bluuebunny/crossref_metadata_2025 huggingface dataset:
What qualities are valued in residential direct care workers from the perspective of people with an intellectual disability and managers of accommodation services?
Authors: Dodevska G. A. , Vassos M. V.
Published: May 2012

Background  To date, the descriptions of a ‘good’ direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a ‘good’ direct care worker differently from service users with an intellectual disability (ID), with professionals placing an emphasis on describing workers with a range of practical skills and knowledge and service users placing an emphasis on describing workers with interpersonal skills. The aim of this research was to replicate this finding using a methodological approach that rectifies some of the weaknesses of previous research in this field.

Method  Semi‐structured interviews were conducted to explore the qualities that are valued in residential direct care workers (RDCWs) from the perspective of seven residents with ID and seven managers of accommodation services located in metropolitan Melbourne, Australia.

Results  Thematic and chi‐squared analysis confirmed the findings of previous research with residents with an ID placing more of an emphasis on the interpersonal behaviours of RDCWs in their descriptions compared to the managers.

Conclusions  The interpersonal skills of a potential worker along with their practical skills and knowledge must be considered when recruiting RDCWs. It is also implied that given the different conceptualisation of a ‘good’ direct care worker across service users and professionals, increased service user participation in the organisation of appropriate supports is warranted.
Cadmium impairs ion homeostasis by altering K+ and Ca2+ channel activities in rice root hair cells
Authors: LI SUN , YU JINGLING , ZHU MINJIE , ZHAO FUGENG , LUAN SHENG
Published: May 2012

Cadmium (Cd2+) interferes with the uptake, transport and utilization of several macro‐ and micronutrients, which accounts, at least in part, for Cd2+ toxicity in plants. However, the mechanisms underlying Cd2+ interference of ionic homeostasis is not understood. Using biophysical techniques including membrane potential measurements, scanning ion‐selective electrode technique for non‐invasive ion flux assays and patch clamp, we monitored the effect of Cd2+ on calcium (Ca2+) and potassium (K+) transport in root hair cells of rice. Our results showed that K+ and Ca2+ contents in both roots and shoots were significantly reduced when treated with exogenous Cd2+. Further studies revealed that three cellular processes may be affected by Cd2+, leading to changes in ionic homeostasis. First, Cd2+‐induced depolarization of the membrane potential was observed in root hair cells, attenuating the driving force for cation uptake. Second, the inward conductance of Ca2+ and K+ was partially blocked by Cd2+, decreasing uptake of K+ and Ca2+. Third, the outward K+ conductance was Cd2+‐inducible, decreasing the net content of K+ in roots. These results provide direct evidence that Cd2+ impairs uptake of Ca2+ and K+, thereby disturbing ion homeostasis in plants.
DNA methylation levels within the CD14 promoter region are lower in placentas of mothers living on a farm
Authors: Slaats Gisela G.G. , Reinius Lovisa E. , Alm Johan , Kere Juha , Scheynius Annika , Joerink Maaike
Published: May 2012

Background

Epigenetic regulation has been suggested to be a link between environmental intrauterine exposures and development of asthma and allergy. The placenta is an essential part of the intrauterine environment. We have previously found the innate immune receptor CD14 to be differentially expressed on the mRNA level in placentas in relation to lifestyle and parental allergen sensitization. We here hypothesized that the promoter region of CD14 may be subject to differential DNA methylation and therefore a link between intrauterine exposure and mRNA expression.

Methods

Ninety‐four placentas from the ALADDIN (Assessment of Lifestyle and Allergic Disease During Infancy) study were investigated. We used methylation‐sensitive high‐resolution melting (MS‐HRM) analysis to semi‐quantitatively analyze the DNA methylation of the promoter region of CD14 in 36 placentas known to have different CD14 mRNA expression. EpiTYPER was used to validate the MS‐HRM data and to analyze an additional 58 placentas selected on mothers living on a farm or not.

Results

MS‐HRM analysis on 36 placenta samples revealed a relation between methylation of the CD14 promoter region with the level of CD14 mRNA expression. The MS‐HRM and EpiTYPER data correlated highly significantly. EpiTYPER analysis of the additional 58 placentas demonstrated that DNA methylation in the CD14 promoter was significantly lower in placentas of mothers living on a farm compared with mothers not living on a farm.

Conclusion

Our data suggest that epigenetic regulation of CD14 in placenta might be involved in the protective effect of ‘living on a farm’, with regard to allergy development.
A new optical leaf‐clip meter for simultaneous non‐destructive assessment of leaf chlorophyll and epidermal flavonoids
Authors: Cerovic Zoran G. , Masdoumier Guillaume , Ghozlen NaÏma Ben , Latouche Gwendal
Published: May 2012

We have characterized a new commercial chlorophyll (Chl) and flavonoid (Flav) meter called Dualex 4 Scientific (Dx4). We compared this device to two other Chl meters, the SPAD‐502 and the CCM‐200. In addition, Dx4 was compared to the leaf‐clip Dualex 3 that measures only epidermal Flav. Dx4 is factory‐calibrated to provide a linear response to increasing leaf Chl content in units of µg cm–2, as opposed to both SPAD‐502 and CCM‐200 that have a non‐linear response to leaf Chl content. Our comparative calibration by Chl extraction confirmed these responses. It seems that the linear response of Dx4 derives from the use of 710 nm as the sampling wavelength for transmittance. The major advantage of Dx4 is its simultaneous assessment of Chl and Flav on the same leaf spot. This allows the generation of the nitrogen balance index (NBI) used for crop surveys and nitrogen nutrition management. The Dx4 leaf clip, that incorporates a GPS receiver, can be useful for non‐destructive estimation of leaf Chl and Flav contents for ecophysiological research and ground truthing of remote sensing of vegetation. In this work, we also propose a consensus equation for the transformation of SPAD units into leaf Chl content, for general use.
Therapeutic efficacy of platelet components treated with amotosalen and ultraviolet A pathogen inactivation method: results of a meta‐analysis of randomized controlled trials
Authors: Cid J. , Escolar G. , Lozano M.
Published: May 2012

Background and Objectives  There are conflicting data regarding the therapeutic efficacy of platelets inactivated using amotosalen and ultraviolet A light. We have performed a meta‐analysis to summarize the results of different randomized controlled trials (RCT).

Materials and Methods  Five RCTs reported through March 2011 met the criteria for meta‐analysis. Weighted mean difference (WMD) in corrected count increment (CCI) at 1 h, CCI‐24 h, and transfusion interval (days) and summary odds ratio (OR) of bleeding in inactivated platelet (I‐P) group vs. noninactivated platelet (C‐P) group were calculated across studies.

Results  Randomized controlled trials were statistically homogeneous when we analysed CCI‐24 h, and the transfusion of C‐P was associated with a higher CCI‐24 h when compared with the transfusion of I‐P (WMD, 3 × 103; 95% CI, 2·32 × 103–3·69 × 103; P < 0·00001). RCTs were statistically heterogeneous when we analysed CCI‐1 h, transfusion interval and OR of bleeding. Regarding the OR of bleeding in the I‐P and C‐P groups, it varied by as much as a multiple of four among the trials, from 0·66 to 2·66. When we combined double‐blinded and high methodologic quality score RCTs, the use of I‐P was not statistically associated with an increase in the OR of bleeding when compared with the use of C‐P (OR, 0·97; 95% CI, 0·75–1·27; P = 0·84).

Conclusion  Although the transfusion of I‐P was associated with lower CCI‐24 h when compared with the transfusion of C‐P, this was not associated with differences in the OR of bleeding between I‐P and C‐P.
Cross sectional survey on the concerns and anxiety of patients waiting for organ transplants
Authors: LI PHILIP KAM‐TAO , CHU KWOK HONG , CHOW KAI MING , LAU MIU FONG , LEUNG CHI BON , KWAN BONNIE CHING HA , TONG YUEN FAN , SZETO CHEUK CHUN , NG MAGGIE MIU MAN
Published: May 2012

Aim:  We aimed to gain an understanding of patient concerns while on a transplantation waiting list in areas with long transplant waiting time.

Methods:  The study population comprised patients with organ failure on the transplant waiting list in Hong Kong. They were invited to complete a questionnaire survey. Demographic data and waiting time were collected. Respondents rated their chance of getting transplanted, their subjective concerns and feelings, level of happiness and support received.

Results:  A total of 442 patients on the waiting list for kidney, liver, lung and heart‐lung transplants completed the questionnaire survey. The majority of patients (93.0%) were waiting for kidney transplantation. More than half of the respondents (63.3%) had been waiting for more than 3 years. Patients with longer transplant waiting times had lower self‐estimated chance of receiving a transplant (P = 0.004). Self‐estimated chance of getting transplanted was positively associated with the happiness score (P < 0.0001). Issues of most concerns to the patients waiting for organ transplants were: inconvenience of therapy (48.2%), disease progression (47.9%), burden to family (59.5%) and financial difficulties (52.3%). More female patients on the waiting list (50.0% vs 25.7% in male) reported concerns about suffering associated with the illnesses. 21.7% of patients considered the level of support received inadequate.

Conclusions:  Our patients had long waiting time for transplantation, which is associated with a lower perceived chance of getting a transplant. Attention to more psychosocial support to these patients waiting for organ transplant is important. Promoting and improving organ donation would be the ultimate way to help these patients.
Depression, but not sleep disorder, is an independent factor affecting exacerbations and hospitalization in patients with chronic obstructive pulmonary disease
Authors: ITO KOSUKE , KAWAYAMA TOMOTAKA , SHOJI YOSHIHISA , FUKUSHIMA NORIKO , MATSUNAGA KAZUKO , EDAKUNI NOBUTAKA , UCHIMURA NAOHISA , HOSHINO TOMOAKI
Published: May 2012

Background and objective:  Patients with chronic obstructive pulmonary disease (COPD) may experience depression and sleep disorders, which can adversely affect their health‐related quality of life (HRQOL). The aim of this study was to investigate depression and sleep disorders among 85 COPD patients and 46 control subjects, aged 40 years and over.

Methods:  Patients underwent spirometry and arterial blood gas analysis, self‐completed St. George's Respiratory Questionnaire and were assessed on the Center for Epidemiologic Studies Depression (CES‐D) and the Pittsburgh Sleep Quality Index (PSQI). The frequency of exacerbations among COPD patients was prospectively monitored for 12 months.

Results:  The prevalence of depression and sleep disorders was significantly higher among COPD patients than control subjects. The relative risks (95% confidence interval) of depression and sleep disorders were 7.58 (1.03 to 55.8) and 1.82 (1.03 to 3.22), respectively, in COPD patients compared with control subjects. Among COPD patients, there was a correlation between CES‐D and PSQI. Lower body mass index, more severe dyspnoea, poorer HRQOL, lower partial pressure of arterial oxygen and higher partial pressure of arterial carbon dioxide were significantly associated with the incidence of depression and sleep disorders. Exacerbations and hospitalizations were more frequent among COPD patients with depression than those with sleep disorders alone or those without depression or sleep disorders.

Conclusions:  Depression and sleep disorders are very common co‐morbidities among COPD patients and significantly reduce activities and HRQOL among these patients. Depression, but not sleep disorder, is an independent risk factor for exacerbations and hospitalization among COPD patients.
Is it useful to perform carbon monoxide diffusion capacity and respiratory muscle function tests in patients with multiple sclerosis without disability?
Authors: CARVALHO SONIA REGINA S. , ALVARENGA FILHO HELCIO , PAPAIS‐ALVARENGA REGINA M. , CHACUR FERNANDO H. , DIAS RICARDO M.
Published: May 2012

Background and objective:  Impairment of respiratory function has been described in end‐stage multiple sclerosis (MS), as well as in patients with mild to severe disability. No data are available regarding the respiratory function of MS patients without disability. The objective of this study was to assess the pulmonary function, respiratory muscle strength and carbon monoxide diffusion capacity of the lungs (DLCO) in patients with relapsing‐remitting multiple sclerosis (RRMS) without disability.

Methods:  Twenty‐seven RRMS patients and 25 healthy control subjects were recruited. All subjects underwent clinical and neurological examination, and spirometry; lung volumes, DLCO and maximal respiratory pressures were measured. All subjects were rated on the Modified Fatigue Impact Scale and Fatigue Severity Scale scales.

Results:  There were no significant differences in age, gender, height, weight or body mass index between the groups. The mean duration of illness in the MS group was 5.44 ± 3.74 years, and the mean Expanded Disability Status Scale was 0.62 ± 0.65. The mean values for total lung capacity, forced expiratory volume in 1 s (FEV1) and FEV1/FVC were normal in both groups. Fifteen RRMS patients exhibited a reduction in maximal expiratory pressure (MEP), but only one patient exhibited a reduction in maximal inspiratory pressure. The mean values for DLCO were lower in RRMS patients (P = 0.0004) than in the control group. DLCO was decreased in 15 (55.55%), out of 27 RRMS patients. The fatigue scale results were not correlated with pulmonary function test results

Conclusions:  DLCO and MEP may be impaired in RRMS patients without disability.
Predicting the current distribution and potential spread of the exotic grass Eragrostis plana Nees in South America and identifying a bioclimatic niche shift during invasion
Authors: BARBOSA FABIANA G. , PILLAR VALÉRIO D. , PALMER ANTHONY R. , MELO ADRIANO S.
Published: May 2012

Eragrostis plana (Poaceae) is a perennial grass introduced from South Africa to the state of Rio Grande do Sul in southern Brazil. Currently, it is considered an invasive grass in several regions of the world, including South America, where it has caused negative ecological and socio‐economic impacts. Ecological niche models, using bioclimatic variables, are often used to predict the potential distribution of invasive species. In this study we prepared two bioclimatic models for E. plana using the Genetic Algorithm for Rule‐set Production, the first based on data from its native region (South Africa) and the second on data from both the native and invaded (South America) regions. We then projected each model onto South America to identify regions vulnerable to invasion by the species, and compared our results with available records of the species in South America. Finally, we explored the model's predictions for the existence of a bioclimatic niche shift during the invasion process of E. plana in South America, using multivariate statistical analysis. The model created with native distribution data was only able to predict (with highly suitable habitat) the region of introduction of E. plana in South America. However, the current distribution, as well as the region of introduction of the species, was reliably predicted by the model created with data from both native and invaded regions. Our multivariate analysis supports a hypothesis of bioclimatic niche shift during the invasion process of E. plana in South America.
Antioxidant supplementation in pregnant women with low antioxidant status
Authors: Wibowo Noroyono , Purwosunu Yuditiya , Sekizawa Akihiko , Farina Antonio , Idriansyah Liana , Fitriana Ika
Published: May 2012

Aim:  The aim of this study was to investigate the benefit of antioxidant supplementation in a cohort of women with low antioxidant status and determine the changes in cell‐free mRNA.

Material and Methods:  This study was a randomized, placebo‐controlled trial of 8–12 weeks' pregnant women who had low antioxidant status treated with either antioxidants or control diets daily until 2 weeks' postpartum. The primary end‐point was the risk of pre‐eclampsia and the secondary end‐point was the changes of angiogenic and anti‐oxidant mRNA markers related to the outcome (ClinicalTrial.gov, number NCT01232205).

Results:  There were 110 women enrolled in the study, randomly assigned to the supplementation (n = 52) and control group (n = 58). The overall rate of pre‐eclampsia was 8.7% (nine subjects). There were significant differences (P = 0.034) between the supplementation and control group in the incidence of pre‐eclampsia (2.0% [one case] and 14.5% [eight cases], respectively) and mRNA level of superoxide‐dismutase, heme oxygenase‐1, vascular endothelial growth factor receptor‐1, endoglin and placental growth factor after supplementation.

Conclusion:  Supplementation of women with low antioxidant status with micronutrients containing antioxidants during early gestation might reduce the risk of pre‐eclampsia.
Perceived helplessness is associated with individual differences in the central motor output system
Authors: Salomons Tim V. , Moayedi Massieh , Weissman‐Fogel Irit , Goldberg Michael B. , Freeman Bruce V. , Tenenbaum Howard C. , Davis Karen D.
Published: May 2012

Learned helplessness is a maladaptive response to uncontrollable stress characterized by impaired motor escape responses, reduced motivation and learning deficits. There are important individual differences in the likelihood of becoming helpless following exposure to uncontrollable stress but little is known about the neural mechanisms underlying these individual differences. Here we used structural MRI to measure gray and white matter in individuals with chronic pain, a population at high risk for helplessness due to prolonged exposure to a poorly controlled stressor (pain). Given that self‐reported helplessness is predictive of treatment outcomes in chronic pain, understanding such differences might provide valuable clinical insight. We found that the magnitude of self‐reported helplessness correlated with cortical thickness in the supplementary motor area (SMA) and midcingulate cortex, regions implicated in cognitive aspects of motor behavior. We then examined the white matter connectivity of these regions and found that fractional anisotropy of connected white matter tracts along the corticospinal tract was associated with helplessness and mediated the relationship between SMA cortical thickness and helplessness. These data provide novel evidence that links individual differences in the motor output pathway with perceived helplessness over a chronic and poorly controlled stressor.
Pronounced seasonal dynamics of freshwater chitinase genes and chitin processing
Authors: Beier Sara , Mohit Vani , Ettema Thijs J. G. , Östman Örjan , Tranvik Lars J. , Bertilsson Stefan
Published: May 2012

Seasonal variation in activity of enzymes involved in polymer degradation, including chitinases, has been observed previously in freshwater environments. However, it is not known whether the seasonal dynamics are due to shifts in the activity of bacteria already present, or shifts in community structure towards emergence or disappearance of chitinolytic organisms. We traced seasonal shifts in the chitinase gene assemblage in a temperate lake and linked these communities to variation in chitinase activity. Chitinase genes from 20 samples collected over a full yearly cycle were characterized by pyrosequencing. Pronounced temporal shifts in composition of the chitinase gene pool (beta diversity) occurred along with distinct shifts in richness (alpha diversity) as well as chitin processing. Changes in the chitinase gene pool correlated mainly with temperature, abundance of crustacean zooplankton and phytoplankton blooms. Also changes in the physical structure of the lake, e.g. stratification and mixing were associated with changes in the chitinolytic community, while differences were minor between surface and suboxic hypolimnetic water. The lake characteristics influencing the chitinolytic community are all linked to changes in organic particles and we suggest that seasonal changes in particle quality and availability foster microbial communities adapted to efficiently degrade them.
Prokaryotic communities and operating metabolisms in the surface and the permafrost of Deception Island (Antarctica)
Authors: Blanco Yolanda , Prieto‐Ballesteros Olga , Gómez Manuel J. , Moreno‐Paz Mercedes , García‐Villadangos Miriam , Rodríguez‐Manfredi José A. , Cruz‐Gil Patricia , Sánchez‐Román Mónica , Rivas Luis A. , Parro Victor
Published: May 2012

In this study we examined the microbial community composition and operating metabolisms on the surface and in the permafrost of Deception Island, (Antarctica) with an on site antibody microarray biosensor. Samples (down to a depth of 4.2 m) were analysed with LDChip300 (Life Detector Chip), an immunosensor containing more than 300 antibodies targeted to bacterial and archaeal antigens. The immunograms showed positive antigen‐antibody reactions in all surface samples (lichens, pyroclasts) and the top layer of the permafrost. The results indicated the presence of exopolysaccharides, bacteria belonging to the Alpha‐, Delta‐ and Gammaproteobacteria, Bacteroidetes, Gram‐positive Actinobacteria and Firmicutes, as well as archaeal species, most probably Methanobacterium spp. Positive reactions with antibodies to proteins and peptides revealed the presence of nitrogen fixation (NifHD, GlnB, HscA), methanogenic (McrB), iron homeostasis and iron scavenging (ferritins and DPS proteins) proteins, as well as ABC transporters, which indicated that these processes were operating at the time of sampling. These results were validated with other molecular ecology techniques such as oligonucleotide microarrays, 16S bacterial rRNA gene sequence analysis, aerobic viable counts and microscopy. Molecular ecology results showed a differentiated pattern along the depth of the drill, being the top active layer the most diverse, with Acidobacteria, Actinobacteria, Proteobacteria, Bacteroidetes and the phototrophs Cyanobacteria and Chloroflexi as dominant groups. Actinobacteria and Firmicutes were dominant in depths from 0.5 to 2 m, and Betaproteobacteria from 3 to 4.2 m. The geochemical analysis revealed the presence of low molecular weight organic acids (acetate, formate) which could be used by microorganisms as energy sources for sulfate, nitrate and metal reduction under anaerobic conditions.
Bacterioplankton groups involved in the uptake of phosphate and dissolved organic phosphorus in a mesocosm experiment with P‐starved Mediterranean waters
Authors: Sebastián Marta , Pitta Paraskevi , González José M. , Thingstad T. Frede , Gasol Josep M.
Published: May 2012

The use of inorganic phosphate (Pi) and dissolved organic phosphorus (DOP) by different bacterial groups was studied in experimental mesocosms of P‐starved eastern Mediterranean waters in the absence (control mesocosms) and presence of additional Pi (P‐amended mesocosms). The low Pi turnover times in the control mesocosms and the increase in heterotrophic prokaryotic abundance and production upon Pi addition confirmed that the bacterial community was originally P‐limited. The bacterioplankton groups taking up Pi and DOP were identified by means of microautoradiography combined with catalysed reporter deposition fluorescence in situ hybridization. Incubations with leucine were also performed for comparative purposes. All the probe‐identified groups showed a high percentage of cells taking up Pi and DOP in the control, P‐limited, mesocosms throughout the experiment. However, in response to Pi addition two contrasting scenarios in Pi use were observed: (i) on day 1 of the experiment Pi addition caused a clear reduction in the percentage of SAR11 cells taking up Pi, whereas Gammaproteobacteria, Roseobacter and Bacteroidetes showed similar percentages to the ones in the control mesocosms and (ii) on day 4 of the experiment, probably when the bacterial community had fully responded to the P input, all the probe‐identified groups showed low percentages of cells taking up the substrate as compared with the control mesocosms. These differences are likely related to different P requirements among the bacterial groups and point out to the existence of two contrasting strategies in P use.
Current UK management of locally recurrent rectal cancer
Authors: Harji D. P. , Griffiths B. , McArthur D. R. , Sagar P. M.
Published: May 2012

Aim  The study aimed to determine current UK practice in the management of locally recurrent rectal cancer (LRRC).

Method  An electronic based survey was sent to UK based Association of Coloproctology of Great Britain and Ireland members to establish current management in this patient group. A total of 188 questionnaires were sent out to consultant surgeons in a total of 105 colorectal units.

Results  Seventy‐nine consultants from 69 units responded, giving an overall response rate from consultants of 42% and from colorectal units of 66%. In all, 688 patients were managed by multidisciplinary teams in the 12 months prior to the survey. Seventy‐four (94% of responders) surgeons had experience of operating on patients with LRRC. Fifty‐nine (74.6%) operated on one to three per year and four (5%) operated on more than 10 patients per year. Central and anterior recurrences were most commonly undertaken locally, with most complex recurrences being referred to a tertiary centre. Forty‐seven (61%) surgeons worked to an algorithm.

Conclusion  A small number of specialist units in the UK manage the full spectrum of LRRC but the majority of patients are managed in small volume centres. The survey provides a snapshot of current activity in the UK and may provide a stimulus for discussion about how to expand and improve the care of a technically challenging group of patients.
Surgery for recurrent rectal cancer: higher and wider?
Authors: Harji D. P. , Griffiths B. , McArthur D. R. , Sagar P. M.
Published: May 2012

Aim  There has been a steady increase in the number of centres that carry out resection of locally recurrent rectal cancer (LRRC). The aim of this review was to highlight the present management and suggest technical strategies that may improve survival and quality of life.

Method  The review identified relevant studies from an electronic search of MEDLINE and PubMed databases between 1980 and 2011. References in published articles were also reviewed.

Results  Surgical intervention offers the best hope to control LRRC but the proportion of patients offered this remains small. Certain contraindications previously considered to be absolute should now be thought of as relative.

Conclusion  Awareness of the surgical options and a willingness to consider more aggressive options may result in more patients being considered for potentially curative resection.
Intra‐operative tumour detection and staging in colorectal cancer surgery
Authors: Tiernan J. P. , Ansari I. , Hirst N. A. , Millner P. A. , Hughes T. A. , Jayne D. G.
Published: May 2012

Aim  Surgical resection for colorectal cancer involves segmental resection and regional lymphadenectomy. The appropriateness of this ‘one‐size‐fits‐all’ strategy is questioned as bowel cancer screening programmes result in a shift to earlier stage disease. Currently, the nodal status of a colorectal cancer can only be reliably determined by histopathological examination of the resected specimen. New methods of intra‐operative staging are required to allow surgical resection to be tailored to the stage of the disease.

Method  A literature search was performed of PubMed and Embase databases using the terms ‘colon’ OR ‘colorectal’ AND ‘intra‐operative detection’ OR ‘intra‐operative staging’ OR ‘intra‐operative detection’ OR ‘radioimmunoguided surgery’. Articles published between January 1980 and January 2012 were included. Technologies that have the potential to allow intra‐operative staging and treatment stratification were identified and further searches performed.

Results  Established techniques such as sentinel lymph node mapping and radioimmunoguided surgery have benefited from combination with other technologies to allow real‐time intra‐operative staging. Intra‐operative fluorescence, using naturally fluorescent biomarkers or fluorescent tumour probes, probably offers the most practical means of intra‐operative lymph node staging and may be facilitated using nanotechnology. Optical coherence tomography and real‐time elastography have the potential to provide an in vivo‘virtual biopsy’.

Conclusion  Technological advances may allow accurate intra‐operative lymph node staging to facilitate tailored surgical resection. This may become the next paradigm shift in colorectal cancer surgery.
A nationwide study on anastomotic leakage after colonic cancer surgery
Authors: Krarup P.‐M. , Jorgensen L. N. , Andreasen A. H. , Harling H. ,   on behalf of the Danish Colorectal Cancer Group
Published: May 2012

Aim  Anastomotic leakage (AL) is a major challenge in colorectal cancer surgery due to increased morbidity and mortality. Possible risk factors should be investigated differentially, distinguishing between rectal and colonic surgery in large‐scale studies to avoid selection bias and confounding.

Method  The incidence and risk factors associated with AL were analysed in an unselected nationwide prospective cohort of patient subjected to curative colonic cancer surgery with primary anastomosis and entered into The Danish Colorectal Cancer Group database between May 2001 and December 2008.

Results  AL occurred in 593 (6.4%) of 9333 patients. Laparoscopic surgery [odds ratio (OR) 1.34; 95% confidence interval (CI) 1.05–1.70; P = 0.03); left hemicolectomy (OR 2.02; 95% CI 1.50–2.72; P = 0.01) or sigmoid colectomy (OR 1.69; 95% CI 1.32–2.17; P = 0.01); intra‐operative blood loss (OR 1.04; 95% CI 1.01–1.07; P = 0.03); blood transfusion (OR 10.27; 95% CI 6.82–15.45; P < 0.001) and male gender (OR 1.41; 95% CI 1.12–1.75; P = 0.02) were associated with AL in the multivariate analysis.

Conclusion  The main finding that a laparoscopic approach was associated with an increased risk of AL should prompt close future monitoring. There was no evidence that centralization of surgery to high‐volume hospitals reduced the rate of AL.
Metformin therapy in patients with chronic kidney disease
Authors: Duong J. K. , Roberts D. M. , Furlong T. J. , Kumar S. S. , Greenfield J. R. , Kirkpatrick C. M. , Graham G. G. , Williams K. M. , Day R. O.
Published: May 2012

Metformin therapy is limited in patients with chronic kidney disease (CKD) due to the potential risk of lactic acidosis. This open‐label observational study investigated metformin and lactate concentrations in patients with CKD (n = 22; creatinine clearances 15–40 ml/min) and in two dialysed patients. Patients were prescribed a range of metformin doses (250–2000 mg daily) and metformin concentrations were compared with data from healthy subjects (scaled to 1500 mg twice daily). A subset of patients (n = 7) was controlled on low doses of metformin (250 or 500 mg daily). No correlation between metformin and lactate concentrations was observed. Three patients had high lactate concentrations (>2.7 mmol/l) and two had high metformin concentrations (3–5 mg/l), but none had any symptoms of lactic acidosis. Reducing metformin dosage and monitoring metformin concentrations will allow the safe use of metformin in CKD, provided that renal function is stable.
Metastatic castrate‐resistant prostate cancer: dawn of a new age of management
Authors: Masson Susan , Bahl Amit
Published: May 2012

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

Metastatic castrate‐resistant prostate cancer (mCRPC) was historically considered to be an aggressive disease resistant to conventional anticancer therapy. Within the last decade the outlook has changed beyond recognition; docetaxel chemotherapy is now firmly established as a well‐tolerated treatment with significant survival benefits. Building on this, more recently there have been several landmark developments using various approaches in patients whose disease has progressed despite previous chemotherapy. Cabazitaxel chemotherapy offers survival and health‐related quality of life (HRQL) improvements in this setting, as does the CYP inhibitor abiraterone acetate. Significant clinical benefits are also seen with novel radioisotope and immunotherapeutic approaches.

There have been many developments in the management of this condition within the last 2 years, with several landmark studies showing new treatments that offer survival and HRQL benefits even in the setting of advanced disease, which has been heavily pretreated. This review article summarises these important developments and gives the reader an overview of current practice, recent changes and future directions.

With current and forthcoming developments in the treatment of metastatic castrate‐resistant prostate cancer (mCRPC) post‐docetaxel, we are embarking on an age of potential ‘chronic’ management of this disease.

It is hoped that the survival benefits associated with the various treatments, cytotoxic, hormonal and immunotherapeutic, will prove to be additive, providing a multimodal continuum of care. If so, it will be necessary to determine the optimal sequence and timing of the new treatments.

One key factor in this regard is likely to be the patient's performance status and hence his eligibility for cytotoxic intervention. If chemotherapy is offered early in the post‐docetaxel pathway, the patient may still be able to benefit from non‐chemotherapeutic options subsequently. However, if this stage of management begins with a non‐chemotherapeutic option, there is a risk that the patient's performance status will decline before he has an opportunity to benefit from chemotherapy.

Further studies and ongoing clinical experience are likely to clarify this important issue, and help clinicians to maximise the survival of men with mCRPC post‐docetaxel.
Reversing bladder outlet obstruction attenuates systemic and tissue oxidative stress
Authors: Lin Wei‐Yu , Wu Shi‐Bei , Lin Yi‐Pai , Chang Pey‐Jium , Levin Robert M. , Wei Yau‐Huei
Published: May 2012

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

Oxidative damage in bladder tissue and systemic oxidative biomarkers were both found to be increased in rabbits with partial bladder outlet obstruction.

It is shown that the reversal of partial bladder outlet obstruction will attenuate the systemic oxidative stress.

OBJECTIVE

To investigate whether partial bladder outlet obstruction (PBOO) increases systemic oxidative stress and whether relief of PBOO could attenuate this stress.

MATERIALS AND METHODS

Surgically created PBOO in male New Zealand white rabbits was assessed after 4 weeks in one group of rabbits (n = 4), and was relieved in two additional groups of rabbits (n = 4 each) that were assessed at 4 and 8 weeks after relief of PBOO.

Four sham‐operated rabbits served as controls. The assessed oxidative stress biomarkers included urinary and plasma 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) and plasma malondialdehyde (MDA), total anti‐oxidant capacity (TAC) and glutathione (GSH).

In addition, the copy number of mitochondrial DNA and the 8‐OHdG content in bladder tissues from these rabbits were also determined at the beginning and at indicated time points in the experiments.

RESULTS

There were significant increases in both the 8‐OHdG levels of urine, plasma and bladder tissue and the plasma MDA after induction of PBOO.

There were also significant decreases in the TAC, in GSH levels and in mitochondrial DNA copy number in bladder tissues after PBOO.

Most importantly, all of the values returned toward the control levels after the PBOO was reversed at 8 weeks.

CONCLUSION

PBOO increases systemic and oxidative stress and its reversal results in a progressive reduction of both systemic and tissue oxidative stress.
Organizational Complexity and Auditor Quality
Authors: Liu Chih‐Liang , Lai Shu‐Miao
Published: May 2012

Manuscript Type: Empirical

Research Question/Issue: This study investigates two questions: (1) What is the relationship between organizational complexity and auditor choice, and (2) Does auditor choice influence the relationship between organizational complexity and firm value?

Research Findings/Insights: Examination of a sample of large public US companies reveals a positive association between auditor quality and various proxies for organizational complexity. We also find a positive association between organizational complexity and firm value when the complex firm hires Big N auditors. The results are robust to alternative measures of auditor quality and firm value and to controls for the regulatory environment.

Theoretical/Academic Implications: The results extend the agency theory argument that agency costs resulting from information asymmetry between managers and investors affect the demand for external monitoring by auditors, specifically the demand by organizationally complex firms for higher quality audits. We also shed light on how the value enhancement of a complex organization depends on auditor quality.

Practitioner/Policy Implications: Our findings offer new perspectives for managers of complex firms that are industrially or geographically diversified. They can use the retention of a larger auditor as a credible signal that their consolidated reports are more informative about their financial performance. Further, the findings provide new insight into the value that investors place on auditor quality when they assess the value of firms with complex organizational structures.
Intra‐specific variance in sperm morphometry: a comparison between wild and domesticated Zebra FinchesTaeniopygia guttata
Authors: IMMLER SIMONE , GRIFFTH SIMON C. , ZANN RICHARD , BIRKHEAD TIM R.
Published: May 2012

The Zebra FinchTaeniopygia guttatais a model bird species for the experimental study of behavioural and evolutionary concepts in captivity and especially sexual selection. The validity of sexual selection studies of domesticated birds is of long‐standing concern as little is known about the influence of domestication on sexually selected traits. Most domesticated Zebra Finch populations are maintained under a strict breeding regime to avoid potential inbreeding. However, these breeding regimes may interfere with the processes of sexual selection and influence the evolution of sexually selected traits because they may limit or prohibit active mate choice. Here, we investigated the potential impact of a monogamous breeding scheme in a domesticated population in which active mate choice is largely inhibited, on the evolution of sperm morphometry as a sexually selected trait. We compared sperm morphometric traits (total sperm length and length of sperm head, midpiece and flagellum), and the variance thereof, between a domesticated and two wild Zebra Finch populations. Although we found significant differences between the three populations for certain sperm traits (head length, midpiece length), which may be of importance in postcopulatory sexual selection, overall, variance in sperm morphometry did not differ between the domesticated and the wild Zebra Finch populations. Our results validate the use of domesticated Zebra Finches for further studies of postcopulatory sexual selection and sperm competition.
THE EFFECTS OF CORROSION AND CONSERVATION TREATMENTS ON NON‐DESTRUCTIVE NEUTRON DIFFRACTION ANALYSIS OF ARCHAEOLOGICAL COPPER ALLOYS: PRELIMINARY RESULTS*
Authors: FRAME L. D. , FREESTONE I. C. , ZHANG SHU YAN , NICHOLAS M.
Published: May 2012

Analysis of residual stress in archaeological copper alloy artefacts by neutron diffraction has considerable potential for the investigation of early fabrication processes. However, residual stresses in metals are known to relax due to conditions similar to those encountered during burial, corrosion and conservation. In this pilot study, we investigate the effects of corrosion and conservation on a small group of replica copper ingots. Although corrosion and light cleaning do indeed cause some relaxation of stresses in the metal, corrosion having the most significant effect, the basic patterns and major features of the stress profiles may still be seen.
NEUTRON ACTIVATION ANALYSIS OF INCA AND COLONIAL CERAMICS FROM CENTRAL HIGHLAND ECUADOR
Authors: JAMIESON R. W. , HANCOCK R. G. V. , BECKWITH L. A. , PIDRUCZNY A. E.
Published: May 2012

Fifty‐three ceramic samples were collected in the area of the colonial city of Riobamba, Ecuador (today Sicalpa/Cajabamba). Neutron activation analysis was used to attempt to establish elemental compositions, and from these gain information on the manufacturing locations of these samples. Colonial samples imported from Panama were separable by their high Cs contents, and can be sorted into glazed and unglazed industries based on As and Cs. High As concentrations in several sherds indicate an origin near Cuenca, in the Southern Highlands of Ecuador, for both colonial and Inca samples. Inca and colonial Quito samples from the north of the country are identifiable through high Na combined with low Sc and Cr concentrations. Locally produced Puruhá, unglazed colonial and majolica samples form a group indicative of local Riobamba elemental composition.
Nociceptive Neuropeptide Increases and Periorbital Allodynia in a Model of Traumatic Brain Injury
Authors: Elliott Melanie B. , Oshinsky Michael L. , Amenta Peter S. , Awe Olatilewa O. , Jallo Jack I.
Published: May 2012

Objective.— This study tests the hypothesis that injury to the somatosensory cortex is associated with periorbital allodynia and increases in nociceptive neuropeptides in the brainstem in a mouse model of controlled cortical impact (CCI) injury.

Methods.— Male C57BL/6 mice received either CCI or craniotomy‐only followed by weekly periorbital von Frey (mechanical) sensory testing for up to 28 days post‐injury. Mice receiving an incision only and naïve mice were included as control groups. Changes in calcitonin gene‐related peptide (CGRP) and substance P (SP) within the brainstem were determined using enzyme‐linked immunosorbent assay and immunohistochemistry, respectively. Activation of ionized calcium‐binding adaptor molecule‐1–labeled macrophages/microglia and glial fibrillary acidic protein (GFAP)‐positive astrocytes were evaluated using immunohistochemistry because of their potential involvement in nociceptor sensitization.

Results.— Incision‐only control mice showed no changes from baseline periorbital von Frey mechanical thresholds. CCI significantly reduced mean periorbital von Frey thresholds (periorbital allodynia) compared with baseline and craniotomy‐only at each endpoint, analysis of variance P < .0001. Craniotomy significantly reduced periorbital threshold at 14 days but not 7, 21, or 28 days compared with baseline threshold, P < .01. CCI significantly increased SP immunoreactivity in the brainstem at 7 and 14 days but not 28 days compared with craniotomy‐only and controls, P < .001. CGRP levels in brainstem tissues were significantly increased in CCI groups compared with controls (incision‐only and naïve mice) or craniotomy‐only mice at each endpoint examined, P < .0001. There was a significant correlation between CGRP and periorbital allodynia (P < .0001, r = −0.65) but not for SP (r = 0.20). CCI significantly increased the number of macrophage/microglia in the injured cortex at each endpoint up to 28 days, although cell numbers declined over weeks post‐injury, P < .001. GFAP+ immunoreactivity was significantly increased at 7 but not 14 or 28 days after CCI, P < .001. Craniotomy resulted in transient periorbital allodynia accompanied by transient increases in SP, CGRP, and GFAP immunoreactivity compared with control mice. There was no increase in the number of macrophage/microglia cells compared with controls after craniotomy.

Conclusion.— Injury to the somatosensory cortex results in persistent periorbital allodynia and increases in brainstem nociceptive neuropeptides. Findings suggest that persistent allodynia and increased neuropeptides are maintained by mechanisms other than activation of macrophage/microglia or astrocyte in the injured somatosensory cortex.
SELECTION OF INTERNAL CONTROL GENE FOR EXPRESSION STUDIES IN PORPHYRA HAITANENSIS (RHODOPHYTA) AT DIFFERENT LIFE‐HISTORY STAGES1
Authors: Wu Xiaojie , Niu Jianfeng , Huang Aiyou , Xu Meiling , Wang Guangce
Published: May 2012

Accurate gene quantification depends on the use of an appropriate internal control gene, which should be verified before its use for normalizing data. Housekeeping genes, which are expressed at relatively constant levels, are generally regarded as candidate internal control genes. To determine the ideal internal control for gene expression profiles for Porphyra haitanensis T. J. Chang et B. F. Zheng (Bangiales, Rhodophyta) at different life‐history stages, we used absolute quantification to assess the expression levels of six housekeeping genes (18S ribosomal RNA, 30S ribosomal protein, glyceraldehyde‐3‐phosphate dehydrogenase, elongation factor 3, alpha‐tubulin, and beta‐tubulin) at the sporophyte and gametophyte stages. Housekeeping genes were selected by comparing the differences of observed copy numbers in sporophytes and in gametophytes. TubB (beta‐tubulin) was found to be the optimal internal control gene, because it showed the smallest difference of gene expression. Compared with TubB, other housekeeping genes had greater variation of expression to different degrees.
The Effectiveness of Repeat Celiac Plexus Neurolysis for Pancreatic Cancer: A Pilot Study
Authors: McGreevy Kai , Hurley Robert W. , Erdek Michael A. , Aner Musa M. , Li Sean , Cohen Steven P.
Published: May 2012

Background:  Celiac plexus neurolysis (CPN) is an effective but temporary management tool for pancreatic cancer pain (PCP). Clinical studies have shown the duration of benefit with initial CPN to be apaproximately 3 months. When pain recurs, CPN may be repeated, but the outcomes for repeat CPN are not well established. The objective of this study is to determine the success rate and duration of relief following repeat celiac plexus neurolysis (rCPN) for PCP.

Methods:  Patients who underwent rCPN were identified from a database and their records reviewed. Responses of rCPN were then compared with iCPN for success rates and duration of relief. Success was defined as ≥ 50% pain relief lasting ≥ 1 month.

Results:  Overall, there were 24 rCPN performed. The success rate decreased from 67% after initial CPN to 29% following rCPN (P = 0.13). The mean duration of pain relief decreased in parallel from 3.4 months (iCPN) to 1.6 months (rCPN) (P = 0.03). Among those who had a successful rCPN, 2.9 months elapsed from iCPN to rCPN, with disease progression noted in 29%. In those who failed rCPN, 7.8 months elapsed, with disease progression apapreciated in 71% of cases.

Conclusions:  rCPN does not provide as much pain relief as iCPN. Disease progression as detailed on imaging appears to be a major factor in the limitations of rCPN. Further prospective studies are warranted to confirm these results and investigate the utility of rCPN.