bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review: the burden of disruptive gastro‐oesophageal reflux disease on health‐related quality of life
Authors: Tack J. , Becher A. , Mulligan C. , Johnson D. A.
Published: April 2012

Background

About one‐third of patients with gastro‐oesophageal reflux disease (GERD) have frequent and/or severe reflux symptoms (‘disruptive GERD’). The relative burden of disruptive GERD on health‐related quality of life (HRQL) has not been systematically investigated.

Aim

To assess the burden of disruptive vs. nondisruptive GERD on HRQL.

Methods

Systematic searches were conducted in PubMed and Embase. To be included, studies had to have used validated questionnaires to assess HRQL.

Results

Nineteen studies were included. Data on the comparative burden of frequent (ranging from daily to ≥weekly) and severe reflux symptoms were provided in eight and 13 studies respectively; six reported on the additional burden of nocturnal symptoms. Compared with individuals with nondisruptive GERD, those with disruptive GERD had 2.4‐times and 1.5‐times higher mean rates of absenteeism and presenteeism respectively (five studies), 1.5‐times lower sleep quality scores (three studies), 1.1‐times lower mean summary scores for physical and mental health (five studies) and 1.3‐times lower mean scores for psychological and general well‐being (four studies). Increasing symptom frequency and severity both increased the burden of disease to a similar extent. The presence of nocturnal symptoms in addition to daytime symptoms led to worsening of physical health, but their effect on mental health and work productivity was less clear.

Conclusions

Disruptive GERD is associated with a high burden of disease compared with occasional or mild reflux symptoms. Disease management needs to vary across the GERD spectrum and should be tailored to patients' requirements for optimal therapeutic outcomes.
Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma
Authors: Kim D. Y. , Ryu H. J. , Choi J. Y. , Park J. Y. , Lee D. Y. , Kim B. K. , Kim S. U. , Ahn S. H. , Chon C. Y. , Han K.‐H.
Published: April 2012

Background

It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC).

Aim

To reveal the clinical relevance of compact lipiodolisation after TACE.

Methods

We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not.

Results

Of the 490 patients, 409 (83.5%) were in Child–Pugh class A and 81 (16.5%) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7% vs. 14.6%, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours ≤5, 5–10 and >10 cm was 46.6%, 13.6%, and 0% respectively. The 1‐, 3‐ and 5‐year survival rates of patients with compact uptake were 92.7%, 70.7% and 52.4% compared to 60.8%, 28.0% and 16.9% in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child–Pugh class, alpha‐fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival.

Conclusions

Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.
Perchlorate and thiocyanate exposure and thyroid function in first‐trimester pregnant women from Greece
Authors: Pearce Elizabeth N. , Alexiou Maria , Koukkou Eftychia , Braverman Lewis E. , He Xuemei , Ilias Ioannis , Alevizaki Maria , Markou Kostas B.
Published: April 2012

Objective

Thyroid hormone, requiring adequate maternal iodine intake, is critical for neurodevelopment in utero. Perchlorate and, less so, thiocyanate decrease uptake of iodine into the thyroid gland by competitively inhibiting the sodium/iodide symporter (NIS). It remains unclear whether environmental perchlorate exposure adversely affects thyroid function in first‐trimester pregnant women.

Design

Cross‐sectional.

Patients

134 pregnant women from Athens, Greece, at mean ± SD 10·9 ± 2·3 weeks' gestation.

Measurements

Urinary iodide, perchlorate, and thiocyanate and thyroid function tests were measured.

Results

The median urinary iodide was 120 μg/l. Urinary perchlorate levels were detectable in all women: median (range) 4·1 (0·2–118·5) μg/l. Serum thyroperoxidase antibodies (TPO Ab) were detectable in 16% of women. Using Spearman's rank correlation analyses, there was no correlation between urinary perchlorate concentrations and serum TSH, although inverse correlations were seen between urine perchlorate and free T3 and free T4 values. In univariate analyses, urine thiocyanate was positively correlated with serum TSH, but was not associated with serum free T3 or free T4. Urine perchlorate was positively correlated with gestational age. In multivariate analyses adjusting for urinary iodide concentrations, urine thiocyanate, gestational age, maternal age and TPO Ab titres, urine perchlorate was not a significant predictor of thyroid function.

Conclusions

Low‐level perchlorate and thiocyanate exposure is ubiquitous, but, in adjusted analyses, is not associated with alterations in thyroid function tests among mildly iodine‐deficient Greek women in the first trimester of pregnancy.
Larval Japanese eel (Anguilla japonica) as sub‐surface current bio‐tracers on the East Asia continental shelf
Authors: HAN YU‐SAN , ZHANG HENG , TSENG YU‐HENG , SHEN MAO‐LIN
Published: April 2012

Larval Japanese eel (leptocephali) are passively transported from their spawning sites of the North Equatorial Current to the Kuroshio and its branch waters for 4–6 months before reaching the East Asian coasts. The larvae mainly stay within water depths between 50–150 m. The dispersal dynamics of larvae thus should reflect the sub‐surface oceanic currents on the East Asia continental shelf. An analysis of Japanese glass eel catch data in East Asian countries during 1985 to 2009, and for Taiwan from 1968 to 2008, indicates that the overall annual catch is generally correlated across countries of East Asia, and between north and west areas of Taiwan. The Kuroshio and its branch waters disperse glass eels throughout East Asian habitats, and the glass eel distribution matches the flow directionality of oceanic currents. Recruitment in western Taiwan occurs with a sequential southwestern to northwestern direction, suggesting that the Taiwan Strait Current penetrates the western coast of Taiwan in the sub‐surface layer in winter. The monthly averaged sub‐surface 50 m circulation pattern in the vicinity of Taiwan and modeled tracer experiments also support the northward winter sub‐surface current in Taiwan Strait. These results suggest that the larval Japanese eel could serve as a valuable bio‐tracer of sub‐surface currents, and the earlier recruitment dynamics of Japanese glass eels in Taiwan could be a good predictor for the subsequent catch in other East Asia areas.
Validation of diagnostic assays to screen broodstock for Flavobacterium psychrophilum infections
Authors: Long A , Polinski M P , Call D R , Cain K D
Published: April 2012

It is hypothesized that the frequency of bacterial coldwater disease outbreaks can be reduced through the detection of the aetiologic agent, Flavobacterium psychrophilum, in broodstock followed by culling of eggs from heavily infected broodstock. Before a culling programme can be instituted, however, it is necessary to determine the sensitivity and specificity of existing assays for the detection of F. psychrophilum. In this study, tissue and ovarian fluid samples were collected from 224 fish at five hatcheries and screened using an enzyme‐linked immunosorbent assay (ELISA), a membrane‐filtration fluorescent antibody test (MF‐FAT), bacteriological culture and nested PCR. Latent class analysis was used to estimate sensitivity and specificity of kidney culture, kidney ELISA, nested PCR and MF‐FAT. Analytical sensitivity of the ELISA varied but was greatest when bacteria were cultured under iron‐limiting conditions. Diagnostic sensitivity estimates ranged from 0.02 (kidney culture) to 0.97 (kidney ELISA). Specificity estimates ranged from 0.02 (MF‐FAT) to 0.98 (kidney ELISA). In a separate challenge experiment, the ELISA confirmed the presence of F. psychrophilum in sub‐clinically infected fish. Results from this study demonstrate that the ELISA is an appropriate tool to screen broodstock and provides an indication of infection severity, which is crucial for implementation of a screening/culling programme.
A cross‐over randomised clinical trial of eccentric occlusion in complete dentures
Authors: PALEARI A. G. , MARRA J. , RODRIGUEZ L. S. , De SOUZA R. F. , PERO A. C. , De A. MOLLO JR. F. , COMPAGNONI M. A.
Published: April 2012

Summary  The objective of this study is to compare the effects of canine guidance (CG) and bilateral balanced occlusion (BBO) on denture satisfaction and kinesiographic parameters of complete denture wearers, by means of a cross‐over trial. Fifty edentulous patients received new maxillary and mandibular complete dentures. After the intra‐oral adjustments and adaptation period, 44 participants were enrolled in the trial and randomly received a sequence of occlusal schemes: BBO followed by CG, or CG followed by BBO. Outcomes were assessed after 30 days of each occlusal scheme. Participants answered a denture satisfaction questionnaire and a kinesiograph instrument recorded mandibular physiologic movements and pattern of maxillary denture movement during chewing. Wilcoxon test and paired sample t‐test were used to compare satisfaction levels and kinesiographic data for each occlusal scheme, respectively (α = 0·05). The results showed no differences between occlusal schemes on participant’s satisfaction and in any of the kinesiographic parameters studied, except for the vertical intrusion of the maxillary complete denture during chewing, which was lower with CG. It can be concluded that the occlusal scheme did not influence on satisfaction and kinesiographic parameters evaluated, as long as volume and resilience of residual edentulous ridges of the participants were normal. Clinical Trial Registration Identifier: NC.T01420536.
The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations
Authors: TÜRP J. C. , SCHINDLER H.
Published: April 2012

Summary  The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross‐sectional survey – the Study of Health in Pomerania (Germany) – associations between 15 occlusion‐related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. However, statistical associations do not prove causality. By using Hill’s nine criteria of causation, it becomes apparent that the evidence of a causal relationship is weak. Only bruxism, loss of posterior support and unilateral posterior crossbite show some consistency across studies. On the other hand, several reported occlusal features appear to be the consequence of TMDs, not their cause. Above all, however, biological plausibility for an occlusal aetiology is often difficult to establish, because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance‐induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non‐occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs.
Correlated evolution of senescence and ephemeral substrate use in the Sordariomycetes
Authors: GEYDAN THOMAS D. , DEBETS ALFONS J. M. , VERKLEY GERARD J. M. , Van DIEPENINGEN ANNE D.
Published: April 2012

Evolutionary theory predicts that senescence—a decline in reproduction and survival with increasing age—can evolve as a trade‐off between investment in reproduction on one side and in somatic maintenance and repair on the other. The ecology of a species is crucial because it provides the external causes of death that determine the statistical limit to a species’ lifespan. Filamentous fungi are generally believed to be nonsenescent, and there are indeed spectacular examples of very old fungal individuals in nature. However, some fungi utilize ephemeral resources, and therefore, senescence is expected to have evolved, like in the coprophilic Podospora anserina, the only well‐studied filamentous fungus with intrinsic senescence. Here, we hypothesize that rapid senescence is more common in fungi than generally believed and that the phylogenetic distribution of senescence correlates with ecology. We collected lifespan data for a set of Sordariomycetes and constructed phylogenies based on several nuclear sequences. Several of the strains were from the CBS culture collection, originally isolated from various substrates, some of which ephemeral. In addition, we isolated new strains from short‐lived substrates. Senescence was observed throughout the phylogeny. Correlation tests support the hypothesis that in the Sordariomycetes, senescence is a trait that has arisen in response to ephemeral substrates, and that it has evolved repeatedly and independently along the phylogeny.
Multi‐tier regulation of the streptomycete morphogenetic peptide SapB
Authors: Gaskell Alisa A. , Giovinazzo Joseph A. , Fonte Vanessa , Willey Joanne M.
Published: April 2012

Streptomyces coelicolor is a morphologically complex bacterium requiring the secretion of surface‐active proteins to progress through its life cycle. SapB represents an important class of these biosurfactants, as illustrated by its ability to restore aerial hyphae formation when applied exogenously to developmental mutants. However, such aerial hyphae fail to sporulate, exemplifying the need to co‐ordinate the timing of SapB production with other developmental events. SapB has an unusual lantibiotic structure. Its structural gene, ramS, is only 38 nucleotides downstream of the gene encoding its putative modification enzyme, RamC. Transient, co‐ordinated expression of the operon was thought to be controlled by the response regulator RamR. However, we show that ramS is transcribed throughout the cell cycle with a dual expression profile dissimilar to the tightly controlled ramC expression. Surprisingly, post‐translational modification relies on prior membrane localization of the precursor peptide, RamS, as demonstrated by the absence of RamS modification in S. coelicolor hyphae treated with the Bacillus subtilis lipoprotein surfactin. Our results demonstrate that interspecies interaction can also be mediated by interference of post‐translational events. Further, temporal and spatial regulation of irreversible post‐translational modification of a surface‐active morphogenetic peptide suggests a new model for the control of key developmental events.
Deficiency of the Y14 protein is a critical factor underlying the etiology of thrombocytopenia with absent radii syndrome
Authors: Jan A
Published: April 2012

Compound inheritance of a low‐frequency regulatory SNP and a rare null mutation in exon‐junction complex subunit RBM8A causes TAR syndrome Albers CA et al. (2012) Nature Genetics 44(4): 435–439.
Genic DNA methylation changes during in vitro organogenesis: organ specificity and conservation between parental lines of epialleles
Authors: Maury Stéphane , Trap‐Gentil Marie‐Véronique , Hébrard Claire , Weyens Guy , Delaunay Alain , Barnes Steve , Lefebvre Marc , Joseph Claude
Published: April 2012

During differentiation, in vitro organogenesis calls for the adjustment of the gene expression program toward a new fate. The role of epigenetic mechanisms including DNA methylation is suggested but little is known about the loci affected by DNA methylation changes, particularly in agronomic plants for witch in vitro technologies are useful such as sugar beet. Here, three pairs of organogenic and non‐organogenic in vitro cell lines originating from different sugar beet (Beta vulgaris altissima) cultivars were used to assess the dynamics of DNA methylation at the global or genic levels during shoot or root regeneration. The restriction landmark genome scanning for methylation approach was applied to provide a direct quantitative epigenetic assessment of several CG methylated genes without prior knowledge of gene sequence that is particularly adapted for studies on crop plants without a fully sequenced genome. The cloned sequences had putative roles in cell proliferation, differentiation or unknown functions and displayed organ‐specific DNA polymorphism for methylation and changes in expression during in vitro organogenesis. Among them, a potential ubiquitin extension protein 6 (UBI6) was shown, in different cultivars, to exhibit repeatable variations of DNA methylation and gene expression during shoot regeneration. In addition, abnormal development and callogenesis were observed in a T‐DNA insertion mutant (ubi6) for a homologous sequence in Arabidopsis. Our data showed that DNA methylation is changed in an organ‐specific way for genes exhibiting variations of expression and playing potential role during organogenesis. These epialleles could be conserved between parental lines opening perspectives for molecular markers.
Development of the Permanent Mandibular Cheek Teeth in Fallow Deer (Dama dama)
Authors: Kierdorf H. , Hommelsheim S. , Kierdorf U.
Published: April 2012

The study describes crown and root formation of the permanent mandibular cheek teeth of fallow deer from a gestational age of 22–23 weeks up to a post‐natal age of 33 months. Tooth development was recorded using a scoring scheme based on morphological criteria ranging from crypt formation to completion of root growth. The morphological appearance of the enamel surface during three different stages (secretory‐stage enamel, maturation‐stage enamel and mature enamel) was described, and the approximate age at termination of the secretory stage of amelogenesis in the deciduous and permanent mandibular cheek teeth was determined. The data enable an age estimation of fallow deer up to 3 years of age and provide a basis for assessing the timing of stress episodes that affect tooth crown formation. This information is useful for the management of the species as well as in bioarchaeological and bioindication studies.
A 13‐lipoxygenase is Expressed Early in the Hypersensitive Reaction of Cotton Plants to Xanthomonas campestris pv. malvacearum
Authors: Sanier Christine , Sayegh‐Alhamdia Majd , Jalloul Aïda , Clerivet Alain , Nicole Michel , Marmey Philippe
Published: April 2012

Lipoxygenases (LOXs) are enzymes responsible for lipid peroxidation processes during plant defence responses to pathogen infection. Jasmonates are lipid‐derived signals that mediate plant stress responses with chloroplastic LOXs implicated in the biosynthesis of oxylipins like jasmonic acid (JA). Hypersensitive reaction (HR) cell death of cotton to the incompatible race 18 of Xanthomonas campestris pathovar malvacearum (Xcm) is associated with 9S‐lipoxygenase activity and expression of a 9‐LOX GhLOX1. Here, we report the cloning of cotton (Gossypium hirsutum L.) LOX gene GhLOX2. Sequence analysis showed that GhLOX2 is a putative 13‐LOX with a chloroplast‐transit peptide in the amino acid terminus. GhLOX2 was found to be significantly expressed in the first hour of Xcm‐induced HR. Investigation into LOX signalization on cotyledons incubated with methyl‐jasmonate (MeJA) or infiltrated with salicylic acid (SA) or ethylene (ET) revealed that the first two treatments induced GhLOX2 gene expression. Our results show that GhLOX2 gene expression occurred at the stage of the HR prior biochemical events previously highlighted. The role that GhLOX2 may have in the defence strategy of cotton to Xcm is discussed regarding the HR.
Reproductive system and fitness of Vriesea friburgensis, a self‐sterile bromeliad species
Authors: PAGGI GECELE MATOS , DA SILVEIRA LUCAS CAETANO TIEPPO , ZANELLA CAMILA MARTINI , BRUXEL MANUELA , BERED FERNANDA , KALTCHUK‐SANTOS ELIANE , PALMA‐SILVA CLARISSE
Published: April 2012

Reproductive biology and plant fertility are directly related to many aspects of plant evolution and conservation biology. Vriesea friburgensis is an epiphytic and terrestrial bromeliad endemic to the Brazilian Atlantic rainforest. Hand‐pollination experiments were used to examine the reproductive system in a wild population of V. friburgensis. Plant fertility was assigned considering flower production, fruit and seed set, seed germination, and pollen viability. Self‐sterility observed from spontaneous selfing and manual self‐pollination treatments may be the consequence of late‐acting self‐incompatibility. Hand‐pollination results indicated no pollen limitation in the population studied. Floral biology features such as a few daily open flowers, nectar production, and sugar concentration corroborate hummingbirds as effective pollinators, although bees were also documented as pollinators. Components of fitness such as high flower, fruit, and seed production together with high seed and pollen viability indicate that this wild population is viable. From a conservation point of view, we highlight that this self‐sterile species depends on pollinator services to maintain its population fitness and viability through cross‐pollination. Currently, pollinators are not limited in this population of V. friburgensis. Conversely, the maintenance and continuous conservation of this community is essential for preserving this plant–pollinator mutualism.
Body mass index predicts cecal insertion time: The higher, the better
Authors: Krishnan Prashant , Sofi Aijaz Ahmed , Dempsey Robert , Alaradi Osama , Nawras Ali
Published: April 2012

Background:  It is essential to determine the factors that predict prolonged procedural time during colonoscopy. The aim of this study was to determine the effect of body mass index (BMI) on cecal insertion time (CIT) during colonsocopy.

Methods:  Consecutive outpatients who received colonoscopies over a 10 month period (April–October 2007) were enrolled. Exclusion criteria included colonic resection, strictures or exophytic masses precluding colonic evaluation. Data were collected for age, sex, race, height, weight, BMI, waist circumference, prior history of abdominal or pelvic surgery, history of diverticulosis, participation of fellow, CIT, quality of colon cleansing and the amount of sedation used during the procedure.

Results:  A total of 1430 patients (586 men and 844 women; mean age 60.3 years) were included in the final analysis. The mean CIT was 648.5 seconds (SE = 11.47). Older age, female gender, fellow involvement, poor bowel preparation and lower BMI were associated with prolonged mean CIT on linear regression analysis (R2 = 0.116; P < 0.001). Mean CIT declined linearly with increasing BMI.

Conclusion:  A higher BMI is strongly associated with progressively shorter CIT.
Effect of the Fukushima nuclear power plant accident on radioiodine (131I) content in human breast milk
Authors: Unno Nobuya , Minakami Hisanori , Kubo Takahiko , Fujimori Keiya , Ishiwata Isamu , Terada Hiroshi , Saito Shigeru , Yamaguchi Ichiro , Kunugita Naoki , Nakai Akihito , Yoshimura Yasunori
Published: April 2012

Background:  Environmental pollution with radioiodine (iodine‐131, 131I) occurred after an accident at the Fukushima nuclear power plant (FNP) on March 11, 2011, in Japan. Whether environmental pollution with 131I can contaminate human breast milk has not been documented.

Methods:  The 131I content was determined in 126 breast milk samples from 119 volunteer lactating women residing within 250 km of the FNP, between April 24 and May 31, 2011. The degree of environmental pollution was determined based on the data released by the Japanese government.

Results:  An 131I content of 210 Bq/kg in the tap water in Tokyo, which is located 230 km south of the FNP, on March 22 and of 3500 Bq/kg in spinach sampled in a city located 140 km southwest of the FNP on March 19 decreased over time to <21 Bq/kg on March 27 and 12 Bq/kg on April 26, respectively. Seven of the 23 women who were tested in April secreted a detectable level of 131I in their breast milk. The concentrations of 131I in the breast milk of the seven women were 2.3 Bq/kg (on April 24), and 2.2, 2.3, 2.3, 3.0, 3.5 and 8.0 (on April 25); the concentrations of 131I in the tap water available for these seven women at the same time were estimated to be <1.3 Bq/kg. None of the remaining 96 women tested in May exhibited a detectable concentration of 131I in their breast milk samples.

Conclusions:  The contamination of breast milk with 131I can occur even when only mild environmental 131I pollution is present.
Review of the pandemic (H1N1) 2009 among pregnant Japanese women
Authors: Nakai Akihito , Saito Shigeru , Unno Nobuya , Kubo Takahiko , Minakami Hisanori
Published: April 2012

Pregnant women are prone to serious complications when they contract influenza, and a considerable number of pregnant women died from the pandemic (H1N1) 2009 worldwide; however, no maternal mortality occurred in Japan during this pandemic. This review explores the reasons why maternal mortality did not occur in Japan. Two studies conducted during and soon after the pandemic (H1N1) 2009 in Japan suggested the following: 40 000–50 000 pregnant Japanese women took antiviral medicines for prophylaxis after close contact with an infected person; 40% of them (16 000–20 000) contracted the novel influenza and accounted for a half of all 30 000–40 000 pregnant patients with the novel influenza; at least 181 of them required hospitalization; and at least 17 of them developed pneumonitis. Hospitalized women had a 2.5 times higher risk of preterm delivery (at <37 weeks) compared with the general population. The two studies suggested that the following may have contributed to the lack of maternal mortality in Japan: (i) more than 60% of candidates were vaccinated within 1.5 months after the availability of a vaccine against the novel virus; (ii) vaccination reduced the infection rate by 89%; (iii) a large number of women took antiviral drugs before symptom onset after close contact with an infected person; and (iv) approximately 90% of hospitalized pregnant patients took antiviral drugs within 48 hours after symptom onset.
Decreased expression of elastin, fibulin‐5 and lysyl oxidase‐like 1 in the uterosacral ligaments of postmenopausal women with pelvic organ prolapse
Authors: Zhao Bai‐hui , Zhou Jian‐hong
Published: April 2012

Aim:  Pelvic organ prolapse is associated with defects in connective tissues, including elastic fibers. The purpose of this study was to investigate the expression of fibulin‐5 and lysyl oxidase‐like 1 (LOXL1), which play an essential role in the synthesis and assembly of elastic fibers, in the uterosacral ligaments of women with advanced pelvic organ prolapse (POP) compared with controls.

Method:  Specimens were obtained prospectively during transvaginal or abdominal hysterectomy from 30 women with advanced pelvic organ prolapse and 30 controls matched to the POP group for age and parity among postmenopausal women with benign gynecologic diseases. The expressions of elastin, fibulin‐5 and LOXL1 in uterosacral ligaments were measured by immunohistochemistry.

Results:  We detected a decreased, sometimes absent, expression of fibulin‐5 and LOXL1 in the uterosacral ligaments of women with POP, despite a positive expression of elastin. There was a decrease in positive percentage of LOXL1 in the POP group (23.3%) compared with the controls (60%) (P = 0.004). With immunolabeling intensity classified as negative, weak, moderate or strong, there was a decrease in the expression of fibulin‐5 in the POP group (P = 0.049). We also detected a significantly decreased expression of LOXL1 in the POP group (P = 0.001).

Conclusions:  There was decreased expression of fibulin‐5 and LOXL1 in the uterosacral ligaments of patients with pelvic organ prolapse, while the elastin expression was equivalent, which may suggest the possibility of defects in elastic fiber remodeling in the postpartum period and contribute to POP.
Risk of infant mortality with weekend versus weekday births: A population‐based study
Authors: Salihu Hamisu M. , Ibrahimou Boubakari , August Euna M. , Dagne Getachew
Published: April 2012

Aim:  To examine the association between infant mortality, the day of birth and sociodemographic factors.

Methods:  This population‐based retrospective study analyzed all singleton live births in the state of Missouri during the period 1989 to 1997. The main outcome of interest was infant survival after birth. Hazard ratios (HR) and 95% confidence intervals (CI) for the association between infant mortality and the day of birth were obtained through parametric time to event models.

Results:  The neonatal mortality rate was higher on weekends (3.25/1000) compared to weekdays (2.87/1000) (P = 0.042). Cesarean section delivery increased the risk of neonatal death by a magnitude of 31.5 compared to vaginal births (HR = 31.47, 95% CI: 15.79, 62.74). Adolescent females (age <18) were more likely to experience neonatal (HR = 2.20, 95% CI: 1.47, 3.31), post‐neonatal (HR = 2.20, 95% CI: 1.47, 3.30) and infant mortality (HR = 4.06, CI: 2.02, 8.14).

Conclusions:  Cesarean section delivery heightens the risk of all infant death, including neonatal and post‐neonatal death, regardless of the day of birth, underscoring the need for multi‐tiered strategies to reduce the occurrence of medically unnecessary cesarean sections. Furthermore, the elevated risk of infant mortality among adolescent mothers highlights the importance of enhanced preconception care and age‐appropriate pregnancy prevention interventions.
Proximal epithelioid sarcoma of the vulva: A case report and review of current medical literature
Authors: Ong Aihui Clara , Lim Timothy Yong Kuei , Tan Thiam Chye , Wang Shi , Raju Gangaraju Changal
Published: April 2012

Proximal‐type epithelioid sarcoma (PES) of the vulva is an exceedingly rare soft tissue tumor with an unpredictable symptom pattern and frequent recurrences. Information on management is limited. This report describes a 51‐year‐old woman with proximal‐type epithelioid sarcoma of the vulva which was resected surgically and reviewed the current medical literature regarding the diagnosis and management of this disease.
Changing trends in rectal cancer surgery in Ontario: 2002–2009
Authors: Musselman R. P. , Gomes T. , Chan B. P. , Auer R. C. , Moloo H. , Mamdani M. , Al‐Omran M. , Al‐Obeed O. , Boushey R. P.
Published: April 2012

Aim  The safety and efficacy of laparoscopic surgery for colon cancer have been demonstrated in large, multicentre clinical trials. The study aimed to determine the use of laparoscopic surgery for rectal cancer in Ontario over a 7‐year period.

Method  We conducted a retrospective study examining rates of elective rectal cancer surgery among 10.5 million adults in Ontario, Canada, from 1 April 2002 to 31 March 2009. We linked the Canadian Institute for Health Information Discharge Abstract Database, the Registered Persons Database and the database of the Ontario Cancer Registry to assess procedures used over the period. Data on demographics were collected. Trends were assessed using time series analysis.

Results  Over the 7‐year period, 8189 open and 1079 laparoscopic elective operations for rectal cancer were identified. The annual rate of laparoscopic rectal cancer procedures increased from 0.60 per 100 000 population in 2003 to 2.24 per 100 000 population in 2008 (P < 0.01). Laparoscopic patients were similar to open with respect to age (66.5 ± 11.8 vs 66.2 ± 12.1 years; standardized difference 0.02), gender (63.2%vs 59.4%; standardized difference 0.08), Charlson Comorbidity Index score (standardized difference < 0.1) and socioeconomic status (standardized difference < 0.1).

Conclusion  Laparoscopic rectal cancer surgery rates are increasing in Ontario. Ongoing research regarding the long‐term safety and effectiveness of the laparoscopic approach for rectal cancer surgeries may lead to greater increases in its utilization.
Phylogeny of three choreotrich genera (Protozoa, Ciliophora, Spirotrichea), with morphological, morphogenetic and molecular investigations on three strobilidiid species
Authors: Liu Weiwei , Yi Zhenzhen , Lin Xiaofeng , Warren Alan , Song Weibo
Published: April 2012

Liu, W., Yi, Z., Lin, X., Warren, A. & Song, W. (2012). Phylogeny of three choreotrich genera (Protozoa, Ciliophora, Spirotrichea), with morphological, morphogenetic and molecular investigations on three strobilidiid species. —Zoologica Scripta, 41, 417–434.

The phylogenetic relationships among three strobilidiid genera, namely Strobilidium, Rimostrombidium and Pelagostrobilidium, are investigated using a combination of morphological, morphogenetic and molecular data. The results indicate that all three genera belong to the same lineage, in which Rimostrombidium evolved first and Strobilidium and Pelagostrobilidium derived later. Improved genus diagnoses for Rimostrombidium and Pelagostrobilidium are supplied. The curved kinety 2 and the caudal spiralling of some somatic kineties are confirmed as generic characters for Pelagostrobilidium and Strobilidium, respectively. In addition, the morphology and morphogenesis of three species, namely R. veniliae (Montagnes & Taylor, 1994) Petz et al., 1995, P. paraepacrum sp. n. and P. minutum sp. n., isolated from the South China Sea are described. Pelagostrobilidium paraepacrum sp. n. is characterized by the presence of six somatic kineties, 30–32 external and two internal membranelles. Pelagostrobilidium minutum sp. n. is characterized by its extremely small body size, four somatic kineties, and in having one internal and 19–21 external membranelles. Rimostrombidium conicum Kahl, 1932 is transferred to the genus Pelagostrobilidium as P. conicum (Kahl, 1932) comb. nov.
Dynamic Bayesian Network for Probabilistic Modeling of Tunnel Excavation Processes
Authors: Špačková Olga , Straub Daniel
Published: April 2012

Abstract:  A dynamic Bayesian network (DBN) model for probabilistic assessment of tunnel construction performance is introduced. It facilitates the quantification of uncertainties in the construction process and of the risk from extraordinary events that cause severe delays and damages. Stochastic dependencies resulting from the influence of human factors and other external factors are addressed in the model. An efficient algorithm for evaluating the DBN model is presented, which is a modification of the so‐called Frontier algorithm. The proposed model and algorithm are applied to an illustrative case study, the excavation of a road tunnel by means of the New Austrian Tunneling Method.
PUBLIC AGENCY LEADERSHIP: THE IMPACT OF INFORMAL UNDERSTANDINGS WITH POLITICAL APPOINTEES ON PERCEIVED AGENCY INNOVATION IN TAIWAN
Authors: BERMAN EVAN , CHEN DON‐YUN , JAN CHUNG‐YUANG , HUANG TONG‐YI
Published: April 2012

In Taiwan's post‐democratization, public managers reduced their leadership and initiative‐taking, thereby creating concerns about public sector leadership. This article defines the concept of informal ‘executive initiative understandings' (EIUs) between political appointees and career executives, and examines how such understandings affect public managers' efforts and agency leadership. Based on an in‐person survey of Taiwan central government executives, findings show that: (1) about half of senior career executives agree that they have an informal understanding with appointees' about their initiative‐taking; and (2) having an EIU significantly and strongly increases executives' efforts and perceptions of agency innovation. This study also finds (3) that EIUs are associated with executives' public service motivation, perceptions of appointees' competence, and executives and appointees having similar political views. This article concludes with suggestions for increasing executive initiative‐taking in public agencies.
Failure to Deliver: The Investment Effects of US Preferential Economic Agreements
Authors: Peinhardt Clint , Allee Todd
Published: April 2012

Global trade and investment rules are increasingly determined by bilateral and regional agreements, which are widely expected to increase economic ties between the signatories. Even though the United States is a relative newcomer to these narrower economic agreements, it has signed several different types with dozens of partner countries. These agreements, which often require partners to make costly policy changes, are nonetheless attractive because they provide preferential access to the US market and promise increased inward investment. In this paper, we compare the investment effects of three different types of agreements and find little evidence that existing international agreements (trade and investment framework agreements, bilateral investment treaties or preferential trade agreements) tend to increase investment from the United States. After exploring other potential explanations, we conclude that US treaty partners may have unrealistic expectations for agreements to increase direct investment.
New Estimates of the Equilibrium Exchange Rate: The Case for the Chinese Renminbi
Authors: Sato Kiyotaka , Shimizu Junko , Shrestha Nagendra , Zhang Zhaoyong
Published: April 2012

We estimate the nominal equilibrium exchange rate (EER) of the Chinese renminbi (RMB)vis‐à‐visthe US dollar from 1995 to 2009. While most of the recent empirical studies on the EER employ a cross‐country analysis, country‐specific factors, especially supply‐side real factors, are not fully taken into consideration in estimating the EER. To better reflect China’s processing exports in the context of growing intra‐regional trade in Asia, we incorporate in the empirical analysis the source‐country breakdown data on import prices and input coefficients of intermediate inputs by constructing an annual new International input–output (IIO) table for the period from 1995 to 2009. The results show that the nominal EER of the RMB appreciates sharply from 2006 to 2009, suggesting that the current RMB exchange rate has been substantially undervalued and should be revalued by 74 per cent as of 2008 compared to the year 2004 level. Such sharp appreciation of the nominal EER corresponds to the dramatic increase in China’s current account surplus from the mid‐2000s, especially against the United States, which is ascribed to the significant improvement of China’s intermediate input coefficients and, to a lesser extent, an increase in US import prices of intermediate inputs.
Effects of Financial Liberalisation and Political Connection on Listed Chinese Firms’ Financing Constraints
Authors: Chan Kenneth S. , Dang Vinh Q. T. , Yan Isabel K. M.
Published: April 2012

This study examines the impact of recent financial liberalisation in China on the financing constraints of publicly listed Chinese firms with and without politically connected CEO/Chairman. Two continuous indices are used to measure the evolution and intensity of financial reforms: a financial liberalisation index and a capital control index. The results indicate that while firms without politically connected CEO/Chairman face significant financing constraints and politically connected firms do not, financial liberalisation has reduced the constraints for the former. Similarly, lower capital control in China’s equity market lessens credit constraints for non‐connected firms. No statistically significant impact of financial liberalisation is detected with regard to firms that have CEO/Chairman with powerful political background.
Dynamic Linkages among Financial Markets in the Greater China Region: A Multivariate Asymmetric Approach
Authors: Ho Kin‐Yip , Zhang Zhaoyong
Published: April 2012

This study examines the volatility dynamics of the Greater China stock markets by employing a multivariate framework that incorporates the features of asymmetries, persistence and time‐varying correlations. The multivariate framework with these features will contribute to a better understanding of the interdependence and integration among the stock markets in the Greater China region. Our results confirm the existence of volatility persistence and asymmetries, and there is some evidence of a common degree of persistence (‘co‐persistence’) among the markets. It is also found that the Mainland Chinese markets are actually less volatile than the Taiwan and Hong Kong stock exchanges in the late 1990s and early 2000s. The Shenzhen and Shanghai stock exchanges are positively (not perfectly) correlated with each other, but they show a weaker correlation with the Hong Kong and Taiwan markets. These findings have important implications for hedging and portfolio management.
Which Competitive Efforts Lead to Future Abnormal Economic Rents? Using Accounting Ratios to Assess Competitive Advantage
Authors: Dickinson Victoria , Sommers Gregory A.
Published: April 2012

Abstract:  Strategy theory suggests that firms can impede mean reversion of economic rents by employing competitive efforts, thereby impacting profitability, forecasting, and valuation. We use realized operating performance to establish which competitive effort proxies effectively protect rents. The inclusion of competitive advantage proxies improves future accounting return forecasts and several efforts generalize across industries including power over suppliers and the credible threat of expected retaliation (Porter, 1980). Traditional barriers‐to‐entry proxies (product differentiation, innovation, and capital requirements) do not result in higher profitability once risk‐ and industry‐adjusted. Finally, competitive efforts are not fully impounded into stock price, resulting in abnormal future returns.
Firm Valuation in Venture Capital Financing Rounds: The Role of Investor Bargaining Power
Authors: Heughebaert Andy , Manigart Sophie
Published: April 2012

Abstract:  This study explores the impact of the bargaining power of venture capital (VC) firms on the valuation of their portfolio companies. VC firm types with greater bargaining power vis‐à‐vis the entrepreneur are expected to negotiate lower valuations compared with VC firm types with less bargaining power. Consistent with this hypothesis, university and government VC firms, which have comparatively greater bargaining power, negotiate lower valuations compared with independent VC firms. The valuations of captive VC firms equal those of independent VC firms. Our findings suggest that valuations in the VC contract reflect the relative bargaining power of the VC investor.
Blood flow velocity and vascular resistance during passive leg exercise in the critically ill patient
Authors: Thelandersson Anneli , Volkmann Reinhard , Cider Åsa
Published: April 2012

Passive range of motion exercise is a very common physical therapy treatment for patients admitted to an intensive care unit. However is the knowledge scarce regarding its impact on blood circulation in the extremities. The objective of this study was therefore to investigate the effect of passive range of motion on arterial peripheral leg blood flow velocity (BFV) and vascular resistance. A cross‐sectional consecutive study of twelve patients admitted to an intensive care unit and twelve healthy age‐ and gender‐matched controls was conducted. Passive range of motion was performed in one leg by a physical therapist. Blood flow velocities and resistance index in the common femoral artery (CFA), blood pressure and heart rate were measured before, directly after and at rest after passive range of motion. No changes were seen in BFV or resistance index in the patient group or the control group. No changes were found in blood pressure or heart rate in the patient group. In the control group, changes were found in systolic and mean blood pressure, with a higher pressure before passive range of motion. The controls had lower BFV and higher resistance index than the patients when comparing the groups. The conclusion of this study including twelve patients is that passive range of motion does not alter BFV or resistance index in the CFA in comatose and/or sedated critically ill patients.
Exercise acts as a drug; the pharmacological benefits of exercise
Authors: Vina J , Sanchis‐Gomar F , Martinez‐Bello V , Gomez‐Cabrera MC
Published: April 2012

The beneficial effects of regular exercise for the promotion of health and cure of diseases have been clearly shown. In this review, we would like to postulate the idea that exercise can be considered as a drug. Exercise causes a myriad of beneficial effects for health, including the promotion of health and lifespan, and these are reviewed in the first section of this paper. Then we deal with the dosing of exercise. As with many drugs, dosing is extremely important to get the beneficial effects of exercise. To this end, the organism adapts to exercise. We review the molecular signalling pathways involved in these adaptations because understanding them is of great importance to be able to prescribe exercise in an appropriate manner. Special attention must be paid to the psychological effects of exercise. These are so powerful that we would like to propose that exercise may be considered as a psychoactive drug. In moderate doses, it causes very pronounced relaxing effects on the majority of the population, but some persons may even become addicted to exercise. Finally, there may be some contraindications to exercise that arise when people are severely ill, and these are described in the final section of the review. Our general conclusion is that exercise is so effective that it should be considered as a drug, but that more attention should be paid to the dosing and to individual variations between patients.
Adnexal masses in women with breast cancer
Authors: Tuncer Zafer Selcuk , Boyraz Gokhan , Selcuk Ilker , Şahin Nihal , Kaynaroğlu Volkan , Özışık Yavuz
Published: April 2012

Background

Adnexal masses detected in breast cancer survivors are of particular concern because of the increased risk of ovarian malignancy.

Aims

This study was performed to analyse adnexal masses among women with breast cancer with regard to variables predictive of malignancy.

Methods

The study included women with breast cancer who had undergone surgery for an adnexal mass between 2002 and 2010 at Hacettepe University Hospital. A total of 45 consecutive women with a mean age of 47.3 years (range 25–76) were analysed retrospectively.

Results

Of 45 cases reviewed, benign ovarian pathology was found in 35 cases (77.8%) and malignant ovarian neoplasms were found in 10 cases (22.2%). A simple ovarian cyst was observed in 25 cases (71.4%) as the most common type of benign pathology. Of the 10 cases with malignancy, 5 (50%) had primary ovarian carcinoma, while the remaining five women had breast carcinoma metastases to the ovary. Complex mass at ultrasonography, increased CA 125 level and oestrogen receptor–negative tumour were found to be the significant predictors of ovarian malignancy.

Conclusions

Although an adnexal mass in a woman with breast cancer is most commonly a benign ovarian cyst, the overall risk of ovarian malignancy is increased with breast cancer. An adnexal mass with complex architecture detected by ultrasonography and high CA 125 level were the strongest risk factors associated with increased risk of malignancy.