bluuebunny/crossref_metadata_2025 huggingface dataset:
Ochtodes searlesii sp. nov. (Gigartinales, Rhodophyta), from the Pacific tropical coast of Mexico, based on morphological and molecular evidence
Authors: Mendoza‐González A. Catalina , Sentíes Abel , Mateo‐Cid Luz Elena , Díaz‐Larrea Jhoana , Pedroche Francisco F. , Villanueva Reyna Alvarado
Published: October 2011

Ochtodes searlesii Mendoza‐González, Mateo‐Cid et Sentíes sp. nov. is described from Michoacán, tropical Mexican Pacific, on the basis of comparative morphology and rbcL sequence analysis. It is distinguished from other Ochtodes species by its erect axes arising from an encrusting base, its small terete fronds, regularly dichotomously branched axes, and obliquely divided zonate tetrasporangia. Phylogenetic analyses showed that three Pacific Mexican samples, from Caletilla, Zapote and La Majahuita (Michoacán), were identical and formed a distinctive and well supported Clade segregated from other species of Ochtodes from Brazil, Cuba, Ecuador, Guadeloupe and Mexico. The Mexican entity is morphologically distinct from other Ochtodes species as well. On this basis we propose a new Ochtodes species.
Determination of some cyanopeptides synthesized by Woronichinia naegeliana (Chroococcales, Cyanophyceae)
Authors: Bober Beata , Lechowski Zbigniew , Bialczyk Jan
Published: October 2011

Nineteen compounds isolated from field samples of cyanobacteria Woronichinia naegeliana (Unger) Elenkin were identified. They fell into four classes of peptides: cyanopeptolins (cyanopeptolin B, cyanopeptolin C, cyanopeptolin D, cyanopeptolin 880, micropeptin 88D, micropeptin 478‐B, micropeptin SD999, micropeptin T2, planktopeptin BL1061), microginins (microginin 478, microginin 757, microginin 51A, microginin 91E, microginin FR3, microginin FR4), anabaenopeptins (oscillamide B) and possibly microcystins (trace amounts of microcystin‐LR) showing respectively fragment patterns in their electrospray ion source‐MS spectra. The molecular masses of the determined peptides range from 700 to 1100 Da. These results confirm the remarkable ability of cyanobacteria to synthesize a wide array of peptides.
Asthma and obesity: A known association but unknown mechanism
Authors: FARAH CLAUDE S. , SALOME CHERYL M.
Published: October 2011

The obese asthma phenotype is an increasingly common encounter in our clinical practice. Epidemiological data indicate that obesity increases the prevalence and incidence of asthma, and evidence that obesity precedes the development of asthma raises the possibility of a causal association. Obese patients with asthma experience more symptoms and increased morbidity compared with non‐obese asthma patients. Despite more than a decade of research into this association, the exact mechanisms that underlie the interaction of obesity with asthma remain unclear. It is unlikely that the asthma–obesity association is simply due to comorbidities such as obstructive sleep apnoea or gastroesophageal reflux disease. Although inflammatory pathways are purported to play a role, there is scant direct evidence in humans that systemic inflammation modulates the behaviour of the asthmatic airway or the expression of symptoms in the obese. The role of non‐eosinophilic airway inflammation also requires further study. Obesity results in important changes to the mechanical properties of the respiratory system, and these obesity‐related factors appear to exert an additive effect to the asthma‐related changes seen in the airways. An understanding of the various physiological perturbations that might be contributing to symptoms in obese patients with asthma will allow for a more targeted and rational treatment approach for these patients.
Angiotensin II receptor blocker partially ameliorated intrarenal hypoxia in chronic kidney disease patients: a pre‐/post‐study
Authors: Manotham K. , Ongvilawan B. , Urusopone P. , Chetsurakarn S. , Tanamai J. , Limkuansuwan P. , Tungsanga K. , Eiam‐Ong S.
Published: October 2011

Chronic intrarenal hypoxia has been regarded as a pathogenic factor of progressive renal damage. However, the lack of available human data has impeded the progress in this field. In this work, blood oxygen level‐dependent magnetic resonance imaging was used to determine intrarenal oxygen status pre‐ and post‐angiotensin receptor blockade (olmesartan) treatment in normal subjects, diabetic chronic kidney disease (CKD) patients and non‐diabetic CKD patients. The mean R2*, which represents intrarenal oxygenation, was significantly lower in the control group than in the CKD group (12.42 ± 0.53 /s vs 18.89 ± 3.15 /s, P < 0.01), indicating the presence of intrarenal hypoxia in the CKD patients. The olmesartan treatment induced a 16.2 ± 7.7% decrement of the mean R2* in CKD patients, suggesting that this drug had an intrarenal hypoxia ameliorating effect.
Clinical evaluation of a novel method for the measurement of prostate‐specific antigen, AccuPSATM, as a predictor of 5‐year biochemical recurrence‐free survival after radical prostatectomy: results of a pilot study
Authors: Lepor Herbert , Cheli Carol D. , Thiel Robert P. , Taneja Samir S. , Laze Juliana , Chan Dan W. , Sokoll Lori J. , Mangold Leslie , Partin Alan W.
Published: October 2011

Study Type – Diagnostic (validating cohort)

Level of Evidence 1b

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

Nadir Ultrasensitive PSA levels has some value for predicting BCR following RD.

AccuPSA assays lower limit of PSA quantification of <0.01 pg/ml greatly enhances sensitivity and specificity of nadir PSA to predict BCR following RP. Our pilot study shows an AccuPSA of 3 pg/ml has a sensitory and specificity of 100% and 75% respectively for predicting 5 year BCR following RP.

OBJECTIVES

To conduct a proof of concept study to evaluate a novel digital single molecule immunoassay (AccuPSATM) that detects prostate‐specific antigen (PSA) a thousandfold more sensitively than current PSA detection methods.

To determine the ability of the AccuPSATM assay to predict 5‐year biochemical recurrence (BCR)‐free survival after radical prostatectomy (RP).

PATIENTS AND METHODS

A total of 31 frozen serum specimens were obtained from specimen logs maintained at New York University Langone Medical Center and the Johns Hopkins University School of Medicine on men who had undergone RP. Those men without evidence of BCR had a minimum of 5 years' PSA follow‐up.

In all cases, preoperative and pathological information were available, as was a serum specimen 3–6 months after RP, with a PSA level of <0.1 ng/mL measured by conventional PSA methods at the time of serum collection.

Specimens were tested using the AccuPSATM method.

A Cox proportional hazard model and Kaplan–Meier analysis were used to determine whether AccuPSATM predicted the risk of BCR.

RESULTS

Overall, 11/31 (35.5%) men developed BCR.

Mean AccuPSATM nadir levels were significantly different (P < 0.001) between the non‐BCR group (2.27 pg/mL) and the BCR group (46.99 pg/mL).

Using a multivariate Cox proportional hazard model, AccuPSATM nadir level was a significant predictor of BCR‐free survival (P < 0.01).

Kaplan–Meier analysis of up to 5 years follow‐up showed that 100% of men with AccuPSATM nadir values <3 pg/mL did not develop BCR, whereas 62.5% of men with values >3 pg/mL developed BCR (P= 0.00024).

The sensitivity, specificity, positive predictive value and negative predictive value of the AccuPSATM method was 100%, 75%, 69% and 100%, respectively.

CONCLUSIONS

AccuPSATM assay predicts 5‐year BCR‐ free survival after RP.

Identifying a reliable predictor of BCR soon after RP has important implications for frequency of PSA testing, selection of candidates for adjuvant therapy, and reassuring a large subset of men that they are not at risk of recurrence.

Larger studies are needed to validate these findings.
Off‐clamp versus complete hilar control laparoscopic partial nephrectomy: comparison by clinical stage
Authors: Rais‐Bahrami Soroush , George Arvin K. , Herati Amin S. , Srinivasan Arun K. , Richstone Lee , Kavoussi Louis R.
Published: October 2011

Study Type – Therapy (case series)

Level of Evidence 4

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

Minimizing renal ischemia and reperfusion injury is an area of active investigation and is particularly significant in cases of laparoscopic renal surgery where the kidney experiences warm ischemia. Reports of partial clamping, early unclamping, and off‐clamp laparoscopic partial nephrectomy have demonstrated potential technical modifications that can offer a protective role in preserving renal function.

We investigated off‐clamp laparoscopic partial nephrectomy for tumours with varying clinical stage to determine feasibility, perioperative outcomes, and renal functional changes when compared to a contemporary cohort of standard laparoscopic partial nephrectomy with complete hilar clamping performed by a single surgeon.

OBJECTIVE

To compare the operative outcomes and oncological efficacy of off‐clamp (OC) laparoscopic partial nephrectomy (LPN) vs complete hilar control (HC) LPN for stage T1a–T2 renal cell carcinoma.

METHODS

Retrospective review of all LPNs between June 2006 and March 2010 was performed, stratifying 390 patients by clinical T stage (cT1a = 313, cT1b = 62, cT2 = 15).

Perioperative and postoperative parameters were analysed comparing patients who underwent OC LPN (n= 126) with those who had HC LPN (n= 264) collectively and within each clinical stage cohort.

RESULTS

There was no significant difference in the proportion of OC LPN for cT1a tumours compared with cT1b and cT2, P= 0.21.

OC vs HC LPN patients had a greater estimated blood loss (EBL) but with no significant difference in perioperative blood transfusion rates.

When compared by clinical stage, EBL was greater only for clinical stage T1a disease (P= 0.02) but not cT1b (P= 0.91) or cT2 (P= 0.42) tumours.

There was no difference in the operative time or length of hospitalization between OC and HC LPN by stage: cT1a (P= 0.77 and P= 0.17), cT1b (P= 0.77 and P= 0.07) and cT2 (P= 0.42 and P= 0.66), respectively.

In our series, one case (0.3%) of HC LPN had a positive margin on final pathology, one case was converted to open partial nephrectomy (0.3%), and two cases of OC LPN (1.6%) were intraoperatively converted to HC LPN.

CONCLUSIONS

OC LPN is a feasible surgical option for patients with cT1–T2 renal cell carcinoma that completely avoids renal ischaemic injury with the benefits of minimally invasive surgery.

LPN can be performed OC in patients with larger, more complex renal tumours without compromising the operative time, blood loss requiring transfusions, length of hospitalization, complication rates, or positive surgical margin rates compared with HC LPN.
Nodal counts during pelvic lymph node dissection for prostate cancer: an objective indicator of quality under the influence of very subjective factors
Authors: Mazzola Clarisse , Savage Caroline , Ahallal Youness , Reuter Victor E. , Eastham James A. , Scardino Peter T. , Guillonneau Bertrand , Touijer Karim A.
Published: October 2011

Study Type – Therapy (case series)

Level of Evidence 4

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

In lymph node dissections for cancer, the more extended the dissection, the higher the number of lymph nodes removed. In addition, the higher the number of nodes retrieved, the better the staging. This leads many investigators to set a threshold of a minimal number of nodes below which the dissection is considered inadequate.

Although the minimal threshold concept is generally good, it is not based on very objective data. a number of factors might influence the final number of nodes removed: (i) the surgeon and the surgical technique; (ii) the pathologists and tissue processing technique; (iii) the patient; and (iv) the audit effect and feedback to the surgeons about the number of nodes removed.

OBJECTIVE

To examine the number of lymph nodes removed over time for men undergoing a standard pelvic lymph node dissection (PLND) during radical prostatectomy.

PATIENTS AND METHODS

In total, 2119 consecutive patients with clinically localized prostate cancer were scheduled for non‐salvage radical prostatectomy between February 2005 and September 2009.

All patients underwent PLND, including the external iliac, hypogastric and obturator fossa nodal groups.

We tested whether the number of lymph nodes increased over time by including the date of each patient's surgery into a linear regression model using nonlinear terms.

RESULTS

From 2008 onward, there appears to be a large increase in the number of nodes removed.

Date of surgery was a significant predictor of the number of nodes removed (P < 0.001).

The anatomical template of dissection, the specimen submission and pathological assessment were reportedly unchanged.

The nodal yield increase in the later part of the study coincides with an increase in the academic interest in PLND and nodal metastasis in prostate cancer at the institutional level and worldwide.

CONCLUSIONS

Without any intentional change in surgical technique or pathological processing, the number of lymph nodes removed in our radical prostatectomy experience increased.

This change coincided with an increased academic interest in the subject and highlights the positive feedback effect.

The change also raises concerns about unaccounted for confounding factors that could affect multi‐institutional datasets and surgical clinical trials.
Gunshot wounds to the scrotum: a large single‐institutional 20‐year experience
Authors: Simhan Jay , Rothman Jason , Canter Daniel , Reyes Jose M. , Jaffe William I. , Pontari Michel A. , Doumanian Leo R. , Mydlo Jack H.
Published: October 2011

Study Type – Therapy (case series)

Level of Evidence 4

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

Penetrating trauma to the scrotum often requires operative intervention, with testicular salvage only possible when enough testicular tissue can be re‐approximated in the traumatic setting.

The present report represents the largest series of gunshot wound trauma to the scrotum in the literature. Further, it validates recommendations of the European Association of Urology guidelines on urological trauma that advocate operative intervention due to minimal rates of patient morbidity and the inherent limitations of scrotal ultrasonography in discerning testicular compromise.

OBJECTIVE

To report our 20‐year experience of gunshot wounds (GSWs) to the scrotum and outline the management of this traumatic injury.

PATIENTS AND METHODS

We queried our institutional database for patients presenting with GSWs to the scrotum between 1985 and 2006.

All patients underwent the standard trauma evaluation upon presentation, including physical examination of the external genitalia. Management was dictated by the presence or absence of a penetrating injury to the scrotum and associated traumatic injuries.

Nonoperative and operative management of traumatic injury to the scrotum were used. Testicular salvage was performed when anatomically feasible. If testicular salvage was not feasible, an orchiectomy was performed.

RESULTS

Scrotal exploration was performed in 91 (94%) patients while six (6%) patients were treated nonoperatively.

Testicular injury was found in 44 (48%) patients undergoing exploration, six (7%) of whom had bilateral testicular injuries, which gave a total of 50 injured testicles.

Of the injured testicles, 24 (48%) could not be salvaged and required orchiectomy, while 26 (52%) were debrided and repaired.

The most common associated genitourinary (GU) injuries were to the corpora cavernosum (n= 20 [21%]) and urethra (n= 10 [10%]). Soft tissue injury of the extremities occurred in 54 patients (56%), representing the most common non‐GU‐associated injury.

Postoperative complications occurred infrequently: one patient (1%) returned for abscess drainage and one (1%) for haematoma evacuation.

CONCLUSIONS

The present report confirms that any patient with a penetrating injury to the scrotum should undergo immediate scrotal exploration.

A low clinical suspicion for performing additional studies to rule out associated urethral and/or penile injury is clinically warranted.

Testicular loss occurs in ≈50% of injured testicles.
The European Union at Work? The European Employment Strategy from Crisis to Crisis*
Authors: VAN RIE TIM , MARX IVE
Published: October 2011

The European Employment Strategy (EES) emerged in the early 1990s under the influence of an acute rise in unemployment and the introduction of economic and monetary union (EMU). Its purpose is to foster convergence towards lower unemployment and higher employment. This article considers these outcomes over a longer time frame and in a broader geographical context than previous studies have done. Overall, outcomes in the EU‐15 improved and converged since the introduction of EES. Comparisons suggest that these developments do not merely reflect long‐term or international trends. The recent crisis, with deteriorating and divergent outcomes, might signal the start of a new EES cycle.
Evaluation of gender differences in endothelium‐independent dilation using peripheral arterial tonometry
Authors: McCue Meghan C. , Marlatt Kara L. , Kelly Aaron S. , Steinberger Julia , Dengel Donald R.
Published: October 2011

Background:  A change in peripheral arterial tonometry (PAT) in response to reactive hyperaemia is often used to provide a non‐invasive measure of endothelium‐dependent dilation (EDD). Reactive hyperaemia does not allow one to quantify endothelium‐independent dilation (EID), which is part of overall vascular function. Although most research examining vascular function and cardiovascular disease has focused on EDD, there is evidence that cardiovascular risk factors may impair EID.

Purpose:  To examine the microvascular vasodilation response to nitroglycerin (NTG) in healthy adults using PAT.

Methods:  Microvascular responses to reactive hyperaemia and NTG were evaluated in 86 (41 female and 45 male) healthy subjects (age 37 ± 5 years). Beat‐to‐beat plethysmographic measurements of finger arterial pulse waves were recorded for 5 min following reactive hyperaemia. After a 10‐min rest period, sublingual NTG (0·4 mg) was administered and PAT signal changes were measured for 10 min. Peak reactive hyperaemic index (RHI) and peak NTG‐mediated index (NMI) were determined in all subjects.

Results:  There were no significant gender differences in peak RHI (females: 2·07 ± 0·56 versus males: 1·91 ± 0·58, P = 0·20). Mean peak NMI for all subjects was 2·78 (±1·49). Peak NMI was significantly greater in females than in males (3·11 ± 1·59 versus 2·50 ± 1·34, P = 0·05). Time to peak NMI was not significantly different between genders (7 min, 28 s [±1 min, 47 s], versus 7 min, 14 s [±1 min, 49 s], P = 0·58).

Conclusion:  In this population of healthy adults, peak NMI was significantly greater in females than in males. These findings suggest that gender differences exist in the microvascular vasodilation responses to NTG using PAT.
Lack of inhibitory effect of acetylsalicylic acid and meloxicam on whole blood platelet aggregation in cats
Authors: Cathcart Curtis J. , Brainard Benjamin M. , Reynolds Lisa R. , Al‐Nadaf Sami , Budsberg Steven C.
Published: October 2011

Objective

To determine the effects of acetylsalicylic acid (ASA) and meloxicam on feline platelet aggregation and associated platelet thromboxane production and serotonin release.

Design

Prospective interventional study.

Setting

University research facility.

Animals

Eight healthy male castrated domestic short hair cats from a research colony.

Interventions

Oral medications were administered to 8 cats for 14 days in a randomized, placebo‐controlled, crossover design. Treatment groups included: aspirin (ASA) (5 mg/kg q 48 h), meloxicam (0.05 mg/kg q 24 h), and placebo (0.5 mL of water q 24 h). Thromboxane assays (TXB2) and whole blood (impedance) aggregometry (WBA) were performed on samples collected before drug administration, and on days 7, 15, and 17, using adenosine diphosphate (ADP; 10 μM) and collagen (5 μg/mL) as agonists for WBA. Serotonin release was assayed on postaggregation plasma. Oral mucosal bleeding time (OMBT) and complete blood cell counts were measured on days 0 and 15.

Measurements and Main Results

Neither medication affected WBA at any time point. OMBT decreased in the ASA group relative to baseline. No differences were detected in WBA and OMBT baseline between any groups. No difference was detected in serotonin secretion at any time point. TXB2 was significantly decreased in the ASA group at all times after initiation of treatment but no change was noted in the meloxicam or placebo groups.

Conclusions

At the doses studied, neither meloxicam nor ASA had an inhibitory effect on WBA or OMBT in cats. Thromboxane concentrations were significantly decreased with ASA treatment.
High density lipoprotein in patients with liver failure; relation to sepsis, adrenal function and outcome of illness
Authors: Atogo‐Asse Frederique‐Estelle , Vincent Royce P. , Hughes Sarah A. , Auzinger Georg , Le Roux Carel W. , Wendon Julia , Bernal William
Published: October 2011

Background and Aims

High density lipoprotein (HDL) plays an important role in the transport of cholesterol to the adrenal gland for steroidogenesis and may have actions that modulate response to infection and critical illness. The clinical relevance of HDL level in patients with liver failure remains poorly characterised.

Methods

In 164 critically‐ill patients with acute (ALF) and acute on chronic liver failure (AOCLF) we evaluated the relationship between HDL levels measured on admission to intensive care unit (ICU) and survival, predisposition to sepsis and adrenocortical function assessed through the cortisol response to short synacthen testing (SST).

Results

In acute liver failure and acute on chronic liver failure, high density lipoprotein levels were significantly lower in non‐survivors (P < 0.01). Levels correlated closely with biochemical markers of liver function and the duration of liver failure. However, predictive accuracy was not superior to conventional markers and on multi‐variate analysis did not show independent association with survival. Low HDL concentration was not associated with an increased incidence of sepsis either precipitating or complicating ICU admission. Evidence of adrenocortical insufficiency was present in more than half of patients undergoing SST and HDL level but not other lipid parameters correlated closely with cortisol increment after SST (r = 0.364, P < 0.0001).

Conclusions

High density lipoprotein levels are low in patients with liver failure and reflect its severity. Levels are lower in non‐survivors but do not offer an advantage as early indicators of prognosis over conventional markers. No evidence of a major predisposing role for infection was found, but findings suggest a close link to adrenal function.
Luminescence dating of Pleistocene alluvial sediments affected by the Alhama de Murcia fault (eastern Betics, Spain) – a comparison between OSL, IRSL and post‐IRIRSL ages
Authors: Sohbati Reza , Murray Andrew S. , Buylaert Jan‐Pieter , Ortuño Maria , Cunha Pedro P. , Masana Eulàlia
Published: October 2011

The ages of nine alluvial units, identified by the integration of data obtained from five trenches at the southern termination of the Alhama de Murcia Fault (AMF) (eastern Betics, Spain), are constrained using luminescence dating based on the Optically Stimulated Luminescence (OSL) from quartz, Infrared Stimulated Luminescence (IRSL) at 50°C, and post‐IR elevated temperature (225°C) IRSL signals from K‐feldspar. All signals pass the routine tests associated with the Single Aliquot Regenerative (SAR) protocol, including the recycling ratio, recuperation, and dose recovery tests. The equivalent doses (De), residual doses and anomalous fading rates (‘g’‐values) of the IRSL at 50°C (IR50) and post‐IR IRSL at 225°C (pIRIR225) from K‐feldspar are compared for 16 samples. The residual doses in laboratory‐bleached samples suggest that there is no significant unbleachable residual dose using these signals; the residual doses are 0.17±0.15 Gy and 0.93±0.80 Gy, respectively. For both signals, the residual doses appear to depend on the corresponding natural doses; that is, the larger the natural doses, the larger the residuals, an observation made for the first time for IRSL signals. The average fading rate for the pIRIR225 (0.94±0.07%/decade, n = 48) is markedly lower than that for IR50 (2.08±0.16%/decade, n = 48), indicating that the age correction for the pIRIR225 is much smaller than that for IR50. The agreement between the quartz OSL, corrected IR50, and corrected pIRIR225 for the two youngest samples suggests that the pIRIR225 is an accurate dating signal in this age range (<25 ka). The oldest age obtained using the corrected pIRIR225 signal is 320±20 ka for sample 098807; the corrected IR50 age is only 154±15 ka. Although this suggests that the pIRIR225 signal circumvents the effect of anomalous fading to a great extent, the resulting age cannot be regarded as necessarily accurate because of the limitations of the fading correction model used, and the absence of independent age control for the old samples. Nevertheless, our luminescence ages provide the first age constraints on the seismic activity of the southern termination of the AMF.
TAXONOMY AND PHYLOGENY OF NEPHROSELMIS CLAVISTELLA SP. NOV. (NEPHROSELMIDOPHYCEAE, CHLOROPHYTA)1
Authors: Faria Daphne G. , Kato Aki , de la Peña Milagros R. , Suda Shoichiro
Published: October 2011

Nephroselmis clavistella D. G. Faria et S. Suda sp. nov. is collected from coastal sand samples from the eastern and western coasts of Okinawa‐jima Island, Japan. The description of the cultured strains is based on light and electron microscopic observations. The cultured strains are phylogenetically analyzed based on 18S rDNA sequences. The cells are remarkably right–left flattened and appear round or ellipse when viewed from their right or left side, and are ∼5.0 μm in diameter. The posterior flagellum curved around the cell body at rest. A single, parietal, crescent chloroplast is yellowish green and contains one conspicuous eyespot in its anterior‐ventral edge near the short flagellum base. A pyrenoid with one starch sheath is located dorsal of the chloroplast. The cells are divided by transverse binary cell division, as is common in other species of this genus. The cell body is covered with five types of scales, and among them four scale types are similar to Nephroselmis rotunda. The fifth scale type is a distinctive spiny and club‐shaped stellate scale with 10 spines, four of the 10 spines extended ∼150 nm and each are slightly curved with a hook at the end, whereas six spines are club‐shaped blunt ended. This scale morphology, an important taxonomic characteristic, has never been described before for the genus Nephroselmis. The cell’s morphology is distinctive from previously described Nephroselmis species, and its unique scale characteristics led us to name this newly proposed species “clavistella,” meaning club star.
Quality of Care Provided in a Special Needs Plan Using a Nurse Care Manager Model
Authors: Wenger Neil S. , Roth Carol P. , Martin David , Nickels Lorraine , Beckman Robin , Kamberg Caren , Mach John , Ganz David A.
Published: October 2011

Objectives

To comprehensively evaluate the quality of care provided in special needs plans (SNPs; Medicare Advantage plans that aim to provide specialized care for complex older adults) and specifically the nurse care management model in the community setting.

Design

We adapted 107 process‐of‐care quality measures across 12 conditions from the Assessing Care of Vulnerable Elders set to obtain a clinically detailed evaluation of the quality of care received by complex older enrollees in a dual eligible Evercare SNP. We abstracted 13 months of primary care medical records to delineate quality of care provided by physicians and whether there was value added from the nurse care manager model.

Setting

Dual eligible Evercare SNP located in central Florida.

Participants

Two‐hundred thirty‐one vulnerable older enrollees in the SNP who had complex disease.

Results

Based on physician medical records alone, the 231 high‐risk participants (mean age 77, 67% women) received recommended care for 53% of 5,569 evaluated clinical circumstances, ranging from 12% for end‐of‐life care to 78% for diabetes mellitus. In fewer than 40% of these clinical circumstances was recommended care provided for dementia, falls, and urinary incontinence. In a second analysis accounting for care provided by both the Evercare nurse and the physician, recommended care was provided to patients in 69% of the 5,684 evaluated clinical circumstances.

Conclusion

Comprehensive quality measurement applied to vulnerable older adults enrolled in one mature SNP showed that the Evercare nurse model addresses important deficits in physician care for geriatric conditions. Such measurement should be applied to other SNP models and to compare SNP care with that for complex, older, fee‐for‐service Medicare cohorts.
The Psychological Distance of Climate Change
Authors: Spence Alexa , Poortinga Wouter , Pidgeon Nick
Published: October 2011

Avoiding dangerous climate change is one of the most urgent social risk issues we face today and understanding related public perceptions is critical to engaging the public with the major societal transformations required to combat climate change. Analyses of public perceptions have indicated that climate change is perceived as distant on a number of different dimensions. However, to date there has been no in‐depth exploration of the psychological distance of climate change. This study uses a nationally representative British sample in order to systematically explore and characterize each of the four theorized dimensions of psychological distance—temporal, social, and geographical distance, and uncertainty—in relation to climate change. We examine how each of these different aspects of psychological distance relate to each other as well as to concerns about climate change and sustainable behavior intentions. Results indicate that climate change is both psychologically distant and proximal in relation to different dimensions. Lower psychological distance was generally associated with higher levels of concern, although perceived impacts on developing countries, as an indicator of social distance, was also significantly related to preparedness to act on climate change. Our findings clearly point to the utility of risk communication techniques designed to reduce psychological distance. However, highlighting the potentially very serious distant impacts of climate change may also be useful in promoting sustainable behavior, even among those already concerned.
Abundance Estimation of Long‐Diving Animals Using Line Transect Methods
Authors: Okamura Hiroshi , Minamikawa Shingo , Skaug Hans J. , Kishiro Toshiya
Published: October 2011

SummaryLine transect sampling is one of the most widely used methods for estimating the size of wild animal populations. An assumption in standard line transect sampling is that all the animals on the trackline are detected without fail. This assumption tends to be violated for marine mammals with surfacing/diving behaviors. The detection probability on the trackline is estimated using duplicate sightings from double‐platform line transect methods. The double‐platform methods, however, are insufficient to estimate the abundance of long‐diving animals because these animals can be completely missed while the observers pass. We developed a more flexible hazard probability model that incorporates information on surfacing/diving patterns obtained from telemetry data. The model is based on a stochastic point process and is statistically tractable. A simulation study showed that the new model provides near‐unbiased abundance estimates, whereas the traditional hazard rate and hazard probability models produce considerably biased estimates. As an illustration, we applied the model to data on the Baird’s beaked whale (Berardius bairdii) in the western North Pacific.
Thermal Conductivity of Al2O3–ZrO2 Composite Ceramics
Authors: Hostaša Jan , Pabst Willi , Matějíček Jiří
Published: October 2011

The Al2O3–ZrO2 composite ceramics were prepared by slip casting in plaster molds and sintering at 1350°C in air. The composition of prepared samples varied from pure alumina to doped zirconia (3Y‐TZP) with steps of 10 vol%. The relative density of the sintered samples varied from 94% to 98%, depending on the composition. Thermal diffusivity of sintered samples was measured by means of the xenon flash method at 100°C, 200°C, 400°C, 600°C, 800°C, and 1000°C and thermal conductivities were calculated based on measured bulk densities and specific heat data and finally corrected for porosity effects. As expected, the thermal conductivity decreased with increasing zirconia content, and in the case of samples with higher alumina content, it also decreased with increasing temperature. Effective thermal conductivities are close to the lower Hashin–Shtrikman bound and the recently proposed sigmoidal average. Empirical relations were used to fit the dependence of effective thermal conductivity of Al2O3–ZrO2 composite ceramics on both composition and temperature.
Fabrication of Highly Transmitting LaGdHf2O7 Ceramics
Authors: Yi Hailan , Zou Xiaoqing , Yang Yan , Zhou Guohong , Wang Shiwei
Published: October 2011

Transparent LaGdHf2O7 ceramic was successfully prepared by reactive sintering using vacuum sintering at 1900°C for 6 h. The resultant ceramic has an in‐line transmittance of 74% at 1100 nm and the density was measured to be 8.37 g/cm3. The average grain size was about 10 μm with uniform structure.
The effects of oestrogens on linear bone growth
Authors: Juul Anders
Published: October 2011

Regulation of linear bone growth in children and adolescents comprises a complex interaction of hormones and growth factors. Growth hormone (GH) is considered to be the key hormone regulator of linear growth in childhood. The pubertal increase in growth velocity associated with GH has traditionally been attributed to testicular androgen secretion in boys, and to oestrogens or adrenal androgen secretion in girls. Research data indicating that oestrogen may be the principal hormone stimulating the pubertal growth spurt in boys as well as girls is reviewed. Such an action is mediated by oestrogen receptors (ER‐α and ER‐β) in the human growth plate, and polymorphisms in the ER gene may influence adult height in healthy subjects. Prepubertal oestradiol concentrations are significantly higher in girls than in boys, explaining sex‐related differences in pubertal onset. Men with a disruptive mutation in the ER gene (oestrogen resistance) or in the CYP19 gene (aromatase deficiency) who have no pubertal growth spurt and continue to grow into adulthood due to lack of epiphyseal fusion supports this notion. Furthermore, phenotypic females with complete androgen insensitivity syndrome have a normal female growth spurt despite lack of androgen action. Oestrogens may also influence linear bone growth indirectly via modulation of the GH‐insuIin‐like growth factor‐I (IGF‐I) axis. Thus, ER blockade diminishes endogenous GH secretion, androgen receptor (AR) blockade increases GH secretion in peripubertal boys, and non‐aromatizable androgens [oxandrolone or dihydrotestosterone (DHT)] have no effect on GH secretion. Treatment with aromatase inhibitors reduces circulating IGF‐I concentrations in healthy males, and reduces growth in boys with testotoxicosis. Taken together, these findings suggest that oestrogens may, in addition to their direct effects, stimulate GH secretion and thereby increase circulating IGF‐I, which in turn may stimulate growth. Thus, oestrogens have important biphasic actions on longitudinal growth in boys as well as in girls. Very low levels of oestrogens may stimulate bone growth without affecting sexual maturation directly at the growth plate as well as through stimulation of the GH‐IGF axis, which in turn may stimulate growth. Conversely, higher levels of oestrogens stimulate secondary sexual characteristics and epiphyseal fusion.
Human exposure to endocrine disrupters: Standardisation of a marker of estrogenic exposure in adipose tissue
Authors: RIVAS ANA , FERNANDEZ MARIANA F. , CERRILLO ISABEL , IBARLUZEA JESÚS , OLEA‐SERRANO M. FÁTIMA , PEDRAZA VICENTE , OLEA NICOLÁS
Published: October 2011

In many epidemiological studies based on the direct measurement of exposure to organochlorines, the chemicals of concern are determined directly from adipose tissue samples. Although the measurement of all possible organochlorines, their metabolites, isomers and congeners may be desirable, it is expensive and time‐consuming and many chemicals with hormonal activity may not yet have been identified. Testing systems are therefore required to screen for estrogenicity and to identify appropriate biomarkers of human exposure. To address this issue, we developed and standardised a method to assess the total estrogenic xenobiotic burden in human adipose tissue. The method extracts and separates the more lipophilic xenoestrogens from ovarian estrogens, with a subsequent bioassay determination of the cumulative effect of the xenoestrogens. It was applied to 400 women, using 200 mg of adipose tissue: 65% of samples showed measurable estrogenicity in the fraction where most non‐polar xenoestrogens eluted, and 76% of fractions where ovarian estrogens eluted were positive for estrogenicity. Residues of 16 organochlorine pesticides were determined. No correlation was found between pesticide content and estrogenicity of the samples. The high percentage of positive samples suggests that the method is sensitive enough to be used as a biomarker of human exposure to estrogenic xenobiotics and can be applied in epidemiological studies.
Intrauterine exposure to diethylstilbestrol: Long‐term effects in humans
Authors: SWAN S. H.
Published: October 2011

DES is the most carefully scrutinized EDC and its history provides valuable insights into the current evaluation of less well‐studied EDCs. This review summarizes the health effects of prenatal exposure to diethylstilbestrol (DES) and emphasizes the role of DES as the first endocrine disrupting chemical (EDC). Vaginal clear cell adenocarcinoma (CCAC), the most severe consequence of prenatal exposure to DES, affected only 0.1% of exposed females, while the far more prevalent teratogenic and reproductive effects of DES were only discovered when DES daughter were screened for CCAC. Initial studies, conducted before most DES daughters had tried to conceive, examined vaginal cancer and vaginal, cervical and uterine abnormalities. Subsequently, several controlled studies demonstrated the increased risk of adverse reproductive outcomes in DES daughters. While most DES daughters can eventually experience a live birth, this is less likely in women with genital tract abnormalities, in whom there is a two‐thirds chance that each pregnancy will be unsuccessful. In DES sons, who have been far less studied, results suggest male reproductive toxicity, but are less consistent. The importance of dose and gestational age at initial exposure are discussed, and the implications of DES findings for the evaluation of risks from current EDCs emphasized.
Adverse effects of exposure to agropesticides on male reproduction
Authors: BUSTOS‐OBREGÓN EDUARDO
Published: October 2011

Adverse effects of chemical pollutants on spermatogenesis have become a relevant issue in modern andrology, since environmental chemical contamination increases everyday world‐wide. Agropesticides are one important group of such chemicals. Their relevance is due to their widespread use, mostly in the Third World, and to the various ways they interfere with male reproduction. Most organochlorine pesticides behave as xenoestrogens and though they have been banned in most countries many years ago, they have long lasting effect in the biosphere and are still illegally used. They have been largely replaced by organophosphorous pesticides (OP) which since then have been demonstrated as hazardous to human reproduction. This article provides a brief review on agropesticides, their use in Latin America, and occupational and environmental risks. Some of the clinical and biological effects of an OP pesticide parathion are presented. Animal experiments showed that OP chemicals damage germ and somatic cells of the testis, both at the onset of spermatogenesis and in the adults. Effects are not only genotoxic, but also teratogenic. The present knowledge advices prompt replacement of chemical pest control by environmentally safer methods.
Altered prostate growth and daily sperm production in male mice exposed prenatally to subclinical doses of 17α‐ethinyl oestradiol
Authors: Thayer K.A. , Ruhlen R.L. , Howdeshell K.L. , Buchanan D.L. , Cooke P.S. , Preziosi D. , Welshons W.V. , Haseman J. , vom Saal F.S.
Published: October 2011

Approximately 2 million women in the USA and Europe continue taking oral contraceptives each year during undetected pregnancy due primarily to non‐compliance and also to individual variation in sensitivity to hormones in the contraceptives. Prenatal exposure to oral contraceptives containing 17α‐ethinyl oestradiol (EE) has generally not been associated with an increased incidence of externally observable malformations at birth. The purpose of this study was to assess effects on reproductive organs in adult male mice that had been exposed during gestation day 0 through 17 (equivalent to gestation week 16 in humans) to clinically relevant (˜0.5 üg/kg/day) and lower doses of EE. Doses used in this study ranged from 0.002 to 2 (μg/kg/day. By 5 months of age, prostate weight was significantly (P < 0.05) higher than controls in most treatment groups of EE (0.02‐2 μg/kg). Prostatic androgen receptor populations were significantly elevated only in the 0.02 μg/kg group, suggesting different mechanisms for the increase in prostate weight at different doses. Daily sperm production (DSP) and DSP per gramme of testis were reduced in all treatment groups during adolescence, but not later in adulthood. These findings are consistent with prior studies showing that prenatal exposure of mice to very low doses of a number of oestrogenic chemicals can alter the adult male reproductive system without causing gross external malformations.
Reassessment of models used to test xenobiotics for oestrogenic potency is overdue
Authors: Spearow L. Jimmy , Barkley Marylynn
Published: October 2011

Product safety bioassays need to include data from animals with susceptible genotypes or the potential for environmental compounds to disrupt reproductive development in hormonally sensitive populations may be greatly underestimated. The continued use of resistant animal models is likely to result in allowable releases of toxic levels of oestrogenic agents that could differentially disrupt reproductive development and function of sensitive genotypes, leading to reproductive failure and loss or extinction of susceptible individuals, populations and species. Rather than ignoring the role of genetic differences in susceptibility to oestrogenic agent‐induced carcinogenicity and endocrine disruption, government agencies should support efforts to identify the genetic mechanisms involved in these responses, and to screen for and develop strains of mice and rats which are sensitive to the induction of genotoxicity/carcinogenicity as well as the inhibition of reproductive development and function by oestrogenic agents. Such sensitive strains would be even more optimal for testing chemicals for endocrine disruptor activity.
Trends in incidence of testicular cancer and prostate cancer in Denmark
Authors: Møller Henrik
Published: October 2011

This article presents a detailed analysis of the incidence trends of testicular cancer and prostate cancer, using information from the Danish Cancer Registry in the period 1943–1996. The rate of increase of testicular cancer was about 2.6% per year. The analyses indicated that incidence was more strongly dependent on the man's birth cohort than on the calendar period. The analysis confirmed the significantly reduced incidence of testicular cancer in the 1943 cohort and suggested a levelling off in the increase in testicular cancer incidence from cohorts born after around 1963. This may imply that the great part of the recent increase in incidence has been due to a rapid increase in incidence in successive birth cohorts born in the relatively short period from 1945 to 1960. The rate of increase of prostate cancer was about 1.6% per year. The analyses indicated a stronger dependency on period than on birth cohort. The cohort parameters had very low values in the three earliest cohorts (1858–1868) and the period parameters showed a low incidence in the most recent period. The epidemiological pattern of prostate cancer incidence seems dominated by changes in diagnosis and registration and does not permit inferences about changes in causal factors.
A new method to measure phthalate exposure in humans
Authors: BROCK JOHN W. , SILVA MANORI J. , MALEK NICOLE A. , HODGE CAROLYN C. , BLOUNT BEN C.
Published: October 2011

We developed a new method for phthalate exposure assessment that uses glucuronidase digestion of urine, solid‐phase extraction followed by liquid chromatography tandem mass spectrometry to analyze eight mono‐esters of phthalates (1, 2). The mono‐esters, one of the primary human metabolites of phthalate diesters, are monitored to avoid the ubiquitous background contamination of phthalate diesters. This method is sufficiently sensitive to measure urinary levels in non‐occupationally exposed humans. The technique can also be used to measure the degree of glucuronidation of the phthalate metabolites in urine.

1. Blount BC, Milgram KE, Silva M, Malek N, Reidy JA, Needham LL and Brock JW. Quantitative detection of eight phthalate metabolites in human urine using HPLC‐APCI‐MS/MS. Analyt Chem 2000;72:4127‐34.

2. Blount BC, Silva MJ, Caudill SP, Needham LL, Pirkle JL, Sampson EJ, Lucier GW, Jackson RJ and Brock JW Urinary phthalate metabolites in a reference human population. Environ Health Perspect 2000;108:979‐82.
Residues from anabolic preparations after _good veterinary practice*
Authors: HENRICKS D. M. , GRAY S. L. , OWENBY J. J. , LACKEY B. R.
Published: October 2011

The purpose of this study was to determine the endogenous concentrations of estrogens, particularly estradiol‐17β (E2β), in edible tissues of beef cattle (females and intact and neutered males) and the concentrations of E2β, and trenbolone beta and alpha (βTb, αTb) after an E2β and/or trenbolone acetate (TA) ear implant. Radioimmunoassays were validated for quantitation of E2β (active isomer), E2α, estrone (E1), βTb and αTb for bovine muscle, liver, kidney and fat tissues. The criteria of accuracy, precision, specificity and sensitivity were applied according to the standards of the U.S. Food & Drug Administration. In steer tissues, endogenous E2β was <15 ppt, as was heifer muscle; but heifer liver and kidney were 3‐fold greater. An E2β implant in steers had no effect on muscle E2β concentration, but increased E2β in liver and fat 4‐ and 3‐fold, respectively, but by 24 h post‐implant removal, E2β had fallen by half. Tissue E1 concentrations in cyclic females were similar to E2β, but rose many fold greater than did E2β during gestation; E2β rose 3‐fold during gestation. After E2β/TA implant, steer tissues had E2β concentrations equal to (for muscle and fat) and one‐half (for liver) the E2β measured in E2β implant only steers; βTb was in a low range (250–380 ppt) in muscle, liver and fat and αTb was even lower, except in liver (800–1500 ppt). An implant of TA only (no E2β) resulted in βTb and αTb concentrations 2–3‐fold greater in liver, kidney and fat, but no greater in muscle than βTb in tissues of E2β/TA implant steers. In conclusion, anabolic implants in steers resulted in tissue E2β concentrations less than the FDA allowable increment and βTb in the lowest quartile (0.25) of a part per billion 30 days after implant.