bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycobacterium shigaense sp. nov., a novel slowly growing scotochromogenic mycobacterium that produced nodules in an erythroderma patient with severe cellular immunodeficiency and a history of Hodgkin’s disease
Authors: NAKANAGA Kazue , HOSHINO Yoshihiko , WAKABAYASHI Makiko , FUJIMOTO Noriki , TORTOLI Enrico , MAKINO Masahiko , TANAKA Toshihiro , ISHII Norihisa
Published: September 2011

A novel slow‐growing scotochromogenic mycobacterium was isolated from skin biopsies from a patient with a history of Hodgkin’s disease and severe cellular immunodeficiency as an opportunistic pathogen. Clinical characterization of these lesions revealed papules and nodules with pathological granuloma formation. Genotypic analysis using 16S rRNA misidentified this isolate as Mycobacterium simiae. However, multiple gene analysis using the internal transcribed spacer between the 16S and 23S rRNA genes, and the rpoB and hsp65 genes revealed the presence of a novel mycobacterium. The antimicrobial susceptibility of this isolate was completely different from that of M. simiae. On the basis of these findings, we propose naming this new species Mycobacterium shigaense sp. nov., and conclude that multiple gene analysis is required for the appropriate diagnosis and treatment of non‐tuberculous mycobacterial infections.
Real‐time 4‐D radiotherapy for lung cancer
Authors: Shirato Hiroki , Onimaru Rikiya , Ishikawa Masayori , Kaneko Jun‐ichi , Takeshima Tsuguhide , Mochizuki Kenta , Shimizu Shinichi , Umegaki Kikuo
Published: September 2011

Respiratory motion considerably influences dose distribution, and thus clinical outcomes in radiotherapy for lung cancer. Breath holding, breath coaching, respiratory gating with external surrogates, and mathematical predicting models all have inevitable uncertainty due to the unpredictable variations of internal tumor motion. The amplitude of the same tumor can vary with standard deviations >5 mm occurring in 23% of T1–2N0M0 non‐small cell lung cancers. Residual motion varied 1–6 mm (95th percentile) for the 40% duty cycle of respiratory gating with external surrogates. The 4‐D computed tomography is vulnerable to problems relating to the external surrogates. Real‐time 4‐D radiotherapy (4DRT), where the temporal changes in anatomy during the delivery of radiotherapy are explicitly considered in real time, is emerging as a new method to reduce these known sources of uncertainty. Fluoroscopic, real‐time tumor‐tracking technology using internal fiducial markers near the tumor has ±2 mm accuracy, and has achieved promising clinical results when used with X‐ray therapy. Instantaneous irradiation based on real‐time verification of internal fiducial markers is considered the minimal requisite for real‐time 4DRT of lung cancers at present. Real‐time tracking radiotherapy using gamma rays from positron emitters in tumors is in the preclinical research stage, but has been successful in experiments in small animals. Real‐time tumor tracking via spot‐scanning proton beam therapy has the capability to cure large lung cancers in motion, and is expected to be the next‐generation real‐time 4DRT. (Cancer Sci 2012; 103: 1–6)
The effectiveness of opioid maintenance treatment in prison settings: a systematic review
Authors: Hedrich Dagmar , Alves Paula , Farrell Michael , Stöver Heino , Møller Lars , Mayet Soraya
Published: September 2011

Aims  To review evidence on the effectiveness of opioid maintenance treatment (OMT) in prison and post‐release.

Methods  Systematic review of experimental and observational studies of prisoners receiving OMT regarding treatment retention, opioid use, risk behaviours, human immunodeficiency virus (HIV)/hepatitis C virus (HCV) incidence, criminality, re‐incarceration and mortality. We searched electronic research databases, specialist journals and the EMCDDA library for relevant studies until January 2011. Review conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.

Results  Twenty‐one studies were identified: six experimental and 15 observational. OMT was associated significantly with reduced heroin use, injecting and syringe‐sharing in prison if doses were adequate. Pre‐release OMT was associated significantly with increased treatment entry and retention after release if arrangements existed to continue treatment. For other outcomes, associations with pre‐release OMT were weaker. Four of five studies found post‐release reductions in heroin use. Evidence regarding crime and re‐incarceration was equivocal. There was insufficient evidence concerning HIV/HCV incidence. There was limited evidence that pre‐release OMT reduces post‐release mortality. Disruption of OMT continuity, especially due to brief periods of imprisonment, was associated with very significant increases in HCV incidence.

Conclusions  Benefits of prison OMT are similar to those in community settings. OMT presents an opportunity to recruit problem opioid users into treatment, to reduce illicit opioid use and risk behaviours in prison and potentially minimize overdose risks on release. If liaison with community‐based programmes exists, prison OMT facilitates continuity of treatment and longer‐term benefits can be achieved. For prisoners in OMT before imprisonment, prison OMT provides treatment continuity.
Alteration of gene expression profile in maize infected with a double‐stranded RNA fijivirus associated with symptom development
Authors: JIA MENG‐AO , LI YONGQIANG , LEI LEI , DI DIANPING , MIAO HONGQIN , FAN ZAIFENG
Published: September 2011

Maize rough dwarf disease caused by Rice black‐streaked dwarf virus (RBSDV) is a major viral disease in China. It has been suggested that the viral infection of plants might cause distinct disease symptoms through the inhibition or activation of host gene transcription. We scanned the gene expression profile of RBSDV‐infected maize through oligomer‐based microarrays to reveal possible expression changes associated with symptom development. Our results demonstrate that various resistance‐related maize genes and cell wall‐ and development‐related genes, such as those for cellulose synthesis, are among the genes whose expression is dramatically altered. These results could aid in research into new strategies to protect cereal crops against viruses, and reveal the molecular mechanisms of development of specific symptoms in rough dwarf‐related diseases.
Medical comorbidity associated with psoriasis in adults: a population-based study
Authors: Yang Y-W. , Keller J.J. , Lin H-C.
Published: September 2011

Background Most publications to date on comorbidities associated with psoriasis have focused on cardiovascular and metabolic diseases. Few comprehensive investigations of medical comorbidities in a cohort of patients with psoriasis appear in the literature.

Objectives To examine the prevalence of comorbidities in adult patients with psoriasis, including a comparison of comorbid prevalence vs. that in controls without psoriasis, in a nationally representative dataset in Taiwan.

Methods There were 1685 adult patients with psoriasis in the study group and 5055 randomly selected subjects in the comparison group. We used conditional logistic regression analyses to examine the risk of 29 comorbidities for these two groups after adjusting for monthly income, geographical region of residence and the level of urbanization of each patient’s community of residence.

Results After adjusting for several potential confounders, patients with psoriasis had higher odds of comorbid congestive heart failure [odds ratio (OR) 1·63], ischaemic heart disease (OR 1·51), renal failure (OR 1·45), uncomplicated diabetes (OR 1·37), liver diseases (OR 1·34), hepatitis B or C (OR 1·34), complicated diabetes (OR 1·32), hyperlipidaemia (OR 1·28), hypertension (OR 1·24) and peptic ulcer (OR 1·22) than did patients without psoriasis. However, patients with mild psoriasis had higher odds of comorbidity only with uncomplicated diabetes (OR 1·55), asthma (OR 1·30), liver diseases (OR 1·30) and peptic ulcer (OR 1·26) than patients without psoriasis.

Conclusions We conclude that psoriasis is associated with a variety of medical comorbidities including cardiovascular diseases, metabolic diseases, renal failure, liver diseases, viral hepatitis B or C, asthma and peptic ulcers.
Factors predicting therapeutic efficacy of combination treatment with sitagliptin and metformin in type 2 diabetic patients: the COSMETIC study
Authors: Lim Soo , An Jee Hyun , Shin Hayley , Khang Ah Reum , Lee Yenna , Ahn Hwa Young , Yoon Ji Won , Kang Seon Mee , Choi Sung Hee , Cho Young Min , Park Kyong Soo , Jang Hak Chul
Published: September 2011

Objective  We assessed the predictive parameters for therapeutic efficacy of initial combination therapy with sitagliptin and metformin in drug‐naïve type 2 diabetic patients.

Design, Patients, and Measurements  In this 52‐week treatment study, 150 patients (mean age, 54·9 ± 12·5 years) with type 2 diabetes and HbA1c of 7·0–10% were treated with sitagliptin 100 mg once and metformin 500 mg twice daily. To assess the predictive parameters for therapeutic efficacy, a multivariate regression analysis was performed with baseline fasting glucose, insulin, C‐peptide, and glucagon levels, homoeostasis model assessment‐insulin resistance (HOMA‐IR) and β‐cell function (HOMA‐B), insulinogenic index (IGI, defined as 30–0 min insulin/30–0 min glucose), and area under the curve for glucose, insulin, and C‐peptide obtained after 75‐g oral glucose tolerance test.

Results  After 52 weeks, mean HbA1c levels and fasting and postload 2‐h glucose were significantly decreased from 8·7 ± 1·4% to 7·2 ± 1·3%, 9·2 ± 3·0 to 7·2 ± 1·8 mm, and 17·5 ± 5·1 to 10·9 ± 3·6 mm, respectively (P < 0·01). HOMA‐B and IGI increased significantly from 50·3 ± 33·5 to 75·1 ± 32·8 and from 11·3 ± 1·3 to 35·0 ± 6·3 at 52 weeks, respectively (P < 0·01). Multivariate regression analysis indicated that the reduction in HbA1c was significantly associated with high baseline HbA1c, low IGI, and short duration of diabetes after adjusting for age, sex, body mass index, blood pressure, triglycerides, creatinine, high‐sensitivity CRP, glucagon, C‐peptide, HOMA‐B, and HOMA‐IR. No severe adverse events were observed.

Conclusion  These results suggest that drug‐naïve type 2 diabetic patients with low β‐cell function would benefit the most from early initial combination therapy of sitagliptin and metformin.
Spontaneous remission of idiopathic aldosteronism after long‐term treatment with spironolactone: results from the German Conn’s Registry
Authors: Fischer Evelyn , Beuschlein Felix , Degenhart Christoph , Jung Philip , Bidlingmaier Martin , Reincke Martin
Published: September 2011

Context  Primary aldosteronism (PA) is mainly caused by aldosterone‐producing adenoma and idiopathic bilateral adrenal hyperplasia (IHA). Recently, spontaneous resolution of IHA has been described.

Objective  We aimed to determine the frequency of spontaneous remission of PA during long‐term treatment with mineralocorticoid receptor (MR) antagonists.

Design, setting and patients  Thirty‐seven patients of the Munich PA registry with IHA treated by MR antagonists were investigated. The patients were identified retrospectively by chart review and prospectively assessed by clinical and biochemical means.

Main outcome measures  Complete remission of IHA was defined as normal aldosterone to renin ratio (ARR), normal suppression test and normalization of hypokalaemia in the presence of normal blood pressure. Partial remission was defined as normalization of normal ARR, normal suppression test and normalization of hypokalaemia in the presence of persistent hypertension.

Results  The mean period of MR antagonist treatment was 5·8 ± 0·7 years in the patients. We identified two of 37 (5·4%) patients with spontaneous remission: one with complete remission and one with partial remission.

Conclusion  Remission of IHA in PA may occur in some patients after long‐term mineralocorticoid antagonist treatment.
Hepcidin expression in patients with acute leukaemia
Authors: Cheng Pan‐Pan , Sun Zhen‐Zhen , Jiang Fang , Tang Yue‐Ting , Jiao Xiao‐Yang
Published: September 2011

Eur J Clin Invest 2012; 42 (5): 517–525

Background  Hepcidin plays a central role in iron homeostasis, which is regulated by iron stores, the rate of erythropoiesis, inflammation, and hypoxia. Aberrant expression of hepcidin was found in many diseases, however, there is scant information on hepcidin expression in acute leukemia (AL).

Materials and methods  32 patients with AL which diagnosis according to FAB criteria were studied. Serum hepcidin levels, erythropoietin (EPO), interleukin‐6 (IL‐6), hematological parameters, intracellular and extracellular iron store were evaluated.

Results  Hepcidin was elevated significantly with increased iron storage in patients at onset of AL when erythropoiesis was depressed by blast cells, then decreased significantly with AL remission, while soluble transferrin receptor (sTfR) concentration was elevated. Negative correlations were found between serum hepcidin and erythropoietic markers including RBC, Hb, Ret and sTfR. Positive correlations were shown between hepcidin and ferritin, between hepcidin and ratio of sideroblasts, as well as between hepcidin and IL‐6.

Conclusions  Hepcidin production was regulated by iron stores, inflammation and erythropoietic activity in AL patients. Erythropoietic activity may play the main role among the regulators of hepcidin expresssion.
Peripheral blood immunologic phenotype of population‐based breast cancer cases and matched controls
Authors: Goedert James J. , Pfeiffer Ruth , Zhu Mingzhu , Yang Xiaohong R. , Garcia‐Closas Montserrat , Lissowska Jolanta , Kopp William C.
Published: September 2011

Eur J Clin Invest 2012; 42 (5): 572–574
Size scaling of whole‐body metabolic activity in the noble crayfish (Astacus astacus) estimated from measurements on a single leg
Authors: SIMČIČ TATJANA , PAJK FRANJA , VREZEC AL , BRANCELJ ANTON
Published: September 2011

1. Use of electron transport system (ETS) activity in a single leg for estimating whole‐body ETS activity was explored in the noble crayfish Astacus astacus. Oxygen consumption and ETS activity of the whole body and of a walking leg were measured in different‐sized animals at 10 °C to compare the size scaling of oxygen consumption, whole‐body ETS activity and the ratio of whole‐body ETS activity to oxygen consumption (ETS/R).

2. Electron transport system activity of a leg and the ratio of ETS activity of a whole crayfish to that of a leg were correlated with wet mass of animals. Therefore, metabolic potential in whole noble crayfish can be estimated on the basis of the measured ETS activity in a single leg and crayfish mass. This approach provides a valuable tool for determining metabolic characteristics of crayfish without killing them.

3. Mass‐specific oxygen consumption decreased with increasing wet mass, while ETS activity of whole crayfish showed no significant correlation with wet mass. Both oxygen consumption and ETS activity correlated significantly with protein mass.

4. The increase in ETS/R with increasing wet mass of the noble crayfish indicates that small organisms exploit a greater proportion of their metabolic potential for standard metabolism than larger ones. This is the first report on ETS/R in crayfish.
Quantifying relationships between land‐use gradients and structural and functional indicators of stream ecological integrity
Authors: CLAPCOTT J. E. , COLLIER K. J. , DEATH R. G. , GOODWIN E. O. , HARDING J. S. , KELLY D. , LEATHWICK J. R. , YOUNG R. G.
Published: September 2011

1. Modification of natural landscapes and land‐use intensification are global phenomena that can result in a range of differing pressures on lotic ecosystems. We analysed national‐scale databases to quantify the relationship between three land uses (indigenous vegetation, urbanisation and agriculture) and indicators of stream ecological integrity. Boosted regression tree modelling was used to test the response of 14 indicators belonging to four groups – water quality (at 578 sites), benthic invertebrates (at 2666 sites), fish (at 6858 sites) and ecosystem processes (at 156 sites). Our aims were to characterise the ecological response curves of selected functional and structural metrics in relation to three land uses, examine the environmental moderators of these relationships and quantify the relative utility of metrics as indicators of stream ecological integrity.

2. The strongest indicators of land‐use effects were nitrate + nitrite, delta‐15 nitrogen value (δ15N) of primary consumers and the Macroinvertebrate Community Index (a biotic index of organic pollution), while the weakest overall indicators were gross primary productivity, benthic invertebrate richness and fish richness. All indicators declined in response to removal of indigenous vegetation and urbanisation, while variable responses to agricultural intensity were observed for some indicators.

3. The response curves for several indicators suggested distinct thresholds in response to urbanisation and agriculture, specifically at 10% impervious cover and at 0.1 g m−3 nitrogen concentration, respectively.

4. Water quality and ecosystem process indicators were influenced by a combination of temperature, slope and flow variables, whereas for macroinvertebrate indicators, catchment rainfall, segment slope and temperature were significant environmental predictor variables. Downstream variables (e.g. distance to the coast) were significant in explaining residual variation in fish indicators, not surprisingly given the preponderance of diadromous fish species in New Zealand waterways. The inclusion of continuous environmental variables used to develop a stream typology improved model performance more than the inclusion of stream type alone.

5. Our results reaffirm the importance of accounting for underlying spatial variation in the environment when quantifying relationships between land use and the ecological integrity of streams. Of distinctive interest, however, were the contrasting and complementary responses of different indicators of stream integrity to land use, suggesting that multiple indicators are required to identify land‐use impact thresholds, develop environmental standards and assign ecological scores for reporting purposes.
Host plant variation plastically impacts different traits of the immune system of a phytophagous insect
Authors: Vogelweith Fanny , Thiéry Denis , Quaglietti Bastien , Moret Yannick , Moreau Jérôme
Published: September 2011

1. Host plant quality affects herbivorous insect performance and consequently their susceptibility to natural enemies. Recently, it has been hypothesized that the immune function of herbivorous insects can be altered by their host plant, thus generating variation in their susceptibility to entomopathogens. Previous studies testing this hypothesis provided contradictory outcomes, mainly as a result of the differences in methodology such as measuring a single‐immune parameter rather than considering trade‐off‐mediated interactions between immune defence systems of the insect. Here, we hypothesized that plant‐mediated changes in insect immunity could result from the alteration of physiological immune effectors of the herbivore evident as trade‐offs.

2. Larvae of an inbred strain of the European grape berry moth Eupoecilia ambiguella were reared on five artificial diets each based on a different grape variety (Chardonnay, Chasselas, Gewurztraminer, Merlot, Riesling) and tested for changes in the baseline concentration of haemocytes, activities of the prophenoloxidase (PPO) system and of antimicrobial peptides of their haemolymph. Immune responsiveness of larvae across diets was also assessed by measuring changes in haemocyte concentration and activity of the PPO system after a bacterial immune challenge.

3. We found that variation among diets significantly affected immune defences of larvae. The alteration of the E. ambiguella immune system appears plastic and partly mediated by existing physiological trade‐offs between immune pathways, at least between induced antibacterial defences and the PPO system.

4. These results clearly show that host plant quality can affect immune defences and potentially disease resistance of E. ambiguella and that these changes in immunity may also result from intrinsic trade‐offs between immune defence systems in insects.
Interactive effects of nutrient heterogeneity and competition: implications for root foraging theory?
Authors: Mommer Liesje , van Ruijven Jasper , Jansen Corien , van de Steeg Harry M. , de Kroon Hans
Published: September 2011

1. Plants are known to respond to heterogeneous distribution of nutrients in the soil, and they also respond to the presence of neighbouring roots. However, it is unclear whether plants are able to distinguish between these factors and adjust their root responses accordingly.

2. We investigated whether the simultaneous response to nutrient heterogeneity and competition could be predicted from the responses to these factors separately. As a null model, we hypothesized that the responses to nutrients and competition are additive and thus no interactions occur. We performed a short‐term competition experiment in the greenhouse with two floodplain species in homogeneous and heterogeneous conditions. The consequences of different root distributions for nutrient uptake were tested using 15N pulse‐labelling.

3. Both species responded to nutrient heterogeneity by investing significantly more roots in the nutrient‐rich patch, and both species showed a significant reduction in root growth in response to competition, albeit that the reduction was much more pronounced for the grass species. For Rumex palustris, the effects of heterogeneity and competition were additive. However, the response to nutrient heterogeneity of Agrostis stolonifera was reversed by competition: instead of proliferating in the nutrient‐rich patch, it significantly increased root investments in the ‘empty’ (nutrient‐poor) patches. As the partitioning of total N was less asymmetric than 15N uptake from the nutrient‐rich patch, it appears that these altered root investments of A. stolonifera in the ‘empty’ patches have also been functional with respect to compensating N uptake.

4. Our results suggest that root responses to nutrient distribution in a competitive environment depend on the competitive strength of the neighbouring species. The foraging response of the superior species (R. palustris) was hardly affected, but that of the inferior species (A. stolonifera) was greatly inhibited and even reversed by competition: instead of proliferating in the nutrient‐rich patch, it increased root growth and foraging activity in less favourable patches. Incorporating competitive hierarchy into root foraging studies may help to explain the ambiguous results found in previous studies.
Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension
Authors: Ma Chunhua , Chen Shaoxian , You Liming , Luo Zhimin , Xing Caixia
Published: September 2011

ma c., chen s., you l., luo z. & xing c. (2012) Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. Journal of Advanced Nursing68(6), 1402–1413.

Aim.  This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension.

Background  Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients.

Methods.  A multi‐phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test–retest reliability were assessed.

Results.  The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six‐factor model. Cronbach’s α of the overall questionnaire was 0·86 and 0·82 for test–retest reliability.

Conclusions.  The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients’ treatment adherence and to be applied in the research and clinical fields.
Environmental factors determining the phylogenetic structure of C4grass communities
Authors: Visser Vernon , Woodward F. Ian , Freckleton Rob P. , Osborne Colin P.
Published: September 2011

Aim To determine how the distribution of species richness is associated with environmental factors for the four major C4grass lineages in South Africa, as a means to explore the mechanisms responsible.

Location South Africa, Lesotho and Swaziland.

Methods The geographical distributions of species richness for four major C4grass lineages (Aristidoideae, Chloridoideae, Andropogoneae and Paniceae) were sourced from a recently published flora that divided the study region into different vegetation types. Mean values of potential environmental correlates were calculated for each vegetation type, and the relative importances of these were determined using single‐ and multiple‐predictor generalized linear models, with and without control for spatial autocorrelation. Model selection of the multiple‐predictor generalized linear models was conducted using an Akaike’s information criterion–information theoretic approach. Association with wet, intermediate or dry, shady or open, and disturbed or undisturbed habitats was also determined for each C4grass clade using habitat data for all the grass species, and analysed using chi‐square tests of independence.

Results Andropogoneae and Paniceae are most species‐rich in areas of high precipitation and in mesic habitats. Andropogoneae are associated with high fire frequencies. Species richness in Andropogoneae decreases and in Paniceae increases in relation to livestock density. Chloridoideae species richness is relatively constant across South Africa, but is highest where there are infrequent fires, high temperatures and basic soils, and in mesic and disturbed habitats. Aristidoideae are most species‐rich in arid regions and in habitats with high temperatures, and are associated with disturbed habitats.

Main conclusions Environmental variables other than precipitation, including temperature, fire frequency and grazing pressure, are strongly associated with the contrasting distributions of species richness for the various C4grass clades in South Africa. Our results suggest that ecological sorting is an important determinant of phylogenetic patterns in the species richness of these C4grass lineages.
Present and past genetic connectivity of the Indo‐Pacific tropical eel Anguilla bicolor
Authors: Minegishi Yuki , Gagnaire Pierre‐Alexandre , Aoyama Jun , Bosc Pierre , Feunteun Eric , Tsukamoto Katsumi , Berrebi Patrick
Published: September 2011

Aim  The objective of this study was to reveal the present population structure and infer the gene‐flow history of the Indo‐Pacific tropical eel Anguilla bicolor.

Location  The Indo‐Pacific region.

Methods  The entire mitochondrial control region sequence and the genotypes at six microsatellite loci were analysed for 234 specimens collected from eight representative localities where two subspecies have been historically designated. In order to infer the population structure, genetic differentiation estimates, analysis of molecular variance and gene‐tree reconstruction were performed. The history of migration events and population growth was assessed using neutrality tests based on allelic frequency spectrum, coalescent‐based estimation of gene flow and Bayesian demographic analysis using control region sequences.

Results  Population structure analysis showed genetic divergence between eels from the Indian and Pacific oceans (FST = 0.0174–0.0251, P < 0.05 for microsatellites; ΦST = 0.706, P < 0.001 for control region), while no significant variation was observed within each ocean. Two mitochondrial sublineages that do not coincide with geographical regions were found in the Indian Ocean clade of a gene tree. However, these two sublineages were not differentiated at the microsatellite markers. The estimation of mitochondrial gene‐flow history suggested allopatric isolation between the Indian and Pacific oceans, and a possible secondary contact within the Indian Ocean after an initial population splitting. Bayesian demographic history reconstruction and neutrality tests indicated population growth in each ocean after the Indo‐Pacific divergence.

Main conclusions  Anguilla bicolor has diverged between the Indian and Pacific oceans, which is consistent with the classical subspecies designation, but is apparently genetically homogeneous in the Indian Ocean. The analysis of gene‐flow and demographic history indicated that the two mitochondrial sublineages observed in the Indian Ocean probably represent the haplotype groups of relict ancestral populations. A comparison with a sympatric congener suggested that absolute physical barriers to gene flow may not be necessary for population divergence in eels.
Coping with challenging behaviours of children with autism: effectiveness of brief training workshop for frontline staff in special education settings
Authors: Ling C. Y. M. , Mak W. W. S.
Published: September 2011

Background  The present study examined the effectiveness of three staff training elements: psychoeducation (PE) on autism, introduction of functional behavioural analysis (FBA) and emotional management (EM), on the reaction of challenging behaviours for frontline staff towards children with autism in Hong Kong special education settings.

Methods  A sample of 311 frontline staff in educational settings was recruited to one of the three conditions: control, PE‐FBA and PE‐FBA‐EM groups. A total of 175 participants completed all three sets of questionnaires during pre‐training, immediate post‐training and 1‐month follow‐up.

Results  Findings showed that the one‐session staff training workshop increased staff knowledge of autism and perceived efficacy but decrease helping behavioural intention.

Conclusions  In spite of the limited effectiveness of a one‐session staff training workshop, continued staff training is still necessary for the improvement of service quality. Further exploration on how to change emotion response of staff is important.
‘I think we're all guinea pigs really’: a qualitative study of medication and borderline personality disorder
Authors: ROGERS B. , ACTON T.
Published: September 2011

Accessible summary

Seven service users with Borderline Personality Disorder (BPD) were interviewed to explore their experience of being treated with medication.

Service users identified there was a lack of knowledge and understanding around the BPD diagnosis, which made treating this group difficult for staff.

Service users also reported there was also a lack of resources for this diagnostic group so staff relied on medication, although this had improved with the introduction of a specialist service for people with a personality disorder.

Service users had different opinions on whether they thought medication was a part of their recovery pathway, but agreed they should be involved in deciding whether it would be used as a treatment.

National Institute for Clinical Excellence recommended the use of medication only in times of crisis for individuals with borderline personality disorder (BPD). Despite this recommendation most service users referred to a specialist personality disorder service were found to be on numerous medications. Although a number of qualitative studies have explored the experience of individuals with a diagnosis of BPD they have failed to discuss their experience of being treated with medication, despite its high prescription with this group (e.g. Sansone et al.). The aim of this study was to explore the experience of service users being treated with medication for the BPD diagnosis. Semi‐structured interviews were carried out with seven service users under a specialist service for personality disorder. Interviews were transcribed and analysed using thematic analysis. The main themes to emerge were: staff knowledge and attitudes, lack of resources for BPD and the recovery pathway for BPD. Overall, service users felt that receiving the BPD diagnosis had had a negative impact on the care they received, with staff either refusing treatment or focusing on medication as a treatment option. The introduction of specialist services for this group appears to improve service user satisfaction with their treatment and adherence to the National Institute for Clinical Excellence guidelines.
Late‐life depression: systematic assessment of care needs as a basis for treatment
Authors: HOUTJES W. , VAN MEIJEL B. , DEEG D. J. H. , BEEKMAN A. T. F.
Published: September 2011

Accessible summary

Systematic assessment of the care needs of older patients using the CANE contributes significantly to a targeted nursing anamnesis and diagnostic process.

The Camberwell Assessment of Need for the Elderly appears to be a very suitable tool for structured and high quality of care.

Patients may benefit more from depression treatment when significant others of the patients (carers and staff) would be more sensitive to the unmet needs of depressed patients in different stages of their depression, and when treatment would be better targeted at these unmet needs.

Given the broad range of possible unmet needs, collaborative care arrangements should be established with home care, welfare and other organizations, to achieve adequate and efficient referrals to the responsible care providers.

Research shows that most of the variance in depression severity levels in late life can be explained by the unmet psychological needs of patients, more in particular the care needs of patients related with psychological distress. This case report describes the treatment of an 84‐year‐old patient suffering from depression. Her complaints faded upon the use of nursing interventions that were defined on the basis of a systematic assessment of her care needs with the Camberwell Assessment of Needs for the Elderly. The methodical attention to her needs for care and the interventions carried out led to the patient feeling acknowledged and to a diminished need for care and a better quality of life. Although there is no scientific evidence to date, a systematic assessment of care needs may well be a meaningful addition to the nursing diagnostic process. Moreover, alleviating distress in patients by fulfilling unmet care needs through tailored interventions can be seen as an essential element of an effective multidisciplinary depression treatment process.
A quantitative analysis of the submentalis muscle electromyographic amplitude during rapid eye movement sleep across the lifespan
Authors: FERRI RAFFAELE , BRUNI OLIVIERO , FULDA STEPHANY , ZUCCONI MARCO , PLAZZI GIUSEPPE
Published: September 2011

The current definition of rapid eye movement (REM) sleep without atonia has no quantitative character, and cut‐off values above which the level of electromyographic tone can be considered to be ‘excessive’ are unclear. The aim of this study was to analyse the characteristics of chin electromyographic amplitude by means of an automatic approach in a large group of normal controls, subdivided into different age groups. Eighty‐eight normal controls were included, subdivided into six age groups: preschoolers (≤6 years); schoolers (6–10 years); preadolescents (10–13 years); young adults (24–40 years); middle‐aged (58–65 years); and old (>65 years). The average amplitude of the rectified submentalis muscle electromyographic signal was used for the computation of the REM sleep Atonia Index. Chin muscle activations were detected, and their amplitude, duration and interval analysed. REM sleep Atonia Index showed a progressive and rapid increase from the preschool age to school and preadolescent age, reaching the maximum in the young adult group; after this age a small decline was observed in the middle‐aged and old subjects. Conversely, the number of movements per hour in REM sleep showed a ‘U’‐shaped distribution across these age groups, with the minimum in the preadolescent group and the two extremes (preschool age and old) showing similar average levels of activity. Our results show that REM sleep atonia develops continuously during the lifespan, and undergoes complex changes with different developmental trajectories for REM atonia and electromyographic activations during REM sleep. Different mechanisms might subserve these two phenomena and their differential developmental dynamics.
Impact of hepatitis B virus infection on metabolic profiles and modifying factors
Authors: Hsu C.‐S. , Liu C.‐H. , Wang C.‐C. , Tseng T.‐C. , Liu C.‐J. , Chen C.‐L. , Chen P.‐J. , Chen D.‐S. , Kao J.‐H.
Published: September 2011

Summary.  The metabolic syndrome may cause disease progression in patients with chronic hepatitis B (CHB). However, the interactions between hepatitis B virus (HBV) infection and metabolic factors remain unknown. We investigated the association of HBV infection with metabolic profiles in HBV‐infected and noninfected subjects. In addition, the impacts of serum HBV DNA level on metabolic profiles were studied. Initially, a case–control analysis of patients with and without chronic HBV infection was performed. The HBV group consisted of 322 patients with chronic HBV infection, and the control group consisted of 870 matched subjects without HBV infection. Fasting blood glucose, lipid profiles and adiponectin levels were compared. The results were then confirmed in a second retrospective cohort study in 122 CHB patients with serum HBV DNA levels and HOMA‐IR index values. In the case–control analysis, the HBV group had significantly higher serum adiponectin, but lower triglyceride (TG) and high‐density lipoprotein cholesterol (HDL) levels than the control group. These relationships already existed in subjects younger than 45 years of age and were modified by serum alanine aminotransferase (ALT) levels. In the retrospective cohort, serum HBV DNA levels were negatively proportional to TG levels, but not to other metabolic parameters. Moreover, this relationship was significant only in subjects with higher ALT levels. Compared with healthy adults, patients with chronic HBV infection have significantly higher serum adiponectin, but lower TG and HDL levels. These relationships are modified by ALT levels and already exist in middle‐age patients with chronic HBV infection, implying HBV may interact with host metabolism.
Galectin‐11 induction in the gastrointestinal tract of cattle following nematode and protozoan infections
Authors: HOORENS P. , RINALDI M. , MIHI B. , DREESEN L. , GRIT G. , MEEUSEN E. , LI R. W. , GELDHOF P.
Published: September 2011

Galectin‐11 (LGALS11) has been suggested to play an important role in protective immunity against gastrointestinal nematodes in ruminants. However, in cattle, this molecule has not been characterized in detail. In the current study, it was shown that transcription of LGALS11 was highly inducible in the bovine abomasal mucosa after an Ostertagia ostertagi infection. LGALS11 protein expression was also increased in the abomasal mucosa following O. ostertagi infection and localized to the nucleus and cytoplasm of epithelial cells and the mucus. Using in vitro abomasal epithelial cell cultures, it was shown that LGALS11 induction was associated with the proliferative and dedifferentiated status of cells. However, LGALS11 was not induced following stimulation with O. ostertagi excretory–secretory products. These results suggest that LGALS11 induction in vivo may be an indirect rather than a direct effect of the parasite on the epithelium. In addition, LGALS11 transcript was also detected in the abomasal lymph nodes where it was shown to be transcribed in MHCII+ cells; however, transcription levels in the lymph nodes were not altered after O. ostertagi infection. In addition, LGALS11 was also induced in the small intestine by different types of parasites, including the nematode Cooperia oncophora and the protozoan parasite Giardia duodenalis.
Transient alkalinization in the leaf apoplast of Vicia faba L. depends on NaCl stress intensity: an in situ ratio imaging study
Authors: GEILFUS CHRISTOPH‐MARTIN , MÜHLING KARL HERMANN
Published: September 2011

The apoplast is suggested to be involved not only in the response, but also in the perception and transduction of various environmental signals. In this context, apoplastic alkalinization has previously been discussed as a general stress factor caused by abiotic and biotic stress events. In this study, an ion‐sensitive fluorescence probe in combination with inverted fluorescence microscopy has been used for in planta monitoring of apoplastic shoot pH during challenging of Vicia faba L. plants by NaCl stress encountered at the roots. We demonstrate that transient increases in leaf apoplastic pH are dependent on the NaCl stress intensity. Moreover, we have visualized spatial pH gradients within the leaf apoplast. Our results indicate that these pH responses are propagated from root to leaf and that this occurs along the apoplast.
Molecular Diagnostic Challenges and Complex Management of Consecutive Twin Pregnancies in a Family with CD40 Ligand Deficiency
Authors: Török O. , Tóth B. , Erdős M. , Csorba G. , Gyimesi E. , Balogh I. , Tóth Z. , Maródi L.
Published: September 2011

X‐linked hyper‐IgM syndrome (XHIGM) is a primary immunodeficiency disorder (PID) caused by mutation in the gene encoding the CD40 ligand (CD40L) expressed on activated T cells. Prenatal genotyping in carriers with twin pregnancies is more challenging than in women with singleton pregnancies. In addition, women with twin pregnancies may decide on selective termination for which the risk of loss of the healthy foetus may exceed 7%. We report here on a family affected by XHIGM. Diagnosis of the disease was made in a male patient as late as 33 years of age. After family screening, the sister of the proband conceived male twins in two consecutive pregnancies. In the first pregnancy, one of the male foetuses was hemizygous for the c.521A>G (Q174R) mutation in the CD40L gene. In the second pregnancy, ultrasound scan showed one foetus to have exencephaly and karyotyping revealed this foetus to have trisomy 18. Several options were discussed, but the parents decided on selective termination in both pregnancies. The interventions were successful in both cases, and the mother now has two healthy sons. This report demonstrates the way in which advanced technologies in molecular medicine and obstetric interventions may assist families with decisions about possible selective termination in case of life‐threatening molecular or chromosomal disorders. Diagnosis of CD40L deficiency at the age of 33 years in the proband was striking and indicated that PIDs are still neglected as disease entities in the evaluation of patients with recurrent severe infectious diseases.
New World biogeography and the evolution of polychromatism: evidence from the bee assassin genus Apiomerus (Heteroptera: Reduviidae: Harpactorinae)
Authors: BERNIKER LILY , WEIRAUCH CHRISTIANE
Published: September 2011

The crassipes and pictipes species groups of Apiomerus Hahn together contain 12 species, many with high intraspecific chromatic variability, which represent the majority of Nearctic species in this New World assassin bug genus. Because of their geographical distribution and their varying degrees of polychromatism, these two species groups provide a unique opportunity to study the evolution of polychromatism and analyse relationships among areas of endemism in the Nearctic, as well as determine the boundary between the Nearctic and Neotropical regions. The results of a morphology based phylogenetic analysis allowed investigation of these questions while also determining relationships among the 12 species in the two species groups. The crassipes and pictipes species groups were each supported as monophyletic and as sister taxa. Apiomerus rufipennis (Fallou) was not included in the original concept of the crassipes species group, but is shown here to be a member of the group. Apiomerus barrocoloradoi Forero, Berniker & Szerlip, which had been hypothesized previously to belong to the pictipes species group, is excluded from this group. Intraspecific polychromatism for each species was identified as being present in one of three states: no polychromatism; limited polychromatism; or polychromatism as discrete colour morphs. Limited polychromatism was here found to be the ancestral state for Apiomerus, and species with discrete colour morphs are restricted to the crassipes and pictipes species groups. Polychromatism appears to be a greatly homoplastic character within the genus. A Brooks parsimony analysis recovered distinct Nearctic and Neotropical clades. The Nearctic clade is divided between areas in the central and eastern U.S.A. and areas in the Western U.S.A. and Mexico. The Nearctic–Neotropical boundary for the taxa included in the analysis is along the Isthmus of Tehuantepec in southern Mexico.
Women who experience obstetric haemorrhage are at higher risk of anaemia, in both rich and poor countries
Authors: Wagner K. S. , Ronsmans C. , Thomas S. L. , Calvert C. , Adler A. , Ganaba R. , Goufodji S. , Filippi V.
Published: September 2011

Objectives  Anaemia is a potential long‐term sequel of obstetric blood loss, but the increased risk of anaemia in women who experience a haemorrhage compared to those who do not has not been quantified. We sought to quantify this risk and explore the duration of increased risk for these women.

Methods  Systematic review of articles published between 1990 and 2009. Data were analysed by high‐ and low‐income country groupings. Prevalence and incidence ratios, and mean haemoglobin levels were compared.

Results  Eleven of 822 studies screened were included in the analysis. Most studies showed a higher prevalence or incidence of anaemia in women who had experienced haemorrhage than in those who did not, irrespective of the timing of measurement post‐partum. In high‐income countries, women who had a haemorrhage were at 5.68 (95% CI 5.04–6.40) times higher risk of post‐partum anaemia than women who did not. In low‐income countries, the prevalence of anaemia was 1.58 (95% CI 0.96–2.60) times higher in women who had a haemorrhage than in women who did not, although this ratio was greater when the study including mild anaemia in its definition of anaemia was excluded (1.93, 95% CI 1.42–2.62). Population‐attributable fractions ranged from 14.9% to 39.6%. Several methodological issues, such as definitions, exclusion criteria and timing of measurements, hindered the comparability of study results.

Conclusions  Women who experience haemorrhage appear to be at increased risk of anaemia for many months after delivery. This important finding could have serious implications for their health care and management.