bluuebunny/crossref_metadata_2025 huggingface dataset:
Salicylates Increase Insulin Secretion in Healthy Obese Subjects
Authors: Fernández-Real José-Manuel , López-Bermejo Abel , Ropero Ana-Belén , Piquer Sandra , Nadal Angel , Bassols Judit , Casamitjana Roser , Gomis Ramón , Arnaiz Eva , Pérez Iñaki , Ricart Wifredo
Published: May 2008

Context: Conflicting results on the effects of salicylates on glucose tolerance in subjects with normal glucose tolerance or type 2 diabetes have been reported.

Objective: The objective of the study was to investigate the effects of a salicylate derivative (triflusal) on insulin sensitivity and insulin secretion.

Design, Setting, and Participants: This was a double-blind, randomized, crossover study with three treatment periods corresponding to two dose levels of triflusal and placebo in healthy obese subjects.

Main Outcome Measures: Insulin sensitivity and insulin secretion, evaluated through frequently sampled iv glucose tolerance test that was performed after each treatment period, were measured. Insulin secretion was also evaluated in vitro in mice and human islets of Langerhans.

Results: The administration of triflusal led to decreased fasting serum glucose concentration in the study subjects. Insulin sensitivity did not significantly change after each treatment period. Insulin secretion, however, significantly increased in a dose-dependent fashion after each triflusal treatment period. The administration of 800 μm of the main triflusal metabolite to whole mice islets of Langerhans led to a sustained increase in intracellular calcium concentration level. This was followed by a significantly increase in insulin secretion. In human islets, 200 μm of 2-hydroxy-4-trifluoromethylbenzoic acid was sufficient to increase insulin release.

Conclusions: The administration of a salicylate compound led to lowering of serum glucose concentration. We suggest that this effect was mediated through increased insulin secretion induced by salicylate directly on the β-cell.
Effects of Intrabrachial Metacholine Infusion on Muscle Capillary Recruitment and Forearm Glucose Uptake during Physiological Hyperinsulinemia in Obese, Insulin-Resistant Individuals
Authors: Murdolo Giuseppe , Sjöstrand Mikaela , Strindberg Lena , Gudbjörnsdóttir Soffia , Lind Lars , Lönnroth Peter , Jansson Per-Anders
Published: May 2008

Context: Impairment of insulin-mediated capillary recruitment in skeletal muscle contributes to a hampered glucose uptake in obesity.

Objective: The objective of this study was to evaluate whether metacholine (MCh), a nitric oxide vasodilator, potentiates muscle capillary recruitment and forearm glucose uptake (FGU) during physiological hyperinsulinemia.

Design: The double-forearm technique [i.e. infused vs. control (Ctrl) forearm] was combined with im microdialysis during an oral glucose tolerance test in 15 nondiabetic, obese subjects divided into a group of insulin-resistant (IR) (n = 7) and insulin-sensitive (n = 8) individuals.

Results: After the oral glucose tolerance test, forearm blood flow in the Ctrl forearm was unchanged, whereas it increased about 3-fold (P < 0.0001 vs. baseline) in response to MCh. Capillary permeability surface area product for glucose (PSglu) (capillary recruitment), FGU, and interstitial insulin concentrations increased significantly over time (P < 0.001) in both forearms. Compared with insulin-sensitive, the IR subjects exhibited lower PSglu (P < 0.001) and FGU (P < 0.01) in the Ctrl arm, whereas this difference was insignificant in the MCh arm despite the blunted forearm blood flow increase. Moreover, in IR individuals MCh significantly (P < 0.05) ameliorated the delayed onset of insulin action, i.e. the FGU response to hyperinsulinemia. Finally, we found PSglu to be a strong and independent predictor of FGU response (adjusted R2 0.72; P < 0.0001).

Conclusions: MCh-induced vasodilation may improve the microvascular and metabolic responses to physiological hyperinsulinemia in obese, IR individuals. Further studies are required to unravel whether stimulation of nitric oxide production in skeletal muscle may represent an attractive therapeutic approach to bypassing cellular resistance to glucose disposal.
Comparison of Single and Combined Treatment with Exenatide and Metformin on Menstrual Cyclicity in Overweight Women with Polycystic Ovary Syndrome
Authors: Elkind-Hirsch Karen , Marrioneaux Ory , Bhushan Madhu , Vernor Denise , Bhushan Rajat
Published: May 2008

Context: Insulin resistance and obesity are common features of the polycystic ovary syndrome (PCOS). Weight loss and use of insulin-lowering drugs have been shown to improve both reproductive and metabolic aspects of PCOS.

Objective: We evaluated exenatide (EX) and metformin (MET), alone and in combination (COM), on menstrual cyclicity, hormonal parameters, metabolic profiles, and inflammatory markers in overweight, insulin-resistant women with PCOS.

Design, Setting, and Participants: Sixty overweight oligoovulatory women with PCOS (body mass index > 27; 18–40 yr) were randomized to one of three treatment groups: MET [1000 mg twice daily (BID)], EX (10 μg BID), or COM (MET 1000 mg BID, EX 10 μg BID) for 24 wk. The primary outcome was menstrual frequency; secondary outcome measures included changes in ovulation rate, insulin action, anthropometric measures, androgen levels, and inflammatory markers.

Results: Forty-two (70%) patients completed the study. COM therapy was superior to EX or MET monotherapy in improving menstrual cyclicity, ovulation rate, free androgen index, and insulin sensitivity measures and reducing weight and abdominal fat. Both EX arms were more effective in promoting weight loss than MET (P = 0.003).

Conclusions: COM appears better than either EX or MET alone on menstrual cycle frequency and hormonal and metabolic derangements. A marked decrease in central adiposity could partly explain the improvements in reproductive function, insulin-glucose parameters, and adiponectin observed in these overweight women with PCOS treated with COM therapy. Larger trials of longer duration are warranted to assess the long-term efficacy and safety of combined EX-MET therapy in overweight women with PCOS.
UV-induced degradation of securin is mediated by SKP1-CUL1-βTrCP E3 ubiquitin ligase
Authors: Limón-Mortés M. Cristina , Mora-Santos Mar , Espina Águeda , Pintor-Toro José A. , López-Román Antonio , Tortolero María , Romero Francisco
Published: May 2008

Securin is a chaperone protein with bifunctional properties. It binds to separase to inhibit premature sister chromatid separation until the onset of anaphase, and it also takes part in cell-cycle arrest after UV irradiation. At metaphase-to-anaphase transition, securin is targeted for proteasomal destruction by the anaphase-promoting complex or cyclosome (APC/C), allowing activation of separase. However, although securin is reported to undergo proteasome-dependent degradation after UV irradiation, the ubiquitin ligase responsible for securin ubiquitylation has not been well characterized. In this study, we show that UV radiation induced a marked reduction of securin in both the nucleus and cytoplasm. Moreover, we show that GSK-3β inhibitors prevent securin degradation, and that CUL1 and βTrCP are involved in this depletion. We also confirmed that SKP1-CUL1-βTrCP (SCFβTrCP) ubiquitylates securin in vivo, and identified a conserved and unconventional βTrCP recognition motif (DDAYPE) in the securin primary amino acid sequence of humans, nonhuman primates and rodents. Furthermore, downregulation of βTrCP caused an accumulation of securin in non-irradiated cells. We conclude that SCFβTrCP is the E3 ubiquitin ligase responsible for securin degradation after UV irradiation, and that it is involved in securin turnover in nonstressed cells.
Plasma membrane recruitment of dephosphorylated β-catenin upon activation of the Wnt pathway
Authors: Hendriksen Jolita , Jansen Marnix , Brown Carolyn M. , van der Velde Hella , van Ham Marco , Galjart Niels , Offerhaus G. Johan , Fagotto Francois , Fornerod Maarten
Published: May 2008

The standard model of Wnt signaling specifies that after receipt of a Wnt ligand at the membranous receptor complex, downstream mediators inhibit a cytoplasmic destruction complex, allowing β-catenin to accumulate in the cytosol and nucleus and co-activate Wnt target genes. Unexpectedly, shortly after Wnt treatment, we detected the dephosphorylated form of β-catenin at the plasma membrane, where it displayed a discontinuous punctate labeling. This pool of β-catenin could only be detected in E-cadherin–/– cells, because in E-cadherin+/+ cells Wnt-induced, membranous β-catenin was concealed by a constitutive junctional pool. Wnt-signaling-dependent dephosphorylated β-catenin colocalized at the plasma membrane with two members of the destruction complex – APC and axin – and the activated Wnt co-receptor LRP6. β-catenin induced through the Wnt receptor complex was significantly more competent transcriptionally than overexpressed β-catenin, both in cultured cells and in early Xenopus embryos. Our data reveal a new step in the processing of the Wnt signal and suggest regulation of signaling output beyond the level of protein accumulation.
Synthesis of Unnatural Mono- and Oligosaccharides of Farnesol, Geraniol, and (S)-Perillyl Alcohol by Biocatalytic Glycosylations
Authors: Shimoda Kei , Sakamoto Sou , Nakajima Nobuyoshi , Hamada Hatsuyuki , Hamada Hiroki
Published: May 2008

Farnesol and geraniol were glucosylated to the corresponding unnatural β-glucosides, which were two new biotransformation products, by cultured plant cells of Eucalyptus perriniana, Strophanthus gratus, and Phytolacca americana. Cultured E. perriniana cells glycosylated (S)-perillyl alcohol to two β-glycosides, i.e., β-glucoside and unnatural β-gentiobioside, whereas only perillyl β-glucoside was produced by S. gratus and P. americana. Perillyl β-glucoside was further converted into two unnatural β-maltooligosaccharides, i.e., β-maltoside and β-maltotrioside, by cyclodextrin glucanotransferase.
Observations of Domain Structure and Ferroelectricity in Bi(Ni0.5Ti0.5)O3 Ceramics Fabricated by High-pressure Sintering
Authors: Kitada Kazuya , Kobune Masafumi , Adachi Wataru , Yazawa Tetsuo , Saitoh Hiroyuki , Aoki Katsutoshi , Mizuki Jun’ichiro , Ishikawa Kenya , Hiranaga Yoshiomi , Cho Yasuo
Published: May 2008

Bi(Ni0.5Ti0.5)O3 (BNT) ceramics with a perovskite structure, which were almost impossible to fabricate under atmospheric pressure, were synthesized at a high pressure of 6 GPa using a multianvil-type high-pressure apparatus. It was confirmed that the synthesized samples had a multidomain structure and ferroelectricity on the basis of scanning nonlinear dielectric microscopy (SNDM) and polarization–electric field (P–E) hysteresis loop measurements.
PEG-b-polyamine Stabilized Bionanoparticles for Nanodiagnostics and Nanotherapy
Authors: Nagasaki Yukio
Published: May 2008

Poly(ethylene glycol)-b-poly(2-(N,N-dimethylamino)ethyl methacrylate) block copolymers possessing a reactive group at the PEG chain end (R-PEG-b-PAMA) was synthesized by two different polymerization techniques. Using R-PEG-b-PAMA block copolymer thus obtained, gold nanoparticles (GNPs) were prepared. The PEG-b-PAMA worked as not only reducing agent of aurate ions but also coordination on the obtained nanoparticle surface. The obtained GNP had controlled sizes and narrow size distributions. It is also showed extremely high dispersion stability due to the PEG tethering chains on the surface. The same strategy could be applicable to other nanoparticles such as semiconductor quantum dot and inorganic porous nanoparticles. Using PEGylated GNPs thus prepared, several applications such as molecular recognitions, siRNA release and enzyme immobilizations were carried out. The functionalities of these materials are described in this review.
Quantitative Spin-trapping ESR Investigation on Reaction of Hydroxyl Radical and Selected Scavengers by a Newly Developed Flow-injection ESR System
Authors: Komatsu-Watanabe Rushiru , Sakurai Yasuhiro , Morimoto Chie , Sakamoto Shunji , Kanaori Kenji , Tajima Kunihiko
Published: May 2008

A new flow-injection ESR system (FI-ESR) special for the quantitative spin-trapping ESR measurements is developed to estimate the second-order rate constants (ks) of the reaction between hydroxyl radical and selected scavengers, glycine, mannitol, and 4-hydroxycoumaric acid. The ks values of these scavengers show reasonable agreement with those evaluated by pulse radiolysis method.
An Evaluating Technique for Variety Compatibility of Fruit Applied to a near Infrared Brix Calibration System: A Case Study Using Brix Calibration for Nectarines
Authors: Reita Giorgio , Peano Cristiana , Saranwong Sirinnapa , Kawano Sumio
Published: May 2008

In a practical near infrared (NIR) sweetness sorting facility, there is a high possibility that the variety of incoming fruit will be different from the one(s) used to develop a calibration model. In this kind of situation, significant bias could occur and result in a high price difference. In this work, a method to identify whether the pre-installed calibration models could be used to predict Brix values of the unknown samples or not was established. Two kinds of calibration model for Brix determination of nectarines were examined, one developed from spectra of the single nectarine variety called Big Bang Maillarà (BB), the other developed from spectra of two nectarine varieties, BB and Nectaross (NT). Another variety called Sweet Red (SR) was used to demonstrate the situation of an unknown sample or a different variety. For the general biases evaluation, significant biases occurred in the SR samples whether the prediction was done using the BB calibration (bias = −6.74°Brix) or the BB+NT calibration (bias = −3.09°Brix). A survey using score plots of principle component analysis (PCA) indicated that the characteristics of the BB and the SR samples were quite different from each other, while the NT samples were located in between. Even though the trend of differences between the PCA scores of the three varieties could be observed, a clear classification result could not be obtained. Another classification attempt was made using soft independent model for classification analogy (SIMCA). For each calibration (BB and BB+NT), a SIMCA model was developed using the samples used to develop the calibration model. A calculation was performed to evaluate whether the unknown samples (BB, NT and SR) were in the same class as the calibration sample or not. It was found that, in the case of the single variety calibration where the SIMCA model was also developed from the single variety (BB), clear identification of unfitted samples could be obtained with classification accuracy more than 95% (false negative 0%). However, in the case of the two varieties calibration, the use of a SIMCA box developed from two varieties would make the in-class distance become too wide and this reduced the classification accuracy of unfitted samples (false negatives = 74%). The solution was to develop two SIMCA boxes, one for BB and one for NT, then examine the compatibility of unknown samples twice. Using this technique, satisfactory classification results with false negatives of 10% could be obtained.
Application of Time-of-Flight near Infrared Spectroscopy to Fruits—Permeability of Pulsed Laser Beam into Satsuma Mandarin, White Grapefruit and Fuji Apple
Authors: Kurata Yohei , Ikemoto Yuka , Tsuchikawa Satoru
Published: May 2008

The permeability of a pulsed laser beam into Satsuma mandarin, White grapefruit and Fuji apple was compared by time-of-flight near infrared (ToF-NIR) spectroscopy. In this study, a compact measurement system including a dye-doped plastic laser cavity with a wavelength of 800 nm and an avalanche photodiode were employed. The NIR radiation attenuance (i.e. optical density) in apple was higher than in the citrus fruit. The peak maxima of transmitted radiation of intact Satsuma mandarin increased 130 times more than that of intact grapefruit. Differences in diameter related directly to attenuance. The peak maxima of transmitted radiation of peeled grapefruit increased 250 times more than that of intact grapefruit; however, these increases were not found for Satsuma mandarin or apple. NIR radiation attenuance of the grapefruit peel was greater than for the peel of the other fruits. The incident pulsed laser beam was uniformly scattered in the citrus sample, whereas the scattering condition of the pulsed laser beam in apple might not be uniform because of the presence of core tissue. Thus, while the pulsed laser beam could be transmitted through citrus fruit and apple, the effect of fruit size and peel on the NIR radiation attenuance characteristically varied.
Near Infrared Spectroscopy of the Smithsonite Minerals
Authors: Frost Ray L. , Reddy B. Jagannadha , Hales Matthew C. , Wain Daria L.
Published: May 2008

The importance of NIR spectroscopy has been successfully demonstrated in the present study of smithsonite minerals. The fundamental observations in the NIR spectra, in addition to the anions of OH− and CO32–, are Fe and Cu in terms of cation content. These ions exhibit broad absorption bands ranging from 13,000 cm−1 to 7000 cm−1 (770 nm to 1430 nm). One broad diagnostic absorption feature centred at 9000 cm−1 (1110 nm) is the result of ferrous ion spin allowed transition, (5T2g → 5Eg). The splitting of this band (> 1200 cm−1) is a common feature in all the spectra of the studied samples. The light green coloured sample from Namibia show two Cu(II) bands in NIR at 8050 cm−1 and 10,310 cm−1 (1240 nm and 970 nm) assigned to 2B1g → 2A1g and 2B1g → 2B2g transitions. The effects of structural cations substitution (Ca2+, Fe2+, Cu2+, Cd2+ and Zn2+) on band shifts in the electronic spectral region of 11,000 cm−1 to 7500 cm−1 (910 nm to 1330 nm) and vibrational modes of OH− and CO32– anions in the 7300 cm−1 to 4000 cm−1 (1370 nm to 2500 nm) region were used to distinguish between the smithsonites.
Detection of Factors Affecting the Acquisition of Visible-Near Infrared Fibre-Optic Probe Spectra of Commercial Meat Products
Authors: Gaitán-Jurado Antonio J. , Rincón Francisco , Ortiz-Somovilla Victor , España-España Fidelina
Published: May 2008

Near infrared (NIR) spectroscopic analysis of sliced and packaged dry fermented sausages was standardised in order to identify the main sources of error during the spectrum acquisition process. The aim of the study was to ascertain how many of the apparent critical factors (ACFs) were really significant key factors for spectrum acquisition. Using a 27-4III, Plackett–Burman experimental design, and enhancing resolution via a fold-over such as 27-3IV, seven ACFs were investigated to determine their effect on root mean square (RMS) values obtained using 15 combinations of spectral range and mathematical pre-treatment. The results showed that for the on-line control of products of this type, the spectrum acquisition process was not affected by the ACFs studied when using the whole spectral range of the instrument (400–2500 nm), with the first derivative and either of the scatter corrections examined here, since in these conditions control of factor variability proved unnecessary.
Perceptions of childhood immunization in a minority community: qualitative study
Authors: Henderson Lesley , Millett Christopher , Thorogood Nicki
Published: May 2008

Summary

Objective

To assess reasons for low uptake of immunization amongst orthodox Jewish families.

Design

Qualitative interviews with 25 orthodox Jewish mothers and 10 local health care workers.

Setting

The orthodox Jewish community in North East London.

Main outcome measures

Identification of views on immunization in the orthodox Jewish community.

Results

In a community assumed to be relatively insulated from direct media influence, word of mouth is nevertheless a potent source of rumours about vaccination dangers. The origins of these may lie in media scares that contribute to anxieties about MMR. At the same time, close community cohesion leads to a sense of relative safety in relation to tuberculosis, with consequent low rates of BCG uptake. Thus low uptake of different immunizations arises from enhanced feelings of both safety and danger. Low uptake was not found to be due to the practical difficulties associated with large families, or to perceived insensitive cultural practices of health care providers.

Conclusions

The views and practices of members of this community are not homogeneous and may change over time. It is important that assumptions concerning the role of religious beliefs do not act as an obstacle for providing clear messages concerning immunization, and community norms may be challenged by explicitly using its social networks to communicate more positive messages about immunization. The study provides a useful example of how social networks may reinforce or challenge misinformation about health and risk and the complex nature of decision making about children's health.
‘Surgical’ causes of benign intracranial hypertension
Authors: Bodkin Peter Alwyn , Hassan Md Faizul , Kane Philip John , Brady Nick , Whittle Ian Roger
Published: May 2008

Summary

Benign intracranial hypertension is a clinical diagnosis linked to a number of medical and surgical disorders. A common aetiology has not yet been established. It would seem, however, that many, if not all, of these cases can be related to some degree of cerebral venous outflow obstruction. We present here a series of patients with extraluminal compression of the cerebral venous sinuses that has been amenable to surgical resection. These ‘surgical’ causes of BIH illustrate an important subset of the disease and inform us about the possible pathophysiological principles underlying the disorder.
Atypical Anaphylactic Reaction to Patent Blue During Sentinel Lymph Node Biopsy for Breast Cancer
Authors: Lanitis Sophocles , Filippakis George , Sidhu Virinder , Mufti Ragheed AL , Lee Tak H , Hadjiminas Dimitri J
Published: May 2008

INTRODUCTION

We present an unusual case of severe anaphylaxis to Patent Blue dye with atypical clinical features during sentinel lymph node biopsy (SLNB). The medical personnel involved with sentinel node biopsies should be alert, and familiar with this unusual entity. We also present current data from the literature.

CASE REPORT

During a wide local excision for primary breast cancer and SLNB, and early during the operation, the patient became severely tachycardic and hypotensive without any signs of urticaria, rash, oedema, or bronchospasm. Resuscitation required the addition of noradrenaline infusion followed by an overnight admission to the intensive care unit. Raised serum tryptase levels supported the diagnosis of anaphylactic shock while skin tests showed a severe reaction to Patent Blue dye.

CONCLUSIONS

Severe, life-threatening anaphylaxis to Patent Blue dye may present without obvious previous exposure to the dye and without the cardinal signs of oedema, urticaria and bronchospasm making the diagnosis and management of such cases challenging. Correct diagnosis and identification of the causative factor is important and requires a specific set of laboratory tests that are not commonly requested in every-day medical practice. It is not clear from the literature whether the condition is common enough to justify pre-operative prophylactic or diagnostic measures.
Biopsy for Malignant Melanoma – Are We Following the Guidelines?
Authors: Tadiparthi S , Panchani S , Iqbal A
Published: May 2008

INTRODUCTION

Guidelines for suspected malignant melanoma recommend a prompt, full-thickness excision biopsy allowing diagnosis and assessment of the Breslow thickness. Incisional biopsy is acceptable only for extensive facial lentigo maligna or acral melanoma. Punch, shave and other types of biopsies do not allow pathological staging and are, therefore, not recommended.

PATIENTS AND METHODS

A total of 100 referrals for histology-proven malignant melanoma were assessed retrospectively over a 1-year period (2005).

RESULTS

Of the 100 patients included in this study, 52 were male and 48 female. Ages ranged from 18–91 years, with a mean of 63 years. Origin of referrals was: dermatology, 63%; general practitioner (GP), 33%; and other sources in the remaining 4% of cases. Malignant melanoma was suspected in 84% and a benign lesion in remaining 16% of patients. However, only 56% of the patients were seen in our unit within 14 days of the referral as per the 2-week cancer rule. In these 100 patients, various types of biopsy were performed: 50 were referred without biopsy, 17 excision, 20 punch, 3 shave, 1 curettage, and 1 incisional biopsy. The type of biopsy was not recorded in the remaining 3 patients. Of the GP group, 48% were referred without biopsy, 12% had excision and 3% had incisional biopsies. The remaining 30% were punch, shave biopsies, and even curettage, inconsistent with current recommendations. Of the dermatology group, 54% were referred without biopsy, 21% underwent excision biopsy and 22% were punch biopsies. In total, 20 punch biopsies were performed, of which 7 were for lesions on the face ranging from 1.7–25 mm in size. The remaining punch biopsies were for lesions on the trunk or limbs (4–50 mm). Of the 20 punch biopsies performed, Breslow thickness was available in only 9 cases (45%). Sixteen of the punch biopsies were done when malignant melanoma was suspected and lesion otherwise was suitable for excisional biopsy. In the GP group, 3 shave biopsies and 1 curettage were performed, of which malignant melanoma was clinically suspected in one patient. The Breslow thickness was not obtained from any of the shave biopsies or curettage cases. Of the 17 excision biopsies performed, 3 were incompletely excised (2 by dermatology and 1 by GP).

CONCLUSIONS

A significant proportion of biopsies are inappropriate and inconsistent with the malignant melanoma guidelines. Punch biopsies are performed even when malignant melanoma is clinically suspected and excision biopsy is feasible. Only a small proportion of patients appear to be seen on an urgent basis within 14 days of referral. Such factors can lead to a delay in diagnosis, subsequent definitive treatment and adversely affect patient outcome. This study identifies a need to provide feedback and education to sources of malignant melanoma referrals.
Self-Assessment of Technical Skill in Surgery: The Need for Expert Feedback
Authors: Pandey VA , Wolfe JHN , Black SA , Cairols M , Liapis CD , Bergqvist D
Published: May 2008

INTRODUCTION

Technical skill has been formally assessed in the Fellow of the European Board of Vascular Surgery Examinations (FEBVS) since 2002. The aim of this study was to examine the relationship between expert assessment and trainee self-assessment.

MATERIALS AND METHODS

Forty-two examination candidates performed a saphenofemoral junction (SFJ) ligation and an anterior tibial anastomosis on a synthetic simulation. Each candidate was rated by two examiners using a validated rating scale for their generic surgical skill for both procedures. Candidates then anonymously rated their own performance using the same scale. Parametric tests were used in the statistical analysis; a P-value <0.05 was considered significant.

RESULTS

The maximum mark in each assessment was 40; 24 was considered a competent score. The interobserver correlation for examiners marks were high (SFJ ligation, α = 0.68; distal anastomosis, α = 0.76). Examiners' marks were averaged. The mean examiner score for the SFJ ligation station was 27.8 (SD = 4.1) with 36 candidates (85.8%) attaining a competent score. The mean self-assessment score for this station was 30.7 (SD = 4.66). The mean examiners' marks for the distal anastomosis station was 29.2 (SD = 4.2); 39 candidates (92.8%) attained a competent score. The mean self-assessment score was 32.1 (SD = 4.0). There was no correlation between examiner and self-assessment scores in either station (Pearson's correlation coefficient: SFJ, r = 0.045, P = NS); distal anastomosis, r = 0.089, P = NS). Bland and Altman plots assessed the agreement between examiner and self-assessment. These showed candidates marked themselves higher than examiners with a mean difference of 2.9 marks in each station.

CONCLUSIONS

Candidates' self-assessment and expert independent assessment correlate poorly. Trainees overestimate their ability according to independent assessment; regular technical feedback during training is, therefore, essential.
Improving safety with surgical equipment: how you can help MHRA
Authors: Brittain Christopher
Published: May 2008

The Medicines and Healthcare products Regulatory Agency (MHRA) is the executive agency of the Department of Health charged with protecting and promoting public health and patient safety by ensuring that medicines and medical equipment meet appropriate standards of safety, quality, performance and effectiveness – and that they are used safely. One way it aims to achieve this is by investigating reports of adverse incidents involving medical devices and instigating corrective actions to reduce the risk of recurrence. The MHRA is keen to increase awareness of its role in this area and, furthermore, the vital role that all surgeons, medics and health care professionals have in making medical devices safer.
Should our health service be consultant-led or consultant-delivered?
Authors: Bentley Lesley , Church Jo
Published: May 2008

Against a background of blurring boundaries between the roles of health professionals there is debate as to whether our health service should be 'consultant-led' or 'consultant-delivered'.
NHS 60th: view from Lord Darzi
Authors: Darzi Lord Ara
Published: May 2008

This Bulletin marks the 60th anniversary of our National Health Service, a source of national pride and the greatest expression of social solidarity found anywhere in the world. As a fellow of the Royal College of Surgeons and a practising surgeon in the NHS it is therefore a great honour to be given this opportunity to reflect both on the changes we have witnessed in surgery and on the provision of surgical care since the NHS's inception – and what I believe our future direction must be.
Role of Mirtazapine in the Treatment of Antipsychotic-Induced Akathisia
Authors: Hieber Robin , Dellenbaugh Timothy , Nelson Leigh Anne
Published: May 2008

Objective:

To evaluate the role of mirtazapine in the treatment of antipsychotic-induced akathisia.

Data Sources:

MEDLINE (1966–February 2008) and PsycINFO (1967–February 2008) were searched using the terms akathisia and mirtazapine. A bibliographic search was conducted as well.

Study Selection and Data Extraction:

All English-language articles identified from the search were evaluated. All primary literature was included in the review.

Data Synthesis:

Antipsychotic-induced akathisia can be difficult to manage and may respond to mirtazapine based on its antagonist activity at the serotonin 5-HT2A/5-HT2C receptors. Three case reports (N = 9 pts.>, 1 placebo-controlled trial (N = 26), and 1 placebo- and propranolol-controlled study (N = 90) that evaluated mirtazapine for antipsychotic-induced akathisia have been published. Mirtazapine demonstrated a response rate of 53.8% compared with a 7.7% response rate for placebo, based on at least a 2-point reduction on the Barnes Akathisia Scale (global subscale; p = 0.004). Using the same criterion, mirtazapine and propranolol demonstrated efficacy based on response rates of 43.3% and 30.0% compared with placebo (6.7%; p = 0.0051). Mirtazapine was better tolerated than propranolol. In both studies, drowsiness was the most common adverse event associated with mirtazapine.

Conclusions:

Mirtazapine may be considered a treatment option for antipsychotic-induced akathisia. It may be especially useful for patients with contraindications or intolerability to β-blockers and for those with comorbid depression or negative symptoms. Additional studies should be conducted to provide further evidence of mirtazapine's effectiveness in treating akathisia.
Impact of an Inpatient Anticoagulation Management Service on Clinical Outcomes
Authors: Biscup-Horn Paula J , Streiff Michael B , Ulbrich Timothy R , Nesbit Todd W , Shermock Kenneth M
Published: May 2008

Background:

Antithrombotic medications require careful management to avoid thrombotic or hemorrhagic complications. The benefits of specialized anticoagulation management services (AMS) in the outpatient setting are well established; less evidence of benefit in the hospital setting is available.

Objective:

To evaluate the clinical benefits of an inpatient AMS to cardiac surgery patients requiring warfarin anticoagulation therapy.

Methods:

After obtaining institutional review board approval, we conducted a retrospective, single-center, cohort study of consecutive cardiac surgery patients treated before (January 2003–May 2005) and after (June–December 2005) establishment of an inpatient AMS. Demographic and clinical characteristics as well as laboratory and clinical data were retrieved from institutional electronic databases and compared between the 2 patient cohorts. Comparisons between study groups were conducted using a χ2 or Fisher's Exact test for categorical variables and a Student's t-test for continuous variables. Analysis of rare event data was conducted using Poisson regression analysis.

Results:

Of 1919 patients admitted during the study interval, 826 received warfarin (674 pre-AMS, 152 post-AMS). The number of patients with postsurgical panic international normalized ratio (INR) values declined after initiation of the AMS (pre-AMS 90/674 [13.4%] vs post-AMS 11/152 [7.2%]; p = 0.036). There was a trend toward fewer clinically significant postoperative bleeding events (pre-AMS 21/674 [3.1%] vs post-AMS 2/152 [1.3%]; p = 0.22) and fewer repeat surgeries for late postoperative bleeding (pre-AMS 8/674 [1.2%) vs post-AMS 0/152 [0%]; p = 0.08). AMS intervention was associated with a 17% decrease in the average postsurgical length of stay (13.9 days vs 11.6 days; p = 0.015).

Conclusions:

A multidisciplinary AMS can improve anticoagulation management, leading to fewer panic INR values and a reduced length of hospital stay.
Job definition discrepancy between supervisors and subordinates: The antecedent role of LMX and outcomes
Authors: Hsiung Hsin‐Hua , Tsai Wei‐Chi
Published: May 2008

This study proposed that leader–member exchange (LMX) might encourage an employee to define job breadth close to or beyond the level of his/her supervisor's expectation (enlargement effect), while simultaneously fostering a reduction in supervisor–subordinate definition discrepancy on job content (congruence effect). Using data from 184 subordinate–supervisor dyads in Taiwan, we examined the relationships among LMX, job definition discrepancy, in‐role/extra‐role behaviour, and performance rating. Results showed that LMX was positively related to employee relative job breadth and the supervisor–subordinate congruence on job content, supporting the existence of enlargement effect and congruence effect. Additionally, employee relative job breadth was positively related to extra‐role behaviour and the congruence on job content was positively related to in‐role behaviour. However, neither in‐role nor extra‐role behaviour was related to performance rating. Theoretical and practical implications are discussed.
OMCOS for functional polymers - double-stranded DNA-like polymers
Authors: Luh Tien-Yau , Yang Hui-Chun , Lin Nai-Ti , Lin Shu-Yi , Lee Shern-Long , Chen Chun-hsien
Published: May 2008

The first helical double-stranded polymer by ring-opening metathesis polymerization (ROMP) of a bisnorbornene derivative and the replication of a single-stranded polynorbornene leading to its complementary polynorbornene derivative are described. Base-promoted hydrolysis of this polymer affords the corresponding single-stranded polymer and the linker, ferrocene-1,1'-dicarboxylic acid, in excellent yield. Three forms (helical, supercoil, and ladder) of the polymer have been observed by scanning tunneling microscopy (STM) and simulated by molecular mechanical and dynamical calculations. The polymer thus obtained has a structural resemblance to DNA by having similar width, number of monomeric units per pitch, five-membered rings in the polymeric frame, perpendicular linkers to the backbones, and similar spacing between neighboring monomeric units. In the replication study, the single-stranded polynorbornene acts as a template for norbornene monomer adhesion via ester linkage. This polymer is treated with Grubbs-I catalyst to proceed the ROMP to afford the corresponding unsymmetric double-stranded polymer. After hydrolysis, a complementary polynorbornenecarboxylic acid is produced. This approach may provide a versatile entry for the design, synthesis, and physicochemical investigations of new types of polymers for simulation of biological systems as well as materials applications.
Organometallic catalysts in synthetic organic chemistry: From reactions in aqueous media to gold catalysis
Authors: Genêt Jean-Pierre , Darses Sylvain , Michelet Véronique
Published: May 2008

Water has attracted significant attention as an alternative solvent for transition-metal-catalyzed reactions. The use of water as solvent allows simplified procedures for separation of the catalyst from the products and recycling of the catalyst. Water is an inexpensive reagent for the formation of oxygen-containing products such as alcohols. The use of water as a medium for promoting organometallic and organic reactions is also of great potential. This chapter will focus on old and recent developments in the design and applications of some catalytic reactions using aqueous-phase Pd, Rh, Pt, and Au complexes.
Catalytic enantioselective Reformatsky reactions
Authors: Cozzi Pier Giorgio , Mignogna Alessandro , Zoli Luca
Published: May 2008

The Reformatsky reaction is a venerable named reaction that was introduced more than 120 years ago. Diastereoselective variants based on the use of chiral auxiliary and enantioselective protocols, based on the employment of stoichiometric amount of chiral ligands, have been successfully applied in organic synthesis during the years. However, a facile and general catalytic enantioselective variant was still a difficult task. Recently, we have established a new general and straightforward methodology for catalytic enantioselective Reformatsky reaction based on different concepts. In this paper, we present our general finding in catalytic enantioselective Reformatsky reaction of ketones, imines, and aldehydes. Our simple methodologies could become benchmark reactions for testing new synthesized chiral ligands for asymmetric transformations.
Metal carbonyl complexes and chirality
Authors: Gibson Susan E. , Kaufmann Karina A. C. , Loch Jennifer A. , Miyazaki Ayako
Published: May 2008

A study of the Pauson-Khand reaction (PKR) based on Co2(CO)8 and binap has revealed that a key precatalyst is (binap)Co2(CO)6, and that alkynes add to this species to generate isomers that interconvert under typical PKR conditions. A 31P NMR study of (binap)(N-(prop-2-enyl)-N-(prop-2-ynyl)-p-toluenesulfonamide)Co2(CO)4 revealed that heating this species gives rise to an unexpected cobalt hydride species (binap)Co(CO)2H together with (binap)Co2(CO)6. Observation of a PKR reaction by 31P NMR spectroscopy revealed that the hydride species is generated during the course of the reaction.
Nickel-catalyzed coupling reactions of alkenes
Authors: Ng Sze-Sze , Ho Chun-Yu , Schleicher Kristin D. , Jamison Timothy F.
Published: May 2008

Several reactions of simple, unactivated alkenes with electrophiles under Ni(0) catalysis are discussed. The coupling of olefins with aldehydes and silyl triflates provides allylic or homoallylic alcohol derivatives, depending on the supporting ligands and, to a lesser extent, the substrates employed. Reaction of alkenes with isocyanates yields N-alkyl acrylamides. In these methods, alkenes act as the functional equivalents of alkenyl- and allylmetal reagents.
Carbon-carbon bond-forming reactions using alkyl fluorides
Authors: Terao Jun , Todo Hirohisa , Watabe Hiroyasu , Ikumi Aki , Shinohara Yoshiaki , Kambe Nobuaki
Published: May 2008

This account reviews C-C bond formation reactions using alkyl fluorides mostly focusing on the transition-metal-catalyzed reactions. These reactions proceed efficiently under mild conditions by the combined use of Grignard reagents and transition-metal catalysts, such as Ni, Cu, and Zr. It is proposed that ate complex intermediates formed by the reaction of these transition metals with Grignard reagents play important roles as the active catalytic species. Organoaluminun reagents react directly with alkyl fluorides in nonpolar solvents at room temperature to form C-C bonds. These studies demonstrate the practical usefulness of alkyl fluorides in C-C bond formation reactions and provide a promising method for the construction of carbon frameworks employing alkyl fluorides. The scope and limitations, as well as reaction pathways, are discussed.
Transition-metal-catalyzed synthesis of organosulfur compounds
Authors: Arisawa Mieko , Yamaguchi Masahiko
Published: May 2008

Rhodium complexes are efficient catalysts for the synthesis of organosulfur compounds. They catalyze the addition reaction of organosulfur groups to unsaturated compounds, the substitution of C-H with organosulfur groups, and single-bond metathesis reactions. They cleave S-S bonds and transfer the organosulfur groups to various organic and inorganic molecules, including alkynes, allenes, disulfides, sulfur, isonitriles, imines, diphosphines, thiophosphinites, hydrogen, 1-alkylthio-1-alkynes, thioesters, and allyl sulfides.
Copper-catalyzed substitution of allylic carbonates with diboron: A new approach to allylboronate synthesis
Authors: Ito Hajime , Ito Shinichiro , Sasaki Yusuke , Matsuura Kou , Sawamura Masaya
Published: May 2008

Copper-catalyzed γ-selective substitution of allylic carbonates with diboron provides a new method for the efficient synthesis of allylboronates. Optically active α-chiral allylboronates were synthesized through the reaction of chiral allylic carbonates with bis(pinacolato)diboron in the presence of achiral Cu(I)-catalyst with highly efficient chirality transfer. Additionally, in the presence of a chiral Cu(I) catalyst, optically active α-chiral allylboronates were obtained with >90 % ee through the reaction of prochiral substrates with the diboron.
Hydrogenation of polar functionalities with Cp*Ru(PN) catalysts
Authors: Ito Masato
Published: May 2008

This account deals with an overview of our recent progress toward the development of molecular catalysts for the reduction in polar functionalities with molecular hydrogen (H2). An emphasis is placed on the newly designed Cp*Ru(PN) complexes, which have been identified as efficient catalysts for the hydrogenation of imides. The structural modification of the complex enhances the catalytic performance and allows efficient access to various chiral synthetic intermediates.
Asymmetric epoxidation of olefins catalyzed by Ti(salan) complexes using aqueous hydrogen peroxide as the oxidant
Authors: Matsumoto Kazuhiro , Sawada Yuji , Katsuki Tsutomu
Published: May 2008

Ti(salan) complexes were found to be efficient catalysts for asymmetric epoxidation with aqueous hydrogen peroxide as the oxidant. In the presence of pH 7.4 phosphate buffer, the reaction of various conjugate olefins proceeded smoothly to afford the corresponding epoxides in high yield with high enantioselectivity, even on a multigram scale. Ti(salan) complexes could be prepared from Ti(OiPr)4 and the corresponding salan ligand and directly used without isolation and purification.
Rhodium- and iridium-catalyzed oxidative coupling of benzoic acids with alkynes and alkenes
Authors: Satoh Tetsuya , Ueura Kenji , Miura Masahiro
Published: May 2008

The oxidative coupling of benzoic acids with alkynes and alkenes effectively proceeds in the presence of a Rh catalyst and an appropriate oxidant to produce the corresponding isocoumarin and phthalide derivatives, respectively. Interestingly, by using an Ir catalyst in place of Rh, the acids and alkynes undergo 1:2 coupling accompanied by decarboxylation to afford naphthalene derivatives exclusively.
γ-Methylidene-δ-valerolactones as a coupling partner for cycloaddition: Palladium-catalyzed [4+3] cycloaddition with nitrones
Authors: Shintani Ryo , Murakami Masataka , Hayashi Tamio
Published: May 2008

A new type of reagent, γ-methylidene-δ-valerolactones, has been devised, which acts as a four-carbon unit in a Pd-catalyzed cycloaddition reaction through the formation of a 1,4-zwitterionic species. The utility has been demonstrated in the context of stereoselective [4+3] cycloaddition with nitrones to provide highly functionalized 1,2-oxazepines, including the asymmetric variant with high enantioselectivity.
New hydrosilylation reaction of arylacetylene accompanied by C-H bond activation catalyzed by a xantsil ruthenium complex
Authors: Tobita Hiromi , Yamahira Nobukazu , Ohta Keisuke , Komuro Takashi , Okazaki Masaaki
Published: May 2008

A new type of catalytic hydrosilylation of arylalkynes was induced by a 16-electron ruthenium bis(silyl) phosphine complex, resulting in ortho-silylation of the aryl group as well as a hydrogenation of the alkyne CC bond to give an (E)-form of alkene selectively. On the other hand, the same reaction using a related bis(silyl) complex having an η6-toluene ligand instead of the phosphine ligand as a catalyst led to a normal hydrosilylation reaction to afford silylalkene.
Palladium-catalyzed cross-addition of triisopropylsilylacetylene to unactivated alkynes
Authors: Tsukada Naofumi , Ninomiya Satoshi , Aoyama Yoshimi , Inoue Yoshio
Published: May 2008

Selective cross-addition of triisopropylsilylacetylene (TIPSA) to unactivated alkynes is catalyzed by dinuclear and mononuclear palladium complexes supported by a multidentate ligand, N,N'-bis[2-(diphenylphosphino)phenyl]formamidine (dpfamH). While the addition reactions of TIPSA to dialkylacetylenes using palladium catalysts supported by monodentate and bidentate ligands gives dimers of TIPSA as major products, the reactions with the palladium complexes supported by dpfam affords cross-adducts selectively, in which the yields of TIPSA dimers are less than 5 %. The addition of TIPSA to monoalkylacetylenes also gives cross-adducts as major products, although the selectivity and yield are moderate.
Cationic palladium-catalyzed hydrosilylative cross-coupling of alkynes with alkenes forming 4-silylated-1-butene frameworks
Authors: Shimamoto Takamitsu , Chimori Motoharu , Sogawa Hiroaki , Harada Yuki , Aoki Masaharu , Yamamoto Keiji
Published: May 2008

A new hydrosilylative cross-coupling reaction of a variety of alkynes with several alkenes, which is catalyzed by a cationic Pd complex [Pd(η3-C3H5)(cod)]+[PF6]- (cod = 1,5-cyclooctadiene) was studied systematically. The reaction using HSiCl3 as an addend afforded more or less two types of products consisting of four possible derivatives, R1CH=CR2-CHR3-CHR4-SiCl3, which always contained 4-trichlorosilyl-1-butene frameworks, in acceptable combined yields. The coupling pattern was markedly dependent both on the precatalyst in the absence or presence of PPh3 ligand and on the combination of the alkyne and alkene partners employed. A possible catalytic cycle that involves an initial hydropalladation of an alkyne, followed by a facile and specific carbopalladation of an alkene, is proposed. At the same time, the lack of regioselectivity in the latter step is noted.
Boryllithium: A novel boron nucleophile and its application in the synthesis of borylmetal complexes
Authors: Yamashita Makoto , Nozaki Kyoko
Published: May 2008

The first boryl anion, boryllithium, was synthesized by a reduction of bromoborane precursor using lithium naphthalenide in tetrahydrofuran (THF) solvent at -45 °C. Structural and spectroscopic study revealed an ionic character of B-Li bond. Boryllithium could be utilized as a source of boryl ligand in the transition-metal chemistry. Structural and spectroscopic features of the resulting boryl complexes confirmed the large trans influence of boryl ligand.