bluuebunny/crossref_metadata_2025 huggingface dataset:
Endotoxemia affects citrulline, arginine and glutamine bioavailability
Authors: Elwafi Fatimazahra , Curis Emmanuel , Zerrouk Naima , Neveux Nathalie , Chaumeil Jean‐Claude , Arnaud Philippe , Cynober Luc , Moinard Christophe
Published: July 2011

Eur J Clin Invest 2012; 42 (3): 282–289

Background  Sepsis considerably alters the intestinal barrier functions, which in turn modify the absorption and bioavailability of nutrients. However, the effects of septic shock on aminoacid (AAs) bioavailability are poorly documented. The aim of this study was to compare the bioavailability of citrulline, arginine and glutamine during endotoxemia.

Materials and methods  Thirty‐six rats were randomised into two groups: control and lipopolysaccharides (LPS). The LPS group received an intraperitoneal injection of endotoxins (7·5 mg/kg). After 12 h, each group was again randomised into three subgroups, each of which received an oral bolus of citrulline, arginine or glutamine (5·7 mmol/kg). Blood samples were collected at various times from 0 to 600 min after AA administration. The concentrations of citrulline, arginine, glutamine and their metabolites arginine and ornithine were measured to determine pharmacokinetic parameters Area Under Curve (AUC), Cmax and Tmax.

Results  The AUC values of citrulline decreased in LPS rats [citrulline, control: 761 ± 67 and LPS: 508 ± 72 μmol min/mL (P = 0·02)]. Maximum concentrations of citrulline were also significantly decreased by endotoxemia (P = 0·01). The pharmacokinetic parameters of arginine and glutamine were not significantly modified by endotoxemia. The AUC value of arginine from citrulline conversion was diminished in endotoxemic rats. The other pharmacokinetic parameters of arginine were not significantly modified after arginine or citrulline supply in either group (control or LPS).

Conclusion  Endotoxemia affects the bioavailability of AAs differently according to the amino acid considered. This feature may be important for nutritional strategy in ICU patients.
Dietary fenugreek and onion attenuate cholesterol gallstone formation in lithogenic diet–fed mice
Authors: Reddy Raghunatha R. L. , Srinivasan Krishnapura
Published: July 2011

An animal study was conducted to evaluate the antilithogenic effect of a combination of dietary fenugreek seeds and onion. Lithogenic conditions were induced in mice by feeding them a high (0.5%) cholesterol diet (HCD) for 10 weeks. Fenugreek (12%) and onion (2%) were included individually and in combination in this HCD. Fenugreek, onion and their combination reduced the incidence of cholesterol gallstones by 75%, 27% and 76%, respectively, with attendant reduction in total cholesterol content by 38–42%, 50–72% and 61–80% in serum, liver and bile respectively. Consequently, the cholesterol/phospholipid ratio was reduced significantly in serum, liver and bile. The cholesterol saturation index of bile was reduced from 4.14 to 1.38 by the combination of fenugreek and onion and to 2.33 by onion alone. The phospholipid and bile acid contents of the bile were also increased. Changes in the hepatic enzyme activities (3‐hydroxy‐3‐methylglutaryl Coenzyme A reductase, cholesterol‐7α‐hydroxylase and cholesterol‐27‐hydroxylase) induced by HCD were countered by fenugreek, onion and their combination. Hepatic lipid peroxides were reduced by 19–22% and 39–45% with fenugreek, onion and their combination included in the diet along with the HCD. Increased accumulation of fat in the liver and inflammation of the gallbladder membrane produced by HCD were reduced by fenugreek, onion and their combination. The antilithogenic influence was highest with fenugreek alone, and the presence of onion along with it did not further increase this effect. There was also no additive effect of the two spices in the recovery of antioxidant molecules or in the antioxidant enzyme activities.
Do nurses have a different physical health profile? A systematic review of experimental and observational studies on nurses’ physical health
Authors: Fronteira Inês , Ferrinho Paulo
Published: July 2011

Aim. To review the evidence on nurses’ health systematically.

Background. Nurses are one of the most important resources of a health system. They are subjected to biological, socio‐economic, cultural and health system factors that determine their health. Although mental and physical health problems seem to prevail among nurses, literature is often contradictory. The literature on health styles, health behaviours and self perceived health of nurses is also unclear.

Design. Systematic review of experimental and observational studies on nurses’ health.

Methods. Forty‐three databases searched. 2692 references identified as of potential interest; 187 studies included. Only the results from studies on physical health are presented. No meta‐analysis was possible. The Scottish Intercollegiate Guidelines Network system was used to rate evidence.

Results. Nurses were at greater risk of musculoskeletal injuries and more prone to blood‐borne pathogens infections than other health care workers. They were at greater risk of breast cancer than other female health care workers. Nurses in hospitals were more at risk of tuberculosis. They did not have excess risk of cancer in general, Hodgkin’s disease, stomach, colon, rectum, pancreatic, ovary, kidney, brain or thyroid cancer or of lymphosarcoma. They have a higher prevalence of occupational allergies than clerical workers.

Discussion. Nurses suffer more from musculoskeletal disorders which is consistent with the nature of nursing work. They are at greater risk of acquiring tuberculosis, particularly if they work in pulmonary, medicine or Human Immunodeficiency Virus wards which might be due to repeated contact with infected patients. Nurses are also more prone to blood‐borne pathogens infections which might be explained by exposure while working. The proneness to occupational allergies can be explained by exposure to a series of chemical agents.

Relevance to clinical practice. Without sound knowledge on nurses’ health and it is not possible to develop specific occupational health programmes.
Patterns of morning and evening fatigue among adults with HIV/AIDS
Authors: Lerdal Anners , Gay Caryl L , Aouizerat Bradley E , Portillo Carmen J , Lee Kathryn A
Published: July 2011

Aims and objectives.  Describe patterns of morning and evening fatigue in adults with HIV and examine their relationship to demographic and clinical factors and other symptoms.

Background.  Most studies of HIV‐related fatigue assess average levels of fatigue and do not address its diurnal fluctuations. Patterns of fatigue over the course of the day may have important implications for assessment and treatment.

Design.  A cross‐sectional, correlational design was used with six repeated measures over 72 hours.

Method.  A convenience sample of 318 HIV‐infected adults was recruited in San Francisco. Socio‐demographic, clinical and symptom data were collected with questionnaires. CD4+ T‐cell count and viral load were obtained from medical records. Participants completed a four‐item version of the Lee Fatigue Scale each morning and evening for three consecutive days. Participants were grouped based on their diurnal pattern of fatigue (high evening only, high morning only, high morning and evening and low morning and evening). Group comparisons and logistic regression were used to determine the unique predictors of each fatigue pattern.

Results.  The high evening fatigue pattern was associated with anxiety and the high morning pattern was associated with anxiety and depression. The morning fatigue pattern showed very little fluctuation between morning and evening, the evening pattern showed the largest fluctuation. The high morning and evening pattern was associated with anxiety, depression and sleep disturbance and this group reported the most fatigue‐related distress and interference in functioning.

Conclusions.  These results provide initial evidence for the importance of assessing the patient’s daily pattern of fatigue fluctuation, as different patterns were associated with different symptom experiences and perhaps different aetiologies.

Relevance to clinical practice.  Different fatigue patterns may benefit from tailored intervention strategies. Management of depressive symptoms could be tested in patients who experience high levels of morning fatigue.
Adolescents’ and school nurses’ perceptions of using a health and lifestyle tool in health dialogues
Authors: Golsäter Marie , Sidenvall Birgitta , Lingfors Hans , Enskär Karin
Published: July 2011

Aim and objective.  To describe and explore adolescents’ and nurses’ perceptions of using a health and lifestyle tool in health dialogues in the School Health Service.

Background.  In Sweden, dialogues concerning health and lifestyle are offered to adolescents aged 14 years with the purpose of encouraging an interest in a healthy lifestyle. A health and lifestyle tool including a health questionnaire and a health profile has recently been developed, with the aim of facilitating the communication about health and lifestyle in these dialogues.

Design.  Qualitative descriptive design.

Method.  Twenty‐nine adolescents and 23 nurses participated in focus group interviews, which were subjected to qualitative content analysis.

Results.  The health and lifestyle tool was perceived as constituting a structure for the dialogues and as a clear and applicable starting point, focusing on individual aspects. The tool contributed to an understanding of the health situation and to the transmittal of health information on an individual as well as a group level.

Conclusion.  The tool was perceived as constituting a useful structure for the dialogues about health and lifestyle. When it was used the individual’s health and lifestyle were concretised, which opened up for a dialogue and different aspects of health and lifestyle were detected. However, in some cases the outcome of the tool could be conceived as a stringent assessment and thereby complicate the dialogues.

Relevance to clinical practice.  The use of a tool, such as the one used in this study, is one way to improve the dialogues in the School Health Service, allowing them to be more focused on the individual’s needs and to detect aspects that would otherwise not be so easily detected. The implications of this study include using the findings to guide counselling sessions in the schools and other health care settings.
Classification algorithms for predicting sleepiness and sleep apnea severity
Authors: EISEMAN NATHANIEL A. , WESTOVER M. BRANDON , MIETUS JOSEPH E. , THOMAS ROBERT J. , BIANCHI MATT T.
Published: July 2011

Identifying predictors of subjective sleepiness and severity of sleep apnea are important yet challenging goals in sleep medicine. Classification algorithms may provide insights, especially when large data sets are available. We analyzed polysomnography and clinical features available from the Sleep Heart Health Study. The Epworth Sleepiness Scale and the apnea–hypopnea index were the targets of three classifiers: k‐nearest neighbor, naive Bayes and support vector machine algorithms. Classification was based on up to 26 features including demographics, polysomnogram, and electrocardiogram (spectrogram). Naive Bayes was best for predicting abnormal Epworth class (0–10 versus 11–24), although prediction was weak: polysomnogram features had 16.7% sensitivity and 88.8% specificity; spectrogram features had 5.3% sensitivity and 96.5% specificity. The support vector machine performed similarly to naive Bayes for predicting sleep apnea class (0–5 versus >5): 59.0% sensitivity and 74.5% specificity using clinical features and 43.4% sensitivity and 83.5% specificity using spectrographic features compared with the naive Bayes classifier, which had 57.5% sensitivity and 73.7% specificity (clinical), and 39.0% sensitivity and 82.7% specificity (spectrogram). Mutual information analysis confirmed the minimal dependency of the Epworth score on any feature, while the apnea–hypopnea index showed modest dependency on body mass index, arousal index, oxygenation and spectrogram features. Apnea classification was modestly accurate, using either clinical or spectrogram features, and showed lower sensitivity and higher specificity than common sleep apnea screening tools. Thus, clinical prediction of sleep apnea may be feasible with easily obtained demographic and electrocardiographic analysis, but the utility of the Epworth is questioned by its minimal relation to clinical, electrocardiographic, or polysomnographic features.
Association of self‐reported snoring with carotid artery intima‐media thickness and plaque
Authors: LI YAN , LIU JING , WANG WEI , YONG QIANG , ZHOU GUANGHUA , WANG MIAO , SUN JIAYI , ZHAO DONG
Published: July 2011

Previous studies have suggested that self‐reported snoring is associated with atherosclerotic vascular diseases. However, the role of self‐reported snoring as an independent risk factor for subclinical atherosclerosis has not been well established. This study aimed to evaluate whether and to what extent self‐reported snoring is associated with subclinical carotid atherosclerosis after adjusting for traditional cardiovascular risk factors. Carotid intima‐media thickness and plaque were investigated with ultrasonography in 1245 urban Chinese aged 50–79 years between September 2007 and November 2007. Information on self‐reported snoring and measurements of traditional cardiovascular risk factors was also collected. A total of 1050 participants were involved in the final analysis. The prevalence of self‐reported snoring habitually (snoring frequency ≥5 days per week) was 31.5, and 64.3% of the participants in this population had a history of snoring. The mean values of the maximum intima‐media thickness of bifurcation and common carotid arteries in snorers were significantly higher than in non‐snorers (1.08 ± 0.14 mm versus 1.04 ± 0.14 mm, P < 0.001, in carotid bifurcation; 1.03 ± 0.15 mm versus 1.00 ± 0.15 mm, P = 0.002, in common carotid artery). After adjustment for traditional cardiovascular risk factors, logistic regression analysis showed that the odds ratio of self‐reported snoring habitually for increased intima‐media thickness and carotid bifurcation plaque was 1.71 [95% confidence interval (CI): 1.22–2.39; P = 0.002] and 3.63 (95% CI: 2.57–5.12; P < 0.001), respectively. In conclusion, the current study suggested that self‐reported snoring is associated significantly with carotid bifurcation intima‐media thickness and the presence of plaque, independent of traditional cardiovascular risk factors.
Adherence to nucleos(t)ide analogues for chronic hepatitis B in clinical practice and correlation with virological breakthroughs
Authors: Chotiyaputta W. , Hongthanakorn C. , Oberhelman K. , Fontana R. J. , Licari T. , Lok A. S. F.
Published: July 2011

Summary.  Medication adherence is important for the success of nucleos(t)ide analogue (NUC) treatment for chronic hepatitis B. The aims of this study were to determine adherence to NUCs and factors associated with NUC adherence and to correlate NUC adherence with the occurrence of virological breakthroughs in patients with chronic hepatitis B. Consecutive patients with chronic hepatitis B receiving NUC were asked to complete a survey every 3 months. Adherence was also assessed by healthcare providers in the clinic. Adherence rate was defined as the per cent of days the patients took their hepatitis B virus medications during the last 30 days. A total of 111 patients were studied. The mean age was 47.7 years, 73.9% were men, 57.7% were Asian, 42.3% had postgraduate education and 80% had private insurance. Sixty‐nine (74.1%) patients reported 100% adherence in the survey, while 78 (83.9%) reported 100% adherence to their healthcare providers. Patients with 100% adherence based on the survey were older (P = 0.02), more likely to be men (P = 0.006), and had higher annual household income (P = 0.04) than those with <100% adherence. In the 80 patients who completed three surveys, viral breakthrough was observed in 1/46 (2.2%) with 100% adherence on all three surveys, 1/18 (5.6%) with <100% adherence on one survey and 3/16 (18.8%) with <100% adherence on ≥2 surveys, (P = 0.06). In conclusion, adherence to NUC therapy in our patients with chronic hepatitis B was high but self‐reporting of adherence to healthcare providers may be inflated. Patients with chronic hepatitis B with better adherence to NUC therapy had a trend towards a lower rate of viral breakthroughs.
A new family of bacterial condensins
Authors: Petrushenko Zoya M. , She Weifeng , Rybenkov Valentin V.
Published: July 2011

Condensins play a central role in global chromatin organization. In bacteria, two families of condensins have been identified, the MukBEF and SMC–ScpAB complexes. Only one of the two complexes is usually found in a given species, giving rise to a paradigm that a single condensin organizes bacterial chromosomes. Using sequence analysis, we identified a third family of condensins, MksBEF (MukBEF‐like SMC proteins), which is broadly present in diverse bacteria. The proteins appear distantly related to MukBEF, have a similar operon organization and similar predicted secondary structures albeit with notably shorter coiled‐coils. All three subunits of MksBEF exhibit significant sequence variation and can be divided into a series of overlapping subfamilies. MksBEF often coexists with the SMC–ScpAB, MukBEF and, sometimes, other MksBEFs. In Pseudomonas aeruginosa, both SMC and MksB contribute to faithful chromosome partitioning, with their inactivation leading to increased frequencies of anucleate cells. Moreover, MksBEF can complement anucleate cell formation in SMC‐deficient cells. Purified PaMksB showed activities typical for condensins including ATP‐modulated DNA binding and condensation. Notably, DNA binding by MksB is negatively regulated by ATP, which sets it apart from other known SMC proteins. Thus, several specialized condensins might be involved in organization of bacterial chromosomes.
MukBEF on the march: taking over chromosome organization in bacteria?
Authors: Gruber Stephan
Published: July 2011

Smc–ScpAB complexes, also called bacterial condensin, are comprised of highly conserved proteins present in a wide variety of bacteria and archaea. They facilitate bacterial chromosome segregation probably by organizing and/or compacting nascent sister chromosomes. In some γ‐proteobacteria however the Smc–ScpAB complex appears to have been replaced by a different SMC complex, called MukBEF. Petrushenko et al., (2011) now show in this issue of Molecular Microbiology that distantly related homologues of MukBEF, called MksBEF, can be found in the genomes of many more species of bacteria (such as Pseudomonas aeruginosa and Bacillus cereus) that seem to be scattered over the phylogenetic tree. The newly identified MksBEF proteins are organized in operons like MukBEF and occur in combination with Smc–ScpAB and/or MukBEF. Mutations in mksBEF in P. aeruginosa result in the formation of anucleate cells whereas its mild overexpression can suppress the accumulation of anucleate cells in smc null mutants. These findings suggest that MksBEF and Smc–ScpAB share their duties in chromosome partitioning in P. aeruginosa and possibly in other bacteria too. Thus, chromosome organization and segregation in bacteria appear to be governed by up to three distinct condensin complexes, indicating that this process could be much more sophisticated than previously appreciated.
Elucidation of a novel Vibrio cholerae lipid A secondary hydroxy‐acyltransferase and its role in innate immune recognition
Authors: Hankins Jessica V. , Madsen James A. , Giles David K. , Childers Brandon M. , Klose Karl E. , Brodbelt Jennifer S. , Trent M. Stephen
Published: July 2011

Similar to most Gram‐negative bacteria, the outer leaflet of the outer membrane of Vibrio cholerae is comprised of lipopolysaccharide. Previous reports have proposed that V. cholerae serogroups O1 and O139 synthesize structurally different lipid A domains, which anchor lipopolysaccharide within the outer membrane. In the current study, intact lipid A species of V. cholerae O1 and O139 were analysed by mass spectrometry. We demonstrate that V. cholerae serogroups associated with human disease synthesize a similar asymmetrical hexa‐acylated lipid A species, bearing a myristate (C14:0) and 3‐hydroxylaurate (3‐OH C12:0) at the 2′‐ and 3′‐positions respectively. A previous report from our laboratory characterized the V. cholerae LpxL homologue Vc0213, which transfers a C14:0 to the 2′‐position of the glucosamine disaccharide. Our current findings identify V. cholerae Vc0212 as a novel lipid A secondary hydroxy‐acyltransferase, termed LpxN, responsible for transferring the 3‐hydroxylaurate (3‐OH C12:0) to the V. cholerae lipid A domain. Importantly, the presence of a 3‐hydroxyl group on the 3′‐linked secondary acyl chain was found to promote antimicrobial peptide resistance in V. cholerae; however, this functional group was not required for activation of the innate immune response.
Genetic susceptibility to inflammation and colonic transit in lower functional gastrointestinal disorders: preliminary analysis
Authors: Camilleri M. , Carlson P. , McKinzie S. , Zucchelli M. , D’Amato M. , Busciglio I. , Burton D. , Zinsmeister A. R.
Published: July 2011

Background  Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) coexist in some patients. We observed an association between Crohn’s disease (CD) candidate gene TNFSF15 and IBS symptom phenotype. Three genes (TLR9, IL6, and CDH1) have been associated with postinfectious (PI)‐IBS. Our aim was to preliminarily assess association between 30 susceptibility loci for CD, three genes associated with PI‐IBS, and PARM1, with colonic transit in lower functional gastrointestinal disorders (FGID).

Methods  A cohort of 665 persons was assembled in previous studies. TaqMan assay was used for all single nucleotide polymorphisms (SNPs) associated with the loci of interest. Data were analyzed for univariate associations with symptoms phenotype and colonic transit (nominal P values, uncorrected) using dominant and co‐dominant genetic models.

Key Results  Carriers of the rs5743836 risk allele had increased odds for IBS‐D (vs control, P = 0.02, uncorrected). Among the CD risk loci, rs7927894 (P = 0.007), rs7746082 (P = 0.011), rs2872507 (P = 0.014), together with rs5743836 (P = 0.010) were univariately associated with colonic transit at 24 or 48 h. Specific tests for genetic interactions between loci revealed potential association of genes that influence neural, barrier, or mast cell function with colonic transit.

Conclusions & Inferences  Genetic variations that may influence local mucosal immune functions are univariately associated with altered colonic transit in lower FGID.
Plant responses to insect herbivory: interactions between photosynthesis, reactive oxygen species and hormonal signalling pathways
Authors: KERCHEV PAVEL I. , FENTON BRIAN , FOYER CHRISTINE H. , HANCOCK ROBERT D.
Published: July 2011

Under herbivore attack plants mount a defence response characterized by the accumulation of secondary metabolites and inhibitory proteins. Significant changes are observed in the transcriptional profiles of genes encoding enzymes of primary metabolism. Such changes have often been interpreted in terms of a requirement for an increased investment of resources to ‘fuel’ the synthesis of secondary metabolites. While enhanced secondary metabolism undoubtedly exerts an influence on primary metabolism, accumulating evidence suggests that rather than stimulating photosynthesis insect herbivory reduces photosynthetic carbon fixation and this response occurs by a re‐programming of gene expression. Within this context, reactive oxygen species (ROS) and reductant/oxidant (redox) signalling play a central role. Accumulating evidence suggests that ROS signalling pathways are closely interwoven with hormone‐signalling pathways in plant–insect interactions. Here we consider how insect infestation impacts on the stress signalling network through effects on ROS and cellular redox metabolism with particular emphasis on the roles of ROS in the plant responses to phloem‐feeding insects.
Interactions between Fusarium verticillioides and Fusarium graminearum in maize ears and consequences for fungal development and mycotoxin accumulation
Authors: Picot A. , Hourcade‐Marcolla D. , Barreau C. , Pinson‐Gadais L. , Caron D. , Richard‐Forget F. , Lannou C.
Published: July 2011

Fungal interactions of Fusarium verticillioides and F. graminearum in maize ears and the impact on fungal development and toxin accumulation were investigated in a 2‐year field study at two locations in France. Maize ears were inoculated either with a spore mixture of F. graminearum and F. verticillioides or using a sequential inoculation procedure consisting of a first inoculation with F. graminearum followed by a second with F. verticillioides 1 week later. Toxin and fungal biomass were assessed on mature kernels, using HPLC and quantitative PCR. Correlation between the levels of DNA and toxin was high concerning F. graminearum DNA and deoxynivalenol (R² = 0·73) and moderate for F. verticillioides DNA and fumonisin (R² = 0·44). Fusarium graminearum DNA either decreased in mixed inoculations or was not influenced by subsequent inoculations with F. verticillioides, compared to single inoculations. In contrast, F. verticillioides DNA either significantly increased or was not affected in mixed and sequential inoculations. In two of the replicates, it can be assumed that natural contamination by F. verticillioides was favoured by previous contamination with F. graminearum. Overall, the results suggest that F. verticillioides has competitive advantages over the F. graminearum strains. Additionally, the data provide, for the first time, key evidence that previous contamination by F. graminearum in maize ears can facilitate subsequent infections by F. verticillioides.
The glutaredoxin ATGRXS13 is required to facilitate Botrytis cinerea infection of Arabidopsis thaliana plants
Authors: La Camera Sylvain , L’Haridon Floriane , Astier Jérémy , Zander Mark , Abou‐Mansour Eliane , Page Gonzague , Thurow Corinna , Wendehenne David , Gatz Christiane , Métraux Jean‐Pierre , Lamotte Olivier
Published: July 2011

Botrytis cinerea is a major pre‐ and post‐harvest necrotrophic pathogen with a broad host range that causes substantial crop losses. The plant hormone jasmonic acid (JA) is involved in the basal resistance against this fungus. Despite basal resistance, virulent strains of B. cinerea can cause disease on Arabidopsis thaliana and virulent pathogens can interfere with the metabolism of the host in a way to facilitate infection of the plant. However, plant genes that are required by the pathogen for infection remain poorly described. To find such genes, we have compared the changes in gene expression induced in A. thaliana by JA with those induced after B. cinerea using genome‐wide microarrays. We have identified genes that are repressed by JA but that are induced by B. cinerea. In this study, we describe one candidate gene, ATGRXS13, that encodes for a putative glutaredoxin and that exhibits such a crossed expression. In plants that are infected by this necrotrophic fungus, ATGRXS13 expression was negatively controlled by JA and TGA transcription factors but also through a JA‐salicylic acid (SA) cross‐talk mechanism as B. cinerea induced SA production that positively controlled ATGRXS13 expression. Furthermore, plants impaired in ATGRXS13 exhibited resistance to B. cinerea. Finally, we present a model whereby B. cinerea takes advantage of defence signalling pathways of the plant to help the colonization of its host.
Comparing federal and state healthcare provider performance in villages targeted by the conditional cash transfer programme of Mexico
Authors: Bustamante Arturo Vargas
Published: July 2011

Objective  This study investigates household out‐of‐pocket healthcare expenditures (OPH) and preventive care utilization (PHU) to compare federal and state healthcare provider performance in villages targeted by conditional cash transfer (CCT) programmes in poor rural areas of Mexico.

Methods  Lower OPH and higher PHU are indicative of better performance in the study setting. Log‐linear and probit regression models were used to compare outcomes in households from treatment and control villages reached by federal and state healthcare providers. In treatment villages, eligible households receive cash grants from the CCT programme. In control villages, eligible households do not receive cash grants from the CCT programme at the time of the survey.

Results  Families who live in treatment villages reported lower OPH (−52.5% for federal and −46.2% for state clinics) and higher PHU (21% for federal and 20% for state clinics) regardless of clinic setting. As the reduction in OPH is higher in areas reached by the federal clinics, it implies better performance from this healthcare delivery system. Additionally, federal clinic outcomes were also more homogeneous because OPH are not significantly different between treatment and control villages. Alternative measures such as drug and physician expenditures, diabetes and hypertension tests and nutritional‐supplement receipt confirmed these findings.

Conclusions  Mexico has two healthcare delivery systems that cater to identical rural populations. The better‐funded and more centralized federal system is more effective at providing health care in poor rural villages of Mexico regardless of CCT participation. State clinics in villages targeted by the CCT programme, however, perform significantly better.
Quantifying the effect of drought on carbon dioxide‐induced changes in competition between a C3 crop (tomato) and a C4 weed (Amaranthus retroflexus)
Authors: VALERIO M , TOMECEK M B , LOVELLI S , ZISKA L H
Published: July 2011

Valerio M, Tomecek MB, Lovelli S & Ziska LH (2011). Quantifying the effect of drought on carbon dioxide‐induced changes in competition between a C3 crop (tomato) and a C4 weed (Amaranthus retroflexus). Weed Research51, 591–600.

Recent and projected increases in atmospheric carbon dioxide concentration ([CO2]) and subsequent effects on climate are likely to alter competitive outcomes of weeds and crops. Rising [CO2] per se could increase the competitive ability of C3 crops relative to C4 weeds. However, such an outcome may depend on other climatic variables. In this study, tomato, a C3 crop species, was grown from emergence to anthesis using replacement series mixtures with Amaranthus retroflexus, a C4 weed species at three different [CO2], 400, 600 and 800 μmol mol−1, with and without water stress. Under well‐watered conditions, leaf photosynthetic rates and plant height, leaf area and biomass all increased with elevated [CO2] for tomato relative to A. retroflexus, consistent with the kinetics of C3 photosynthesis. However, if water was limiting, a significant positive effect of [CO2] was noted for plant height and biomass of A. retroflexus with increased competition. This result may be related to a greater increase in leaf water potential with rising [CO2] for A. retroflexus relative to tomato under water stress. Overall, these are the first data to suggest that increases in atmospheric CO2 could still exacerbate crop losses from a C4 weed, even with a C3 crop, if drought occurs.
Sex education during the school‐aged years influences sexual attitudes and sexual health in college: A comparative study from Korea
Authors: Shin Kyung Rim , Park Hyojung , Cha Chiyoung
Published: July 2011

Sex education is provided routinely to school‐aged children in many countries without enough evidence that it will benefit them when they become adults. The purpose of this study was to examine the long‐term influence of the sex education that was provided during the school‐aged years on the attitudes, behaviors, and sexual health among male and female college students in Korea. For this descriptive, comparative study, the data were obtained from 3609 male and 2180 female college students by using the proportional quota sampling method. Overall, the female students had more opportunities for sex education. Receiving this education during the school‐aged years lowered the sexual double standard score but was not related to sexual activity among the male and female students. Receiving sex education at different time points during the school‐aged years had differential influences on the sexual attitudes and indicators of sexual health between the male and the female students. The results of this study suggest extending the role of school nurses to include redesigning the content of sex education programs, based on the sex and age of the students, and using midwives to provide sex education in community settings.
COMPARISON OF ADJUVANT THERAPIES BY AN H2‐RECEPTOR ANTAGONIST AND A PROTON PUMP INHIBITOR AFTER ENDOSCOPIC TREATMENT IN HEMOSTATIC MANAGEMENT OF BLEEDING GASTRODUODENAL ULCERS
Authors: SAKURADA TOMOYA , KAWASHIMA JUNICHI , ARIYAMA SHIGEKAZU , KANI KAZUHITO , TAKABAYASHI HIDEHIKO , OHNO SHINO , KATO SHINGO , YAKABI KOJI
Published: July 2011

Aim:  Upper gastrointestinal bleeding is often associated with a higher risk of serious blood loss. Both H2‐receptor antagonists and proton pump inhibitors are commonly given intravenously for endoscopic hemostatic therapies. We compared the effects of a H2‐receptor antagonist (famotidine) and a proton pump inhibitor (omeprazole) injected during the early phase (the first 3 days) on cessation of bleeding and prevention of its recurrence in patients who underwent endoscopic therapy for gastroduodenal ulcer bleeding.

Methods:  Consecutive patients who were hospitalized at our clinic with bleeding gastroduodenal ulcers and underwent endoscopic therapy were randomly assigned to receive injections of famotidine, omeprazole, or both. Injection of acid suppressants was switched on the fourth day to the oral administration of omeprazole continued for 8 weeks.

Results:  Over a 25‐month period, 116 patients were enrolled. The overall success rate for endoscopic hemostasis was 115/116 (99.1%). The success rate of hemostasis and prevention of recurrent ulcer bleeding by type of acid suppressant following endoscopic hemostasis was 39/40 (97.5%) for Group 1 (3‐day omeprazole administration), 35/37 (94.6%) for Group 2 (3‐day famotidine administration), and 38/39 (97.4%) for Group 3 (1‐day famotidine and then 2‐day omeprazole administration), yielding an overall rate of 112/116 (96.6%). No significant difference in the hemostatic effect was observed among the groups. There were also no differences in the duration of hospital days and the number of fasting days between the three groups.

Conclusion:  Famotidine and omeprazole injected during the early phase of a bleeding ulcer may have similar effects to an adjuvant therapy for preventing rebleeding from endoscopically treated upper gastrointestinal bleeding in Japanese patients.
CLINICOPATHOLOGICAL CHARACTERISTICS OF ABNORMAL MICRO‐LESIONS AT THE ORO‐HYPOPHARYNX DETECTED BY A MAGNIFYING NARROW BAND IMAGING SYSTEM
Authors: TANAKA SHINWA , MORITA YOSHINORI , FUJITA TSUYOSHI , YOKOZAKI HIROSHI , OBATA DAISUKE , FUJIWARA SHOKO , WAKAHARA CHIKA , MASUDA ATSUHIRO , SUGIMOTO MAKI , SANUKI TSUYOSHI , YOSHIDA MASARU , TOYONAGA TAKASHI , KUTSUMI HIROMU , AZUMA TAKESHI
Published: July 2011

Background:  Narrow band imaging (NBI) with magnifying endoscopy (NBI‐ME) allows the detection of abnormal micro‐lesions smaller than 5 mm in diameter in the oro‐hypopharynx that could not be visualized previously. The purpose of the present study was to clarify the clinicopathological characteristics of abnormal micro‐lesions of the oro‐hypopharynx detected by NBI‐ME

Methods:  Of the 62 lesions detected by NBI‐ME, 40 abnormal micro‐lesions in 37 patients were removed by endoscopic treatment and were pathologically evaluated. We reviewed the medical records of patients with these lesions and investigated the relationship between NBI‐ME findings and pathological findings.

Results:  Pathological examination revealed the following: high‐grade intraepithelial neoplasia (HGIN) in nine (23%) lesions, low‐grade intraepithelial neoplasia (LGIN) in 22 (55%), pharyngitis in seven (18%) and papilloma in two (5%). Two NBI‐ME findings, high microvascular density (MVD) and a brownish area (BA), were recognized more frequently as the grade of malignancy advanced. The likelihood ratio (confidential interval) for having HGIN in the patients with both MVD and BA was 13 (3.62–127).

Conclusions:  The pathological diagnosis of abnormal micro‐lesions ranged from pharyngitis to HGIN. High MVD and BA may be important findings for grading the malignancy of abnormal micro‐lesions.
PROSPECTIVE SINGLE‐ARM TRIAL OF TWO‐WEEK RABEPRAZOLE TREATMENT FOR ULCER HEALING AFTER GASTRIC ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: NIIMI KEIKO , FUJISHIRO MITSUHIRO , GOTO OSAMU , KODASHIMA SHINYA , MINATSUKI CHIHIRO , HIRAYAMA ITSUKO , MOCHIZUKI SATOSHI , ONO SATOSHI , YAMAMICHI NOBUTAKE , KAKUSHIMA NAOMI , ICHINOSE MASAO , KOIKE KAZUHIKO
Published: July 2011

Aim:  Endoscopic submucosal dissection (ESD) causes artificial ulcers, and there is no consensus regarding the degree of healing in ESD‐induced ulcers or the optimal duration of proton pump inhibitor (PPI) treatment. The aim of the present study was to investigate the healing rates of post‐ESD ulcers in response to the protective effect of 2‐week PPI treatment.

Methods:  Between February 2007 and March 2010, 75 patients/75 lesions and 55 patients/55 lesions were enrolled as interim and per‐protocol groups, respectively. All patients were prescribed rabeprazole (10 mg/day) orally for 16 days beginning on the day before ESD. Follow‐up endoscopy was carried out 8 weeks after ESD to evaluate ulcer healing. The primary end‐point was the healing rate of post‐ESD ulcers at 8 weeks after ESD. Secondary end‐points were the rate of post‐ESD bleeding with emergency endoscopy and the rate of other severe adverse effects during the study period.

Results:  The transitional rate to scarring‐stage ulcers was 80.0% (44/55). Location in the lesser curve and large resected size (>40 mm) were statistically significant predictors for delayed ulcer healing by univariate analysis and the latter was still significant by the multivariate analysis. Post‐ESD bleeding occurred within 2 weeks in two cases (2.7%), but both cases were successfully managed with endoscopic hemostasis only. Severe adverse effects did not occur.

Conclusions:  Two‐week administration of PPI for post‐ESD gastric ulcers may be sufficient to aid healing without increasing any adverse effects in cases where there are no possible deteriorating factors on ulcer healing, although large resection and/or resection in the lesser curve may result in delayed healing even after 8 weeks of ESD.
Linné’s floral clock is slow without pollinators – flower closure and plant‐pollinator interaction webs
Authors: Fründ Jochen , Dormann Carsten F. , Tscharntke Teja
Published: July 2011

Ecology Letters (2011) 14: 896–904

Temporal patterns of flower opening and closure within a day are known as Linné’s floral clock. Time of flower closure has been explained mainly by light in the traditional botanical literature. We show with a set of experiments that Asteraceae flower heads can close within three hours after pollination, whereas un‐pollinated flower heads stay open until the late afternoon. This suggests that closing time strongly depends on pollinators. Using plant‐pollinator interaction webs we further demonstrate that the daily pattern of flower opening and the rapid response to pollination can impose strong temporal dynamics on interspecific interactions within a single day. We observed pollinator species turnover and changes in facilitation vs. competition among plants. Our results show for the first time that pollination induces rapid flower closure on the community level. This causes imprecision in Linné’s floral clock with far‐reaching consequences for plant‐pollinator interactions.
Temperature dependence of the functional response
Authors: Englund Göran , Öhlund Gunnar , Hein Catherine L. , Diehl Sebastian
Published: July 2011

Ecology letters (2011) 14: 914–921

The Arrhenius equation has emerged as the favoured model for describing the temperature dependence of consumption in predator–prey models. To examine the relevance of this equation, we undertook a meta‐analysis of published relationships between functional response parameters and temperature. We show that, when plotted in lin‐log space, temperature dependence of both attack rate and maximal ingestion rate exhibits a hump‐shaped relationship and not a linear one as predicted by the Arrhenius equation. The relationship remains significantly downward concave even when data from temperatures above the peak of the hump are discarded. Temperature dependence is stronger for attack rate than for maximal ingestion rate, but the thermal optima are not different. We conclude that the use of the Arrhenius equation to describe consumption in predator–prey models requires the assumption that temperatures above thermal optima are unimportant for population and community dynamics, an assumption that is untenable given the available data.
Ovarian folliculogenesis in the southern sea lion Otaria flavescens
Authors: Palma‐Cerda Francisco , Di Fiore Maria Maddalena , Sepúlveda Maritza , Duran Luis Rene , Raucci Franca
Published: July 2011

Palma‐Cerda, F., Di Fiore, M.M., Sepúlveda, M., Duran L.R. and Raucci, F. 2011. Ovarian folliculogenesis in the southern sea lion Otaria flavescens. —Acta Zoologica (Stockholm) 93: 444–452.

In Otaria flavescens, folliculogenesis occurs within ovary cortex. This process attains successively higher level of organization through cell proliferation and differentiation. Here, we identified eight major follicular stages from I to VIII, plus corpus luteum and corpus albicans. Otaria folliculogenesis is divided into (1) primordial follicle recruitment; (2) pre‐antral follicle development; (3) growth of antral follicle; and (4) follicle atresia. The primordial follicle is surrounded by thin and flat granulosa cells. As recruitment occurs, granulosa cells organize into cuboidal monolayer marking the transition into pre‐antral phase. Pre‐antral phase (from stage I to stage V) is characterized by follicular growth and theca layer formation. The typical feature of the antral phase (from stage V to pre‐ovulatory Graafian follicle or stage VIII) is the formation of a fluid‐filled cavity (antrum) within the follicle. In the Graafian preovulatory follicle, theca cells organize two distinguishable layers surrounding the follicle. In gravid females, the corpus luteum persists. In nongravid females, the corpus luteum transforms into corpus albicans. The corpus albicans is formed by granulosa, thecal cells, and invading blood tissue. Our results provide a detailed histological description of follicular development in O. flavescens and add new knowledge to the reproductive biology of this species.
The use of estramustine phosphate in the modern management of advanced prostate cancer
Authors: Ravery Vincent , Fizazi Karim , Oudard Stephane , Drouet Ludovic , Eymard Jean‐Christophe , Culine Stephane , Gravis Gwenaelle , Hennequin Christophe , Zerbib Marc
Published: July 2011

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

Estramustine phosphate has anti‐tumour properties and it improves patient outcomes if combined with other chemotherapy agents such as doeetaxel.

The efficacy of estramustine phosphate in selected patients and its safety profile, provided used with any low‐molecular‐weight heparin support its use as a second‐line treatment in hormone‐resistant prostate cancer.

OBJECTIVES

Estramustine phosphate is a nitrogen mustard derivative of estradiol‐17β‐phosphate and has anti‐tumour properties.

Interest in estramustine has been renewed because of the results of clinical studies showing improved patient outcomes if estramustine is combined with other chemotherapy agents such as docetaxel.

PATIENTS AND METHODS

Relevant clinical studies using chemotherapy combinations including estramustine are discussed.

Efficacy and safety outcomes are summarized.

RESULTS

Combination therapy with estramustine and docetaxel can increase PSA response rates, improve quality of life and increase median patient survival compared with chemotherapy regimens that do not include estramustine.

Although the overall tolerability of estramustine is favourable, its use can be associated with an increased risk of thromboembolic events.

CONCLUSIONS

The identification of suitable patient groups and the effective management of the risk of thromboembolism with the adjunct of low‐molecular‐weight heparins support the use of estramustine as an effective second‐line treatment strategy in hormone‐resistant prostate cancer.

These promising findings warrant further investigation in a randomized clinical trial.
GermlineBRCAmutation does not prevent response to taxane‐based therapy for the treatment of castration‐resistant prostate cancer
Authors: Gallagher David J. , Cronin Angel M. , Milowsky Matthew I. , Morris Michael J. , Bhatia Jasmine , Scardino Peter T. , Eastham James A. , Offit Kenneth , Robson Mark E.
Published: July 2011

Study Type – Prognosis (case series)

Level of Evidence 4

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

In the preclinical setting BRCA mutations appear to modulate response to chemotherapy, increasing sensitivity to platinums and increasing resistance to taxanes. Clinical data supports a greater platinum sensitivity among BRCA mutation carriers. This study suggests that BRCA mutation carriers may also respond to taxanes.

OBJECTIVE

• To investigate the relationship betweenBRCAmutation status and response to taxane‐based chemotherapy, sinceBRCAmutation carriers with prostate cancer appear to have worse survival than non‐carriers and docetaxel improves survival in patients with castration‐resistant prostate cancer.

PATIENTS AND METHODS

• We determinedBRCAmutation prevalence in 158 Ashkenazi Jewish (AJ) men with castration‐resistant prostate cancer. Clinical data were collected as part of an institutional prostate cancer research database and through additional medical record review.

• Clinical records and DNA samples were linked through a unique identifier, anonymizing the samples before genetic testing for the AJBRCA1/2founder mutations.

• Response to taxane‐based therapy was defined by the prostate‐specific antigen nadir within 12 weeks of therapy.

RESULTS

• In all, 88 men received taxane‐based treatment, seven of whom wereBRCAcarriers (threeBRCA1, fourBRCA2; 8%). Initial response to taxane was available for all sevenBRCAcarriers and for 69 non‐carriers.

• Overall, 71% (54/76) of patients responded to treatment, with no significant difference between carriers (57%) and non‐carriers (72%) (absolute difference 15%; 95% confidence interval –23% to 53%;P= 0.4).

• Among patients with an initial response, the median change in prostate‐specific antigen was similar forBRCAcarriers (−63%, interquartile range −71% to −57%) and non‐carriers (−60%, interquartile range −78% to −35%) (P= 0.6).

• At last follow‐up, all sevenBRCAcarriers and 49 non‐carriers had died from prostate cancer. OneBRCA2carrier treated with docetaxel plus platinum survived 37 months.

CONCLUSION

• In this small, hypothesis‐generating study approximately half ofBRCAcarriers had a prostate‐specific antigen response to taxane‐based chemotherapy, suggesting that it is an active therapy in these individuals.