bluuebunny/crossref_metadata_2025 huggingface dataset:
Do heart failure specialist nurses think differently when faced with ‘hard’ or ‘easy’ decisions: a judgement analysis
Authors: Thompson Carl , Spilsbury Karen , Dowding Dawn , Pattenden Jill , Brownlow Ros
Published: July 2008

Aims. To unpack specialist heart failure nurses’ decision‐making and explore whether viewing a decision as ‘hard’ or ‘easier’ is associated with different decision‐making characteristics.

Background. Specialist heart failure nurses exemplify modern nursing roles. They face diagnostic, prognostic and treatment uncertainties of varying degrees of complexity in the choices they face. Nurses’ cognitive handling of complexity is largely unknown.

Design. Judgement analysis survey.

Methods. Judgement analysis with 29 nurses and two judgement tasks was undertaken. A drug titration decision (classed as ‘easier’ by nurses) was compared with a ‘harder’ palliative care referral choice. Measures of agreement between the nurses, the linearity and non‐linearity in information processing by nurses and the degree of cognitive control exercised by them were explored. Differences between nurses with varying degrees of education were explored using pairedt‐testing. The relationship between experience and key measures was explored using bivariate correlations.

Results. Nurses varied in their judgements and the weighting afforded to information. Self‐reported decision difficulty was less important for cognitive handling of information and agreement between nurses than we predicted. Nurses had high degrees of cognitive control in the drug task and far less in the palliative referral condition. However, there was no change in the linear or non‐linear processing of information of the two tasks. Education and clinical experience were not related to agreement or information processing.

Conclusions. Nurses’ self‐reported difficulty in decisions should not be relied upon as valid indicators of decisional complexity. The title ‘specialist nurse’ should not be assumed to equate by default with clinical expertise. Thinking in a more sophisticated way about the relationship between experience, uncertainty, decision structure and information available may help nurses make better choices.

Relevance to clinical practice. Teaching nurses about what makes for hard and difficult decisions and increasing awareness of the decisions they make may lead to better quality choices. Practice developers should pay attention to the quality of clinical experience as well as the quantity when considering decision‐making expertise.
Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses
Authors: Garrett Bernard , Klein Gerri
Published: July 2008

Aims and objectives.  The aims were to explore advanced practice nurses’ perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice.

Background.  The wireless Personal Digital Assistant is becoming established as a hand‐held computing tool for healthcare professionals. The reflections of advanced practice nurses’ about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated.

Design.  A qualitative interpretivist design was used to explore advanced practice nurses’ perceptions on the value of wireless Personal Digital Assistant technologies to support their practice.

Methods.  The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open‐coding content analysis was performed using qualitative data analysis software.

Results.  Wireless Personal Digital Assistant’s use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice.

Conclusions.  Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless communications.

Relevance to clinical practice.  Nurses in this study support integrating wireless mobile computing technologies into their practice to improve client care.
A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication
Authors: Finke Erinn H , Light Janice , Kitko Lisa
Published: July 2008

Aims and objectives.  To systematically review the research regarding communication between nurses and patients with complex communication needs (CCN). The research was reviewed with respect to the following themes: (a) the importance of communication; (b) the barriers to effective communication; (c) the supports needed for effective communication; and (d) recommendations for improving the effectiveness of communication between nurses and patients with CCN. Augmentative and alternative communication (AAC) strategies that can be used by nurses to facilitate more effective communication with patients with CCN are discussed.

Background.  Effective nurse‐patient communication is critical to efficient care provision. Difficulties in communication between nurses and patients arise when patients are unable to speak. This problem is further complicated because nurses typically receive little or no training in how to use AAC to communicate with patients with CCN.

Design.  Systematic review.

Method.  This paper reviewed the published research focusing on the perspectives of nurses, patients with CCN and their caregivers regarding the challenges to effective communication between nurses and patients with CCN. Further, specific strategies (i.e., using AAC) that nurses can use to improve and facilitate communication with patients with CCN are provided.

Conclusions.  Communication between nurses and patients is critical to providing and receiving quality care. Nurses and patients have reported concern and frustration when communication is not adequate. Using AAC strategies will help nurses and patients better communicate with each other when speech is not an option.

Relevance to clinical practice.  Communication with all patients is very important to the provision of quality nursing care. Communication cannot always be achieved using the speech modality. Nurses need to have tools and skills that will allow them to communicate with all of their patients whether or not they can speak.
An observational study of health professionals’ use of evidence to inform the development of clinical management tools
Authors: Hutchinson Alison M , Johnston Linda
Published: July 2008

Aim.  This observational study sought to investigate the process of evidence use by health professionals during development of evidence‐based clinical management tools.

Background.  Studies conducted to explore the process of research use are scarce and knowledge of this process is essential for our understanding of the influences on research use in practice.

Design.  A qualitative, non‐participant, observational design.

Methods.  Behaviour and actions of two separate multidisciplinary teams were observed and audio‐recorded during a combined total of seven meetings for the development of clinical management tools. Semi‐structured, one‐to‐one interviews were conducted approximately half‐way through the development process and following completion of the clinical management tools.

Results.  Three major themes emerged from this research. First, the process of clinical management tool development and evidence use. Nurses assumed responsibility for coordination of development which focused on describing current practice. Second, the forms of evidence employed during the development process included the use of experiential knowledge, opinions and knowledge of the context, in addition to research evidence. However, reference to research evidence was limited and its incorporation into the instrument was infrequently observed. Third, the use of research evidence emerged with respect to how such evidence was employed.

Conclusion.  This study focused on real‐life discussion and decision‐making that occurred between health professionals when developing evidence‐based clinical management tools. Health professionals may have a tendency to rely on their professional experience and current practice in preference to seeking and applying relevant research evidence.

Relevance to clinical practice.  Nurses have an important role to play in the development of multidisciplinary evidence‐based clinical management tools, but to actively participate in this process they need to be familiar with the relevant research evidence and have the skills and confidence to integrate the evidence into practice.
Regional variation in the neurochemical coding of the myenteric plexus of the human colon and changes in patients with slow transit constipation
Authors: Wattchow D. , Brookes S. , Murphy E. , Carbone S. , De Fontgalland D. , Costa M.
Published: July 2008

Abstract  There are differences in the structure and function between regions of the colon. In patients with slow transit constipation the activity of all regions is markedly slowed. Counts of colonic neurones in slow transit constipation have been semiquantitative and led to varying results. We have applied new methods of quantification of markers in whole mounts of the colonic myenteric plexus to compare density of innervation between regions and between normal patients and those undergoing resection for severe constipation. Whole mounts of colonic myenteric plexus were made from specimens removed for cancer treatment (controls) and cases of severe constipation. All neurones were labelled by anti‐human neuronal protein antibodies. Neurones synthesizing acetyl choline were labelled for choline acetyltransferase (ChAT) and those for nitric oxide by antisera to nitric oxide synthase (NOS). Four populations of neurones were distinguished and quantified according to the two selective markers, ChAT and NOS. In the normal major populations were NOS alone (51% of ascending colon neurones and 44% of descending colon neurones) and ChAT alone (41% ascending colon, 48% descending colon). Nitric oxide synthase/ChAT and NOS‐/ChAT‐comprised only small populations. In all regions in severe constipation, the percentage of NOS‐only colonic myenteric neurones was raised (54% ascending colon, 49% descending colon) and ChAT only was reduced (36% ascending colon, 42% descending colon). The other populations were not changed. Accurate quantification of neuronal populations in whole mounts of human colon reveals inter‐regional differences in innervation and marked changes in innervation in cases of very severe constipation.
Oesophageal peristaltic transition zone defects: real but few and far between
Authors: Ghosh S. K. , Pandolfino J. E. , Kwiatek M. A. , Kahrilas P. J.
Published: July 2008

Abstract  This study analysed the association between oesophageal transition zone (TZ) defects [characterized by a delay and/or spatial gap between the terminus of the proximal oesophageal (striated muscle) contraction and the initiation of the distal oesophageal (smooth muscle) contraction] and dysphagia in a large patient cohort. Four hundred consecutive patients (178 with dysphagia) and 75 controls were studied with 36‐channel high‐resolution manometry (HRM). The resultant pressure topography plots were first analysed for impaired oesophagogastric junction (OGJ) relaxation, distal segment contractile abnormalities, and proximal contractile abnormalities using normal values from the 75 controls. If these aspects of oesophageal motility were deemed normal, the TZ was characterized by length and duration between the proximal and distal contractions using a 20 mmHg isobaric contour to establish the segment boundaries. Patients were then classified according to whether or not they exhibited TZ defects (spatial separation or delay) and the occurrence of unexplained dysphagia. Of the 400 patients, 267 were suitable for TZ analysis and of these 55 had a spatial or temporal TZ measurement exceeding the 95th percentile of the controls (2 cm, 1 s). Exactly 34.6% of the patients (n = 19) with spatial and/or temporal TZ defects had unexplained dysphagia, which was significantly more than seen with normal TZ dimensions (19.8%). Although far less common than distal peristaltic or OGJ abnormailites, TZ defects may be related to dysphagia in a minority of patients (<4% in this series) and should be considered a distinct oesophageal motility disorder.
Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases
Authors: Morita Ken , Iwami Daiki , Hotta Kiyohiko , Shimoda Naohiko , Miura Masayoshi , Watarai Yoshihiko , Hoshii Sakurako , Obikane Katsuyuki , Nakashima Taiji , Sasaki Satoshi , Nonomura Katsuya
Published: July 2008

Abstract:  The aim of the current study was to evaluate long‐term outcomes of pediatric live kidney transplantation in patients with genitourinary anomalies relative to those with primary kidney diseases. The study included 35 pediatric patients who received a live kidney transplantation during the last 25 yr (28 males, six females). Median age at the time of transplantation was nine yr (range 1–15 yr), and the median follow‐up period was 151 months (range 6–239 month). The patients were divided into two groups. The urological group (n = 14) included patients with primary obstructive/reflux nephropathy. The renal group (n = 20) included patients with primary renal disorders. Differences between groups in graft survival, clinical course, and final graft function were evaluated. Original diseases represented in the urological group included five cases with primary VUR and eight cases with secondary VUR. Diseases in the renal group included eight cases with bilateral hypo‐dysplastic kidney, three cases with focal/segmental glomerular sclerosis, two cases with membranous proliferative glomerulonephritis, two cases with congenital nephrotic syndrome and five cases with other forms of chronic nephritis. Ten of 14 cases in the urological group, relative to six of 20 in the renal group, were preemptive. Median age at transplantation was 7.5 or 10 yr old, respectively, in the urological or renal group. Twelve kidney recipients in the urological group had also undergone other urinary surgeries, including upper urinary tract drainage, ureteroneocystostomy, augmentation cystoplasty, endoscopic incision of posterior‐urethral valve, urethroplasty, etc. Cumulative post‐operative complications occurred in nine or 16, respectively, in the urological or renal group. The acute rejection free and overall graft survival were similar in both groups. One patient in the urological group lost his graft while six patients in the renal group lost their grafts. Thus, the post‐transplant clinical outcome of pediatric transplantation in patients with urological anomalies is comparable to that of recipients with primary renal disease. Appropriate urinary tract reconstruction and management is essential to reduce the risk of graft dysfunction because of urinary problems.
Sterility screening of platelet concentrates: questioning the optimal test strategy
Authors: Dreier J. , Störmer M. , Pichl L. , Schottstedt V. , Grolle A. , Bux J. , Kleesiek K.
Published: July 2008

Background  Routine bacterial monitoring of apheresis platelet concentrates (APC) and pooled platelet concentrates (PPC) was introduced in two German blood services using culture and real‐time reverse transcriptase (RT)‐polymerase chain reaction (PCR). The results of testing are reviewed and used to discuss different strategies for detection of bacterial contamination of PCs.

Study Design and Methods  Two thousand three hundred and sixty‐two APCs and 1993 PPCs have been tested by real‐time RT‐PCR and the BacT/Alert automated culturing system using aerobic and anaerobic culture bottles. After standard processing of PCs and storage of 22–24 h at 20–24°C with agitation, samples were taken under aseptic conditions. Reactive culture bottles were confirmed as positive and bacterial isolates were identified by 16S rRNA analysis and biochemical tests.

Results  Seventeen of 2362 tested APCs were reactive in culture and one also in RT‐PCR. Of these, 13 APCs were identified as initially positive as Staphylococcus warneri (n = 1, positive in aerobic and anaerobic culture), Propionibacterium acnes (n = 12, positive only in anaerobic culture) and four were initially reactive. Two of 1993 PPCs were initially reactive (anaerobic) and two more were confirmed positive (anaerobic) from a repeat culture and identified as P. acnes. All remaining specimens were tested negative.

Conclusion  Our study demonstrates that the predominant organisms implicated in platelet bacterial contamination are part of the human skin flora. Inoculating blood culture systems and anaerobic cultivation detects these bacteria after approximately 3–7 days when blood products have been transfused. Based on the presented data different screening strategies are discussed.
Impact of Verticillium longisporum on Yield and Morphology of Winter Oilseed Rape (Brassica napus) in Relation to Systemic Spread in the Plant
Authors: Dunker S. , Keunecke H. , Steinbach P. , Von Tiedemann A.
Published: July 2008

The impact of Verticillium longisporum on single plant and whole plot yield of oilseed rape (OSR) was studied in field experiments with natural infection or artificial soil infestation. Disease incidence (DI) and disease severity (DS) correlated with the amount of inoculum provided at four different levels by addition of infested rapeseed straw to the soil. DI and DS were higher in 2003, a year with higher average soil and air temperatures, than in 2004, at similar levels of added inoculum. Maximum DI and DS levels achieved with artificial soil infestation were 54.3% and 0.57 (rating scale from 0 to 2), respectively, which was insufficient to induce significant yield reduction in whole plots. In contrast, a significant decrease in yield was recorded on single naturally infected plants removed from the field at growth stage (GS) 83 to 85. Yield losses of single plants accounted for 20 to more than 80% at DS levels above 5 (scale 0 to 9). The systemic spread of V. longisporum was significantly delayed in plants in the field with substantial colonization of the shoots not occurring before maturity stages. However, fungal systemic spread into the shoots was faster in 2003, consistent with the visual disease assessment in the field. Conversely, the pathogen systemically spread after 28 days in plants (susceptible cultivar ‘Falcon’) in the greenhouse. Root dip inoculation with conidia suspension induced earlier and more severe disease symptoms than microsclerotia added to the soil. In contrast to the field, intense stunting was recorded on inoculated plants in the greenhouse. The susceptible cultivar, ‘Falcon’, showed higher DS, stronger reduction in root and shoot lengths and a faster fungal spread in the plant tissue than the moderate susceptible cultivar, ‘Talent’. Climatic conditions appear to be responsible for the strong delay in fungal invasion of plants in the field. This may prevent the plants from stunting and mitigate the overall yield effects of the disease. This study indicates a significant yield damage potential of V. longisporum in areas with DI above 60% and conditions accelerating the systemic pathogen spread in the plants.
Effect of Sowing Time on Toxigenic Fungal Infection and Mycotoxin Contamination of Maize Kernels
Authors: Blandino Massimo , Reyneri Amedeo , Vanara Francesca
Published: July 2008

Field experiments were set up from 2000 to 2002 in northwest Italy to determine the effects of sowing date on the susceptibility of maize hybrids to ear rot and mycotoxin contamination in natural infection conditions. Three sowing dates (March, April and May) were compared using two hybrids with different maturity classes. The ears were rated for the incidence and severity of disease symptoms at harvest and the harvested kernels were analysed for mycotoxin fumonisin B1, zearalenone, deoxynivalenol, aflatoxin B1 and ochratoxin A. The last sowing date resulted in higher values of European corn borer incidence (+39%), kernel Fusarium infection and fungal ear rot severity (increased respectively by a factor of 4 and 3) than the plots sowed in March. The sowing date did not influence the type of mycotoxin found in the kernel, which only depended on the climatic conditions during the season and on their influence on the infection and the development of the fungal species. The natural occurrence of fumonisin B1 and deoxynivalenol was always significantly higher in late‐sowed plots. A late sowing, after May 10, multiplies the risk of the occurrence of fumonisins and deoxynivalenol in the grains at harvest by a factor of 11.2 and 1.9, respectively. No significant difference was observed for the contamination of zearalenone or aflatoxin B1 for the different sowing dates. An earlier sowing time than April, resulted in a significant reduction in mycotoxin contamination only in the years in which the meteorological trend protracted the kernel dry down to the autumn months. The use of a late‐maturity hybrid with late sowing, compared with a medium‐maturity hybrid, could lead to a serious risk of mycotoxin contamination. To the authors’ knowledge, this is the first study to report on the effects of sowing time on maize kernel contamination of mycotoxins other than aflatoxins in non‐inoculated conditions.
Red Light‐induced Systemic Disease Resistance against Root‐knot Nematode Meloidogyne javanica and Pseudomonas syringae pv. tomato DC 3000
Authors: Islam Sayed Zahirul , Babadoost Mohammad , Bekal Sadia , Lambert Kris
Published: July 2008

The pretreatment of Arabidopsis with red light (600–700 nm) induces systemic resistance against root‐knot nematode Meloidogyne javanica and Pseudomonas syringae pv. tomato DC 3000. Red light treatment significantly (P = 0.05) reduced the number of root galls in both wild type (Col‐0) and nahG‐expressing Arabidopsis compared with those of white light‐treated control plants, while red light treatment only induced resistance to P. syringae in wild‐type plants. This result suggests that red light induces resistance against root‐knot nematode in Arabidopsis through a transduction pathway, which is independent of salicylic acid (SA) accumulation in roots, but resistance to P. syringae is SA‐dependent. PR1 gene expression was monitored as a marker for systemic acquired resistance (SAR). Relative quantification of expression of the PR1 gene corresponding to the cDNA was examined in both leaves and roots. There was no significant difference between leaves and roots of red light‐treated Arabidopsis in quantitative PR1 gene expression. In red light‐treated wild type (Col‐0) Arabidopsis, PR1 mRNA was induced by 23.11‐ and 22.47‐fold for leaf and root, respectively, compared with the plants treated with white light. However, in nahG plants, PR1 gene expression changed only by 0.4‐fold. These findings indicate that plant defense responses activated by the foliar SA‐dependent pathway depend on the specific host–pathogen system. This is the first report of red light‐induced resistance in Arabidopsis against root‐knot nematode.
Tryptamine Pathway‐mediated DNA Fragmentation is Involved in Sekiguchi Lesion Formation for Light‐enhanced Resistance in Lesion Mimic Mutant of Rice to Magnaporthe grisea Infection
Authors: Ueno Makoto , Imaoka Atsuko , Kihara Junichi , Arase Sakae
Published: July 2008

In this study, the correlation between tryptamine pathway‐mediated Sekiguchi lesion formation and DNA fragmentation in the sl mutant infected with Magnaporthe grisea under light was investigated. DNA fragmentation was observed beginning at 12 h after M. grisea inoculation, and then increased with increasing time after inoculation under light, but not in the dark. However, in cycloheximide (CHX)‐ or heat shock (HS)‐pretreated leaves of the sl mutant, Sekiguchi lesion formation and DNA fragmentation were significantly inhibited, but not in chloramphenicol (CP)‐pretreated leaves. Tryptamine accumulation and enzyme activity such as tryptophan decarboxylase (TDC) and monoamine oxidase (MAO) were also inhibited, even under light in the CHX‐ or HS‐pretreated leaves, but not in the CP‐pretreated ones. DNA fragmentation and TDC gene expression were induced in the leaves by the treatment with tryptamine or H2O2 under light, but not in the presence of the MAO inhibitor and H2O2 scavenger. The suppressive and inducible effects of biotic and abiotic agents on the induction of DNA fragmentation in the leaves of the sl mutant agree well with those effects on the activation of the tryptamine pathway involved in Sekiguchi lesion formation. These results suggested that tryptamine pathway‐mediated DNA fragmentation induces Sekiguchi lesion formation, which is responsible for light‐enhanced resistance in the sl mutant infected with M. grisea under light.
Patterns of Multiple Virus Infections in the Conifer Pathogenic Fungi, Diplodia pinea and Diplodia scrobiculata
Authors: De Wet Juanita , Preisig Oliver , Wingfield Brenda D. , Wingfield Michael J.
Published: July 2008

Diplodia pinea and Diplodia scrobiculata are opportunistic pathogens associated with various disease symptoms on conifers that most importantly include die‐back and stem cankers. Two viruses with dsRNA genomes, Sphaeropsis sapinea RNA virus 1 and 2 (SsRV1 and SsRV2) are found in D. pinea and an undescribed dsRNA element is known to occur in D. scrobiculata. We have partially characterized the putative RNA‐dependent RNA polymerase (RdRp) of the undescribed dsRNA element and designed virus‐specific primers from the RdRp regions of all three virus genomes. This made it possible to screen for the presence of the three viruses in a collection of D. pinea and D. scrobiculata isolates using real‐time PCR. Triple infections with all three viruses occurred in D. pinea and D. scrobiculata. Co‐infections with SsRV1 and SsRV2 were common but found only in D. pinea. Co‐infection with SsRV1 and the undescribed dsRNA element was rare and observed only in D. pinea. Single infections with either SsRV1 or SsRV2 were equally common, while the undescribed dsRNA element never occurred alone. SsRV1 occurred alone in both D. pinea and D. scrobiculata while SsRV2 occurred alone only in D. pinea. There were only two instances where the undescribed dsRNA element was observed in D. pinea and it was otherwise found only in D. scrobiculata. This study highlights the complex interactions between the viruses found in the closely related plant pathogenic fungi, D. pinea and D. scrobiculata. It illustrates the importance of not only characterizing viruses infecting fungi but also of determining the interactions between mycoviruses and their fungal hosts.
Occurrence and Partial Characterization of a Phytoplasma Associated with Phyllody Disease of Fennel (Foeniculum vulgare Mill.) in India
Authors: Bhat Alangar I. , Jiby Mary V. , Anandaraj Muthuswamy , Bhadramurthy Vemulapati , Patel Kirtikumar D. , Patel Nareshkumar R. , Jaiman Rakeshkumar K. , Agalodia Abbasbhai V.
Published: July 2008

In India, fennel showing symptoms of phyllody disease were noticed since 2003. As symptoms were suggestive of a phytoplasma infection, tissues were assayed by nested PCR using universal primers that amplify a 1.2‐kb phytoplasma 16S rDNA fragment. The phytoplasma specific fragment was amplified from diseased plants, but not from healthy plants, indicating that a phytoplasma was associated with fennel phyllody (FP) disease. On the basis of 16S rDNA sequence identity and phylogenetic relationship, it is concluded that FP belongs to peanut witches’ broom group and may be considered as a strain of the ‘Candidatus Phytoplasma aurantifolia’. This is the first report of occurrence and association of phytoplasma in fennel.
Granule‐bound starch synthase (GBSS) diversity of ancient wheat and related species
Authors: Caballero L. , Bancel E. , Debiton C. , Branlard G.
Published: July 2008

Granule‐bound starch synthase of ancient wheat and related species was examined by sodium dodecyl sulphate polyacrylamide gel. A total of 13 different alleles were revealed in a collection of three accessions of diploid wheat, six accessions of tetraploid wheat, 49 accessions of spelt wheat, nine accessions of Sitopsis and two accessions of Aegilops tauschii. A new allele named Wx‐A1a′ appeared in four spelt wheat accessions. The tetraploid wheat accessions evaluated did not show any polymorphism; nevertheless the tetraploid accessions of Sitopsis section revealed three novel alleles. The novel allele Wx‐Ddn1g was found in two accessions of A. ventricosa and the Wx‐Ddcm1h and Wx‐Ddcm1i in two accessions of A. crassa. A novel allele named Wx‐Au1g was found in Triticum urartu, which is different from the also new Wx‐Am1h allele of T. monococcum. The diploid‐related species accessions revealed two novel alleles named Wx‐Bsl1h and Wx‐Bs1g found, respectively, in A. longissima and A. speltoides. The amylose content was measured for the different alleles found in all evaluated species and no significant effects of the allele composition on the amylose content were detected.
Barley adaptation and improvement in the Mediterranean basin
Authors: Pswarayi A. , Van Eeuwijk F. A. , Ceccarelli S. , Grando S. , Comadran J. , Russell J. R. , Francia E. , Pecchioni N. , Li Destri O. , Akar T. , Al‐Yassin A. , Benbelkacem A. , Choumane W. , Karrou M. , Ouabbou H. , Bort J. , Araus J. L. , Molina‐Cano J. L. , Thomas W. T. B. , Romagosa I.
Published: July 2008

To study barley adaptation and improvement in the Mediterranean basin, a collection of 188 entries comprising landraces and old genotypes and current modern varieties from the Mediterranean basin and elsewhere was tested on moisture‐contrasted environments in seven Mediterranean countries, during 2004 and 2005 harvest seasons. The experimental design consisted of an unreplicated trial for all entries, augmented by four repeated checks to which a partial replicate containing a quarter of the entries was added. Best Linear Unbiased Predictions (BLUPs) representing adjusted genotypic means were generated for individual trials using a mixed model. BLUPs were used for genotype by environment interaction analysis using main effect plus genotype by environment interaction (GGE) biplots of yield ranked data and for comparisons of landraces, old and modern genotypes using analysis of variance. Mean yields ranged from near crop failure to 6 t/ha. Local landraces were better adapted to environments yielding below 2 t/ha, thus breeding has mostly benefited environments yielding above 2 t/ha where modern genotypes out yielded landraces and old cultivars by 15%. Current barley selection is leading to specifically adapted genotypes.
The use of ISSR markers to identify Texas bluegrass interspecific hybrids
Authors: Goldman J. J.
Published: July 2008

Seventeen ISSR primers were screened on Texas bluegrass (Poa arachnifera), Kentucky bluegrass (P. pratensis), Canadian bluegrass (P. compressa), Argentine bluegrass (P. ligularis), cv. ‘Sherman’ (P. secunda), putative Texas × Kentucky (TK) (P. arachnifera ×P. pratensis) hybrids and hybrids involving Texas, Canadian, and Sherman bluegrass [(P. arachnifera × P. compressa) × (P. arachnifera ×P. secunda)], to determine whether they could be used to produce robust and reproducible DNA fingerprints and identify interspecific hybrids. Nine of the 17 primers consistently produced robust fingerprints and nine 2‐way primer combinations were also selected. DNA fingerprints were highly reproducible and the majority of the selected primers (16/18) amplified hybrid profiles using two putative TK full‐sib hybrids. Combined with a rapid DNA extraction protocol, the ISSR technique enabled a fast and practical way to detect F1 interspecific hybrids early in the breeding programme and could also be useful for other applications that require DNA‐based markers.
Clinical Effect of alpha 1D/A adrenoceptor inhibitor naftopidil on Benign Prostatic Hyperplasia: An International Prostate Symptom Score and King's Health Questionnaire assessment
Authors: Awa Yusuke , Suzuki Hiroyoshi , Hamano Satoshi , Okano Tatsuya , Sakurayama Yuri , Ohki Takemasa , Egoshi Ken‐ichi , Ota Sho , Mori Ikuo , Ichikawa Tomohiko
Published: July 2008

Objectives:  To examine the effect of alpha 1D/A adrenoceptor inhibitor naftopidil on health‐related quality of life (QOL) in men with benign prostatic hyperplasia (BPH).

Methods:  A total of 56 newly diagnosed patients with symptomatic BPH were prospectively enrolled and treated with 50 mg naftopidil daily for more than 12 weeks. All underwent pre‐treatment documentation of lower urinary tract symptoms, QOL assessment using the international prostate symptom score (IPSS) and King's Health Questionnaire (KHQ), and uroflowmetry. A post‐treatment assessment was performed at 12 weeks.

Results:  IPSS scores as well as QOL index showed a significant improvement after naftopidil administration. Similarly, all seven domains except general health perceptions and social limitations in the KHQ questionnaire were significantly improved. When dividing the patients into overactive bladder (OAB) and non‐OAB groups, only the OAB group showed significant improvement in almost all the domains of KHQ. Change ratios of the IPSS were not associated with those of KHQ domain scores in the OAB group. On the other hand, in the non‐OAB group more domains presented improvements, which were associated with those of IPSS scores.

Conclusions:  Twelve‐week treatment with naftopidil for symptomatic BPH patients is associated with significant improvement in the IPSS, QOL index, maximum urinary flow rate, post‐void residual urine volume (PVR) and almost all domains in KHQ. KHQ is useful for the evaluation of clinical response in BPH patients, particularly in those with associated OAB.
A nomogram predicting metastatic progression after radical prostatectomy
Authors: Porter Christopher R , Suardi Nazareno , Kodama Koichi , Capitanio Umberto , Gibbons Robert P , Correa Roy , Jeldres Claudio , Perrotte Paul , Montorsi Francesco , Karakiewicz Pierre I
Published: July 2008

Objectives:  To develop and internally validate a nomogram predicting the individual probability of metastatic progression after radical prostatectomy according to the length of disease‐free interval.

Methods:  Cox regression modeled the probability of metastatic progression of prostate cancer in 752 patients treated with radical prostatectomy with a mean follow up of 11.6 years (median 11.4; range 0.1–40.5). The significance of the predictors was confirmed in competing risks analysis, which accounts for other causes of mortality. The Cox regression model‐based nomogram was internally validated with 200 bootstrap resamples.

Results:  Eighty‐five of 752 patients (11.3%) developed metastatic progression. The 5, 10, 15 and 20‐year actuarial rates of metastatic progression‐free survival were, respectively, 95.9, 90.5, 84.8 and 80.5%. Pathological stage T3, elevated radical prostatectomy Gleason sum and delivery of adjuvant radiotherapy represented independent predictors of metastatic progression in both Cox and competing risks regression models, and constituted the nomogram predictors along with a fourth variable describing the presence of co‐morbidities. After 200 bootstrap resamples the nomogram achieved 80.2, 77.7, 77.6 and 76.0% accuracy in predicting metastatic progression at 5, 10, 15 and 20 years after radical prostatectomy.

Conclusions:  Metastatic progression is a sign of poor prognosis in men with prostate cancer. Our nomogram is able to accurately predict the conditional probability of metastatic progression up to 20 years after radical prostatectomy.
Nine cases of nonpalpable testicular mass: an incidental finding in a large scale ultrasonography survey
Authors: Avci Ali , Erol Bulent , Eken Cenker , Ozgok Yasar
Published: July 2008

Objectives:  Nonpalpable testicular masses are usually diagnosed during routine ultrasonography (US) examinations for other conditions. There are conflicting results on the final diagnosis and management of these lesions. In the present study we report the results of a large US series of 5104 patients on nonpalpable testicular masses and discuss the management of these patients.

Methods:  This retrospective observational study was performed in a secondary care military hospital. A total of 5104 patients underwent a US and 11 of them were diagnosed as having a nonpalpable testicular mass. These 11 patients also underwent magnetic resonance imaging (MRI). Two of them refused surgery and were excluded from the study. The remaining nine patients underwent intraoperative US‐guided localization and excisional biopsy of the non‐palpable testicular parenchymal mass. A radical orchiectomy was required in all of them. US and MRI findings, frozen and final pathology results were recorded.

Results:  The median age of study subjects was 24 years. The final pathology revealed a malign tumor in eight patients and an inflammatory mass in one patient. There were inconsistent results in four patients between frozen section analysis and final pathology. MRI improved the definition of the solid masses in all patients.

Conclusions:  MRI enhances the certainty of the diagnosis of malignity in nonpalpable testicular masses, particularly in conditions that generally can not be diagnosed with ultrasonography alone. Frozen section analysis is not an accredited method in diagnosing malign lesions in non‐palpable testicular masses.
The identification of response regulator‐specific binding sites reveals new roles of two‐component systems in Bacillus cereus and closely related low‐GC Gram‐positives
Authors: de Been Mark , Bart Marieke J. , Abee Tjakko , Siezen Roland J. , Francke Christof
Published: July 2008

In bacteria, environmental challenges are often translated into a transcriptional response via the cognate response regulators (RRs) of specialized two‐component systems (TCSs). A phylogenetic footprinting/shadowing approach was designed and used to identify many novel RR‐specific operators for species of the Bacillus cereus group and related Gram‐positives. Analysis of the operator sequences revealed characteristic traits for each RR subfamily. For instance, operators related to the largest subfamily (OmpR) typically consisted of direct repeats (e.g. TTAAGA‐N5‐TTAAGA), whereas operators related to the second largest family (NarL) consisted of inverted repeats (e.g. ATGACA‐N2‐TGTCAT). This difference indicates a fundamentally different organization of the bound RR dimers between the two subfamilies. Moreover, the identification of the specific operator motifs allowed relating several RRs to a minimal regulon and thereby to a characteristic transcriptional response. Mostly, these regulons comprised genes encoding transport systems, suggesting a direct coupling of stimulus perception to the transport of target compounds. New biological roles could be attributed to various TCSs, including roles in cytochrome c biogenesis (HssRS), transport of carbohydrates, peptides and/or amino acids (YkoGH, LytSR), and resistance to toxic ions (LiaSR), antimicrobial peptides (BceRS) and beta‐lactam antibiotics (BacRS, YcbLM). As more and more bacterial genome sequences are becoming available, the use of comparative analyses such as the approach applied in this study will further increase our knowledge of bacterial signal transduction mechanisms and provide directions for the assessment of their role in bacterial performance and survival strategies.
The microbial community of Vetiver root and its involvement into essential oil biogenesis
Authors: Del Giudice Luigi , Massardo Domenica Rita , Pontieri Paola , Bertea Cinzia M. , Mombello Domenico , Carata Elisabetta , Tredici Salvatore Maurizio , Talà Adelfia , Mucciarelli Marco , Groudeva Veneta Ivanova , De Stefano Mario , Vigliotta Giovanni , Maffei Massimo E. , Alifano Pietro
Published: July 2008

Vetiver is the only grass cultivated worldwide for the root essential oil, which is a mixture of sesquiterpene alcohols and hydrocarbons, used extensively in perfumery and cosmetics. Light and transmission electron microscopy demonstrated the presence of bacteria in the cortical parenchymatous essential oil‐producing cells and in the lysigen lacunae in close association with the essential oil. This finding and the evidence that axenic Vetiver produces in vitro only trace amounts of oil with a strikingly different composition compared with the oils from in vivo Vetiver plants stimulated the hypothesis of an involvement of these bacteria in the oil metabolism. We used culture‐based and culture‐independent approaches to analyse the microbial community of the Vetiver root. Results demonstrate a broad phylogenetic spectrum of bacteria, including α‐, β‐ and γ‐Proteobacteria, high‐G+C‐content Gram‐positive bacteria, and microbes belonging to the Fibrobacteres/Acidobacteria group. We isolated root‐associated bacteria and showed that most of them are able to grow by using oil sesquiterpenes as a carbon source and to metabolize them releasing into the medium a large number of compounds typically found in commercial Vetiver oils. Several bacteria were also able to induce gene expression of a Vetiver sesquiterpene synthase. These results support the intriguing hypothesis that bacteria may have a role in essential oil biosynthesis opening the possibility to use them to manoeuvre the Vetiver oil molecular structure.
Diversity of ring‐hydroxylating dioxygenases in pristine and oil contaminated microbial mats at genomic and transcriptomic levels
Authors: Bordenave Sylvain , Goñi‐urriza Marisol , Vilette Cécile , Blanchard Sophie , Caumette Pierre , Duran Robert
Published: July 2008

The aim of this work was to characterize bacterial ring‐hydroxylating dioxygenase (RHD) diversity in a pristine microbial mat and follow their diversity changes in response to heavy fuel oil contamination. In order to describe the RHDs diversity, new degenerate primers were designed and a nested‐PCR approach was developed to gain sensitivity and wider diversity. RHD diversity in artificially contaminated mats maintained in microcosms and in chronically contaminated mats was analysed by clone libraries and terminal restriction fragment length polymorphism (T‐RFLP) at genomic and transcriptomic levels. The RHD diversity in the pristine microbial mat was represented by Pseudomonas putida nahAc‐like genes and no increase of diversity was detected after 1 year of oil contamination. The diversity observed in a 30 year chronically polluted microbial mat was represented by four main RHD clusters and two new genes revealing higher polyaromatic hydrocarbon (PAH) degradation capacity. This study illustrates that a single petroleum contamination (such as oil spill) is not enough to involve a detectable modification of RHD diversity. The new degenerate primers described here allowed RHD gene amplification from pristine and contaminated samples thereby showing their diversity. The proposed approach solves one of the main problems of functional gene analysis providing effective amplification of the environmental diversity of the targeted genes.
Hand‐assisted laparoscopic colectomy versus standard laparoscopic colectomy: a cost analysis
Authors: Roslani A. C. , Koh D. C. , Tsang C. B. , Wong K. S. , Cheong W. K. , Wong H. B.
Published: July 2008

Objective There is a relative dearth of literature comparing hand‐assisted (HALC) to standard (SLC) laparoscopic colectomies. HALC seems beneficial in terms of shorter operative times and lower conversion rates, but this is counterbalanced by a greater inflammatory response, larger incisions and higher direct costs. Nevertheless, these results are not consistent throughout existing studies and there are to date no detailed cost comparisons. Our hypothesis was that HALC would not incur significantly higher institutional costs compared with standard laparoscopic techniques.

Method Patients undergoing either SLC or HALC between August 2004 and September 2006 were retrospectively reviewed. All patients were managed using a standard protocol. Outcomes assessed included operative times, conversion rates, pain scores, time to resolution of ileus, length of stay and complications. Total costs were calculated from the day of surgery. Statistical analyses included χ2, Fisher’s exact test, the Mann–WhitneyU‐test or nonparametric bootstrapping method.

Results Seventy‐three patients underwent SLC while 101 had HALC. Demographics and indications for surgery in both groups were similar; the majority were performed for colorectal cancers. Operative times were shorter (147.5vs172.5 min,P < 0.05) and complication rates lower (28.7%vs45.2%,P < 0.025) for HALC. There was no significant difference in the other clinical outcomes. Operative costs and cost of consumables were higher for HALC (US$4024.2vsUS$3568.1,P = 0.01 and US$1724.7vsUS$1302.7,P < 0.001, respectively). However, total costs were not significantly different (HALC US$8999.8, SLC US$7910.7,P = 0.11).

Conclusion Institutional costs are not significantly higher for HALC compared with SLC.
Extended total mesorectal excision in locally advanced rectal cancer (T4a) and the clinical role of MRI‐evaluated neo‐adjuvant downstaging
Authors: Larsen S. G. , Wiig J. N. , Emblemsvaag H. L. , Grøholt K. K. , Hole K. H. , Bentsen A. , Dueland S. , Vetrhus T. , Giercksky K.‐E.
Published: July 2008

Objective  To compare the clinical ability of MRl taken before and after neo‐adjuvant treatment in locally advanced rectal cancer (LARC) to predict the necessary extension of TME (ETME) and the possibility to achieve a R0 resection.

Method  Prospective registration of 92 MRI evaluated T4a cancers undergoing elective surgery between 2002 and 2007 in a tertiary referral centre for multimodal treatment of rectal cancer.

Results  MRI identified patients in need of neo‐adjuvant treatment and predicted T‐downstaging in 10% and N‐downstaging in 59%. Seventy‐nine percent R0 resections, 18% R1 and 3% R2 were obtained after ETME in 95% of the patients and TME in the rest. Higher tumour regression grade (TRG) was achieved in higher ypT‐stage (P < 0.01). Preoperative chemo radiotherapy resulted in that more patients obtained TRG1‐3 compared to those receiving radiotherapy (79% vs. 57%, P = 0.02). The pelvic wall was the area of failure in 70% of the R1 resections. Tumour cells outside the mesorectal fascia scattered within fibrosis was found in 18 TRG2‐3 among 33 ypT4 tumours (55%).

Conclusion  MRl cannot discriminate tumour within fibrosis. Therefore, if a R0 resection is the goal, we advocate optimal surgery in accordance with the pre‐treatment MRI. Post treatment MRI is a poor predictor of final histology and should not be relied upon to guide the extent of surgical resection. The study has initiated a new approach to histopathological classification of the removed specimen where we introduce a MRI assisted technique for investigating the areas at risk outside the mesorectal fascia in the specimen.
The use of a wound protector to prevent port site recurrence may not be totally logical
Authors: Seow‐Choen F. , Wan W.‐H. , Tan K.‐Y.
Published: July 2008

The wound protector has been used widely to prevent port site metastases (PSM). Although port site metastases ties in with poor survival, it is not because of PSM itself, but rather because PSM is a sign of more widespread metastatic disease. Whilst being touted as a method of preventing PSM, it fails to address the bigger issue of preventing intra‐abdominal recurrence. Proper surgical technique in tumour handling following rigorous oncological principles, and not just putting in a wound protector is the key to good surgery with low recurrences and excellent survival rates.