bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming the ‘Ndrangheta: contrasting methods and continuities of action: A report from the ‘La ferita’ conference, Reggio Calabria, November 2010
Authors: Mete Vittorio , Sciarrone Rocco , Oglethorpe Stuart
Published: April 2012

The ‘Ndrangheta is one of southern Italy's three traditional mafias; with its roots in Calabria, it has a presence in other Italian regions and operates from bases abroad, including outside Europe. Until a few years into the new millennium the other two, the Sicilian Cosa Nostra and the Camorra of Campania, were much better known. Serious studies of the ‘Ndrangheta could be counted on the fingers of two hands, the few journalists who took an interest were not well known, and its public image was largely linked to kidnapping, in which the Calabrian gangs were specialists. In 2005, however, the vice-president of the Calabrian Regional Council was murdered, and on 15 August 2007, the Ferragosto holiday, six young Calabrians were killed in Duisburg; these events helped to break the silence around the ‘Ndrangheta that had prevailed for a long time. Anti-Ndrangheta groups, consisting mainly of young people, have formed; journalists with a national profile have started to file reports from Calabria; there has been an explosion in reportage (not, in truth, of high quality) on the ‘Ndrangheta's origins, characteristics and business activity; and finally, in 2008, the Parliamentary Commission on the Mafia devoted a special report to the Calabrian mafia for the first time. Despite this rapid growth of interest, there have still been very few serious studies.
Hic-5 promotes invadopodia formation and invasion during TGF-β–induced epithelial–mesenchymal transition
Authors: Pignatelli Jeanine , Tumbarello David A. , Schmidt Ronald P. , Turner Christopher E.
Published: April 2012

Transforming growth factor β (TGF-β)–stimulated epithelial–mesenchymal transition (EMT) is an important developmental process that has also been implicated in increased cell invasion and metastatic potential of cancer cells. Expression of the focal adhesion protein Hic-5 has been shown to be up-regulated in epithelial cells in response to TGF-β. Herein, we demonstrate that TGF-β–induced Hic-5 up-regulation or ectopic expression of Hic-5 in normal MCF10A cells promoted increased extracellular matrix degradation and invasion through the formation of invadopodia. Hic-5 was tyrosine phosphorylated in an Src-dependent manner after TGF-β stimulation, and inhibition of Src activity or overexpression of a Y38/60F nonphosphorylatable mutant of Hic-5 inhibited matrix degradation and invasion. RhoC, but not RhoA, was also required for TGF-β– and Hic-5–induced matrix degradation. Hic-5 also induced matrix degradation, cell migration, and invasion in the absence of TGF-β via Rac1 regulation of p38 MAPK. These data identify Hic-5 as a critical mediator of TGF-β–stimulated invadopodia formation, cell migration, and invasion.
P-type sensitized organic solar cells with cascade energy alignment
Authors: Huang Junhua , Chen Lijia , He Fu , Zhang Ting , Niu Guoxi , Pan Jing , Xiong Zuhong , Song Qunliang
Published: April 2012

When a C60-based device with the structure indium tin oxide (ITO)/N, N′-di-[(1-naphthyl)-N, N′-diphenyl]-1,1′-biphenyl)-4,4′-diamine (NPB)/fullerene (C60)/tris-(8-hydroxyquinoline) aluminium (Alq3)/aluminium (Al) is treated as a p-type sensitized solar cell, some methods for improving charge transportation and suppressing charge backflow in dye-sensitized solar cells can be applied to increase the performance of the C60 device. In this study, a 5 nm layer of molybdenum oxide (MoO3) is inserted between ITO and NPB to realize this idea. This thin layer with higher mobility and higher dielectric constant than NPB forms a cascade energy alignment with NPB, improving hole injection from C60 into NPB and hole transportation from NPB to ITO. The power conversion efficiency (PCE) of the C60-based device with MoO3 is enhanced to 0.976%, which is 3.92 times that of the device without MoO3. When MoO3 is replaced by copper phthalocyanine or rubrene, which has higher mobility than NPB and forms a cascade energy structure with NPB, the PCE of C60-based devices is improved to 0.539% and 0.529% respectively, which is 2.16 and 2.12 times that of devices without such treatments.
Variability in Blood and Blood Component Utilization as Assessed by an Anesthesia Information Management System
Authors: Frank Steven M. , Savage Will J. , Rothschild Jim A. , Rivers Richard J. , Ness Paul M. , Paul Sharon L. , Ulatowski John A.
Published: April 2012

Background

Data can be collected for various purposes with anesthesia information management systems. The authors describe methods for using data acquired from an anesthesia information management system to assess intraoperative utilization of blood and blood components.

Methods

Over an 18-month period, data were collected on 48,086 surgical patients at a tertiary care academic medical center. All data were acquired with an automated anesthesia recordkeeping system. Detailed reports were generated for blood and blood component utilization according to surgical service and surgical procedure, and for individual surgeons and anesthesiologists. Transfusion hemoglobin trigger and target concentrations were compared among surgical services and procedures, and between individual medical providers.

Results

For all patients given erythrocytes, the mean transfusion hemoglobin trigger was 8.4 ± 1.5, and the target was 10.2 ± 1.5 g/dl. Variation was significant among surgical services (trigger range: 7.5 ± 1.2-9.5 ± 1.1, P = 0.0001; target range: 9.1 ± 1.2-11.3 ± 1.4 g/dl, P = 0.002), surgeons (trigger range: 7.2 ± 0.7-9.8 ± 1.0, P = 0.001; target range: 8.8 ± 0.9-11.8 ± 1.3 g/dl, P = 0.001), and anesthesiologists (trigger range: 7.2 ± 0.8-9.6 ± 1.2, P = 0.001; target range: 9.0 ± 0.9-11.7 ± 1.3 g/dl, P = 0.0004). The use of erythrocyte salvage, fresh frozen plasma, and platelets varied threefold to fourfold among individual surgeons compared with their peers performing the same surgical procedure.

Conclusions

The use of data acquired from an anesthesia information management system allowed a detailed analysis of blood component utilization, which revealed significant variation among surgical services and surgical procedures, and among individual anesthesiologists and surgeons compared with their peers. Incorporating these methods of data acquisition and analysis into a blood management program could reduce unnecessary transfusions, an outcome that may increase patient safety and reduce costs.
Effect of Growth Stage on the Efficacy of Postemergence Herbicides on Four Weed Species of Direct-Seeded Rice
Authors: Chauhan Bhagirath Singh , Abugho Seth Bernard
Published: April 2012

The efficacy of bispyribac-sodium, fenoxaprop + ethoxysulfuron, and penoxsulam + cyhalofop was evaluated against barnyardgrass, Chinese sprangletop, junglerice, and southern crabgrass when applied at four-, six-, and eight-leaf stages. When applied at the four-leaf stage, bispyribac-sodium provided greater than 97% control of barnyardgrass, junglerice, and southern crabgrass; however, it was slightly weak (74% control) on Chinese sprangletop. Irrespective of the weed species, fenoxaprop + ethoxysulfuron provided greater than 97% control when applied at the four-leaf stage. At the same leaf stage, penoxsulam + cyhalofop controlled 89 to 100% barnyardgrass, Chinese sprangletop, and junglerice and only 54% of southern crabgrass. The efficacy of herbicides was reduced when applied at the eight-leaf stage of the weeds; however, at this stage, fenoxaprop + ethoxysulfuron was effective in controlling 99% of Chinese sprangletop. The results demonstrate the importance of early herbicide application in controlling the weeds. The study identified that at the six-leaf stage of the weeds, fenoxaprop + ethoxysulfuron can effectively control Chinese sprangletop and southern crabgrass, penoxsulam + cyhalofop can effectively control Chinese sprangletop, and bispyribac-sodium can effectively control junglerice.
Preparation and Characterization of Ni-Doped Materials for Photocurrent and Photocatalytic Applications
Authors: Ganesh Ibram , Gupta A. K. , Kumar P. P. , Sekhar P. S. C. , Radha K. , Padmanabham G. , Sundararajan G.
Published: April 2012

Different amounts of Ni-doped TiO2( to 10%) powders and thin films were prepared by following a conventional coprecipitation and sol-gel dip coating techniques, respectively, at 400 to 800°C, and were thoroughly characterized by means of XRD, FT-IR, FT-Raman, DRS, UV-visible, BET surface area, zeta potential, flat band potential, and photocurrent measurement techniques. Photocatalytic abilities of Ni-doped TiO2powders were evaluated by means of methylene blue (MB) degradation reaction under simulated solar light. Characterization results suggest that as a dopant, Ni stabilizes TiO2in the form of anatase phase, reduces its bandgap energy, and adjusts its flat band potentials such that this material can be employed for photoelectrochemical (PEC) oxidation of water reaction. The photocatalytic activity and photocurrent ability of TiO2have been enhanced by doping of Ni in TiO2. The kinetic studies revealed that the MB degradation reaction follows the Langmuir-Hinshelwood first-order reaction relationship.
Effects of Exercise on Oxidative Stress in Rats Induced by Ozone
Authors: Martinez-Campos Catalina , Lara-Padilla Eleazar , Bobadilla-Lugo Rosa Amalia , Kross Robert David , Villanueva Cleva
Published: April 2012

Oxidative stress (OS) induced by acute exercise is reduced by chronic exercise. Ozone (O3) exposure produces OS. The aim of this study was to determine if aerobic exercise (AE) reduced OS produced by O3. A pilot experiment was performed with male Wistar rats submitted to AE (trained to swim 90 min/day). Adaptation to exercise was demonstrated three weeks after training by means of changes in reduced nitrates (NOx) in plasma. Therefore, two-week training was chosen for the following experiments. Six of twelve trained rats were exposed to O3(0.5 ppm, 4 h/day, one hour before exercise). Two groups of sedentary animals (n=6each) were used as controls, one of which was exposed to O3. At the end of the experiments NOx, 8-isoprostane (8-IP), malondialdehyde (MDA), superoxide dismutase (SOD) activity, and carbonyls (CBs) were measured in plasma. CBs did not change in any group. O3-induced OS was manifested by reduced NOxand SOD activity, as well as increased 8-IP and MDA. Exercise significantly blocked O3effects although SOD was also decreased by exercise (a greater drop occurring in the O3group). It is concluded that AE protects against OS produced by O3and the effect is independent of SOD.
Pantoea agglomeransin Immunodeficient Patients with Different Respiratory Symptoms
Authors: Flores Popoca Erika Odilia , Miranda García Maximino , Romero Figueroa Socorro , Mendoza Medellín Aurelio , Sandoval Trujillo Horacio , Silva Rojas Hilda Victoria , Ramírez Durán Ninfa
Published: April 2012

The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains ofMycobacteriumspp. had been reported. The strains were isolated and identified by 16S rRNA gene amplification, API 20E and 50CH, biochemical test, and antibiotic sensitivity. The strains found were 10Pantoea agglomerans, 6Mycobacteriumspp., 6Pseudomonasspp. and 10 strains of normal floral species:Thermoactinomycetes bacterium(1),Enterococcus faecium(2),Bacillus licheniformis(1),Lactobacillus rhamnosus(2),Streptococcus oralis(2),Streptococcus anginosus(1), andEnterobacter hormaechei(1).
Quantitative Analysis of Driving Factors of Grassland Degradation: A Case Study in Xilin River Basin, Inner Mongolia
Authors: Xie Yichun , Sha Zongyao
Published: April 2012

Current literature suggests that grassland degradation occurs in areas with poor soil conditions or noticeable environmental changes and is often a result of overgrazing or human disturbances. However, these views are questioned in our analyses. Based on the analysis of satellite vegetation maps from 1984, 1998, and 2004 for the Xilin River Basin, Inner Mongolia, China, and binary logistic regression (BLR) analysis, we observe the following: (1) grassland degradation is positively correlated with the growth density of climax communities; (2) our findings do not support a common notion that a decrease of biological productivity is a direct indicator of grassland degradation; (3) a causal relationship between grazing intensity and grassland degradation was not found; (4) degradation severity increased steadily towards roads but showed different trends near human settlements. This study found complex relationships between vegetation degradation and various microhabitat conditions, for example, elevation, slope, aspect, and proximity to water.
Childhood in Children's Eyes: Analysis of a Discourse among Middle‐Income Sectors in Santiago, Chile
Authors: Vergara Ana , Vergara Enrique , Peña Mónica , Chávez Paulina
Published: April 2012

This article describes the results of a qualitative study, based on the perspective of critical discourse analysis, which explores the discourse on childhood of 10‐ and 11‐year‐old boys and girls from a middle‐income socioeconomic sector in Santiago, Chile. Among the findings, a complex and relational notion of childhood is highlighted. The children perceive themselves as overwhelmed and subjected to excessive demands by grown‐ups, and conceive of adulthood as a state without real freedom due to the excessive demands of work and family.
CHRNB3 is more strongly associated with Fagerström Test for Cigarette Dependence‐based nicotine dependence than cigarettes per day: phenotype definition changes genome‐wide association studies results
Authors: Rice John P. , Hartz Sarah M. , Agrawal Arpana , Almasy Laura , Bennett Siiri , Breslau Naomi , Bucholz Kathleen K. , Doheny Kimberly F. , Edenberg Howard J. , Goate Alison M. , Hesselbrock Victor , Howells William B. , Johnson Eric O. , Kramer John , Krueger Robert F. , Kuperman Samuel , Laurie Cathy , Manolio Teri A. , Neuman Rosalind J. , Nurnberger John I. , Porjesz Bernice , Pugh Elizabeth , Ramos Erin M. , Saccone Nancy , Saccone Scott , Schuckit Marc , Bierut Laura J. ,   the GENEVA Consortium
Published: April 2012

Aims

Nicotine dependence is a highly heritable disorder associated with severe medical morbidity and mortality. Recent meta‐analyses have found novel genetic loci associated with cigarettes per day (CPD), a proxy for nicotine dependence. The aim of this paper is to evaluate the importance of phenotype definition (i.e. CPD versus Fagerström Test for Cigarette Dependence (FTCD) score as a measure of nicotine dependence) on genome‐wide association studies of nicotine dependence.

Design

Genome‐wide association study.

Setting

Community sample.

Participants

A total of 3365 subjects who had smoked at least one cigarette were selected from the Study of Addiction: Genetics and Environment (SAGE). Of the participants, 2267 were European Americans, 999 were African Americans.

Measurements

Nicotine dependence defined by FTCD score ≥4, CPD.

Findings

The genetic locus most strongly associated with nicotine dependence was rs1451240 on chromosome 8 in the region of CHRNB3 [odds ratio (OR) = 0.65, P = 2.4 × 10−8]. This association was further strengthened in a meta‐analysis with a previously published data set (combined P = 6.7 × 10−16, total n = 4200). When CPD was used as an alternate phenotype, the association no longer reached genome‐wide significance (β = −0.08, P = 0.0004).

Conclusions

Daily cigarette consumption and the Fagerstrom Test for Cigarette Dependence show different associations with polymorphisms in genetic loci.
Maternal perceptions of children's weight status
Authors: Lopes L. , Santos R. , Pereira B. , Lopes V.
Published: April 2012

Background  Several studies have addressed mothers' perceptions of their children's weight status; however, there is no investigation on Portuguese children (a country with one of the highest levels of children's overweight and obesity in Europe). The aim of this study was to quantify maternal misclassification of child weight status in a sample of Portuguese children aged 9 to 12 years, according to gender, family income, and maternal weight status, education level and age.

Methods  Data were collected in a school‐based study (school year 2009/2010) in northern Portugal with 499 urban children (236 girls; 47.3%). Body mass index was calculated from measurements of height and weight [body mass (kg)/height (m2)]. Mothers' perceptions of child's weight status, age, height and weight were accessed by a questionnaire. Children's age, gender and socio‐economic status were extracted from the schools' administrative record systems. Cohen's Kappa was used to analyse the misperceptions and the agreement between children's objectively measured weight status and mothers' perception of their child's weight status.

Results  The prevalence of underweight, overweight and obesity in children was 4.6%, 25.5% and 6.4%, respectively. A proportion of 65.2% of underweight and 61.6% of overweight/obese children were misclassified by their mothers. For the majority of variables presented, the values of agreement were fair (k ranged from 0.257 to 0.486), but were statistically significant. Significant differences in the percentages of mothers who correctly classified their children's weight status were only found among the most educated in the overweight/obese group and among the normal‐weight mothers in the underweight group.

Conclusions  Many mothers do not properly recognize their children's weight status and frequently underestimate their children's body size.
Adherence in severe asthma
Authors: Bourdin A. , Halimi L. , Vachier I. , Paganin F. , Lamouroux A. , Gouitaa M. , Vairon E. , Godard P. , Chanez P.
Published: April 2012

Adherence in asthma is an important cause for concern. Although nearly 50% of asthma patients are considered poorly adherent to therapeutic advices, adherence is still difficult to assess, understand and improve despite major medical consequences. In this review, we revisited the literature of the last 10 years related to adherence in severe asthma. The concepts have changed and “compliance” is usually replaced by “adherence”. Assessment of adherence is addressing ethical issues, but provides important insight into difficult‐to‐treat asthma. Different tools have been used but none is routinely recommended. Health‐related outcomes (poor control, exacerbations, hospitalizations, lung function decline), which are clearly associated with severe asthma, are often worsened by non‐adherence with consequences also on patient related outcomes (quality of life). The potential behaviour associated with non‐adherence and all other related factors including easy‐to‐recognize psychological traits can help for patient's future management. Therapeutic educational interventions have been recognized with a scientifically proven efficiency even though evolution and improvements are needed. A multidisciplinary approach is required in severe asthma. Therapeutic adherence for a given patient is always a prerequisite to any other aspects when addressing severe asthma phenotypes. Severe asthma should be considered only in those who still experienced poor asthma outcomes despite optimal adherence. At a glance, poor adherence and severe asthma should be considered antinomic. Better understanding of the causes and customised management are potential future directions.
Postprandial triglyceride profile after a standardized oral fat load is altered in growth hormone (GH)‐deficient adult patients and is not improved after short‐term GH replacement therapy
Authors: Perotti Mario , Caumo Andrea , Brunani Amelia , Cambiaghi Nadia , Casati Marco , Scacchi Massimo , Perra Silvia , Rocco Cristina , Mancia Giuseppe , Grassi Guido , Cavagnini Francesco , Pincelli Angela Ida
Published: April 2012

Objective

Adult growth hormone deficiency (GHD) has detrimental effects on metabolic profile, leading to an increased cardiovascular mortality and morbidity. Above all, disturbance in postprandial triglyceride metabolism is of major concern because of the crucial role of triglyceride‐rich lipoproteins in atherogenesis. The majority of previous studies on GH replacement have shown favourable changes in the fasting lipid profile. Aim of this study is to investigate whether this beneficial effect is exerted also on postprandial triglyceride (TG) metabolism.

Patients and methods

We challenged nine GHD patients with a standardized fat loading meal at baseline and after 6 months of GH replacement therapy. Nine healthy control subjects were similarly tested under baseline conditions. Blood samples were obtained before and up to 8 h after fat loading for serum lipid analysis.

Results

We found that GHD patients with fasting TG level in the normal range (1·29 ± 0·31 mm) had a delayed postprandial TG clearance compared to healthy controls (triglyceride level at 8 h, 3·82 ± 0·83 vs 1 ± 0·06 mm P < 0·01), and the postprandial hypertriglyceridaemia was not corrected by 6 months of GH therapy.

Conclusions

This study has shown for the first time that GHD adult patients have a higher postprandial triglyceridaemia compared to healthy controls when challenged by a standardized fat load and that this atherogenic feature is not normalized by short‐term GH treatment despite a decrease in visceral fat mass described during the replacement therapy.
Longevity and lifetime reproductive success of barn swallow offspring are predicted by their hatching date and phenotypic quality
Authors: Saino Nicola , Romano Maria , Ambrosini Roberto , Rubolini Diego , Boncoraglio Giuseppe , Caprioli Manuela , Romano Andrea
Published: April 2012

1. Longevity is a major determinant of individual differences in Darwinian fitness. Several studies have analyzed the stochastic, time‐dependent causes of variation in longevity, but little information exists from free‐ranging animal populations on the effects that environmental conditions and phenotype early in ontogeny have on duration of life.

2. In this long‐term (1993–2011) study of a migratory, colonial, passerine bird, the barn swallow (Hirundo rustica), we analyzed longevity and, in a subsample of individuals, lifetime reproductive success (LRS) of the offspring that reached sexual maturity in relation to hatching date, which can affect the rearing environment through a seasonal deterioration in ecological conditions. Moreover, we analyzed the consequences of variation in body size and, for the first time in any species, of a major component of immunity on longevity, both by looking at absolute phenotypic values and at deviations from the brood mean.

3. Accelerated failure time models showed that individuals of both sexes that hatched early in any breeding season enjoyed larger longevity and larger LRS, indicating directional selection for early breeding. Both male and female offspring with large T cell‐mediated immune response relative to their siblings and female nestlings that dominated the brood size/age hierarchy had larger longevity than their siblings of inferior phenotypic quality/age. Conversely, absolute phenotypic values did not predict longevity.

4.Frailty modelling disclosed marked spatial heterogeneity in longevity among colonies of origin, again stressing the impact of rearing conditions on longevity.

5. This study therefore reinforces the notion that perinatal environment and maternal decisions over timing and site of breeding, and position in the brood hierarchy can have marked effects on progeny life history that extend well into adulthood. In addition, it provides the first evidence from any bird population in the wild that immune response when nestlings predicts individuals’ longevity after sexual maturation.
Does restriction of mandibular movements during sleep influence jaw‐muscle activity?
Authors: ARIMA T. , TOMONAGA A. , TOYOTA M. , INOUE S.‐I. , OHATA N. , SVENSSON P.
Published: April 2012

Summary  To investigate the effect of restriction of mandibular movements during sleep on jaw‐muscle electromyographic (EMG) activity. Eleven healthy subjects (four men and seven women; age, 25·9 ± 3·1 years) with self‐reports of sleep bruxism participated in three randomised sessions with three different types of oral appliances: (i) full‐arch maxillary and mandibular appliances which did not allow any mandibular movement, that is, restrictive oral appliance (restrict‐MMOA), (ii) full‐arch maxillary and mandibular oral appliances (free‐MMOA) with no restrictions of mandibular movements and (iii) conventional full‐arch flat stabilisation appliance, that is, maxillary oral appliance (free‐MOA). Baseline recordings (1st EMG recording) of jaw‐muscle activity during sleep without any oral appliance were performed and followed by 1 week of nightly use of each oral appliance (three sessions). During the last night in each session, jaw‐muscle activity was recorded (2nd, 3rd and 4th EMG recordings) and compared to baseline values. All EMG data were analysed in accordance with the gold‐standard diagnostic method. The average jaw‐muscle activity expressed as number of EMG episodes and bursts per hour sleep was significantly reduced during any combination of appliance compared to baseline values. The inhibitory effect of the appliances was specific to the number of phasic EMG episodes and bursts (P < 0·01), with no effects on tonic EMG bursts or episodes (P > 0·30). The results indicated that restriction of mandibular movements with oral appliances do not have any major influence on jaw‐muscle activity during sleep but rather that the immediate effect of any combination of oral appliances lead to a suppression of phasic EMG bursts and episodes.
Associations between medical school and career preferences in Year 1 medical students in Scotland
Authors: Cleland Jennifer , Johnston Peter W , French Fiona H , Needham Gillian
Published: April 2012

Medical Education 2012: 46: 473–484

Objectives  Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students’ medical training.

Methods  Year 1 (2009–2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors.

Results  The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first‐choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work–life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job‐related factors by most respondents. Few differences were found among schools in terms of the impact of job‐related factors on future career preferences. Students for whom the work–life balance was extremely important (odds ratio [OR] = 0.6) were less likely to prefer surgery. Students for whom the work–life balance (OR = 2.2) and continuity of care (OR = 2.1) were extremely important were more likely to prefer general practice.

Conclusions  Students’ early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work–life balance is very important to tomorrow’s doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students’ career preferences change as they progress through medical school and training.
Clinical reasoning processes: unravelling complexity through graphical representation
Authors: Charlin Bernard , Lubarsky Stuart , Millette Bernard , Crevier Françoise , Audétat Marie‐Claude , Charbonneau Anne , Caire Fon Nathalie , Hoff Lea , Bourdy Christian
Published: April 2012

Medical Education 2012: 46: 454–463

Context  Clinical reasoning is a core skill in medical practice, but remains notoriously difficult for students to grasp and teachers to nurture. To date, an accepted model that adequately captures the complexity of clinical reasoning processes does not exist. Knowledge‐modelling software such as mot Plus (Modelling using Typified Objects [MOT]) may be exploited to generate models capable of unravelling some of this complexity.

Objectives  This study was designed to create a comprehensive generic model of clinical reasoning processes that is intended for use by teachers and learners, and to provide data on the validity of the model.

METHODS  Using a participatory action research method and the established modelling software (mot Plus), knowledge was extracted and entered into the model by a cognitician in a series of encounters with a group of experienced clinicians over more than 250 contact hours. The model was then refined through an iterative validation process involving the same group of doctors, after which other groups of clinicians were asked to solve a clinical problem involving simulated patients.

Results  A hierarchical model depicting the multifaceted processes of clinical reasoning was produced. Validation rounds suggested generalisability across disciplines and situations.

Conclusions  The MOT model of clinical reasoning processes has potentially important applications for use within undergraduate and graduate medical curricula to inform teaching, learning and assessment. Specifically, it could be used to support curricular development because it can help to identify opportune moments for learning specific elements of clinical reasoning. It could also be used to precisely identify and remediate reasoning errors in students, residents and practising doctors with persistent difficulties in clinical reasoning.
Residency selection: do the perceptions of US programme directors and applicants match?
Authors: Go Pauline H , Klaassen Zachary , Chamberlain Ronald S
Published: April 2012

Medical Education 2012: 46: 491–500

Objectives  This study sought to evaluate the practices and perceptions of US residency programme directors (PDs) and residency applicants with reference to the use of social media and Internet resources in the resident doctor selection process.

Methods  A survey was distributed via e‐mail (SurveyMonkey®) to 2592 PDs of programmes in 22 specialties accredited by the Accreditation Council for Graduate Medical Education. A separate survey was distributed to all residency candidates applying for postgraduate year 1 (PGY1) positions at the Saint Barnabas Medical Center, Livingston, New Jersey.

Results  A total of 1200 (46.3%) PDs completed the survey. Overall, 16.3% (n = 196) of respondents reported visiting Internet resources to gain more information about applicants, 38.1% (74 of 194) of whom had ranked an applicant lower as a result. American medical graduates (AMGs), US international medical graduates (USIMGs) and non‐USIMGs all felt that performance on Step 1 of the US Medical Licensing Examination (USMLE) was a critical aspect of a residency application. More AMGs than USIMGs and non‐USIMGs believed that PDs made use of social media resources when evaluating applicants and that their online profiles might influence their rankings.

Conclusions  Residency candidates universally understand the importance of USMLE Step 1 scores in maintaining a competitive application. However, significant differences exist among AMGs, USIMGs and non‐USIMGs in their perceptions of the value of other applicant criteria, which may place some applicants at a disadvantage. A small but growing number of PDs currently use Internet resources to learn more about applicants and base their recruitment decisions in part on the information they encounter. At present, applicants are generally unaware of the implications their online activity may have on their selection for residency. Content guideline programmes that raise awareness of the possible impact of social media on the residency recruitment process are needed and should be delivered early in medical education.
The quorum‐sensing protein TraR of Agrobacterium tumefaciens is susceptible to intrinsic and TraM‐mediated proteolytic instability
Authors: Costa Esther D. , Chai Yunrong , Winans Stephen C.
Published: April 2012

TraR of Agrobacterium tumefaciens is a LuxR‐type transcription factor that regulates genes required for replication and conjugation of the tumour‐inducing plasmid. TraR binds the pheromone 3‐oxo‐octanoylhomoserine lactone (OOHL) and requires this molecule for folding into a protease‐resistant, soluble conformation. Even after binding to OOHL, TraR is degraded at readily detectable rates. Here we show that the N‐terminal domain of TraR, which binds OOHL, is more resistant to degradation than the full length protein, suggesting that sites on the C‐terminal DNA binding domain [TraR(170–234)] enhance protein turnover. A fusion between GFP and TraR(170–234) was poorly fluorescent, and truncations of this fusion protein allowed us to identify residues in this domain that contribute to protein degradation. TraR activity was previously shown to be inhibited by the antiactivator TraM. These proteins form 2:2 complexes that fail to bind DNA sequences. Here we show that TraM sharply decreased the accumulation of TraR in whole cells, indicating that TraM facilitates proteolysis of TraR. The TraM component of these complexes is spared from proteolysis, and could therefore act catalytically.
Inactivation of PbTopo IIIβ causes hyper‐excision of the Pathogenicity Island HAI2 resulting in reduced virulence of Pectobacterium atrosepticum
Authors: Vanga Bhanupratap R. , Butler Ruth C. , Toth Ian K. , Ronson Clive W. , Pitman Andrew R.
Published: April 2012

Topoisomerase III enzymes are present only in a limited set of bacteria and their physiological role remains unclear. Here, we show that PbTopo IIIβ, a homologue of topoisomerase III encoded on the chromosome of Pectobacterium atrosepticum strain SCRI1043 (Pba SCRI1043), is involved in excision of HAI2, a discrete ∼ 100 kb region, from the Pba SCRI1043 chromosome. HAI2 is a Pathogenicity Island (PAI) that encodes coronafacic acid (Cfa), a major virulence determinant required for infection of potato. PAIs are horizontally acquired genetic elements that in some instances are able to excise from the chromosome of their host cell to form a circular episome prior to transfer to a recipient bacterium. We demonstrate excision of HAI2 from the chromosome, a process that is independent of growth phase and that results in the production of a circular intermediate. Inactivation of PbTopo IIIβ causes a 103‐ to 104‐fold increase in excision, leading to reduced fitness in vitro and a decrease in the virulence of Pba SCRI1043 on potato. These results suggest that PbTopo IIIβ is required for stable maintenance of HAI2 in the chromosome of Pba SCRI1043 and may control as yet unidentified genes involved in viability and virulence of Pba SCRI1043 on potato.
Characterization of the dog lipocalin allergen Can f 6: the role in cross‐reactivity with cat and horse
Authors: Nilsson O. B. , Binnmyr J. , Zoltowska A. , Saarne T. , van Hage M. , Grönlund H.
Published: April 2012

Background

Allergy to the domestic dog (Canis familiaris) affects 5–10% of the population in affluent countries. Three of four patients are allergic to more than one pet, which can only partially be explained by cross‐reactivity between serum albumins. The lipocalin protein family harbours allergens in mammalian species.

Methods

We set out to clone and characterize a novel dog allergen, and investigate its potential role in cross‐sensitization between dog, cat and horse. The gene encoding Can f 6 was amplified from dog skin and bladder cDNA libraries. The corresponding allergen was produced and purified by recombinant techniques and evaluated by SDS‐PAGE, size exclusion chromatography, circular dichroism spectra, ELISA and basophil activation test.

Results

IgE antibodies to Can f 6 were found in serum from 38% of dog‐sensitized subjects. Sequence similarities between the lipocalin allergens Can f 6, Fel d 4 (cat) and Equ c 1 (horse) suggested a probability for cross‐reactivity, which was demonstrated by competitive ELISA. The biological relevance of Can f 6 was confirmed by basophil activation test in dog‐allergic patients.

Conclusion

Can f 6 is a new lipocalin dog allergen that cross‐reacts with lipocalins from horse and cat. Can f 6 and homologous allergens may contribute to multisensitization and symptoms in individuals allergic to mammals.
Coloration signals the ability to cope with elevated stress hormones: effects of corticosterone on growth of barn owls are associated with melanism
Authors: ALMASI B. , ROULIN A. , KORNER‐NIEVERGELT F. , JENNI‐EIERMANN S. , JENNI L.
Published: April 2012

Stressful situations during development can shape the phenotype for life by provoking a trade‐off between development and survival. Stress hormones, mainly glucocorticoids, play an important orchestrating role in this trade‐off. Hence, how stress sensitive an animal is critically determines the phenotype and ultimately fitness. In several species, darker eumelanic individuals are less sensitive to stressful conditions than less eumelanic conspecifics, which may be due to the pleiotropic effects of genes affecting both coloration and physiological traits. We experimentally tested whether the degree of melanin‐based coloration is associated with the sensitivity to an endocrine response to stressful situations in the barn owl. We artificially administered the mediator of a hormonal stress response, corticosterone, to nestlings to examine the prediction that corticosterone‐induced reduction in growth rate is more pronounced in light eumelanic nestlings than in darker nest mates. To examine whether such an effect may be genetically determined, we swapped hatchlings between randomly chosen pairs of nests. We first showed that corticosterone affects growth and, thus, shapes the phenotype. Second, we found that under corticosterone administration, nestlings with large black spots grew better than nestlings with small black spots. As in the barn owl the expression of eumelanin‐based coloration is heritable and not sensitive to environmental conditions, it is therefore a reliable, genetically based sign of the ability to cope with an increase in blood corticosterone level.
Transfusion‐related mortality after primary hip arthroplasty – an analysis of mechanisms and confounders
Authors: Jans Ø. , Kehlet H. , Johansson P. I.
Published: April 2012

Background and Objectives  Bleeding and postoperative anaemia after total hip arthroplasty (THA) may trigger transfusion of red blood cells (RBC). However, large observational studies have reported associations between RBC transfusion and increased postoperative morbidity and mortality. As major bleeding or severe postoperative anaemia is intrinsically linked with RBC transfusion, direct causality between transfusion and adverse outcomes remains unclear. This study aimed to identify possible relations between RBC transfusion, severe bleeding or anaemia and mortality in all patients who died < 90 days after THA in Denmark in 2008.

Materials and Methods  Nationwide review of patient records. Cases of adverse transfusion events, infections following transfusion, severe perioperative bleeding or anaemia and possible causal relations to mortality were identified by two independent reviewers.

Results  Of 6932 THA patients, 45 (0·6%) were transfused within 30 days and died < 90 days from surgery. Three patients (7%) died from causes possibly related to either severe anaemia, major bleeding alone or major bleeding with transfusion‐related acute lung injury, while five (11%) died from infections occurring after RBC transfusion. Mortality in the remaining 37 patients (82%) was of unknown cause (nine patients) or related to patient or surgical factors (28 patients).

Conclusion  Transfusion‐related mortality after THA included cases of major perioperative bleeding or severe postoperative anaemia with delayed RBC transfusion in addition to possible complications to RBC transfusion per se. Future studies should account for pretransfusion haemoglobin and perioperative blood loss when evaluating RBC transfusion‐associated outcomes after surgery.
Association of 3D Reconstruction and Conventional Radiography for the Description of the Appendicular Skeleton of Chelonoidis carbonaria (Spix, 1824)
Authors: Bortolini Z. , Lehmkuhl R. C. , Ozeki L. M. , Tranquilim M. V. , Sesoko N. F. , Teixeira C. R. , Vulcano L. C.
Published: April 2012

In this study, we associated imaging modalities, such as computed tomography (CT) and standard radiography, with anatomical specimens to describe the anatomy of the appendicular skeleton of red‐footed tortoises (Chelonoidis carbonaria), using animals of different sizes, ages, sexes and weights. Manus and pes bones were described from conventional radiography and osteological specimens, because they have small structures that could not be reconstructed. The main anatomical feature that differentiates C. carbonaria from others Testudines is the ischial‐pubic tuberculum. The pectoral girdle is formed by the union of two bones, the scapula and the coracoid, showing no bone connection with the shell. Carpal and tarsal bones can be fused or not and include: carporadial and central carpus, carpoulnar and V carpal, central tarsal and fibular tarsal, distal tarsal I and II. The phalangeal formula is 2:2:2:2:2 in the forelimb and 2:2:2:2:1 in the hind limb. Imaging examinations are important tools in anatomical description and can be used in living individuals, replacing or aiding the study with anatomical specimens.
Patch testing is an effective method for the diagnosis of carbamazepine‐induced drug reaction, eosinophilia and systemic symptoms (DRESS) syndrome in an 8‐year‐old girl
Authors: Buyuktiryaki Ayse Betul , Bezirganoglu Handan , Sahiner Umit Murat , Yavuz Suleyman Tolga , Tuncer Ayfer , Kara Ates , Sackesen Cansin
Published: April 2012

Drug reaction, eosinophilia and systemic symptoms (DRESS) is an acute and life‐threatening disease, characterised by fever, rash and systemic symptoms, including lymphadenopathy, abnormal liver function, interstitial nephritis, pulmonary and cardiac infiltrates and haematological abnormalities with eosinophilia and atypical lymphocytes. The drugs mostly associated with DRESS are anticonvulsants, allopurinol, minocycline and sulfonamides. This syndrome is rarely seen in childhood even though a large number of children have anticonvulsant treatment. An 8‐year‐old girl was admitted with fever, lymphadenopathy and skin eruptions on her trunk. Her medical history was notable for epilepsy and carbamazepine treatment had been started 5 weeks previously. Laboratory studies showed a white cell count of 6200/µL (normal, 4100–11 200/µL) with 22% eosinophils and a γ‐glutamyl transpeptidase level of 296 U/L (normal, 0–23 U/L). Laboratory tests for infections and collagen diseases were in the normal range. Persistence of fever and maculopapular eruption with generalised desquamation and the appearance of cheilitis and facial angioedema suggested a hypersensitivity reaction to carbamazepine. The carbamazepine was replaced with levetiracetam. All clinical symptoms improved within a week with corticosteroids and antihistamine treatment. Six weeks after complete recovery an epicutaneous patch test with carbamazepine was performed and a carbamazepine‐induced positive skin reaction was observed at 48‐h. Carbamazepine‐induced DRESS syndrome is a rare entity in children. An epicutaneous patch test is a useful tool for identifying the inducing agent for the DRESS syndrome and for identifying a safe anticonvulsant drug.
Development and evolution of cerebellar neural circuits
Authors: Hashimoto Mitsuhiro , Hibi Masahiko
Published: April 2012

The cerebellum controls smooth and skillful movements and it is also involved in higher cognitive and emotional functions. The cerebellum is derived from the dorsal part of the anterior hindbrain and contains two groups of cerebellar neurons: glutamatergic and gamma‐aminobutyric acid (GABA)ergic neurons. Purkinje cells are GABAergic and granule cells are glutamatergic. Granule and Purkinje cells receive input from outside of the cerebellum from mossy and climbing fibers. Genetic analysis of mice and zebrafish has revealed genetic cascades that control the development of the cerebellum and cerebellar neural circuits. During early neurogenesis, rostrocaudal patterning by intrinsic and extrinsic factors, such as Otx2, Gbx2 and Fgf8, plays an important role in the positioning and formation of the cerebellar primordium. The cerebellar glutamatergic neurons are derived from progenitors in the cerebellar rhombic lip, which express the proneural gene Atoh1. The GABAergic neurons are derived from progenitors in the ventricular zone, which express the proneural gene Ptf1a. The mossy and climbing fiber neurons originate from progenitors in the hindbrain rhombic lip that express Atoh1 or Ptf1a. Purkinje cells exhibit mediolateral compartmentalization determined on the birthdate of Purkinje cells, and linked to the precise neural circuitry formation. Recent studies have shown that anatomy and development of the cerebellum is conserved between mammals and bony fish (teleost species). In this review, we describe the development of cerebellar neurons and neural circuitry, and discuss their evolution by comparing developmental processes of mammalian and teleost cerebellum.
Anti‐inflammatories and the gastrointestinal tract: Victores et Victis
Authors: Winter Trevor A , Quan Susan Y
Published: April 2012

See article in J. Gastroenterol. Hepatol. 2012; 27: 857–861.
CD44 in human glioma correlates with histopathological grade and cell migration
Authors: Yoshida Tsuneyasu , Matsuda Yoko , Naito Zenya , Ishiwata Toshiyuki
Published: April 2012

Glioblastomas are associated with high mortality due to their aggressive growth and invasiveness. Interactions and functional cross‐talk between tumor cells and their microenvironments are mediated by cell surface receptors that are responsible for cell‐cell and cell‐extracellular matrix adhesion. Central nervous tissues contain plenty of the glycosaminoglycan hyaluronan, and glioma cells express the major cell surface hyaluronan receptor, CD44. In this study, we analyzed the expression and roles of CD44 in human brain tissues. Normal brain tissues showed no or weak CD44 expression, while reactive astrocytes and astrocytoma cells expressed CD44 at variable levels. Immunohistochemically, a higher percentage and intensity of CD44‐positive tumor cells were detected in high‐grade astrocytomas compared with low‐grade astrocytomas. Glioblastoma cells that express CD44 were localized in perivascular and perinecrotic lesions. The human glioma cell lines A172 and KG‐1‐C expressed CD44 mRNA and protein. Administration of monoclonal anti‐human‐CD44 antibody inhibited the migration of A172 cells, which are glioblastoma‐derived, but did not affect cell growth. In conclusion, CD44 expression levels correlated with the histopathological grade of gliomas, and monoclonal anti‐CD44 antibody inhibited the migration of glioblastoma cells. These findings suggest that CD44 is a potential therapeutic target of glioblastomas.