bluuebunny/crossref_metadata_2025 huggingface dataset:
Intratumoral injection of interleukin‐2 augments the local and abscopal effects of radiotherapy in murine rectal cancer
Authors: Yasuda Koji , Nirei Takako , Tsuno Nelson Hirokazu , Nagawa Hirokazu , Kitayama Joji
Published: March 2011

Recent studies have suggested that tumor shrinkage in response to radiotherapy (RT) is greatly dependent on the host immune response. A Balb/c mouse model of simultaneous subcutaneous tumor and liver metastasis of Colon26 was prepared and, after irradiation of the subcutaneous tumor (2 Gy × 5 day × 2 cycles), interleukin‐2 (IL‐2) (2 × 104 U) was injected intra‐tumorally, and the fate of both the subcutaneous tumor and liver metastatic lesions was evaluated. Intratumoral injection of IL‐2 greatly enhanced the anti‐tumor effects of RT and completely eradicated the established subcutaneous tumor. Interestingly, although RT was given locally to the subcutaneous tumor, liver metastasis formation was also inhibited in mice receiving only local RT. More impressively, the combination of RT + IL‐2 completely inhibited liver metastasis formation. Splenocytes in mice receiving RT + IL‐2 contained a higher percentage of CD4(+) T cells, but lower percentages of CD4(+)CD25(+) regulatory T cells and CD11b(+) Gr‐1(+) myeloid‐derived suppressor cells. Immunohistochemical investigation of human rectal cancer revealed that the density of CD8(+) cells infiltrating into irradiated rectal tumor was positively associated with a lower frequency of distant metastasis as well as histological response grade. Local administration of IL‐2 not only enhances shrinkage of the irradiated tumor itself, but can also suppress the development of distant metastasis located outside the RT field, possibly though the induction of a systemic T cell response. Augmentation of T‐cell‐mediated antitumor immunity during RT might be critical for improvement of the clinical efficacy of neoadjuvant RT for the treatment of advanced rectal cancer. (Cancer Sci 2011; 102: 1257–1263)
Genotypechecker: an interactive tool for checking the inheritance consistency of genotyped pedigrees
Authors: Paterson T. , Law A.
Published: March 2011

Datapoint errors in pedigree genotype data sets are difficult to identify and adversely affect downstream genetic analyses. We present GenotypeChecker, a desktop software tool for assisting data cleansing. The application identifies likely data errors in pedigree/genotype data sets by performing an inheritance‐checking algorithm for each marker across the pedigree, and highlights inconsistently inherited genotypes in an exploratory user interface. By ‘masking’ suspect datapoints and rechecking inheritance consistency, erroneous datapoints can be confirmed and cleansed from the data set. The software, examples and documentation are freely available at http://bioinformatics.roslin.ac.uk/genotypechecker.
Bovine milk fat enriched in conjugated linoleic and vaccenic acids attenuates allergic dermatitis in mice
Authors: Sun X. , Zhang J. , MacGibbon A. K. H. , Black P. , Krissansen G. W.
Published: March 2011

Background
Orally administered milk fat enriched in conjugated linoleic acid (CLA) and trans‐vaccenic acid (VA) (‘enriched milk fat’), produced by supplementing the diet of pasture‐fed cows with fish and sunflower oil, has been shown previously to suppress the development of allergic airway disease in mice.

Objective
To investigate whether topical or oral application of enriched milk fat and its two major fatty acids cis‐9, trans‐11 CLA (c9,t11‐CLA) and VA inhibit allergic dermatitis in mice.

Methods
Allergic dermatitis was induced in C57BL/6 mice by epicutaneous sensitization of tape‐stripped skin with ovalbumin (OVA). Enriched milk fat and its two major fatty acids were either topically applied to the OVA‐sensitized skin, or orally fed to mice by supplementation of the diet. Blood and skin tissues were collected for analysis after the third skin sensitization.

Results
Both topical and oral administration of enriched milk fat and its two major fatty acids led to significant suppression of allergic dermatitis as evidenced by reduced clinical and histological scores of affected skins, infiltration of inflammatory cells, and circulating allergen‐specific IgE levels, compared with treatment with normal milk fat or the base control diet. C9,t11‐CLA and VA individually inhibited multiple facets of allergic dermatitis when topically applied, and their combination produced a strong additive effect.

Conclusion and Clinical Relevance
Enriched milk fat, and its two major fatty acids c9,t11‐CLA and vaccenic acid attenuate allergic dermatitis in mice.

Cite this as: X. Sun, J. Zhang, A. K. H. MacGibbon, P. Black and G. W. Krissansen, Clinical & Experimental Allergy, 2011 (41) 729–738.
Restoration of hay meadows on ex‐arable land: commercial seed mixtures vs. spontaneous succession
Authors: Lencová K. , Prach K.
Published: March 2011

In many areas of Europe there are policies to restore former arable land to grassland. In practice, this usually involves the use of commercial seed mixtures. The abundance of all vascular plants species in 35 ex‐arable fields, sown with a commercial seed mixture or spontaneously revegetated, was studied in one landscape area to compare two methods of grassland restoration. Species abundance was also evaluated in the close surroundings of the fields. Data were processed using multivariate (ordination) and univariate statistics. Period of time since abandonment, size of the field and type of grassland restoration (sown vs. spontaneously revegetated) had a significant influence on vegetation. However, for the target meadow species, the type of restoration did not exhibit any influence. After about 20 years the contribution of meadow species that had established spontaneously in the studied fields was similar to that of their surroundings. We concluded that artificial sowing on ex‐arable land is not necessary to develop semi‐natural grasslands if (i) there are sources of appropriate diaspores in the immediate surroundings, (ii) the site is not very rich in nutrients and (iii) farmers do not need grass production immediately. In these situations and over this timescale natural regeneration would allow substantial savings of money and labour.
Effects ofin situfreezing on soil net nitrogen mineralization and net nitrification in fertilized grassland of northern China
Authors: Zhang X. , Bai W. , Gilliam F. S. , Wang Q. , Han X. , Li L.
Published: March 2011

Effects of soil freezing on nitrogen (N) mineralization have been the subject of increased attention in the ecological literature, though fewer studies have examined N mineralization responses to successive mild freezing, severe freezing and cyclic freeze–thaw events. Even less is known about relationships of responses to soil N status. This study measured soil N mineralization and nitrification in the field along an experimental N gradient in a grassland of northern China during the dormant season (October 2005–April 2006), a period in which freezing naturally occurs. Net N mineralization exhibited great temporal variability, with nitrification being the predominant N transformation process. Soil microbial biomass C and N and extractable NH4 + pools declined by 40, 52, and 56%, respectively, in April 2006, compared with their initial concentrations in October 2005; soil NO3–pools increased by 84%. Temporal patterns of N mineralization were correlated with soil microbial biomass C and N. N mineralization and nitrification increased linearly with added N. Microbial biomass C in treated soils increased by 10% relative to controls, whereas microbial N declined by 9%. Results further suggest that freezing events greatly alter soil N dynamics in the dormant season at this site, with considerable available N accumulating during this period.
A subcellular localization compendium of hydrogen peroxide‐induced proteins
Authors: INZÉ ANNELIES , VANDERAUWERA SANDY , HOEBERICHTS FRANK A. , VANDORPE MICHAËL , VAN GAEVER TIM , VAN BREUSEGEM FRANK
Published: March 2011

The signal transduction mechanisms of the oxidative stress response in plants remain largely unexplored. Previously, increased levels of cellular hydrogen peroxide (H2O2) had been shown to drastically affect the plant transcriptome. Genome‐wide transcriptome analyses allowed us to build a comprehensive inventory of H2O2‐induced genes in plants. Here, the primary objective was to determine the subcellular localization of these genes and to assess potential trafficking during oxidative stress. After high‐throughput cloning in Gateway‐derived vectors, the subcellular localization of 49 proteins fused to the green fluorescent protein (GFP) was identified in a transient assay in tobacco (Nicotiana benthamiana) by means of agro‐infiltration and confirmed for a selection of genes in transgenic Arabidopsis thaliana plants. Whereas eight of the GFP‐tagged proteins are exclusively localized in the nucleus, 23 reside both in the nucleus and cytosol, in which several classes of known transcription factors and proteins of unknown function can be recognized. In this study, the mapping of the subcellular localization of H2O2‐induced proteins paves the way for future research to unravel the H2O2 responses in plants. Furthermore, the effect of increased H2O2 levels on the subcellular localization of a subset of proteins was assessed.
Stress homeostasis – the redox and auxin perspective
Authors: TOGNETTI VANESA B. , MÜHLENBOCK PER , VAN BREUSEGEM FRANK
Published: March 2011

Under environmental stresses, plant development is adaptively modulated. This modulation is influenced by the steady‐state balance (homeostasis) between reactive oxygen species (ROS) and phytohormones. Frequently observed symptoms in plant stress adaptation responses include growth retardation, reduced metabolism and photosynthesis, reallocation of metabolic resources and increased antioxidant activities to maximize plant survival under adverse environmental conditions. In view of stress‐induced morphogenetic changes during adaptation, ROS and auxin are the main players in the regulatory networks because both are strongly affected by exposure to environmental cues. However, the mechanisms underlying the crosstalk between ROS and auxin are poorly understood. In this review, we aim at surveying how the integration of environmental stress‐related signals is modulated by crosstalk between ROS and auxin regulatory networks.
Unstable green fluorescent protein for study of Xanthomonas citri subsp. citri survival on citrus
Authors: Cubero J. , Gell I. , Johnson E. G. , Redondo A. , Graham J. H.
Published: March 2011

Xanthomonas citri subsp. citri (Xac) is the causal agent of citrus bacterial canker, an important disease for the citrus industry. Studies of Xac survival in environments outside of the lesion performed in the past may have underestimated the viable population because the recovery was based on the ability of the bacterium to grow on culture media. This study monitored survival of Xac that express green fluorescent protein (GFP) in two different forms: the native protein, and a protein that is unstable due to a specific oligopeptide tail targeted by proteases within the bacterium. Transformed strains of Xac were verified to be stable in their expression of GFP and to show no differences in virulence and fitness compared to wild type strains. Evaluation of protein stability confirmed that strains with unstable GFP only expressed and fluoresced in metabolically active cells, and not in dead bacteria. Fluorescence of unstable GFP strains under confocal microscopy was used to track bacterial survival and biofilm formation on leaf and fruit surfaces. After spray inoculation, aggregates of fluorescing cells of unstable GFP strains formed biofilms on leaves and fruit. Bacterial cells that aggregated on the surfaces only survived when protected from desiccation. Aggregation of viable bacteria in biofilms confirms their role in pathogen survival outside of lesions and protection from bactericide treatments in the field or in the fruit disinfection process.
Resistance to powdery mildew (Blumeria graminis f.sp. avenae) in oat seedlings and adult plants
Authors: Sánchez‐Martín J. , Rubiales D. , Prats E.
Published: March 2011

In this work, 165 Avena sativa and Avena byzantina accessions were screened for resistance to powdery mildew caused by Blumeria graminis f.sp. avenae and the defence mechanisms of resistant plants were further characterized. Ten resistant and moderately resistant accessions were selected according to macroscopic assessment. A detailed histological study of selected genotypes showed a range of defence mechanisms, acting alone or in combination, that impeded fungal development at different stages. Since the resistance observed in the collection was scarce, a study of adult plant resistance was carried out in 45 genotypes selected from field trials. Nine oat landraces and two commercial varieties showed very high levels of adult plant resistance. A detailed study of the components of the adult plant resistance revealed a high increase of penetration and post‐haustorial resistance in the fifth compared to the first leaves. Identification of the resistance sources and characterization of underlying defence mechanisms will be useful for future breeding programmes and for further cellular and molecular studies to unravel the genetic basis of resistance, in this species in particular and in cereal–powdery mildew interactions in general.
A global picture of tRNA genes in plant genomes
Authors: Michaud Morgane , Cognat Valérie , Duchêne Anne‐Marie , Maréchal‐Drouard Laurence
Published: March 2011

Although transfer RNA (tRNA) has a fundamental role in cell life, little is known about tRNA gene organization and expression on a genome‐wide scale in eukaryotes, particularly plants. Here, we analyse the content and distribution of tRNA genes in five flowering plants and one green alga. The tRNA gene content is homogenous in plants, and is mostly correlated with genome size. The number of tRNA pseudogenes and organellar‐like tRNA genes present in nuclear genomes varies greatly from one plant species to another. These pseudogenes or organellar‐like genes appear to be generated or inserted randomly during evolution. Interestingly, we identified a new family of tRNA‐related short interspersed nuclear elements (SINEs) in the Populus trichocarpa nuclear genome. In higher plants, intron‐containing tRNA genes are rare, and correspond to genes coding for tRNATyr and tRNAMete. By contrast, in green algae, more than half of the tRNA genes contain an intron. This suggests divergent means of intron acquisition and the splicing process between green algae and land plants. Numerous tRNAs are co‐transcribed in Chlamydomonas, but they are mostly transcribed as a single unit in flowering plants. The only exceptions are tRNAGly–snoRNA and tRNAMete–snoRNA cotranscripts in dicots and monocots, respectively. The internal or external motifs required for efficient transcription of tRNA genes by RNA polymerase III are well conserved among angiosperms. A brief analysis of the mitochondrial and plastidial tRNA gene populations is also provided.
Journey through the past: 150 million years of plant genome evolution
Authors: Proost Sebastian , Pattyn Pedro , Gerats Tom , Van de Peer Yves
Published: March 2011

The genome sequence of the plant model organism Arabidopsis thaliana was presented in December of the year 2000. Since then, the 125 Mb sequence has revealed many of its evolutionary secrets. Through comparative analyses with other plant genomes, we know that the genome of A. thaliana, or better that of its ancestors, has undergone at least three whole genome duplications during the last 120 or so million years. The first duplication seems to have occurred at the dawn of dicot evolution, while the later duplications probably occurred <70 million years ago (Ma). One of those younger genome‐wide duplications might be linked to the K‐T extinction. Following these duplication events, the ancestral A. thaliana genome was hugely rearranged and gene copies have been massively lost. During the last 10 million years of its evolution, almost half of its genome was lost due to hundreds of thousands of small deletions. Here, we reconstruct plant genome evolution from the early angiosperm ancestor to the current A. thaliana genome, covering about 150 million years of evolution characterized by gene and genome duplications, genome rearrangements and genome reduction.
A P450‐centric view of plant evolution
Authors: Nelson David , Werck‐Reichhart Danièle
Published: March 2011

Being by far the largest family of enzymes to support plant metabolism, the cytochrome P450s (CYPs) constitute an excellent reporter of metabolism architecture and evolution. The huge superfamily of CYPs found in angiosperms is built on the successful evolution of 11 ancestral genes, with very different fates and progenies. Essential functions in the production of structural components (membrane sterols), light harvesting (carotenoids) or hormone biosynthesis kept some of them under purifying selection, limiting duplication and sub/neofunctionalization. One group (the CYP71 clan) after an early trigger to diversification, has kept growing, producing bursts of gene duplications at an accelerated rate. The CYP71 clan now represents more than half of all CYPs in higher plants. Such bursts of gene duplication are likely to contribute to adaptation to specific niches and to speciation. They also occur, although with lower frequency, in gene families under purifying selection. The CYP complement (CYPomes) of rice and the model grass weed Brachypodium distachyon have been compared to view evolution in a narrower time window. The results show that evolution of new functions in plant metabolism is a very long‐term process. Comparative analysis of the plant CYPomes provides information on the successive steps required for the evolution of land plants, and points to several cases of convergent evolution in plant metabolism. It constitutes a very useful tool for spotting essential functions in plant metabolism and to guide investigations on gene function.
AtPPR2, an Arabidopsis pentatricopeptide repeat protein, binds to plastid 23S rRNA and plays an important role in the first mitotic division during gametogenesis and in cell proliferation during embryogenesis
Authors: Lu Yuqing , Li Cong , Wang Hai , Chen Hao , Berg Howard , Xia Yiji
Published: March 2011

Pentatricopeptide repeat (PPR) proteins are mainly involved in regulating post‐transcriptional processes in mitochondria and plastids, including chloroplasts. Mutations in the Arabidopsis PPR2 gene have previously been found to cause defects in seed development and reduced transmission through male and female gametophytes. However, the exact function of AtPPR2 has not been defined. We found that a loss‐of‐function mutation of AtPPR2 leads to arrest of the first mitotic division during both male and female gametogenesis. In addition, the Atppr2 mutation causes delayed embryogenesis, leading to embryonic lethality. Mutation in emb2750, which appears to be a weak mutant allele of the AtPPR2 locus, also results in defective seeds. However, a majority of emb2750 seeds were able to germinate, but their cotyledons were albino and often deformed, and growth of the emb2750 seedlings were arrested after germination. AtPPR2 is mainly expressed in plant parts that undergo cell division, and AtPPR2 protein was localized to chloroplasts. RNA immunoprecipitation and protein gel mobility shift assays showed that AtPPR2 binds to plastid 23S rRNA. Our study adds to a growing body of evidence that plastids and/or chloroplasts play a key role in cell division. AtPPR2 may modulate the translational process to fine‐tune plastid function, thereby regulating cell division.
Malate transport by the vacuolar AtALMT6 channel in guard cells is subject to multiple regulation
Authors: Meyer Stefan , Scholz‐Starke Joachim , De Angeli Alexis , Kovermann Peter , Burla Bo , Gambale Franco , Martinoia Enrico
Published: March 2011

Gas exchange in plants is controlled by guard cells, specialized cells acting as turgor pressure‐driven valves. Malate is one of the major anions accumulated inside the vacuole during stomatal opening counteracting the positive charge of potassium. AtALMT6, a member of the aluminum‐activated malate transporter family, is expressed in guard cells of leaves and stems as well as in flower organs of Arabidopsis thaliana. An AtALMT6‐GFP fusion protein was targeted to the vacuolar membrane both in transient and stable expression systems. Patch‐clamp experiments on vacuoles isolated from AtALMT6‐GFP over‐expressing Arabidopsis plants revealed large inward‐rectifying malate currents only in the presence of micromolar cytosolic calcium concentrations. Further analyses showed that vacuolar pH and cytosolic malate regulate the threshold of activation of AtALMT6‐mediated currents. The interplay of these two factors determines the AtALMT6 function as a malate influx or efflux channel depending on the tonoplast potential. Guard cell vacuoles isolated from Atalmt6 knock‐out plants displayed reduced malate currents compared with wild‐type vacuoles. This reduction, however, was not accompanied by phenotypic differences in the stomatal movements in knock‐out plants, probably because of functional redundancy of malate transporters in guard cell vacuoles.
Functional anatomy of the footpad vasculature of dogs: scanning electron microscopy of vascular corrosion casts
Authors: Ninomiya Hiroyoshi , Akiyama Emi , Simazaki Kanae , Oguri Atsuko , Jitsumoto Momoko , Fukuyama Takaaki
Published: March 2011

Dogs are well adapted to cold climates and they can stand, walk and run on snow and ice for long periods of time. In contrast to the body trunk, which has, dense fur, the paws are more exposed to the cold due to the lack of fur insulation. The extremities have a high surface area‐to‐volume ratio, so they lose heat very easily. We offer anatomical evidence for a heat‐conserving structure associated with dog footpad vasculature. Methylmethacrylate vascular corrosion casts for scanning electron microscopy, Indian ink‐injected whole‐mount and histological specimens were each prepared, in a series of 16 limbs from four adult dogs. Vascular casts and Indian ink studies showed that abundant venules were arranged around the arteries supplying the pad surface and formed a vein–artery–vein triad, with the peri‐arterial venous network intimately related to the arteries. In addition, numerous arteriovenous anastomoses and well‐developed venous plexuses were found throughout the dermal vasculature. The triad forms a counter‐current heat exchanger. When the footpad is exposed to a cold environment, the counter‐current heat exchanger serves to prevent heat loss by recirculating heat back to the body core. Furthermore, the arteriovenous anastomoses shift blood flow, draining blood to the skin surface, and the venous plexuses retain warm blood in the pad surface. Hence, the appropriate temperature for the footpad can be maintained in cold environments.
Improving graft survival for patients undergoing liver transplantation
Authors: Dickson Rolland C. , Pungpapong Surakit , Keaveny Andrew P. , Taner C. Burcin , Ghabril Marwan , Aranda‐Michel Jaime , Satyanarayana Raj , Bonatti Hugo , Kramer David J. , Nguyen Justin H.
Published: March 2011

Dickson RC, Pungpapong S, Keaveny AP, Taner BC, Ghabril M, Aranda‐Michel J, Satyanarayana R, Bonatti H, Kramer DJ, Nguyen JH. Improving graft survival for patients undergoing liver transplantation. Clin Transplant 2011: 25: E345–E355. © 2011 John Wiley & Sons A/S.

Abstract:  Liver transplant (LT) outcomes are reported to be improving in non‐HCV recipients but not for those infected with HCV. Our aim was to evaluate graft survival and predictors of outcome in HCV and non‐HCV patients before and after 2003. Patients with primary LT between February 1, 1998, and December 31, 2005, were included. Patients were divided into Era 1 (1998–2002) and Era 2 (2003–2005) with follow‐up through May 31, 2009. Graft survival was compared for HCV, non‐HCV, and all patients. There was significant improvement in graft survival in Era 2 for HCV patients. Graft survival in Era 2 of HCV patients was equivalent to non‐HCV patients. The most significant improvement between eras was in outcomes of grafts from donors ≥60 yr with three‐yr graft survival 58.6 (51.3–65.9) vs. 75.4 (68.9–81.9), p = 0.002. The use of donors ≥60 did not change between eras: 31% vs. 34%; however, utilization in HCV recipients decreased from 36% to 3% (p < 0.001). In conclusion, graft survival of HCV patients has improved significantly since 2003 and was comparable to non‐HCV patients up to three yr. The change in management of donor organs into HCV and non‐HCV patients likely contributed to this outcome.
Rapidly progressive cutaneous Rhizopus microsporus infection presenting as Fournier's gangrene in a patient with acute myelogenous leukemia
Authors: Durand C.M. , Alonso C.D. , Subhawong A.P. , Kwiatkowski N.P. , Showel M. , Carroll K.C. , Marr K.A.
Published: March 2011

C.M. Durand, C.D. Alonso, A.P. Subhawong, N.P. Kwiatkowski, M. Showel, K.C. Carroll, K.A. Marr. Rapidly progressive cutaneous Rhizopus microsporus infection presenting as Fournier's gangrene in a patient with acute myelogenous leukemia. Transpl Infect Dis 2011: 13: 392–396. All rights reserved

Abstract: Members of the genus Rhizopus within the class Zygomycetes can cause devastating opportunistic infections. Cutaneous disease arising from direct inoculation of fungal spores has the potential to disseminate widely. Here, we describe a dramatic case of cutaneous Rhizopus infection involving the penis in a patient with acute myelogenous leukemia. Despite aggressive surgical debridement, systemic antifungal therapy, and donor lymphocyte infusion, the infection was ultimately fatal. This case illustrates the unique diagnostic and therapeutic challenges in the clinical management of cutaneous Rhizopus infection.
Changes in blood pressure in the sitting and standing positions in hypertensive patients
Authors: Ersoy Siddika , Pinar Rukiye , Ersoy Ismail H.
Published: March 2011

Ersoy S, Pinar R, Ersoy IH. International Journal of Nursing Practice 2011; 17: 105–109

Changes in blood pressure in the sitting and standing positions in hypertensive patients

Most guidelines for management of hypertension do not give special preference to a specific position of patient during blood pressure (BP) measurement, suggesting that BP readings taken with patients sitting, supine and standing are equivalent. The objective of this study was to examine whether there was any difference between BP readings with hypertensive participants comfortably sitting on chair and those with participants standing with the arm supported horizontally at the right atrial level. BP was measured twice each for 168 hypertensive patients (medicated and unmedicated) at sitting, standing and sitting positions, respectively, with a mercury‐filled column sphygmomanometer. We found significantly lower in systolic and diastolic BP readings in standing position than in sitting position. The present study indicates that the BP readings are related to the posture; thus, BP measured in different positions cannot automatically be regarded as equivalent.
Being transferred from an intensive care unit to a ward: Searching for the known in the unknown
Authors: Forsberg Angelica , Lindgren Elenor , Engström Åsa
Published: March 2011

Forsberg A, Lindgren E, Engström Å. International Journal of Nursing Practice 2011; 17: 110–116

Being transferred from an intensive care unit to a ward: Searching for the known in the unknown

People who have been cared for in intensive care units (ICUs) are transferred between different levels of care and hospitals. The aim with this study was to describe peoples' experiences of being cared for in an ICU and transferred to a ward. An inductive, descriptive qualitative study was performed with qualitative individual interviews with 10 participants. The interviews were transcribed verbatim and subjected to qualitative thematic content analysis which resulted in one theme; searching for the known in the unknown, and five categories. The findings showed the importance of being prepared for the transfer and knowing what was going to happen. Some participants felt secure in the ICU and excluded on the ward, others appreciated leaving the stressful environment in the ICU for a more peaceful ward. Feelings of anxiety and exposure were experienced during the transfer and it was helpful if staff involved were known to the participants. Better information and patients' involvement concerning the transfer from ICUs to general wards are suggested as means of improving nursing care. Further studies are needed to improve continuity of care for critically ill people.
Economical and clinical impact of surgical site infection following coronary artery bypass graft surgery in north Jordan
Authors: Al‐Zaru Ibtisam M , AbuAlRub Raeda , Musallam Eyad A
Published: March 2011

Al‐Zaru IM, AbuAlRub R, Musallam EA. International Journal of Nursing Practice 2011; 17: 117–125

Economical and clinical impact of surgical site infection following coronary artery bypass graft surgery in north Jordan

Surgical site infection (SSI) is one of the most devastating complications following cardiac surgery, which significantly lead to prolonged hospitalization and increased hospital costs. The aims of this retrospective study were to identify the incidence rate, causative microorganisms, and the clinical and economical impact of SSI. An existing coronary artery surgery data base on adults (n = 631) who had undergone coronary artery bypass graft (CABG) surgeries between January 2005 and January 2008 at a Jordanian university hospital was used. The results of this study showed that: (i) the incidence rate of SSI after CABG was 16.8% at the targeted hospital; (ii) the most causative microorganisms was coagulase‐negative staphylococci (40%); (iii) the predictors for SSI were sex/males, having chronic obstructive pulmonary disease, and having combined valve CABG surgery; and (iv) each patient who developed SSI had ≈ 9 additional days at the hospital and add ≈ $3159 to the total cost of care.
Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover
Authors: Street Maryann , Eustace Paula , Livingston Patricia M , Craike Melinda J , Kent Bridie , Patterson Denise
Published: March 2011

Street M, Eustace P, Livingston PM, Craike MJ, Kent B, Patterson D. International Journal of Nursing Practice 2011; 17: 133–140

Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover

Strategies to support continuity of care and improve patient safety during clinical handover have been developed. The aims of this study were to identify the strengths and limitations in current practice of nursing clinical handover and implement a new bedside handover process. A total of 259 nurses completed a cross‐sectional survey at change of shift on 1 day, which was followed by an audit of the pilot implementation of bedside handover. The survey results showed great variation in the duration, location and method of handover with significant differences in the experience of nurses employed part‐time compared with full‐time. Following implementation of standardized bedside handover on two wards, the audit revealed significant improvement in the involvement of patients, use of Situation‐Background‐Assessment‐Recommendation, active patient checks and checking of documentation. These findings suggest the use of standardized protocols and communication tools for bedside handover improve continuity of patient care.
Self‐mutilation among Finnish adolescents: Nurses' conceptions
Authors: Rissanen Marja‐Liisa , Kylmä Jari , Laukkanen Eila
Published: March 2011

Rissanen M‐L, Kylmä J, Laukkanen E. International Journal of Nursing Practice 2011; 17: 158–165

Self‐mutilation among Finnish adolescents: Nurses' conceptions

The purpose of this qualitative study was to explore nurses' views on self‐mutilation among adolescents as a phenomenon. The data were collected using focus group interviews, personal interviews and written descriptions from 10 nurses. A qualitative content analysis was applied. Four main themes from nurses' descriptions of self‐mutilation emerged: (i) a definition of self‐mutilation; (ii) characteristics of self‐mutilation; (iii) factors contributing to self‐mutilation; and (iv) purposes of self‐mutilation. Nurses' conceptions of self‐mutilation differ from previously described views of parents and adolescents. Further research is needed focusing on nurses' experiences of caring for adolescents who self‐mutilate.
Advanced practice nurses: A new resource for Swedish primary health‐care teams
Authors: Altersved Ewa , Zetterlund Lone , Lindblad Ulf , Fagerström Lisbeth
Published: March 2011

Altersved E, Zetterlund L, Lindblad U, Fagerström L. International Journal of Nursing Practice 2011; 17: 174–180

Advanced practice nurses: A new resource for Swedish primary health‐care teams

This study is associated with the first evaluation of the four first advanced practice nurses (APNs), part of a primary health‐care team in Sweden. The aim is to describe health‐care teams' experiences of the new APN role and investigate what opportunities and barriers to the role exist. Eighty‐one respondents answered a 14‐question questionnaire with a Likert scale and one open‐ended question. The Kruskal–Wallis test was used to investigate differences between professional groups' answers. The qualitative material was analysed using deductive content analysis. Though mostly positive experiences of the role were found, differences did exist between the professional groups. APNs are considered a resource in that access to care, cooperation and patient flow increased. Barriers include APNs' limited autonomy and inability to prescribe medication. To further develop the role, the right to prescribe medication and strategic leadership within the Swedish health‐care system, policy and legislation are needed.
Respiratory effects of balloon occluded retrograde transvenous obliteration of gastric varices: A prospective controlled study
Authors: Arai Hirotaka , Abe Takehiko , Takayama Hisashi , Toyoda Mitsuo , Mori Kazuyo , Ueno Takashi , Takagi Hitoshi , Shimoda Ryuya
Published: March 2011

Background and Aim:  We evaluated the respiratory effects of balloon‐occluded retrograde transvenous obliteration (BRTO) performed for the treatment of gastric varices complicating liver cirrhosis.

Methods:  From 2005 to 2009, we performed BRTO in 20 patients with gastric fundal varices, by intravariceal injection of 5% ethanolamine oleate (EO) as the sclerosant. We studied the effect of BRTO on the respiratory gas exchange, chest X‐ray findings, computed tomography (CT) findings, pulmonary function parameters, and 99mTc‐MAA lung perfusion scintigraphy findings. Subjects undergoing balloon‐occluded retrograde transvenous varicerography (BRTV) without injection of the sclerosant served as the controls.

Results:  Arterial blood gas analysis revealed a decrease in the mean arterial partial oxygen tension (PaO2) (P < 0.01), and increase in the alveolar‐arterial oxygen tension difference (AaDO2) after BRTO (P < 0.01), as compared with the results obtained before the BRTO, while breathing room air. No changes were observed after BRTV as compared with the previous findings. In addition, a significant correlation was observed between the change of the PaO2 and the volume of the sclerosant injected (rs = 0.511, P = 0.011). Left‐pleural effusion was noted on the chest CT in 20% of the patients. On pulmonary function testing, decrease of the vital capacity was noted in two of the 20 patients after BRTO.

Conclusion:  The aforementioned results suggest that BRTO performed using EO as the sclerosant induces pulmonary function disorders. The effect was found to depend on the total amount of EO injected. Therefore, careful respiratory monitoring seems necessary in patients undergoing BRTO, particularly those in whom large volumes of the sclerosant are used.
Pleural controversy: Closed needle pleural biopsy or thoracoscopy—Which first?
Authors: KOEGELENBERG COENRAAD F.N. , DIACON ANDREAS H.
Published: March 2011

The most efficient and cost‐effective approach to the diagnosis of pleural exudates remains controversial. Important considerations include the respective diagnostic yields of thoracocentesis, closed pleural biopsy and thoracoscopy; the incremental gain in diagnostic yield when sequentially combining these investigations; and the role of various image modalities. The diagnostic yield of thoracocentesis is in the order of 60% for malignancy and >90% for tuberculosis. A second aspiration may increase the yield for malignancy, but a third is generally superfluous. Many authorities consider thoracoscopy the investigation of choice in exudative pleural effusions where a thoracocentesis was nondiagnostic and particularly when malignancy is suspected. It allows for the direct inspection of the pleura and for talc poudrage. Thoracoscopy has a diagnostic yield of 91–95% for malignant disease and as high as 100% for pleural tuberculosis. Access to thoracoscopy is, however, limited in many parts of the world, as significant resources and expertise are required. Blind closed pleural biopsy has a yield of 80% for tuberculosis and <60% for pleural malignancy. Recent studies suggest that CT and/or ultrasound guidance may improve the yield, particularly for malignancy, where it may be as high as 88% and 83%, respectively. A second thoracocentesis combined with an image‐assisted pleural biopsy with either an Abrams needle or cutting needle, depending on the setting, may therefore be an acceptable alternative to thoracoscopy. With such an approach, thoracoscopy may potentially be reserved for cases not diagnosed by means of closed pleural biopsy.
Tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure
Authors: Shao Yuan , He Hong‐chao , Shen Zhou‐jun , Zhou Wen‐long
Published: March 2011

Objectives:  To verify the efficacy and to clarify the mechanism of the tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure.

Methods:  A total of 24 women having tension‐free vaginal tape retropubic sling placement for recurrent stress urinary incontinence after a previous failed Burch urethropexy were enrolled in the present study. Median follow up was 57 months (range 12–96). Pre‐ and postoperative urethral mobility and urodynamics were evaluated.

Results:  Preoperatively, all 24 patients had intrinsic sphincter deficiency and 14 had urethral hypermobility. Postoperatively, 15 patients were completely dry and two had a leakage of urine less than 5 g/h. The overall success rate was 70.8%. There was a significant postoperative increase of maximum urethral closure pressure (P < 0.001), and a decrease of average flow rate (P = 0.001) and urethral hypermobility (P < 0.001). When comparing successful with failure cases, only elevated maximum urethral closure pressure (P = 0.002) was significantly different. Multivariate logistic regression showed the change of maximum urethral closure pressure (P = 0.011) was the only independent parameter significantly correlated with the outcome of sling placement.

Conclusions:  Recurrent stress urinary incontinence with intrinsic sphincter deficiency after Burch colposuspension might be well treated with the tension‐free vaginal tape retropubic sling by effectively elevating the maximum urethral closure pressure.
Predicting microbial nitrogen pathways from basic principles
Authors: van de Leemput Ingrid A. , Veraart Annelies J. , Dakos Vasilis , de Klein Jeroen J. M. , Strous Marc , Scheffer Marten
Published: March 2011

Nitrogen compounds are transformed by a complicated network of competing geochemical processes or microbial pathways, each performed by a different ecological guild of microorganisms. Complete experimental unravelling of this network requires a prohibitive experimental effort. Here we present a simple model that predicts relative rates of hypothetical nitrogen pathways, based only on the stoichiometry and energy yield of the performed redox reaction, assuming competition for resources between alternative pathways. Simulating competing pathways in hypothetical freshwater and marine sediment situations, we surprisingly found that much of the variation observed in nature can simply be predicted from these basic principles. Investigating discrepancies between observations and predictions led to two important biochemical factors that may create barriers for the viability of pathways: enzymatic costs for long pathways and high ammonium activation energy. We hypothesize that some discrepancies can be explained by non‐equilibrium dynamics. The model predicted a pathway that has not been discovered in nature yet: the dismutation of nitrite to the level of nitrate and dinitrogen gas.
Varicocele as a risk factor for androgen deficiency and effect of repair
Authors: Tanrikut Cigdem , Goldstein Marc , Rosoff James S. , Lee Richard K. , Nelson Christian J. , Mulhall John P.
Published: March 2011

Study Type – Therapy (case control)

Level of Evidence 2b

OBJECTIVE

• To determine whether men with varicoceles have lower testosterone levels than those without and to ascertain if testosterone levels increase after varicocelectomy.

PATIENTS AND METHODS

• We measured preoperative testosterone levels in 325 men with palpable varicoceles and in 510 men with vasectomy reversal without varicoceles who served as a comparison group.

• The testosterone levels between groups were compared by age. Of the men with varicoceles, 200 had data on both pre‐ and postoperative testosterone levels, which were compared to assess postoperative changes.

RESULTS

• Men with varicocele had significantly lower testosterone levels than the comparison group, with mean (sd) levels of 416 (156) vs 469 (192) ng/dL (P < 0.001). This difference persisted when analysed by age.

• The testosterone levels significantly increased after repair from 358 (126) to 454 (168) ng/dL (P < 0.001).

• Of the 70% of patients with postoperative improvement in testosterone levels, the mean (sd) increase in testosterone was 178 (142) ng/dL. The percentage change in testosterone levels was: 30% had no increase, 41% increased by ≤50%, 19% increased between by 51–100%, and 10% increased by >100%.

• There was no association between change in testosterone level and age, laterality of varicocele, or varicocele grade.

CONCLUSIONS

• Men with varicoceles had significantly lower testosterone levels than the comparison group of men with vasectomy reversal.

• Microsurgical varicocele ligation resulted in a significant increase in serum testosterone levels in more than two‐thirds of men.

• These findings suggest that varicocele is a significant risk factor for androgen deficiency and that repair may increase testosterone levels in men with varicocele and low testosterone levels.
Feasibility and safety of retroperitoneoscopic laparoendoscopic single‐site nephrectomy: technique and early outcomes
Authors: Chueh Shih‐Chieh Jeff , Sankari Bashir R. , Chung Shiu‐Dong , Jones J. Stephen
Published: March 2011

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

Laparoendoscopic single‐site (LESS) nephrectomy is feasible to remove diseased kidneys. Most of such procedures previously reported were performed through a transperitoneal (trans‐abdominal) approach.

We report the feasibility, safety, and techniques of performing such operations without disturbing the bowels (a retroperitoneal LESS approach). This approach provides acceptable operative outcomes, and is especially valuable for patients who need to have an intact peritoneal envelope, or those with potentially abnormal or obliterated peritoneal space.

Study Type – Therapy (case series)

Level of Evidence 4

OBJECTIVES

• To retrospectively review our experience with respect to evaluating the feasibility and safety of retroperitoneoscopic laparoendoscopic single‐site surgery (LESS) nephrectomy.

• To present the technical details of such a procedure.

PATIENTS AND METHODS

• In total, eight retroperitoneoscopic LESS nephrectomies (in seven patients) were completed for a variety of indications in a single centre.

• The GelPOINT apparatus (Applied Medical, Rancho Santa Margarita, CA, USA) was used as an access platform through a flank incision (3–5 cm).

• Except for a bendable grasper and flexible vascular staplers, all instruments used were conventional straight laparoscopic instruments.

• Perioperative data were retrospectively obtained for all patients, including demographic data, operative indications, operative records, length of stay, complications, and pathological analysis.

RESULTS

• All retroperitoneoscopic LESS nephrectomy procedures attempted were completed successfully without complications. No extra working port was required for any case.

• Median (range) operating time was 164 (87–198) min and median (range) estimated blood loss was 50 (10–200) cm3. Median (range) length of hospital stay was 2 (1–3) days.

• The median narcotic used was 34 mg of parental morphine sulphate equivalent. The median (range) visual analogue pain scale score at discharge was 2 (0–3) out of 10.

• The present single arm observation study is limited by the small patient number and the absence of a control cohort.

CONCLUSIONS

• Retroperitoneoscopic LESS nephrectomy using the GelPOINT apparatus as an access platform is feasible and safe.

• It provides adequate flexibility and spacing of port placements as well as acceptable operative outcomes.

• It is especially valuable for those patients who need to maintain peritoneal integrity or those with an abnormal or obliterated peritoneal space.
HOW RELIABLE ARE CYCLICALLY ADJUSTED BUDGET BALANCES IN REAL TIME?
Authors: HUGHES HALLETT ANDREW , KATTAI RASMUS , LEWIS JOHN
Published: March 2011

Cyclically adjusted budget balances (CABs) are often used to provide an indication of the structural state of public finances. This paper analyzes the reliability of these figures in real time. In a test of the ability to forecast the “final data,” we find that real‐time CABs are outperformed by a simpler methodology. Furthermore, we find that real‐time CABs have low power in detecting fiscal slippages and in correctly identifying fiscal improvements. Finally, we find that CABs are systematically less reliable under conditions of poor or deteriorating public finances, which means they are at their most unreliable precisely when they are needed most. (JEL H62, H87)
TAXES, HEALTH INSURANCE, AND WOMEN'S SELF‐EMPLOYMENT
Authors: VELAMURI MALATHI
Published: March 2011

I examine whether the availability of health coverage through the spouse's health plan influences a married woman's decision to become self‐employed. The Tax Reform Act of 1986 (TRA86) introduced a tax subsidy for the self‐employed to purchase their own health insurance. I test whether this “natural” experiment induced more women without spousal health insurance coverage to select into self‐employment. The most conservative difference‐in‐difference estimates based on an analysis of employed women indicate that the incidence of self‐employment among single women rose by 10% in the post‐TRA86 period, while a multinomial specification based on a sample of both employed and nonemployed women suggests that the increase was about 13%.(JELJ0, J3, I1)