bluuebunny/crossref_metadata_2025 huggingface dataset:
Seamounts as refugia from ocean acidification for cold‐water stony corals
Authors: Tittensor Derek P. , Baco Amy R. , Hall‐Spencer Jason M. , Orr James C. , Rogers Alex D.
Published: September 2010

Cold‐water stony corals create habitat for a diverse range of deep‐water species but are thought to be threatened by ocean acidification due to oceanic uptake of anthropogenic CO2. Knowledge of the severity of this threat is hampered by our limited understanding of the distribution and habitat requirements of these corals. Here we estimate the global acidification threat to these organisms using a global database of cold‐water stony coral records and a species distribution modelling approach. We parameterised the models using present‐day environmental data, and then replaced these data with future projections of ocean chemistry from the year 2099. We found suitable coral habitat to be very heterogeneously distributed, being concentrated in the northern North Atlantic and around New Zealand. Projected changes in ocean chemistry induced a pronounced reduction in habitat suitability in the North Atlantic, and a low‐to‐moderate impact elsewhere under both the IPCC IS92a and S650 scenarios. Seamount summits are impacted by these changes, but consistently provide more suitable habitat than the surrounding seafloor, with around 98% of seamount summits having higher suitability in both future scenarios; this is because they lie in shallower waters with a higher aragonite saturation state. These results suggest that anthropogenic‐induced changes in ocean chemistry are likely to severely impact cold‐water stony coral habitat in the deep‐sea of the North Atlantic, and that impacts will be less severe elsewhere. We predict that coral communities on the summits and upper slopes of seamounts will be less susceptible to ocean acidification during this century than those on the surrounding seafloor, and thus that seamounts may serve as temporary refugia.
Survey of pediatric ward hospitalization due to respiratory syncytial virus infection after the introduction of palivizumab to high‐risk infants in Japan
Authors: Kusuda Satoshi , Takahashi Naoto , Saitoh Takami , Terai Masaru , Kaneda Hisashi , Kato Yuichi , Ohashi Atsushi , Watabe Shinichi , Joh‐o Kunitaka , Hirai Katsuki
Published: September 2010

Background:  Respiratory syncytial virus (RSV) infection is a major cause of hospitalization during the winter among infants and young children. In 2002 palivizumab was introduced to high‐risk infants for RSV hospitalization in Japan. It is important to characterize the hospitalized children due to RSV infection after the introduction of palivizumab.

Methods:  A survey was conducted to collect the data from the hospitalized children at 12 participating hospitals during the winter of 2007.

Results:  From October 2007 through April 2008, 8163 children were admitted to participating hospitals, with RSV infection accounting for 811 of those hospitalizations. Mean age in children with RSV infection at hospitalization was 12.4 ± 12.7 months, and children under 24 months of age accounted for 86.4%. The mean gestational age of those at birth was 38.0 ± 2.6 weeks, with 82.4% of the children born at term. Palivizumab was administered in 24 cases of RSV infection, while there were 28 patients who were not treated with palivizumab, even though they met the indication for palivizumab. Death, in a total of five cases, occurred in children who were not treated with palivizumab.

Conclusions:  Palivizumab has been widely used in high‐risk infants who were covered by health insurance, and most of the hospitalized children with RSV infection in the study hospitals were not treated with palivizumab.
Diagnosis of invasion depth in early colorectal carcinoma by pit pattern analysis with magnifying endoscopy
Authors: Tanaka Shinji , Haruma Ken , Nagata Shinji , Oka Shiro , Chayama Kazuaki
Published: September 2010

Background: The aim of this study was to clarify whether various pit patterns on the surface of colorectal tumors are associated with various levels of submucosal invasion.

Methods: We examined pathologic features of the pit pattern of the tumor surface in 457 colorectal adenomas and early carcinomas. The examinations involved the use of magnifying endoscopy with indigocarmine dye spraying or crystal violet staining methods. Regarding the pit pattern classification, we used the types I, II, IIIL, IIIS, IV, VA and VN. We subclassified the VN pit pattern according to the area of the tumor surface covered into grades A (small), B (medium) and C (large).

Results: Magnifying colonoscopic observation revealed the rates of submucosal invasion associated with specific pit patterns to be 1% (3/213) for IIIL, 5% (2/42) for IIIS, 8% (4/57) for IV, 14% (13/93) for VA and 80% (42/52) for VN. The rates of submucosal massive invasion (> 400 μm) associated with specific pit patterns was 0% (0/213) for IIIL, 0% (0/42) for IIIS, 4% (2/57) for IV, 5% (5/93) for VA and 72% (38/52) for VN. Within the VN pit pattern subclassification, the incidence of submucosal invasion ≥ 1500 μm was found each grade (A, B & C): 5% (1/19) for grade A, 64% (14/22) for grade B and 93% (13/14) for grade C.

Conclusion: Determination of pit pattern is useful for prediction of submucosal invasion depth and for decisions concerning treatment in colorectal tumors. Lesions with VA and non‐grade C VN pit patterns are candidates for total endoscopic resection. A grade C VN pit pattern is a definite indicator of severely invasive submucosal carcinoma, which is unresectable by endoscopic resection.
DIFFERENTIAL DIAGNOSIS OF GASTRIC LESIONS BY MAGNIFYING ENDOSCOPY
Authors: Niwa Yasumasa , Ohashi Akira , Miyahara Ryouji , Ohmiya Naoki , Goto Hidemi
Published: September 2010

We performed magnifying endoscopy for patients with suspected gastric diseases. Among these patients, 67 patients with early gastric cancer and 31 benign gastric diseases were enrolled in this study. The patients with early gastric cancer included 46 differentiated tubular adenocarcinoma (33 mucosal cancer, 13 submucosal cancer) and 21 non‐differentiated tubular adenocarcinoma (12 mucosal cancer, 9 submucosal cancer). The benign gastric lesions included 23 gastric ulcer or gastric ulcer scars, three gastritis, and five gastric adenomas. Small regular patterns were observed; 39% in differentiated adenocarcinoma, 5% in undifferentiated adenocarcinoma, and 19% in benign gastric diseases. Irregular patterns were observed 37%, 52%, and 6%. Lack of visible structure was observed 18%, 90%, and 10%. Abnormal vessels were observed 26%, 81%, and 16%. Small regular patterns were observed significantly more frequently in differentiated adenocarcinoma than in undifferentiated adenocarcinoma (P < 0.001). Lack of visible structure and Irregular patterns were observed significantly more frequently in undifferentiated adenocarcinoma than in differentiated adenocarcinoma (P < 0.001). In order to spread this useful endoscopy widely easy recognition of abnormality, histological backbone, and further technical developments in hardware and software should be required.
INTRADUCTAL ULTRASONOGRAPHY FOR THE STAGING OF BILE DUCT CARCINOMA
Authors: Tamada Kiichi , Wada Shinichi , Tano Shigeo , Ohashi Akira , Sugano Kentaro
Published: September 2010

Intraductal ultrasonography is useful in the staging of extrahepatic bile duct cancer including tumor depth infiltration, pancreatic parenchymal invasion, portal vein invasion, and right hepatic artery invasion. However, it has limitations in assessing lymph node metastases. The assessment of longitudinal cancer extension along the bile duct is a promising aspect of this area. However, a thickening of the bile duct wall may represent either inflammatory changes that may result from mechanical irritation by a biliary drainage catheter or other factors, or the longitudinal extension of the cancer.
TWO CASES OF MUCIN‐PRODUCING CHOLANGIOCARCINOMA DIAGNOSED BY PERORAL CHOLANGIOSCOPY
Authors: Uno Koji , Yasuda Kenjiro , Tanaka Kiyohito , Cho Eisai , Nakajima Masatsugu
Published: September 2010

Mucin‐producing cholangiocarcinoma, which excretes excessive amounts of mucin into the biliary tract and causes obstructive jaundice and cholangitis due to the mucin retention, is rare. In this paper, we report two cases of this disease, which were demonstrated by peroral cholangioscopy (POCS). The radiologic features of these tumors show the diffuse dilatation of the bile ducts demonstrated by computed tomography (CT) and ultrasonography (US), the amorphous filling defects in the dilated bile ducts revealed by cholangiography. Their endoscopic features are mucin flowing out from the papilla of Vater during endoscopic retrograde cholangiography (ERC), and the papillary tumor with contiguous superficial spread in the bile ducts observed by cholangioscopy, although removal of mucin in the biliary tract is sometimes necessary before cholangioscopy in order to examine the lesion sufficiently. According to the previous reports, prognosis after curative resection of these tumors is better than that of ordinary type of cholangiocarcinoma. Therefore, it is important to examine the tumor extension in the bile ducts by cholangioscopy, although a selection of route inserting cholangioscope is controversial.
A CASE WITH GALLBLADDER CANCER DIAGNOSED BY PERORAL CHOLECYSTOSCOPY (POCCS) AFTER LITHOTRIPSY IN THE COMMON BILE DUCT STONES
Authors: Itoi Takao , Kurihara Toshio , Tsuchiya Takayoshi
Published: September 2010

A 76‐year‐old woman was admitted for treatment of obstructive jaundice. An abdominal computed tomography revealed common bile duct stones and gallstones in addition to gallbladder wall thickness. The endoscopic retrograde cholangiopancreatography (ERCP) also revealed common bile duct stones, gallstones, and irregular imaging of gallbladder wall. After lithotripsy in the bile duct completely, we observed inside the gallbladder by peroral cholecystoscopy (POCCS). POCCS findings and biopsy under direct vision showed papillary adenocarcinoma were observed in body of the gallbladder.
ENDOSCOPIC NECROSECTOMY UNDER DIRECT VISION AFTER ENDOSCOPIC ULTRASOUND‐GUIDED CYSTGASTROSTOMY FOR ORGANIZED PANCREATIC NECROSIS
Authors: Hisa Takeshi , Tanaka Masaki , Ohkubo Hiroki , Furutake Masayuki , Takamatsu Masato
Published: September 2010

A 56‐year‐old man was referred for an enlarging pancreatic pseudocyst that developed after severe acute pancreatitis with gallstones. Abdominal ultrasound showed a huge cystic lesion with a large amount of solid high echoic components. Arterial phase contrast‐enhanced computed tomography scan revealed arteries across the cystic cavity. Stents were placed after endoscopic ultrasound‐guided cystgastrostomy; however, the stents were obstructed by necrotic debris, and secondary infection of the pseudocyst occurred. Therefore, the cystgastrostomy was dilated by a dilation balloon, and a forward‐viewing endoscope was inserted into the cystic cavity. Many vessels and a large amount of necrotic debris existed in the cavity. Under direct vision, all necrotic debris was safely removed using a retrieval net and forceps. One year after this procedure, there was no recurrence. Our case indicates that peripancreatic fat necrosis can cause exposure of vessels across/along the cystic cavity, and blind necrosectomy should be avoided.
LAPAROSCOPIC FEATURES AND INTEROBSERVER VARIATION OF HISTOLOGICAL DIAGNOSIS IN PATIENTS WITH NON‐ALCOHOLIC FATTY LIVER DISEASE
Authors: Miyaoka Hiroaki , Michitaka Kojiro , Tokumoto Yoshio , Miyake Teruki , Shigematsu Shuichiro , Soga Yoshiko , Abe Masanori , Hiasa Yoichi , Matsuura Bunzo , Horiike Norio , Onji Morikazu
Published: September 2010

Background: There is a lack of information regarding the laparoscopic features and interobserver variation of histological diagnosis in patients with non‐alcoholic fatty liver disease (NAFLD).

Methods: Thirty‐five patients with NAFLD were studied for laparoscopic and histological findings. For the study of interobserver variation of histological diagnosis, two pathologists from different hospitals independently observed the 35 liver samples with patient names blinded to the pathologists. Assessment of laparoscopic findings on the diagnosis of non‐alcoholic steatohepatitis (NASH) was also investigated.

Results: Histological diagnoses of the two pathologists were identical in 28 (five fatty liver, 23 NASH) patients, whereas they were not identical in seven patients (20%). The difference of diagnosis was mainly caused by the difference of judgment of minimal fibrosis and minimal necroinflammatory grade. Analysis of the laparoscopic findings revealed that small regular depressions were frequently found on the liver surface in patients with NASH. Scatter of dye on the liver surface facilitated the observation of this finding. Sensitivity and specificity of small depressions in the diagnosis of NASH was 73.9% and 80.0%, respectively.

Conclusion: Interobserver variation of the diagnosis was found in 20% of patients with NAFLD. Small regular depressions were characteristic findings of NASH. Laparoscopy is assessed to be useful for diagnosis of NAFLD, especially of early stage of NASH.
A COMPARISON OF BLADDER NECK INCISION AND TRANSURETHRAL PROSTATIC RESECTION
Authors: Miller John , Edyvane Katherine A. , Sinclair Graham R. , Porter Adrian J. , Marshall Villis R.
Published: September 2010

Book reviews in this article:

Between 1978 and 1988, 108 patients underwent bladder neck incision (BNI) for bladder outflow obstruction. These patients were compared to a similar group who underwent transurethral resection of the prostate (TURP), during the same time period. Only patients with minimal prostatic enlargement (< 10 g) with prominent bladder necks and small lateral lobes were included in the study. In addition, all patients in the resection group had a resection weight of less than 10 g on the histopathology report. Patients were followed up by means of a posted questionnaire to which 59 patients in the BNI group and 86 in the TURP group responded. Pre‐operative and peri‐operative data were also collected from these respondents by a retrospective case record review. This found both operations to be safe with low morbidity and mortality. BNI was better than TURP in terms of shorter operation length (P < 0.017) and shorter duration of catheterization (P < 0.004). No other peri‐operative differences were found. Follow‐up results from the questionnaire showed no significant differences in symptoms between the two groups. Similarly, there was no difference in the number of re‐operations performed over the 10 year period studied. Patient assessment of their operation was initially favourable in both groups (> 80% patient approval) however, both treatment groups experienced a gradual drop in patient approval over the 10 year period. There were no differences in the level of approval between the BNI and TURP groups.
COLLIS‐NISSEN GASTROPLASTY FUNDOPLICATION FOR COMPLICATED GASTRO‐OESOPHAGEAL REFLUX DISEASE
Authors: Martin Christopher J. , Cox Michael R. , Cade Richard J.
Published: September 2010

Book reviews in this article:

Collis‐Nissen gastroplasty fundoplication is a widely accepted operation for patients with gastro‐oesophageal reflux disease complicated by oesophageal shortening. Assessment of this operation by 24 h oesophageal pH monitoring has not previously been reported. Our aim was to correlate clinical and endoscopic results with 24 h pH studies. Twenty‐nine patients had a gastroplasty fundoplication, as a result of which twenty‐five (86%) had an excellent clinical result, 2 (7%) had a good result and 2 (7%) had a poor result. The two poor results were in patients who had previously undergone anti‐reflux surgery. All 29 patients had pre‐operative pH monitoring. Twenty‐three patients had postoperative pH studies. Oesophageal acidification times were normal postoperatively in 16 of 23 patients however, 7 still had an abnormal study. One of the two patients with a poor clinical result was studied and persistent severe oesophageal acidification was demonstrated. The remaining 6 patients with abnormal studies were asymptomatic. Five of the 6 asymptomatic patients also had a normal oesophagogastroscopy with no macroscopic oesophagitis. We conclude that 24 h pH monitoring after the Collis‐Nissen operation should only be performed to assess clinically and endoscopically poor results.
OVARIAN ACTINOMYCOSIS PRESENTING AS ACUTE PERITONITIS
Authors: Dawson John McL. , O'Riordan Brendan , Chopra Saif
Published: September 2010

Book reviews in this article:

A patient with acute peritonitis due to ovarian actinomycosis and the association of this disease with the intrauterine contraceptive device is discussed. Because adequate treatment requires prolonged antibiotics the diagnosis should be sure. Unfortunately if antibiotics are given pre‐operatively culture is usually unsuccessful and thus careful examination of all removed material is essential. As many of these women are of child bearing age surgical intervention should aim to preserve fertility wherever possible.
Biological stoichiometry from genes to ecosystems
Authors: Elser J.J. , Sterner R.W. , Gorokhova E. , Fagan W.F. , Markow T.A. , Cotner J.B. , Harrison J.F. , Hobbie S.E. , Odell G.M. , Weider L.W.
Published: September 2010

Ecological stoichiometry is the study of the balance of multiple chemical elements in ecological interactions. This paper reviews recent findings in this area and seeks to broaden the stoichiometric concept for use in evolutionary studies, in integrating ecological dynamics with cellular and genetic mechanisms, and in developing a unified means for studying diverse organisms in diverse habitats. This broader approach would then be considered “biological stoichiometry”. Evidence supporting a hypothesised connection between the C:N:P stoichiometry of an organism and its growth rate (the “growth rate hypothesis”) is reviewed. Various data indicate that rapidly growing organisms commonly have low biomass C:P and N:P ratios. Evidence is then discussed suggesting that low C:P and N:P ratios in rapidly growing organisms reflect increased allocation to P‐rich ribosomal RNA (rRNA), as rapid protein synthesis by ribosomes is required to support fast growth. Indeed, diverse organisms (bacteria, copepods, fishes, others) exhibit increased RNA levels when growing actively. This implies that evolutionary processes that generate, directly or indirectly, variation in a major life history trait (specific growth rate) have consequences for ecological dynamics due to their effects on organismal elemental composition. Genetic mechanisms by which organisms generate high RNA, high growth rate phenotypes are discussed next, focusing on the structure and organisation of the ribosomal RNA genes (the “rDNA”). In particular, published studies of a variety of taxa suggest an association between growth rate and variation in the length and content of the intergenic spacer (IGS) region of the rDNA tandem repeat unit. In particular, under conditions favouring increased growth or yield, the number of repeat units (“enhancers”) increases (and the IGS increases in length), and transcription rates of rRNA increase. In addition, there is evidence in the literature that increased numbers of copies of rDNA genes are associated with increased growth and production. Thus, a combination of genetic mechanisms may be responsible for establishing the growth potential, and thus the RNA allocation and C:N:P composition, of an organism. Furthermore, various processes, during both sexual and asexual reproduction, can generate variation in the rDNA to provide the raw material for selection and to generate ecologically significant variation in C:N:P stoichiometry. This leads us to hypothesize that the continuous generation of such variation may also play a role in how species interactions develop in ecosystems under different conditions of energy input and nutrient supply.
Genetic Allee effects on performance, plasticity and developmental stability in a clonal plant
Authors: Fischer M. , Van Kleunen M. , Schmid B.
Published: September 2010

Negative effects of small population size on fitness, so‐called Allee effects, may threaten population persistence even in intact habitat remnants. We studied genotypes of 14 isolated populations of the clonal plantRanunculus reptans,for which molecular genetic (RAPD‐) variability is higher for large than for small populations. In a competition‐free greenhouse environment vegetative offspring of genotypes from large populations produced more rosettes and flowers, indicating higher fitness. Within‐genotype coefficients of variation in performance traits, indicating developmental instability, were lower for genotypes from populations with higher RAPD‐variability. In competition with a taller grass, we found relative reduction in leaf length less pronounced for plants from large populations, suggesting higher adaptive plasticity. Our experimental study of a plant with predominantly vegetative reproduction suggests, that negative genetic effects of recent habitat fragmentation, which so far rather were expected in plants with frequent sexual reproduction, are more severe and more common than previously acknowledged.
Demographic analysis of continuous‐time life‐history models
Authors: De Roos André M.
Published: September 2010

I present a computational approach to calculate the population growth rate, its sensitivity to life‐history parameters and associated statistics like the stable population distribution and the reproductive value for exponentially growing populations, in which individual life history is described as a continuous development through time. The method is generally applicable to analyse population growth and performance for a wide range of individual life‐history models, including cases in which the population consists of different types of individuals or in which the environment is fluctuating periodically. It complements comparable methods developed for discrete‐time dynamics modelled with matrix or integral projection models. The basic idea behind the method is to use Lotka's integral equation for the population growth rate and compute the integral occurring in that equation by integrating an ordinary differential equation, analogous to recently derived methods to compute steady‐states of physiologically structured population models. I illustrate application of the method using a number of published life‐history models.
Bilateral intraocular malignant neuroectodermal tumors in a telescope goldfish (Carassius auratus)
Authors: Bartlett Susan L. , Peters Rachel M. , Lombardino Ingrid M. , Bowser Paul R.
Published: September 2010

A 5‐year‐old male telescope goldfish (Carassius auratus) developed buphthalmia of the left eye. An enucleation was performed and a diagnosis of a neuroectodermal tumor was made on histological examination. Although the fish initially recovered, it was killed 49 days postsurgery due to a severe decline in its condition. On histological evaluation of postmortem tissue samples, it was determined that the fish also had a neuroectodermal tumor of the right eye with local invasion of the brain. On immunohistochemistry, the neoplastic cells were positive for S‐100. To the authors’ knowledge, this is the first published case of naturally occurring bilateral intraocular neuroectodermal tumors in a fish.
CASE REPORT: Medical and surgical management of severe inflammation of the nictitating membrane in a Giant Panda (Ailuropoda melanoleuca)
Authors: Boedeker Nancy C. , Walsh Timothy , Murray Suzan , Bromberg Nancy
Published: September 2010

A 10‐year‐old male giant panda (Ailuropoda melanoleuca) presented for severe, acute swelling and protrusion of the right nictitating membrane, unresponsive to topical therapy. Excisional biopsy of the nictitating membrane and its associated lacrimal gland was elected due to necrosis and friability of the tissue. Histopathology revealed suppurative, necrotizing conjunctivitis and dacryoadenitis. Culture grew Stenotrophomonas maltophila and Enterococcus spp with extensive antibiotic resistance. Treatment with topical and systemic antibiotics based on sensitivity results was initiated. All treatments were well tolerated. Healing was uncomplicated with no recurrence of the lesion and no clinical evidence of keratoconjunctivitis sicca. Ophthalmic exams and Schirmer tear tests performed opportunistically during postoperative anesthetic procedures were unremarkable, confirming that excision of the nictitating membrane had not caused clinically significant detrimental effects. The etiology of this lesion remains undetermined, but trauma is suspected. To the authors’ knowledge, this is the first report of nictitating membrane pathology and excision in the giant panda.
CASE REPORT: Iridociliary melanoma with secondary lens luxation: distinctive findings in a long‐horned cowfish (Lactoria cornuta)
Authors: Da Silva Enry Garcia , Gionfriddo Juliet R. , Powell Cynthia C. , Campbell Terry W. , Ehrhart E. J.
Published: September 2010

This report describes a long‐horned cowfish, which was diagnosed with buphthalmia and lens sub‐luxation in the right eye, conditions that progressed to complete anterior lens luxation and secondary keratoconus. Three months after the initial evaluation, a pigmented mass was observed protruding from the vitreous. An enucleation was performed under general anesthesia. Ocular histopathology revealed an iridociliary melanoma. Reports of intraocular melanomas are extremely rare in fish. To the authors’ knowledge, this is the first report of an iridociliary melanoma that led to buphthalmia, lens luxation, and keratoconus in a fish. Histological findings of lens luxation are also demonstrated. Due to the presence of a complex suspensory apparatus involving the teleost lens, this report speculates that lens luxation is a more devastating disease process in teleosts than in mammals.
Ocular parameters in a captive colony of fruit bats
Authors: Blackwood Sarah E. , Plummer Caryn E. , Crumley William , MacKay Edward O. , Brooks Dennis E. , Barrie Kathleen P.
Published: September 2010

Objectives  To establish normal reference ranges of ocular parameters including phenol read thread, palpebral fissure length, horizontal and vertical corneal diameter, upright and hanging intraocular pressure (IOP) and to report ophthalmic examination findings of the anterior segment and lens, in a population of captive fruit bats.

Animals studied  Eyes of 30 bats of three species were included in this study: 10 (5 males, 5 females) Malayan Flying Foxes (Pteropus vampyrus), 10 (5 males, 5 females) Little Golden‐mantled Flying Foxes (Pteropus pumilus), and 10 (4 males, 6 females) Island Flying Foxes (Pteropus hypomelanus).

Results  The most common ophthalmic examination findings included iris‐iris persistent pupillary membranes (83%), nuclear sclerosis (56.7%), prominent arterial circle (40%), iridal hyperpigmented foci (30%), pupillary margin cysts (27%), and third eyelid defects (20%). The mean, among all species for: phenol red thread was 20.23 ± 1.28 mm/15 s both eyes (OU); palpebral fissure length was 13.34 ± 0.33 mm for OU; for horizontal corneal diameter was 10.72 ± 0.32 mm for OU; for vertical corneal diameter was 9.90 ± 0.30 mm for OU; for the hanging intraocular pressures was 19.38 ± 0.77 mmHg for OU; for upright IOP was 13.95 ± 0.60 mmHg for OU. Measurements for the individual species groups and eyes were also calculated.

Conclusions  Results revealed the IOP of bats in a hanging position were significantly higher than the IOP of bats in an upright position. The size of the bat, between the species, affected palpebral fissure length, horizontal corneal diameter, and vertical corneal diameter. Information about the ocular structures and normal ophthalmic parameters for the Pteropus species is crucial for species protection because of dependence on vision for survival.
Clinical and immunomodulatory effects of bevacizumab and low‐dose interleukin‐2 in patients with metastatic renal cell carcinoma: results from a phase II trial
Authors: Garcia Jorge A. , Mekhail Tarek , Elson Paul , Triozzi Pierre , Nemec Cheryl , Dreicer Robert , Bukowski Ronald M. , Rini Brian I
Published: September 2010

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

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

As single agents, both IL‐2 and bevacizumab have demonstrated clinical activity in advanced RCC.

This study demonstrated the feasibility of the combination, its safety and unfortunately the lack of enhanced activity if one compares the combination with existing data of bevacizumab alone.

OBJECTIVE

Low‐dose interleukin‐2 (IL‐2) is a historical treatment for metastatic renal cell carcinoma (mRCC). Increased vascular endothelial growth factor (VEGF) levels inhibit dendritic cell (DC) differentiation and augment production of immunosuppressive regulatory T (Treg) cells. Bevacizumab is an antibody that binds to VEGF, has activity in mRCC and may augment the anti‐tumour immune effects of IL‐2. To determine the clinical and immunomodulatory effects of this combination, a prospective, phase II trial of bevacizumab plus low‐dose IL‐2 was conducted.

PATIENTS AND METHODS

Patients with untreated mRCC received bevacizumab (10 mg/kg i.v. every 2 weeks) and IL‐2 (125 000 units/kg/day subcutaneously from Monday to Friday for 6 consecutive weeks followed by a 2‐week rest period). Endpoints included progression‐free survival, Response Evaluation Criteria in Solid Tumors‐defined objective response rate, immunomodulatory effects and safety.

RESULTS

Between January 2005 and September 2007, twenty‐six patients with untreated mRCC were enrolled. The median progression‐free survival was 9.6 months (95% CI, 4.1–16.9 months) The objective response rate was 15% and an additional 38% of patients had tumour burden reduction of <30%. Grade 3 constitutional adverse events (fatigue, fever/chills) and neutropenia were observed in 42% and 12% of patients, respectively. Peripheral blood CD1c+ myeloid and CD303+ plasmacytoid DC increased during treatment as did IL‐8 levels and CD4+ CD25+ FoxP3+ Treg cells. No changes in T helper type 1/2‐associated cytokines were observed.

CONCLUSION

Bevacizumab plus low‐dose IL‐2 has modest clinical activity in mRCC. Toxicity was largely IL‐2 related without enhancement of bevacizumab‐related toxicity. Biological data indicate inhibition of VEGF levels and increase of immunosuppressive Treg cells without an effect on DC activation.
Emphysematous pyelonephritis
Authors: Ubee Sarvpreet Singh , McGlynn Laura , Fordham Mark
Published: September 2010

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

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

Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal parenchyma. The clinical course of EPN can be severe and life‐threatening if not recognized and treated promptly. Most of the information has been from case reports, a few large series have also been reported. Using an evidence‐based approach, this review describes the pathogenesis, classification, complications, and management of EPN.

Emphysematous pyelonephritis (EPN) is an acute severe necrotizing infection of the renal parenchyma and its surrounding tissues that results in the presence of gas in the renal parenchyma, collecting system, or perinephric tissue. The cause for mortality in EPN is primarily due to septic complications. Up to 95% of the cases with EPN have underlying uncontrolled diabetes mellitus. The risk of developing EPN secondary to a urinary tract obstruction is about 25–40%. There are three classifications of EPN based on radiological findings. Acute renal failure, microscopic or macroscopic haematuria, severe proteinuria are other positive findings in EPN. Escherichia coli is the most common causative pathogen with the organism isolated on urine or pus cultures in nearly 70% of the reported cases.

A plain radiograph shows an abnormal gas shadow in the renal bed raising the suspicion whereas an ultrasound scan or computed tomography (CT) will confirm the presence of intra‐renal gas thus supporting the diagnosis of EPN. Gas may extend beyond the site of inflammation to the sub capsular, perinephric and pararenal spaces. In some cases, gas was found to be extending into the scrotal sac and spermatic cord.

Subsequent case studies have shown patients being successfully treated with PCD when used in addition to medical management, with significant reduction in the morality rates. PCD should be performed on patients who have localized areas of gas and functioning renal tissue is present. The treatment strategies include MM alone, PCD plus MM, MM plus emergency nephrectomy, and PCD plus MM plus emergency nephrectomy. In small proportion of patients managed with MM and PCD, subsequent nephrectomy will be required and in these patients the reported mortality is 6.6% Nephrectomy in patients with EPN can be simple, radical or laparoscopic.
Linagliptin (BI 1356), a potent and selective DPP‐4 inhibitor, is safe and efficacious in combination with metformin in patients with inadequately controlled Type 2 diabetes
Authors: Forst T. , Uhlig‐Laske B. , Ring A. , Graefe‐Mody U. , Friedrich C. , Herbach K. , Woerle H.‐J. , Dugi K. A.
Published: September 2010

Diabet. Med. 27, 1409–1419 (2010)

Aims  The efficacy and safety of the dipeptidyl peptidase‐4 inhibitor, linagliptin, added to ongoing metformin therapy, were assessed in patients with Type 2 diabetes who had inadequate glycaemic control (HbA1c≥ 7.5 to ≤ 10%; ≥58.5 to ≤85.8 mmol/mol) with metformin alone.

Methods  Patients (n = 333) were randomized to receive double‐blind linagliptin (1, 5 or 10 mg once daily) or placebo or open‐label glimepiride (1–3 mg once daily). The primary outcome measure was the change from baseline in HbA1c at week 12 in patients receiving combination therapy compared with metformin alone.

Results  Twelve weeks of treatment resulted in a mean (sem) placebo‐corrected lowering in HbA1c levels of 0.40% (± 0.14); 4.4 mmol/mol (± 1.5) for 1 mg linagliptin, 0.73% (± 0.14); 8.0 mmol/mol (± 1.5) for 5 mg, and 0.67% (± 0.14); 7.3 mmol/mol (± 1.5) for 10 mg. Differences between linagliptin and placebo were statistically significant for all doses (1 mg, P = 0.01; 5 mg and 10 mg, P < 0.0001). The change in mean (sem) placebo‐corrected HbA1c from baseline was −0.90% (± 0.13); −9.8 mmol/mol (± 1.4) for glimepiride. Adjusted and placebo‐corrected mean changes in fasting plasma glucose were −1.1 mmol/l for linagliptin 1 mg (P = 0.002), −1.9 mmol/l for 5 mg and −1.6 mmol/l for 10 mg (both P < 0.0001). One hundred and six (43.1%) patients reported adverse events; the incidence was similar across all five groups. There were no hypoglycaemic events for linagliptin or placebo, whereas three patients (5%) receiving glimepiride experienced hypoglycaemia.

Conclusions  The addition of linagliptin to ongoing metformin treatment in patients with Type 2 diabetes was well tolerated and resulted in significant and clinically relevant improvements in glycaemic control, with 5 mg linagliptin being the most effective dose.
Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: Utility of a mixed methods approach
Authors: BRENER LOREN , VON HIPPEL WILLIAM , VON HIPPEL COURTNEY , RESNICK ILYSE , TRELOAR CARLA
Published: September 2010

Introduction and Aims. Staff interactions with their clients are an important factor in the quality of care that is provided to people in drug treatment. Yet there is very little research that addresses staff attitudes or clients' perceptions of discrimination and prejudice by staff with regard to treatment outcomes. This research aimed to assess whether perceptions of discrimination by staff predict drug treatment completion. Design and Methods. The study used a mixed methods approach. Ninety‐two clients in residential rehabilitation facilities in Sydney were administered a series of quantitative measures assessing drug history, severity of drug use, treatment history, perceptions of staff discrimination and treatment motivation. Clients were followed up regularly until an outcome (dropout or completion) was obtained for the full sample. Results. Perceptions of discrimination were a significant predictor of treatment completion, with greater perceived discrimination associated with increased dropout. Qualitative interviews with 13 clients and eight health‐care workers from these treatment services were then conducted to gain insight into how perceived discrimination may impact on treatment experiences. Clients and staff discussed how they would address the issue of perceived discrimination during the current treatment experience. Discussion and Conclusions. Adopting a mixed methods approach facilitated exploration of the impact of perceived discrimination on treatment from both clients' and health‐care workers' perspectives. This methodology may also enhance interpretation and utilisation of these findings in drug treatment.[Brener L, von Hippel W, von Hippel C, Resnick I, Treloar C. Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: Utility of a mixed methods approach. Drug Alcohol Rev 2010;29;491–497]
QUALITY OF AVAILABLE MATES, EDUCATION, AND HOUSEHOLD LABOR SUPPLY
Authors: NEGRUSA BRIGHITA , OREFFICE SONIA
Published: September 2010

We investigate the impact of sex ratios by education and metropolitan area on spouses’ bargaining power and labor supplies, to capture the local and qualitative nature of mate availability. Using Current Population Survey and Census data for 2000, 1990, and 1980, we estimate these effects in a collective household framework. We find that a higher relative shortage of comparably educated women in the couple’s metropolitan area reduces wives’ labor supply and increases their husbands’. The impact is stronger for couples in higher education groups but not significant for high school graduates. Results are similar across decades. No such effects are found for unmarried individuals. (JEL D1, J22)
Representing nursing knowledge on maternal and neonatal health: a study on the cultural suitability of ICNP®
Authors: Cardoso A. , Paiva e Silva A.
Published: September 2010

Cardoso A. & Paiva e Silva A. (2010) Representing nursing knowledge on maternal and neonatal health: a study on cultural suitability of ICNP®. International Nursing Review

Purpose:  The purpose of this study was to explore the representation of knowledge among nurses and midwives in a maternal and obstetrics setting, in a hospital in northern Portugal. The research had two main objectives: to contribute to the identification and definition of concepts that represent nursing knowledge in obstetrics and to participate in the validation of the International Classification for Nursing Practice (ICNP)®.

Methods:  Using a qualitative approach, the study was designed in three phases. The first phase aimed to identify the terms and expressions used by nurses in nursing documentation and oral report, using document analysis, observation and interview as data collection methods. The second phase intended to determine which terms and expressions corresponded to ICNP® concepts. The third phase aimed to analyse the definition of some ICNP® concepts. In both the second and third phases, a consensus approach was used based on the Delphi Technique. ICNP® concepts were identified from the words and expressions used by nurses and midwives to describe their practice.

Results:  The results of this study suggested modifications on some ICNP® concept definitions, namely burping, bonding, mother–child attachment, infant sucking, false labour pain, aborting, and uterine contraction; and the inclusion of specific characteristics in others, i.e. uterine expulsion, breast engorgement, colic, and hunger. New ICNP® concepts were also suggested, specifically mother–foetal attachment, uterine contraction after labour, pain after labour and foetal well‐being.

Conclusion:  The study confirmed that ICNP® is an important instrument to identify the concepts needed to describe mother and child needs during the perinatal period.
Individualised care and the professional practice environment: nurses’ perceptions
Authors: Charalambous A. , Katajisto J. , Välimäki M. , Leino‐Kilpi H. , Suhonen R.
Published: September 2010

CHARALAMBOUS A., KATAJISTO J., VÄLIMÄKI M., LEINO‐KILPI H. & SUHONEN R. (2010) Individualised care and the professional practice environment: nurses’ perceptions. International Nursing Review

Aim:  To describe individualised care and the professional practice environment from nurses’ point of view and to explore the associations between them.

Background:  There is an increasing emphasis on individualised nursing care within the literature and the health‐care context. Preliminary evidence suggests that the implementation of individualised care is associated with the practice style of care, work organization and the practice environment.

Methods:  An exploratory correlational survey was used. Data were collected using the Individualised Care Scale and Revised Professional Practice Environment instruments from nurses and nurse managers (n = 207, response rate 59%) working in in‐patient wards of three acute hospitals’ 13 different units in Finland in 2008. Data were analysed based on descriptive statistics and Spearman's rho correlations.

Findings:  Nurses perceived that they generally support patient individuality and that the care they provided was individualised. Nurses’ perceptions about the support of individuality and views on individuality of care provided were associated with handling conflict, work motivation, control over practice, leadership and autonomy, relationships with physicians and cultural sensitivity.

Discussion:  The findings support the perception that individualised care and the professional practice environment are associated. There is a need for further studies to examine these associations more closely. Manipulating aspects of the environment may possibly be used to increase the ability of the nurses to provide individualised care. Patient perspectives should be included in future studies. Because of the national data, the results are indicative only.

Conclusions:  The recognition of the associations between individualised care and professional practice environment elements may help to develop individualised clinical nursing care.
Pricing of off‐balance sheet debt: how do bond market participants use the footnote disclosures on operating leases and postretirement benefit plans?
Authors: Sengupta Partha , Wang Zheng
Published: September 2010

In this study, we examine whether the public debt market prices information on off‐balance sheet debt arising from operating leases and postretirement plans. We find that bond‐rating agencies price off‐balance sheet debt arising from operating leases and the coefficient on off‐balance sheet debt measure of operating leases is similar to that of capital leases on the balance sheet. Regarding postretirement benefit plans, we find that bond‐rating agencies do price postretirement benefit obligations that are reported in balance sheet but do not price such obligations disclosed in footnotes. We find similar results when we examine corporate bond yields on new debt issues.
Rational early exercise of call options: Australian evidence
Authors: Phang Grace , Brown Rob
Published: September 2010

Alpert (2010) develops a detailed analysis of the conditions for rational early exercise of call options in the presence of taxes. Using Alpert’s analysis as the theoretical framework, we examine the early exercise of call options in Australia over the period from 1 January 2001 to 30 June 2008. We find that exercises occurring on the last cum‐dividend trading day can be fully explained by non‐tax reasons, whilst taxation is a potential explanation for a large proportion of the early exercises that occur at other times.
THE QUALITY OF INFORMATION AND INCENTIVES FOR EFFORT*
Authors: MOAV OMER , NEEMAN ZVIKA
Published: September 2010

We study the relationship between the precision of information about the performance of an agent in a market, and the incentives this agent has for exerting effort to produce high quality. We show that this relationship can be nonmonotonic. There exists an efficient plausible equilibrium that induces a threshold beyond which any further improvement in the precision of information weakens the agent's incentive to produce high quality. Accordingly, both very accurate and very inaccurate signals about the agent's performance may destroy its incentive to exert effort. A few applications of this result are discussed.
Design and Validation of a Practical Index for Trauma Assessment
Authors: GUZMAN N. , PAZ M.X. , PAZ M.I. , MORENO N.R. , NINO F.
Published: September 2010

In the past 20 years a variety of indices have been suggested for measuring the severity of trauma, however none of them meets the requirement of being a simple and objective instrument that can be utilized efficiently by lay persons and providers of health services without previous experience in triaging. A new system has been proposed which meets this requirement and which has been validated with 197 injured persons at the emergency ward of the Valle University Hospital in Call, Colombia. The instrument showed a high level of concordance with the conventional triaging method and classifies victims into four categories: critical with recovery unlikely, critical but recoverable, moderately serious, and ambulatory. There is discussion on the reliability of this instrument and it is recommended that it be validated with victims from larger disasters. Regardless, it has the advantage of being specific and free of the subjectivity that characterizes other indices.
Conducting research on disaster mental health in developing countries: a proposed model
Authors: LIMA B. , PAI S. , SANTACRUZ H. , LOZANO J. , CHAVEZ H. , SAMANIEGO N.
Published: September 2010

The psychological consequences of disasters are known to be significant, but research efforts in developing countries have been sporadic. This paper reports a successful collaborative project conducted in Armero, Colombia, and in Ecuador. It outlines its origins, summarizes its findings, and identifies the essential ingredients that were responsible for its positive outcome. It is recommended that these guidelines be adhered to for the development of similar projects elsewhere, to ensure a significant impact on advancing the field, policy‐making, delivering appropriate mental health care, and training of providers.
A SEMIPARAMETRIC BAYESIAN APPROACH TO MULTIVARIATE LONGITUDINAL DATA
Authors: Ghosh Pulak , Hanson Timothy
Published: September 2010

We extend the standard multivariate mixed model by incorporating a smooth time effect and relaxing distributional assumptions. We propose a semiparametric Bayesian approach to multivariate longitudinal data using a mixture of Polya trees prior distribution. Usually, the distribution of random effects in a longitudinal data model is assumed to be Gaussian. However, the normality assumption may be suspect, particularly if the estimated longitudinal trajectory parameters exhibit multi‐modality and skewness. In this paper we propose a mixture of Polya trees prior density to address the limitations of the parametric random effects distribution. We illustrate the methodology by analysing data from a recent HIV‐AIDS study.