bluuebunny/crossref_metadata_2025 huggingface dataset:
An examination of the influences on New South Wales general practitioners regarding the provision of opioid substitution therapy
Authors: Holliday Simon , Magin Parker , Oldmeadow Christopher , Attia John , Dunbabin Janet , Henry Julie‐Marie , Lintzeris Nicholas , Goode Susan , Dunlop Adrian
Published: April 2013

Introduction.

Few general practitioners (GP) prescribe opioid substitution therapy. Our aim was to analyse their previously identified motivating factors by describing their frequency and demographic associations.

Methods.

An anonymous, cross‐sectional questionnaire‐based survey on opioid prescribing in pain and dependency was distributed across five New South Wales Divisions of GPs. Questions elicited opinions on 11 barriers and five facilitators previously described in qualitative literature. Data were analysed against demographic variables, including opioid substitution therapy prescriber (OSTP) status and postgraduate training status. ‘Profiles’ of non‐OSTPs were then constructed using latent class analysis.

Results.

Of the 1735 surveys posted, there were 404 responses (23.3%), with 16% respondents being OSTPs. Frequently reported barriers included: ‘negative experiences with the opioid dependent’ (72%), ‘heavy workload’ (60%) and ‘lack of specialist support’ (58%), with most barriers less frequent among OSTPs. Facilitating factors included: ‘more accessible specialist support’ (75%), ‘more accessible training’ (67%) and ‘better evidence of safety and efficacy’ (64%), with the latter two significantly less frequently among OSTPs. Latent class analysis of the non‐OSTPs revealed three distinct clusters. The smallest (‘class 3’) had the least barriers and resembled OSTPs demographically.

Discussion and Conclusions.

The pattern of motivating factors towards the psychological, social and behavioural challenges of the management of dependency has a predominantly negative bias. However, this lessens with postgraduate training and OSTP experience. Structural and logistical options are identified to promote OSTP recruitment and retention. GPs resembling class 3 may be more amenable to becoming OSTPs and may be worth targeting for recruitment. [Holliday S, Magin P, Oldmeadow C, Dunbabin J, Henry J‐M, Lintzeris N, Attia J, Goode S, Dunlop A. An examination of the influences on New South Wales general practitioners regarding the provision of opioid substitution therapy. Drug Alcohol Rev 2013;32:495–503]
Delayed perforation: A hazardous complication of endoscopic resection for non‐ampullary duodenal neoplasm
Authors: Inoue Takuya , Uedo Noriya , Yamashina Takeshi , Yamamoto Sachiko , Hanaoka Noboru , Takeuchi Yoji , Higashino Koji , Ishihara Ryu , Iishi Hiroyasu , Tatsuta Masaharu , Takahashi Hidenori , Eguchi Hidetoshi , Ohigashi Hiroaki
Published: April 2013

Background

Perforation is a major complication of endoscopic resection for gastrointestinal neoplasms. However, little is known about delayed perforation after endoscopic resection for non‐ampullary duodenal neoplasm. The aim of the present study was to investigate the clinical features of delayed perforation after endoscopic resection for non‐ampullary duodenal neoplasm.

Patients and Methods

This was a retrospective cohort study conducted in a referral cancer center. A total of 63 patients (41 with adenomas and 22 with carcinomas) underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) from January 1993 to December 2011. Incidence, outcome, and factors associated with occurrence of delayed perforation were investigated.

Results

Delayed perforation occurred in four patients (6.3%). All lesions were located distal to Vater's ampulla. Three of four delayed perforations occurred within 36 h after endoscopic resection. All patients developed retroperitonitis, and two also had retroperitoneal abscesses. Although three patients were cured with conservative management, a long hospital stay was required (28‐, 80‐, and 81‐day hospital stay, respectively). One patient required emergency surgery as a result of panperitonitis. There was, fortunately, no mortality in this series. The significant predictors of delayed perforation were location (distal to Vater's ampulla, P = 0.007) and resection method (ESD and piecemeal EMR, P = 0.003).

Conclusion

Endoscopic resection for non‐ampullary duodenal neoplasms has a possible risk of morbid complication i.e. delayed perforation, especially in patients with lesions located on the side distal from the ampulla and who are treated with piecemeal EMR or ESD.
Evaluation of a new image‐enhanced endoscopic technology using band‐limited light for detection of esophageal squamous cell carcinoma
Authors: Kodashima Shinya , Fujishiro Mitsuhiro , Ono Satoshi , Niimi Keiko , Mochizuki Satoshi , Asada‐Hirayama Itsuko , Konno‐Shimizu Maki , Matsuda Rie , Minatsuki Chihiro , Nakayama Chiemi , Takahashi Yu , Sakaguchi Yoshiki , Yamamichi Nobutake , Tanaka Chinari , Koike Kazuhiko
Published: April 2013

Background

The aim of the present study was to evaluate the clinical utility of a new image‐enhanced endoscopy (IEE) technology called optical enhancement imaging (OEI‐1, ‐2, ‐3) by quantitatively evaluating diagnostic performance in superficial esophageal squamous cell carcinoma (SCC) in order to facilitate detection and characterization of gastrointestinal tumors.

Patients and Methods

The study involved 10 esophageal SCC resected endoscopically at our hospital. Ex vivo observation of the boundary area between normal and SCC was done using each mode (white light image [WLI], OEI‐1, OEI‐2, and OEI‐3) with and without magnification. The additional effect of OEI on WLI was evaluated by calculating the color difference (expressed as ΔE94) between SCC and normal epithelium, and that between the intraepithelial papillary capillary loop (IPCL) and inter‐vascular background coloration (IVBC).

Results

Mean ΔE94 values between SCC and normal epithelium for WLI, OEI‐1, OEI‐2, and OEI‐3 were 9.37 ± 4.64, 13.82 ± 4.46,13.26 ± 4.73, and 16.44 ± 4.83, respectively; the corresponding values between IPCL and IVBC were 17.57 ± 10.17, 29.32 ± 9.95, 25.41 ± 11.72, and 23.71 ± 11.58, respectively. Compared with WLI, all OEI exhibited significant additional effect on ΔE94. Furthermore, we found significant additional effect of OEI‐3 in observing SCC and normal epithelium, and of OEI‐1 in observing IPCL and IVBC, compared with other OEI.

Conclusion

These results suggest that OEI improves endoscopic detection and characterization of esophageal SCC compared with WLI. Moreover, the data indicate that OEI‐3 is useful for detection and OEI‐1 is useful for characterization of esophageal SCC.
Novel antireflux covered metal stent for recurrent occlusion of biliary metal stents: A pilot study
Authors: Hamada Tsuyoshi , Isayama Hiroyuki , Nakai Yousuke , Kogure Hirofumi , Togawa Osamu , Kawakubo Kazumichi , Yamamoto Natsuyo , Ito Yukiko , Sasaki Takashi , Tsujino Takeshi , Sasahira Naoki , Hirano Kenji , Tada Minoru , Koike Kazuhiko
Published: April 2013

Background

Feasibility of antireflux metal stent (ARMS), designed to prevent duodenobiliary reflux, was reported in patients with distal malignant biliary obstruction. In this prospective pilot study, we aimed to evaluate a newly designed ARMS as a reintervention for self‐expandable metallic stent (SEMS) occlusion believed to be caused by duodenobiliary reflux.

Patients and Methods

Patients with non‐resectable distal malignant biliary obstruction were included in whom a prior SEMS was occluded as a result of sludge or food impaction between March 2010 and January 2012 at two Japanese tertiary referral centers. The occluded SEMS were endoscopically removed, if possible, and subsequently replaced by a newly designed ARMS. We evaluated the technical success rate and complications of ARMS and compared the time to occlusion of ARMS with that of prior SEMS.

Results

A total of 13 patients were included. ARMS was successfully placed in all patients in a single procedure. No procedure‐related complications were identified. ARMS occlusion occurred in two patients (15%), the causes of which were sludge in one patient and unknown in the other. ARMS migration occurred in four patients (31%). ARMS patency time was significantly longer than that of prior SEMS (median, not available vs 58 days; P = 0.039).

Conclusions

This newly designed ARMS is a technically feasible, safe, and effective reintervention for SEMS occlusion as a result of sludge or food impaction. An anti‐migration mechanism to improve the outcomes of ARMS should be considered.
Transgenesis and imaging in birds, and available transgenic reporter lines
Authors: Sato Yuki , Lansford Rusty
Published: April 2013

Avian embryos are important model organism to study higher vertebrate development. Easy accessibility to developing avian embryos enables a variety of experimental applications to understand specific functions of molecules, tissue–tissue interactions, and cell lineages. The whole‐mount ex ovo culture technique for avian embryos permits time‐lapse imaging analysis for a better understanding of cell behaviors underlying tissue morphogenesis in physiological conditions. To study mechanisms of blood vessel formation and remodeling in developing embryos by using a time‐lapse imaging approach, a transgenic quail model, Tg(tie1:H2B‐eYFP), was generated. From a cell behavior perspective, Tg(tie1:H2B‐eYFP) quail embryos are a suitable model to shed light on how the structure and pattern of blood vessels are established in higher vertebrates. In this manuscript, we give an overview on the biological and technological background of the transgenic quail model and describe procedures for the ex ovo culture of quail embryos and time‐lapse imaging analysis.
Molecular viewing of actin polymerizing actions and beyond: Combination analysis of single‐molecule speckle microscopy with modeling, FRAP and s‐FDAP (sequential fluorescence decay after photoactivation)
Authors: Watanabe Naoki , Yamashiro Sawako , Vavylonis Dimitrios , Kiuchi Tai
Published: April 2013

Live‐cell single‐molecule imaging is a powerful tool to elucidate the in vivo biochemistry of cytoskeletal proteins. However, it is often somewhat difficult to interpret how a bulk population of the observed molecule might behave as a whole. We review our recent studies in which the combination of image analysis with modeling and bulk kinetics measurements such as FRAP (fluorescence recovery after photobleaching) clarified basic problems in the regulation of actin remodeling pathways.
Melanocytomas of the Central Nervous System: a clinicopathological and molecular study
Authors: Wang Hai , Zhang Shu , Wu Chun , Zhang Zhiyuan , Qin Taichun
Published: April 2013

Background

Melanocytomas of the Central Nervous System (CNS) are rare and benign lesions. These slow‐growing tumours can behave aggressively, with local recurrence. Various genetic aberrations occur in malignant melanomas and raise possible new therapeutic options. However, little information is available regarding these characteristic genetic alterations in melanocytomas of the CNS. This study was designed to better understand the clinicopathological and molecular features of melanocytomas.

Materials and Methods

Twenty cases of melanocytoma were studied by light microscopy, electron microscopy and immunohistochemistry. Clinical characteristics, therapeutic options and prognosis were analysed. BRAF, NRAS and KIT gene mutations were tested by direct DNA sequencing.

Results

Fourteen of twenty patients had intracranial tumours including one associated with naevus of Ota and six were spinal. Histologically, these tumours contain fusiform and epithelioid cells with little or no cellular pleomorphism and rare mitoses. Immunohistochemical and ultrastructural findings confirmed the origin of tumour cells as melanocytic. None of the melanocytomas harboured BRAF, NRAS and KIT mutations. Patients with complete resection had no tumour recurrence. Moreover, patients with incomplete tumour resection followed by radiotherapy showed a higher local control (LC) rate than incomplete resection alone (P < 0·05).

Conclusions

BRAF, NRAS and KIT mutations appear to be rare, if not completely absent in melanocytomas of the CNS. The complete resection of the tumour or incomplete resection followed by radiotherapy should be considered as better therapeutic options to reduce the tumour recurrence.
Motivation to study dental professions in one London Dental Institute
Authors: Belsi A. , Asimakopoulou K. , Donaldson N. , Gallagher J.
Published: April 2013

Introduction

While past research has explored dental students' motivation to study, there is limited understanding in the reasons behind career choice for hygienists/therapists and dental nurses. The aim of this study was to investigate simultaneously the views of students of dentistry, hygiene/therapy and dental nursing in King's College London and explore similarities or differences in career choice.

Methods

All first‐year students were invited to the questionnaire survey, exploring motivation to study using a 23‐item instrument. Data were analysed using SPSS v18; statistical analysis included one‐way analyses of variance and factor analysis.

Results

The overall response rate to the study was 75% (n = 209). Ten out of 23 factors were considered important by more than 80% of respondents, with ‘job security’ (93.8%), ‘desire to work with people’ (88%) and ‘degree leading to recognised job’ (87.5%) being top three. Analysis suggested that 52% of the total variation in motivating influences was explained by four factors: ‘features of the job’ (26%), ‘education/skills’ (11%), ‘public service’ (8%) and ‘careers‐advising’ (7%); at group level ‘features of the job’ were significantly more important for the direct entrants to dentistry (P = 0.001).

Discussion

The findings suggest that across groups students were motivated to study by common influences reflecting altruistic, but also pragmatic and realistic motives, while ‘features of the job’ were more important for the direct entrants to dentistry.
Distance from Water, Sex and Approach Direction Influence Flight Distances Among Habituated Black Swans
Authors: Guay Patrick‐Jean , Lorenz Rachael D. A. , Robinson Randall W. , Symonds Matthew R. E. , Weston Michael A.
Published: April 2013

In many animals, response to predators occurs at greater distances the further an individual is from a refuge, but this has rarely been investigated in birds. Here, we test the hypothesis that the further from refuge (i.e. water) a foraging black swan Cygnus atratus is situated, the longer its flight initiation distance (FID) in response to a pedestrian approach on land. As predicted, swans situated farther from water exhibited longer FIDs compared with those closer to the shore. In addition, there was the possibility of an interesting interaction effect (p < 0.061) of sex and direction of approach on FID. Whilst males tended to not alter their response in relation to the angle of approach relative to the water, females tended to respond at longer distances, when approached from the shore than when approached from the land or parallel to the shore. This is one of the first reports of sex differences in FIDs for birds, with sex differences only manifesting themselves under certain approach types. Group size, the order of repeated approaches, and time of day did not influence responses, although starting distance of approach was positively related to FID.
Variations in Member States’ Preliminary References to the Court of Justice—Are Structural Factors (Part of) the Explanation?
Authors: Broberg Morten , Fenger Niels
Published: April 2013

The preliminary reference procedure in Article 267 of the Treaty on the Functioning of the European Union (TFEU), which enables national courts to request the Court of Justice to provide a ruling on the interpretation or validity of an EU legal act, is widely considered to be the jewel in the crown of EU law. When considering the number of references from different Member States, it will become immediately apparent that there are considerable variations. This article examines to what extent these variations may be explained by three structural factors, namely (1) population size, (2) willingness to litigate and (3) Member State compliance with EU law. It is concluded that some—but not all—of the variations in number of references from Member State judiciaries may be attributed to structural factors rather than being merely a reflection of different Member State courts’ willingness to make use of Article 267 TFEU on such references (the so‐called behavioural factors).
miR‐155 is involved in tumor progression of mycosis fungoides
Authors: Moyal Lilach , Barzilai Aviv , Gorovitz Batia , Hirshberg Avi , Amariglio Ninette , Jacob‐Hirsch Jasmine , Maron Leah , Feinmesser Meora , Hodak Emmilia
Published: April 2013

Biopsy specimens from 23 early stage and 19 tumor‐stage mycosis fungoides (MF) patients were evaluated for miR‐155 expression by real‐time qualitative PCR and compared with 15 biopsy specimens from patients with T‐cell‐rich inflammatory skin diseases. Significant upregulation of miR‐155 was found in MF tumors compared with both early‐stage MF lesions and controls. There was no difference in miR‐155 expression between early‐stage and inflammatory dermatoses. Using laser capture microdissection, it was found that miR‐155 was significantly higher in the lymphoma cells in tumor stage compared with the intraepidermal lymphocytes in early stage. In contrast, there was no difference in miR‐155 expression between the intraepidermal lymphocytes and the dermal lymphocytes in early‐stage MF. These findings suggest that although miR‐155 expression cannot serve to discriminate early‐stage MF from inflammatory dermatoses; however, it is involved in the switch from the indolent early stage into the aggressive tumor stage of the disease.
Convergent responses of nitrogen and phosphorus resorption to nitrogen inputs in a semiarid grassland
Authors: Lü Xiao‐Tao , Reed Sasha , Yu Qiang , He Nian‐Peng , Wang Zheng‐Wen , Han Xing‐Guo
Published: April 2013

Human activities have significantly altered nitrogen (N) availability in most terrestrial ecosystems, with consequences for community composition and ecosystem functioning. Although studies of how changes in N availability affect biodiversity and community composition are relatively common, much less remains known about the effects of N inputs on the coupled biogeochemical cycling of N and phosphorus (P), and still fewer data exist regarding how increased N inputs affect the internal cycling of these two elements in plants. Nutrient resorption is an important driver of plant nutrient economies and of the quality of litter plants produce. Accordingly, resorption patterns have marked ecological implications for plant population and community fitness, as well as for ecosystem nutrient cycling. In a semiarid grassland in northern China, we studied the effects of a wide range of N inputs on foliar nutrient resorption of two dominant grasses, Leymus chinensis and Stipa grandis. After 4 years of treatments, N and P availability in soil and N and P concentrations in green and senesced grass leaves increased with increasing rates of N addition. Foliar N and P resorption significantly decreased along the N addition gradient, implying a resorption‐mediated, positive plant–soil feedback induced by N inputs. Furthermore, N : P resorption ratios were negatively correlated with the rates of N addition, indicating the sensitivity of plant N and P stoichiometry to N inputs. Taken together, the results demonstrate that N additions accelerate ecosystem uptake and turnover of both N and P in the temperate steppe and that N and P cycles are coupled in dynamic ways. The convergence of N and P resorption in response to N inputs emphasizes the importance of nutrient resorption as a pathway by which plants and ecosystems adjust in the face of increasing N availability.
Genome‐wide analysis of histone H3 lysine9 trimethylation by ChIP‐seq in peripheral blood mononuclear cells of uremia patients
Authors: Sui Weiguo , He Huiyan , Yan Qiang , Chen Jiejing , Zhang Ruohan , Dai Yong
Published: April 2013

Treatment of uremia is now dominated by dialysis, in some cases, patients are treated with dialysis for decades, but overall outcomes are disappointing. A number of studies have confirmed the relevance of several experimental insights to the pathogenesis of uremia, but the specific biomarkers of uremia have not been fully elucidated. Studies of the epigenome have attracted little interest in nephrology, especially in uremia. However, to date, our knowledge about the alterations in histone methylation in uremia is unclear. H3K9me3 variations were analyzed in peripheral blood mononuclear cells from 10 uremia patients and 10 healthy subjects, using chromatin immunoprecipitation followed by high‐throughput sequencing (ChIP‐seq). There were 96 genes with significantly different expressions in the uremia patients compared with the normal controls. Forty‐two increased and 54 decreased H3K9me3 genes displaying significant differences were found in uremia patients compared with healthy subjects. Five positive genes, ras‐related C3 botulinum toxin substrate 3 (RAC3), polycomb group ring finger 2 (PCGF2), myosin heavy chain 3 (MYH3), noggin (NOG), serpin peptidase inhibitor 8 (SERPINB8), were selected and quantified. Our studies indicate that there are significant alterations of H3K9me3 in uremia patients; these significant H3K9me3 candidates may help to explain the immunological disturbance and high cardiovascular complications in uremia patients. Such novel findings show the significance of H3K9me3 as a potential biomarker or promising target for epigenetic‐based uremia therapies.
Differential expression analysis of Golgi apparatus proteomes in hepatocellular carcinomas and the surrounding liver tissues
Authors: Yang Yaying , Luo Yi , Li Xiujun , Yi Yongfen
Published: April 2013

Aim

Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide. Liver is the largest human digestive gland with abundant Golgi apparatus involved in cell division, migration and apoptosis and others.

Methods

In the present study, Golgi apparatus of HCC and the surrounding liver tissues were isolated by sucrose density gradient centrifugation and identified by electron microscopy and enzymology methods. Using 2‐D gel electrophoresis and mass spectrometry, 17 differentially expressed protein of Golgi apparatus in HCC and the surrounding liver tissue were screened and identified in the Mascot database.

Results

Of those differentially expressed proteins, six were upregulated and 11 were downregulated, some of them were related to the biological processes such as protein sorting, glycosylation, cell cycle regulation, transcription regulation and Golgi integrity. One protein, annexin A5, was verified to be upregulated in HCC by western blot.

Conclusion

The differentially expressed proteins may provide new insight into HCC biology and potential diagnostic and therapeutic biomarkers.
Patient information comes of age
Authors: Murphy Jeannette
Published: April 2013

This virtual issue (VI) has been assembled to coincide with the 8th Annual Patient Information Conference 2013 organised by the UK Patient Information Forum (PiF). The conference theme ‘Information and support – a service in its own right’ is a response to policy documents and initiatives in both Scotland and England which signal the coming of age of patient/consumer information. The VI consists of a collection of open access articles and addresses the question ‘What can health science librarians do to ensure that the public are able to find, appraise and use health information?’ This material provides research evidence, and examples of the types of initiatives librarians have undertaken to make information a health and care service in its own right. Two recurrent messages are that health science librarians need to form partnerships with healthcare providers and they have a role to play in improving health literacy skills.
The carotenoid‐based red cap of theMiddleSpottedWoodpeckerDendrocopos mediusreflects individual quality and territory size
Authors: Leniowski Konrad , Węgrzyn Ewa
Published: April 2013

Carotenoid‐based plumage ornaments have the potential to signal individual condition and health in many species of birds. However, very little is known about the function of red plumage in woodpeckers. We assessed whether the red cap displayed by both male and femaleMiddleSpottedWoodpeckers reflects individual quality, finding that the size of the cap is sex‐dependent, whereas the brightness of the cap correlates with the body condition of an individual. Furthermore, birds with brighter caps had larger clutches, suggesting that cap coloration may be an honest signal of parental quality in woodpeckers. Interestingly, more colourful individuals also occupied smaller territories, suggesting that territory size and territory quality may be inversely related in theMiddleSpottedWoodpecker.
Local extinction processes rather than edge effects affect ground beetle assemblages from fragmented and urbanised old beech forests
Authors: Gaublomme Eva , Eggermont Hilde , Hendrickx Frederik
Published: April 2013

Local extinction of specialist species due to fragmentation is one of the major causes of biodiversity loss. Increased extinction rates in smaller fragments are expected to result from both smaller local population sizes, which increase the effect of environmental or demographic stochasticity, and increased edge effects. The relative effect sizes of these two factors are still poorly investigated, however.

We attempt to disentangle these effects on ground beetle communities of temperate broadleaved woodland fragments situated in one of the most urbanised regions in Belgium. Assemblages were sampled along transects that extended from 30 m outside to 100 m inside both small and large historical forest fragments.

Although species assemblages within the forest were highly distinct compared to those sampled outside the forest, species turnover along these transects was less pronounced within forest fragments indicating only weak edge effects. The magnitude of edge effects did not differ significantly between large and small fragments. Nevertheless, larger differences in species composition were observed with respect to fragment size, wherein highly specialised species persisted only in the largest fragment.

In summary, increased local extinction processes in smaller fragments, which led to a strong reduction in specialised and wingless forest species, appeared to be the most important factor that drives changes in species composition in this historical and fragmented woodland complex.
Role of NF‐κB in the pathogenesis of psoriasis elucidated by its staining in skin biopsy specimens
Authors: Moorchung Nikhil , Kulaar Janmeet S. , Chatterjee Manas , Vasudevan Biju , Tripathi Tanu , Dutta Vibha
Published: April 2013

Background

NF‐κB is a transcription factor belonging to the Re1 family, and it regulates the activity of a large number of proinflammatory genes. Its role in psoriasis, which is a prototype chronic inflammatory disease, is therefore expected to be considerable. It has been found that many of the triggering factors for psoriasis initiate inflammation by activation of NF‐κB.

Methods

Skin biopsies of 74 psoriatic cases were studied for the grade of NF‐κB staining. They were then correlated with the histopathological indices of severity, especially epidermal hyperplasia and inflammatory infiltrate.

Results

Epidermal nuclear positivity for NF‐κB correlated with the grade of epidermal hyperplasia (P = 0.043). There was a significant correlation between grade of basal cell positivity of NF‐κB and inflammatory infiltrate (P = 0.004). Lymphocyte staining showed a strong correlation with epidermal and basal cell staining pattern for NF‐κB (P = 0.004 and 0.003, respectively). There was, however, no correlation of lymphocyte staining with any histopathological parameter. There was also a peculiar propensity for NF‐κB to show a positive nuclear stain at the tips of dermal papillae.

Conclusions

The study has demonstrated that translocation of NF‐κB in the epidermis and basal cells is responsible for two of the key pathological features of psoriasis, epidermal hyperplasia, and inflammation. We have postulated that translocation of NF‐κB in lymphocytes, in psoriatic skin leads to NF‐κB translocation in the epidermis and basal cells. NF‐κB is therefore likely to be one of the key molecules in the pathogenesis of psoriasis.
Interpreting elevated fetal hemoglobin in pathology and health at the basic laboratory level: new and known γ‐ gene mutations associated with hereditary persistence of fetal hemoglobin
Authors: Amato A. , Cappabianca M. P. , Perri M. , Zaghis I. , Grisanti P. , Ponzini D. , Di Biagio P.
Published: April 2013

Fetal hemoglobin may be slightly or significantly elevated in post‐natal life due to a number of causes. We report two novel mutations found on the promoter of the Aγ gene and summarize all common and rare determinants associated with hereditary persistence of fetal hemoglobin (HPFH) described thus far. Hematological and molecular analysis of the Aγ globin gene in two cases of HPFH. Comparison of the novel cases with all those described in the literature. We have found two novel mutations in three Italian patients with HbF values between 5.9% and 6.5% without an elevated HbA2 and with normal hemoglobin parameters. In two probands (mother and son), a −197 C>T transition was observed, while in a single individual, a −113 A>G transition was present on the distal CCAAT box of the Aγ gene. As no other abnormalities were present in both γ‐gene promoters and the changes are located on regulatory sequences, we may conclude that these mutations are responsible for the HPFH phenotype shown by the carriers. The laboratory should be able to discriminate between elevated HbF due to artifacts or to serious causes including bone marrow malignancies, aplastic anemia, and β‐thalassemia major or recessive traits such as β‐thalassemia minor, δβ‐thalassemia, or nonpathological conditions induced by mutations or polymorphisms of the γ‐gene promoters that may even be beneficial when present in patients with thalassemia major or sickle cell disease and, in particular, when these patients are treated with hydroxyurea.
Analysis of gene transcription and relative abundance of the cys‐motif gene family from Campoletis sonorensis ichnovirus (CsIV) and further characterization of the most abundant cys‐motif protein, WHv1.6
Authors: Gill T. A. , Webb B. A.
Published: April 2013

The cys‐motif gene family associated with Campoletis sonorensis ichnovirus contains 10 members, WHv1.6, WHv1.0, VHv1.1, VHv1.4, AHv1.0, A'Hv0.8, FHv1.4, LHv2.8, UHv0.8, and UHv0.8a. The results of this study indicated that, within the encapsidated virion, WHv1.6 is the most abundant cys‐motif gene, while the combined AHv genes are the least abundant. During parasitization of Heliothis virescens by Campoletis sonorenis, WHv1.6 transcripts were the mostly highly expressed, while the combined UHv genes had the lowest expression. Further proteomic analysis of WHv1.6 showed that it accumulates at high levels in parasitized plasma by 6 h, and is detectable in the haemocytes, fat body, malpighian tubules, nerve cord and epidermis by 2 days after parasitization. Localization experiments led us to conclude that WHv1.6 interacts with the cell membrane along with other organelles within a virus‐infected cell and prevents immunocytes from spreading or adhering to a foreign surface. Similarly to VHv1.4 and VHv1.1, WHv1.6 is able to inhibit the translation of haemocyte and Malpighian tubule RNAs. Our results showed that the expression of cys‐motif genes during parasitization is related to the gene copy number of each gene within the encapsidated virion and may also be dependent upon cis‐regulatory element activity in different target tissues. In addition, WHv1.6 plays a major role in inhibiting the cellular encapsulation response by H. virescens.
Reevaluating leishmanin skin test as a marker for immunity against cutaneous leishmaniasis
Authors: Momeni Boroujeni Amir , Aminjavaheri Malih , Moshtaghian Bahador , Momeni Arash , Momeni Ali Z
Published: April 2013

Objective

The leishmanin skin test (LST) has been used for clinical diagnosis of leishmaniasis and epidemiological studies of the disease. Thus far, evidence has suggested that LST conversion indicates a degree of protection against leishmaniasis. In this study, we have put this assumption to test.

Methods and materials

A total of 273 participants with positive LST living in a hyperendemic area for leishmaniasis were followed for three years for any occurrence of cutaneous leishmaniasis.

Results

Twenty‐two of the 273 participants contracted leishmaniasis during the 3‐year follow‐up. These new cases included participants who had a previous history of active disease, those who had a history of leishmanization, or those who were suspected of having a history of subclinical infection.

Discussion

In this study, the incidence of leishmaniasis in individuals with positive LST was close to the general incidence of the disease in the same hyperendemic area. These results suggest that although LST conversion may be a marker for partial immunity towards leishmaniasis, it may not, however, indicate complete protection against the disease, and consequently there is a need for revision of current vaccine development approaches which are based on rendering vaccinated individuals LST positive.
Bi‐Oblique Dynamic Proximal Ulnar Osteotomy in Dogs: Reconstructed Computed Tomographic Assessment of Radioulnar Congruence over 12 weeks
Authors: Fitzpatrick Noel , Caron Alexandre , Solano Miguel Angel
Published: April 2013

Objective

To evaluate radioulnar joint modification using computed tomography (CT) after bi‐oblique dynamic proximal ulnar osteotomy (BODPUO).

Study design

Clinical study.

Animals

Dogs (n = 18, 26 elbows) with elbow incongruence treated by a single surgeon with BODPUO.

Methods

Radioulnar space measurements were performed on transverse, frontal, and sagittal CT projections preoperatively and after radiographically determined osteotomy healing.

Results

Three transverse plane measurements were statistically different than preoperatively at 12 weeks after the surgery demonstrating divergence of the lateral coronoid region of the radial incisure of the ulna from the radial head. None of the other measurements within the elbow were statistically different, but measurements of the radioulnar space at the level of the osteotomy site documented a statistically significant caudal tipping of the distal extent of the proximal ulnar segment.

Conclusion

CT measurements documented a significant increase in radioulnar joint space at the mid‐coronoid level, at the level of the base of the medial coronoid process, and at the level of the lateral coronoid process. This corresponds to cranially directed rotation of the medial coronoid process around the proximal radial epiphysis. A tendency for cranial tilting of the medial coronoid process was observed, which was confirmed by statistically significant caudal tipping of the distal extent of the proximal ulnar segment.
Burden of Stroke in Estonia
Authors: Kõrv Janika , Vibo Riina
Published: April 2013

Estonia is the smallest of the three Baltic countries. The decline in incidence of first-ever stroke during the 1990s has left Tartu, Estonia with a relatively low stroke incidence. However, the incidence rates for younger age groups, and the 28-day case fatality rate are higher compared with several other studies. Developments in the national health care system in recent years have been positive: the decline of mortality rate of stroke in Estonia is greater than the European Union average. However, the mortality of cardiovascular diseases is higher compared with several European countries. The prevalence of most stroke risk factors is comparable with European Union countries, while atrial fibrillation is somewhat more frequent (30%) among the patients having suffered from ischemic stroke. The management of stroke in Estonia has been in accordance with European and national stroke guidelines. Stroke units are organized in regional and central hospitals in bigger cities. A well-developed and free ambulance service, and a high priority of stroke code, enable a quick transportation of patients to the nearest hospital providing thrombolytic therapy. The number of thrombolyzed stroke cases has increased since 2003. The Estonian Stroke Initiative was founded in 2008 to improve stroke care, promote regional networks, and increase stroke knowledge among the general population and medical professionals. Since then, several activities regarding stroke awareness have been organized.
Reduced prevalence of obesity in children with primary fructose malabsorption: a multicentre, retrospective cohort study
Authors: Disse S. C. , Buelow A. , Boedeker R.‐H. , Keller K.‐M. , Kim‐Berger H.‐S. , Wudy S. A. , Zimmer K.‐P.
Published: April 2013

Background

Studies in animals and in man have demonstrated that excessive consumption of fructose can cause all components of the metabolic syndrome.

Objective

To investigate the impact of a condition resulting in decreased absorption of fructose, on obesity.

Methods

In a multicentre study, we analyzed a cohort of paediatric patients with suspected primary fructose malabsorption (FM). Patients with chronic intestinal diseases were excluded. The final cohort comprised 628 patients.

Results

302 patients were diagnosed with primary FM (48.1%). The proportion of obese patients was lower among FM patients, compared to non‐FM patients (2.3 vs. 6.1%, P = 0.029). Logistic regression analysis with inclusion of various covariates showed that FM was negatively associated with obesity (OR 0.35, 95% CI [0.13; 0.97]). We discuss several mechanisms involving the metabolic, endocrine and gastrointestinal system.

Conclusions

Our data indicate that primary FM is negatively associated with childhood obesity.
Patients' experiences of bladder emptying in connection with hip surgery: an issue but of varying impact
Authors: Nyman Maria Hälleberg , Gustafsson Margareta , Langius‐Eklöf Ann , Isaksson Ann‐Kristin
Published: April 2013

Aim

To describe patients' experiences of bladder emptying and urinary catheterization in connection with hip surgery.

Background

The capacity of bladder emptying in connection with hip surgery is affected by pain, medication and confinement to bed. In connection with such surgery urinary catheterization is often performed, either intermittent or indwelling. Hip surgery patients' experiences of urinary catheterization and urination have not been studied before.

Design

A qualitative study with descriptive design was conducted among hip surgery patients.

Methods

Thirty face‐to‐face interviews were conducted from October 2009–March 2010 and analysed with inductive qualitative content analysis.

Results

The main category ‘An issue but of varying impact’ illustrated the patients' experiences of bladder emptying and urinary catheterization. Five generic categories were identified: ability to urinate, catheter is convenient, bothersome bladder emptying, intrusion on dignity and concern about complications. Irrespectively of whether the patients were able to urinate or were catheterized, the bladder emptying situation was not as usual. It was described as uncomplicated and experienced as being positive if the patients were able to urinate by themselves or when catheterization was experienced as convenient. Some patients did not want to be catheterized, approving it only reluctantly. Independently of the method for bladder emptying, the patients in our study would choose the same method next time.

Conclusions

The patients undergoing hip surgery seem to experience bladder emptying as an issue but of varying impact. Both bladder emptying through micturition and bladder emptying through catheterization are described in positive and negative terms.
The impact of the psychological contract, justice and individual differences: nurses take it personally when employers break promises
Authors: Rodwell John , Gulyas Andre
Published: April 2013

Aim

To explore affective and attitudinal outcomes of aspects of the psychological contract, organizational justice and negative affectivity in nursing.

Background

Job satisfaction, mental health and commitment to organizations and the nursing profession is important for nurse retention. The psychological contract and organizational justice are related constructs that have been linked to these outcomes, as has the characteristic of negative affectivity. Rarely have the relationships between these concepts and outcomes been examined.

Design

Cross‐sectional data were collected during November, 2007.

Method

Survey data collected on Registered Nurses and midwives from a large metropolitan hospital in Australia (n = 193, after removing missing cases and outliers) were analysed using structural equation modelling. The model used self‐report measures of psychological contract obligations, fulfilment and breach, organizational justice and negative affectivity as predictors of job satisfaction, organizational commitment, career commitment and psychological distress.

Results

Goodness‐of‐fit statistics confirmed a well‐fitting model. The model explained 49%, 29%, 60% and 47% of the variance in psychological distress, job satisfaction, organizational commitment and career commitment respectively.

Conclusion

Findings support the influence of the psychological contract, fairness and individual differences on outcomes important to nurse retention. Keeping promises is more important than making promises that cannot be kept. The results support a discrepancy mechanism underlying fulfilment and breach. The impact of breach suggests that nurses take breach personally, whereas fulfilment may represent a global evaluation of discrepancies. Ultimately, fulfilling, rather than making promises, keeps nurses happy.
Emotional intelligence: enhancing values‐based practice and compassionate care in nursing
Authors: Rankin Bob
Published: April 2013

Aims

This article reports on a study which examined the predictive relationship between emotional intelligence and the following programme outcomes for student nurses: clinical practice performance; academic performance and retention.

Background

In the context of concerns about a lack of compassionate care and amid calls for values‐based selection procedures, emotional intelligence is emerging as a potential factor which might help the nursing profession to address some of these concerns.

Design

The study employed a longitudinal survey.

Methods

Student nurse applicants (n = 307) were asked to complete self‐report scales to establish a total score and four subscores for emotional intelligence and these scores were matched to individual student's performance on the undergraduate programme. The scales were completed between June–September 2007 and performance data were collected up until January 2009.

Results

A significant predictive relationship was found between emotional intelligence and all three programme outcomes: practice performance; academic performance and retention, after controlling for prior academic achievement, age and gender. There was a zero Pearson correlation between prior academic attainment and overall emotional intelligence, indicating that both predict different outcomes.

Conclusions

Recruitment and selection procedures should consider emotional intelligence as a legitimate additional entrance criterion for student nurses and further research is required to examine the potential relationship between emotional intelligence and compassionate care.
Exploring risk, prevention and educational approaches for the non‐diabetic offspring of patients with type 2 diabetes – a qualitative study
Authors: Gordon Charlotte , Walker Mark , Carrick‐Sen Debbie
Published: April 2013

Aim

To understand the knowledge and perceptions of type 2 diabetes and to explore preferable educational strategies in the non‐diabetic offspring of patients with the disease.

Background

Type 2 diabetes is an increasingly prevalent disease with significant long‐term consequences. Offspring of patients with type 2 diabetes have an increased risk of developing the disease compared with the general population. Previous studies have shown that offspring have a poor perception of their own risk.

Design

A qualitative study was carried out using semi‐structured one‐to‐one interviews. Analysis was completed using a structured framework approach.

Methods

Research was carried out during January–March 2011 in the north east of UK. Six offspring of patients diagnosed with the disease were interviewed.

Results

Participants balanced positive and negative aspects of their lifestyle behaviours to estimate their own risk. They had adequate knowledge of healthy lifestyle behaviours, but were uncertain about the long‐term effects and seriousness of the disease and the role of inheritance. Behavioural changes at an individual level would only be motivated by an event, which would impact on their own health. Participants believed that ‘fear’‐based strategies to health promotion would be most effective to encourage behaviour change.

Conclusion

Knowledge of individual risk and why diabetes was serious was limited and variable. The health behaviours of this at‐risk group were complex. Nurses engaged in the care of at‐risk individuals must take this complexity into account when developing and implementing multi‐faceted strategies to improve awareness.
Telocytes in neuromuscular spindles
Authors: Díaz‐Flores Lucio , Gutiérrez Ricardo , Sáez Francisco J. , Díaz‐Flores Lucio , Madrid Juan F.
Published: April 2013

A new cell type named telocyte (TC) has recently been identified in various stromal tissues, including skeletal muscle interstitium. The aim of this study was to investigate by means of light (conventional and immunohistochemical procedures) and electron microscopy the presence of TCs in adult human neuromuscular spindles (NMSs) and lay the foundations for future research on their behaviour during human foetal development and in skeletal muscle pathology. A large number of TCs were observed in NMSs and were characterized ultrastructurally by very long, initially thin, moniliform prolongations (telopodes – Tps), in which thin segments (podomeres) alternated with dilations (podoms). TCs formed the innermost and (partially) the outermost layers of the external NMS capsule and the entire NMS internal capsule. In the latter, the Tps were organized in a dense network, which surrounded intrafusal striated muscle cells, nerve fibres and vessels, suggesting a passive and active role in controlling NMS activity, including their participation in cell‐to‐cell signalling. Immunohistochemically, TCs expressed vimentin, CD34 and occasionally c‐kit/CD117. In human foetus (22–23 weeks of gestational age), TCs and perineural cells formed a sheath, serving as an interconnection guide for the intrafusal structures. In pathological conditions, the number of CD34‐positive TCs increased in residual NMSs between infiltrative musculoaponeurotic fibromatosis and varied in NMSs surrounded by lymphocytic infiltrate in inflammatory myopathy. We conclude that TCs are numerous in NMSs (where striated muscle cells, nerves and vessels converge), which provide an ideal microanatomic structure for TC study.