bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure and Mechanism of an Arabidopsis Medium/Long-Chain-Length Prenyl Pyrophosphate Synthase
Authors: Hsieh Fu-Lien , Chang Tao-Hsin , Ko Tzu-Ping , Wang Andrew H.-J.
Published: January 2011

Prenyltransferases (PTSs) are involved in the biosynthesis of terpenes with diverse functions. Here, a novel PTS from Arabidopsis (Arabidopsis thaliana) is identified as a trans-type polyprenyl pyrophosphate synthase (AtPPPS), which forms a trans-double bond during each homoallylic substrate condensation, rather than a homomeric C10-geranyl pyrophosphate synthase as originally proposed. Biochemical and genetic complementation analyses indicate that AtPPPS synthesizes C25 to C45 medium/long-chain products. Its close relationship to other long-chain PTSs is also uncovered by phylogenetic analysis. A mutant of contiguous surface polar residues was produced by replacing four charged surface amino acids with alanines to facilitate the crystallization of the enzyme. The crystal structures of AtPPPS determined here in apo and ligand-bound forms further reveal an active-site cavity sufficient to accommodate the medium/long-chain products. The two monomers in each dimer adopt different conformations at the entrance of the active site depending on the binding of substrates. Taken together, these results suggest that AtPPPS is endowed with a unique functionality among the known PTSs.
Food selection of Coregonus lavaretus in a brackish water ecosystem
Authors: Verliin A. , Kotta J. , Orav‐Kotta H. , Saks L. , Vetemaa M.
Published: January 2011

This study examined how variability in the abundance and biomass structure of benthic invertebrates affected the feeding choice of the whitefish Coregonus lavaretus on a hard bottom habitat of the brackish Baltic Sea. In general, crustaceans such as Idotea balthica and Gammarus spp. were preferred over molluscs. Although being the most numerous taxon in the invertebrate samples, Mytilus trossulus was the lowest ranking in C. lavaretus food preference. The availability of benthic invertebrate prey set the dietary range of fish but the selectivity largely described fish feeding within this range. There was no clear link between fish predation and the dominance structure of benthic invertebrate communities, suggesting that species composition, abundance and biomass of invertebrate species had no impact on the feeding selectivity of the fish. Thus, while fish predation may not affect the dominant species within a benthic community, due to strong selectivity fish may impose strong pressure on some rarer but highly preferred invertebrate prey species.
Current concepts of platelet activation: possibilities for therapeutic modulation of heterotypic vs. homotypic aggregation
Authors: Passacquale Gabriella , Ferro Albert
Published: January 2011

Thrombogenic and inflammatory activity are two distinct aspects of platelet biology, which are sustained by the ability of activated platelets to interact with each other (homotypic aggregation) and to adhere to circulating leucocytes (heterotypic aggregation). These two events are regulated by distinct biomolecular mechanisms that are selectively activated in different pathophysiological settings. They can occur simultaneously, for example, as part of a pro‐thrombotic/pro‐inflammatory response induced by vascular damage, or independently, as in certain clinical conditions in which abnormal heterotypic aggregation has been observed in the absence of intravascular thrombosis. Current antiplatelet drugs have been developed to target specific molecular signalling pathways mainly implicated in thrombus formation, and their ever increasing clinical use has resulted in clear benefits in the treatment and prevention of arterial thrombotic events. However, the efficacy of currently available antiplatelet drugs remains suboptimal, most likely because their therapeutic action is limited to only few of the signalling pathways involved in platelet homotypic aggregation. In this context, modulation of heterotypic aggregation, which is believed to contribute importantly to acute thrombotic events, as well to the pathophysiology of atherosclerosis itself, may offer benefits over and above the classical antiplatelet approach. This review will focus on the distinct biomolecular pathways that, following platelet activation, underlie homotypic and heterotypic aggregation, aiming potentially to identify novel therapeutic targets.
Multikinase inhibitor sorafenib exerts cytocidal efficacy against Non‐Hodgkin lymphomas associated with inhibition of MAPK14 and AKT phosphorylation
Authors: Chapuy Bjoern , Schuelper Nikolai , Panse Melanie , Dohm Andrea , Hand Elisabeth , Schroers Roland , Truemper Lorenz , Wulf Gerald G.
Published: January 2011

Intracellular signal transduction by kinase‐mediated phosphorylation is essential for the survival and growth of lymphoma cells. This study analysed the multikinase inhibitor sorafenib for its cytotoxic activity against lymphoma cells. We found that sorafenib reduced cell viability at low micromolar concentrations in a time‐dependent manner in cell lines and primary cell suspensions representing major types of aggressive B‐ and T‐cell lymphomas. In cells surviving short term exposure, proliferative arrest occurred leading to complete loss of in vitro clonogenicity. Previously described sorafenib targets within the RAF kinase family were found to be expressed and phosphorylated in all cell lines, and sorafenib perturbed the activation of classical RAF/MEK/ERK pathway targets. However, using a global phoshoprotein array, the most consistent downstream effect of sorafenib in NHL cells was the inhibition of mitogen‐activated protein kinase 14 (MAPK14) and panAKT phosphorylation. In conclusion, sorafenib has significant in vitro efficacy against aggressive B‐ and T‐cell lymphoma cells, associated with inhibition of MAPK14 and panAKT.
An exploration of the relationship between adherence with dietary sodium restrictions and health beliefs regarding these restrictions in Irish patients receiving haemodialysis for end‐stage renal disease
Authors: Walsh Ella , Lehane Elaine
Published: January 2011

Aims.  To measure adherence levels with dietary restrictions in Irish patients with end‐stage renal disease receiving haemodialysis and to explore the relationships between adherence with dietary sodium restrictions and health beliefs in relation to following these restrictions in this group.

Background.  Non‐adherence to medical regimes is an important healthcare issue and an ever‐present problem, particularly in patients with a chronic illness. The literature revealed a lack of studies measuring adherence with the sodium component of the renal dietary restrictions and associated factors; despite the fact that adherence with sodium restrictions is essential to the optimal management of end‐stage renal disease. Furthermore, despite increased emphasis on ‘the patients’ view’ in healthcare no study to date has contextualised health beliefs and adherence in end‐stage renal disease from an Irish perspective.

Design.  A quantitative, descriptive, correlational design was employed using the Health Belief Model as a theoretical framework.

Methods.  A convenience sample (n = 79) was recruited from the haemodialysis units of a large hospital. Data were collected using self‐report questionnaires. Data were analysed using descriptive and correlational statistics.

Results.  Non‐adherence with dietary restrictions was a problem among a proportion of the sample. Greater adherence levels with dietary sodium restrictions were associated with greater ‘perceived benefits’ and fewer ‘perceived barriers.’

Conclusion.  For the Irish patient, beliefs in relation to following a low sodium diet significantly affected adherence levels with this diet. This is an important finding as delineating key beliefs, particularly key barriers, facilitates an increased understanding of non‐adherence for nurses.

Relevance for clinical practice.  These findings have implications for the care of patients with end‐stage renal disease in that they can provide guidance in terms of developing interventions designed to improve adherence.
Usefulness of the Mini Nutritional Assessment (MNA) in predicting the nutritional status of people with mental disorders in Taiwan
Authors: Tsai Alan C , Chou Yuan‐Ti , Chang Tsui‐Lan
Published: January 2011

Objective.  The study was to evaluate the ability of the Mini Nutritional Assessment in predicting malnutrition in people with three subtypes of mental disorder (schizophrenia, major depression and bipolar disorder) in Taiwan.

Design.  The study involved a convenience sample of 120 residents of psychiatric wards managed by a hospital in central Taiwan (52 with schizophrenia, 36 with major depression and 32 with bipolar disorder) classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria.

Methods.  A structured questionnaire elicited subjects’ personal data, disease history and answers to questions in the Mini Nutritional Assessment. Serum and anthropometrical parameters were measured. Nutritional status was evaluated with a content‐equivalent version of the Mini Nutritional Assessment (Taiwan version‐1, T1).

Results.  The Mini Nutritional Assessment‐Taiwan version‐1 was effective in assessing the nutritional status of people of all three subtypes of disorder. Nutritional statuses predicted with the Mini Nutritional Assessment‐Taiwan version‐1 agreed well with other nutritional indicators such as BMI, waist circumference and appetite status. According to the Mini Nutritional Assessment‐Taiwan version‐1, people with major depression were more likely to be at risk of undernutrition, whereas people with schizophrenia or bipolar disorder were more likely to be at risk of overnutrition.

Conclusion.  The Mini Nutritional Assessment‐Taiwan version‐1 can effectively grade both undernutrition and overnutrition of people with schizophrenia, major depression or bipolar disorder.

Relevance to clinical practice.  The Mini Nutritional Assessment enables nurses to monitor emerging nutritional problems in people with psychiatric disorder without relying on subjective judgement. With proper intervention, it can help reduce nutrition‐related chronic conditions in these individuals and save on healthcare cost.
Is it economically viable to employ the nurse practitioner in general practice?
Authors: Dierick‐van Daele Angelique TM , Steuten Lotte MG , Romeijn Arla , Derckx Emmy WCC , Vrijhoef Hubertus JM
Published: January 2011

Aims.  This article provides insight into the potential economic viability of nurse practitioner employment in Dutch general practices.

Background.  General practitioners face the challenging task of finding the most efficient and effective mix of professionals in general practice to accommodate future care demands within scarce health care budgets. To enable informed decision‐making about skill mix issues, economic information is needed.

Design.  Discursive paper.

Method.  A descriptive and explorative design was chosen to study the economic viability of nurse practitioner employment in general practice. The conditions under which the nurse practitioner is able to earn back his/her own cost of employment were identified. Preferences and expectations of general practitioners and health insurers about nurse practitioner reimbursement were made transparent.

Results.  Although general practitioners and health insurers acknowledge the importance of the nurse practitioner in accommodating primary care demands, they have polarised views about reimbursement. The employment of nurse practitioners is seldom economically viable in current practices. It requires a reallocation of (80% of) the general practitioner’s freed up time towards practice growth (12% number of patients).

Conclusion.  The economic viability of the nurse practitioner has proven difficult to achieve in every day health care practice. This study provided insight into the complex interaction of the (cost) parameters that result in economic viability and feeds a further discussion about the content of the nurse practitioner role in general practice based on optimal quality of care vs. efficiency.

Relevance to clinical practice.  Effective and efficient health care can only be provided if the actual care needs of a population provide the basis for deciding which mix of professionals is best equipped to deal with the changing and increasing demand of care. A macro‐level intervention is needed to help a broad‐scale introduction of the nurse practitioner in general practice.
The psychometric properties of the Chinese version of the Problem Areas in Psychological Empowerment Scale (PES): scale development
Authors: Sun Ning , Li Qiu‐Jie , Lv Dong‐Mei , Lin Ping , Lu Gui‐Zhi , An Xue‐Mei
Published: January 2011

Aims.  This study was conducted to adapt the Problem Areas in Psychological Empowerment Scale for use among staff nurses and to evaluate the psychometric properties.

Background.  Considering the importance of psychological aspects in the administration of nursing, there is a need for validated measurements in this area. Such tools make it possible to understand staff nurses as well as they serve as reliable measures when evaluating medical, psychological and educational interventions.

Design.  Instrument development.

Methods.  A convenience sample of 750 staff nurses was systematically selected from six hospitals in Harbin, China. Following the linguistic adaptation using the forward–backward translation method, the 12‐item Psychological Empowerment Scale was answered by the selected staff nurses. Statistics covered exploratory factor analysis, content validity, Cronbach’s alpha and item‐to‐total correlation.

Results.  In the factor analysis, a four‐factor solution was found to be reasonable with the subdimensions psychological empowerment‐related meaning problems (three items), competence problems (three items), self‐determination (three items) and impact problems (three items). Cronbach’s alpha coefficient for the total score was 0·85 and varied between 0·82–0·89 in the four subscales. The item‐to‐total correlation coefficient was 0·40, and items were excluded with item‐to‐total correlation coefficient of lower than 0·40. The findings also gave support for the content validity.

Conclusions.  The Chinese version of the Problem Areas in Psychological Empowerment Scale seems to be reliable and valid outcome for measuring empowerment‐related psychological response in staff nurses.

Relevance to clinical practice.  The Psychological Empowerment Scale can be used to evaluate staff nurses’ empowerment‐related psychological response in clinical.
Adherence to leg ulcer lifestyle advice: qualitative and quantitative outcomes associated with a nurse‐led intervention
Authors: Van Hecke Ann , Grypdonck Maria , Beele Hilde , Vanderwee Katrien , Defloor Tom
Published: January 2011

Aim and objectives. Examining the (experienced) changes associated with a nursing intervention to enhance adherence to leg ulcer lifestyle advice.

Background. Few interventions to enhance adherence to leg ulcer treatment are developed and tested.

Design. Qualitative evaluation approach and pre–post‐test design were used.

Method. Twenty‐six patients with venous ulcers in a community care setting participated. Data were collected by means of interviews and participant observation. Frequency and duration of wearing compression, leg exercising and leg elevation, activity level, pain and ulcer size were registered at baseline, after the end of the intervention and three months later. Inductive content analysis and Wilcoxon signed‐rank test were used.

Results. Knowledge about leg ulcer advice increased. The education contributed to more consciously following of the advice. The rationale of the advice and its association with healing or recurrence remained often unclear. More patients performed exercises after the intervention and at follow‐up. Patients often looked out onto a ‘new’ perspective where enhancement of quality of life and even healing might be attainable. Some patients regained independence after learning how to apply and remove compression garments themselves. The frequency of exercising and the duration of exercises increased significantly. Step counts had not altered significantly. Patients not elevating the legs at baseline elevated the legs more and for a longer period of time after the intervention. This effect on leg elevation decreased after three months. No significant changes were reported on hours wearing compression.

Conclusions. The perceived changes suggest that the intervention holds a promise for current home care. Combining qualitative and quantitative research assisted to determine the possible effects of the intervention, increasing the potential for a meaningful randomised trial in the future.

Relevance to clinical practice. Education about leg ulcer advice should be incorporated in nursing practice. Further testing of the intervention is recommended.
Person‐centred medicine for older people
Authors: Snaedal Jon
Published: January 2011

It can be argued that person‐centred medicine is more important in old age than it is in young or middle age. The older patient is in many respects more of an individual than he was in his younger age as life experiences including diseases have shaped each person for a long time. For evaluation of an older person, the team approach has been shown to be the most efficient method. Cognitive factors and social support must be addressed specifically.
Falls in older adult psychiatric patients: equipping nurses with knowledge to make a difference
Authors: STUBBS B.
Published: January 2011

Accessible summary

Falls and injuries sustained as a consequence are a major source of increased mortality, morbidity and death in older adults.

Osteoporotic fractures, particularly at the hip, are of particular concern.

Older adults with serious mental illness are at increased risk of falls and subsequent fracture because of a complex multitude of factors.

Nurses have a central role in monitoring patient falls risk in ward settings and can work with the multidisciplinary team to reduce this risk.

Falls are the most common cause of accidental death among older adults and are associated with increased morbidity and mortality. A particularly serious sequela of falls is osteoporotic fractures. Older adults with mental illness are at increased risk of both falls and subsequent fractures, because of a range of complex risk factors. Many falls are preventable and an awareness of the risk factors for falls among nurses will empower them to promptly refer a patient at risk to the multidisciplinary team. A multidisciplinary approach is required to be successful in any efforts to reduce an individual's risk of falls and nurses have a central role in achieving this. This article reviews the relevant literature on the causes and consequences of falls in older adults with mental illness in order to enable nurses to reduce falls and subsequent fractures.
Pathogen dynamics in a crop canopy and their evolution under changing climate
Authors: Pangga I. B. , Hanan J. , Chakraborty S.
Published: January 2011

Canopy‐level interactions have been largely ignored in epidemiological models and their applications in defining disease risks under climate change, although these interactions are important for disease management. This paper uses anthracnose of Stylosanthes scabra as a case study and reviews research on dynamics of the pathogen (Colletotrichum gloeosporioides) at the canopy level and pathogen evolution under changing climate. It argues that linking of pathogen dynamics, crop growth and climate models is essential in predicting disease risks under climate change. A plant functional‐structural model was used to couple S. scabra growth and architecture with disease under ambient and elevated CO2. A level of induced resistance in plants with enlarged canopy determined anthracnose severity at elevated CO2. Moisture‐related microclimatic variables determined infection at ambient but not at elevated CO2. At high CO2 increased disease level from raised pathogen fecundity in enlarged canopy accelerated pathogen evolution after 25 sequential infection cycles. Modelling of pathogen dynamics under climate change currently suffers from a paucity of quantitative data, mismatch of scales in coupling climate and disease models, and model uncertainties. Further experimental research on interactions of biotic and abiotic factors on plant diseases under climate change and validation of models are essential prior to their use in climate‐change prediction. Understanding and anticipating trends in host–pathogen evolution under climate change will improve the durability of resistance and lay the foundation for increased crop adaptation through pre‐emptive plant breeding.
Complexity in climate‐change impacts: an analytical framework for effects mediated by plant disease
Authors: Garrett K. A. , Forbes G. A. , Savary S. , Skelsey P. , Sparks A. H. , Valdivia C. , van Bruggen A. H. C. , Willocquet L. , Djurle A. , Duveiller E. , Eckersten H. , Pande S. , Vera Cruz C. , Yuen J.
Published: January 2011

The impacts of climate change on ecosystem services are complex in the sense that effective prediction requires consideration of a wide range of factors. Useful analysis of climate‐change impacts on crops and native plant systems will often require consideration of the wide array of other biota that interact with plants, including plant diseases, animal herbivores, and weeds. We present a framework for analysis of complexity in climate‐change effects mediated by plant disease. This framework can support evaluation of the level of model complexity likely to be required for analysing climate‐change impacts mediated by disease. Our analysis incorporates consideration of the following set of questions for a particular host, pathogen, host–pathogen combination, or geographic region. 1. Are multiple biological interactions important? 2. Are there environmental thresholds for population responses? 3. Are there indirect effects of global change factors on disease development? 4. Are spatial components of epidemic processes affected by climate? 5. Are there feedback loops for management? 6. Are networks for intervention technologies slower than epidemic networks? 7. Are there effects of plant disease on multiple ecosystem services? 8. Are there feedback loops from plant disease to climate change? Evaluation of these questions will help in gauging system complexity, as illustrated for fusarium head blight and potato late blight. In practice, it may be necessary to expand models to include more components, identify those components that are the most important, and synthesize such models to include the optimal level of complexity for planning and research prioritization.
Impacts of changing air composition on severity of arable crop disease epidemics
Authors: Fitt B. D. L. , Fraaije B. A. , Chandramohan P. , Shaw M. W.
Published: January 2011

This review assesses the impacts, both direct and indirect, of man‐made changes to the composition of the air over a 200 year period on the severity of arable crop disease epidemics. The review focuses on two well‐studied UK arable crops, wheat and oilseed rape, relating these examples to worldwide food security. In wheat, impacts of changes in concentrations of SO2 in air on two septoria diseases are discussed using data obtained from historical crop samples and unpublished experimental work. Changes in SO2 seem to alter septoria disease spectra both through direct effects on infection processes and through indirect effects on soil S status. Work on the oilseed rape diseases phoma stem canker and light leaf spot illustrates indirect impacts of increasing concentrations of greenhouse gases, mediated through climate change. It is projected that, by the 2050s, if diseases are not controlled, climate change will increase yields in Scotland but halve yields in southern England. These projections are discussed in relation to strategies for adaptation to environmental change. Since many strategies take 10–15 years to implement, it is important to take appropriate decisions soon. Furthermore, it is essential to make appropriate investment in collation of long‐term data, modelling and experimental work to guide such decision‐making by industry and government, as a contribution to worldwide food security.
Effects of fungicide on growth of Leptosphaeria maculans and L. biglobosa in relation to development of phoma stem canker on oilseed rape (Brassica napus)
Authors: Huang Y. J. , Hood J. R. , Eckert M. R. , Stonard J. F. , Cools H. J. , King G. J. , Rossall S. , Ashworth M. , Fitt B. D. L.
Published: January 2011

Controlled‐environment and field experiments were done to investigate effects of the fungicide Punch C (flusilazole plus carbendazim) on growth of Leptosphaeria maculans and L. biglobosa in oilseed rape. In controlled‐environment experiments, for plants inoculated with L. maculans, fungicide treatment decreased lesion size and amount of L. maculans DNA in leaves; for plants inoculated with L. biglobosa, fungicide did not affect lesion size or amount of pathogen DNA. When release of ascospores was monitored using a Burkard spore sampler, the timing and pattern of ascospore release differed between the four seasons. In 2006/2007, the majority of ascospores released were L. maculans, whilst in 2007/2008 the majority were L. biglobosa; in both seasons L. maculans ascospores were released before L. biglobosa ascospores. In field experiments in 2002/2003 and 2003/2004, fungicide treatment decreased severity of stem canker on cv. Apex, but gave no significant yield response. In 2006/2007 and 2007/2008, fungicide treatment decreased phoma leaf spot incidence in autumn and stem canker severity at harvest, and increased yield. Fungicide treatment decreased stem canker severity more on cv. Courage, with a good yield response, than on cv. Canberra. In 2002/2003 and 2003/2004, fungicide treatment decreased the frequency of spread of L. maculans into stem pith tissues and in 2006/2007 fungicide decreased the amount of L. maculans DNA in stem tissues (measured by quantitative PCR). These results are used to suggest how effects of fungicides on interactions between L. maculans and L. biglobosa might affect severity of phoma stem canker and yield response.
ESAT‐6‐ and CFP‐10‐Specific Th1, Th22 and Th17 Cells in Tuberculous Pleurisy May Contribute to the Local Immune Response Against Mycobacterium Tuberculosis Infection
Authors: Qiao D. , Yang B. Y. , Li L. , Ma J. J. , Zhang X. L. , Lao S. H. , Wu C. Y.
Published: January 2011

Th1 cell‐mediated adaptive immune response is very important but may not be sufficient to control Mycobacterium tuberculosis (M. tuberculosis) infection. The roles of the various T cell subsets and cytokines in the inflammatory processes are not clearly elucidated. We investigated whether Th1, Th22 and Th17 cells mediated cellular immunity at the local site of M. tuberculosis infection in patients with tuberculous pleurisy (TBP). The results showed that the cytokines IFN‐γ and IL‐22 but not IL‐17 were elevated in tubercular pleural fluid. Following stimulation with immune‐dominant peptides of early secreted antigenic target‐6 (ESAT‐6), culture filtrate protein‐10 (CFP‐10) or Bacille Calmette–Guerin, pleural fluid mononuclear cells expressed high levels of cytokines IFN‐γ, IL‐22 and IL‐17 as revealed by mRNA and protein measurements. In addition, we showed that cytokines IFN‐γ, IL‐22 and IL‐17 were produced in M. tuberculosis‐specific immune response by distinct subsets of CD4+ T cells with the phenotype of CD45RA−CD62L−CCR7+CD27+. Our results demonstrated for the first time that ESAT‐6‐ and CFP‐10‐specific Th1, Th22 and Th17 cells existed in the patients with TBP and might play an essential role against M. tuberculosis infection. The findings of this study raised the possibility of unravelling the critical targets for therapeutic intervention in chronic inflammatory diseases such as TBP.
Glomus tumours in the skin and subcutis of three horses
Authors: Burns Rachel E. , Pesavento Patricia A. , McElliott Valerie R. , Ortega Joaquin , Affolter Verena K.
Published: January 2011

Three horses presented with variably painful, nonulcerated masses of the head or neck that were diagnosed as glomus tumours. Grossly, they were fleshy, pink to tan masses ranging from 0.4 to 9 cm in diameter, involving either the deep dermis and subcutis or the subcutis and underlying skeletal muscle. Microscopically, neoplastic epithelioid cells were arranged in sheets, cords and packets within lobules. The neoplastic cells frequently abutted and formed nodular bulges into large endothelium‐lined vascular spaces, especially around the tumour periphery. Large nerve branches were associated with each tumour. As determined by immunohistochemistry, the neoplastic cells consistently expressed α‐smooth muscle actin and vimentin, and some cells in two of the cases expressed desmin. A laminin‐ or collagen IV‐positive basement membrane was demonstrated around individual tumour cells or small groups of cells in all three cases. Morphological features and immunohistochemistry supported the diagnosis of glomus tumour, most consistent with the solid type in humans. Applying a classification system used in humans, two of these tumours met criteria of malignancy (glomangiosarcomas). One horse was euthanized due to complications associated with recurrence and treatment‐related necrosis and secondary infection.
Downregulation of the B‐cell receptor signaling component CD79b in plasma cell myeloma: A possible post transcriptional regulation
Authors: Huang Xingang , Takata Katsuyoshi , Sato Yasuharu , Tanaka Takehiro , Ichimura Kouichi , Tamura Maiko , Oka Takashi , Yoshino Tadashi
Published: January 2011

The CD79 molecule, encoded by the CD79a and CD79b genes, is a signaling unit of the B‐cell receptor complex, which transmits signals of B‐cell activation, growth, and differentiation. They are B‐cell‐specific and expressed at most stages of B‐cell development. Although plasma cells have been believed to lack these gene products, the regulation of CD79 expression in plasma cells is still controversial. In particular, the regulation of CD79b expression remains unclear. We sought to examine CD79b expression in normal and neoplastic plasma cells by immunohistochemical analysis. Out of the 23 clinical samples and 11 cell lines of plasma cell myeloma (PCM), none of the clinical samples and only 1 of 11 cell lines expressed CD79b immunohistologically, whereas non‐neoplastic plasma cells in reactive hyperplastic lymph nodes exhibited loss of CD79b protein expression. This finding is quite different from our previous report on CD79a. Not only immunocytochemistry, but also RT‐PCR and Western blot analysis of PCM cell lines gave identical results. Interestingly, we detected mRNA transcripts of CD79b in PCM cell lines, although protein translation was lacking. These findings suggest that expression of CD79b is downregulated in both plasma cells and plasma cell myeloma, and this process is possibly under post transcriptional regulation.
Voiding dynamics in women with stress urinary incontinence and high‐stage cystocele
Authors: Seki Narihito , Shahab Nouval , Hara Ritsuko , Takei Mineo , Yamaguchi Akito , Naito Seiji
Published: January 2011

Objectives:  The aim of this study was to identify the urodynamic features of women with stress urinary incontinence (SUI) or with high‐stage (stage 3 or greater) cystocele (HSC) as compared with symptom‐free women.

Methods:  Fifty‐six neurologically intact women with SUI and 47 women with HSC but without SUI were prospectively evaluated. All patients underwent full urodynamics, in addition to basic clinical evaluations. The urodynamic parameters of SUI and HSC were compared to the ones obtained from 78 urologically symptom‐free normal women over the same period.

Results:  Patients with HSC, after correction of cystocele using a temporary vaginal pessary, had consistently lower maximum urinary flow rate with a lower detrusor pressure during micturition than the controls or those with SUI. On the other hand, patients with SUI had an equivalent to higher maximum urinary flow rate, normal detrusor contraction strength with a lower detrusor pressure during micturition than the controls. Both maximum Watts factor and bladder contractility index were significantly lower in the whole HSC cohort in comparison to the controls and patients with SUI. The urodynamic characteristics observed among the three groups were all maintained even after adjusting for age.

Conclusions:  Women with SUI demonstrate voiding with low‐pressure, normal contraction strength with an equivalent to high urinary flow rate. Women with HSC demonstrate voiding with low pressures with weak contraction strengths and low urinary flow rates, suggesting a higher prevalence of detrusor underactivity. Chronically decreased or increased urethral resistance might alter voiding dynamics and performance.
Outcome for the extremely premature neonate: how far do we push the edge?
Authors: Boat Anne C. , Sadhasivam Senthilkumar , Loepke Andreas W. , Kurth Charles D.
Published: January 2011

Background

Significant advances in perinatal and neonatal medicine over the last 20 years and the recent emergence of fetal surgery has resulted in anesthesia providers caring for a growing number of infants born at the margin of viability. Anesthetic management in this patient population has to take into consideration the immature function of many vital organ systems as well as the effects of the underlying disease processes, which can frequently lead to severe physiological derangements. Accordingly, premature infants presenting for major surgeries early in life can represent a significant anesthetic challenge. However, even with advanced anesthetic and surgical management and optimal intensive care, extremely premature infants face substantial postoperative morbidity and mortality, as well as prolonged hospital courses. In this article, we will discuss the following questions: How far have we come in improving outcomes of extreme prematurity? And what will the future medical and societal challenges be, as we continue to redefine the limits of viability?
Basin‐scale distribution patterns of photosynthetic picoeukaryotes along an Atlantic Meridional Transect
Authors: Kirkham Amy R. , Jardillier Ludwig E. , Tiganescu Ana , Pearman John , Zubkov Mikhail V. , Scanlan David J.
Published: January 2011

Photosynthetic picoeukaryotes (PPEs) of a size < 3 µm play a crucial role in oceanic primary production. However, little is known of the structure of the PPE community over large spatial scales. Here, we investigated the distribution of various PPE classes along an Atlantic Meridional Transect sampled in boreal autumn 2004 that encompasses a range of ocean provinces (gyres, upwelling, temperate regions), using dot blot hybridization technology targeting plastid 16S rRNA gene amplicons. Two algal classes, Prymnesiophyceae and Chrysophyceae, dominated the PPE community throughout the Atlantic Ocean, over a range of water masses presenting different trophic profiles. However, these classes showed strongly complementary distributions with Chrysophyceae dominating northern temperate waters, the southern gyre and equatorial regions, while prymnesiophytes dominated the northern gyre. Phylogenetic analyses using both plastid and nuclear rRNA genes revealed a high diversity among members of both classes, including sequences contained in lineages with no close cultured counterpart. Other PPE classes were less prevalent along the transect, with members of the Cryptophyceae, Pelagophyceae and Eustigmatophyceae essentially restricted to specific regions. Multivariate statistical analyses revealed strong relationships between the distribution patterns of some of these latter PPE classes and temperature, light intensity and nutrient concentrations. Cryptophyceae, for example, were mostly found in the upwelling region and associated with higher nutrient concentrations. However, the key classes of Prymnesiophyceae and Chrysophyceae were not strongly influenced by the variables measured. Although there appeared to be a positive relationship between Chrysophyceae distribution and light intensity, the complementary distributions of these classes could not be explained by the variables recorded and this requires further explanation.
Alphaproteobacteria dominate active 2‐methyl‐4‐chlorophenoxyacetic acid herbicide degraders in agricultural soil and drilosphere
Authors: Liu Ya‐Jun , Liu Shuang‐Jiang , Drake Harold L. , Horn Marcus A.
Published: January 2011

2‐Methyl‐4‐chlorophenoxyacetic acid (MCPA) is a widely used phenoxyalkanoic acid herbicide and subject to aerobic microbial degradation. Earthworms stimulate both growth and activity of MCPA‐degrading bacteria in soil. Thus, active MCPA degraders in soil and drilosphere (i.e. burrow walls, gut content and cast) were assessed by 16S rRNA stable isotope probing in soil columns under experimental conditions designed to minimize laboratory incubation biases. Agriculturally relevant concentrations of [13C]MCPA (20 µg gdw−1) were degraded in soil within 23 and 27 days in the presence and absence of earthworms respectively. Total 16S rRNA analysis revealed 73 operational taxonomic units indicative of active Acidobacteria, Actinobacteria, Bacteroidetes, Chloroflexi, Cyanobacteria, Firmicutes, Gemmatimonadetes, Planctomycetes, Proteobacteria and Verrucomicrobia in soil and drilosphere derived material. Seven operational taxonomic units indicative of Alpha‐, Beta‐, Gammaproteobacteria and Firmicutes consumed MCPA‐[13C]. Dominant consumers of MCPA‐[13C] were Alphaproteobacteria (Sphingomonadaceae and Bradyrhizobiaceae) in soil and drilosphere. Beta‐ (Comamonadaceae) and Gammaproteobacteria (Xanthomonadaceae) were also important MCPA‐[13C] consumers in burrow walls only, indicating that earthworms favour betaproteobacterial MCPA degraders. In oxic microcosms with bulk soil, burrow walls and cast, 20 and 300–400 µg gdw−1[13C]MCPA were consumed within 24 h and 20 days respectively. Gut contents did not facilitate the degradation of [13C]MCPA. Sphingomonadaceae dominated MCPA‐[13C] consumers in bulk soil and burrow wall microcosms, while Beta‐ and Gammaproteobacteria (Burkholderiacea, Comamonadaceae, Oxalobacteraceae and Xanthomonadaceae) dominated MCPA‐[13C] consumers in microcosms of cast, indicating that the latter taxa are prone to respond to MCPA in cast. The collective data indicated that Alphaproteobacteria are major MCPA degraders in soil and drilosphere.
Prostate cancer in Spain: from guidelines to clinical practice
Authors: Alcaraz Antonio , Burgos Francisco J. , Cózar José M. , Gómez‐Veiga Francisco , Morote Juan , Solsona Eduardo , Unda Miguel , Carballido Joaquín
Published: January 2011

Study Type – Therapy (outcomes research)  Level of Evidence 2b

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

To our knowledge, this is the first study which addresses the degree of compliance of Spanish clinical practice with the EAU Guidelines on prostate cancer (PCa).

The study identifies aspects of clinical practice in PCa that diverge from the recommendations in the EAU guidelines, as well as a series of grey areas where specific recommendations are lacking, providing insights for further improvement. The study describes the level of compliance among Spanish urologists.

OBJECTIVE

• To determine how closely practice in prostate cancer (PCa) follows European Association of Urology (EAU) guidelines.

MATERIALS AND METHODS

• This project involving 242 experts comprised four phases: (1) selection of controversial topics by a panel of experts; (2) preparation of case descriptions and associated questionnaires; (3) determination of their face validity; and (4) completion (November 2007 to January 2008).

• The primary endpoint was percentage agreement with the recommendations given by the EAU guidelines. Topics not specifically addressed in these guidelines were also analysed.

RESULTS

• For the selected controversial topics, the overall mean adherence to the guidelines was 52.1%. Topics with a mean adherence <40% are detailed below.

• For localized/locally advanced PCa the lowest adherence was found for the type of anaesthesia used during biopsy (30.3%, sd= 14.4), local staging (17.3%, sd= 10.4), new criteria for biochemical relapse after radiotherapy (32.9%, sd= 27.6), and the interpretation of raised PSA after prostatectomy (34.4%, sd= 20.1).

• For metastatic PCa, the lowest adherence referred to androgen blockade (34.5%, sd= 24.94) and the reintroduction of hormone therapy (21.8%, sd= 13.5).

• Regarding the monitoring of patients, 83.9% of the urologists stated that they measure testosterone levels at some point, and the conventional threshold level of 50 ng/dL testosterone was only used by 17.4%.

• Differences in opinion were also observed for the recommendation for a digital rectal examination at each visit (agreed by only 22.3%).

CONCLUSION

• The PROSEO project represents an opportunity to consolidate and improve EAU guidelines by identifying issues that, on the basis of clinical practice in PCa and topics of current concern to urologists, have not been fully addressed or might need specific recommendations.
The suburethral tension adjustable sling (REMEEX system) in the treatment of female urinary incontinence due to ‘true’ intrinsic sphincter deficiency: results after 5 years of mean follow‐up
Authors: Giberti Claudio , Gallo Fabrizio , Cortese Pierluigi , Schenone Maurizio
Published: January 2011

Study Type – Therapy (case series)

Level of Evidence 4

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

The treatment of female stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) still remains a very difficult target for urologists. Tension‐free sling positioning is the most used procedure. However, in cases of ISD with fixed urethra, or following anti‐incontinence and surgical procedures, tension‐free slings are more likely to fail spurring an interest in alternative less invasive but more effective techniques.

The aim of our study was to assess the outcomes of Remeex procedure in a worse prognosis patient group affected by “true” ISD (mainly iathrogenic ISD with lead pipe and fixed urethra). Our data provided a longer follow‐up than those reported in literature to date, confirming the effectiveness and durability of the Remeex technique up to five years after surgery.

OBJECTIVE

• To retrospectively report the objective and subjective outcomes of suburethral tension adjustable sling (Remeex system) implantation for stress urinary incontinence (SUI) caused by ‘true’ intrinsic sphincter deficiency (ISD) with fixed urethra.

PATIENTS AND METHODS

• Thirty female patients with severe SUI, mainly because of iatrogenic ISD, underwent Remeex system positioning between May 2002 and July 2008 (mean follow‐up 60.6 months, range 22–96 months).

• Before surgery, patients were evaluated by physical examination, translabial ultrasonography, flexible cystoscopy, urodynamics, 1‐hour pad test and compilation of a quality‐of‐life questionnaire.

• Postoperatively, based on the physical examination and pad test, patients were stratified into three groups: (i) Cured: perfectly dry patients at stress test, pad weight 0–1 g; (ii) Improved: patients with mild to moderate incontinence, pad weight 2–50 g; and (iii) Failed: unchanged or worsened patients, pad weight >50 g.

RESULTS

• At the final follow‐up visit, 26 (86.0%) patients were cured, 2 (7.0%) were improved and 2 (7.0%) had failed.

• In particular, the total mean pad weight decreased to 33.2 ± 15.6 (71%) and the total mean questionnaire score significantly increased to 86.9 ± 6.7 (74.0%).

• Sling tension readjustment was needed during follow‐up in two patients (7%).

• Among the complications, persistent urinary retention (10%), seroma formation (3%) and de novo urgency (7%) were easily treated.

CONCLUSION

• The Remeex system produced remarkable 5‐year results with a low complication rate. These outcomes have also been confirmed in a worse prognosis patient group as reported in the present study.
Resilience among Japanese atomic bomb survivors
Authors: Knowles A.
Published: January 2011

KNOWLES A. (2011) Resilience among Japanese atomic bomb survivors. International Nursing Review58, 54–60

Aim:  The purpose of the study was to explore the experience of atomic bomb survivors from Hiroshima and Nagasaki.

Background:  Never has the world experienced such extreme devastation as with the atomic bombings of Hiroshima and Nagasaki, Japan, in August 1945. Although significant quantitative research has been completed about the medical effects following radiation, the literature lacks qualitative exploration from a holistic health perspective.

Methods:  This was a qualitative descriptive study, using methods of narrative analysis, oral history and ethnography. The sample for this research included eight individuals who were exposed to the atomic bombings in Japan and currently reside in the United States.

Findings:  Findings provide insight to the resilience that the survivors exhibited immediately following the bomb, as well as throughout the 65 years following the event. From ethnographic data and interviews with survivors, a thematic structure was developed that depicts the essential elements of the atomic bomb experience. Two ways of being in the world followed the bombing: surviving and thriving, with resilience serving as a lever, allowing for fluid movement over time across the continuum.

Individuals experiencing surviving exhibited anxiety about their personal and family members' health, expressed mistrust, and felt a stigma associated with being a survivor. For those who were thriving, peace activism, overcoming and forgiveness were typically displayed.

Conclusion:  Findings from this study add to the disaster nursing literature and highlight the role resilience plays in the atomic bomb survivors' life perspective.
Nursing research in three regions in China: a bibliometric study
Authors: Peng J. , Hui Z.‐Y.
Published: January 2011

PENG J., HUI Z.‐Y. (2011) Nursing research in three regions in China: a bibliometric study. International Nursing Review58, 21–25

Objective:  To analyse scientific papers published by Chinese authors in nursing journals included in the Science Citation Index Expanded and compare the published scientific papers from mainland China (ML), Taiwan (TW) and Hong Kong (HK).

Methods:  All articles published in 62 journals that were related to nursing originating from ML, TW and HK from 1999 to 2008 were retrieved from the PubMed and Institute for Scientific Information (ISI) Web of Knowledge database. The total number of articles published in nursing journals, impact factors and citation reports and articles were estimated for quantity and quality comparisons.

Results:  The number of articles from the three regions increased significantly from 1999 to 2008. There were 1015 articles in total from the three regions: ML (48), HK (414) and TW (553) in PubMed. In the ISI Web of Knowledge database, TW derived the highest total citations (1755 citations from 500 articles), followed by HK (1316 citations from 347 articles) and ML (158 citations from 55 articles). HK had the highest average citations of 3.79, followed by TW (3.51) and then ML (2.87).

Discussion:  The difference between the quantity and quality of nursing research articles published in ML, TW and HK is significant, although the gap appears to be narrowing. Long‐term job stresses, low levels of education and language barriers are likely the main factors. ML, TW and HK have the same culture and ethnicity. We expect that ML will benefit significantly from increased exchanges with TW and HK in nursing research and education. We also speculate that TW and HK will benefit from exchanges because ML may have diverse nursing problems.