bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics, causes and treatment of postpartum haemorrhage in first and second pregnancies
Authors: Ford Jane B. , Shand Antonia W. , Roberts Christine L.
Published: December 2012

We investigated characteristics, causes and treatment of postpartum haemorrhage (PPH) in a random sample of 294 women's first and second pregnancies involving at least one PPH. Among 588 pregnancies, PPH affected 169 first pregnancies, 105 second pregnancies only and recurrent PPH affected 48 pregnancies. In 34% of PPHs, atony was the primary cause. Second pregnancy PPH involved increased pharmacological therapy, blood transfusion and median blood loss. It is important to ascertain PPH history in parous women and be prepared for PPH recurrence.
Understanding the molecular sensitization for Cypress pollen and peach in the Languedoc‐Roussillon area
Authors: Caimmi D. , Barber D. , Hoffmann‐Sommergruber K. , Amrane H. , Bousquet P.‐J. , Dhivert‐Donnadieu H. , Demoly P.
Published: December 2012

Background

Cypress allergy is a typical winter pollinosis and the most frequent one in the South of France. Main symptoms are rhinitis, conjunctivitis, and asthma. Peach allergy is common too in Southern Europe. Allergic cross‐reactions between cypress and peach have been reported, including an oral allergy syndrome. We wanted to investigate whether a cross‐reactive allergen between cypress and peach might be responsible for the observed clinical association.

Methods

We analyzed 127 patients included over a 3‐month period, outside the pollen season, and we dosed specific IgE levels, for selected, individual allergens.

Results

Patients sensitized to peach were mainly positive for the peach‐nonspecific lipid‐transfer protein.

Conclusions

Profilins or thaumatins could not explain the observed clinical association between cypress and peach.
Challenges in testing genetically modified crops for potential increases in endogenous allergen expression for safety
Authors: Panda R. , Ariyarathna H. , Amnuaycheewa P. , Tetteh A. , Pramod S. N. , Taylor S. L. , Ballmer‐Weber B. K. , Goodman R. E.
Published: December 2012

Premarket, genetically modified (GM) plants are assessed for potential risks of food allergy. The major risk would be transfer of a gene encoding an allergen or protein nearly identical to an allergen into a different food source, which can be assessed by specific serum testing. The potential that a newly expressed protein might become an allergen is evaluated based on resistance to digestion in pepsin and abundance in food fractions. If the modified plant is a common allergenic source (e.g. soybean), regulatory guidelines suggest testing for increases in the expression of endogenous allergens. Some regulators request evaluating endogenous allergens for rarely allergenic plants (e.g. maize and rice). Since allergic individuals must avoid foods containing their allergen (e.g. peanut, soybean, maize, or rice), the relevance of the tests is unclear. Furthermore, no acceptance criteria are established and little is known about the natural variation in allergen concentrations in these crops. Our results demonstrate a 15‐fold difference in the major maize allergen, lipid transfer protein between nine varieties, and complex variation in IgE binding to various soybean varieties. We question the value of evaluating endogenous allergens in GM plants unless the intent of the modification was production of a hypoallergenic crop.
Anaesthesia for vascular emergencies
Authors: Ellard L. , Djaiani G.
Published: December 2012

Patients presenting with vascular emergencies including acute aortic syndrome, ruptured thoracic or abdominal aortic aneurysms, thoracic aortic trauma and acute lower limb ischaemia have a high risk of peri‐operative morbidity and mortality. Although anatomical suitability is not universal, endovascular surgery may improve mortality and the results of ongoing randomised controlled trials are awaited. Permissive hypotension pre‐operatively should be the standard of care with the systolic blood pressure kept to 50–100 mmHg as long as consciousness is maintained. The benefit of local anaesthesia over general anaesthesia is not definitive and this decision should be tailored for a given patient and circumstance. Cerebrospinal fluid drainage for prevention of paraplegia is often impractical in the emergency setting and is not backed by strong evidence; however, it should be considered postoperatively if symptoms develop. We discuss the pertinent anaesthetic issues when a patient presents with a vascular emergency and the impact that endovascular repair has on anaesthetic management.
Poisoning with illicit substances: toxicology for the anaesthetist
Authors: Wong G. T. C. , Irwin M. G.
Published: December 2012

The consumption of illicit substances represents a considerable threat to the health and wellbeing of particular sectors of our communities. Hospitalisation is sometimes required for the treatment of the direct toxic effects of the drugs as well as for injuries sustained while under their influence. Although poisoning with ‘traditional‘ substances of abuse such as opioids, cocaine and cannabis still predominate in terms of numbers, the availability and use of new psychoactive substances are on the rise. These latter agents, some of which began life as failed pharmaceutical products, have enjoyed renewed status as recreational stimulants, entactogens or hallucinogens, properties that originally precluded them from legitimate use. These drugs may act by enhancing endogenous release of neurotransmitters, inhibiting their reuptake back into neurons or having direct effects on receptors, and may involve adrenergic, dopaminergic or serotonergic systems. The use of intravenous lipid emulsion for the symptomatic treatment of drug overdose has become a fertile ground for research and may hold promise as a non‐specific treatment for poisoning with illicit substances. Dexmedetomidine, an α2‐receptor agonist with a central sympatholytic effect, may be able to counteract the cardiovascular and central nervous system overstimulation that may accompany stimulant toxicity.
Haemorrhage and coagulopathy in the Defence Medical Services
Authors: Mercer S. J. , Tarmey N. T. , Woolley T. , Wood P. , Mahoney P. F.
Published: December 2012

Over the past 12 years, the United Kingdom Defence Medical Services have evolved an integrated ‘damage control resuscitation – damage control surgery’ sequence for the management of patients sustaining complex injuries. During 2009, over 3200 units of blood products were administered as massive transfusions to severely injured UK personnel. An important part of the approach to traumatic bleeding is the early, empirical use of predefined ratios of blood and clotting products. As soon as control of bleeding is achieved, current practice is to switch towards a tailored transfusion, based on clinical and laboratory assessments, including point‐of‐care coagulation testing. A key goal is to provide resuscitation seamlessly throughout surgery, so that patients leave the operating room with their normal physiology restored. This article outlines the current management of haemorrhage and coagulation employed in Afghanistan from the point of wounding to transfer back to the National Health Service.
Anaesthesia and pre‐hospital emergency medicine
Authors: Booth A. , Steel A. , Klein J.
Published: December 2012

Major trauma is a leading cause of death and disability in the UK, particularly in the young. Pre‐hospital emergency medicine (PHEM) involves provision of immediate medical care to critically ill and injured patients, across all age ranges, often in environments that may be remote and are not only physically challenging but also limited in terms of time and resources. PHEM is now a GMC‐recognised subspecialty of anaesthesia or emergency medicine and the first recognised training program in the UK commenced in August 2012. This article discusses subspeciality development in PHEM, the competency based framework for training in PHEM, and the provision of pre‐hospital emergency anaesthesia.
Congenital cataract screening in maternity wards is effective: evaluation of the Paediatric Cataract Register of Sweden
Authors: Magnusson Gunilla , Bizjajeva Svetlana , Haargaard Birgitte , Lundström Mats , Nyström Alf , Tornqvist Kristina
Published: December 2012

Aim

To study which eye‐screening protocol prevails in Swedish maternity/neonatal wards, evaluate efficacy in a prospective study and compare results with earlier Swedish retrospective results.

Methods

Surveys were sent in 2006 to maternity/neonatal and women's health departments regarding screening policy. Response frequency was 96% (122/127). Data were derived from the Paediatric Cataract Register (PECARE), Sweden. All Swedish children diagnosed with congenital cataract and operated on before 1 year of age between January 2007 and December 2009 were included. Statistical comparison with earlier retrospective results was performed.

Results

Eye screening is a routine protocol at a rate of 90% of Swedish maternity wards. Sixty‐one children were included in the study. An increase was shown in case referrals from maternity wards compared to 10 years ago (64% vs. 50%). Detection was performed within 6 weeks of age in 75% of the cases. A significant difference between the probabilities of early referral (0.38; p < 0.001, < 6 weeks of age) and early surgery (0.36; p < 0.001) (PECARE) was found in comparison with the historical data of no maternity‐ward screening. Well‐baby clinics were instrumental in early detection, as well.

Conclusion

Eye screening in maternity wards is effective. Clear Swedish directives are to be preferred.
Management of renal dysfunction following term perinatal hypoxia‐ischaemia
Authors: Sweetman Deirdre U , Riordan Michael , Molloy Eleanor J
Published: December 2012

Acute kidney injury frequently develops following the term perinatal hypoxia‐ischaemia. Quantifying the degree of acute kidney injury is difficult, however, as the methods currently in use are suboptimal. Acute kidney injury management is largely supportive with little evidence basis for many interventions. This review discusses management strategies and novel biomarkers that may improve diagnosis and management of renal injury following perinatal hypoxia‐ischaemia.

Conclusion

Following perinatal hypoxia‐ischaemia, acute kidney injury is common. Management of neonatal acute kidney injury is largely supportive. Novel acute kidney injury biomarkers may play a role in optimizing new categorical definitions of renal injury. Studies are needed to investigate the impact of neonatal acute kidney injury on long‐term outcome.
Prospective antibody case finding of coeliac disease in type‐1 diabetes children: need of biopsy revisited
Authors: Popp Alina , Mihu Mihaela , Munteanu Mihai , Ene Adina , Dutescu Monica , Colcer Florin , Raducanu Diana , Laurila Kaija , Anca Ioana , Mäki Markku
Published: December 2012

Aim

To evaluate whether coeliac disease (CD) can be diagnosed by measuring autoantibodies without small‐intestinal mucosal biopsies in children with type 1 diabetes.

Methods

Case finding of CD was undertaken in 181 consecutive IgA‐competent children with type 1 diabetes using transglutaminase 2 (TG2) and endomysial IgA antibody (EMA) tests in serum and the rapid point of care test in fingertip whole‐blood sample. Endoscopy with intestinal biopsies was recommended for patients with high TG2‐IgA titres (>96 U) and in children with lower positive tests if either the EMA test or the rapid point of care test was additionally positive. The duodenal mucosal biopsies were graded according to the Marsh classification.

Results

The TG2‐IgA test had a 15.5% and the EMA test a 6.0% seropositivity. All seven biopsied high‐titre TG2‐IgA‐positive children were symptom free and found to have CD (Marsh 3 type lesion). These patients were also positive for EMA and in the rapid point of care test. Lower titre TG2‐IgA‐positive children had histological Marsh 1 to 3a lesions.

Conclusions

None of the type 1 diabetes children with high TG2‐IgA titres would have needed endoscopy with duodenal biopsies to reach a CD diagnosis. Lower TG2‐IgA‐positive patients need to be biopsied.
Smoking is a risk factor for recurrence of intestinal stricture after endoscopic dilation in Crohn's disease
Authors: Gustavsson A. , Magnuson A. , Blomberg B. , Andersson M. , Halfvarson J. , Tysk C.
Published: December 2012

Background

Endoscopic balloon dilation is an efficacious and safe alternative to surgery as treatment of short intestinal strictures in Crohn's disease (CD). Factors predicting outcome of the procedure are not well described.

Aim

To evaluate whether smoking at diagnosis, treatment with azathioprine, or other clinical variables may affect clinical outcome after endoscopic dilation. The endpoint was requirement of a new intervention such as dilation or surgery with intestinal resection or strictureplasty.

Methods

Retrospective study of 83 patients with CD who underwent endoscopic balloon dilation of an intestinal stricture between 1987 and 2009.

Results

After index dilation 55/83 patients underwent a new intervention. Among current smokers, 31/32 (97%) underwent another intervention compared to 18/33 (55%) among never smokers (adjusted HR: 2.50, 95% CI: 1.14–5.50, P = 0.022). After 5 years, cumulative probability of new intervention was 0.81 in smokers compared to 0.52 in never smokers; difference 0.29 (95% CI: 0.07–0.52, P = 0.01). In 16 patients, therapy with azathioprine was initiated before or shortly after the index dilation; 7/16 underwent a new intervention compared to 48/67 of those without azathioprine (HR: 0.46, 95% CI: 0.21–1.03, P = 0.06). After adjustment for other variables, the association was even weaker (HR: 0.80, 95% CI: 0.29–2.18, P = 0.668). Sex, age at diagnosis, age at first dilation, balloon size, location of stricture, and treatment period did not influence outcome.

Conclusions

Smoking doubles the risk of recurrent stricture formation requiring a new intervention after index dilation. Maintenance therapy with azathioprine did not influence the subsequent course and need for a new intervention.
Effect of fructo‐oligosaccharide on nitrogen utilization in guinea pigs
Authors: Kawasaki Kiyonori , Min Xiao , Nishiyama Ai , Sakaguchi Ei
Published: December 2012

The present study was conducted to determine the effects of fructo‐oligosaccharide (FOS) on the nitrogen (N) utilization and digestibilities of dietary nutrients through cecotrophy in guinea pigs. Adult male guinea pigs that were housed or not housed in wooden frames to prevent cecotrophy were fed a commercial pellet diet (50 g/day) with 3% and 5% glucose or FOS for 8 days in individual metabolism cages. In the guinea pigs allowed cecotrophy, addition of FOS to the diet had no significant effects on body weight gain or apparent digestibility of N, but showed significantly lower value for the urinary N excretion and acid‐detergent fiber digestibility (P < 0.05 and P < 0.01, respectively) and significantly higher value for N retention and the N retention rate (P < 0.05). In the guinea pigs prevented from cecotrophy, FOS had no effect on N retention, but showed tendencies toward a higher value for fecal N excretion and a lower value for urinary N excretion. These results suggest that FOS stimulates cecal microbial proliferation, thereby improving N utilization in guinea pigs.
Disturbance and recovery in semi‐arid Mediterranean grasslands
Authors: Merou Theodora P. , Tsiftsis Spyros , Papanastasis Vasilios P.
Published: December 2012

Aims

(1) To investigate the temporal response of semi‐arid Mediterranean grasslands to multiple disturbances as well as P fertilization and irrigation; and (2) to determine the reaction of single species or groups of species as well as the extent of recovery of the grassland community following cessation of the above interventions.

Location

North Greece.

Methods

In a fenced area, six treatments (burning, irrigation, digging, cutting, P fertilization and control) were applied, for three growing seasons, in a completely randomized block design with four blocks. Biomass was sampled in five (0.5 × 0.5 m) quadrats per plot at the end of the growing season and sorted into the following functional groups: annual grasses, perennial grasses, annual legumes and forbs (that included all the other species). Measurements were repeated 1 and 7 yr after cessation of the treatments.

Results

Annual grasses and legumes were positively favoured by cutting, burning and digging, which produced changes in vegetation composition over time. P fertilization had a positive influence on total legume biomass. Effects on individual species were not uniform. Plant composition after cessation of the disturbance treatments was quite different. Total legume biomass remained high 1 yr after the cessation of P fertilization but declined thereafter. Annual grasses and legumes constituted the largest portion of the total biomass in the first year of the experiment. Disturbance (burning, cutting and digging) gradually reduced their biomass in favour of forbs. Seven years after cessation of the treatments, the tall annual, as well as perennial grasses constituted more than 80% of the total biomass. Under conditions of disturbance, short annual species had an advantage over perennials, while cessation of disturbance enables perennial grasses to dominate.

Conclusions

Disturbance promotes the dominance of annuals, especially species with a persistent seed bank. Repeated disturbance encourages an increase of small or prostrate species. Cessation of disturbance leads to the rapid recovery of biomass production. Tall annuals are promoted. P fertilization clearly favours legumes in the short term.
Expression of CD70 in nasal natural killer/T cell lymphoma cell lines and patients; its role for cell proliferation through binding to soluble CD27
Authors: Yoshino Kazumi , Kishibe Kan , Nagato Toshihiro , Ueda Seigo , Komabayashi Yuki , Takahara Miki , Harabuchi Yasuaki
Published: December 2012

Nasal natural killer (NK)/T cell lymphoma (NNKTL) is associated with Epstein–Barr virus (EBV). The present study analysed gene expression patterns of the NNKTL cell lines SNK6, SNK1 and SNT8, which are positive for EBV and latent membrane protein (LMP)‐1, using a complementary DNA array analysis. We found that CD70 was specifically expressed in SNK6 and SNT8. Reverse transcription polymerase chain reaction and flow cytometric analyses confirmed that CD70 was expressed in all 3 NNKTL cell lines, but not in the other EBV‐positive NK‐cell lines. In vitro studies showed that NNKTL cell lines proliferated, in a dose‐dependent fashion, in response to exogenous soluble CD27, which is the ligand for CD70. In NNKTL patients, we confirmed that the CD70 was expressed on the lymphoma cells in NNKTL tissues and that soluble CD27 was present in sera at higher levels as compared to healthy individuals. Finally, complement‐dependent cytotoxicity assay showed that anti‐CD70 antibody mediated effective complement‐dependent killing of NNKTL cells and the affected target CD70 expression on the cells. These results suggest that CD70 acts as a functional receptor binding to soluble CD27, resulting in lymphoma progression and that immunotherapy using anti‐CD70 antibody may be a potential candidate for treatment for NNKTL.
Diagnostic evaluation of patients with suspected haemophagocytic lymphohistiocytosis
Authors: Lehmberg Kai , Ehl Stephan
Published: December 2012

Haemophagocytic lymphohistiocytosis (HLH) is a life‐threatening hyperinflammatory syndrome characterized by severely disturbed immune homeostasis. It can affect all age groups. Diagnostic evaluation of the patient with suspected HLH has to address three main questions: (i) does the patient have HLH? There is no simple diagnostic test, but a number of clinical and laboratory criteria define this clinical syndrome. (ii) Can a trigger be identified? A variety of infections, malignant or autoimmune diseases can contribute to the disturbed immune homeostasis with important consequences for treatment. (iii) Does the patient suffer from a genetic disease predisposing to HLH? Recent advances in the understanding of the genetic and pathophysiological basis of HLH have enabled a better and more rapid answer to this question, which is relevant for prognosis and the decision to perform haematopoietic stem cell transplantation. This review summarizes the current diagnostic approach to the patient with HLH.
Calsenilin Contributes to Neuronal Cell Death in Ischemic Stroke
Authors: Park Jong‐Sung , Manzanero Silvia , Chang Jae‐Woong , Choi Yuri , Baik Sang‐Ha , Cheng Yi‐Lin , Li Yu‐I , Gwon A‐Ryeong , Woo Ha‐Na , Jang Jiyeon , Choi In‐Young , Lee Joo‐Yong , Jung Yong‐Keun , Tang Sung‐Chun , Sobey Christopher G. , Arumugam Thiruma V. , Jo Dong‐Gyu
Published: December 2012

Calsenilin is a calcium sensor protein that interacts with presenilin and increases calcium‐triggered neuronal apoptosis, and γ‐secretase activity. Notch is a cell surface receptor that regulates cell‐fate decisions and synaptic plasticity in brain. The aim of the present study was to characterize the role of calsenilin as a regulator of the γ‐secretase cleavage of Notch in ischemic stroke. Here, we determined the modulation of expression level and cellular distribution of calsenilin in neurons subjected to ischemic‐like conditions. The levels of calsenilin and presenilin were increased in primary neurons after oxygen and glucose deprivation. Furthermore, calsenilin was found to enhance the γ‐secretase cleavage of Notch and to contribute to cell death under ischemia‐like conditions. The inhibition of γ‐secretase activity and a presenilin deficiency were both found to protect against calsenilin‐mediated ischemic neuronal death. The expression of calsenilin was found to be increased in brain following experimental ischemic stroke. These findings establish a specific molecular mechanism by which the induction of calsenilin enhances Notch activation in ischemic stroke, and identify calsenilin as an upstream of the γ‐secretase cleavage of Notch.
Negative Effects of Conspecific Floral Density on Fruit Set of Two Neotropical Understory Plants
Authors: Stein Katharina , Templin Mathias , Hensen Isabell , Fischer Markus , Matthies Diethart , Schleuning Matthias
Published: December 2012

Plant reproductive success is usually positively related to conspecific floral density, but neutral or negative effects of floral density on reproduction have also been reported. Differences in the relationship between reproduction and floral density largely originate from a trade‐off between increasing attractiveness versus increasing competition for pollinators at high floral densities. Although floral densities strongly vary in the understory of tropical forests, for instance, due to variation in light availability, little is known about the density dependence of reproduction in tropical understory plants. We used path analyses to disentangle direct and indirect effects of canopy openness and floral density on fruit set and analyzed the relationship between pollen load and floral density for two Neotropical understory plants, Heliconia metallica and Besleria melancholica. In both species, fruit set was not directly related to canopy openness, but decreased with increasing floral density. In H. metallica, canopy openness had an indirect negative effect on reproduction mediated by its effects on floral density. Effects of floral density on pollen loads were species‐specific. In B. melancholica, pollen loads linearly decreased with increasing floral density, indicating competition for pollinators at high densities. In H. metallica, pollen loads were reduced at both low and high densities, indicating an interplay of facilitative and competitive effects of floral density on pollen deposition. In contrast to other studies, we found negative density dependence of reproduction in both understory species. Negative effects of floral density on reproduction appear to be related to pollinator‐mediated effects on reproduction rather than to variation in abiotic conditions.
Syndromic non‐compaction of the left ventricle: associated chromosomal anomalies
Authors: Digilio MC , Bernardini L , Gagliardi MG , Versacci P , Baban A , Capolino R , Dentici ML , Roberti MC , Angioni A , Novelli A , Marino B , Dallapiccola B
Published: December 2012

Non‐compaction of the left ventricle (NCLV) is a cardiomyopathy characterized by prominent left ventricular trabeculae and deep intertrabecular recesses. Associated extracardiac anomalies occur in 14–66% of patients of different series, while chromosomal anomalies were reported in sporadic cases. We investigated the prevalence of chromosomal imbalances in 25 syndromic patients with NCLV, using standard cytogenetic, subtelomeric fluorescent in situ hybridization, and array‐comparative genomic hybridization (CGH) analyses. Standard chromosome analysis disclosed an abnormality in three (12%) patients, including a 45,X/46,XX mosaic, a 45,X/46,X,i(Y)(p11) mosaic, and a de novo Robertsonian 13;14 translocation in a child affected by hypomelanosis of Ito. Cryptic chromosome anomalies were found in six (24%) cases, including 1p36 deletion in two patients, 7p14.3p14.1 deletion, 18p subtelomeric deletion, 22q11.2 deletion associated with velo‐cardio‐facial syndrome, and distal 22q11.2 deletion, each in one case. These results recommend accurate clinical evaluation of patients with NCLV, and suggest that chromosome anomalies occur in about one third of syndromic NCLV individuals, without metabolic/neuromuscular disorder. Array‐CGH analysis should be included in the diagnostic protocol of these patients, because different submicroscopic imbalances are causally associated with this disorder and can pinpoint candidate genes for this cardiomyopathy.
Clinical Effectiveness of Rivastigmine Monotherapy and Combination Therapy in Alzheimer's Patients
Authors: Sonali Nirmal , Tripathi Manjari , Sagar Rajesh , Velpandian Thirumurthy , Subbiah Vivekanandhan
Published: December 2012

Background

Rivastigmine is an acetylcholinesterase inhibitor; the genotype data seen alongside the phenotype data explain the mutation or the molecular genetics involved and also help to relate the phenotype of an individual with their genotype.

Aim

To determine the clinical effectiveness of CYP2D6, CYP3A4, CYP2C9/19, and UGT polymorphism on the steady‐state plasma concentrations and therapeutic outcome of rivastigmine monotherapy and combination therapy in patients with Alzheimer's disease.

Result

In this study, a significant allele frequency was observed for CYP2D6*3 polymorphism in patients under rivastigmine combination therapy (A>del = 0.50 [patients] and A>del = 0.20 [controls]), UGT2B7 (T = 0.17 [patients] and 0.33 [Controls], and UGT1A9*5 A = 0.58 [patients] and 0.26 [Controls]). The drug levels and P value of responders/nonresponders were found to be 0.17 ± 0.08/0.22 ± 0.16 and 0.574 for rivastigmine and 0.18 ± 0.11/0.66 ± 0.63 and 0.009 for rivastigmine in combination therapy and 1.40 ± 0.65/0.59 ± 0.84 and 0.05 for memantine in combination therapy.

Conclusion

Poor metabolizer subjects of UGT2B7 polymorphism in patients under rivastigmine combination therapy have higher drug levels with a poor response to the drug treatments.
Developing Corporate Governance Research through Qualitative Methods: A Review of Previous Studies
Authors: McNulty Terry , Zattoni Alessandro , Douglas Thomas
Published: December 2012

Manuscript Type

Review

Research Question/Issue

The article is concerned with the prevalence, character, and development of qualitative research within the field of corporate governance. The paper provides an overview of published qualitative research in the field of corporate governance based on a structured literature search of papers published in scholarly peer‐reviewed journals between 1986 and 2011.

Research Findings/Insights

A fine‐grained search based on key words resulted in a sample of 78 qualitative corporate governance studies. A review and content analysis of these studies show that qualitative studies in governance have grown in number since the 1990s, but remain a small fraction of the published work on corporate governance. Studies are mostly developed by UK and European scholars, published in European journals and tend to explore boards of directors more than other governance related actors and mechanisms. These studies utilize a range of disciplines, predominantly management, adopting a wide range of methods, the most prevalent being that of the interview, often in combination with other methods to get a better account of the empirical phenomenon.

Theoretical/Academic Implications

The search reveals an eclectic range of theories, spanning several disciplines, which is serving to generate, elaborate, and refine theorizing about corporate governance and the associated meanings, mechanisms, processes and relationships. There is much scope and need for more qualitative studies of significant rigor and relevance which explore the array of interactions and processes involved in corporate governance, across different levels of analysis and contexts.

Practitioner/Policy Implications

After over two decades of research and reform of corporate governance, problems of practice remain, and corporate governance prescription via codes and other forms of regulation is increasing in search of better governance. Qualitative research can assist policy‐makers and practitioners to develop more efficient governance mechanisms, by shedding light on the efficacy of policy prescription. Qualitative research provides a basis for rethinking and challenging some of the dominant assumptions and meanings about how governance actors and institutions actually function.
An antibiotic formulary for a tertiary care foot clinic: admission avoidance using intramuscular antibiotics for borderline foot infections in people with diabetes
Authors: Gooday C. , Hallam C. , Sieber C. , Mtariswa L. , Turner J. , Schelenz S. , Murchison R. , Messenger G. , Morrow D. , Hutchinson R. , Williams H. , Dhatariya K.
Published: December 2012

Aims

To develop an antibiotic foot formulary for the empirical treatment of diabetes‐related foot infections presenting to our service. Subsequently, to asses costs associated with the introduction of our protocol, in particular to assess the effect on admissions avoidance and any cost savings achieved.

Methods

We reviewed several existing antibiotic protocols. We analysed data on costs related to treatment and admission rates prior to and after the introduction of the protocol.

Results

We rationalized our antibiotic protocol and adapted the Infectious Disease Society of America guideline by introducing a category of ‘moderate infection—borderline admission’ to our classification. This enabled the administration of outpatient intramuscular antibiotics. After introducing the rationalized protocol, our average antibiotic prescribing costs for a 3‐week course of treatment fell from £17.12 to £16.42. Over 22 months of follow‐up, 26 episodes were eligible for treatment with intramuscular antibiotics. Over the same time period, 121 people were admitted directly from the foot clinic. The costs saved as a result of avoided or delayed admission for those 26 episodes was over £76 000. For 12 people who required subsequent admission, their length of hospital stay was significantly shorter than those admitted directly [9.25 days (range 2–25) vs. 16.11 (2–64), P = 0.045].

Conclusions

By modifying the Infectious Disease Society of America classification and adopting a protocol to administer outpatient oral and intramuscular antibiotics, we have led to substantial cost savings, shorter hospital admissions and also have developed a successful admissions avoidance strategy.
Higher expression of induced defenses in teosintes (Zea spp.) is correlated with greater resistance to fall armyworm, Spodoptera frugiperda
Authors: Szczepaniec Adrianna , Widney Sarah E. , Bernal Julio S. , Eubanks Micky D.
Published: December 2012

Selection for plant traits important for agriculture can come at a high cost to plant defenses. While selecting for increased growth rate and yield, domestication and subsequent breeding may lead to weakened defenses and greater susceptibility of plants to herbivores. We tested whether expression of defense genes differed among maize, Zea mays ssp. mays L. (Poaceae), and its wild relatives Zea mays ssp. parviglumis Iltis & Doebley and Zea diploperennis Iltis et al. We used two populations of Z. mays ssp. parviglumis: one expected to express high levels of an herbivore resistance gene, wound‐inducible protein (wip1), and another expected to have low expression of wip1. To test whether maize and wild Zea differed in induction of defenses against Spodoptera frugiperda (Smith) (Lepidoptera: Noctuidae), we quantified expression of several genes involved in plant defense: wip1, maize protease inhibitor (mpi), pathogenesis‐related protein (PR‐1), and chitinase. Moreover, we compared growth, development, and survival of caterpillars on maize and wild Zea plants. We found that maize expressed low levels of all but one of the genes when attacked by caterpillars, whereas the wild relatives of maize expressed induced defense genes at high levels. Expression of wip1, in particular, was much greater in the Z. mays ssp. parviglumis population that we expected to naturally express high levels of wip1, with expression levels 29‐fold higher than in herbivore‐free plants. Elevated expression of defenses in wild plants was correlated with higher resistance to caterpillars. Larvae were 15–20% smaller on wild Zea compared with maize, developed 20% slower, and only 22% of them survived to pupation on Z. mays ssp. parviglumis with high levels of wip1. Our results suggest that domestication has inadvertently reduced the resistance of maize, and it is likely that expression of wip1 and other genes associated with defenses play an important role in this reduction in resistance.
Factors influencing adult male Grapholita molesta dispersal in commercial Malus and Prunus host crops
Authors: Ellis N.H. , Hull L.A.
Published: December 2012

The oriental fruit moth (OFM), Grapholita molesta (Busck) (Lepidoptera: Tortricidae), has been an economic pest of apples (Malus spp.) and peaches (Prunus spp.; both Rosaceae) in the eastern USA since the 1930s. Successful management of G. molesta with insecticides requires careful timing of these products based on sex‐pheromone trap captures of male moths. In Pennsylvania, apple and peach orchards are often planted adjacently. Factors such as trap distance from release points, host crop, and wind were considered in relation to male moth movement within and between hosts. Our practical objective was to understand male G. molesta dispersal within and between these two hosts to achieve better management. Recapture of moths decreased over distance; the majority of moths were recaptured 50–100 m from the release point regardless of crop type. Male G. molesta released into commercial apple and peach orchards were most likely to remain in the crop of release and to not exhibit host shifts over the season, even after peach fruit were harvested. Our analyses of wind direction data with respect to recapture showed that the likelihood of recapture was similar regardless of the orientation of the traps relative to the mean wind direction at peak flight times. The apple and peach host crops appeared to affect male G. molesta dispersal to the extent that wind in orchards affects their perception of pheromone. Crop effects were most likely due to the traps closest to the release points being in the same crop as the release points.
Distinct behavioural strategies underlying asymmetric mating interactions between invasive and indigenous whiteflies
Authors: Luan Jun‐Bo , De Barro P.J. , Ruan Yong‐Ming , Liu Shu‐Sheng
Published: December 2012

Knowledge of animal mating strategy may provide insight into the evolution of mating behaviour, speciation, and species competition interactions. Our previous study showed that asymmetric mating interactions between invasive and indigenous species of the worldwide distributed whitefly Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) complex contribute to invasion and displacement. Here, we reobserved in detail the video recordings of mating behaviour and behavioural interactions of a previous study and did an integrated analysis on the new data obtained here and some aspects of the data reported earlier. We compared the mating strategies of an invasive whitefly species and an indigenous congeneric competitor from each of two geographic regions, China and Australia. We found that in both regions, females of the invasive species had higher propensity to copulate than those of the indigenous species. In addition, females of the invasive species increased their frequency of copulation in response to increases in courting by males. Compared with males of the indigenous species, those of the invasive species were more likely to court per unit time as well as to interrupt courting pairs, and they also exhibited shorter durations of copulation. In addition, males of the invasive species exhibited post‐copulatory guarding behaviour, whereas those of the indigenous species did not. The different mating strategies exhibited by the invasive and indigenous species may be the evolutionary basis of their asymmetric mating interactions. Such differences in mating strategies confer on the invasive whitefly species the capacity to both invade and displace indigenous whitefly competitors.
Bigger is not always better: egg size influences survival throughout incubation in brown trout (Salmo trutta)
Authors: Régnier Thomas , Bolliet Valérie , Gaudin Philippe , Labonne Jacques
Published: December 2012

Classical optimality models for the evolution of egg size predict a single optimal investment for females inferior to the optimal investment for offspring because of the egg size–fecundity trade‐off and the assumption that ‘bigger is better’ for offspring fitness. Such models do not satisfactorily represent observed within‐population variation in egg size. We measured the influence of maternal investment in egg size on offspring survival in brown trout. Individual measures of egg size, metabolism and survival at different temperatures throughout ontogeny were carried out. We then developed a survival model with regard to egg size, incubation temperature and observed metabolic rate. Small eggs were found to survive at higher rates than large eggs, and the egg size–survival relationship was found to differ among females in accordance with average metabolic rate measured at hatching. These results provide insights for the understanding of the evolutionary significance of egg size variations within a population.
A novel epsilon gamma delta beta thalassemia presenting with pregnancy complications and severe neonatal anemia
Authors: Shalev Hanna , Landau Daniela , Pissard Serge , Krasnov Tanya , Kapelushnik Joseph , Gilad Oded , Broides Arnon , Dgany Orly , Tamary Hannah
Published: December 2012

Objective

The epsilon gamma delta beta (εγδβ)‐thalassemias are rare sporadic disorders caused by deletion of the β‐globin gene cluster. The main clinical feature is marked prenatal and neonatal anemia that resolves spontaneously within a few months. Reports originating mainly from Europe have so far identified 30 such deletions The aim of the present work was to describe a novel 1.78‐Mb deletion, the longest ever reported, and to detail the clinical features in 12 members of an extended Bedouin family.

Methods

The deletion was identified by globin gene multiplex ligation‐dependent probe amplification (MLPA) of the β‐globin cluster and further characterized by comparative genomic hybridization. Past and present clinical and laboratory data of ten symptomatic and two asymptomatic patients were collected.

Results

A 1.78‐Mb εγδβ‐deletion, the largest ever described, was identified in all patients. Although other genes were included in the deletion, no other symptoms were observed. Of the ten symptomatic fetuses and neonates, three died of the disease. The remainder required packed cell transfusions during the first months of life. Pregnancy complications included intrauterine growth restriction and oligohydramnios, as well as additional neonatal complications including prematurity and persistent pulmonary hypertension of the neonate.

Conclusions

We suggest that εγδβ‐thalassemia be added to the list of hemoglobinopathies that can cause neonatal anemia and that MLPA of the β‐globin cluster be used to confirm its diagnosis. Careful surveillance during pregnancy is important to reduce neonatal mortality and morbidity, especially given the dramatic improvement that occurs later.
Direct binding of GABAA receptor β2 and β3 subunits to gephyrin
Authors: Kowalczyk Sarah , Winkelmann Aline , Smolinsky Birthe , Förstera Benjamin , Neundorf Ines , Schwarz Guenter , Meier Jochen C.
Published: December 2012

GABAergic transmission is essential to brain function, and a large repertoire of GABA type A receptor (GABAAR) subunits is at a neuron's disposition to serve this function. The glycine receptor (GlyR)‐associated protein gephyrin has been shown to be essential for the clustering of a subset of GABAAR. Despite recent progress in the field of gephyrin‐dependent mechanisms of postsynaptic GABAAR stabilisation, the role of gephyrin in synaptic GABAAR localisation has remained a complex matter with many open questions. Here, we analysed comparatively the interaction of purified rat gephyrin and mouse brain gephyrin with the large cytoplasmic loops of GABAAR α1, α2, β2 and β3 subunits. Binding affinities were determined using surface plasmon resonance spectroscopy, and showed an ~ 20‐fold lower affinity of the β2 loop to gephyrin as compared to the GlyR β loop–gephyrin interaction. We also probed in vivo binding in primary cortical neurons by the well‐established use of chimaeras of GlyR α1 that harbour respective gephyrin‐binding motifs derived from the different GABAAR subunits. These studies identify a novel gephyrin‐binding motif in GABAAR β2 and β3 large cytoplasmic loops.
Cortical processing of saccade‐related efference copy signals in patients with cerebellar lesion
Authors: Peterburs Jutta , Koch Benno , Schwarz Michael , Hoffmann Klaus‐Peter , Daum Irene , Bellebaum Christian
Published: December 2012

The updating of visual space across saccades is thought to rely on efference copies of motor commands. In humans, thalamic lesions impair performance on a saccadic double‐step task, which requires the use of efference copy information, and the altering of saccade‐related efference copy processing. This deficit is attributed to disruption of a pathway from the superior colliculus to the frontal eye field. However, the cerebellum is probably also involved in efference copy processing, due to its pivotal role for predictive motor control. The present study investigated the processing of efference copy information in eight patients with focal cerebellar lesions and 22 healthy controls by means of a saccadic double‐step task with simultaneous event‐related potential recording. Despite intact behavioural performance, a positive event‐related potential component between 150 and 450 ms after first saccade onset in the updating condition, which has been interpreted in terms of the integration of efference copy signals with motor intentions for a subsequent saccade, was markedly reduced in the patients. These findings suggest that the cerebellum contributes to on‐line saccade monitoring, and that cerebellar lesions alter saccade‐related efference copy processing. However, given the intact behavioural performance, the reduced positivity in the patients may indicate that cerebellar damage is accounted for by either exploiting reduced saccade‐related information, or making use of compensatory strategies to circumvent a deficit in using efference copy information procured by the cerebellum. The present study extends previous findings on the neural underpinnings of saccadic updating and further elucidates the mechanisms underlying cerebellar predictive motor control.
How theories evolved concerning the mechanism of action of barbiturates
Authors: Löscher Wolfgang , Rogawski Michael A.
Published: December 2012

The barbiturate phenobarbital has been in use in the treatment of epilepsy for 100 years. It has long been recognized that barbiturates act by prolonging and potentiating the action of γ‐aminobutyric acid (GABA) on GABAA receptors and at higher concentrations directly activating the receptors. A large body of data supports the concept that GABAA receptors are the primary central nervous system target for barbiturates, including the finding that transgenic mice with a point mutation in the β3 GABAA‐receptor subunit exhibit diminished sensitivity to the sedative and immobilizing actions of the anesthetic barbiturate pentobarbital. Although phenobarbital is only modestly less potent as a GABAA‐receptor modulator than pentobarbital, phenobarbital is minimally sedating at effective anticonvulsant doses. Possible explanations for the reduced sedative effect of phenobarbital include more regionally restricted action; partial agonist activity; reduced propensity to directly activate GABAA receptors (possibly including extrasynaptic receptors containing δ subunits); and reduced activity at other ion channel targets, including voltage‐gated calcium channels. In recent years, substantial progress has been made in defining the structural features of GABAA receptors responsible for gating and allosteric modulation by drugs. Although the precise sites of action of barbiturates have not yet been defined, the second and third transmembrane domains of the β subunit appear to be critical; binding may involve a pocket formed by β‐subunit methionine 286 as well as α‐subunit methionine 236. In addition to effects on GABAA receptors, barbiturates block AMPA/kainate receptors, and they inhibit glutamate release through an effect on P/Q‐type high‐voltage activated calcium channels. The combination of these various actions likely accounts for their diverse clinical activities. Despite the remarkable progress of the last century, there is still much to learn about the actions of barbiturates that can be applied to the discovery of new, more therapeutically useful agents.