bluuebunny/crossref_metadata_2025 huggingface dataset:
The learning curve of robotic lobectomy
Authors: Meyer Mark , Gharagozloo Farid , Tempesta Barbara , Margolis Marc , Strother Eric , Christenson Douglas
Published: September 2012

Background

Robotic lobectomy has been shown to be feasible, safe and oncologically efficacious. The actual learning curve of robotic lobectomy has yet to be defined. This study was designed to define the learning curve of robotic lobectomy.

Methods

We performed a retrospective review of prospectively accrued patients at our institution who underwent robotic lobectomy from January 2004 until December 2011. Six scatter graphs were constructed, comparing operative time, conversion rate, morbidity, mortality, length of stay and surgeon comfort with the number of consecutive cases. In each graph, a regression trendline was drawn and the change in the slope of the curve corresponding to the beginning of the plateau defined the learning curve. The overall learning curve was defined as mean ± SD of the sum of the individual learning curves.

Results

Based on operative times, mortality and surgeon comfort, the overall learning curve was 18 ± 3 cases. The learning curve based on operative times, mortality and surgeon comfort was 15, 20 and 19 cases, respectively. There was no association between the need for conversion and number of consecutive cases. There was a trend towards lower morbidity and decreased length of stay with greater experience. However, these parameters did not define a specific learning curve.

Conclusions

Operative time, mortality and surgeon comfort were found to be key parameters for the learning curve of robotic lobectomy when performed by surgeons who are experienced with video‐assisted thoracic surgery (VATS). The learning curve was 18 ± 3 cases. Copyright © 2012 John Wiley & Sons, Ltd.
Concise Review: Spermatogenesis in an Artificial Three-Dimensional System
Authors: Mahmoud Huleihel
Published: September 2012

Culture of spermatogonial stem cells has been performed under a variety of conditions. Most featured two-dimensional systems, with different types of sera, conditioned media, feeder layers, and growth factors. Some have used three-dimensional (3D) matrices produced from gelatin, collagen, or other material. In spite of their increasingly sophisticated composition, however, complete spermatogenesis in vitro has not yet been achieved. In the seminiferous tubules, spermatogenesis occurs in an environment where cells are embedded in a 3D structure with specific niches regulating each stage of germ cell maturation mediated by hormones and paracrine/autocrine factors. We have recently reported achievement of complete in vitro spermatogenesis of mouse testicular germ cells in a 3D culture system featuring a soft agar matrix. This review discusses the advantages of the 3D culture system for studying the spermatogenic process in its entirety. Also discussed are the steps necessary to expand the applicability of the 3D culture system to human germ cell development and determine the functionality of culture-produced spermatozoa for generating offspring.
Three-dimensional instabilities in tornado-like vortices with secondary circulations
Authors: Nolan David S.
Published: September 2012

Tornadoes and other intense atmospheric vortices are known to occasionally transition to a flow structure with multiple vortices within their larger circulations. This phenomenon has long been ascribed to fluid dynamical instability of the inner-core circulation, and many previous studies have diagnosed low-wavenumber unstable modes in tornado-like vortices that resemble the observed structures. However, relatively few of these studies have incorporated the strong vertical motions of the inner-core circulation into the stability analysis, and no stability analyses have been performed using a complete, frictionally driven secondary circulation with strong radial inflow near the surface. Stability analyses are presented using the complete circulations generated from idealized simulations of tornado-like vortices. Fast-growing unstable modes are found that are consistent with the asymmetric structures present in these simulations. Attempts to correlate the structures and locations of these modes with instability conditions for vortices with axial jets derived by Howard & Gupta and by Leibovich & Stewartson produce only mixed results. Analyses of perturbation energy growth show that interactions between eddy fluxes and the radial shear of the azimuthal wind contribute very little to the growth of the dominant modes. Rather, the radial shear of the vertical wind and the vertical shear of the vertical wind (corresponding to deformation in the axial direction) are the primary energy sources for perturbation growth. Relatively weak axisymmetric instabilities are also identified that have some similarity to symmetric oscillations that have been observed in tornadoes.
What was the “Right to theHeimat”? West German Expellees and the Many Meanings ofHeimkehr
Authors: Demshuk Andrew
Published: September 2012

Twenty years and a day after Nazi Germany's unconditional surrender, Hanover county administrator Helmut Janssen declared to an assembly of East Prussian expellee leaders that Germany was still destined to recover all of the territory it had possessed in 1937. One day, he claimed, the roughly twelve million ethnic Germans expelled from the lost eastern territories and eastern Europe in the wake of the war would return home. Although by 1965 this political goal seemed “further away than ever before,” he repeated an expellee declaration of March 1960, which pledged that all expellees “still want to return to theHeimat[homeland]—now, in the future, and forever.”
Morphology and surface topography of the schistosome Bivitellobilharzia nairi from the Asian elephant (Elephas maximus maximus) in Sri Lanka
Authors: Rajapakse R.P.V.J. , Iwagami M. , Wickramasinghe S. , Walker S.M. , Agatsuma T.
Published: September 2012

Bivitellobilharzia nairi was first recorded from an Indian elephant (Elephas maximus) in Berlin. Infections with this parasite have become increasingly important in E. maximus maximus populations in Sri Lanka. The present work is the first morphological description of this schistosome from Sri Lanka. A number of adult worms were recovered from a dead Asian elephant near the elephant orphanage, Pinnawala, in Sri Lanka. The observed clinical features of the infected elephant included emaciation, subventral oedema and anaemia. Post-mortem results indicated that the liver was enlarged and adult schistosomes were found in the blood vessels of the liver parenchyma. The total number of worms recovered from a portion of the liver was 129,870, which is an average of 22 worms per 100 g of liver. The present study uses both light microscopic and scanning electron microscope (SEM) techniques for the morphological and topographical characterization of this parasite and to permit comparison with other species of schistosomes. Morphologically, these worms correspond very well to the description of B. nairi by Dutt & Srivastava (1955). Moreover, it is clear that B. nairi is a distinctive species easily differentiated from other schistosomes. The SEM study of the tegument of male worms shows that the surface of B. nairi is smoother than in other schistosomes.
High altitude hypoxia and blood pressure dysregulation in adult chickens
Authors: Herrera E. A. , Salinas C. E. , Blanco C. E. , Villena M. , Giussani D. A.
Published: September 2012

Although it is accepted that impaired placental perfusion in complicated pregnancy can slow fetal growth and programme an increased risk of cardiovascular dysfunction at adulthood, the relative contribution of reductions in fetal nutrition and in fetal oxygenation as the triggering stimulus remains unclear. By combining high altitude (HA) with the chick embryo model, we have previously isolated the direct effects of HA hypoxia on embryonic growth and cardiovascular development before hatching. This study isolated the effects of developmental hypoxia on cardiovascular function measuredin vivoin conscious adult male and female chickens. Chick embryos were incubated, hatched and raised at sea level (SL, nine males and nine females) or incubated, hatched and raised at HA (seven males and seven females). At 6 months of age, vascular catheters were inserted under general anaesthesia. Five days later, basal blood gas status, basal cardiovascular function and cardiac baroreflex responses were investigated. HA chickens had significantly lower basal arterial PO2and haemoglobin saturation, and significantly higher haematocrit than SL chickens, independent of the sex of the animal. HA chickens had significantly lower arterial blood pressure than SL chickens, independent of the sex of the animal. Although the gain of the arterial baroreflex was decreased in HA relative to SL male chickens, it was increased in HA relative to SL female chickens. We show that development at HA lowers basal arterial blood pressure and alters baroreflex sensitivity in a sex-dependent manner at adulthood.
Has the Three‐Gorges Dam made the Poyang Lake wetlands wetter and drier?
Authors: Zhang Q. , Li L. , Wang Y.‐G. , Werner A. D. , Xin P. , Jiang T. , Barry D. A.
Published: September 2012

The Three‐Georges Dam holds many records in the history of engineering. While the dam has produced benefits in terms of flood control, hydropower generation and increased navigation capacity of the Yangtze River, serious questions have been raised concerning its impact on both upstream and downstream ecosystems. It has been suggested that the dam operation intensifies the extremes of wet and dry conditions in the downstream Poyang Lake, and affects adversely important local wetlands. A floodgate has been proposed to maintain the lake water level by controlling the flow between the Poyang Lake and Yangtze River. Using extensive hydrological data and generalized linear statistical models, we demonstrated that the dam operation induces major changes in the downstream river discharge near the dam, including an average “water loss”. The analysis also revealed considerable effects on the Poyang Lake water level, particularly a reduced level over the dry period from late summer to autumn. However, the dam impact needs to be further assessed based on long‐term monitoring of the lake ecosystem, covering a wide range of parameters related to hydrological and hydraulic characteristics of the lake, water quality, geomorphological characteristics, aquatic biota and their habitat, wetland vegetation and associated fauna.
Observation of equatorial nighttime medium‐scale traveling ionospheric disturbances in 630‐nm airglow images over 7 years
Authors: Fukushima D. , Shiokawa K. , Otsuka Y. , Ogawa T.
Published: September 2012

We report on nighttime medium‐scale traveling ionospheric disturbances (MSTIDs) observed at Kototabang, Indonesia (geographic longitude: 100.3°E; geographic latitude: 0.2°S; and geomagnetic latitude: 10.6°S) during a 7‐year period from October 2002 to October 2009. MSTIDs were observed in 630‐nm nighttime airglow images by using a highly sensitive all‐sky airglow imager at Kototabang. The averages and standard deviations of horizontal phase velocity, period, and horizontal wavelength of MSTIDs observed during the 7 years were 320 ± 170 m/s, 42 ± 11 min, and 790 ± 440 km, respectively. The occurrence rate of the observed MSTIDs decreased with decreasing solar activity. The average horizontal wavelength of MSTIDs increased with decreasing solar activity. Southward MSTIDs were dominant throughout the 7 years of observations. These facts are consistent with the hypothesis that the observed MSTIDs are caused by gravity waves in the thermosphere. Moreover, we compared the propagation directions of the observed MSTIDs with the locations of tropospheric convection activity for the events where gravity waves producing the observed MSTIDs could have existed in the lower atmosphere. Strong tropospheric convection was found within ±30 degrees from the source directions of MSTIDs in 81% of the MSTID events. In such events, gravity waves were possibly generated from deep convection in the troposphere and directly propagated into the thermosphere.
Methane storage in advanced porous materials
Authors: Makal Tegan A. , Li Jian-Rong , Lu Weigang , Zhou Hong-Cai
Published: September 2012

This review describes advances in the adsorptive storage of methane in advanced porous materials, metal–organic frameworks and porous organic polymers.
Mentoring as a Communication Coach in a Public School Setting
Authors: George Catherine , Warren Faye
Published: September 2012

People using speech generating devices face many challenges, one of which is the lack of role models. They seldom have the opportunity to meet and interact with other proficient SGD users. This article addresses key considerations for initiating an AAC mentoring position as a Communication Coach in a public school setting. Outcomes and considerations to facilitate the likelihood of success are discussed from both administrative and mentor perspectives.
Crossing Borders Without Leaving the University: MISTIC—An International Collaboration
Authors: Resendiz Maria , Gonzales Maria Diana , Rodriguez Clarissa
Published: September 2012

International collaborations usually involve individuals from one country traveling to another country (Kuehn & Henne, 2003). However, for various reasons, students and faculty from the United States do not always have the option to travel to another country. This was the case when the Department of Communication Disorders Speech-Language Hearing Clinic at Texas State University was contacted by personnel from a clinic in Monterrey, México. Together, we developed an international collaboration that would be mutually beneficial to all parties involved. We developed goals for the clinical component of the speech-language pathology graduate program, the participating clients and their families, professionals employed at the private clinic in Monterrey, México, and research goals to document the effectiveness of the international collaboration we called the Multicultural Intensive Speech-Language Therapy Intervention Clinic (MISTIC). In this case, families and professionals from México traveled to the United States to participate in this international collaboration.
Engineering of blended nanoparticle platform for delivery of mitochondria-acting therapeutics
Authors: Marrache Sean , Dhar Shanta
Published: September 2012

Mitochondrial dysfunctions cause numerous human disorders. A platform technology based on biodegradable polymers for carrying bioactive molecules to the mitochondrial matrix could be of enormous potential benefit in treating mitochondrial diseases. Here we report a rationally designed mitochondria-targeted polymeric nanoparticle (NP) system and its optimization for efficient delivery of various mitochondria-acting therapeutics by blending a targeted poly(
d
,
l
-lactic-
co
-glycolic acid)-block (PLGA-
b
)-poly(ethylene glycol) (PEG)-triphenylphosphonium (TPP) polymer (PLGA-
b
-PEG-TPP) with either nontargeted PLGA-
b
-PEG-OH or PLGA-COOH. An optimized formulation was identified through in vitro screening of a library of charge- and size-varied NPs, and mitochondrial uptake was studied by qualitative and quantitative investigations of cytosolic and mitochondrial fractions of cells treated with blended NPs composed of PLGA-
b
-PEG-TPP and a triblock copolymer containing a fluorescent quantum dot, PLGA-
b
-PEG-QD. The versatility of this platform was demonstrated by studying various mitochondria-acting therapeutics for different applications, including the mitochondria-targeting chemotherapeutics lonidamine and α-tocopheryl succinate for cancer, the mitochondrial antioxidant curcumin for Alzheimer’s disease, and the mitochondrial uncoupler 2,4-dinitrophenol for obesity. These biomolecules were loaded into blended NPs with high loading efficiencies. Considering efficacy, the targeted PLGA-
b
-PEG-TPP NP provides a remarkable improvement in the drug therapeutic index for cancer, Alzheimer’s disease, and obesity compared with the nontargeted construct or the therapeutics in their free form. This work represents the potential of a single, programmable NP platform for the diagnosis and targeted delivery of therapeutics for mitochondrial dysfunction-related diseases.
Relying on Fin Erosion to Identify Hatchery-Reared Brown Trout in a Tennessee River
Authors: Meerbeek Jonathan R. , Bettoli Phillip W.
Published: September 2012

Hatchery-induced fin erosion can be used to identify recently stocked catchable-size brown trout Salmo trutta during annual surveys to qualitatively estimate contributions to a fishery. However, little is known about the longevity of this mark and its effectiveness as a short-term (≤1 year) mass-marking technique. We evaluated hatchery-induced pectoral fin erosion as a mass-marking technique for short-term stocking evaluations by stocking microtagged brown trout in a tailwater and repeatedly sampling those fish to observe and measure their pectoral fins. At Dale Hollow National Fish Hatchery, 99.1% (228 of 230) of microtagged brown trout in outdoor concrete raceways had eroded pectoral fins 1 d prior to stocking. Between 34 and 68 microtagged and 26–35 wild brown trout were collected during eight subsequent electrofishing samples. In a blind test based on visual examination of pectoral fins at up to 322 d poststocking, one observer correctly identified 91.7% to 100.0% (mean of 96.9%) of microtagged brown trout prior to checking for microtags. In the laboratory, pectoral fin length and width measurements were recorded to statistically compare the fin measurements of wild and microtagged hatchery brown trout. With only one exception, all pectoral fin measurements on each date averaged significantly larger for wild trout than for microtagged brown trout. Based on the number of pectoral fin measurements falling below 95% prediction intervals, 93.7% (148 of 158) of microtagged trout were correctly identified as hatchery fish based on regression models up to 160 d poststocking. Only 72.2% (70 of 97) of microtagged trout were identified correctly after 160 d based on pectoral fin measurements and the regression models. We concluded that visual examination of pectoral fin erosion was a very effective way to identify stocked brown trout for up to 322 d poststocking.

Received January 27, 2012; accepted May 7, 2012
MeDIP-HMM: genome-wide identification of distinct DNA methylation states from high-density tiling arrays
Authors: Seifert Michael , Cortijo Sandra , Colomé-Tatché Maria , Johannes Frank , Roudier François , Colot Vincent
Published: September 2012

Motivation: Methylation of cytosines in DNA is an important epigenetic mechanism involved in transcriptional regulation and preservation of genome integrity in a wide range of eukaryotes. Immunoprecipitation of methylated DNA followed by hybridization to genomic tiling arrays (MeDIP-chip) is a cost-effective and sensitive method for methylome analyses. However, existing bioinformatics methods only enable a binary classification into unmethylated and methylated genomic regions, which limit biological interpretations. Indeed, DNA methylation levels can vary substantially within a given DNA fragment depending on the number and degree of methylated cytosines. Therefore, a method for the identification of more than two methylation states is highly desirable.

Results: Here, we present a three-state hidden Markov model (MeDIP-HMM) for analyzing MeDIP-chip data. MeDIP-HMM uses a higher-order state-transition process improving modeling of spatial dependencies between chromosomal regions, allows a simultaneous analysis of replicates and enables a differentiation between unmethylated, methylated and highly methylated genomic regions. We train MeDIP-HMM using a Bayesian Baum–Welch algorithm, integrating prior knowledge on methylation levels. We apply MeDIP-HMM to the analysis of the Arabidopsis root methylome and systematically investigate the benefit of using higher-order HMMs. Moreover, we also perform an in-depth comparison study with existing methods and demonstrate the value of using MeDIP-HMM by comparisons to current knowledge on the Arabidopsis methylome. We find that MeDIP-HMM is a fast and precise method for the analysis of methylome data, enabling the identification of distinct DNA methylation levels. Finally, we provide evidence for the general applicability of MeDIP-HMM by analyzing promoter DNA methylation data obtained for chicken.

Availability: MeDIP-HMM is available as part of the open-source Java library Jstacs (www.jstacs.de/index.php/MeDIP-HMM). Data files are available from the Jstacs website.

Contact:  seifert@ipk-gatersleben.de

Supplementary information:  Supplementary data are available at Bioinformatics online.
ITQs in Swedish demersal fisheries
Authors: Waldo Staffan , Paulrud Anton
Published: September 2012

Waldo, S., and Paulrud, A. 2013. ITQs in Swedish demersal fisheries. – ICES Journal of Marine Science, 70:68–77. Individual transferable quota (ITQ) is a management measure that is widely discussed, not least in the reform of the European Common Fisheries Policy. While the system is expected to reduce overcapacity and improve economic performance, questions are raised concerning the future of small-scale fisheries. This paper uses a model for Swedish fisheries (the Swedish Resource Rent Model for the Commercial Fisheries, SRRMCF) where the economics and fleet structure in a potential Swedish ITQ-system are analysed. The model is an optimization model based on linear programming and data from the European Union's data collection framework. The modelling approach can readily be used by other member states. Three main conclusions can be drawn on how ITQs will affect fisheries: The fishing fleet measured in number of vessels will decrease by approximately 30–50%.Profitability will increase so that the fishing industry will be able to provide competitive wages and make a financial contribution to fisheries management.The system can be designed so that small-scale fisheries are not disadvantaged.
Low neutral genetic variability in a specialist puffin hunter: the Norwegian Lundehund
Authors: Melis Claudia , Borg Åsa A. , Espelien Ingvild S. , Jensen Henrik
Published: September 2012

The genetic variability of 125 Norwegian Lundehund and 27 Nova Scotia Duck Tolling Retriever was analysed using a set of 26 microsatellite markers. In Lundehund, the average number of alleles per locus was 1.73, and average observed (HO) and expected (HE) heterozygosity were 0.07. In Toller, all measures of genetic diversity were much higher than in Lundehund and similar to studies on other dog breeds. The cluster analysis correctly assigned individuals to their respective breed. The low genetic variability in Lundehund was not surprising, given the two strong bottlenecks in the 1940s and the 1960s. The relatedness of Lundehund to other Nordic small spitzes should be investigated in the view of possible outcrossing.
Hypercalciuria and kidney function in children with haemophilia
Authors: Ranta S. , Valta H. , Viljakainen H. , Mäkitie O. , Mäkipernaa A.
Published: September 2012

Adults with haemophilia have a higher incidence of chronic kidney disease than general male population. We recently showed that children with haemophilia have higher urinary calcium excretion and lower whole body bone mineral density than controls in spite of prophylaxis with the deficient coagulation factor concentrate, serum vitamin D concentrations comparable to those of healthy children and physically active lifestyle. Persistent hypercalciuria may result in nephrocalcinosis and impact renal function. This study sought to assess persistence of urinary calcium excretion and kidney function in children with haemophilia. We investigated retrospectively urinary calcium excretion in 30 children with haemophilia (mean age 12.5 years) from consecutive urine samples over a 2‐year period. Renal evaluation included blood and urine specimen, blood pressure, and renal ultrasound. High number of children with haemophilia had intermittent hypercalciuria. Hypercalciuria was not associated with age, severity of haemophilia or previous hypercalciuria. Kidney function and renal ultrasound were normal with the exception of suspected kidney stone in one patient with haemophilia and transient hypercalciuria. Vitamin D concentrations improved after the families had received information and recommendations concerning vitamin D substitution. Our findings indicate that haemophilia per se predisposes to hypercalciuria which may in turn affect bone mineral content and kidney function. Whether childhood‐onset intermittent hypercalciuria contributes to hypertension and renal complications in adulthood remains to be elucidated in future studies.
Consensus recommendations for the use of FEIBA® in haemophilia A patients with inhibitors undergoing elective orthopaedic and non‐orthopaedic surgery
Authors: Rangarajan S. , Austin S. , Goddard N. J. , Négrier C. , Rodriguez‐Merchan E. C. , Stephensen D. , Yee T. T.
Published: September 2012

A growing number of publications have described the efficacy and safety of FEIBA as a first‐line haemostatic agent for surgical procedures in haemophilia A patients with high‐responding FVIII inhibitors. The aim of this study was to provide practical guidance on patient management and selection and also to communicate a standardized approach to the dosing and monitoring of FEIBA during and after surgery. A consensus group was convened with the aims of (i) providing an overview of the efficacy and safety of FEIBA in surgery; (ii) sharing best practice; (iii) developing recommendations based on the outcome of (i) and (ii). To date there have been 17 publications reporting on the use of FEIBA in over 210 major and minor orthopaedic and non‐orthopaedic surgical procedures. Haemostatic outcome was rated as ‘excellent’ or ‘good’ in 78–100% of major cases. The reporting of thromboembolic complications or anamnestic response to FEIBA was very rare. Key to the success of FEIBA as haemostatic cover in surgery is to utilize the preplanning phase to prepare the patient both for surgery and also for rehabilitation. Haemostatic control with FEIBA should be continued for an adequate period postoperatively to support wound healing and to cover what can in some patients be an extended period of physiotherapy. Published data have demonstrated that FEIBA can provide adequate, well tolerated, peri and postoperative haemostatic cover for a variety of major and minor surgical procedures in patients with haemophilia A. The consensus recommendations provide a standardized approach to the dosing and monitoring of FEIBA.
Payback time: the associations of debt and income with medical student career choice
Authors: Grayson Martha S , Newton Dale A , Thompson Lori F
Published: September 2012

Medical Education 2012: 46: 983–991

Context  With impending health care reform in the USA, there is an imperative to increase the number of students choosing primary care (PC) careers. Research is needed to better understand the roles of economic factors in medical student career choice. The objective of this study was to examine the relationships among debt, income and career choice by comparing students planning PC careers with those aspiring to one of the 12 non‐PC fields in which median income exceeds US$300 000 (‘high‐paying non‐primary care’ [HPNPC]).

Methods  Surveys (response rate = 81%) were administered to Year 1 students scheduled to graduate between 1996 and 2012, and Year 4 students graduating between 1993 and 2010. Respondents were students at New York Medical College and East Carolina University’s Brody School of Medicine. Analyses focused on the 2674 Year 1 respondents choosing a PC (n = 1437, 54%) or HPNPC (n = 1237, 46%) career, and the 2307 Year 4 respondents intending to pursue PC (n = 992, 43%) or HPNPC (n = 1315, 57%). Longitudinal analyses examining changes in career goals during medical school were based on students who completed surveys in both Years 1 and 4. The outcome measures studied were self‐reported debt, anticipated income and self‐rated value placed on income.

Results  Relative to their PC counterparts, students intending to pursue HPNPC careers anticipated an average of US$24 904 (Year 4 students) or US$29 237 (Year 1 students) greater debt, placed a higher importance value on income, and anticipated earning an average of US$58 463 (Year 1 students) and US$89 909 (Year 4 students) more in annual income after graduation. Debt was associated with the value placed on income in the choice of career and the amount of future income anticipated. Students who valued income highly were especially inclined to switch from PC during medical school. The switch away from PC was associated with debt, as well as with a marked increase in anticipated income.

Conclusions  Debt and anticipated income are important concerns which may shape future supplies of PC doctors.
Vicarious learning during simulations: is it more effective than hands‐on training?
Authors: Stegmann Karsten , Pilz Florian , Siebeck Matthias , Fischer Frank
Published: September 2012

Medical Education 2012: 46: 1001–1008

Context  Doctor–patient communication skills are often fostered by using simulations with standardised patients (SPs). The efficiency of such experiences is greater if student observers learn at least as much from the simulation as do students who actually interact with the patient.

Objectives  This study aimed to investigate whether the type of simulation‐based learning (learning by doing versus vicarious learning) and the order in which these activities are carried out (learning by doing → vicarious learning versus vicarious learning → learning by doing) have any effect on the acquisition of knowledge on effective doctor–patient communication strategies. In addition, we wished to examine the extent to which an observation script and a feedback formulation script affect knowledge acquisition in this domain.

Methods  The sample consisted of 200 undergraduate medical students (126 female, 74 male). They participated in two separate simulation sessions, each of which was 30 minutes long and was followed by a collaborative peer feedback phase. Half of the students first performed (learning by doing) and then observed (vicarious learning) the simulation, and the other half participated in the reverse order. Knowledge of doctor–patient communication was measured before, between and after the simulations.

Results  Vicarious learning led to greater knowledge of doctor–patient communication scores than learning by doing. The order in which vicarious learning was experienced had no influence. The inclusion of an observation script also enabled significantly greater learning in students to whom this script was given compared with students who were not supported in this way, but the presence of a feedback script had no effect.

Conclusions  Students appear to learn at least as much, if not more, about doctor–patient communication by observing their peers interact with SPs as they do from interacting with SPs themselves. Instructional support for observing simulations in the form of observation scripts facilitates both vicarious learning and learning by doing. An observation script may focus learners’ attention on the important aspects of doctor–patient communication and increase the content‐related accuracy of peer feedback.
Two‐module organization of the mandible in the yellow‐necked mouse: a comparison between two different morphometric approaches
Authors: Jojić V. , Blagojević J. , Vujošević M.
Published: September 2012

Mandibles of yellow‐necked mouse (Apodemus flavicollis) were used to explore modularity. We tested a biological hypothesis that two separate modules (alveolar region and ascending ramus) can be recognized within the mandible. As a second research goal, we compared two different morphometric procedures under the assumption that methodological approaches that use either geometric or traditional morphometric techniques should give similar results. Besides confirmation of the predicted hypothesis of modularity, the application of both approaches revealed that: (i) modularity was somewhat more evident when it was analysed on the asymmetric (fluctuating asymmetry,FA) than on the symmetric (individual variation) component of variation; (ii) there is correspondence in the patterns of individual variation andFA, which indicates that integration of mandibular traits among individuals is primarily due to direct developmental interactions; and (iii) allometry does not obscure the hypothesized modularity for individual variation or forFA. In addition, traditional morphometric method allowed us to check whether allometry influenced each module to the same extent and to conclude that the ascending ramus is more heavily influenced by general size than the alveolar region. In studies of modularity, differences in methods can lead to discrepancies in the results, and therefore, some caution is required when comparing findings from different investigations. The substantial agreement between our results provides evidence that, when considering two‐module organization of the mouse mandible, direct comparison among studies that use the methods applied herein is, in great part, reliable.
History of lower limb reconstruction after trauma
Authors: Wagels Michael , Rowe Dan , Senewiratne Shireen , Theile David R.
Published: September 2012

Background

The principles guiding reconstruction of the lower limb after trauma have become established over 300 years through advances in technology and studies of epidemiology. This paper reviews how these principles came about and why they are important.

Methods

This is a structured review of historical and recent literature pertinent to lower limb reconstruction. The outcomes assessed in the pre‐modern era were wound mortality, amputation mortality and amputation rate. In the modern era, infection and non‐union emerged as measures of outcome, which are morbidity‐ rather than mortality‐based. Indications for amputation published during the eras are taken to reflect the reconstructive practices of the time.

Results

Amputation and wound mortality fell throughout the pre‐modern era, from 70% and 20% to 1.8% and 1.8%, respectively. Amputation rates peaked in the American Civil War (53%) but have remained less than 20% since then. Infection and non‐union rates in the modern era have fluctuated between 5% and 45%.

Conclusions

Priority areas for research include refinement of soft tissue reconstruction, injury classification, standardization of outcome measures and primary prevention. The impact of débridement and antisepsis on outcomes should not be forgotten as progress is made.
Canine dacryolithiasis: a case description and mineral analysis
Authors: Malho Pedro , Sansom Jane , Johnson Phillipa , Stewart Jennifer
Published: September 2012

A 4‐year‐old, female, spayed, Labrador retriever was presented with a painless swelling of the left ventromedial eyelid and epiphora of 3 months duration. Bilateral patency of the nasolacrimal system was confirmed by the appearance of fluorescein dye at both nares. Ultrasonography revealed a well‐demarcated fluid‐filled structure containing echogenic ill‐defined material in close proximity to the nasolacrimal system. A transconjunctival surgical approach confirmed the close anatomical proximity of the cyst and the absence of a communication with the inferior canaliculus. The cyst contained multiple intraluminal calculi (dacryoliths). Following surgical excision of the cyst, the epiphora resolved and no recurrence was noted over a 12‐month follow‐up period. On histopathology, the cystic structure was lined by stratified squamous epithelium, consistent with lacrimal canaliculus epithelium. Presumed progression of a canalicular diverticulum to a cyst with the formation of intraluminal dacryoliths was suspected. Mineral analysis of the dacryoliths revealed a calcium carbonate composition.
Prostate cancer incidence and newly diagnosed patient profile in Spain in 2010
Authors: Cózar José M. , Miñana Bernardino , Gómez‐Veiga Francisco , Rodríguez‐Antolín Alfredo , Villavicencio Humberto ,   on behalf of 25 Urology Units, Asociación Española de Urología), Cantalapiedra Arancha , Pedrosa Emilio
Published: September 2012

Study Type – Therapy (practice pattern evaluation)

Level of Evidence 2b

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

Prostate cancer (PCa) accounts for 12% of newly diagnosed cases of cancer in Europe. It is one of the most frequently diagnosed tumours in the developed world. Since the introduction of prostate specific antigen as a test for early detection of PCa, the rate of diagnosis has increased significantly and specific mortality has reduced in most western countries.

Most of the data on the incidence of PCa are obtained from population‐based cancer registries which frequently do not cover the whole population. This first national hospital‐based PCa registry aims not only to estimate the incidence of the disease but to ascertain the clinical profile of newly diagnosed PCa patients, a useful tool for evaluating the impact of the disease and its socio‐health management.

OBJECTIVES

To estimate the 2010 incidence of prostate cancer (PCa) in Spain.

To describe the clinical profile of newly diagnosed cases using a nationwide hospital‐based registry.

PATIENTS AND METHODS

This was a national epidemiological observational study in 25 public hospitals with a specific reference population according to the National Health System.

Sociodemographic and clinical variables of all newly diagnosed, histopathologically confirmed PCa cases were collected in 2010, in the area of influence of each centre. Cases diagnosed in private practice were not collected (estimated nearly 10% in Spain).

Data monitoring was external to guarantee quality and homogeneity.

The age‐standardized PCa incidence was determined based on the age distribution of the European standard population.

RESULTS

In all, 4087 new cases of PCa were diagnosed for a reference population of 4 933 940 men (21.8% of the Spanish male population).

The estimated age‐standardized PCa incidence was 70.75 cases per 100 000 men.

Mean age at diagnosis was 69 years; 11.6% of patients presented with tumour‐related symptoms and 39.5% with LUTS. Median PSA was 8 ng/mL. Gleason score was ≤6 in 56.5%, 7 in 26.7% and >7 in 16.8% of patients. At diagnosis, 89.8% had localized, 6.4% locally advanced and 3.8% metastatic disease.

CONCLUSIONS

This study on PCa incidence in Spain, a western country with intensive opportunistic PSA screening, shows that PCa is a high incidence tumour, diagnosed close to 70 years, usually asymptomatic.

Almost 40% of cases have low risk disease with a risk of over‐diagnosis and over‐treatment.

Around 55% of patients with intermediate or high risk disease are candidates for active therapy which may result in a reduction of cancer‐specific mortality.
Dilemmas of Discourse: Legitimising Britain's War on Terror
Authors: Kettell Steven
Published: September 2012

The sphere of foreign policy provides a hitherto unexplored field for studying the applicability of interpretivist concepts and concerns. Here, a particularly useful topic of analysis is that of discursive strategies; namely, the way in which government figures seek to legitimise and justify their decisions and behaviour. Operating at the intersection between beliefs, traditions and dilemmas, the examination of foreign policy discourse offers key insights into a variety of important issues, including political communication and media management. This article considers these themes by examining the changing form of New Labour's discursive strategy on Britain's role in the war on terror during the period of Tony Blair's premiership from 2001 to mid-2007. Charting the various shifts to have taken place in this discursive landscape, the article analyses the way in which these changes were driven by dilemmas resulting from tensions between practical developments and the discursive claims made about them. This shows how various rationalities within the sphere of British politics were operationalised and sustained, and how numerous ‘dilemmas of discourse’ were addressed.
Evolutionary adaptation of plant annexins has diversified their molecular structures, interactions and functional roles
Authors: Clark Greg B. , Morgan Reginald O. , Fernandez Maria‐Pilar , Roux Stanley J.
Published: September 2012

Annexins are an homologous, structurally related superfamily of proteins known to associate with membrane lipid and cytoskeletal components. Their involvement in membrane organization, vesicle trafficking and signaling is fundamental to cellular processes such as growth, differentiation, secretion and repair. Annexins exist in some prokaryotes and all eukaryotic phyla within which plant annexins represent a monophyletic clade of homologs descended from green algae. Genomic, proteomic and transcriptomic approaches have provided data on the diversity, cellular localization and expression patterns of different plant annexins. The availability of 35 complete plant genomes has enabled systematic comparative analysis to determine phylogenetic relationships, characterize structures and observe functional specificity between and within individual subfamilies. Short amino termini and selective erosion of the canonical type 2 calcium coordinating sites in domains 2 and 3 are typical of plant annexins. The convergent evolution of alternate functional motifs such as ‘KGD’, redox‐sensitive Cys and hydrophobic Trp/Phe residues argues for their functional relevance and contribution to mechanistic diversity in plant annexins. This review examines recent findings and advances in plant annexin research with special focus on their structural diversity, cellular and molecular interactions and their potential integrated functions in the broader context of physiological responses.

Contents

Summary
695

I.
Introduction
695

II.
Structural analyses
696

III.
Membrane‐related functions
702

IV.
Enzyme‐related functions
703

V.
Functional insights from proteome and transcriptome analyses
704

VI.
Future perspectives
706

Acknowledgements
708

References
708
The Client Is King: Do Mutual Fund Relationships Bias Analyst Recommendations?
Authors: FIRTH MICHAEL , LIN CHEN , LIU PING , XUAN YUHAI
Published: September 2012

This paper investigates whether the business relations between mutual funds and brokerage firms influence sell‐side analyst recommendations. Using a unique data set that discloses brokerage firms’ commission income derived from each mutual fund client as well as the share holdings of these mutual funds, we find that an analyst's recommendation on a stock relative to consensus is significantly higher if the stock is held by the mutual fund clients of the analyst's brokerage firm. The optimism in analyst recommendations increases with the weight of the stock in a mutual fund client's portfolio and the commission revenue generated from the mutual fund client. However, this favorable recommendation bias toward a client's existing portfolio stocks is mitigated if the stock in question is highly visible to other mutual fund investors. Abnormal stock returns are significantly greater both for the announcement period and, in the long run, for favorable stock recommendations from analysts not subject to client pressure than for equally favorable recommendations from business‐related analysts. In addition, we find that, subsequent to announcements of bad news from the covered firms, analysts are significantly less likely to downgrade a stock held by client mutual funds. Mutual funds increase their holdings in a stock that receives a favorable recommendation but this impact is significantly reduced if the recommendation comes from analysts subject to client pressure.
Inherent sex‐dependent regulation of human hepatic CYP3A5
Authors: Thangavel Chellappagounder , Boopathi Ettickan , Shapiro Bernard H
Published: September 2012

Background and Purpose

Expression of hepatic cytochromes P450 (CYP) in all species examined, including humans, is generally sexually dimorphic. We examined the sex‐dependent expression of CYP3A5 and the hormone‐regulated molecular mechanism(s) responsible for any dimorphism.

Experimental Approach

CYP3A5 levels as well as nuclear translocation and promoter binding of transcription factors regulating CYP3A5 expression were measured in primary hepatocyte cultures derived from men and women exposed to physiological‐like levels of growth hormone alone, dexamethasone alone and the combined regimen.

Key Results

We observed a dramatic inherent CYP3A5 sexual dimorphism (women > men) with all treatments as a result of a ∼2‐fold greater level of hormone‐induced activation and nuclear accumulation of hepatocyte nuclear factor‐4α (HNF‐4α), pregnane X receptor (PXR) and retinoic X receptorα (RXRα) in female hepatocytes. Furthermore, PXR : RXRα exhibited significantly higher DNA binding levels to its specific binding motif on the CYP3A5 promoter in female hepatocytes, inferring a possible explanation for the elevated expression of the isoform in women. Results from experiments using HepG2 cells treated with siRNA‐induced knockdown of HNF‐4α and/or transfected with luciferase reporter constructs containing the CYP3A5 promoter were in agreement with the basic mechanism observed in primary hepatocytes of both sexes.

Conclusions and Implications

Female‐predominant expression of human CYP3A5 is due to an inherent, sex‐dependent suboptimal activation of the transcription networks responsible for hormone‐induced expression of the isoform in men. Accordingly, in conjunction with previous studies of other human CYPs, men and women are intrinsically unlikely to handle many drugs in the same way; thus, sex should be a requisite component factored into the design of personalized drug therapies.
Conscience and Context: Attitudes Toward Abortion in Mexico
Authors: Tuman John P. , Roth‐Johnson Danielle , Jelen Ted
Published: September 2012

Objective

We seek to explain variation in attitudes toward legal abortion in Mexico, a nation in which the abortion issue has become quite salient.

Methods

Using data from the 2005 World Values Survey, we estimate an ordered logistic model to analyze the effects of different demographic and attitudinal variables on Mexican abortion attitudes.

Results

In general, the attitudinal and demographic predictors of abortion attitudes in Mexico are similar to those found in other Western democracies, such as the United States. In two areas, Mexican attitudes seem distinctive. First, contrary to expectations, opposition to legal abortion is not related to strong identification with the National Action Party (PAN), but support for legal abortion is positively related to strong support for the Democratic Revolutionary Party (PRD). Second, opposition to abortion is strongest among residents of the northern region, which we attribute to the region's proximity to the United States.

Conclusion

The effects of party identification and region on Mexican abortion attitudes provide distinctive national sources of abortion attitudes in Mexico. In other respects, the correlates of abortion attitudes closely resemble those of other nations.
Terminated or Just Interrupted? How the End of a Rivalry Plants the Seeds for Future Conflict
Authors: Rudkevich Gennady , Travlos Konstantinos , Diehl Paul F.
Published: September 2012

Objective

The objectives of the study were to explain why some interstate rivalries recur while others remain terminated. We argue that the recurrence is largely contingent on the congruence between the first rivalry's military outcome and the resulting political settlement as well as the intensity of the original rivalry.

Methods

Our hypotheses are tested using a data set of interstate rivalries from 1816 to 2001. We use a logistic regression to examine which rivalries recur. As a robustness check, we use an event history model to test the effect of factors that change after the initial rivalry.

Results

Our results indicated that a rivalry with an incongruent termination is nearly three times more likely to recur than one where the settlement reflects the preceding outcome, and more intense rivalries recur more than twice as frequently as their less intense counterparts.

Conclusion

Whether a rivalry recurs is strongly conditioned by how it concludes, and not by later events after the initial termination.