bluuebunny/crossref_metadata_2025 huggingface dataset:
Melon RNA interference (RNAi) lines silenced for Cm‐eIF4E show broad virus resistance
Authors: RODRÍGUEZ‐HERNÁNDEZ ANA M. , GOSALVEZ BLANCA , SEMPERE RAQUEL N. , BURGOS LORENZO , ARANDA MIGUEL A. , TRUNIGER VERÓNICA
Published: February 2012

Efficient and sustainable control of plant viruses may be achieved using genetically resistant crop varieties, although resistance genes are not always available for each pathogen; in this regard, the identification of new genes that are able to confer broad‐spectrum and durable resistance is highly desirable. Recently, the cloning and characterization of recessive resistance genes from different plant species has pointed towards eukaryotic translation initiation factors (eIF) of the 4E family as factors required for the multiplication of many different viruses. Thus, we hypothesized that eIF4E may control the susceptibility of melon (Cucumis melo L.) to a broad range of viruses. To test this hypothesis, Cm‐eIF4E knockdown melon plants were generated by the transformation of explants with a construct that was designed to induce the silencing of this gene, and the plants from T2 generations were genetically and phenotypically characterized. In transformed plants, Cm‐eIF4E was specifically silenced, as identified by the decreased accumulation of Cm‐eIF4E mRNA and the appearance of small interfering RNAs derived from the transgene, whereas the Cm‐eIF(iso)4E mRNA levels remained unaffected. We challenged these transgenic melon plants with eight agronomically important melon‐infecting viruses, and identified that they were resistant to Cucumber vein yellowing virus (CVYV), Melon necrotic spot virus (MNSV), Moroccan watermelon mosaic virus (MWMV) and Zucchini yellow mosaic virus (ZYMV), indicating that Cm‐eIF4E controls melon susceptibility to these four viruses. Therefore, Cm‐eIF4E is an efficient target for the identification of new resistance alleles able to confer broad‐spectrum virus resistance in melon.
Topological plasticity increases robustness of mutualistic networks
Authors: Ramos‐Jiliberto Rodrigo , Valdovinos Fernanda S. , Moisset de Espanés Pablo , Flores José D.
Published: February 2012

1. Earlier studies used static models to evaluate the responses of mutualistic networks to external perturbations. Two classes of dynamics can be distinguished in ecological networks; population dynamics, represented mainly by changes in species abundances, and topological dynamics, represented by changes in the architecture of the web.

2. In this study, we model the temporal evolution of three empirical plant–pollination networks incorporating both population and topological dynamics. We test the hypothesis that topological plasticity, realized through the ability of animals to rewire their connections after depletion of host abundances, enhances tolerance of mutualistic networks to species loss. We also compared the performance of various rewiring rules in affecting robustness.

3. The results show that topological plasticity markedly increased the robustness of mutualistic networks. Our analyses also revealed that network robustness reached maximum levels when animals with less host plant availability were more likely to rewire. Also, preferential attachment to richer host plants, that is, to plants exhibiting higher abundance and few exploiters, enhances robustness more than other rewiring alternatives.

4. Our results highlight the potential role of topological plasticity in the robustness of mutualistic networks to species extinctions and suggest some plausible mechanisms by which the decisions of foragers may shape the collective dynamics of plant–pollinator systems.
Did geckos ride the Palawan raft to the Philippines?
Authors: Siler Cameron D. , Oaks Jamie R. , Welton Luke J. , Linkem Charles W. , Swab John C. , Diesmos Arvin C. , Brown Rafe M.
Published: February 2012

Aim  We examine the genetic diversity within the lizard genus Gekko in the Philippine islands to understand the role of geography and geological history in shaping species diversity in this group. We test multiple biogeographical hypotheses of species relationships, including the recently proposed Palawan Ark Hypothesis.

Location  Southeast Asia and the Philippines.

Methods  Samples of all island endemic and widespread Philippine Gekko species were collected and sequenced for one mitochondrial gene (NADH dehydrogenase subunit 2) and one nuclear gene (phosducin). We used maximum likelihood and Bayesian phylogenetic methods to derive the phylogeny. Divergence time analyses were used to estimate the time tree of Philippine Gekko in order to test biogeographical predictions of species relationships. The phylogenetic trees from the posterior distribution of the Bayesian analyses were used for testing biogeographical hypotheses. Haplotype networks were created for the widespread species Gekko mindorensis to explore genetic variation within recently divergent clades.

Results  Both maximum likelihood and Bayesian phylogenetic analyses indicated that Philippine Gekko species are a diverse clade with a long history in the archipelago. Ancestral range reconstruction and divergence time analyses suggest a Palawan microcontinental origin for this clade, coinciding with Palawan’s separation from Asia beginning 30 Ma, with subsequent diversification in the oceanic Philippine islands. The widespread species G. mindorensis and G. monarchus diversified in the late Miocene/early Pliocene and are potentially complexes of numerous undescribed species.

Main conclusions  The view of the Philippine islands as a ‘fringing archipelago’ does not explain the pattern of species diversity in the genus Gekko. Philippine Gekko species have diversified within the archipelago over millions of years of isolation, forming a large diverse group of endemic species. Furthermore, the Philippine radiation of gekkonid lizards demonstrates biogeographical patterns most consistent with stochastic colonization followed by in situ diversification. Our results reveal the need to consider deeper time geological processes and their potential role in the evolution of some Philippine terrestrial organisms.
In vivo dynamic imaging of intestinal motions using diet‐related autofluorescence
Authors: Kwon S. , Davies‐Venn C. , Sevick‐Muraca E. M.
Published: February 2012

Background  Tissue background autofluorescence induced by standard murine diets containing chlorophyll is a significant problem for fluorescence whole‐body imaging. However, as red chlorophyll autofluorescence delineates the gastrointestinal (GI) tract in the abdomen of the mouse, it should be possible to dynamically and non‐invasively image intestinal motions. Herein, we non‐invasively imaged for the first time intestinal motions, such as peristaltic and segmental motions, without an exogenous imaging agent, using red chlorophyll fluorescence.

Methods  Mice were illuminated with 660‐nm light from a laser diode and autofluorescence at 710 nm was acquired dynamically for 5 min with 200‐ms exposure time. Fluorescent imaging data were analyzed to generate a three‐dimensional spatiotemporal map to quantitate intestinal motions.

Key Results  Peristaltic and segmental motions were observed in vivo in mice. Our quantification showed that the frequency and propagation velocity of peristaltic contractile waves in the small intestine were measured to be 28.6 cycles per min and 1.82 ± 0.56 cm s−1, respectively.

Conclusions & Inferences  This simple, but unexplored imaging technique can provide a means to monitor intestinal motility disorders and response to therapeutic agents.
Abnormal sebaceous gland differentiation in 10 kittens (‘sebaceous gland dysplasia’) associated with generalized hypotrichosis and scaling
Authors: Yager Julie A. , Gross Thelma Lee , Shearer David , Rothstein Emily , Power Helen , Sinke Jacqueline D. , Kraus Hans , Gram Dunbar , Cowper Ellie , Foster Aiden , Welle Monika
Published: February 2012

A rare congenital dermatosis, characterized by progressive hypotrichosis with variable scaling and crusting, occurred in 10 short‐haired kittens in North America and Europe. Lesions appeared at between 4 and 12 weeks of age, commencing on the head and becoming generalized. The tail was spared in two kittens. Generalized scaling was mild to moderate, often with prominent follicular casts. Periocular, perioral, pinnal and ear canal crusting was occasionally severe. The skin was thick and wrinkled in two kittens.

Histologically, the main lesion was abnormal sebaceous gland morphology. Instead of regular differentiation from basal cells to mature sebocytes, the glands were composed of a haphazard collection of undifferentiated basaloid cells, some partly vacuolated and a few containing eosinophilic globules. Mitotic figures and apoptotic cells were present in an irregularly thickened follicular isthmus. Lymphocytic mural folliculitis and mild sebaceous adenitis were rare. Orthokeratotic hyperkeratosis and follicular casts were present. Hair follicles were of normal density and were mostly in anagen, but some contained malacic hair shafts. Perforating folliculitis, leading to dermal trichogranuloma formation, occurred occasionally. Further biopsy samples taken at 2 years and at 3 and 4 years, respectively, from two kittens revealed similar but often more severe sebaceous gland lesions. Hair follicles were smaller, with many in telogen.

The young age of onset suggests a genetic defect interfering with sebaceous and, possibly, follicular development. These lesions are discussed with reference to studies of mouse mutants in which genetic defects in sebaceous differentiation cause a similar phenotype of hyperkeratosis and progressive alopecia.
Sound or Silence: Call Recognition in the Temporal Domain by the Frog Allobates femoralis
Authors: Vélez Alejandro , Hödl Walter , Amézquita Adolfo
Published: February 2012

Acoustic communication often mediates agonistic interactions in territorial species. Because both the reaction to potential intruders and the lack thereof are costly, mechanisms that allow recognition of conspecific signals should be evident in intrasexual communication systems. While the spectral domain of the recognition space of the frog Allobates femoralis appears asymmetrically shaped in a way that reduces masking interference by the often syntopic frog Ameerega trivittata, frequency alone does not appear to account for the correct identification of conspecific intruders (Amézquita et al., Animal Behaviour, 70, 2005: 1377). As signal recognition may rely on a combination of spectral and temporal parameters of the signal, we test here the subsequent prediction that the recognition space should be asymmetrical in the temporal domain as well. We conducted playback experiments with 80 synthetic calls on 30 males and modeled all‐or‐none responses to define unidimensional functions of the recognition space for two call parameters: note duration and internote interval. For both parameters, male maximal response matched very well the average values of the conspecific signal and decreased with concomitant deviations from these values. While the response curves exceeded the range of signal variation and were not asymmetrical for either call parameter, they differed in breadth. The highest male permissiveness to variation in internote interval, as evidenced by a broader response curve, coincided with the lower probability of between‐species overlap in this signal parameter. Together with previous studies, our data suggest that a combination of spectral and temporal parameters of the advertisement call is necessary for recognition of calling intruders in A. femoralis. Our results emphasize the importance of multidimensional approaches in understanding signal recognition mechanisms in acoustically complex environments.
Risk factors for the prognosis of acute kidney injury under the Acute Kidney Injury Network definition: A retrospective, multicenter study in critically ill patients
Authors: ZHOU JIAOJIAO , YANG LICHUAN , ZHANG KANGYI , LIU YUN , FU PING
Published: February 2012

Aim:  Despite significant advances in medical management and therapeutics, acute kidney injury (AKI) is still a common and serious complication with high morbidity and mortality in hospitalized patients, especially in patients admitted to the intensive care unit (ICU). The primary purpose of this study is to apply the definition proposed by the Acute Kidney Injury Network (AKIN) to investigate the incidence, 28‐day mortality and risk factors for the prognosis of AKI in ICU.

Methods:  In this retrospective study, data from a cohort of 4642 patients admitted to five ICUs were analyzed. Univariate and multivariate analyses were performed to investigate the risk factors for prognosis of AKI.

Results:  A total of 1036 patients were enrolled. AKI occurred in 353 of them (34.1%) under the AKIN criteria and the mortality was 54.4%. Multivariable analysis showed that variables related to the prognosis of AKI were: four or more (≥4) organ failed systems (odds ratio (OR) = 25.612), AKI III (OR = 14.441), AKI II (OR = 4.491), mechanical ventilation (OR = 7.201), sepsis (OR = 4.552), severe acute pancreatitis (OR = 3.299), base serum creatinine (OR = 1.004) and the length of stay in ICU (OR = 1.050).

Conclusions:  For critically ill patient, the ICU mortality of AKI was correlated with various independent risk factors, especially AKI II, AKI III, severe acute pancreatitis and multiple organ failed systems.
Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: A literature review
Authors: CAFARELLA PAUL A. , EFFING TANJA W. , USMANI ZAFAR‐AHMAD , FRITH PETER A.
Published: February 2012

Chronic obstructive pulmonary disease (COPD) is a serious contemporary health issue. Psychological co‐morbidities such as anxiety and depression are common in COPD. Current evidence for treatment options to reduce anxiety and depression in patients with COPD was examined. There is evidence available for the efficacy of pharmacological treatments, cognitive behavioural therapy, pulmonary rehabilitation, relaxation therapy and palliative care in COPD. Therapeutic modalities that have not been proven effective in decreasing anxiety and depression in COPD, but which have theoretical potential among patients, include interpersonal psychotherapy, self‐management programmes, more extensive disease management programmes, supportive therapy and self‐help groups. Besides pulmonary rehabilitation that is only available for a small percentage of patients, management guidelines make scant reference to other options for the treatment of mental health problems. The quantity and quality of research on mental health treatments in COPD have historically been insufficient to support their inclusion in COPD treatment guidelines. In this review, recommendations regarding assessment, treatment and future research in this important field were made.
Lack of dystrophin in mdx mice modulates the expression of genes involved in neuron survival and differentiation
Authors: Licursi Valerio , Caiello Ivan , Lombardi Loredana , De Stefano Maria Egle , Negri Rodolfo , Paggi Paola
Published: February 2012

Duchenne muscular dystrophy is an X‐linked disease characterized by progressive and lethal muscular wasting. Dystrophic patients, however, are also afflicted by several neurological disorders, the importance of which is generally underestimated. As promising therapies for muscles are currently in clinical trial stages, with the potential to provide an increase in the lifespan of young patients, determination of the genetic and molecular aspects characterizing this complex disease is crucial in order to allow the development of therapeutic approaches specifically designed for the nervous system. In this study, differences in gene expression in the superior cervical ganglion of postnatal day (P)5, P10 and 6–7‐week‐old wild‐type and genetically dystrophic mdx mice were evaluated by DNA microarray analysis. The main aim was to verify whether the lack of dystrophin affected the transcript levels of genes related to different aspects of neuron development and differentiation. Ontological analysis of more than 500 modulated genes showed significant differences in genetic class enrichment at each postnatal date. Upregulated genes mainly fell in the categories of vesicular trafficking, and cytoskeletal and synaptic organization, whereas downregulated genes were associated with axon development, growth factors, intracellular signal transduction, metabolic processes, gene expression regulation, synapse morphogenesis, and nicotinic receptor clustering. These data strongly suggest that the structural and functional alterations previously described in both the autonomic and central nervous systems of mdx mice with respect to wild‐type mice and related to crucial aspects of neuron life (i.e. postnatal development, differentiation, and plasticity) result not only from protein post‐translational modifications, but also from direct and/or indirect modulation of gene expression.
Glucocorticoid‐induced tumour necrosis factor receptor expression: a potential molecular link between steroid intake and complicated diverticulitis?
Authors: von Rahden B. H. A. , Kircher S. , Landmann D. , Schlegel N. , Lazariotou M. , Jurowich C. F. , Germer C.‐T. , Grimm M.
Published: February 2012

Aim  Immunosuppression and steroid medication have been identified as risk factors for complicated sigmoid diverticulitis. The underlying molecular mechanisms have not yet been elucidated. We hypothesized that glucocorticoid‐induced tumour necrosis factor receptor (GITR) and matrix metalloproteinase‐9 (MMP‐9) might play a role.

Method  GITR and MMP‐9 were analysed at protein [immunohistochemistry/immunofluorescence (IF)] and messenger RNA level (real‐time polymerase chain reaction) in surgical specimens with complicated and non‐complicated diverticulitis (n = 101). IF double staining and regression analysis were performed for both markers. GITR expression was correlated with clinical data and its usefulness as a diagnostic test was investigated.

Results  High GITR expression (≥ 41%) was observed in the inflammatory infiltrate in complicated diverticulitis, in contrast to non‐complicated diverticulitis where GITR expression was low (P < 0.001). High GITR expression was significantly associated with steroid use and pulmonary diseases (both P < 0.001). MMP‐9 expression correlated with GITR expression (R2 = 0.7268, P < 0.0001, r = 0.85) as demonstrated with IF double‐staining experiments. Co‐labelling of GITR with CD68, but not CD15, suggested that GITR‐expressing cells in diverticulitis are macrophages. GITR expression was superior to C‐reactive protein (CRP), white cell count and temperature in distinguishing complicated and non‐complicated diverticulitis.

Conclusions  Our results suggest that GITR expression in inflammatory cells might potentially indicate a molecular link between steroid use and complicated forms of acute sigmoid diverticulitis. Increased MMP‐9 expression by GITR signalling might explain the morphological changes in the colonic wall of perforated and phlegmonous diverticulitis. Analysis of soluble GITR might be a promising strategy for future research.
Management of severe blunt renal trauma in adult patients: a 10‐year retrospective review from an emergency hospital
Authors: Aragona Francesco , Pepe Pietro , Patanè Domenico , Malfa Pierantonio , D'Arrigo Letterio , Pennisi Michele
Published: February 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Immediate surgery for major renal trauma has led to a high rate of nephrectomy in comparison with an expectant management.

We reviewed our case material on the management of severe blunt renal trauma in adults with emphasis on conservative management. Only shattered kidneys and pedicle avulsion required immediate surgery.

OBJECTIVE

To review retrospectively the management of major blunt renal truma in adult patients admitted to our level I trauma centre.

PATIENTS AND METHODS

Among 1460 blunt abdominal trauma cases collected from January 2001 to December 2010, 221 (15%) affected the kidneys.

All patients, except seven who needed immediate laparotomy, underwent a computed tomography scan to stage the injuries.

Renal injuries were graded according to the American Association for the Surgery of Trauma Grading System; grade 4 and 5 injuries were subclassified based on vascular or parenchymal injury.

RESULTS

Only 45/221 patients (20%) suffered major blunt renal trauma (21 grade 3, 18 grade 4 and six grade 5); 43% of the patients had associated lesions and 77% had gross haematuria.

Nephrectomy rates were 9% for grade 3, 22% for grade 4 and 83% for grade 5 with an exploration rate of 26% for major renal trauma.

CONCLUSIONS

Conservative management of grade 3–5 blunt renal trauma in haemodynamically stable patients yields more favourable results with high renal salvage rate.

Grade 5 injuries still result in a nephrectomy rate of more than 80%.

The absence of data on long‐term outcomes and a potential inclusion bias due to the retrospective nature of the data represent major limitations of this review.
Rapid detection of urinary tract pathogens using microcalorimetry: principle, technique and first results
Authors: Bonkat Gernot , Braissant Olivier , Widmer Andreas F. , Frei Reno , Rieken Malte , Wyler Stephen , Gasser Thomas C. , Wirz Dieter , Daniels Alma U. , Bachmann Alexander
Published: February 2012

Study Type – Diagnostic (exploratory cohort)

Level of Evidence 2b

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

Microcalorimetry has been applied in several microbiological studies, but never in a clinical urological context. In addition, basic knowledge on the growth of urinary pathogens in urine is still scarce and data regarding the growth rate of many urinary pathogens in urine are still not available.

The study demonstrates that this innovative application of microcalorimetry is useful in (i) investigating the growth of urinary pathogens in sterilized urine and (ii) as a rapid tool for diagnosis of urinary infection as well as for further identification of the causative infectious agent.

OBJECTIVE

To investigate the value of isothermal microcalorimetry (IMC) in the detection and differentiation of common urinary tract pathogens in urine. IMC is a non‐specific analytical tool for the measurement of heat in the microwatt range.

PATIENTS AND METHODS

A microcalorimeter equipped with 48 channels was used. Detection was accomplished, and growth was monitored for four bacterial strains in sterilized urine at 37 °C by measuring metabolic heat flow (µW =µJ/s) as a function of time.

The strains were Escherichia coli, Proteus mirabilis, Enterococcus faecalis and Staphylococcus aureus.

RESULTS

Bacterial growth was detected after 3.1 to 17.1 h with decreasing inocula.

The detection limit was 1 colony‐forming unit (CFU)/mL for E. coli, 10 CFU/mL for P. mirabilis and E. faecalis and 103 CFU/mL for S. aureus.

The total heat was highest in P. mirabilis ranging from 10 to 12 J, followed by E. coli (3–4 J), S. aureus (2–3 J) and E. faecalis (1.3–1.5 J).

The shape of the heat flow curves was characteristic for each species independent of its initial concentration.

CONCLUSIONS

IMC allows rapid detection of bacteriuria, much faster than conventional culture. Urinary tract pathogen detection after only 3.1 h is realistic.

Clearly different heat flow patterns enable accurate pathogen differentiation.

Due to expeditious identification of urine samples that contain only low colony counts (i.e. less than 103 CFU/mL), IMC may become a valuable screening tool for detecting the presence of significant bacteriuria.
The value of extended transurethral resection of bladder tumour (TURBT) in the treatment of bladder cancer
Authors: Richterstetter Mario , Wullich Bernd , Amann Kerstin , Haeberle Lothar , Engehausen Dirk Gerhard , Goebell Peter Juergen , Krause Frens Steffen
Published: February 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Transurethral resection of bladder tumour (TURBT) is the ‘gold standard’ in the diagnosis and therapy of non‐muscle‐invasive bladder cancer. To improve the quality of this technique an additional TUR (after 4–6 weeks) or a simultaneous photodynamic diagnosis is often offered.

The present study shows different variables that influence, to a greater or lesser extent, the accuracy of the TUR diagnosis and the success of the operation. This is very important for the further management of bladder cancer, be it in tumour follow‐up or in preparation for more invasive therapies.

OBJECTIVE

To analyse the impact of a standardised extended transurethral resection of bladder tumour (TURBT) protocol on the determination of the residual tumour status at initial TURBT session and recurrence rate in the primary resection area. Despite, the fact that there is a clear consensus on the aims of TURBT, there is little agreement on how to perform TURBT to achieve that goal.

PATIENTS AND METHODS

We retrospectively evaluated 221 consecutive patients, who underwent 305 TURBT sessions for bladder cancer, including patients with recurrent tumours.

All the TURBTs were extended by taking additional deep and marginal specimens, according to a standardised protocol.

Clinical and histopathological data were retrieved from the patients' records.

RESULTS

Across all tumour stages, residual tumour (pR1) was found in 38% of the additionally taken specimens.

There was a significant association of pR1 status with tumour stage, grade, and size.

Also in the group of non‐muscle‐invading tumours, the rate of R1 resection was rather high at 22%.

There was no association with focality and the training status of the surgeon.

At follow‐up, of all the patients with a unifocal primary tumour there was recurrence in the same area as the primary in 5.1%.

CONCLUSIONS

Extended TURBT provides detailed information about the horizontal and vertical extent of the bladder tumour.

The implementation of standardised TURBT procedures, such as our protocol of an extended TURBT, is greatly needed to improve local tumour control.

Whether a diagnostic re‐TUR may be restricted to those cases with positive margins or ground specimens remains to be studied.
Complications following prostate needle biopsy requiring hospital admission or emergency department visits – experience from 1000 consecutive cases
Authors: Pinkhasov G. Igor , Lin Yu‐Kuan , Palmerola Ricardo , Smith Paul , Mahon Frank , Kaag Matthew G. , Dagen J. Edward , Harpster Lewis E. , Reese Carl T. , Raman Jay D.
Published: February 2012

Study Type – Harms (cohort series)

Level of Evidence 2b

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

Population‐based studies implicate an increased incidence of complications after prostate needle biopsy. Such information is essential for adequate patient counselling before the procedure.

A limitation of population‐based studies is the absence of individual patient data to better characterize the nature of post‐biopsy complications. This study of 1000 consecutive patients treated at a single centre highlights hospital admissions as well as Emergency Department visits for patients after prostate needle biopsy. Importantly, it allows for characterization of specific complications, aetiologies, management and outcomes for affected patients.

OBJECTIVE

To review a contemporary cohort of patients undergoing a transrectal ultrasound‐guided prostate needle biopsy (TRUS PNBx) at a single centre to determine the incidence of major complications necessitating hospital admission or emergency department (ED) visits.

PATIENTS AND METHODS

The charts of 1000 consecutive patients undergoing TRUS PNBx were reviewed.

All patients received peri‐procedural antibiotic prophylaxis with either ciprofloxacin or co‐trimoxazole.

Hospital admission and ED visits within 30 days of the procedure were identified for indication, management and outcome.

Patient comorbidities and biopsy characteristics were reviewed for association with complications.

RESULTS

Of the 1000 patients, 25 (2.5%) had post‐biopsy complications requiring hospital admission or an ED visit.

Indications included twelve patients (1.2%) with urosepsis, eight (0.8%) with acute urinary retention requiring urethral catheterization, four (0.4%) with gross haematuria requiring bladder irrigation for <24 h, and one (0.1%) with a transient ischaemia attack 1 day after biopsy.

Patients with urosepsis had an average hospitalization of 5 days, and 75% carried quinolone‐resistant Escherichia coli organisms.

All patients with urinary retention had catheters removed within 10 days. No patients with haematuria required a blood transfusion.

No demographic or biopsy variables were particularly associated with development of a post‐procedure complication.

CONCLUSIONS

In this large contemporary series of TRUS PNBx, we observed a 2.5% rate of major complications requiring hospital admission or an ED visit.

No clinical or biopsy variables were directly associated with development of complications.

These data may be valuable when counselling patients before biopsy.
Prospective assessment of histological serial sectioning of pelvic lymph nodes in prostate cancer: a cost‐benefit analysis
Authors: Schilling David , Hennenlotter Jörg , Gakis Georgios , Schwentner Christian , Kuehs Ursula , Stenzl Arnulf , Sotlar Karl
Published: February 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Metastatic spread to the regional lymph nodes (LNs) is the single worst predictor of survival in prostate cancer. Knowledge of the LN status is crucial, as the treatment strategy is substantially altered in non‐organ‐confined disease. Current routine pathological protocols for evaluation of LN resection specimens do not demand a minimum of cross‐sections per LN to be examined. Depending on the LN size, usually one to two sections are examined. This might lead to underestimation of the true metastatic burden.

The present study shows that additional examination of cross‐sections in pelvic LNs and applying prostate cancer‐specific cytokeratine immunostaining does not lead to significantly increased detection of prostate cancer metastases. However, the work‐load and the expenses were significantly higher compared with routine evaluation.

OBJECTIVE

To evaluate the diagnostic gain in the detection of lymph node (LN) metastases of prostate cancer and the additional expenses of histological step‐section analysis, including immunohistochemistry compared with routine histopathological evaluation.

PATIENTS AND METHODS

In a prospective study, 19 patients with prostate cancer at high risk of LN metastases (>cT2c and/or PSA level of >20 ng/mL and/or Gleason score >8) underwent sentinel‐guided LN resection.

All palpable LNs were submitted to step‐section analysis in 200‐µm sections and concomitant immunohistochemical staining for cytokeratine (AE1/AE3), in addition to routine histopathology of one or two haematoxylin and eosin‐stained sections per LN.

The number of positive LNs and LN‐positive patients for each method was compared; additional expenses in labour time and material for the extended evaluation were estimated.

RESULTS

In all, 413 LNs were resected; 220 LNs were palpable and were included in the study.

In seven of the 19 patients routine histopathological evaluation revealed LN metastases in 24 of 220 LNs (10.9%).

Extended LN evaluation with step sectioning and cytokeratin immunohistochemistry did not reveal any additional patients with LN metastases.

In one patient already diagnosed with LN metastases on routine histology, four additional LN metastases were detected upon extended LN evaluation. Three LNs of two patients, one of them pN0, contained disseminated tumour cells.

Compared with conventional histological evaluation, serial‐section analysis and immunohistochemistry increased expenses in materials and labour time 18.7‐fold.

CONCLUSIONS

Serial‐section analysis seems to have only a minimal diagnostic gain; however, valid conclusions cannot be drawn, as not all LNs were submitted to extended evaluation.

Considering the additional expenses, extensive LN evaluation in prostate cancer cannot generally be recommended.
A case–control study of chronic prostatitis/chronic pelvic pain syndrome and colorectal cancer
Authors: Chung Shiu‐Dong , Keller Joseph J. , Lin Herng‐Ching
Published: February 2012

Study Type – Symptom prevalence (case control)

Level of Evidence 2b

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

Associations are well established between intestinal infection/inflammation or inflammatory bowel diseases and colorectal cancer (CRC).

Our study found an association between CRC and previously diagnosed chronic prostatitis/chronic pelvic pain syndrome. Patients with CRC had a 1.45‐fold higher risk of having a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome than controls. This phenomenon was found to be more prominent in subjects younger than 60 years.

OBJECTIVE

To estimate the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and colorectal cancer (CRC) using a nationwide population‐based data set.

PATIENTS AND METHODS

This case–control study used data sourced from the Taiwan Longitudinal Health Insurance Database.

The cases comprised 2899 patients with CRC and 14 995 randomly selected subjects as controls.

We used conditional logistic regression to examine the association between CRC and previous diagnosis of CP/CPPS.

RESULTS

Of the sampled patients, 531(3.05%) had been diagnosed with CP/CPPS before the index date, with 123 (4.24% of the patients with CRC) coming from the cases and 408 individuals (2.81% of patients without CRC) coming from the controls.

Conditional logistic regression analysis revealed that cases were more likely to have CP/CPPS than controls (odds ratio 1.45, 95% CI 1.17–1.79, P < 0.001) after adjusting for the monthly income, geographic location, urbanization level, hypertension, diabetes, renal disease, obesity and cystic kidney disease.

In subgroup analysis, we found the magnitude of the association to be higher in subjects younger than 60 years (age 40–49, odds ratio 2.01; 95% CI 2.04–3.58 and aged 50–59, 2.40, 95% CI 1.48–3.87, both P < 0.001) than among other age groups.

CONCLUSION

We conclude that CP/CPPS patients are at higher risk for CRC, especially in males under 60 years of age.
Type 2 diabetes mellitus in a patient with malignant insulinoma manifesting following surgery
Authors: Ademoğlu E. , Ünlütürk U. , Ağbaht K. , Karabork A. , Çorapçıoğlu D.
Published: February 2012

Diabet. Med. 29, e133–e137 (2012)

Background  Insulinomas, although they are rare, are the most common of pancreatic islet cell tumours. The incidence is estimated at only four per million person‐years and only 5–12% of reported cases are malignant. Distinction between malignant and benign tumours can only be made by the presence of metastasis, as there are no specific morphologic, biochemical or genetic features distinguishing them. Most patients with malignant insulinoma have lymph node or liver metastases and, rarely, bone involvement. The coincidence of insulinoma and diabetes mellitus is an extremely rare condition and reported only in a few cases.

Case report  We report a 45‐year‐old woman who was diagnosed with insulinoma on the basis of clinical and laboratory findings and endoscopic examination. Histopathological diagnosis revealed well‐differentiated endocrine carcinoma of the pancreas with lymph node metastase. The case was accepted as malignant insulinoma and the patient underwent surgery. Interestingly, hyperglycaemia occurred after the removal of the insulinoma, with the requirement for insulin in the post‐operative 3 weeks, which was changed to oral anti‐diabetic agents as a permanent treatment. The patient is still being treated with oral anti‐diabetic agents. We think that the patient might have had diabetes mellitus, because of insulin resistance that developed with a high‐caloric intake stimulated by hypoglycaemia, and which had been masked for many years, but manifested overtly after removal of the tumour.

Conclusions  Although this is a rare condition, clinicians should bear in mind that insulinomas may exist together with diabetes mellitus, and it is important to have this suspicion when considering the perioperative approach and for the prevention of morbidities.
The cost of diagnosing Type 2 diabetes mellitus by clinical opportunistic screening in general practice
Authors: Pereira Gray D. J. , Evans P. H. , Wright C. , Langley P.
Published: February 2012

Diabet. Med. 29, 863–868 (2012)

Aims  Type 2 diabetes is associated with serious complications and shortens life. Its prevalence is increasing rapidly worldwide and no cure is available. One logical response is to diagnose the condition as early as possible. Clinical opportunistic screening is one mechanism for making the diagnosis before symptoms are reported. This paper reports the cost of using this technique in UK general practice.

Methods  In one UK general practice, the electronic medical records were searched to determine the number of blood glucose and oral glucose tolerance tests undertaken for non‐pregnant adults without known diabetes over three consecutive years. The laboratory, staff and administrative costs associated with these screening tests were calculated. The records of all patients newly diagnosed with Type 2 diabetes during the same period were reviewed to identify diagnoses made by clinical opportunistic screening. Total costs were divided by the number of diagnoses to determine a cost per diagnosis detected by opportunistic screening.

Results  During the study period, 5720 screening tests were conducted for 2763 patients. Over the 3 years, 86 patients were diagnosed with Type 2 diabetes, 54 (63%) via screening (yield 2.0%; number needed to screen 51.2). The screening costs totalled £20 372. The average cost per new screen‐detected diagnosis was £377.

Conclusions  Almost two‐thirds of new cases of Type 2 diabetes can be detected before symptoms are reported, at reasonable cost by opportunistic screening in general practice, without the use of extra resources. As an affordable alternative to population screening, clinical opportunistic screening merits further consideration.
Bilingual Effects on Cognitive and Linguistic Development: Role of Language, Cultural Background, and Education
Authors: Barac Raluca , Bialystok Ellen
Published: February 2012

A total of 104 six‐year‐old children belonging to 4 groups (English monolinguals, Chinese‐English bilinguals, French‐English bilinguals, Spanish‐English bilinguals) were compared on 3 verbal tasks and 1 nonverbal executive control task to examine the generality of the bilingual effects on development. Bilingual groups differed in degree of similarity between languages, cultural background, and language of schooling. On the executive control task, all bilingual groups performed similarly and exceeded monolinguals; on the language tasks the best performance was achieved by bilingual children whose language of instruction was the same as the language of testing and whose languages had more overlap. Thus, executive control outcomes for bilingual children are general but performance on verbal tasks is specific to factors in the bilingual experience.
Political Violence and Child Adjustment: Longitudinal Tests of Sectarian Antisocial Behavior, Family Conflict, and Insecurity as Explanatory Pathways
Authors: Cummings Edward M. , Merrilees Christine E. , Schermerhorn Alice C. , Goeke‐Morey Marcie C. , Shirlow Peter , Cairns Ed
Published: February 2012

Understanding the impact of political violence on child maladjustment is a matter of international concern. Recent research has advanced a social ecological explanation for relations between political violence and child adjustment. However, conclusions are qualified by the lack of longitudinal tests. Toward examining pathways longitudinally, mothers and their adolescents (M = 12.33,SD = 1.78, at Time 1) from 2‐parent families in Catholic and Protestant working class neighborhoods in Belfast, Northern Ireland, completed measures assessing multiple levels of a social ecological model. Utilizing autoregressive controls, a 3‐wave longitudinal model test (T1,n = 299; T2,n = 248; T3,n = 197) supported a specific pathway linking sectarian community violence, family conflict, children’s insecurity about family relationships, and adjustment problems.
Longitudinal Associations Among Youth Depressive Symptoms, Peer Victimization, and Low Peer Acceptance: An Interpersonal Process Perspective
Authors: Kochel Karen P. , Ladd Gary W. , Rudolph Karen D.
Published: February 2012

A longitudinal investigation was conducted to explicate the network of associations between depressive symptoms and peer difficulties among 486 fourth through sixth graders (M = 9.93 years). Parent and teacher reports of depressive symptoms; peer, self, and teacher reports of victimization; and peer reports of peer acceptance were obtained. A systematic examination of nested structural equation models provided support for a symptoms‐driven model whereby depressive symptoms contributed to peer difficulties; no evidence was found for interpersonal risk or transactional models. Analyses further revealed that victimization mediated the association between prior depressive symptoms and subsequent peer acceptance. Results extend knowledge about the temporal ordering of depressive symptoms and peer difficulties and elucidate one process through which depressive symptoms disrupt peer relationships.
No Country for Honest Men: Political Philosophers and Real Politics
Authors: Jubb Robert , Kurtulmus A. Faik
Published: February 2012

There are limits on the duty to tell the truth. Sometimes, because of the undesirable consequences of honesty, we are morally required not to reveal certain truths and can even be required to lie. In this article, we explore the implications of this uncontroversial claim for the practice of political philosophers. We argue that, given the consequences of misunderstandings and misrepresentations that might occur, political philosophers will sometimes be under a moral duty not to disseminate their research and, in highly exceptional cases, have a moral duty to lie outright.
New Policy Spaces: The Impact of Devolution on Third Sector Policy in the UK
Authors: Alcock Pete
Published: February 2012

The development of third sector policy in the UK since 1997 has seen changes which have been of significance both for analysts and practitioners. This period has seen government engagement with and support for the sector extend far beyond the levels found throughout much of the last century. This has led to a growth in the size and scale of the sector and a closer involvement of sector representatives in political debate and policy planning. These changes have taken place at the same time as third sector policy has been devolved to the new administrations in Scotland, Wales and Northern Ireland. This article explores the impact of devolution on these policy developments and assesses the extent to which political devolution has led to policy divergence across the four countries in the UK. The conclusion is reached that policy devolution has created important new space for policy development for the third sector across the UK, but that the direction of travel in all four regimes has remained remarkably similar.
Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults
Authors: Nyqvist Fredrica , Nygård Mikael
Published: February 2012

Nyqvist F, Nygård M. Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults

The study examined the association between structural and cognitive social capital and self‐rated health among 65‐ and 75‐year‐olds in Västerbotten in Sweden and Österbotten and Pohjanmaa in Finland. Data were retrieved from a cross‐sectional postal questionnaire survey conducted in 2005 and was answered by 3,370 persons, yielding a total response rate of 69 per cent. The association between self‐rated health and interpersonal trust and membership in organisations was tested by logistic regression analysis. The results showed that older adults in Västerbotten in Sweden experienced better self‐rated health than in Finland. Furthermore, interpersonal trust and active membership in organisations were associated with self‐rated health among 65‐ and 75‐year olds even after having controlled for the influence of region. We therefore conclude that the association between social capital and self‐rated health tends to be robust across contextually similar regions, but that further analyses are warranted in order to clarify the nature of this relationship.

Key Practitioner Message: •Health status can be indirectly strengthened through investments in social capital, such as group participation and active networks; •When working with older adults, more focus needs to be put on how to develop trustful relationships; •The Nordic welfare state, with its universal and subsidised social and health care services, has an indirect and positive effect on health among older adults.
Heat‐induced coagulation of whole milk by high levels of calcium chloride
Authors: RAMASUBRAMANIAN LAKSHMI , D’ARCY BRUCE , DEETH HILTON C
Published: February 2012

This study investigated the interaction of calcium ions and milk proteins during heat‐induced coagulation of milk. Addition of 20–200 mM calcium chloride to milk caused coagulation on heating to 70 °C. Preheating milk at 90 °C for 10 min or ultra‐high temperature treatment at 140 °C for 6 s increased the sensitivity of milk proteins to coagulation. The former treatment was more effective than the latter in coagulating proteins. A maximum of 98% of the protein in milk preheated at 90 °C for 10 min was coagulated by 50 mM added calcium chloride at 70 °C with holding for 5 min.
Managing the first period at home with a newborn: a grounded theory study of mothers’ experiences
Authors: Hjälmhult Esther , Lomborg Kirsten
Published: February 2012

Aim:  The article aims to present a theoretical account of mothers’ first period at home with their newborn in Norway.

Background:  Mothers’ well‐being affects their babies and is therefore an important priority for public health. Early discharge after childbirth is common in many countries. In Norway, this has been practised for 5–10 years but without any distinct agreement between maternity hospitals and the community health services and without documented follow‐up care. Knowledge is lacking in how mothers deal with the first period at home with the baby.

Method:  Seven focus group discussions were conducted with 26 mothers who had babies 1.5–3 months old. The grounded theory method was used to gather and analyse data.

Results:  The mothers were strongly concerned about preserving their control and integrity in the new situation. This main concern was resolved by the strategy of prioritizing newborn care. The strategy encompassed a process of developing competence as a mother, changing focus in relationships, stretching to the critical level and seeking recognition. These parallel processes were inter‐related, sometimes mutually supportive and sometimes conflicting. When conflicts occurred, prioritizing newborn care guided mothers in finding solutions. Breaches of the implied conditions in health care tended to increase mothers’ level of strain and uncertainty and to influence their efficacy in breastfeeding the baby.

Conclusion:  Being a mother to a newborn is a dynamic and extensive process. Succeeding in breastfeeding seems especially sensitive and essential in motherhood. The idea that giving birth is a simple and normal situation may obscure the importance of seamless health care and the need for professional support and information.