Jang Se Jin
Published: January 2012

Global histone modification patterns are presumed to establish epigenetic patterns of gene expression and determine the biology of the cell. In the present study, the global modification status of histone H3 and H4 was evaluated in 408 non‐small cell lung cancer (NSCLC) tissues by immunostaining. NSCLC showed variable staining scores for each antibody. Clinicopathological analyses demonstrated a positive correlation between weak nuclear staining for H3K9Ac (P < 0.001), H3K9TriMe (P= 0.001), H4K16Ac (P < 0.001) and tumor recurrence except H4K20 TriMe (P= 0.201). Staining scores of four different antibodies were not correlated with other clinicopathologic variables. Patients were further clustered according to histone modification patterns: acetylation dominant, methylation dominant, co‐dominant and modification‐negative. The acetylation‐dominant group (P= 0.009) and co‐dominant group exhibited less frequent lymph node metastasis (P= 0.050), recurrence (P= 0.002) and distant metastasis (P= 0.010). The acetylation‐dominant group showed better prognosis in survival analysis (P < 0.001, log‐rank), whereas methylation‐dominant and modification‐negative status was associated with poor prognosis. In conclusion, our data suggest that global histone H3 and H4 modification patterns are potential markers of tumor recurrence and disease‐free survival in NSCLC patients.
A comparison of laparoscopic versus open rectal surgery in 114 consecutive octogenarians
Authors: White S. I. , Wright D. , Taylor C. J.
Published: January 2012

Aim  The study is a retrospective review of the short‐term outcome of all elective rectal resections in 114 consecutive octogenarian patients during the 10‐year period January 2000 to December 2009.

Method  Sixty laparoscopic and 54 open resections were completed. The two groups were evenly matched for age (mean 83 years), American Society of Anesthesiologists score (mean 2.5) and pathology (malignancy 60%).

Results  Morbidity and mortality were comparable with no significant differences. Only length of stay in uncomplicated recoveries was significantly different in favour of laparoscopic surgery at 10 vs 14 days, P < 0.003.

Conclusion  Laparoscopic rectal resection is suitable for octogenarians.
Gore Bio‐A® Fistula Plug: a new sphincter‐sparing procedure for complex anal fistula
Authors: Ratto C. , Litta F. , Parello A. , Donisi L. , Zaccone G. , De Simone V.
Published: January 2012

Aim  The surgical treatment of a complex anal fistula remains controversial, although ‘sphincter‐saving’ operations are desirable. The Gore Bio‐A® Fistula Plug is a new bioprosthetic plug that has been proposed for the treatment of complex anal fistula. This study reports preliminary data following implantation of this plug.

Method  Eleven patients with a complex anal fistula underwent insertion of Gore Bio‐A® Fistula Plugs. The disc diameter and number of tubes in the plug were adapted to the fistula to allow accommodation of the disc into a submucosal pocket, and the excess tubes were trimmed. During the follow‐up period, patients underwent clinical and physical examinations and three‐dimensional endoanal ultrasound.

Results  Fistulas were high anterior transphincteric in five patients and high posterior transphincteric in six patients. All patients had a loose seton placement before plug insertion. Two, three and four tubes were inserted into the fistula plug in seven, three and one patient, respectively. The median follow‐up period was 5 months. No patient reported any faecal incontinence. There was no case of early plug dislodgement. Treatment success was noted for eight (72.7%) of 11 patients at the last follow‐up appointment.

Conclusion  Implanting a Gore Bio‐A® Fistula Plug is a simple, minimally invasive, safe and potentially effective procedure to treat complex anal fistula. Patient selection is fundamental for success.
Re‐epithelialization of demucosalized stomach patch with tissue‐engineered urothelial mucosa combined with Botox A in bladder augmentation
Authors: Zhang Yuanyuan , Liu Guihua , Kropp Bradley P.
Published: January 2012

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

Re‐epithelialization demucosa stomach patch is important to prevent the patch being exposed to urine that might cause patch shrinkage and fibrosis formation due to urine‐derived chemical irritation. Additionally, Botox A acts by blocking the transmission of nerve impulses to smooth muscles and so paralysing the muscles, which is commonly used to relax muscle for treatment of oesophageal achalasia due to overactive smooth muscle and sphincters of gastrointestinal tract.

We fabricated in vitro tissue engineered urothelial mucosa with multi‐layers of urothelium and smooth muscle layers seeded on SIS scaffold and then used this cell‐scaffold construct to cover nuke gastro patch combining with Botox A for gastrocystoplasty in a canine model.

OBJECTIVE

To evaluate the demucosalized stomach patch covered with tissue‐engineered urothelium for gastrocystoplasty and to determine whether or not injections of Botox A into the re‐epithelialized stomach patch can protect the graft from contraction in a canine bladder reconstruction model.

MATERIALS AND METHODS

Gastrocystoplasty was performed in 10 adult beagles after hemi‐cystectomy using five types of stomach patch (n= 2 per group): entire stomach patches (group I); demucosalized patches (group II); demucosalized patches covered with cell‐free small intestinal submucosa (SIS) (group III); demucosalized patches with urothelial and smooth muscle cell‐seeded SIS (group IV); and demucosalized patches with the cell‐seeded SIS combined with injections of Botox A (group V).

The bladder volume/pressure and the graft sizes were measured before surgery and again 10 weeks after bladder augmentation.

The graft tissues were examined both histologically and using immunohistochemistry.

RESULTS

All dogs survived and their gastric grafts were all vital with a good blood supply.

Gastric metaplasia of urothelium appeared on the top of stomach mucosa patches in two animals in group I. There was calcification formation at the centre of the graft in one animal in group II.

As compared with urothelium that was partially covered over with stomach patches in groups II and III, stratified urothelium completely covered the demucosalized gastric patches in groups IV and V.

There was less shrinkage of the stomach grafts in groups I and V, which shrank to half of their original size, than of the stomach grafts in groups II, III, and IV, which shrank significantly to one‐quarter of their original sizes.

CONCLUSIONS

Botox A injections appear to protect the graft contraction in the re‐epithelialized stomach flaps.

The gastrocystoplasty using demucosalized patches covered with tissue‐engineered urothelial mucosa combined with an injection of Botox A could have clinical potential for use in bladder reconstruction.
Different surgical findings in congenital and acquired undescended testes
Authors: van Brakel Jocelyn , Dohle Gert R. , de Muinck Keizer‐Schrama Sabine M.P.F. , Hazebroek Frans W.
Published: January 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Much is known on the aetiology, natural course and treatment of congenital undescended testes (UDT), but these matters are less clear for acquired UDT and still debated. Several studies have examined anatomical findings in patients with UDT. However, most of these studies do not distinguish between congenital and acquired UDT.

This study describes clinical and surgical differences between congenital and acquired UDT, in which full history was known for all patients. Major differences were found in preoperative testis position as well as intraoperative testis position, patency of processus vaginalis and epididymal anomalies between congenital and acquired UDT.

OBJECTIVE

To compare surgical findings in congenital and acquired undescended testes (UDT).

PATIENTS AND METHODS

A review of 139 boys with 158 congenital UDT and 69 boys with 84 acquired UDT was performed. The most caudal testicular position preoperatively, testis position at surgery, patency of the processus vaginalis and epididymal anomalies were prospectively recorded.

RESULTS

In the congenital group, orchiopexy had been performed at median age (range) 4.9 (1.5–14.6) years, while the median age (range) in the acquired group was 11.9 (3.8–23.3) years. Preoperatively, only congenital UDT were found not palpable or emergent inguinal, while only acquired UDT could be manipulated in an unstable scrotal position. In comparison with congenital UDT, acquired UDT were significantly more often located at the scrotal entrance, 27/158 vs 32/84 respectively (P < 0.001). At surgery anorchia, vanished testis or testes lying intra‐abdominally were only registered in the congenital UDT group. Also 37/158 congenital UDT were located in the superficial inguinal pouch vs 52/84 of the acquired UDT (P= 0.04). In congenital UDT the processus vaginalis was wide open in 74/158, while in acquired UDT the processus vaginalis was closed in 46/84 (P < 0.001) and small open in 26/84 (P= 0.04). Epididymal anomalies were more often seen in the congenital UDT group (37%) than in the acquired group (11%).

CONCLUSION

The most caudal position of congenital UDT after manipulation before surgery was at the scrotal entrance. These testes were frequently associated with epididymal anomalies and wide open processus vaginalis. This was in contrast to acquired UDT, which can often be pushed down well below the scrotal entrance and are more likely to be situated in the superficial inguinal pouch, with a normal epididymis and closed processus vaginalis.
NHS Diabetes guideline for the perioperative management of the adult patient with diabetes*
Authors: Dhatariya K. , Levy N. , Kilvert A. , Watson B. , Cousins D. , Flanagan D. , Hilton L. , Jairam C. , Leyden K. , Lipp A. , Lobo D. , Sinclair‐Hammersley M. , Rayman G. ,   for the Joint British Diabetes Societies
Published: January 2012

Diabet. Med. 29, 420–433 (2012)

These Joint British Diabetes Societies guidelines, commissioned by NHS Diabetes, for the perioperative management of the adult patient undergoing surgery are available in full in the Supporting Information.

This document goes through the seven stages of the patient journey when having surgery. These are: primary care referral; surgical outpatients; preoperative assessment; hospital admission; surgery; post‐operative care; discharge. Each stage is given its own considerations, outlining the roles and responsibilities of each group of healthcare professionals. The evidence base for the recommendations made at each stage, discussion of controversial areas and references are provided in the report.

This document has two key recommendations. Firstly, that the management of the elective adult surgery patients should be with modification to their usual diabetes treatment if the fasting is minimized because the routine use of a variable rate intravenous insulin infusion is not recommended. Secondly, that poor preoperative glycaemic control leads to post‐outcomes and thus, where appropriate, needs to be addressed prior to referral for surgery.
ASSESSING PERFORMANCE: THE IMPACT OF ORGANIZATIONAL CLIMATES AND POLITICS ON PUBLIC SCHOOLS' PERFORMANCE
Authors: VASHDI DANA R. , VIGODA‐GADOT ERAN , SHLOMI DVIR
Published: January 2012

This study examines multiple organizational climates and their relationship with politics and performance in public organizations. We argue that four types of climates (participative, innovative, leadership and service) impact employees' performance and public service outcomes, and that perceptions of organizational politics mediate these relationships. A theoretical model is suggested and examined empirically in a field study of 2102 teachers from 108 public schools and three major districts in Israel. Standard regressions and hierarchical linear model statistics are used to examine several hypotheses about the relationship between climate, micro‐level performance and macro‐level performance. The findings, both micro‐ and macro‐level based, indicate that multiple climates in the school environment are positively related to teachers' satisfaction and organizational citizenship behaviour. Furthermore, perceptions of politics and such micro‐level performance indicators are also related to school level achievements.
DROWNING THE DEADWEIGHT IN THE RHETORIC OF ECONOMISM: WHAT SPORT POLICY, FREE SWIMMING, AND EMA TELL US ABOUT PUBLIC SERVICES AFTER THE CRASH
Authors: O'BRIEN DAVE
Published: January 2012

In light of the Coalition government's plans to ‘consider new and radical approaches to public service provision’, this paper discusses the decision making process within central government and argues central government's response to the crisis reflects ongoing trends in Whitehall. The paper explores these trends using sport policy, Free Swimming and the Educational Maintenance Allowance. These funding decisions show the continued power of the Treasury within Whitehall and the extension of the Green Book's economism, along with a specific rhetorical use of economic evidence to present controversial decisions as technical exercises. The Coalition's claims of an overhaul of public service provision reflect the furtherance of longstanding developments in Whitehall's method of policy analysis, displaying remarkable similarity to New Labour's approach to decision making. For those scholars aiming to offer forms of critique to Coalition policy, the paper opens a significant site, and language, for resistance.
REGIONAL POPULATION–EMPLOYMENT DYNAMICS ACROSS DIFFERENT SECTORS OF THE ECONOMY*
Authors: de Graaff Thomas , van Oort Frank G. , Florax Raymond J.G.M.
Published: January 2012

ABSTRACT An important subset of the literature on agglomeration externalities hypothesizes that intrasectoral and intersectoral relations are endogenously determined in models of local and regional economic growth. Remarkably, structural adjustment models describing the spatio‐temporal dynamics of population and employment levels or growth traditionally do not include intersectoral economic dynamics. This paper argues and shows that allowing for economic linkages across sectors in these models adds considerable value, especially in forecasting. An econometric model of population–employment dynamics, in which sectoral variations in economic development are explicitly taken into account, is applied to a large urban planning policy proposal in the Netherlands. The empirical analyses suggest that population dynamics are largely exogenous, population changes drive employment in particular in the industry and retail sectors, and employment in all sectors depends strongly on intersectoral dynamics. Intersectoral dynamics appear as important drivers of regional sectoral employment changes; they are even more important than population changes, and their effect shows up clearly even within the Dutch institutional context where strict regulatory housing and planning restrictions are enforced.
Relationship of initial glucose level and all‐cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level
Authors: Hu G.‐C. , Hsieh S.‐F. , Chen Y.‐M. , Hsu H.‐H. , Hu Y.‐N. , Chien K.‐L.
Published: January 2012

Background and purpose:  Previous studies demonstrated that post‐stroke hyperglycemia was associated with poor outcome in non‐diabetic patients. However, evidence was inconclusive amongst patients with diabetes. The aim of this study was to evaluate the relationship between initial glucose levels and mortality amongst patients with acute ischaemic stroke, and further, to assess whether the association varied by diabetes mellitus and glycated hemoglobin (HbA1c) levels.

Methods:  Data were collected from the medical records of 1277 first‐ever stroke patients admitted to the emergency room between January 1, 2008 and June 30, 2009. Cox regression analysis was performed to assess the relationship between initial glucose level and mortality.

Results:  Compared with the lowest quartile of initial glucose level, a significant association with all‐cause death [hazard ratio (HR), 2.18; 95% CI, 1.36–3.48] and cardiovascular death (HR, 1.91; 95% CI, 1.01–3.61) was seen in the highest quartile. In non‐diabetic subgroup, those patients within the highest quartile of initial glucose level had a 3.29‐fold relative risks (RR) [95% confidence interval (CI), 1.62–6.68] for all‐cause and a 2.54‐fold RR (95% CI, 1.43–8.77) for cardiovascular death compared with those within the lowest quartile. However, the association between initial glucose levels and the risk of death was not significant amongst those with diabetes (P for interaction = 0.01). In addition, the risk amongst patients with diabetes varied by the HbA1c levels.

Conclusions:  A significant association was confirmed between initial glucose level and mortality in non‐diabetic ischaemic stroke patients. The possible relationship between initial glucose level, HbA1c level, and mortality amongst ischaemic stroke patients with diabetes warrants further research.
Change in the clinical activity of multiple sclerosis after treatment switch for suboptimal response
Authors: Río J. , Tintoré M. , Sastre‐Garriga J. , Nos C. , Castilló J. , Tur C. , Comabella M. , Montalban X.
Published: January 2012

Background:  Therapy for multiple sclerosis (MS) has a partial efficacy, and a significant proportion of treated patients will develop a suboptimal response with first‐line disease‐modifying drugs (DMD). Therapy switch in patients with MS can be a strategy after a treatment failure. We studied the change in clinical activity after switching of first‐line DMD because of a treatment failure.

Methods:  Relapsing‐remitting multiple sclerosis (RRMS) patients treated with interferon‐beta (IFNB) or glatiramer acetate (GA) were divided into (i) patients without change in DMD, (ii) patients with a change in DMD because of a poor response, and (iii) those with a change in DMD without relation with response. Annualized relapse rate (ARR) and relapse‐free proportions were analyzed.

Results:  We identified 923 patients with RRMS. Of the 180 who experienced a change because of suboptimal response, 90 switched to another first‐line DMT, 38 to mitoxantrone, and 52 to natalizumab. Median ARR in the pre‐DMD period on first DMD and second DMD was the following: 1, 1, and 0 for switchers from IFNB to another IFNB (P = 0.0001); 0.67, 1, and 0 for switchers from GA to IFNB (P = 0.01); 1, 1, and 0 for switchers from an IFNB to GA (P = 0.02); 1.1, 1.5, 0.2 for switchers from IFNB or GA to mitoxantrone (P = 0.0001); 0.9, 1, 0 for switchers from IFNB or GA to natalizumab (P = 0.0001).

Conclusions:  In patients with RRMS who have a poor response, switch to another DMD may reduce the clinical activity of the disease.
Low ankle–brachial index is a predictive factor for initial severity of acute ischaemic stroke
Authors: Lee D. H. , Kim J. , Lee H. S. , Cha M.‐J. , Kim Y. D. , Nam H. S. , Nam C. M. , Heo J. H.
Published: January 2012

Background:  A low ankle–brachial index (ABI) is predictive of peripheral arterial disease (PAD). For unknown reasons, patients with PAD demonstrate higher vascular mortality during follow‐up than do those without. Initial stroke severity is a strong predictor of long‐term outcome and may be different between patients with and without PAD. Thus, we investigated whether a low ABI was associated with severe stroke presentation.

Methods:  We enrolled 1147 first‐ever ischaemic stroke patients who underwent ABI measurements during hospitalization. Patients were categorized into the normal (≥ 0.90) or the abnormal (<0.90) ABI group. Baseline characteristics and initial National Institutes of Health Stroke Scale (NIHSS) scores were compared between the groups. We further analysed components of the NIHSS subscales in these groups.

Results:  Ankle–brachial index was abnormal in 85 (7.4%) patients. Mean initial NIHSS score was higher in the abnormal ABI group (6.61 ± 6.56) than in the normal ABI group (4.36 ± 4.90) (P = 0.003). A low ABI was independently associated with higher NIHSS score in a multivariate analysis. In the abnormal ABI group, leg weakness was more severe than it was in the normal ABI group, and the contribution of leg weakness to the initial NIHSS score was higher.

Conclusions:  Patients with low ABI values presented with more severe ischaemic stroke. Contribution of pre‐existing PAD to leg weakness may play a role in the initial severity of stroke in patients with PAD. Our findings suggest that poor clinical outcomes in patients with PAD may be partially explained by their increased likelihood for severe stroke.
Immigration, places of worship and the politics of citizenship in the US South
Authors: Ehrkamp Patricia , Nagel Caroline
Published: January 2012

This article considers the ways in which places of worship serve as sites of citizenship politics in immigrant‐receiving liberal democracies. We approach citizenship in terms of the social practices and everyday spaces through which individuals and groups negotiate the terms of societal membership. Places of worship are both the objects of political debates about immigrant assimilability and citizenship, and sites of political agency in which immigrants (and non‐immigrants) formulate and implement narratives of societal membership that mesh with their moral outlooks. Our arguments are based on research in the US South – a region where recent immigration has destabilised a deeply entrenched racial and religious order. We discuss Hindu temples and the notions of multicultural citizenship expressed by Indian immigrants before turning to two diversifying Christian churches to analyse the politics of citizenship between immigrants and non‐immigrants. Overall, our analysis suggests that while religious beliefs and spaces exist in tension with secularism, places of worship and faith communities remain intertwined with political life, albeit in complex and contradictory ways.
NPY controls fear conditioning and fear extinction by combined action on Y1 and Y2 receptors
Authors: Verma D , Tasan RO , Herzog H , Sperk G
Published: January 2012

BACKGROUND AND PURPOSE Neuropeptide Y (NPY) and its receptors have been implicated in the control of emotional‐affective processing, but the mechanism is unclear. While it is increasingly evident that stimulation of Y1 and inhibition of Y2 receptors produce prominent anxiolytic and antidepressant effects, the contribution of the individual NPY receptor subtypes in the acquisition and extinction of learned fear are unknown.

EXPERIMENTAL APPROACH Here we performed Pavlovian fear conditioning and extinction in NPY knockout (KO) and in NPY receptor KO mice.

KEY RESULTS NPY KO mice display a dramatically accelerated acquisition of conditioned fear. Deletion of Y1 receptors revealed only a moderately accelerated acquisition of conditioned fear, while lack of Y2 receptors was without any effect on fear learning. However, the strong phenotype seen in NPY KO mice was reproduced in mice lacking both Y1 and Y2 receptors. In addition, NPY KO mice showed excessive recall of conditioned fear and impaired fear extinction. This behaviour was replicated only after deletion of both Y1 and Y2 receptors. In Y1 receptor single KO mice, fear extinction was delayed and was unchanged in Y2 receptor KO mice. Deletion of NPY and particularly Y2 receptors resulted in a generalization of conditioned fear.

CONCLUSIONS AND IMPLICATIONS Our data demonstrate that NPY delays the acquisition, reduces the expression of conditioned fear while promoting fear extinction. Although these effects appear to be primarily mediated by Y1 receptors, the pronounced phenotype of Y1Y2 receptor double KO mice suggests a synergistic role of Y2 receptors in fear acquisition and in fear extinction.
Role of mixed ion channel effects in the cardiovascular safety assessment of the novel anti‐MRSA fluoroquinolone JNJ‐Q2
Authors: Eichenbaum G , Pugsley MK , Gallacher DJ , Towart R , McIntyre G , Shukla U , Davenport JM , Lu HR , Rohrbacher J , Hillsamer V
Published: January 2012

BACKGROUND AND PURPOSE

JNJ‐Q2, a novel broad‐spectrum fluoroquinolone with anti‐methicillin‐resistant Staphylococcus aureus activity, was evaluated in a comprehensive set of non‐clinical and clinical cardiovascular safety studies. The effect of JNJ‐Q2 on different cardiovascular parameters was compared with that of moxifloxacin, sparfloxacin and ofloxacin. Through comparisons with these well‐known fluoroquinolones, the importance of effects on compensatory ion channels to the cardiovascular safety of JNJ‐Q2 was investigated.

EXPERIMENTAL APPROACH

JNJ‐Q2 and comparator fluoroquinolones were evaluated in the following models/test systems: hERG‐transfected HEK293 cells sodium channel‐transfected CHO cells, guinea pig right atria, arterially perfused rabbit left ventricular wedge preparations and in vivo studies in anaesthetized guinea pigs, anaesthetized and conscious telemetered dogs, and a thorough QT study in humans.

KEY RESULTS

The trend for effects of JNJ‐Q2 on Tp–Te, QT, QRS and PR intervals in the non‐clinical models and the plateau in QTc with increasing plasma concentration in humans are consistent with offsetting sodium and calcium channel activities that were observed in the non‐clinical studies. These mixed ion channel activities result in the less pronounced or comparable increase in QTc interval for JNJ‐Q2 compared with moxifloxacin and sparfloxacin despite its greater in vitro inhibition of IKr.

CONCLUSIONS AND IMPLICATIONS

Based on the non‐clinical and clinical cardiovascular safety assessment, JNJ‐Q2 has a safe cardiovascular profile for administration in humans with comparable or reduced potential to prolong QT intervals, compared with moxifloxacin. The results demonstrate the importance of compensatory sodium and calcium channel activity in offsetting potassium channel activity for compounds with a fluoroquinolone core.
Inhibition of Na+‐H+ exchange as a mechanism of rapid cardioprotection by resveratrol
Authors: Thuc Luong Cong , Teshima Yasushi , Takahashi Naohiko , Nishio Satoru , Fukui Akira , Kume Osamu , Saito Shotaro , Nakagawa Mikiko , Saikawa Tetsunori
Published: January 2012

BACKGROUND AND PURPOSE Resveratrol is a polyphenol abundantly found in grape skin and red wine. In the present study, we investigated whether resveratrol exerts protective effects against cardiac ischaemia/reperfusion and also explored its mechanisms.

EXPERIMENTAL APPROACH Infarct size and functional recovery in rat isolated perfused hearts subjected to no‐flow global ischaemia followed by reperfusion were measured. Cultured neonatal rat cardiomyocytes were exposed to H2O2 (100 µmol·L−1) to induce cell injury. Intracellular ion concentrations were measured using specific dyes. Western blotting was used to quantify protein expression levels.

KEY RESULTS In rat isolated perfused hearts, treatment with resveratrol (20 and 100 µmol·L−1) 15 min before ischaemia considerably improved left ventricular functional recovery and infarct size. In cultured neonatal rat cardiomyocytes, resveratrol significantly attenuated the increase in reactive oxygen species (ROS) and loss of mitochondrial inner membrane potential. Resveratrol also suppressed the increase in intracellular concentrations of Na+ ([Na+]i) and Ca2+ ([Ca2+]i) after H2O2 application; however, it did not suppress the ouabain‐induced [Ca2+]i increase. By measuring changes in intracellular pH recovery after acidification, we also confirmed that acid‐induced activation of the Na+‐H+ exchanger (NHE) was prevented by pretreatment with resveratrol. Furthermore, resveratrol inhibited the H2O2‐induced translocation of PKC‐α from the cytosol to the cell membrane; this translocation is believed to activate NHE.

CONCLUSION AND IMPLICATIONS Resveratrol exerts cardioprotection by reducing ROS and preserving mitochondrial function. The PKC‐α‐dependent inhibition of NHE and subsequent attenuation of [Ca2+]i overload may be a cardioprotective mechanism.
Coexistence of schizophrenia and epilepsy: Record‐linkage studies
Authors: Wotton Clare J. , Goldacre Michael J.
Published: January 2012

For many years, there has been interest in a possible link between epilepsy and schizophrenia. A recent study found a strong, bidirectional link between the two conditions: people with one had a higher than average risk of having the other. Using two large data sets of hospital admission data, we investigated whether schizophrenia and epilepsy occur together in individuals more commonly than expected by chance. We undertook a retrospective cohort study using the Oxford Record Linkage Study (ORLS) and English national linked Hospital Episode Statistics to investigate the coexistence of these conditions. There was an elevated risk of epilepsy in people admitted to hospital with schizophrenia (ORLS rate ratio 2.1, 95% confidence interval 1.6–2.6; England 3.0, 2.9–3.1) and an elevated risk of schizophrenia in people admitted to hospital with epilepsy (ORLS 5.1, 4.1–6.2; England 4.5, 4.3–4.6). We found no consistent difference between male and female patients. Schizophrenia and epilepsy occur together in individuals more frequently than expected by chance.
Subtotal Vaginectomy for Management of Extensive Vaginal Disease in 11 Dogs
Authors: Nelissen Pieter , White Richard A S
Published: January 2012

Objective

To report (1) a surgical technique for subtotal vaginectomy using a combined abdominal and vestibular approach; (2) intra‐ and postoperative complications; and (3) long‐term outcome.

Study Design

Retrospective case series.

Animals

Female dogs (n = 11) with extensive intramural vaginal disease.

Methods

Through a ventral median celiotomy, the cranial aspect of the vagina was freed and ovariohysterectomy (OVH) was performed in intact females. After episiotomy, the vaginal wall was incised at the vestibulovaginal junction cranial to the urethral orifice, and the vagina freed from any remaining pelvic attachments. Dogs were reexamined at 4 weeks and 6 months. Long‐term outcome was evaluated by contacting the primary veterinarian by phone.

Results

Five dogs had benign vaginal disease and 6 had malignant vaginal neoplasia. A combined abdominal and vestibular approach permitted subtotal vaginectomy in all dogs; 6 dogs also had OVH. No major complications occurred and clinical signs had resolved by 4 weeks. One dog with malignant neoplasia was euthanatized 3 months later for metastatic disease and 1 dog developed postoperative urinary incontinence. Local recurrence or metastases were not identified in the other dogs.

Conclusion

Combined abdominal and vestibular approach for subtotal vaginectomy allowed complete resection of extensive vaginal lesions, was not associated with major complications, and outcome was favorable.
Browsing‐mediated shrub canopy changes drive composition and species richness in forest‐tundra ecosystems
Authors: Pajunen Adela , Virtanen Risto , Roininen Heikki
Published: January 2012

Changes in climate and in browsing pressure are expected to alter the abundance of tundra shrubs thereby influencing the composition and species richness of plant communities. We investigated the associations between browsing, tundra shrub canopies and their understory vegetation by utilizing a long‐term (10–13 seasons) experiment controlling reindeer and ptarmigan herbivory in the subarctic forest tundra ecotone in northwestern Fennoscandia. In this area, there has also been a consistent increase in the yearly thermal sum and precipitation during the study period. The cover of shrubs increased 2.8–7.8 fold in exclosures and these contrasted with browsed control areas creating a sharp gradient of canopy cover of tundra shrubs across a variety of vegetation types. Browsing exclusions caused significant shifts in more productive vegetation types, whereas little or no shift occurred in low‐productive tundra communities. The increased deciduous shrub cover was associated with significant losses of understory plant species and shifts in functional composition, the latter being clearest in the most productive plant community types. The total cover of understory vegetation decreased along with increasing shrub cover, while the cover of litter showed the opposite response. The cover of cryptogams decreased along with increasing shrub cover, while the cover of forbs was favoured by a shrub cover. Increasing shrub cover decreased species richness of understory vegetation, which was mainly due to the decrease in the cryptogam species. The effects were consistent across different types of forest tundra vegetation indicating that shrub increase may have broad impacts on arctic vegetation diversity. Deciduous shrub cover is strongly regulated by reindeer browsing pressure and altered browsing pressure may result in a profound shrub expansion over the next one or two decades. Results suggest that the impact of an increase in shrubs on tundra plant richness is strong and browsing pressure effectively counteracts the effects of climate warming‐driven shrub expansion and hence maintains species richness.
Host–parasitoid persistence over variable spatio‐temporally susceptible habitats: bottom–up effects of ephemeral resources
Authors: Reigada Carolina , de Aguiar Marcus A. M.
Published: January 2012

We experimentally and theoretically investigated the persistence of hosts and parasitoids interacting in a metapopulation structure consisting of ephemeral local patches (MELPs). We used a host–parasitoid system consisting of necrophagous Diptera species and their pupal parasitoids. The basal resources used by the host species were assumed to be ephemeral, supporting only one generation of individuals before completely disappearing from the environment. We experimentally measured the host–parasitoid persistence and the effects of local demographic processes in two scenarios: 1) constant occurrence of basal resources at a single site (no dispersion or colonization of other sites) and 2) variable occurrence of basal resources between two sites (colonization of a new patch requiring species dispersal). The experimental setup and findings were then formalized into a mathematical model describing the interaction dynamics in a MELP structure. We evaluated the contribution of several factors to the host–parasitoid coexistence, such as resource allocation probability (probability of resource appearance in a site), variation in resource size and number of sites available to receive resources in the MELP. We found that demographic fluctuations and environmental stochasticity affected the density of migrants, patch habitat connectivity, persistence and spatial distribution of interacting species.
Clinical outcomes of double‐ vs single‐bundle anterior cruciate ligament reconstruction: A systematic review of randomized control trials
Authors: Kongtharvonskul J. , Attia J. , Thamakaison S. , Kijkunasathian C. , Woratanarat P. , Thakkinstian A.
Published: January 2012

Clinical outcomes of anterior cruciate ligament (ACL) reconstruction with double‐bundle and single‐bundle techniques are still controversial. We therefore performed a systematic review to compare postoperative outcomes between the two techniques. Randomized control trials comparing the outcomes between the two techniques were identified from Medline and EMBASE since inception to April 27, 2011. Data were independently extracted by two reviewers. Thirteen of 318 studies were eligible; 9, 11, 7, and 8 studies were pooled for rotation, translation, function, and complication outcomes, respectively. The double‐bundle technique was approximately four times (95% CI: 2.65, 11.99) and two times (95% CI: 1.16, 5.21) more likely to show a normal pivot shift and normal International Knee Documentation Committee (IKDC) grading compared with the single‐bundle technique. However, there were nonsignificant differences in KT grading (OR = 1.66, 95% CI: 0.77, 3.82), IKDC score (0.29, 95% CI: −1.17, 1.75), Lysholm knee score (−0.87, 95% CI: −2.66, 0.93), Tegner activity score (0.37, 95% CI: −0.05, 0.79), and complications (OR = 1.11, 95% CI: 0.48, 2.57). Heterogeneity was present in some outcomes but there was no evidence of publication bias for any outcome. The double‐bundle may be better than the single‐bundle ACL reconstruction technique in rotational stability but not for function, translation, and complications.
A recurrent D‐strand association interface is observed in β‐2 microglobulin oligomers
Authors: Colombo Matteo , de Rosa Matteo , Bellotti Vittorio , Ricagno Stefano , Bolognesi Martino
Published: January 2012

β‐2 microglobulin (β2m) is an amyloidogenic protein responsible for dialysis‐related amyloidosis in man. In the early stages of amyloid fibril formation, β2m associates into dimers and higher oligomers, although the structural details of such aggregates are poorly understood. To characterize the protein–protein interactions supporting the formation of oligomers, three individual β2m cysteine mutants and their disulfide‐linked homodimers (DIMC20, DIMC50 and DIMC60) were prepared. Amyloid propensity, oligomerization state in solution and crystallogenesis were tested for each β2m homodimer: DIMC20 and DIMC50 display a mixture of tetrameric and dimeric species in solution and also yield protein crystals and amyloid fibrils, whereas DIMC60 is dimeric in solution but does not form protein crystals nor amyloid fibrils. The X‐ray structures of DIMC20 and DIMC50 show that the two engineered dimers form a tetrameric assembly; for both tetrameric species, the noncovalent association interface is based on the interaction of facing β2m D‐strands and is conserved. Notably, DIMC20 and DIMC50 trigger amyloid formation in wild‐type β2m in unseeded reactions. Thus, when the D‐D‐strand interface is impaired by an intermolecular disulfide bond (as in DIMC60), the formation of tetramers is hindered, and the protein is not amyloidogenic and does not promote amyloid aggregation of wild‐type β2m. Implications for β2m oligomerization are discussed.

Database

Atomic coordinates and structure factors have been deposited in the Protein Data Bank database under the accession codes 3TLR and 3TM6 for the structures of DIMC20 and DIMC50, respectively.

Structured digital abstract

 Beta‐2‐microglobulin and Beta‐2‐microglobulin bind by transmission electron microscopy (View interaction)

 Beta‐2‐microglobulin and Beta‐2‐microglobulin bind by fluorescence technology (View interaction)
Mapping the spatial distribution of botanical composition and herbage mass in pastures using hyperspectral imaging
Authors: Suzuki Yumiko , Okamoto Hiroshi , Takahashi Makoto , Kataoka Takashi , Shibata Youichi
Published: January 2012

Quantifying the vegetation heterogeneity in pastures is important to understand the behavior and performance of grazing animals. In this study, we developed a technique for mapping spatial distribution of botanical composition (perennial ryegrass, white clover and other plants) and herbage mass of perennial ryegrass in a grazed pasture using a hyperspectral imaging system, which can glean more detailed spectral information than conventional multispectral imaging that uses standard band frequencies. Plant portions were extracted from hyperspectral image using normalized difference vegetation index threshold and classified into the three plant species or species groups using linear discriminant analysis models. The overall success rate of plant extraction and discrimination between plant species or species groups was 91.6 and 80.3%, respectively. Herbage mass of perennial ryegrass was estimated using partial least squares regression analysis, where the estimated values showed a coefficient of determination of 0.60 against the observed values. In consequence of the models, our results suggested that the difference of leaf cell structure and photosynthesis pigments influenced discrimination between plant species or species group and estimation of the herbage mass. The results demonstrate the potential of the hyperspectral imaging system for creating high spatial resolution maps of vegetation characteristics in pastures.