bluuebunny/crossref_metadata_2025 huggingface dataset:
Are elected health boards an effective mechanism for public participation in health service governance?
Authors: Gauld Robin
Published: June 2010

Background  There is growing interest in the idea of elected members on health service governing boards as a means to induce public participation in planning and decision making, yet studies of elected boards are limited. Whether elected boards are an effective mechanism for public participation remains unclear.

Setting and participants  This article discusses the experiences of New Zealand where, since 2001, there have been three sets of elections for District Health Boards. Information on candidates and election results is presented along with data gathered via post‐election voter surveys. The article also considers the broader regulatory context within which the elected boards must operate.

Discussion and conclusions  The New Zealand experience illustrates that elected health boards may not be an effective mechanism for public participation. Voter turnout has declined since the inaugural elections of 2001, and non‐voters form the majority. Reasons for not voting include failure to receive voting papers, a lack of interest, or no knowledge of elections. The elections have also failed to produce minority representation, while the capacity for elected members to represent their communities is subject to constraints. On the upside, elections have enabled public involvement in various dimensions of participation, including oversight and processes of governance. New Zealand’s mixed performance suggests that elected boards may need to be complemented with other participatory channels, if increased public participation is the goal.
‘Never heard of it’– Understanding the public’s lack of awareness of a new electronic patient record
Authors: Bratan Tanja , Stramer Katja , Greenhalgh Trisha
Published: June 2010

Background  The introduction of electronic patient records that are accessible by multiple providers raises security issues and requires informed consent – or at the very least, an opportunity to opt out. Introduction of the Summary Care Record (SCR) (a centrally stored electronic summary of a patient’s medical record) in pilot sites in the UK was associated with low awareness, despite an intensive public information programme that included letters, posters, leaflets, and road shows.

Aim  To understand why the public information programme had limited impact and to learn lessons for future programmes.

Methods  Linguistic and communications analysis of components of the programme, contextualized within a wider mixed‐method case study of the introduction of the SCR in pilot sites. Theoretical insights from linguistics and communication studies were applied.

Results  The context of the SCR pilots and the linked information programme created inherent challenges which were partially but not fully overcome by the efforts of campaigners. Much effort was put into designing the content of a mail merge letter, but less attention was given to its novelty, linguistic style, and rhetorical appeal. Many recipients viewed this letter as junk mail or propaganda and discarded it unread. Other components of the information programme were characterized by low visibility, partly because only restricted areas were participating in the pilot. Relatively little use was made of interpersonal communication channels.

Conclusion  Despite ethical and legal imperatives, informed consent for the introduction of shared electronic records may be difficult to achieve through public information campaigns. Success may be more likely if established principles of effective mass and interpersonal communication are applied.
Young infants with atopic dermatitis can display sensitization to Cor a 9, an 11S legumin‐like seed‐storage protein from hazelnut (Corylus avellana)
Authors: Verweij Marjoke M. , Hagendorens Margo M. , De Knop Kathleen J. , Bridts Chris H. , De Clerck Luc S. , Stevens Wim J. , Ebo Didier G.
Published: June 2010

To cite this article: Verweij MM, Hagendorens MM, De Knop KJ, Bridts CH, De Clerck LS, Stevens WJ, Ebo DG. Young infants with atopic dermatitis can display sensitization to Cor a 9, an 11S legumin‐like seed‐storage protein from hazelnut (Corylus avellana). Pediatr Allergy Immunol 2011; 22: 196–201.

Allergy to hazelnut (Corylus avellana) can be severe and occur at young age. Atopic dermatitis (AD) can involve sensitization to various foods. The objective is to investigate the pattern of hazelnut sensitization in infants with AD. Sera of 34 infants all under 1 year of age and suffering from AD were selected according to prior specific IgE results. Twenty‐nine infants were sensitized to traditional food allergens, five were not. From the 29 infants with a sensitization to at least one food allergen, 20 demonstrated IgE reactivity to hazelnut. All sera were analyzed with the allergen microarray immunoassay (ImmunoCAP ISAC). Twelve (60%) of the children with IgE reactivity to hazelnut demonstrated sensitization to Cor a 9, the 11S legumin‐like seed‐storage protein from hazelnut. In these infants, no sensitization to Cor a 1, the homologue of the major birch pollen allergen Bet v 1 (Betula verrucosa), or the lipid transfer protein (Cor a 8) from hazelnut was demonstrable. Half of the children sensitized to Cor a 9 demonstrated IgE reactivity to its homologue in peanut (Arachis hypogaea; Ara h 3) from which five were also sensitized to Gly m 6 from soy (Glycine max). None of the infants with AD without IgE reactivity to hazelnut demonstrated sensitization to Cor a 1, 8, or 9. In conclusion, young infants with atopic dermatitis sensitized to hazelnut can already display IgE reactivity to Cor a 9, a potentially dangerous hazelnut component. The mechanism(s) of this early sensitization and its clinical significance remain elusive.
Categorizing immunofluorescence mapping in epidermolysis bullosa with pyloric atresia: Use as a broad prognostic indicator
Authors: Frew John W , Dopping‐Hepenstal Patricia J , McGrath John A
Published: June 2010

Epidermolysis bullosa with pyloric atresia is a form of junctional epidermolysis bullosa associated with gastrointestinal abnormalities, which may include pyloric atresia. Genotype phenotype correlation is poorly understood and prognosis is difficult, if not impossible, to predict. Immunofluorescence mapping is an ideal candidate for developing a broad prognostic indicator for epidermolysis bullosa with pyloric atresia without the need for genetic mutation analysis. However, the tool developed in this paper does have limitations due to the small number of cases available and the effects of deleterious mutations in highly conserved cysteine residues on the predicted length of survival.
Reinfection with hepatitis C virus following sustained virological response in injection drug users
Authors: Grebely Jason , Knight Elizabeth , Ngai Tyler , Genoway Krista A , Raffa Jesse D , Storms Michelle , Gallagher Lesley , Krajden Mel , Dore Gregory J , Duncan Fiona , Conway Brian
Published: June 2010

Background and Aim: Despite that 60–90% of injection drug users (IDUs) are infected with hepatitis C virus (HCV) infection, IDUs are often denied therapy based on concerns of reinfection following treatment. However, there are little data in this regard. We evaluated HCV re‐infection following sustained virologic response (SVR) among HCV‐infected IDUs having received HCV treatment in a multidisciplinary program.

Methods: Following treatment, participants were encouraged to return at follow‐up intervals of 1 year and illicit drug use histories were obtained. In those with SVR, HCV RNA testing by PCR was performed to determine if relapse or reinfection occurred.

Results: Among 58 receiving HCV treatment between January 2002 and December 2006, 60% (35 of 58) achieved an SVR. Patients were followed for a median of 2.0 years following SVR (range, 0.4–5.0 years), with ongoing illicit and injection drug use reported in 54% (19 of 35) and 46% (16 of 35). Of the 35 with SVR, 28 remained HCV RNA negative during follow‐up (80%), with four lost to follow‐up and one dying of hepatocellular carcinoma and two cases of reinfection were observed (2 of 35). The rates of reinfection were 3.2 per 100 p‐y (95% CI:0.4, 11.5) overall and 5.3 per 100 p‐y (95% CI:0.6, 19.0) among those reporting injecting following SVR (n = 16). One of two participants with HCV re‐infection spontaneously cleared virus following reinfection.

Conclusion: The rate of reinfection following treatment for HCV infection among current and former IDUs engaged in a multidisciplinary program is low.
Significance of H63D homozygosity in a Basque population with hemochromatosis
Authors: Castiella Agustin , Zapata Eva , De Juan Maria Dolores , Otazua Pedro , Fernandez Javier , Zubiaurre Leire , Arriola Jose A.
Published: June 2010

Background:  The significance of H63D homozygosity remains uncertain, although it is associated with a tendency for patients to develop iron overload.

Aims:  To study the prevalence of homozygotic H63D mutation in patients with phenotypic hemochromatosis (PH) and to compare the results with those of the general population and with patients with porphyria cutanea tarda (PCT) in the Basque Country, Spain. A secondary aim was to evaluate the differences in phenotypic expression and liver injury according to different genotypes in the PH cohort.

Methods:  Mutations of the HFE gene were obtained by polymerase chain reaction (PCR). Forty consecutive patients diagnosed with PH, 116 controls and 54 patients with PCT were included in the study. We performed liver biopsies, measured liver iron concentration (LIC), by atomic spectrophotometry, serum ferritin and transferrin saturation, and compared the histology according to the genotype.

Results:  The H63D homozygote mutation was identified in 7.76% of the control group, in 7.50% of the PH group, and in 11.11% of patients with PCT (P > 0.05). The C282Y/C282Y mutation was present in 50% of patients with PH, and LIC was identified in 15/20. The LIC in C282Y/C282Y patients was higher than in H63D/H63D patients (P = 0.26), while H63D homozygosis caused greater iron overload in PH patients than other genotypes. All the C282Y/C282Y genotype patients had elevated serum ferritin and transferrin saturation. The H63D homozygotes had high ferritin, but two out of three had normal transferrin saturation. Six of the eight patients with high‐grade fibrosis and genetic study results were found to be C282Y/C282Y.

Conclusions:  The prevalence of H63D mutation in patients with PH in our region does not differ from that of the general Basque population.
Prisons, prisoners, and hepatitis C
Authors: Ferguson Lisa , Batey Robert
Published: June 2010

See article in J. Gastroenterol. Hepatol. 2010; 25: 1276–1280 and 1281–1284
Prevalence of abdominal aortic aneurysm in Chinese patients with severe coronary artery disease
Authors: Poon Jensen T. C. , Cheng Stephen W. K. , Wong Joyce S. W. , Ting Albert C. W.
Published: June 2010

Background:  The Asian population is believed to have lower incidence of abdominal aortic aneurysm (AAA), and hence, the benefit of screening is uncertain. The size of native aorta in Asians, which shall affect the definition of AAA, has also never been reported. Our study investigated the prevalence of AAA and the infra‐renal aortic diameter (AD) in Chinese patients with severe coronary artery disease.

Methods:  This is a prospective observational study of infra‐renal aortic size for patients who had coronary artery bypass surgery by ultrasound. The patients' demographics, important co‐morbidities and maximum AD were recorded.

Results:  The study included 624 consecutive Chinese patients (mean age = 63.2 years). The mean maximum infra‐renal AD was 17.5 mm for men and 14.8 mm for women. The presence of AAA was defined as maximum AD greater than 30 mm. The result was also compared with an alternate definition that defines AAA as maximum AD of greater than 1.5 times of the group's mean. Eleven patients had an AD greater than 30 mm, and the prevalence of AAA was only 1.8%. With AAA defined as maximum AD of 1.5 times greater than the group's mean, 19 patients had AAA. The prevalence of AAA in this high‐risk group would become 3% overall.

Conclusion:  The prevalence of AAA in Chinese patients was low, and the result did not support routine screening. The smaller mean infra‐renal AD in Chinese merits validation by large‐scale study and consideration when deciding threshold for small AAA repair in our locality.
Is there a need for routine follow‐up after primary total hip arthroplasty?
Authors: Hacking Craig , Weinrauch Patrick , Whitehouse Sarah L. , Crawford Ross W. , Donnelly William J.
Published: June 2010

Background:  The objective of routine outpatient assessment of well‐functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow‐up of patients after THA.

Methods:  A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a four‐year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow‐up information were recorded and cross‐referenced with Australian Orthopaedic Association National Joint Replacement Registry data.

Results:  One hundred ten THAs in 104 patients (average age 70.4 (SD 9.8 years)). There were 70 (63.6%) in total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri‐prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only four (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3)) follow‐up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years.

Conclusions:  We conclude that patients with prostheses with excellent long‐term clinical results as validated by joint registries, routine follow‐up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow‐up of asymptomatic THA may be excessively costly and unnecessary, and a less resource‐intensive review method may be more appropriate.
Pancreaticoduodenectomy – outcomes from an Australian institution
Authors: Kwok Kelvin H.K. , Rizk Joseph , Coleman Maxwell , Fenton‐Lee Douglas
Published: June 2010

Background:  Operative morbidity and mortality rates have improved markedly since the first single‐stage pancreaticoduodenectomy (PD) was performed by A. O. Whipple in 1940. There is a lack of published data regarding outcomes of PD from Australian centres. The aim of this study was primarily to establish post‐operative morbidity and mortality rates of an Australian unit, and secondly, to investigate the value of preoperative investigation with endoscopic ultrasound and laparoscopy upon tumour stage and survival following PD.

Method:  A retrospective analysis was conducted on consecutive patients undergoing PD at St Vincent's Hospital from 1990 to 2006. Data were collected with particular reference to preoperative investigations, including endoscopic ultrasonography (EUS) and staging laparoscopy, and post‐operative complications. Patient survival was determined from the hospital and consultant surgeons' records and telephone interviews with the patients' general practitioners.

Results:  Eighty‐one patients underwent PD, of which 58 were Whipple's procedures and 23 were pylorus‐preserving pancreaticoduodenectomies (PPPD). Twenty‐six patients had EUS, and 22 had a staging laparoscopy before PD. The post‐operative morbidity rate was 55% and included intra‐abdominal collections (17%), major haemorrhage (10.7%), pancreatic anastomotic leakage (9%) and delayed gastric emptying (22%). The operative (30‐day) mortality rate was 1.6%. There was no survival advantage in the EUS or the laparoscopy group.

Conclusion:  EUS and laparoscopy are useful modalities in the preoperative investigation and staging of patients being considered for PD. PD is a safe procedure with acceptable complication rates when carried out in a specialist unit experienced in this operation.
Medullary thyroid carcinoma presenting with an initial CEA elevation
Authors: Abraham Deepak , Delbridge Leigh , Clifton‐Bligh Roderick , Clifton‐Bligh Phillip , Grodski Simon , Robinson Bruce G. , Messina Marinella , Sidhu Stan
Published: June 2010

Background:  Carcinoembryonic antigen (CEA) is a tumour marker commonly associated with gastrointestinal malignancy. Patients presenting with an elevated CEA will therefore often undergo extensive investigations in order to elucidate an underlying gastrointestinal malignancy that may not be clinically apparent. However the GI tract is not the only source of CEA elevation.

Methods:  We present a series of patients presenting with raised CEA levels that were initially investigated for a gastrointestinal cause, but after work up were detected to have medullary thyroid cancer.

Results:  Four patients with raised CEA were evaluated for a gastrointestinal cause for the elevation. We discuss the non gastrointestinal causes for an elevated CEA.

Conclusion:  The paper highlights that in patients presenting with an elevated CEA, in whom a gastrointestinal cause has been ruled out, a tumour of neuroendocrine origin needs to be considered as a cause for the elevated CEA.
Are invaders different? A conceptual framework of comparative approaches for assessing determinants of invasiveness
Authors: Van Kleunen Mark , Dawson Wayne , Schlaepfer Daniel , Jeschke Jonathan M. , Fischer Markus
Published: June 2010

Ecology Letters (2010) 13: 947–958

What determines invasiveness of alien organisms is among the most interesting and urgent questions in ecology. In attempts to answer this question, researchers compare invasive alien species either to native species or to non‐invasive alien species, and this is done in either the introduced or native ranges. However, inferences that can be drawn from these comparisons differ considerably, and failure to recognize this could hamper the search for determinants of invasiveness. To increase awareness about this issue, we present a framework of the various comparisons that can be used to test for determinants of invasiveness, and the specific questions each comparison can address. Moreover, we discuss how different comparisons complement each other, and therefore should be used in concert. For progress in invasion biology, it is crucial to realize that different comparisons address different biological questions and that some questions can only be answered unambiguously by combining them.
An integrative approach to understanding microbial diversity: from intracellular mechanisms to community structure
Authors: Gudelj Ivana , Weitz Joshua S. , Ferenci Tom , Claire Horner‐Devine M. , Marx Christopher J. , Meyer Justin R. , Forde Samantha E.
Published: June 2010

Ecology Letters (2010) 13: 1073–1084

Trade‐offs have been put forward as essential to the generation and maintenance of diversity. However, variation in trade‐offs is often determined at the molecular level, outside the scope of conventional ecological inquiry. In this study, we propose that understanding the intracellular basis for trade‐offs in microbial systems can aid in predicting and interpreting patterns of diversity. First, we show how laboratory experiments and mathematical models have unveiled the hidden intracellular mechanisms underlying trade‐offs key to microbial diversity: (i) metabolic and regulatory trade‐offs in bacteria and yeast; (ii) life‐history trade‐offs in bacterial viruses. Next, we examine recent studies of marine microbes that have taken steps toward reconciling the molecular and the ecological views of trade‐offs, despite the challenges in doing so in natural settings. Finally, we suggest avenues for research where mathematical modelling, experiments and studies of natural microbial communities provide a unique opportunity to integrate studies of diversity across multiple scales.
Opposing effects of competitive exclusion on the phylogenetic structure of communities
Authors: Mayfield Margaret M. , Levine Jonathan M.
Published: June 2010

Ecology Letters (2010) 13: 1085–1093

Though many processes are involved in determining which species coexist and assemble into communities, competition is among the best studied. One hypothesis about competition’s contribution to community assembly is that more closely related species are less likely to coexist. Though empirical evidence for this hypothesis is mixed, it remains a common assumption in certain phylogenetic approaches for inferring the effects of environmental filtering and competitive exclusion. Here, we relate modern coexistence theory to phylogenetic community assembly approaches to refine expectations for how species relatedness influences the outcome of competition. We argue that two types of species differences determine competitive exclusion with opposing effects on relatedness patterns. Importantly, this means that competition can sometimes eliminate more different and less related taxa, even when the traits underlying the relevant species differences are phylogenetically conserved. Our argument leads to a reinterpretation of the assembly processes inferred from community phylogenetic structure.
The potential distribution of an invasive mealybug Phenacoccus solenopsis and its threat to cotton in Asia
Authors: Wang Yanping , Watson Gillian W. , Zhang Runzhi
Published: June 2010

In recent years, an invasive mealybug Phenacoccus solenopsis Tinsley (Hemiptera: Pseudococcidae) has attacked cotton (Gossypium hirsutum L.) in Pakistan and India, causing severe economic losses. This polyphagous pest was probably introduced accidentally from North America. Infestations have broken out suddenly and spread rapidly.

Seasonal and annual population growth data of P. solenopsis from nine locations in its native range in the U.S.A., and the distribution of the mealybug worldwide, were analyzed using the CLIMEX model. This indicated that tropical regions worldwide were highly suitable for P. solenopsis.

Its potential distribution was limited by cold in high latitudes and altitudes, and dryness in northern Africa, inland Australia and parts of the Middle East. CLIMEX was used to predict where P. solenopsis might establish, and to estimate the potential threat to cotton yield in Asia. The key limiting factors were low precipitation as well as minimum temperatures in northern areas.

When irrigation was factored into the simulation, the potential distribution of P. solenopsis expanded dramatically, indicating that P. solenopsis presents a great economic threat to cotton in Asia and other parts of the world.
In support of an early polypharmacy approach to the treatment of type 2 diabetes
Authors: Wright E. E. , Stonehouse A. H. , Cuddihy R. M.
Published: June 2010

Type 2 diabetes (T2DM) is a multifaceted disease, characterized by hyperglycaemia, resulting from a combination of insulin resistance, impaired incretin action and β‐cell dysfunction leading to relative insulin deficiency. Although traditional anti‐diabetes agents improve hyperglycaemia, they do so at a cost, which may entail hypoglycemia and increased body weight; exacerbating dyslipidemia, hypertension and components of insulin resistance and metabolic syndrome associated with T2DM—potentially increasing cardiovascular risk. At diagnosis, many patients with T2DM are treated with medical nutritional therapy (MNT) and exercise, then single or multiple oral anti‐diabetes agents until treatment failure, when insulin is used. This strategy has been challenged by recommendations for polypharmacy approaches to the treatment of T2DM, as current strategies are unable to improve multiple aspects of the disease, nor are they likely to address underlying pathophysiology. Although the 2009 American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) treatment algorithm recommends a stepwise approach with MNT and metformin, later adding oral agents, incretin‐based therapies or insulin, some experts have recommended a more aggressive approach. In his 2008 ADA Banting Lecture, Dr. Ralph DeFronzo recommended early treatment with metformin, TZD and exenatide at initiation of therapy. The authors' of this article recommend an aggressive early polypharmacy approach addressing underlying pathophysiology, including the incretin defect—with MNT and exercise, metformin and an incretin‐based therapy and/or basal insulin if glycemic goal is not achieved within 3 months. This approach attempts to modify the disease, aiming for tight glycemic control, weight loss, reduced hypoglycemia, improvements to hypertension, dyslipidemia and insulin resistance—and improved cardiovascular outcomes.
Addition of insulin lispro protamine suspension or insulin glargine to oral type 2 diabetes regimens: a randomized trial
Authors: Strojek K. , Shi C. , Carey M. A. , Jacober S. J.
Published: June 2010

Aims: The addition of basal insulin to existing oral therapy can help patients with type 2 diabetes (T2D) achieve glycaemic targets. This study compares the efficacy and safety of insulin lispro protamine suspension (ILPS) and insulin glargine in insulin‐naive patients with T2D and inadequate control on oral antihyperglycaemic medication (OAM).

Materials and Methods: An open‐label, randomized, multicentre, multinational 24‐week study of 471 patients receiving ≥2 OAMs for ≥3 months with a body mass index between 25 and 45 kg/m2 and HbA1c 7.5–10.0% was conducted. ILPS was injected once or twice daily vs. glargine injected once daily plus prestudy OAMs. Primary objective compared the HbA1c change from baseline.

Results: HbA1c change from baseline to endpoint was similar in both groups [−1.46% (ILPS) and −1.41% (glargine)]. Least‐squares mean difference (95% CI) for HbA1c (−0.05 [−0.21, 0.11]%), glycaemic variability (0.06 [−0.06, 0.19] mmol/l) and weight change (−0.01 [−0.61, 0.59] kg) showed non‐inferiority (margins of 0.4%, 0.8 mmol/l and 1.5 kg, respectively). Percentages of patients achieving HbA1c <7.0% were 43.8% ILPS and 41.2% glargine. Mean daily insulin dose was 0.39 vs. 0.35 U/kg (p = 0.02) and weight gain was 1.04 vs. 1.07 kg for ILPS vs. glargine (p = 0.98). Overall hypoglycaemia (episodes/patient/year) was similar for ILPS and glargine (24.2 ± 28.8 vs. 23.0 ± 30.9); nocturnal (6.1 ± 10.6 vs. 4.1 ± 9.4, p < 0.001) rates were higher for ILPS. Severe hypoglycaemia was higher for ILPS vs. glargine (n = 9 vs. n = 2; p = 0.04).

Conclusions: At endpoint, ILPS was non‐inferior to glargine in HbA1c change from baseline, but associated with increased risk of hypoglycaemia.
Expression of human β‐defensin‐2 in the prostate
Authors: Kim Hae Jong , Jung Ja Rang , Kim Hea Jin , Lee Shin Young , Chang In Ho , Lee Tae Jin , Kim Wonyong , Myung Soon Chul
Published: June 2010

What’s known on the subject? and What does the study add?

We found the expression of human β‐defensin‐2 (HBD‐2) in the prostate for the first time and LPS, a gram negative bacterial component, upregulated HBD‐2 in prostate epithelial cells.

We are looking for other antimicrobial peptides expressed in the prostate besides human β‐defensin‐2.

Also, we are studying the relationship between antimicrobial peptides and the development or progression of prostate diseases.

OBJECTIVE

To investigate the expression and regulation of human β‐defensin‐2 (HBD‐2) in the prostate.

PATIENTS AND METHODS

Normal human prostate epithelial cell line (RWPE‐1), human prostate cancer cell lines (DU‐145, PC‐3), and paraffin‐embedded prostate tissue from patients with benign prostatic hyperplasia (BPH) were analysed by RT‐PCR and immunohistochemical staining. HBD‐2 expression was also analysed by RT‐PCR and ELISA in RWPE‐1 cells treated with lipopolysaccharide (LPS). Nuclear factor‐κB (NF‐κB) activation was assessed by IκBα immunoblotting and electrophoretic mobility shift assay (EMSA).

RESULTS

BPH tissue and all of the tested prostate cell lines other than PC‐3 constitutively express HBD‐2 mRNA. HBD‐2 protein was strongly detected in prostate gland tissue surrounded by inflammatory cells including macrophages. Exposure to LPS induced HBD‐2 upregulation and NF‐κB activation, as assessed by IκBα phosphorylation and degradation in RWPE‐1 cells. Bay11‐7082, an NF‐κB inhibitor prevented LPS‐induced HBD‐2 production in RWPE‐1 cells.

CONCLUSIONS

Prostate epithelial cells may constitutively express HBD‐2, and its expression was upregulated by LPS. Our data indicate that HBD‐2 may be an important immunomodulatory factor in prostate function. Expression of HBD‐2 in normal prostates and the potential role of HBD‐2 in prostatitis and BPH should be addressed in the future.
Climate and the inter‐annual variability of fire in southern Africa: a meta‐analysis using long‐term field data and satellite‐derived burnt area data
Authors: Archibald S. , Nickless A. , Govender N. , Scholes R. J. , Lehsten V.
Published: June 2010

Aim  This study investigates inter‐annual variability in burnt area in southern Africa and the extent to which climate is responsible for this variation. We compare data from long‐term field sites across the region with remotely sensed burnt area data to test whether it is possible to develop a general model.

Location  Africa south of the equator.

Methods  Linear mixed effects models were used to determine the effect of rainfall, seasonality and fire weather in driving variation in fire extent between years, and to test whether the effect of these variables changes across the subcontinent and in areas more and less impacted by human activities.

Results  A simple model including rainfall and seasonality explained 40% of the variance in burnt area between years across 10 different protected areas on the subcontinent, but this model, when applied regionally, indicated that climate had less impact on year‐to‐year variation in burnt area than would be expected. It was possible to demonstrate that the relative importance of rainfall and seasonality changed as one moved from dry to wetter systems, but most noticeable was the reduction in climatically driven variability of fire outside protected areas. Inter‐annual variability is associated with the occurrence of large fires, and large fires are only found in areas with low human impact.

Main conclusions  This research gives the first data‐driven analysis of fire–climate interactions in southern Africa. The regional analysis shows that human impact on fire regimes is substantial and acts to limit the effect of climate in driving variation between years. This is in contrast to patterns in protected areas, where variation in accumulated rainfall and the length of the dry season influence the annual area burnt. Global models which assume strong links between fire and climate need to be re‐assessed in systems with high human impact.
Modern sedentary activities promote overconsumption of food in our current obesogenic environment
Authors: Chaput J.‐P. , Klingenberg L. , Astrup A. , Sjödin A. M.
Published: June 2010

Achieving body‐weight stability is certainly challenging in today's obesogenic environment. Every day we are surrounded and affected by stimuli that act on our behaviour. A common feature of these stimuli is that they increase our comfort and well‐being, but unfortunately they promote a positive caloric balance. Intriguingly, the preponderance of sedentary lifestyles is not only a matter of the amount of calories expended. A careful examination of modern sedentary activities reveals that they also promote overconsumption of food. This is particularly the case with television viewing, video game playing, cognitive working, music listening and short sleeping. Moreover, the increased food intake in the absence of hunger observed with the practice of these modern‐life activities emphasizes that the hedonic value of food intake plays an important role. These observations suggest that our quest for reward and pleasure is not fine tuned to our biology, and the development of coping strategies is needed.
THE GENDER GAP IN PRIVATE PENSIONS
Authors: Bardasi Elena , Jenkins Stephen P.
Published: June 2010

In many western countries, older women receive considerably less private pension income than older men on average. We analyse this differential in Britain, examining differences between the sexes both in private pension coverage and in pension income conditional on receipt. Using regression‐based decompositions, we show that both gender gaps are associated mainly with differences in returns to personal characteristics rather than with differences in personal characteristics per se.
The Effect of Corporate Governance on Stock Repurchases: Evidence from Sweden
Authors: Jansson Andreas , Larsson‐Olaison Ulf
Published: June 2010

Manuscript Type: Empirical

Research Question/Issue: The paper examines whether corporate governance differences affect firms' stock repurchasing behavior. Previous hypotheses on stock repurchases, well‐supported by US data, are based on assumptions of managerial autonomy that might not be descriptive in corporate governance systems characterized by influential controlling shareholders such as the Swedish. Firm‐level corporate governance arrangements may also affect firms' incentives to repurchase stock.

Research Findings/Insights: Stock‐repurchasing patterns among Swedish firms differ from those previously observed among US firms. The findings indicate that Swedish firms do not repurchase stock to distribute excess cash, signal undervaluation, or fend off takeovers. Stock repurchases are made in addition to dividends and thus do not substitute for them. Firm‐level corporate governance arrangements directly affect stock repurchasing behavior. Firms without a dominant controlling owner seem to use stock repurchases to increase leverage. The existence of a dominant controlling shareholder diminishes the propensity for stock repurchases, while cross listing on a US or UK stock market increases that propensity.

Theoretical/Academic Implications: The findings suggest that corporate governance differences affect stock repurchasing behavior. The agency‐theoretical view of the firm, on which the leading hypotheses on stock repurchases are based, accurately predicts stock repurchases only in certain institutional and governance settings.

Practitioner/Policy Implications: The study suggests that differences in national and firm‐level corporate governance must be taken into account in order to accurately assess outcomes of regulatory reforms and/or harmonization attempts.
Fuzzy adaptive anisotropic filter for medical images
Authors: Demirci Recep
Published: June 2010

Abstract:An adaptive anisotropic diffusion filter for images is proposed in this paper. First, the gradient of an image was calculated by a novel fuzzy‐rule‐based gradient operator. Accordingly, the centre of gravity of a histogram of the gradient image was estimated and it was assigned as an edge threshold. In conventional anisotropic filters, the conduction coefficients have to be selected by an operator. However, in this study, the centre of gravity of the histogram was assigned as the conduction coefficient of the anisotropic filter. Consequently, an adaptive anisotropic image filter which automatically sets its conduction coefficient without user intervention was developed. The image filter achieved was tested with various medical images.
The Life and Death of Public Organizations: A Question of Institutional Design?
Authors: BOIN ARJEN , KUIPERS SANNEKE , STEENBERGEN MARCO
Published: June 2010

Why do some public organizations grow old and others die young? Since Herbert Kaufman first posed this question, considerable research has been devoted to answering it. The findings of that research suggest that the design of new public organizations affects, to a significant degree, their survival chances. In this article, we test whether and how “design factors” affected the durability of the so‐called New Deal organizations initiated under FDR's first term. Our findings confirm that design factors do matter, but their effects change over time. We draw out some potential implications for institutional design and sketch a renewed research agenda to determine why some public organizations survive environmental pressure whereas others succumb to it.
The Evolution of Budgetary Institutions in Estonia: A Path Full of Puzzles?
Authors: RAUDLA RINGA
Published: June 2010

This article examines the evolution of budgetary institutions in Estonia between 1993 and 2008, with a main focus on rules governing the preparation, adoption, and implementation of the state budget. It discusses the initial choice of budgetary institutions in 1993 and subsequent developments in the light of theoretical propositions put forth by the fiscal governance literature. The case of Estonia poses a number of puzzles, and the article seeks to explain the institutional choices in Estonia: Why did the coalition government opt for a delegation mode of fiscal governance in 1993? Why has the preparation phase of the budget process evolved toward a contracts approach from 1994 onward, while the adoption phase has moved closer to a delegation mode? The article demonstrates that alongside government type, institutional choices can be influenced by lesson‐drawing from history, examples of other countries, and negative experiences gained in legislative budget process.
Local Governance Arrangements and Democratic Outcomes (with Some Evidence from the Italian Case)
Authors: BASSOLI MATTEO
Published: June 2010

This article carries a broad definition of public–private concertation as a flexible form of governance that is able to overcome the distinction between network governance and participatory governance. It creates a unified framework relying on a process‐related democratic approach in order to properly assess these practices in their democratic outcomes. This allows the article to fully depict how local governance arrangements affect local democracy, both positively and negatively. Drawing on four exemplary cases of urban policies developed in the Province of Milan, it highlights two variables that give account of the democratic implication of these practices: the role of the political leadership and the inclusive strategy that they adopt. Moreover, it underlines four additional factors that help more democratic outcomes: presence of cognitive justification, quality of participation, active opposition, and an outward communication.
Renewal of Public Policy via Instrumental Innovation: Implementing Automated Speed Enforcement in France
Authors: HAMELIN FABRICE
Published: June 2010

This article examines the renewal of public policy via instrumental innovation since the adoption in France of an automated sequence of detection and sanctioning of speed limit violations. Involved here is an instrument of public policy that points up the changes that have taken place in recent years in respect of road safety policy and provides a clearer view of some aspects of ongoing state reorganization. The change in public policy permitted by this instrumentation results from an increasingly close focus on the road hazard issue, which has allowed specialists from different epistemic fields to advocate a system used in other countries for over a decade now. However, this success with policymakers is also explained by the fact that the new system involves the return of the state as the core shaper of this public policy, after 20 years of emphasis on local and partnership‐based policies.
Rosacea – global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group
Authors: Elewski BE , Draelos Z , Dréno B , Jansen T , Layton A , Picardo M
Published: June 2010

Background  The absence of specific histological or serological markers, the gaps in understanding the aetiology and pathophysiology of rosacea, and the broad diversity in its clinical manifestations has made it difficult to reach international consensus on therapy guidelines.

Objectives  The main objective was to highlight the global diversity in current thinking about rosacea pathophysiology, classification and medical features, under particular consideration of the relevance of the findings to optimization of therapy.

Methods  The article presents findings, proposals and conclusions reached by the ROSacea International Expert group (ROSIE), comprising European and US rosacea experts.

Results  New findings on pathogenesis provide a rationale for the development of novel therapies. Thus, recent findings suggest a central role of the antimicrobial peptide cathelicidin and its activator kallikrein‐5 by eliciting an exacerbated response of the innate immune system. Cathelicidin/kallikrein‐5 also provide a rationale for the effect of tetracyclines and azelaic acid against rosacea. Clinically, the ROSIE group emphasized the need for a comprehensive therapy strategy – the triad of rosacea care – that integrates patient education including psychological and social aspects, skin care with dermo‐cosmetics as well as drug‐ and physical therapies. Classification of rosacea into stages or subgroups, with or without progression, remained controversial. However, the ROSIE group proposed that therapy decision making should be in accordance with a treatment algorithm based on the signs and symptoms of rosacea rather than on a prior classification.

Conclusion  The ROSIE group reviewed rosacea pathophysiology and medical features and the impact on patients and treatment options. The group suggested a rational, evidence‐based approach to treatment for the various symptoms of the condition. In daily practice this approach might be more easily handled than prior subtype classification, in particular since patients often may show clinical features of more than one subtype at the same time.
Nosocomial Staphylococcal scalded skin syndrome caused by intra‐articular injection
Authors: Emberger M , Koller J , Laimer M , Hell M , Oender K , Trost A , Maass M , Witte W , Hintner H , Lechner AM
Published: June 2010

Background  The pathogenic role of nasal carriage as a source for cutaneous and soft‐tissue Staphylococcus aureus (SA) infections, and Staphylococcal scalded skin syndrome (SSSS) in particular, is unclear.

Observation  We herein describe a nosocomial outbreak of SSSS in three orthopaedic patients who received intra‐articular injections by a single orthopaedic surgeon. Bacteriological samples from the index patients and medical personnel involved in their care were assessed by phage typing, polymerase chain reaction for exfoliative toxin genes, SmaI macro‐restriction analysis and molecular spa‐typing. These studies first revealed SA cultural growth in synovial fluid of all three patients as well as nasal mucosa of one medical assistant. Moreover, all SA isolates had the same phage typing and antibiotic susceptibilities and were positive for exfoliative toxin ETa by polymerase chain reaction. SmaI macro‐restriction and spa‐typing further confirmed all proband isolates to be identical.

Conclusion  These findings provide evidence that SA nasal colonization of otherwise healthy carriers is a risk factor for SA infections, including SSSS, in predisposed individuals.
Hunter‐Schreger Band patterns in human tooth enamel
Authors: Lynch Christopher D. , O’Sullivan Victor R. , Dockery Peter , McGillycuddy Catherine T. , Sloan Alastair J.
Published: June 2010

Using light microscopy, we examined Hunter‐Schreger Band (HSB) patterns on the axial and occlusal/incisal surfaces of 160 human teeth, sectioned in both the buccolingual and mesiodistal planes. We found regional variations in HSB packing densities (number of HSBs per mm of amelodentinal junction length) and patterns throughout the crown of each class of tooth (maxillary and mandibular: incisor, canine, premolar, and molar) examined. HSB packing densities were greatest in areas where functional and occlusal loads are greatest, such as the occlusal surfaces of posterior teeth and the incisal regions of incisors and canines. From this it is possible to infer that the behaviour of ameloblasts forming enamel prisms during amelogenesis is guided by genetic/evolutionary controls that act to increase the fracture and wear resistance of human tooth enamel. It is suggested that HSB packing densities and patterns are important in modern clinical dental treatments, such as the bonding of adhesive restorations to enamel, and in the development of conditions, such as abfraction and cracked tooth syndrome.
Neurological complications in two children with Lemierre syndrome
Authors: PEER MOHAMED BASHEER , CARR LUCINDA
Published: June 2010

Lemierre syndrome is a distinct clinical syndrome comprising oropharyngeal sepsis and fever, internal jugular vein thrombosis and remote septic metastases caused by Fusobacterium species. The mortality rate was historically high and although use of antibiotics led to a dramatic fall in incidence, a resurgence has been seen recently. A 14‐year‐old male developed Lemierre syndrome after tonsillitis. There was extensive leptomeningitis, especially over the clivus, causing 6th and 12th cranial nerve palsies, a clinical feature termed the ‘clival syndrome’. He also developed an epidural abscess in the cervical spine, which was unsafe for surgical drainage. Conservative treatment with an extended course of antibiotics and anticoagulation for jugular vein thrombosis led to a good recovery. A 15‐year‐old female developed Lemierre syndrome after a persistent sore throat lasting 7 weeks. She had palsy of the 12th cranial nerve from clival osteomyelitis. She was treated with a 6‐week course of antibiotics and anticoagulants leading to almost full recovery at 3‐month review. Awareness of the potential neurological complications of Lemierre syndrome and prompt management are crucial in reducing morbidity and mortality in this ‘forgotten disease’.
Healthcare librarians and the delivery of critical appraisal training: attitudes, level of involvement and support
Authors: Maden‐Jenkins Michelle
Published: June 2010

Background:  Although healthcare librarians are undertaking training in critical appraisal skills, what is not so clear is the impact of the training on the understanding and dissemination of these skills.

Objectives:  This study aims to examine the attitudes of healthcare librarians towards delivering critical appraisal training and their level of involvement.

Methods:  A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north‐west England followed up with 21 semi‐structured interviews.

Results:  Seventy‐three per cent of respondents felt that they ought to be involved in delivering critical appraisal training, however less than a third (29%) are actually involved. Librarians are involved in critical appraisal facilitation at various levels.

Conclusions:  Debate continues over the extent of librarian involvement in delivering critical appraisal training. As long as healthcare librarians recognise their own capabilities and identify the boundaries within which they feel comfortable then there is no reason why they should not be involved in delivering critical appraisal training.