bluuebunny/crossref_metadata_2025 huggingface dataset:
Does greater leaf‐level photosynthesis explain the larger solar energy conversion efficiency of Miscanthus relative to switchgrass?
Authors: DOHLEMAN F. G. , HEATON E. A. , LEAKEY A. D. B. , LONG S. P.
Published: June 2009

C4 perennial grasses are being considered for bioenergy because of their high productivity and low inputs. In side‐by‐side replicated trials, Miscanthus (Miscanthus x giganteus) has previously been found more than twice as productive as switchgrass (Panicum virgatum). The hypothesis that this difference is attributable to higher leaf photosynthetic rates was tested on established plots of switchgrass and Miscanthus in central Illinois with >3300 individual measurements on 20 dates across the 2005 and 2006 growing seasons. Seasonally integrated leaf‐level photosynthesis was 33% higher in Miscanthus than switchgrass (P < 0.0001). This increase in carbon assimilation comes at the expense of additional transpiration since stomatal conductance was on average 25% higher in Miscanthus (P < 0.0001). Whole‐chain electron transport rate, measured simultaneously by modulated chlorophyll fluorescence, was similarly 23% higher in Miscanthus (P < 0.0001). Efficiencies of light energy transduction into whole chain photosynthetic electron transport, leaf nitrogen use and leaf water use were all significantly higher in Miscanthus. These may all contribute to its higher photosynthetic rates, and in turn, productivity. Systematic measurement of photosynthesis over two complete growing seasons in the field provides a unique dataset explaining why the productivity of these two species differs and for validating mechanistic production models for these emerging bioenergy crops.
Moderate heat stress reduces the pH component of the transthylakoid proton motive force in light‐adapted, intact tobacco leaves
Authors: ZHANG RU , CRUZ JEFFREY A. , KRAMER DAVID M. , MAGALLANES‐LUNDBACK MARIA E. , DELLAPENNA DEAN , SHARKEY THOMAS D.
Published: June 2009

We measured the ΔΨ and ΔpH components of the transthylakoid proton motive force (pmf) in light‐adapted, intact tobacco leaves in response to moderate heat. The ΔΨ causes an electrochromic shift (ECS) in carotenoid absorbance spectra. The light–dark difference spectrum has a peak at 518 nm and the two components of the pmf were separated by following the ECS for 25 s after turning the light off. The ECS signal was deconvoluted by subtracting the effects of zeaxanthin formation (peak at 505 nm) and the qE‐related absorbance changes (peak at 535 nm) from a signal measured at 520 nm. Heat reduced ΔpH while ΔΨ slightly increased. Elevated temperature accelerated ECS decay kinetics likely reflecting heat‐induced increases in proton conductance and ion movement. Energy‐dependent quenching (qE) was reduced by heat. However, the reduction of qE was less than expected given the loss of ΔpH. Zeaxanthin did not increase with heat in light‐adapted leaves but it was higher than would be predicted given the reduced ΔpH found at high temperature. The results indicate that moderate heat stress can have very large effects on thylakoid reactions.
Myzus persicae (green peach aphid) salivary components induce defence responses in Arabidopsis thaliana
Authors: DE VOS MARTIN , JANDER GEORG
Published: June 2009

Myzus persicae (green peach aphid) feeding on Arabidopsis thaliana induces a defence response, quantified as reduced aphid progeny production, in infested leaves but not in other parts of the plant. Similarly, infiltration of aphid saliva into Arabidopsis leaves causes only a local increase in aphid resistance. Further characterization of the defence‐eliciting salivary components indicates that Arabidopsis recognizes a proteinaceous elicitor with a size between 3 and 10 kD. Genetic analysis using well‐characterized Arabidopsis mutants shows that saliva‐induced resistance against M. persicae is independent of the known defence signalling pathways involving salicylic acid, jasmonate and ethylene. Among 78 Arabidopsis genes that were induced by aphid saliva infiltration, 52 had been identified previously as aphid‐induced, but few are responsive to the well‐known plant defence signalling molecules salicylic acid and jasmonate. Quantitative PCR analyses confirm expression of saliva‐induced genes. In particular, expression of a set of O‐methyltransferases, which may be involved in the synthesis of aphid‐repellent glucosinolates, was significantly up‐regulated by both M. persicae feeding and treatment with aphid saliva. However, this did not correlate with increased production of 4‐methoxyindol‐3‐ylmethylglucosinolate, suggesting that aphid salivary components trigger an Arabidopsis defence response that is independent of this aphid‐deterrent glucosinolate.
In vitro assessment of red‐cell concentrates in SAG‐M filtered through the MacoPharma™ P‐CAPT prion‐reduction filter
Authors: Murphy C. V. , Eakins E. , Fagan J. , Croxon H. , Murphy W. G.
Published: June 2009

summary.

This study investigated whether filtration of leucodepleted red cells in SAG‐M through the P‐CAPT™ filter in order to prevent the potential risk of vCJD infection associated with prion transmission through transfusion has any deleterious effect on red‐cell quality. Bottom‐and‐top SAG‐M leucodepleted red‐cell concentrates (24 units) were prion‐reduction filtered on the day following collection, with half of the units undergoing irradiation on day 14. A control group (12 units) was not prion filtered. Units were sampled at 7‐day intervals up to day 35 and tested using standard measures of red‐cell quality as well as prothrombin content (to examine prion filter efficacy). Haemoglobin loss per unit was ∼9 g and in some cases levels were below standard specification (40 g). Haemolysis increased significantly after filtration [0.01 (0.00‐0.05) vs. 0.23 (0.07‐0.52, p<0.001)]. Prothrombin levels were reduced 41.6‐fold compared to leucodepleted red‐cell units. Product specifications were within or close to routine acceptable levels. Owing to the reduction in haemoglobin levels below those specified, it may be preferable to reduce haemoglobin specification levels and transfuse more prion‐filtered units rather than transfuse potentially unsafe blood product. The risk of transfusing more units with less haemoglobin should be offset against the risk of transfusing unfiltered blood.
Changes in transfusion practice in multiple injury between 1993 and 2006: a retrospective analysis on 5389 patients from the German Trauma Registry
Authors: Maegele Marc , Lefering Rolf , Paffrath Thomas , Simanski Christian , Wutzler Sebastian , Bouillon Bertil ,   the Working Group on Polytrauma of the German Trauma Society (DGU)
Published: June 2009

summary.

To evaluate transfusion practices in multiple injured patients and to demonstrate changes in the pattern of packed red blood cell (pRBC) transfusions over the last one‐and‐half decade (1993–2006). A retrospective analysis using the German Trauma Registry database (DGU‐Traumaregister) including 29 353 multiple injured patients was conducted. The study population included primary admissions presenting to the emergency room (ER) with clinical and laboratory signs of active haemorrhage [haemoglobin < 9 g × dL−1, platelets < 90000 ×μL−1 and prothrombin time (Quick‐value) < 60%]. The pattern of pRBC transfusions was followed from ER to intensive care unit (ICU) admission. A total of 5389 patients with complete data sets were divided into the following three groups according to the year of treatment and analysed: (a) group 1: 1993–1998 (n = 870), (b) group 2: 1999–2002 (n = 2044) and (c) group 3: 2003–2006 (n = 2475). Patients had a mean age of 40.5 (±20) years and were predominantly male (67.2%). All patients were substantially injured (mean injury severity score = 32 ± 15.5) and in 93% the mechanism of injury was blunt. The percentage of patients who received pRBC transfusions between ER and ICU dropped from 72% in 1993–1998 to 54% in 2003–2006 (P < 0.005). Similarly, the percentage of patients receiving mass transfusions (> 10 pRBC units) dropped from 51.3 to 17.1%. This decline was accompanied by lower incidence rates for septic complications, ventilator days, ICU length‐of‐stay and mortality. pRBC transfusion practices in acute trauma care have changed substantially over the last one‐and‐half decade and were associated with better outcome.
False‐positive reactions of some monoclonal anti‐c reagents
Authors: Strobel E. , Bauer M. F.
Published: June 2009

summary.

Cross‐reactivities of monoclonal reagents for red blood cell (RBC) typing are seen very rarely, e.g. in some reagents for testing of ABO or Lewis antigens. We report on two patients in whom we observed weak reactions using a monoclonal anti‐c reagent containing clone MS35, but no reactions with anti‐c reagents containing other monoclonal or polyclonal antibodies. To resolve this discrepancy, we studied RHCE exon 1 (Ex1) and 2 from genomic DNA of one patient and performed quality controls of the false‐positive reacting anti‐c reagent. RHCE Ex1 showed no abnormalities as well as RH Ex2 examined with primers specific for Ex2 D/C. No amplification product of RH Ex2 was received with primers specific for c. A titration study with untreated, papain‐treated and sialidase‐treated adult and newborn RBCs showed anti‐i reactivity of the false‐positive reacting reagent. This reactivity could not be removed by absorption with c‐negative newborn RBCs without reducing the anti‐c titre in the same way, indicating a cross‐reactivity. Some manufacturers give a remark on a possible cold agglutinin activity of their monoclonal anti‐c reagents in the instruction leaflet, but in order to avoid such irritation, we recommend to remove this cross‐reactivity by dilution during the manufacturing process.
Assessment of physicians knowledge in transfusion medicine, Iran, 2007
Authors: Gharehbaghian A. , Javadzadeh Shahshahani H. , Attar M. , Rahbari Bonab M. , Mehran M. , Tabrizi Namini M.
Published: June 2009

summary.

Knowledge of physicians has an important role in optimal use of blood products. This study was carried out to assess Iranian physicians' knowledge in transfusion medicine. In this cross‐sectional study, 1242 physicians were selected through multistage sampling method in March 2007. Physicians' knowledge was assessed by the questionnaire comprising of 50 questions addressing basic knowledge, clinical aspects of blood use and transfusion reactions. One point was awarded for each correct answer. Approximately 22%, 37%, and 40% of the questions referring to basic knowledge, clinical aspects of blood use and transfusion reactions, respectively, were replied correctly. Thirty three percent came out to be the average figure for the questions receiving correct answers. Knowledge score of the specialists who were more frequently involved in blood use was not significantly different from other specialists (radiologists or psychiatrics) and general practitioners. Knowledge score decreased with increasing years in practice (P < 0.001). Ninety nine percent of physicians under the study believed that they required special education to raise their transfusion medicine knowledge. Knowledge of physicians was about one‐third lower than the expected level. Therefore, educational materials concerning transfusion medicine should be provided for medical students, residents and fellows. For practicing physicians, continuous medical education programmes should be offered so that the level of transfusion medicine knowledge can be improved.
Patient perspectives on health advice posted on Internet discussion boards: a qualitative study
Authors: Armstrong Natalie , Powell John
Published: June 2009

Background  Use of the Internet for health information by patients is growing, and there have been diverse responses to this both within the research community and the medical and health‐related professions. The use of Internet discussion boards are one way that people living with long‐term conditions can interact with their peers and offer and seek advice, support and information. We report patient perspectives on using a discussion board within a wider pilot study of an Internet‐based self‐management system for diabetes.

Design  Qualitative data was gathered during three stages of developing and piloting the wider self‐management system. These are: (1) patient focus groups as part of a stakeholder consultation; (2) a pre‐test session and focus group; and 3. a 6‐month pilot study including follow‐up individual interviews.

Results  Three main themes were identified within participants’ perspectives on Internet discussion boards. First, a focus on the importance and value of peer support to these patients. Secondly, participants’ awareness of the need to evaluate the information posted by others in light of their own circumstances. Thirdly, the value placed upon the experiential knowledge of others living with the same condition.

Conclusions  Many people living with long‐term conditions would like to be in contact with their peers, and Internet discussion boards represent a cost‐effective and interactive way of achieving this. Within the context of diabetes, the knowledge and expertise accumulated over many years of self‐management is central to participants’ self‐reported ability to evaluate information posted and make decisions on its possible use.
Cow’s milk allergy related pediatric constipation: Appropriate time of milk tolerance
Authors: El‐Hodhod M. A. , Younis N. T. , Zaitoun Y. A. , Daoud S. D.
Published: June 2009

El‐Hodhod MA, Younis NT, Zaitoun YA, Daoud SD. Cow’s milk allergy related pediatric constipation: Appropriate time of milk tolerance. Pediatr Allergy Immunol 2010: 21: e407–e412. © 2009 John Wiley & Sons A/S

Cow’s milk allergy (CMA) has different clinical presentations according to age. The study aimed to evaluate the extent of CMA as a cause of pediatric constipation and determine the appropriate timing of tolerance to cow milk in such patients. The study included 60 patients suffering from chronic functional constipation, 27 of whom did not respond to 2 month laxative therapy (group I). Thirty age and sex matched apparently healthy infants and children were studied as a control group (group II). Serum specific IgE to cow milk proteins was measured. Withdrawal of cow milk and dairy products for a 1 month period was then followed by cow milk re‐challenge over 2 wk. Patients were classified into: responders to this schedule (cow milk allergic = group Ia; n = 21) and non‐responders (non‐cow milk allergic = group Ib; n = 6). Eighteen CMA patients continued the study where nine of them underwent milk reinstitution after 6 months and another nine patients after 12 months of elimination. The frequency of CMA among constipated patients was 77.7%. Mean values of serum specific IgE to whole cow milk protein and β‐lactoglobulins were significantly higher in constipated patients (0.82 ± 0.08, 0.79 ± 0.13 IU/ml, respectively) compared with controls (0.26 ± 0.14, 0.27 ± 0.14 IU/ml, respectively) and in group Ia (0.99 ± 0.08, 0.95 ± 0.14 IU/ml, respectively) compared with group Ib (0.39 ± 0.06, 0.37 ± 0.10 IU/ml, respectively). Serum specific IgE was positive in 85.7% of CMA group, predominantly in class 2. Tolerance to cow milk was achieved after 6 months in only 22.2% compared with 88.8% after 12 months of elimination. In conclusion, CMA is shown to be a significant etiologic factor for constipation in infants and young children. Serum levels of IgE to cow milk proteins are helpful although not definitive for diagnosis. Based on this limited study, tolerance is better achieved after 12 months of strict cow’s milk elimination.
Mortality in pediatric renal transplantation: A study of the French pediatric kidney database
Authors: Allain‐Launay E. , Roussey‐Kesler G. , Ranchin B. , Guest G. , Maisin A. , Novo R. , André J. L. , Cloarec S. , Guyot C.
Published: June 2009

Abstract:  Objective and Methods:  To assess patient survival in pediatric renal transplantation, we retrospectively reviewed 573 transplants in 553 patients, registered from 1995 to 2005.

Results:  Mean age at transplantation was 9.9 years. Patient survival at 1, 5 and 10 years was respectively 99%, 97% and 96%. Death occurred at a median time of 2.6 years after transplantation. Long‐term patient survival was significantly lower in recipients younger than 5 years old. Seventeen patients (3.1%) died. Two deaths occurred while under maintenance dialysis. Among the remaining patients, the two main causes of death were infections (33%) and malignancies (27%). Interestingly, initial disease‐related complications were a major cause of death (34%).

Conclusion:  A low mortality rate was observed, with the majority of deaths due to malignancies and infections, and with a notable participation of complications related to the initial disease. No impact of cardiovascular disease was noted with the given follow‐up period. Improvements in managing immunosuppression may contribute to reducing mortality in pediatric renal transplantation.
Comparison of fibrin glue with sutures for pterygium excision surgery with conjunctival autografts
Authors: Hall Reece C , Logan Andrew J , Wells Anthony P
Published: June 2009

Abstract

Purpose:  To compare pterygium excision conjunctival autograft surgery using Tisseel fibrin glue versus Vicryl sutures.

Method:  Prospective randomized clinical trial. Fifty patients were randomized into either sutured graft or glued graft groups. Twenty‐five received standard conjunctival autograft sutured with Vicryl and 25 received surgery with the autograft placed with Tisseel fibrin glue. Outcome measures include surgical time, patient discomfort, pathology, complications and recurrence rates at 3, 6 and 12 months. Patients were followed up at days 1, 7, 14, 30, 90, 180 and 365.

Results:  The mean surgical time for the glue group was significantly shorter at 12 min compared with the suture group at 26 min (P < 0.001). Postoperative pain was significantly less at day 1 (P < 0.001) and day 2 (P < 0.05) but was not significantly different following these visits. Complications in the glue group included one patient with an absent graft at week 1 that required revision of the graft. At 3 months there were no recurrences in the glue group and two recurrences in the suture group. The 6‐ and 12‐month recurrence rate was unchanged and not significantly different between the glue and suture groups (both 0/24 and 2/23, respectively).

Conclusion:  Both glued and sutured conjunctival autografting procedures are safe and effective methods for pterygium surgery. The glued autograft recurrence rate at 12 months was similar to that of sutured grafts. Conjunctival autograft with fibrin glue in pterygium surgery decreased surgical time and resulted in less postoperative pain in the first 48 hours but had a higher complication rate.
Performance and consistency of care in admitted trauma patients: our next great opportunity in trauma care?
Authors: Chua Wei Chong , D'Amours Scott K. , Sugrue Michael , Caldwell Erica , Brown Katherine
Published: June 2009

Few studies have prospectively analysed the delivery of care in trauma patients. This study undertook a prospective analysis of performance and consistency of care at a Level 1 trauma centre.

A 3‐month prospective study was undertaken of all admitted trauma patients at Liverpool Hospital. Data were collected on patient demographics, mechanism of injury, injury severity score (ISS), length of hospital stay, patient outcome and cause of death. Delivery of care was evaluated using 30 performance indicators and assessment of errors.

Two hundred and thirty‐six consecutive major trauma patients were studied. 73.3% were male, mean age 39 years. The main mechanism of injury was road trauma in 46.2%. Mean ISS was 12 and 64 patients had an ISS ≥16. Error‐free care was delivered in 145/236 (61.4%). There were 145 errors in 91 patients (38.6%). Errors in judgement and delays in diagnosis accounted for 56/145 (38.6%) and 48/145 (33.1%), respectively. Errors occurred most commonly in the Emergency Department (ED) (48.3%), and trainees from all specialties were responsible for 67.5% of errors. There were 25 near misses detected. Three patients developed major sequelae or complications from errors. One of 13 deaths was deemed potentially preventable.

This study has shown that while 61.4% of admitted trauma patients receive optimal care, errors are frequent, resulting in a spectrum of outcomes from near misses to death. The majority of errors result from the activity of unsupervised trainees and relate to errors in judgement and delays in diagnosis. Clearly, there is room for improvement of the delivery of trauma care.
Soluble Human Leukocyte Antigen class I antigen and interleukin‐12 in hepatectomized patients
Authors: Shimura Tatsuo , Morinaga Nobuhiro , Suzuki Hideki , Araki Kenichiro , Kobayashi Tsutomu , Ishizaki Masatoshi , Kuwano Hiroyuki
Published: June 2009

Background:  Interleukin‐12 (IL‐12) has been shown to enhance the cytotoxic activity of NK cells and CTL. IL‐12 also acts as a growth factor for activated NK, T and NKT cells. The soluble HLA class I (sHLA‐I) has been reported to bind a killer‐cell inhibitory receptor, which is expressed on the NK cell, and its signals inhibit NK cell‐mediated cytotoxicity. Effects of fresh frozen plasma (FFP) on post‐operative immune status have not yet been completely examined.

Methods:  Thirty consecutive patients taking a hepatectomy were enrolled. The levels of IL‐12 and sHLA‐I were examined by enzyme‐linked immunosorbent assay.

Results:  The rate of complication after hepatectomy in the FFP‐administered patients was higher than that in patients without FFP administration (P= 0.0358). Decreased IL‐12 levels after surgery in patients without FFP administration recovered to the preoperative state earlier than those in patients with FFP administration (P < 0.05). The levels of sHLA‐I in the FFP‐administered patients were higher than those in the patients without FFP administration (P < 0.05).

Conclusions:  Administration of FFP, which contains sHLA‐I, affected the levels of sHLA‐I after hepatectomy. Both high levels of sHLA‐I and low levels of IL‐12 could attenuate NK activities after hepatectomy, especially when FFP would be administered.
Background luminance affects the detection of microampere currents delivered to macaque striate cortex
Authors: Tehovnik Edward J. , Slocum Warren M.
Published: June 2009

Monkeys detect electrical microstimulation delivered to the striate cortex (area V1). We examined whether the ability of monkeys to detect such stimulation is affected by background luminance. While remaining fixated on a spot of light centered on a monitor, a monkey was required to detect a 100 ms train of electrical stimulation delivered to a site within area V1 situated from 1 to 1.5 mm below the cortical surface. A monkey signaled the delivery of stimulation by depressing a lever after which it was rewarded with a drop of apple juice. Control trials were interleaved during which time no stimulation was delivered and the monkey was rewarded for not depressing the lever. Biphasic pulses were delivered at 200 Hz and the current ranged from 2 to 30 μA using 0.2 ms anode‐first biphasic pulses. The background luminance level of the monitor could be varied from 0.005 to 148 cd/m2. It was found that, for monitor luminance levels below 10 cd/m2, the current threshold to evoke a detection response increased. We discuss the significance of this result with regard to phosphenes elicited from human V1 and in relation to visual perception.
A common molecular basis for membrane docking and functional priming of synaptic vesicles
Authors: Siksou Léa , Varoqueaux Frédérique , Pascual Olivier , Triller Antoine , Brose Nils , Marty Serge
Published: June 2009

Soluble N‐ethylmaleimide‐sensitive factor attachment protein receptor (SNARE) complexes execute synaptic vesicle (SV) fusion. Vesicle fusion is preceded by an obligatory Munc13‐dependent priming process that conveys fusion competence to SVs by facilitating SNARE complex assembly. Ultrastructural studies after chemical fixation indicated that vesicle docking to the plasma membrane is independent of Munc13s but these results may be misleading because aldehyde fixatives modify the localization of SVs with respect to the plasma membrane. To reinvestigate the role of Munc13s in vesicle docking, cultured hippocampal slices were immobilized using high‐pressure freezing, which circumvents aldehyde artifacts. High‐pressure freezing was combined with electron tomography to reach a resolution that allows the characterization of details of SV docking in a close‐to‐native state. In control slices, docked vesicles are not hemifused with the plasma membrane but linked to it and to dense material at the active zone by small strands. In slice cultures from Munc13‐deficient mice, vesicles are not docked to the active zone plasma membrane. These results indicate that SV docking at the plasma membrane and functional priming are respective morphological and physiological manifestations of the same molecular process mediated by SNARE complexes and Munc13s.
Data sharing for pharmacokinetic studies
Authors: ANDERSON BRIAN J. , MERRY ALAN F.
Published: June 2009

Pooling data from different pediatric studies can provide a single robust pharmacokinetic analysis that allows covariate analysis and hypothesis testing. Data sharing should be driven by the altruistic purpose of improving drug understanding to the clinical benefit of children. Electronic communications have rendered the sharing of data relatively easy, and data sharing within the wider scientific community has become commonplace. Data sharing allows verification of results, save costs and time, allows new interpretation of old data, and can fulfill teaching benefits. It may stimulate cooperative competition between researchers and allow individual researchers to concentrate on unique aspects of the scientific puzzle. However, there is occasionally a reluctance to share, in part because of fear of others stealing the hard work of a research group, which may not be recognized in subsequent publications that reuse data. Providing data may require additional effort for presentation in a suitable format. Data may be abused or used for purposes other than those for which they were collected. Propriety claims may limit access to industry‐sponsored drug research. The question of who has ownership of data is contentious. Investigators often consider data they have collected to be their own property. Reputations and grants may be hinge on ownership of a data set. However, other team members, institutions, funding agencies, and the public also have a stake. The difficulties identified in the general scientific community also apply to data sharing for pediatric pharmacokinetic studies. There are few clearly established rules at present, and consideration of the issues hinges on ethical and philosophical arguments. The development of databases will depend on collaboration and cooperation and greater clarity and consensus over appropriate processes and procedures.
Anesthesia and perioperative medical management of children with spinal muscular atrophy
Authors: GRAHAM ROBERT J. , ATHIRAMAN UMESHKUMAR , LAUBACH ANJOLIE E. , SETHNA NAVIL F.
Published: June 2009

Objective:  To describe the perioperative medical care, anesthetic considerations, and the risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA).

Methods:  There is a retrospective chart review carried out at an urban, tertiary care pediatric hospital. All patients with ICD‐9 codes corresponding to SMA diagnoses were identified, and records screened for anesthetic and perioperative medical management. Medical records were reviewed for demographic, clinical, and outcome data.

Main results:  Twenty‐five children with SMA (10 type I, 8 type II, 7 type III) accounted for 56 general and regional anesthetic cases. Twenty‐one (38%) cases had preexisting ventilator dependence. Total intravenous anesthesia with nitrous oxide was provided in 14 (25%) cases, balanced anesthesia with inhalational agents and epidural or systemic opioids were used in 41 (84%) cases, and one infant received a spinal anesthesia. Intraoperative and postoperative complications occurred in 2 (4%) and 2 (4%) cases respectively. One case required an unplanned postanesthetic intensive care unit admission, and there were two late deaths with redirection of care.

Conclusions:  Perioperative care can be provided for children with SMA safely and effectively with total intravenous or inhaled anesthetics along with the judicious use of opioids to improve patient comfort without increased morbidity. Further prospective studies of standardized anesthetic and perioperative respiratory medical management in this population are required to minimize the decompensation of tenuous preoperative respiratory function.
Anesthetic management of a neonate with type IV laryngotracheo‐esophageal cleft
Authors: TAGAWA TSUYOSHI , OKUDA MASAHIRO , SAKURABA SHIGEKI
Published: June 2009

Laryngotracheo‐esophageal cleft is a rare congenital anomaly that occurs when the trachea and esophagus fail to separate during fetal development. Clinical severity varies greatly in anatomic cleft extent. We report the successful management of the airway of a neonate with type IV laryngotracheo‐esophageal cleft for the gastric division surgery by dividing the esophagogastric continuity between the esophageal orifice and the stomach using the balloon catheter and remaining spontaneous breathing through the large cuffed tracheal tube inserted into the esophageal orifice.
Metagenomic analysis of viruses in reclaimed water
Authors: Rosario Karyna , Nilsson Christina , Lim Yan Wei , Ruan Yijun , Breitbart Mya
Published: June 2009

Reclaimed water use is an important component of sustainable water resource management. However, there are concerns regarding pathogen transport through this alternative water supply. This study characterized the viral community found in reclaimed water and compared it with viruses in potable water. Reclaimed water contained 1000‐fold more virus‐like particles than potable water, having approximately 108 VLPs per millilitre. Metagenomic analyses revealed that most of the viruses in both reclaimed and potable water were novel. Bacteriophages dominated the DNA viral community in both reclaimed and potable water, but reclaimed water had a distinct phage community based on phage family distributions and host representation within each family. Eukaryotic viruses similar to plant pathogens and invertebrate picornaviruses dominated RNA metagenomic libraries. Established human pathogens were not detected in reclaimed water viral metagenomes, which contained a wealth of novel single‐stranded DNA and RNA viruses related to plant, animal and insect viruses. Therefore, reclaimed water may play a role in the dissemination of highly stable viruses. Information regarding viruses present in reclaimed water but not in potable water can be used to identify new bioindicators of water quality. Future studies will need to investigate the infectivity and host range of these viruses to evaluate the impacts of reclaimed water use on human and ecosystem health.
Nodulation of Sesbania species by Rhizobium (Agrobacterium) strain IRBG74 and other rhizobia
Authors: Cummings Stephen P. , Gyaneshwar Prasad , Vinuesa Pablo , Farruggia Frank T. , Andrews Mitchell , Humphry David , Elliott Geoffrey N. , Nelson Andrew , Orr Caroline , Pettitt Deborah , Shah Gopit R. , Santos Scott R. , Krishnan Hari B. , Odee David , Moreira Fatima M. S. , Sprent Janet I. , Young J. Peter W. , James Euan K.
Published: June 2009

Concatenated sequence analysis with 16S rRNA, rpoB and fusA genes identified a bacterial strain (IRBG74) isolated from root nodules of the aquatic legume Sesbania cannabina as a close relative of the plant pathogen Rhizobium radiobacter (syn. Agrobacterium tumefaciens). However, DNA:DNA hybridization with R. radiobacter, R. rubi, R. vitis and R. huautlense gave only 44%, 5%, 8% and 8% similarity respectively, suggesting that IRBG74 is potentially a new species. Additionally, it contained no vir genes and lacked tumour‐forming ability, but harboured a sym‐plasmid containing nifH and nodA genes similar to those in other Sesbania symbionts. Indeed, IRBG74 effectively nodulated S. cannabina and seven other Sesbania spp. that nodulate with Ensifer (Sinorhizobium)/Rhizobium strains with similar nodA genes to IRBG74, but not species that nodulate with Azorhizobium or Mesorhizobium. Light and electron microscopy revealed that IRBG74 infected Sesbania spp. via lateral root junctions under flooded conditions, but via root hairs under non‐flooded conditions. Thus, IRBG74 is the first confirmed legume‐nodulating symbiont from the Rhizobium (Agrobacterium) clade. Cross‐inoculation studies with various Sesbania symbionts showed that S. cannabina could form fully effective symbioses with strains in the genera Rhizobium and Ensifer, only ineffective ones with Azorhizobium strains, and either partially effective (Mesorhizobium huakii) or ineffective (Mesorhizobium plurifarium) symbioses with Mesorhizobium. These data are discussed in terms of the molecular phylogeny of Sesbania and its symbionts.
Complete clinical response to neoadjuvant chemoradiotherapy in patients with rectal cancer: opinions of British and Irish specialists
Authors: Wynn G. R. , Bhasin N. , Macklin C. P. , George M. L.
Published: June 2009

Introduction  Advances in neoadjuvant treatment have highlighted the phenomenon of complete clinical response (CCR) in a proportion of patients with rectal cancer. Radical surgery may be associated with a poor functional outcome and quality of life and has a small but significant risk of mortality. This study aimed to assess opinion of colorectal surgeons on issues surrounding the question of nonoperative management in patients who demonstrate complete response after neoadjuvant therapy.

Method  A questionnaire was sent to members of the Association of Coloproctology of Great Britain and Ireland regarding investigations, clinical management, pathological assessment and oncological outcome in rectal cancer patients with a complete response to neoadjuvant chemoradiotherapy.

Results  A total of 122 consultants responded (26% response rate). Most surgeons (58%) would not consider conservative management of patients with a complete response and even more (69%) expressed that they would never discuss nonoperative management in patients with rectal cancer who are fit for curative surgery. Over 70 different combinations of investigations and imaging modalities were suggested to define a CCR. Eighty‐six per cent of consultants felt that a pathology report stating no evidence of residual adenocarcinoma did not rule out the presence of tumour cells and all respondents estimated the percentage of patients with pathological complete response as < 20%.

Conclusions  No consensus exists as to what defines a complete response and at present there is resistance to offering nonoperative management in selected patients. With improvements in neoadjuvant treatment modalities, it will be increasingly important to consider nonoperative management in the future.
Meta‐analysis of the colon J‐Pouch vs transverse coloplasty pouch after anterior resection for rectal cancer
Authors: Liao C. , Gao F. , Cao Y. , Tan A. , Li X. , Wu D.
Published: June 2009

Purpose  To evaluate the outcome of colonic J‐pouches (CJP) and transverse colonic pouches (TCPs) after anterior resection for rectal cancer.

Method  Trials were located through Medline, Embase, the Cochrane Central Register of Controlled Trials, VIP and CNKI. Main end‐points included functional outcomes, postoperative complications and anorectal physiological outcomes.

Results  Of 120 articles, 34 compared CJP and TCP. Of these only six were randomized controlled trials (RCT), which fulfilled the inclusion criteria. These six included 648 patients, including 326 in the CJP group and 322 in the TCP group. There were no differences in the incidences of anastomotic leak [odds ratio 0.50, 95% confidence interval (CI) 0.21–1.18], chest infection (0.43, 0.09–2.00), wound infection (0.87, 0.33–2.30), anastomotic stricture (1.30, 0.44–3.84), fistula (0.64, 0.18–2.31).There were no difference in functional outcomes such as stool frequency [weighted mean difference (WMD) of −0.01, −0.30–0.27 at 6 months].There was no difference for anorectal physiology but heterogeneity existed: resting pressure (0.39, −1.76 to 2.55; 3.09, −0.04 to 6.23; 4.15, 2.21–6.094, at preoperation, 6 and 12 months,); squeeze pressure (−15.02, −46.14 to 16.10; −15.04, −37.04 to 6.97;0.83, −7.70 to 9.37 at preoperation, 6 and 12 months);(Neo)rectal threshold volume(8.49, 5.18–11.81; 27.13, −5.08 to 59.35, at preoperation and 6 months); Maximal (neo) rectal volume (−14.05, −36.60 to 8.50; 23.37, 2.65–44.09; −0.54, −0.91 to −0.18, at preoperation, 6 and at 12 months).

Conclusions  Transverse colonic pouch has similar results as CJP. As it is a safe, feasible, simple, technically easy and time‐saving surgical procedure, TCP is a good candidate for wider clinical application.
The endoscopic spectrum of segmental colitis associated with diverticulosis
Authors: Tursi A. , Elisei W. , Brandimarte G. , Giorgetti G. M. , Lecca P. G. , Di Cesare L. , Inchingolo C. D. , Aiello F.
Published: June 2009

Objective  An endoscopic classification of ‘Segmental colitis associated with diverticulosis’ (SCAD) is lacking. Our aim was therefore to assess the endoscopic spectrum of SCAD, comparing it with the histological and clinical features.

Method  A prospective study was performed from January 2004 to October 2007. Diagnosis of SCAD was made on the basis of specific endoscopic and histological patterns.

Results  A total of 6230 consecutive colonoscopies were performed during the study period. SCAD was diagnosed in 92 (1.48%) patients, with four endoscopic patterns: pattern A, ‘crescentic fold disease’ (52.20%); pattern B, ‘Mild‐to moderate ulcerative colitis‐like’ pattern (30.40%); pattern C, ‘Crohn’s disease colitis‐like’ pattern (10.90%); pattern D, ‘Severe ulcerative colitis‐like’ pattern (6.50%).

Most patients with patterns A (58.33%, P < 0.018) and B (89.29%, P < 0.00001) showed histological alterations resembling moderate ulcerative colitis (UC). In pattern C, larger histological variability was found (P < 0.01). All patients showing pattern D showed the typical histological alteration changes of severe UC (P < 0.0001).

In pattern A (60.42%, P = n.s.) and pattern B (46.43%, P = n.s.), diarrhoea was the most common symptom whilst abdominal pain was the most frequent in pattern C (50%, P = n.s.) and pattern D (83.33%, P = n.s.) patients.

Conclusions  Endoscopic patterns of SCAD may range from mild to severe inflammation. The histopathological findings but not clinical features showed a statistically significant association with the degree of endoscopic severity.
Effect of Resource Allocation Policies on Urban Transport Diversity
Authors: Feng Cheng‐Min , Hsieh Cheng‐Hsien
Published: June 2009

Abstract:  Maximizing transport diversity is critical to the equitable achievement of stakeholder needs. Resource allocation policies help planners decide when and how to invest transportation infrastructure and services. However, policies for improving transport diversity are difficult to design, implement, and quantify because of the uncertainty, feedback interaction, and complexity of system relationships. This study proposes a hybrid model integrating system dynamics, cognitive maps, and a sensitivity model to tackle the problems. The model application is illustrated through an empirical study to enhance the managerial implications in the Taipei metropolitan area.
6. Effects of Exposure on Prevalence and Cumulative Relative Risk: Direct and Indirect Effects in a Recursive Hazard Model
Authors: Wu Lawrence L. , Martin Steven P.
Published: June 2009

This paper outlines decomposition methods for assessing how exposure affects prevalence and cumulative relative risk. Let x denote a vector of exogenous covariates and suppose that a single dimension of time t governs two event processes T1 and T2. If the occurrence of the event T1 determines entry into the risk of the event T2, then subgroup variation in T1 will affect the prevalence T2, even if subgroups in the population are otherwise identical. Although researchers often acknowledge this phenomenon, the literature has not provided procedures to assess the magnitude of an exposure effect of T1 on the prevalence of T2. We derive decompositions that assess how variation in exposure generated by direct and indirect effects of the covariates x affect measures of absolute and relative prevalence of T2. We employ a parametric but highly flexible specification for baseline hazard for the T1 and T2 processes and use the resulting parametric proportional hazard model to illustrate the direct and indirect effects of family structure when T1 is age at first sexual intercourse and T2 is age at a premarital first birth for data on a cohort of non-hispanic white U.S. women.
Nāgārjuna and the Tathāgatagarbha: A Closer Look at Some Peculiar Features in the Niraupamyastava
Authors: MITRIKESKI DRASKO
Published: June 2009

This article examines several verses from the Niraupamyastava, where Nāgārjuna makes explicit references to the non‐empty aspects of the doctrine of emptiness—a topic systematized and crystallized in the doctrine of Tathāgatagarbha, thought to have appeared later than his date and to have been unknown to him.

Establishing the authenticity of the hymn, in addition to the criteria utilized by Lindtner, the article analyses the style and the relationship of the text with texts belonging to other schools, thus locating Nāgārjuna in his historical and temporal context. The article also brings into focus the overlooked or marginalized topics present in Nāgārjuna's texts such as the practice of devotion and visualization of the Buddha as method for realizing emptiness.
Using Skilful Means Skilfully: The Buddhist Doctrine of Upāya and Its Methodological Implications*
Authors: MCGARRITY ANDREW
Published: June 2009

This article concerns itself with the Buddhist doctrine of upāya (“skilful means”). Rather than provide a historical analysis of the concept, this paper first of all outlines some of the presuppositions that affect both its working in a traditional Buddhist context and its interpretation in modern academic enquiry. It is argued that these contexts differ significantly and that they lead to quite different understandings of the role and function of the concept itself. Then, through reference to the Tibetan dGe lugs pa tradition and the background of Tibetan doxography, it is suggested that there are certain dangers in over‐emphasizing the concept of upāya in isolation. Most notably, if the doctrine of upāya is simplistically posited as some sort of aphilosophical praxis against rational enquiry, then there is a danger of not taking the tradition's own scholastic endeavours seriously enough and downplaying the status of rational enquiry in the tradition itself.
New Perspectives on the English Reformation
Authors: CAPERN AMANDA L.
Published: June 2009

The historiography of the English Reformation has been driven by several key themes for three or four decades: the chronology of religious change and the success or failure of Protestantism to establish itself, the position of Puritanism vis‐à‐vis Church conformity, the role of Arminianism (anti‐Calvinism) in doctrinal and ecclesiological debates and its impact on ecclesiastical politics and, more latterly, the continuities of ideas and beliefs between medieval Catholicism and Reformation Protestantism. This survey article on six new books in the field of Reformation studies argues that while the current historiography is generating very exciting work on the religious mentalité of early‐modern English people and the transmission of ideas across the Catholic‐Protestant divide, as well as generating a thriving debate on Calvinist consensus (or not) and the rise of Arminianism (or not), there are further rich seams to mine that incorporate gender into the analysis and that add the Atlantic World perspective to that of the European context for Reformation.
Europeanization and Institutional Change in Vocational Education and Training in Austria and Germany
Authors: TRAMPUSCH CHRISTINE
Published: June 2009

This article analyzes how the EU's vocational education and training (VET) policy is reflected in domestic reforms in Germany and Austria. It perceives Europeanization as a heuristic concept to disentangle a twofold process of institutional change: The first process, the “Europeanized” arena of change, concerns change initiated by the reactions of domestic actors to EU initiatives; the second process of change—the “domestic” arena of change—concerns the ongoing incremental endogenous change in domestic institutions beneath and independent from the Europeanized arena of institutional change. This procedure allows us to differentiate between two modes of Europeanization: In Germany, Europeanization occurs as reform policies and politics; in Austria, Europeanization occurs more as institutional change by default, hence without strategically enacted reform initiatives shaped by the EU and as domestic institutional change that occurs anyway. The article combines the case‐oriented method of difference with process tracing.
To the Short‐Sighted Victor Belong the Spoils: Politics and Merit Adoption in Comparative Perspective
Authors: LAPUENTE VICTOR , NISTOTSKAYA MARINA
Published: June 2009

This article addresses a persistent puzzle in social science: Why do some rulers adopt merit systems, refusing to enjoy the spoils of their victories? Dominant explanations underscore the importance of interactions among core constituencies of voters, legislators, and executives in a democratic polity but cannot explain the adoption of merit in autocracies and are not corroborated empirically outside Anglo‐Saxon democracies. Based on insights from repeated game theory, this article proposes a simple theoretical explanation that focuses on the future discount rate of rulers—democratic or not—and their interactions with economic agents. An empirical test covering both cross‐country variations among 35 developing nations and within‐country differences among 39 Russian regions is undertaken to test the theory. Controlling for factors from prevailing theories, it is found that rulers' longtime horizons proved to be positively associated with the adoption of merit in both empirical settings tested.
Immunocryosurgery for basal cell carcinoma: results of a pilot, prospective, open‐label study of cryosurgery during continued imiquimod application
Authors: Gaitanis G , Nomikos K , Vava E , Alexopoulos EC , Bassukas ID
Published: June 2009

Background/aim  Theoretical considerations support the combination of cryosurgery and topical imiquimod to treat basal cell carcinomas (BCC). The aim of the present study was to test the feasibility and efficacy of ‘cryosurgery during continued imiquimod application’ (‘immunocryosurgery’) to treat ‘high‐risk‐for‐recurrence’ BCCs.

Methods  Thirteen patients with 21 biopsy‐proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N2 cryosurgery (spray, two cycles, 10–20 s) and imiquimod was continued for additional 2–12 weeks (median, 4). The outcome after at least 18 months of follow‐up (18–24 months) is currently reported.

Results  Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow‐up (cumulative efficacy: 95%).

Conclusions  ‘Immunocryosurgery’ is a promising non‐surgical combination modality to treat ‘high‐risk‐for‐recurrence BCCs’. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results.