bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum HCV RNA levels and HCV genotype do not affect insulin resistance in nondiabetic patients with chronic hepatitis C: a multicentre study
Authors: TSOCHATZIS E. , MANOLAKOPOULOS S. , PAPATHEODORIDIS G. V. , HADZIYANNIS E. , TRIANTOS C. , ZISIMOPOULOS K. , GOULIS I. , TZOURMAKLIOTIS D. , AKRIVIADIS E. , MANESIS E. K. , ARCHIMANDRITIS A. J.
Published: July 2009

Background  Chronic hepatitis C (CHC) induces insulin resistance (IR) and subsequently diabetes.

Aim  To examine viral, metabolic and histological predictors of IR in 275 CHC patients to test the hypothesis that IR differs among HCV genotypes and that viral replication directly affects IR.

Methods  We studied 275 nondiabetic treatment‐naïve CHC patients. Histological lesions were evaluated according to Ishak. IR was assessed using homeostasis model assessment for insulin resistance (HOMA‐IR).

Results  HOMA > 3.0 was found in 37% of patients, independently associated with higher BMI and GGT. In genotype non‐3 patients, HOMA > 3.0 was associated with higher BMI and GGT values, while no significant association was noted in genotype 3 patients. In non‐obese patients with minimal fibrosis, HOMA > 3.0 was found in 20% of cases without significant differences among genotypes. No association between HOMA > 3.0 and HCV‐RNA levels was found. Severe fibrosis (stage 5–6) related to older age (OR:1.048), HOMA‐IR (OR:1.177), necroinflammation (OR: 2.990) and higher ALT (OR: 1.009) and GGT (OR:1.006).

Conclusions  IR develops at early stages of CHC without significant differences among genotypes. It is more frequent in obese patients with steatosis and contributes to fibrosis progression. However, IR does not seem to be associated with viraemia and therefore its exact pathogenetic mechanism in CHC remains elusive.
Analysis of drug resistance and virulence‐factor genotype of Irish Helicobacter pylori strains: is there any relationship between resistance to metronidazole and cagA status?
Authors: TANEIKE I. , NAMI A. , O’CONNOR A. , FITZGERALD N. , MURPHY P. , QASIM A. , O’CONNOR H. , O’MORAIN C.
Published: July 2009

Background  Helicobacter pylori infection is eradicated with antimicrobial agents and drug‐resistant strains make successful treatment difficult. Geographical variations in virulence‐factor genotype also exist.

Aim  To evaluate prevalence of drug resistance and virulence‐factor genotype in Irish H. pylori strains and to investigate if there is any relationship between drug resistance and genotype.

Methods  Helicobacter pylori strains isolated from 103 patients were examined. Antimicrobial susceptibilities were tested by Etest. The virulence‐factor genotypes were determined using PCR. Frequencies of spontaneous metronidazole‐resistance were measured in vitro.

Results  Metronidazole resistance was present in 37.9% of strains examined. 16.5% of strains were clarithromycin‐resistant and resistance to both agents observed was found in 12.6% of strains. 68% of strains were cagA+. The dominant vacA type was s1/m2, followed by s1/m1 and s2/m2. The metronidazole resistance rate in cagA− group was significantly higher than in cagA+ (P = 0.0089). Spontaneous resistance to metronidazole in cagA− occurred in higher frequency when compared with cagA+.

Conclusions  cagA
+ and vacAs1/m2 type was the dominant genotype in Irish H. pylori strains. Significant rates of metronidazole resistance were observed in cagA− group. cagA− strains tend to acquire metronidazole resistance in vitro. Absence of cagA might be a risk factor in development of metronidazole resistance.
Crucial role of the local micro‐environment in fate decision of neonatal rat NG2 progenitors
Authors: Sypecka J. , Sarnowska A. , Domanska‐Janik K.
Published: July 2009

Objectives:  The fate choice of neural progenitor cells could be dictated by local cellular environment of the adult CNS. The aim of our study was to investigate the effect of hippocampal tissue on differentiation and maturation of oligodendrocyte NG2 precursor cells.

Materials and methods:  Hippocampal slice culture was established from the brains of 7‐day‐old rats. NG2 precursor cells, obtained from a 12‐day‐old mixed primary culture of neonatal rat cerebral hemispheres, were labelled with chloromethyl‐fluorescein‐diacetete and seeded on the hippocampal slices. After 7–14 days in co‐culture, cells were stained with neural markers.

Results:  NG2 cells differentiated predominantly into oligodendrocytes, presenting various stages of maturation: progenitors (NG2), pre‐oligodendrocytes (O4) and finally mature GalC‐positive cells. However, except for a few cells with astrocyte‐specific S100b staining, a considerable number of these cells differentiated into neurons: TUJ+ and even MAP‐2+ cells were frequently observed. Moreover, a certain population of these cells preserved proliferative properties of primary precursor cells, as revealed by Ki67 expression.

Conclusions:  The neuronal micro‐environment provided by the culture of hippocampal slices is potent for induction of neurogenesis from oligodendrocyte NG2+/PDGFRα+/CNP+ progenitor cells and promotes their differentiation not only into macroglia but also into neurons. It also sustains their proliferative capacity. The results indicate the crucial role of the local cellular environment in fate decision of primary NG2+ multipotent neural progenitor cells, which may affect their behaviour after transplantation into the central nervous system.
Measuring children's needs: how are we doing?
Authors: Axford Nick , Green Victoria , Kalsbeek Annemieke , Morpeth Louise , Palmer Chris
Published: July 2009

Children's services in England and Wales are legally required to determine the nature and extent of children's needs in their areas as a precursor to providing needs‐led services. However, few needs assessments are ever published. This article analyses 83 such reports conducted between 1999 and 2007 in two local authorities in England (one urban, one rural), focusing on their quality and usefulness. It makes recommendations for improving practice in this important area, both in terms of the type of needs assessment required and how best to produce and use them.
Growing up in foster care: providing a secure base through adolescence
Authors: Schofield Gillian , Beek Mary
Published: July 2009

As the UK Government White Paper, Care Matters: Time for Change, suggested, foster children need the care system to provide them with good quality foster family care that will help them through childhood to success and fulfilment of their potential in adult life.

This paper draws on the third phase of Growing Up in Foster Care, a longitudinal study of 52 children in planned, long‐term foster care (1997–2006). It aims to increase our understanding of the transformational power of foster family relationships over time and particularly in adolescence. It shows how a secure base parenting model, using concepts from attachment and resilience, can be applied to foster care of adolescents. The paper uses case material to demonstrate each dimension of this secure base model and to emphasise how, even when adolescents have had stable and effective placements, they are likely to need support through into adulthood.
PPARγ Pro12Ala Pro/Pro and resistin SNP‐420 G/G genotypes are synergistically associated with plasma resistin in the Japanese general population
Authors: Osawa Haruhiko , Tabara Yasuharu , Kawamoto Ryuichi , Ohashi Jun , Ochi Masaaki , Onuma Hiroshi , Nishida Wataru , Yamada Kazuya , Nakura Jun , Miki Tetsuro , Makino Hideichi , Kohara Katsuhiko
Published: July 2009

Objective  The Ala allele of the Pro12Ala polymorphism (rs1801282) of peroxisome proliferator‐activated receptor γ (PPARγ) is protective against type 2 diabetes (T2DM). Resistin, secreted from adipocytes, causes insulin resistance in rodents. Resistin gene expression is reduced by the PPARγ ligand. We previously reported that subjects with the G/G genotype of a resistin gene single nucleotide polymorphism (SNP) at –420 (rs1862513) had the highest circulating resistin levels, followed by C/G and C/C. The aim of this study was to determine the relationship among PPARγ Pro12Ala polymorphism, resistin SNP‐420, and plasma resistin.

Design, patients and measurements  We cross‐sectionally analysed 2077 community‐dwelling subjects attending an annual medical check‐up. Genotypes were determined by TaqMan analysis. Fasting plasma resistin was measured using ELISA.

Results  Plasma resistin appeared to be higher in subjects with the Pro/Pro genotype of PPARγ than those with Pro/Ala and Ala/Ala genotypes (mean ± SE, 11·6 ± 0·2 vs. 10·4 ± 0·5 μg/l). Multiple regression analysis, adjusted for age, gender, BMI, and resistin SNP‐420, revealed that the Pro/Pro genotype was a positive predictor of plasma resistin (PPARγ ,  Pro/Pro vs. Pro/Ala + Ala/Ala, unstandardized regression coefficient (β) = 1·03, P = 0·0384). The effects of the Pro/Pro genotype of PPARγ (Pro/Pro vs. Pro/Ala + Ala/Ala) and the G/G genotype of resistin SNP‐420 (G/G vs. C/C) on plasma resistin were synergistic (β = 4·76, P = 0·011).

Conclusions  The PPARγ Pro12Ala Pro/Pro and resistin SNP‐420 G/G genotypes were synergistically associated with plasma resistin, when adjusted for age, gender, and BMI, in the Japanese general population.
Regulation of GADD153 induced by mechanical stress in cardiomyocytes
Authors: Cheng W. P. , Wang B. W. , Shyu K. G.
Published: July 2009

Background  Growth arrest and DNA damage‐inducible gene 153 (GADD153), an apoptosis regulated gene, increased during endoplasmic reticulum stress. However, the expression of GADD153 in cardiomyocytes under mechanical stress is little known. We aimed to investigate the regulation mechanism of GADD153 expression and apoptosis induced by mechanical stress in cardiomyocytes.

Materials and methods  Aorta‐caval shunt was performed in adult Sprague–Dawley rats to induce volume overload. Rat neonatal cardiomyocytes grown on a flexible membrane base were stretched by vacuum to 20% of maximum elongation, at 60 cycles min−1.

Results  The increased ventricular dimension measured using echocardiography in the shunt group (n = 8) was reversed to normal by treatment with chaperon 4‐phenylbutyric acid (PBA) (n = 8) at 500 mg kg−1 day−1 orally for 3 days. GADD153 protein and mRNA were up‐regulated in the shunt group when compared with sham group (n = 8). Treatment with PBA reversed the protein of GADD153 to the baseline values. The TUNEL assay showed that PBA reduced the apoptosis induced by volume overload. Cyclic stretch significantly increased GADD153 protein and mRNA expression after 14 h of stretch. Addition of c‐jun N‐terminal kinase (JNK) inhibitor SP600125, JNK small interfering RNA and tumour necrosis factor‐α (TNF‐α) antibody 30 min before stretch, reduced the induction of GADD153 protein. Stretch increased, while GADD153‐Mut plasmid, SP600125 and TNF‐α antibody abolished the GADD153 promoter activity induced by stretch. GADD153 mediated apoptosis induced by stretch was reversed by GADD153 siRNA, GADD153‐Mut plasmid and PBA.

Conclusions  Mechanical stress enhanced apoptosis and GADD153 expression in cardiomyocytes. Treatment with PBA reversed both GADD153 expression and apoptosis induced by mechanical stress in cardiomyocytes.
American eel, Anguilla rostrata, growth in fresh and salt water: implications for conservation and aquaculture
Authors: LAMSON H. M. , CAIRNS D. K. , SHIAO J.‐C. , IIZUKA Y. , TZENG W.‐N.
Published: July 2009

Abstract  Growth of American eels, Anguilla rostrata (Lesueur), sampled in saltwater bays and adjacent freshwater ponds in the southern Gulf of St. Lawrence, Canada, was estimated by otolith annulus back‐calculation, and related to salinity of growth habitat as determined using otolith strontium:calcium ratios. Eels resident in salt water grew on average in length 2.2 times faster than freshwater residents and increased in weight 5.3 times faster than freshwater residents. Previous findings of superior American eel growth rate in brackish water are thus extended to full‐strength salt water. Freshwater residents took an estimated 2.4 times longer than saltwater residents to reach the silver eel stage. The extended time to maturation of eels reared in fresh water increases their vulnerability to fisheries and to bio‐accumulation of contaminants. Freshwater eel populations should be managed more conservatively than those in saline waters. The increase in eel growth with salinity suggests that rearing in brackish or salt water could improve growth rates in eel aquaculture.
Subtype‐specific incidence of testicular cancer in Germany: a pooled analysis of nine population‐based cancer registries
Authors: Stang A. , Rusner C. , Eisinger B. , Stegmaier C. , Kaatsch P.
Published: July 2009

Comparisons of incidence estimates of testicular cancer subtypes beyond seminoma and non‐seminoma are virtually missing in the epidemiologic literature. We analysed incidence data from population‐based German cancer registries to provide subtype‐specific incidences of testicular cancer. We pooled data from nine cancer registries from 1998 to 2003. We estimated incidence and mortality time trends of West and East Germany. Incidence and mortality were standardized by the European standard population. The annual percentage incidence change from 1961 through 1989 was 4.9% in East Germany and 3.0% from 1970 through 2004 in Saarland. Incidence increases were the most pronounced among adolescents and young men aged 15–49 years. In 1998–2003, the seminoma incidence rate was 5.1 per 100 000; among non‐seminomas, the rates were the highest for malignant teratoma (1.6 per 100 000), followed by embryonal carcinoma (1.2 per 100 000). Testicular lymphomas were rare (0.1 per 100 000). The incidence of testicular cancer among children aged 0–14 years was nearly constant from 1987 through 2004. Majority of these cancers were yolk sac tumours (0.1 per 100 000). In East and West Germany, rates of embryonal carcinoma in the early periods were considerably lower than the rates of malignant teratoma. In the most recent periods, rates of embryonal carcinoma became quite similar to the rates of malignant teratoma. The mortality decline started in West Germany roughly 12 years earlier than in East Germany. The later start of the mortality decline in East Germany may be because of a later introduction of platinum‐based chemotherapy compared to West Germany.
Retrospective analysis of the factors influencing mesiodentes eruption
Authors: HONG JONGRAK , LEE DONG‐GEUL , PARK KITAE
Published: July 2009

Aim.  This study aimed to evaluate the factors that predict the spontaneous eruption of mesiodens.

Design.  From the records of 431 patients (346 boys and 85 girls, average age 8.8 years) who visited Samsung Medical Center from January 2002 to December 2006, 471 mesiodentes were reviewed. The eruption rate was investigated according to the width/length ratio, angulation, location, and shape determined from periapical or panoramic radiographs.

Results.  The regression model showed that the width/length ratio and angulation were important determinants influencing the eruption of mesiodentes (P < 0.001, Pearson's r = 0.619). The location of the mesiodentes also affected their eruption (P < 0.01). However, no significant relationship was detected between the shape and eruption rate of mesiodentes (P > 0.05).

Conclusions.  A lower probability of spontaneous eruption existed when the tooth had a greater angulation, shorter length, and wider width. Spontaneous eruption occurs more often when the mesiodens is located between the permanent incisors.
Predator foraging behaviour drives food‐web topological structure
Authors: Lazzaro Xavier , Lacroix Gérard , Gauzens Benoît , Gignoux Jacques , Legendre Stéphane
Published: July 2009

1. The structure and dynamics of prey populations are shaped by the foraging behaviours of their predators. Yet, there is still little documentation on how distinct predator foraging types control biodiversity, food‐web architecture and ecosystem functioning.

2. We experimentally compared the effects of model fish species of two major foraging types of lake planktivores: a size‐selective visual feeder (bluegill), and a filter feeder (gizzard shad). The visual feeder forages on individually captured consumer prey, whereas the filter feeder forages on various prey simultaneously, not only consumers but also primary producers. We ran a 1‐month mesocosm experiment cross‐classifying a biomass gradient of each predator type. We analysed the effect of each fish on food‐web architecture by computing major topological descriptors over time (connectance, link density, omnivory index, etc.). These descriptors were computed from 80 predator–prey binary matrices, using taxa mostly identified at the species level.

3. We found that the visual feeder induced more trophic cul‐de‐sac (inedible) primary‐producer species, lower link density and connectance, and lower levels of food‐web omnivory and generalism than the filter feeder. Yet, predator biomass did not affect food‐web topology.

4. Our results highlight that top‐predator foraging behaviour is a key functional trait that can drive food‐web topology and ultimately ecosystem functioning.
Exploring the perspective of midwives involved in offering serum screening for Down’s syndrome in Northern Ireland
Authors: McNeill Jennifer , Alderdice Fiona
Published: July 2009

Aims.  To explore the perspective of midwives offering serum screening for Down’s syndrome.

Background.  Previous literature has indicated that the offer and discussion of prenatal serum screening tests with women is complex, and health professionals may influence women’s decisions to accept or decline screening. Midwives are usually the key professional to offer serum screening for Down’s syndrome in the UK but their perspective is relatively neglected in the literature.

Design.  An explorative qualitative interview study with 15 midwives employed in a maternity unit in Northern Ireland involved in offering prenatal screening to pregnant women. Data were collected from 1 July 2005–31 October 2005.

Methods.  A focused ethnographic approach was used to explore the perspective of midwives.

Results.  Midwives reported difficulty in explaining the test to women and felt unable to provide the necessary information to adequately inform women within their appointment time. The test offered (the triple test) and potential pathway of subsequent care, were identified as sources of professional and personal conflict by midwives. The expectation that midwives would provide a universal offer of Down’s syndrome serum screening but be unable to support women regarding termination of pregnancy also created dissonance.

Conclusions.  The feasibility of proceeding with a universal serum screening programme for Down’s syndrome is questionable in countries which legally or culturally oppose termination of pregnancy. Professionals practising within environments such as this experience conflict in their role, which affects communication with women when discussing screening tests.

Relevance to clinical practice.  As midwives are often, the primary health professional providing information to women, it is important that midwives are key participants in ongoing planning and discussions about screening policy to ensure programmes are implemented successfully.
Undergraduate nursing students attitude to mental health nursing: a cluster analysis approach
Authors: Gough Karla , Happell Brenda
Published: July 2009

Aims.  The use of cluster analysis to determine if specific groups of students could be identified based on their attitudes towards mental health nursing following the completion of a clinical experience in a mental health setting.

Background.  Research suggests that nursing students generally have a negative image of mental health nursing. This can be improved following clinical exposure in mental health settings, however, specific aspects of clinical experience that might facilitate attitudinal change have been under‐researched.

Design.  Survey.

Methods.  A survey was administered to students (n = 703) immediately after completion of their clinical experience. Cluster analysis was used to identify natural groupings within the study cohort.

Results.  Three distinct clusters were identified. Cluster 1 demonstrated more positive attitudes, greater confidence and viewed mental health more positively than students in the other two Clusters. They were more likely to be male, have spent at least 30 minutes per shift with a preceptor and have completed shifts of eight hours rather than seven hours.

Conclusions.  Attitudes to mental health nursing may be influenced by specific demographic characteristics of students and by specific aspects of their clinical experience.

Relevance to clinical practice.  The nursing workforce is an essential element of quality mental health service delivery. Knowledge about factors influencing more positive attitudes is important for structuring clinical experience and designing effective recruitment strategies to attract more students into this field of practice.
Assessment of pain: can caregivers or relatives rate pain in nursing home residents?
Authors: Van Herk Rhodee , Van Dijk Monique , Biemold Nathalie , Tibboel Dick , Baar Frans PM , De Wit Rianne
Published: July 2009

Aim.  To compare pain reports of nursing home residents to ratings by proxies.

Background.  It is not easy to assess pain in cognitively impaired residents. For residents who are unable to report pain intensity themselves, proxies (i.e. relatives or caregivers) might serve as sources of information. The utility of these proxies in assessing residents’ pain is not clear however.

Design.  A multicenter cross‐sectional study.

Methods.  Pain intensity was rated on a Numeric Rating Scale; proxies were asked how certain they were about their observations. Agreements on ratings were computed by means of intra class correlation (ICC) coefficients for continuous variables and multiple linear regression analyses were performed with the level of pain intensity by proxies as the dependent variable.

Results.  The sample consisted of 174 residents (median age 82 years), of whom 124 were cognitively impaired and 50 intact, and 293 proxies: 171 caregivers and 122 relatives. All three parties reported median pain intensity during the preceding week as 6·0. Data were consistent with low‐to‐moderate correlation coefficients between residents and caregivers (ICC = −0·12 to 0·25), residents and relatives (ICC = −0·51 to 0·48) and caregivers and relatives (ICC = 0·03 to 0·31). Residents themselves judged pain intensity at rest significantly higher than did proxies (p = 0·05). Caregivers scored significantly higher ratings for residents on analgesics (p = 0·001) and significantly lower pain ratings if they were more satisfied with the prescribed analgesics (p = 0·01).

Conclusions.  Proxy report of relatives and caregivers on presence and intensity of pain is unreliable, especially for cognitively impaired persons. The use of a standardised pain observation scale could be helpful.

Relevance to clinical practice.  Pain management in nursing home residents could be improved by educating caregivers about assessment and treatment of chronic pain. Relatives should be informed about chronic pain and learn how to alleviate pain through non‐pharmacological interventions.
A hybrid zone revisited: molecular and morphological analysis of the maintenance, movement, and evolution of a Great Plains avian (Cardinalidae: Pheucticus) hybrid zone
Authors: METTLER R. D. , SPELLMAN G. M.
Published: July 2009

Black‐headed grosbeaks (Pheucticus melanocephalus) and rose‐breasted grosbeaks (Pheucticus ludovicianus) are passerine bird species known to hybridize in the Great Plains of North America. Both extrinsic (environmental) and intrinsic factors (pre‐ and postzygotic reproductive isolation) have been credited for the generation and maintenance of the grosbeak hybrid zone, but little is known about the genetic characteristics of this hybrid zone. To investigate the stability and extent of the grosbeak hybrid zone, we constructed clines from both molecular sequence data (mtDNA, three autosomal intron loci, and one Z‐linked locus) and morphological data (morphometric analyses and hybrid index scores) to determined zone centre and width. Hybrid zone centre and width were also determined for samples collected across the zone 40 years ago from morphological data. The present and past clines were compared and provided support for stability in hybrid zone location and width, and the evolutionary implications of this are discussed. Three models of hybrid zone maintenance were investigated to consider the influence of intrinsic and extrinsic factors on this zone. Our results suggest low hybrid frequencies, a stable zone location and narrow width, and reduced hybrid fitness over the past 40 years best categorize the grosbeak hybrid zone as a tension zone.
Proximal oesophagus: the added value in understanding GORD symptoms
Authors: Cicala M. , Habib F. I. , Emerenziani S.
Published: July 2009

Abstract  Over the past decade, the approach to the understanding of the mechanisms involved in the aetiology of gastro‐oesophageal reflux disease (GORD) symptoms has changed, and growing evidence now supports the concept that visceral hyper‐sensitivity to intra‐oesophageal stimuli plays a major role. Among the recent advances, one of the more consistent findings is that the contact of the refluxate, either acidic or weakly acidic, with the proximal oesophageal mucosa, is a main determinant of GORD symptoms, particularly in the large majority of patients affected by non‐erosive reflux disease. The data reported in the current issue of Neurogastroenterology and Motility by Bredenoord et al., showing only a small proportion of proximal reflux in patients with Barrett’s oesophagus, who are less sensitive to gastro‐oesophageal reflux, further support the consistency of this finding in the pathogenesis of symptoms. In the light of these results, we shall look forward, in the management of patients, to approaches aimed at restoring the antireflux barrier, hopefully decreasing the amount of reflux and, in turn, its proximal extent.
The role of birth cohorts in studies of adult health: the New York women's birth cohort
Authors: Terry Mary Beth , Flom Julie , Tehranifar Parisa , Susser Ezra
Published: July 2009

Epidemiological studies investigating associations between early life factors and adult health are often limited to studying exposures that can be reliably recalled in adulthood or obtained from existing medical records. There are few US studies with detailed data on the pre‐ and postnatal environment whose study populations are now in adulthood; one exception is the Collaborative Perinatal Project (CPP). We contacted former female participants of the New York site of the CPP who were born from 1959 to 1963 and were prospectively followed for 7 years to examine whether the pre‐ and postnatal environment is associated with adult health in women 40 years after birth. The New York CPP cohort is particularly diverse; at enrolment, the race/ethnicity distribution of mothers was approximately 30% White, 40% Black and 30% Puerto Rican. Of the 841 eligible women, we successfully traced 375 women (45%) and enrolled 262 women (70% of those traced). Baseline data were available for all eligible women, and we compared those who participated with the remaining cohort (n = 579).

Higher family socio‐economic status at age 7, availability of maternal social security number, and White race/ethnicity were statistically significantly associated with a higher probability of tracing. Of those traced, race/ethnicity was associated with participation, with Blacks and Puerto Ricans less likely to participate than Whites (OR = 0.5, 95% CI 0.3, 0.8, and OR = 0.5, 95% CI 0.3, 1.0, respectively). In addition, higher weight at 7 years was associated with lower participation (OR = 0.95, 95% CI 0.92, 0.99), but this association was observed only among the non‐White participants. None of the other maternal characteristics, infant or early childhood growth measures was associated with participation or with tracing, either overall or within each racial/ethnic subgroup. Daughters’ recall of early life factors such as pre‐eclampsia (sensitivity = 24%) and birthweight were generally poor, with the latter varying by category of birthweight with the highest sensitivity for the largest babies (81%) and the lowest sensitivity for the smallest babies (54%). These data reinforce the need to rejuvenate existing birth cohorts with prospective data for life course studies of adult health. Understanding the factors that are associated with tracing and participation in these existing cohorts will help in interpreting the validity and generalisability of the findings from these invaluable cohorts.
Difference in binocular rivalry rate between patients with bipolar I and bipolar II disorders
Authors: Nagamine Masanori , Yoshino Aihide , Miyazaki Masaki , Takahashi Yoshitomo , Nomura Soichiro
Published: July 2009

Objective:  When dissimilar figures are presented to each eye individually, perception alternates spontaneously between each monocular view. This phenomenon, known as binocular rivalry, has been used as a powerful tool to investigate conscious visual awareness. Of clinical relevance, Pettigrew and Miller (Proc Biol Sci 1998; 265: 2141‐2148) found slow perceptual alternation rates in patients with bipolar I disorder (BD‐I). For a better understanding of differences between BD‐I and bipolar II disorder (BD‐II), we examined whether perceptual alternation rates of binocular rivalry differ between the two subtypes of bipolar disorder.

Methods:  The subjects comprised 25 healthy controls, 11 patients with BD‐I, and 17 patients with BD‐II. They underwent binocular rivalry examination. One‐way analysis of variance was conducted to determine differences in the phase duration of binocular rivalry between the control, BD‐I, and BD‐II groups.

Results:  Significant differences were observed in the mean phase duration of binocular rivalry between the groups. Although the medication administered did not differ significantly between the BD‐I and BD‐II patients, the phase duration was significantly longer among the BD‐I patients than the BD‐II patients and controls, whereas no significant difference was observed in the phase duration between the BD‐II patients and controls.

Conclusion:  The present results reveal a significant difference in the mean phase duration of binocular rivalry between subjects with BD‐I and those with BD‐II, suggesting the presence of some neurobiological difference between these two subtypes of bipolar disorder.
Neuropsychological functions in patients with bipolar I and bipolar II disorder
Authors: Hsiao Yih‐Lynn , Wu Yi‐Syuan , Wu Jo Yung‐Wei , Hsu Min‐Hsien , Chen Hui‐Chun , Lee Sheng‐Yu , Lee I‐Hui , Yeh Tzung‐Lieh , Yang Yen‐Kuang , Ko Huei‐Chen , Lu Ru‐Band
Published: July 2009

Objectives:  The literature reports persistent cognitive impairments in patients with bipolar disorder even after prolonged remission. However, a majority of studies have focused only on bipolar I disorder (BP‐I), primarily because bipolar II disorder (BP‐II) is often underdiagnosed or misdiagnosed. More attention should be paid to the differences between BP‐I and BP‐II, especially the aspects of neuropsychological functioning. We examined the different neuropsychological functions in BP‐I and BP‐II patients and compared them with those of healthy controls.

Methods:  The study included 67 patients with interepisode bipolar disorder (BP‐I: n = 30; BP‐II: n = 37) and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed, and certain aspects of frontal executive function.

Results:  The BP‐I group performed poorly on verbal memory, psychomotor speed, and executive function compared to the BP‐II and control groups. Both bipolar groups performed significantly less well than the control group on measures of working memory and psychomotor speed, while the BP‐II group showed an intermediate level of performance in psychomotor speed compared to the BP‐I and control groups. There was no difference between the groups on visual memory.

Conclusions:  BP‐I was characterized by reduced performance in verbal memory, working memory, psychomotor speed, and executive function, while BP‐II patients showed a reduction only in working memory and psychomotor speed. Cognitive impairment existed in both subtypes of bipolar disorder, and was greater in BP‐I patients. Rehabilitation interventions should take into account potential cognitive differences between these bipolar subtypes.
Psychological therapies in bipolar disorder: the effect of illness history on relapse prevention – a systematic review
Authors: Lam Dominic H , Burbeck Rachel , Wright Kim , Pilling Steve
Published: July 2009

Objectives:  Despite some encouraging outcomes and shared components of psychological therapies specific to bipolar disorders, not all studies found conclusively that the addition of a psychosocial intervention to pharmacological interventions improves outcomes. There was some tentative evidence from post hoc analyses that patients with more than 12 previous episodes did not benefit from psychoeducation or cognitive therapy. This paper presents a systematic review and meta‐analysis which examines the overall efficacy of bipolar disorder‐specific psychological therapies and the impact of the number of previous episodes on the efficacy of psychological therapies in relapse prevention.

Methods:  Systematic literature searches of electronic databases and reference lists of existing reviews were carried out. The number of participants experiencing relapse in randomized, controlled studies was combined in a meta‐analysis to determine the overall treatment effect in relapse prevention. Metaregression modeling was used to examine whether the number of previous episodes confounded the number of relapses experienced by participants by the end of treatment.

Results:  Meta‐analysis of relapse calculated an overall relative risk of 0.74 [95% confidence interval (CI): 0.64–0.85] with some heterogeneity present (I2 = 43.3%). Metaregression of six studies showed no relationship between number of episodes and number of relapses by endpoint.

Conclusion:  Psychological therapy specifically designed for bipolar disorder is effective in preventing or delaying relapses in bipolar disorders, and there is no clear evidence that the number of previous episodes moderated the effect.
How effective is recognition of siblings on the basis of genotype?
Authors: PATERSON S. , HURST J. L.
Published: July 2009

The ability to recognize kin based on genetic markers has been widely proposed as a mechanism to facilitate altruistic behaviour and inbreeding avoidance. Siblings are an important group of relatives to discriminate from unrelated individuals but present a problem, because siblings can share 0, 1 or 2 alleles at any single recognition locus. Here, we present a Bayesian model of kin recognition that defines the potential for genotypic information to convey kinship. Under the direct comparison model, where the signaller’s genotype is compared with that of the receiver, the odds ratio that a pair of individuals were siblings was substantially increased if they shared both alleles at a single locus, but only a minority of siblings were recognized; increasing the number of recognition loci used could not increase both the odds ratio and the proportion of siblings recognized. A maternal comparison model, where the signaller’s genotype is compared with that of the receiver’s mother, performed poorly when only a single recognition locus was considered, but became increasingly effective with more recognition loci. Nevertheless, incorporating partial‐matching information across multiple, independent loci are likely to be difficult. Further empirical work needs to establish the mechanistic basis of genetic kin recognition used by different taxa.
Functional replacement of a primary metabolic pathway via multiple independent eukaryote‐to‐eukaryote gene transfers and selective retention
Authors: NEDELCU A. M. , BLAKNEY A. J. C. , LOGUE K. D.
Published: July 2009

Although lateral gene transfer (LGT) is now recognized as a major force in the evolution of prokaryotes, the contribution of LGT to the evolution and diversification of eukaryotes is less understood. Notably, transfers of complete pathways are believed to be less likely between eukaryotes, because the successful transfer of a pathway requires the physical clustering of functionally related genes. Here, we report that in one of the closest unicellular relatives of animals, the choanoflagellate, Monosiga, three genes whose products work together in the glutamate synthase cycle are of algal origin. The concerted retention of these three independently acquired genes is best explained as the consequence of a series of adaptive replacement events. More generally, this study argues that (i) eukaryote‐to‐eukaryote transfers of entire metabolic pathways are possible, (ii) adaptive functional replacements of primary pathways can occur, and (iii) functional replacements involving eukaryotic genes are likely to have also contributed to the evolution of eukaryotes. Lastly, these data underscore the potential contribution of algal genes to the evolution of nonphotosynthetic lineages.
Crows break off live camphor twigs: an avian disturbance effect on plants
Authors: Yamazaki K.
Published: July 2009

Birds are usually considered beneficial partners for plants, acting as predators on herbivorous insects, pollinators and seed dispersal agents. However, in an urban area of central Japan, birds break off large quantities of live camphor tree (Cinnamomum camphora) twigs in winter. This loss of vegetative parts was examined quantitatively to estimate the impact on the trees. I also observed bird foraging behaviour to determine the species involved and the possible reasons underlying this destructive activity. Broken twigs on the forest floor were found to have numerous leaves and spring buds. The densities of leaves and buds in the litter were 288.5 and 54.4 m−2, respectively. The jungle crow (Corvus macrorhynchos) may have broken off the twigs either to peck the fruits while perching on stable branches, or possibly to remove twigs obstructing access to fruit. In contrast, brown‐eared bulbuls (Hypsipetes amaurotis), oriental turtle doves (Streptopelia orientalis) and rove doves (Columba livia) ate fruits without breaking twigs. The interaction between C. camphora and C. macrorhynchos only extends back for about 20 years in urban Japan, indicating that this is unlikely to be a stable, co‐evolved relationship.
Strain rate does not affect cortical microtubule orientation in the isolated epidermis of sunflower hypocotyls
Authors: Burian A. , Hejnowicz Z.
Published: July 2009

A hypothesis exists that external and internal factors affect the orientation of cortical microtubules in as much as these lead to changes in cell elongation rate. Factors that stimulate elongation are proposed to lead to transverse microtubule orientation, whereas factors that inhibit elongation lead to longitudinal orientation. The elongation rate is equal to the rate of longitudinal irreversible strain in cell walls. Incubated epidermis peeled from sunflower hypocotyls does not extend unless it is stretched by loading and the pH of the incubation medium is appropriately low. Thus, peels provide a convenient model to investigate the relationship between longitudinal strain rate and cortical microtubule orientation. In the present study, it was found that peeling affects microtubule orientation. Peels were incubated for several hours in Murashige & Skoog medium (both unbuffered and buffered) to attain a steady state of microtubule orientation before loading. The effects of loading and pH on strain rate and orientation of microtubules under the outer epidermal walls were examined in three portions of peels positioned with respect to the cotyledonary node. Appropriate loading caused longitudinal strain of peels at pH 4.5 but not at pH 6.5. However, no clear effect of strain rate on microtubule orientation in the peels was observed. Independent of applied load and pH of the incubation medium, the microtubule orientation remained unchanged, i.e. orientation was mainly oblique. Our results show that strain rate does not affect cortical microtubule orientation in isolated epidermis of the sunflower hypocotyl model system, although orientation could be changed by white light.
Scanning Electron Microscopy of the Orbital Harderian Gland in the Male Atlantic Bottlenose Dolphin (Tursiops truncatus)
Authors: Ortiz G. G. , Feria‐Velasco A. , Pacheco‐Moisés F. P. , Rodríguez‐Reinoso S. , Cruz‐Ramos J. A. , Rosales‐Corral S. A. , Reiter R. J.
Published: July 2009

The ultrastructure of the Harderian gland of Atlantic bottlenose dolphin (Tursiops truncatus) was examined by scanning electron microscopy (SEM). We found the following surface features: the typical round appearance of the ascinar glandular unit with a finely granular surface, a thin cortex and immediately below two types of cells: type I cells (characterized by small lipid vacuoles) and type II cells (characterized by large lipid vacuoles). It has been suggested that different cells forms represent a single cell type in varying activity states. Additionally, a coalescent tubular complex, a small balloon‐like structures and large globular structures were observed. These structures may be reservoirs of secretion products.
Which components of malnutrition–inflammation–atherosclerosis syndrome are more common in haemodialysis patients with diabetic nephropathy?
Authors: JAKUSZEWSKI PIOTR , CZERWIEŃSKA BEATA , CHUDEK JERZY , WIĘCEK ANDRZEJ
Published: July 2009

Aim:  Malnutrition–inflammation–atherosclerosis syndrome (MIA) in haemodialysis (HD) patients is a common clinical condition characterized by increased mortality rate. The aim of this study was to analyze the frequency of MIA components in a selected population of HD patients with and without diabetic nephropathy.

Methods:  The frequency of MIA components was analysed in 49 patients with an over 10‐year history of diabetes before initiation of HD (DM group) and 49 non‐diabetic HD patients (non‐DM group).

Results:  The chance for occurrence of atherosclerosis (odds ratio = 3.26) was markedly higher in DM than non‐DM subjects. The most frequent MIA component in DM and non‐DM subjects was atherosclerosis (67.3% and 40.8%, respectively). Atherosclerosis frequently coexisted with inflammation in both groups (51.5% in DM and 20.0% in non‐DM) and less frequently with malnutrition. The frequency of inflammation was only slightly higher in DM, while of malnutrition was similar. Patients with atherosclerosis in the DM group had significantly higher serum concentrations of interleukin‐6 than the ones in the non‐DM group: 11 (6–24) versus 5 (2–9) pg/mL, respectively (P = 0.002).

Conclusions:  We can conclude that: (i) atherosclerosis is more common in HD patients with diabetic nephropathy; and (ii) this fact may explain the poor outcome of these patients and indicates the challenge in diagnostic and therapeutic management.
Obesity does not increase the risk of lymph node metastases in patients with clinically localized prostate cancer undergoing radical prostatectomy and extended pelvic lymph node dissection
Authors: Briganti Alberto , Karakiewicz Pierre I , Chun Felix K‐H , Suardi Nazareno , Gallina Andrea , Abdollah Firas , Freschi Massimo , Doglioni Claudio , Rigatti Patrizio , Montorsi Francesco
Published: July 2009

Objectives:  Several studies have shown that obesity is associated with more aggressive prostate cancer (PCa) variants. We hypothesized that obesity, quantified as body mass index (BMI), is associated with a higher risk of lymph node invasion (LNI) in patients undergoing extended pelvic lymph node dissection (ePLND).

Methods:  Clinical and pathological data were available for 994 consecutive men with PCa treated with radical prostatectomy (RP) and ePLND at a single European tertiary academic centre. Univariable and multivariable logistic regression analyses addressed the rate of LNI. Covariates consisted of pre‐treatment prostate specific antigen (PSA), biopsy Gleason sum, clinical stage history of diabetes mellitus as well as BMI coded as either continuous or categorized (<25, 25.0–29.9, 30 kg/m2 or more) variable. Predictive accuracy was assessed with area under curve estimates.

Results:  Overall LNI was diagnosed in 105 patients (10.6%). Mean number of removed lymph nodes was 18.3 (range 7–60). Of all 994 patients, 372 (37.4%) were normal weight, 518 (52.1%) overweight, and 104 (10.5%) were clinically obese. Prevalence of LNI did not significantly differ across different BMI categories (<25, 25.0–29.9 and 30 kg/m2 or more; 9.9, 10.6 and 12.5%, respectively; P = 0.75). In logistic regression models, neither continuously coded nor categorized BMI was a significant predictor of LNI at univariable or multivariable analyses (all P‐values ≥0.1). Moreover, inclusion of BMI with PSA, clinical stage, biopsy Gleason sum and presence of DM did not increase the ability of these variables to predict LNI (82.2% without BMI vs 82.5% and 82.9% with BMI coded as continuous and categorized variable, respectively; all P ≥ 0.4).

Conclusions:  In men undergoing RP and ePLND, increased BMI was not associated with increased risk of lymph node metastases. Therefore, routinely considering patient BMI in risk stratification schemes or prognostic LNI models may not be warranted.
Between a rock and a hard place: exploring the conflict between respecting the privacy of patients and informing their carers
Authors: Gold M. , Philip J. , McIver S. , Komesaroff P. A.
Published: July 2009

Background: A patient's right to privacy is considered fundamental to medical care, with physicians assuming the role of guardian of the clinical information which is conveyed to the patient. However, as a patient's health declines, physicians are often challenged by the need to protect patient privacy while addressing the expectations of the patient's carers, who seek medical information to provide appropriate care at home.

Aims: This study sought to explore the expectations of patients, their carers and physicians regarding the communication of clinical information to carers.

Methods: Surveys were distributed in outpatient clinics at a metropolitan quaternary hospital, with responses from 102 patients and carers, as well as 219 medical staff.

Results: The expectations of patients and carers differed from those of medical staff. Physicians typically believed discussions with carers should begin following the patient's permission and at the patient's request. Patients and carers, however, believed information should be automatically offered or provided when questioned. Further, carers generally felt information updates should occur regularly and routinely, whereas physicians indicated updates should occur with prompting either by a major clinical change or in response to a carer's concern.

Conclusion: Physicians should be aware that the expectations of patients and carers regarding information communication to carers may not match their own. Meanwhile, patients and carers should be made aware of the constraints upon physicians and should be encouraged to convey their preferences for information sharing. These tasks could be facilitated by the development of a prompt sheet to assist the clinical encounter.