bluuebunny/crossref_metadata_2025 huggingface dataset:
Equivalent plastic strain gradient enhancement of single crystal plasticity: theory and numerics
Authors: Wulfinghoff Stephan , Böhlke Thomas
Published: April 2012

We propose a visco-plastic strain gradient plasticity theory for single crystals. The gradient enhancement is based on an equivalent plastic strain measure. Two physically equivalent variational settings for the problem are discussed: a direct formulation and an alternative version with an additional micromorphic-like field variable, which is coupled to the equivalent plastic strain by a Lagrange multiplier. The alternative formulation implies a significant reduction of nodal degrees of freedom. The local algorithm and element stiffness matrices of the finite-element discretization are discussed. Numerical examples illustrate the advantages of the alternative formulation in three-dimensional simulations of oligo-crystals. By means of the suggested formulation, complex boundary value problems of the proposed plastic strain gradient theory can be solved numerically very efficiently.
Effects of borrowers' quality on the size of market response to bank loan announcements in China
Authors: Zhang Yuan , Gan Christopher , Li Zhaohua
Published: April 2012

Purpose

The purpose of this paper is to examine the effects of borrowers' quality on the size of market reaction to bank loan announcements in the Chinese financial market, where poor quality borrowers are prevalent and the banking system is highly controlled by the Chinese government.

Design/methodology/approach

The paper uses different measures to proxy for borrower quality, including the borrowers' information opaqueness, possibility of expropriation and their financial status. A cross‐sectional regression analysis was conducted to investigate the relationship between the market response to bank loan announcements and the borrowers' quality.

Findings

It is revealed that the negative market response to bank loan announcements is particularly significant for borrowing firms with lower quality, including firms that are opaque, have a higher possibility of expropriation or tunnelling, have ineffective expropriation‐reduction mechanisms, are controlled by the state and are in financial distress, for the sample period 1996 to 2009. Furthermore, to test whether there is any significant difference on the effects of the borrowers' quality on the size of the market response to bank loan announcements following China's announcement of share‐split reform in 2005, this paper splits the sample period into sub samples, 1996 to 2004 and 2004 to 2005. The results on the effects of the borrowers' quality on the size of market response to bank loan announcements for the sub sample period 1996 to 2004 are similar to those for the full sample 1996 to 2009.

Research limitations/implications

The paper's findings imply that the reforms in the Chinese financial market since 2005 do not have any significant effects on the borrowers' quality on the size of the market response to bank loan announcements for the full sample period.

Originality/value

This paper differs from previous studies in regards to the sample period and the measurements of the possibility of expropriation or tunnelling. The paper contributes to the banking and corporate governance literature.
Coping with customer aggression
Authors: Goussinsky Ruhama
Published: April 2012

Purpose

The purpose of this research is to investigate the direct and moderating effect of negative affectivity (NA) (Study 1) and self‐efficacy (Study 2) on the relationship between customer verbal aggression and three forms of emotion‐focused coping strategies: behavioral disengagement, seeking emotional support, and venting negative emotions.

Design/methodology/approach

Two samples of service workers were recruited from northern Israel in 2007‐2008 (n=178 and n=516), and data were collected using self‐reported questionnaires. Research hypotheses were tested using hierarchical regression analyses.

Findings

The results show that under high levels of exposure to customer aggression, employees with high NA were more likely to use behavioral disengagement than low‐NA individuals, employees with low NA were less likely to vent negative emotions than high‐NA individuals, and employees with high self‐efficacy were less likely to use venting and emotional support than employees with low self‐efficacy. In addition, self‐efficacy was found to reduce the negative impact of customer aggression on emotional exhaustion.

Practical implications

Through appropriate training programs, service organizations can foster their employees' sense of trust in their own ability to cope with customer misbehavior and consequently reduce reliance on dysfunctional coping strategies.

Originality/value

While it has been established that verbal abuse from customers constitutes a common experience for many service workers, little is known about the manner in which workers cope with this particular job stressor and even less about the individual differences that may explain coping behaviors in this context. The present paper begins to bridge this gap and contributes to existing literature by showing that in addition to being predictors of dysfunctional coping strategies, both NA and self‐efficacy may play a moderating role in the relationship between customer aggression and coping behaviors.
A rolling stone gathers no moss: prevent your strategic plan from stagnating
Authors: Myrna John W.
Published: April 2012

Purpose

This article explains the critical importance of actually using and implementing your company's strategic plan, and offers practical tips for avoiding the most four common traps that keep a strategic plan sitting, ignored, on a shelf.

Design/methodology/approach

The examples cited all stem from the author's extensive experience helping companies engage in more effective strategic planning and successful implementation of the shared strategic vision.

Findings

Companies can effectively implement a strategic plan by understanding why a team may not implement as asked, encouraging personal motivation and “ownership” of the strategic goals, maintaining momentum in the face of daily distractions, and understanding how the “real world” works.

Practical implications

Executives must understand how to make their strategic plan a “living document”, and then take specific steps to keep the implementation of that plan on track.

Originality/value

The value of this article to corporate executives lies in its reality‐based perspective on specific techniques and tactics to use for successful implementation of a strategic plan.
Identification and characterization of polymorphic microsatellite loci in the blue shark Prionace glauca, and cross‐amplification in other shark species
Authors: Mendonça F. F. , Ussami L. H. F. , Hashimoto D. T. , Pereira L. H. G. , Porto‐Foresti F. , Oliveira C. , Gadig O. B. F. , Foresti F.
Published: April 2012

Two to 14 alleles were found to be segregating per locus (mean 5·2), with observed and expected heterozygosities ranging from 0·08 to 0·78 and 0·08 to 0·94, respectively. Cross‐amplification of six of these microsatellite loci indicated that they are also polymorphic in three species of Carcharhiniformes and two species of Lamniformes. The newly developed primers reported here constitute a useful tool for genetic population analyses on Prionace glauca and, potentially, other related species.
Young People's Participation — Where Next?
Authors: Fleming Jennie
Published: April 2012

This article is about young people in the UK's participation in decisions that affect them. It draws, in particular, on three research and evaluation projects that were undertaken in partnership with young people as researchers, and directly exploring the views and experience of young people of their participation in the voluntary and statutory sector. Its purpose is to contribute to reflection on young people's participation to review what has been done and what has been learnt, to consider what next, where our efforts should be focused in the future as adults and young people seek together to develop and implement meaningful opportunities for participation.
Development of sandwich enzyme‐linked immunosorbent assay for the detection of Cronobacter muytjensii (formerly called Enterobacter sakazakii)
Authors: Park Sunhyun , Shukla Shruti , Kim Younghoan , Oh Sejong , Hun Kim Sae , Kim Myunghee
Published: April 2012

This study aimed to produce a polyclonal antibody against Cronobacter muytjensii (C. muytjensii, formerly called Enterobacter sakazakii) and to develop an immunoassay for its detection. The optimum production of rabbit anti‐C. muytjensii immunoglobulin G (IgG) and chicken anti‐C. muytjensii IgY was reached in weeks 8 and 9, respectively. Purification of rabbit anti‐C. muytjensii IgG from immunized rabbit sera was accomplished using the caprylic acid and ammonium sulfate precipitation method. As a result, sodium dodecyl sulfate‐polyacrylamide gel electrophoresis produced two bands around 25 and 50 kDa, corresponding to a light and a heavy chain, respectively. The optimized conditions for sandwich enzyme‐linked immunosorbent assay were using rabbit anti‐C. muytjensii IgG (1 μg/mL) as a detection antibody and chicken anti‐C. muytjensii IgY (10 μg/mL) as a capture antibody. In this assay, no cross‐reactivity was observed with the other genera of pathogenic bacteria tested, which included Escherichia coli O157:H7, Salmonella typhimurium, Staphylococcus aureus, Bacillus cereus and Listeria monocytogenes. The developed assay did not show cross‐reactivity with other tested species of Cronobacter and Enterobacter genera such as C. turicensis, C. sakazakii, E. aerogenes, E. pulveris and E. helveticus. The detection limit of sandwich ELISA for C. muytjensii was found to be 2.0 × 104 colony forming units (CFU)/mL. In addition, detection of C. muytjensii in infant formula powder showed a low matrix effect on the detection curve of sandwich ELISA for C. muytjensii, the detection limit being found to be 6.3 × 104 CFU/mL. These findings demonstrate that the developed method is able to detect all strains of C. muytjensii. Hence, this ELISA technique has potent application for the rapid and accurate detection of C. muytjensii in dietary foods.
Integrated pharmacokinetics and pharmacodynamics of epoprostenol in healthy subjects
Authors: Nicolas Laurent B. , Krause Andreas , Gutierrez Marcelo M. , Dingemanse Jasper
Published: April 2012

WHAT IS ALREADY KNOWN

• Continuous infusion with synthetic prostacyclin (epoprostenol) is generally regarded as the most effective treatment against severe cases of primary pulmonary arterial hypertension, associated with decreased pulmonary vascular resistance, increased cardiac index (CIn), and survival benefits. To date, the pharmacokinetics (PK) of epoprostenol have not been fully characterized due in part to the instability of epoprostenol.

WHAT THIS STUDY ADDS

• The present study provides the first characterization of the PK of epoprostenol in man via assessment of 6‐keto‐prostacyclin F1α and another primary metabolite, 6,15‐diketo‐13,14‐dihydro‐prostacyclin F1α. Overall, PK/pharmacodynamic (PD) modelling showed that CIn relates proportionally and linearly to the plasma concentrations of 6‐keto‐prostacyclin F1α suggesting that this major metabolite represents a suitable surrogate marker of plasma concentrations of epoprostenol.

AIM The aim of the study was to report the first thorough characterization of the pharmacokinetics (PK) and pharmacodynamics (PD) of epoprostenol in an integrated manner.

METHOD Twenty healthy male subjects received two formulations of i.v. epoprostenol, in a crossover design, in sequential infusions of 2, 4, 6 and 8 ng kg−1 min−1 for 2 h each. A sensitive assay was developed which allowed accurate PK characterization of epoprostenol via analysis of the concentration–time profiles of its two primary metabolites, 6‐keto‐prostacyclin F1α and 6,15‐diketo‐13,14‐dihydro‐prostacyclin F1α. PD parameters included cardiac output (CO), cardiac index (CIn) and heart rate (HR).

RESULTS The pharmacokinetics of epoprostenol deviated slightly from dose‐proportionality, probably due to a food effect. After infusion of the two formulations of epoprostenol, the t1/2 values expressed as geometric mean (95% confidence interval) were 0.25 h (0.14, 0.46) and 0.22 h (0.13, 0.38) for 6‐keto‐prostacyclin F1α, and 0.32 h (0.22, 0.45) and 0.34 h (0.26, 0.46) for 6,15‐diketo‐13,14‐dihydro‐prostacyclin F1α. A single compartment infusion model with first order elimination adequately described the PK of 6‐keto‐prostacyclin F1α. This model also characterized the food effect. Stepwise infusions with epoprostenol resulted in a progressive increase in CO, CIn and HR.

CONCLUSION Of the two metabolites analyzed, the appearance of 6‐keto‐prostacyclin F1α in plasma was more closely associated with the haemodynamic effects of i.v. epoprostenol. PK and PD profiles showed that CIn relates proportionally and linearly to the plasma concentrations of 6‐keto‐prostacyclin F1α. These results suggest that 6‐keto‐prostacyclin F1α is a suitable surrogate marker of plasma concentrations of epoprostenol.
Acute haemodynamic response in relation to plasma vardenafil concentrations in patients with pulmonary hypertension
Authors: Henrohn Dan , Sandqvist Anna , Hedeland Mikael , Egeröd Hanna , Bondesson Ulf , Wikström Gerhard
Published: April 2012

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Phosphodiesterase‐5 (PDE5) inhibitor therapy is effective in the treatment of patients with pulmonary hypertension (PH). All available PDE5 inhibitors, sildenafil, tadalafil and vardenafil have been reported to cause pulmonary vasodilation acutely in patients with PH. There is a lack of information on the haemodynamic effects in relation to plasma concentrations for the available PDE5 inhibitors and the drug concentration to obtain optimal clinical effect is unknown.

WHAT THIS STUDY ADDS

• This study provides information on the correlation between vardenafil plasma drug concentration and the acute changes in haemodynamics in patients with PH after a single oral dose of vardenafil.

AIMS To evaluate the acute haemodynamic effects of a single oral dose of vardenafil and to study the drug concentration in relation to haemodynamic effects in patients with pulmonary hypertension (PH).

METHODS Sixteen patients with PH (aged 29–85\ years), received one single oral dose of vardenafil (5, 10 or 20 mg). The haemodynamic effect was assessed over a 60 min period. Vardenafil plasma concentrations were measured after 15, 30, 45 and 60 min using liquid chromatography–tandem mass spectrometry.

RESULTS At 60 min a reduction in mPAP with a median % decrease of −20.3% (range −48.3 to 3.0; P < 0.001) and an increase in cardiac output and the cardiac index with a median % change of 10.6% (range −25.0 to 88.1; P = 0.015) and 12.1% (range −24.0 to 94.4; P = 0.01) respectively was observed. The pulmonary vascular resistance (PVR) was reduced with a median % decrease of −28.9% (range −61.5 to −5.9; P < 0.001), and pulmonary selectivity was reflected by a median percent reduction of −16.9% (range −49.0 to 16.5; P = 0.002; n = 14) in the PVR/systemic vascular resistance ratio. There was a correlation between the plasma concentrations of vardenafil and change in mPAP (r = −0.579, P = 0.019) and between vardenafil concentrations and change in PVR (r = −0.662, P = 0.005).

CONCLUSIONS Vardenafil causes rapid changes in cardiopulmonary haemodynamics and there is a correlation between plasma vardenafil drug concentration and the acute changes in mPAP as well as PVR in patients with PH.
Finding out what matters: validity of quality of life measurement in young people with ASD
Authors: Tavernor L. , Barron E. , Rodgers J. , McConachie H.
Published: April 2012

Background  Compared with other conditions there has been a lack of focus on quality of life (QoL) as an outcome measure for children and young people with Autism Spectrum Disorder (ASD). This pilot study aimed to evaluate the validity of existing QoL questionnaires for use with children with ASD aged 8–12 years.

Methods  A literature review (1990–2011) identified the PedsQL (Pediatric Quality of Life Inventory) and Kidscreen as robust measures used with children with neurodevelopmental disorders. These measures were completed by 10 children and 11 parents. In addition semi‐structured interviews were conducted with 10 parents and four children to explore their experience of completing the QoL questionnaires.

Results  Young people with ASD, and their parents, report lower child QoL compared with a normative sample. Framework analysis of the data highlighted six key themes which may affect the validity of generic QoL measures when administered within an ASD sample and which warrant further investigation.

Conclusions  Our results indicate that a new condition‐specific measure of QoL, grounded in ASD children's own perspectives of their lives, is needed and that such a measure should assess experiences of anxiety and access to special interests when measuring QoL of children with ASD. Active involvement of young people and their families is critical for the development of a theoretical framework for QoL within ASD, and any future development of an ASD‐specific measure.
The effectiveness of local child weight management programmes: an audit study
Authors: Upton P. , Taylor C. E. , Peters D. M. , Erol R. , Upton D.
Published: April 2012

Background  Many different child weight management programmes exist, with varying degrees of evaluation to provide evidence of their success. The purpose of this research was to use a standardized approach to audit the effectiveness of weight management intervention programmes in the West Midlands region of the UK, specifically to assess the benefits to participating children in terms of health improvement and behaviour change.

Methods  An audit of seven family‐based intervention programmes currently in place in the West Midlands. Programmes were audited against the Standard Evaluation Framework.

Results  The programmes provided a partial data set relating to a change in weight from the baseline to the end of the programme; none of the programmes provided all of the measures indicated by the Standard Evaluation Form as being essential for evaluation. Weight change ranged from an increase in group mean of 0.4 kg to a decrease of 0.9 kg. Body Mass Index SD decreased by 0.1–0.2 points in four programmes and remained unchanged in two programmes. Four programmes collected long‐term follow‐up data at 6 months. This was often limited because of participant dropout. Improvement in diet and exercise were reported by participants in all programmes which measured these behaviours.

Conclusions  Ongoing evaluation of all programmes, using a standard approach, is essential in order to improve the evidence base and support future commissioning.
What parents find important in the support of a child with profound intellectual and multiple disabilities
Authors: Jansen S. L. G. , van der Putten A. A. J. , Vlaskamp C.
Published: April 2012

Background  The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of ‘family‐centred care’. To what extent family‐centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known.

Aim  The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions.

Method  In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non‐parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level).

Results  Parents rated situations related to ‘Respectful and Supportive Care’ and ‘Enabling and Partnership’ with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for ‘Providing Specific Information about the Child’. Parents of children in the ‘6–12 years’ age group gave significantly higher scores on this scale than did parents of children in the ‘≥17 years’ age group (U = 288, r = −0.34).

Conclusion  This study shows that parents with children with PIMD find family‐centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important.
Screening for attention‐deficit/hyperactivity disorder (ADHD): can high‐risk children be identified in first grade?
Authors: Holmberg K. , Sundelin C. , Hjern A.
Published: April 2012

Aim  Recent studies have demonstrated the beneficial long‐term effects of an indicated parent support programme for acting out behaviour in pre‐school children with attention‐deficit/hyperactivity disorder (ADHD) traits. In this study we wanted to assess different thresholds for screening with the Conners scale for hyperactive–inattentive behaviours in first grade for ADHD in grade four.

Method  The study population consisted of 422 first graders (6‐ to 7‐year‐olds) in one municipality in Stockholm County who were screened with Conners 10‐item scale and followed up by ADHD assessment in grade four. Sensitivity, specificity, likelihood ratios, and positive predictive value (PPV) of the screening by parents and teachers in first grade for being diagnosed with ADHD in fourth grade were calculated.

Results  The prevalence of pervasive and situational ADHD was 5.7% and 5.9% respectively. A score ≥10 on the Conners scale in first grade in teachers' reports identified 63% [95% confidence interval (CI): 43–79] of children diagnosed with pervasive ADHD in grade four (P < 0.001) with a PPV of 29% and a positive likelihood ratio (LR+) of 6.72. Parental reports of a score ≥10 yielded a lower sensitivity (29%; 95% CI: 15–49), PPV of 20% and LR+ of 4.24 for pervasive ADHD. The best predictor was a combination of parent and teacher scores ≥10 with a PPV of 50% and LR+ of 16.63. Associations with situational ADHD were weak with LR+ of 1.81 and 2.49, respectively, for teachers' and parental scores ≥10.

Conclusions  This study indicates a strong association between a teacher's report of a score ≥10 on the Conners scale in first grade and pervasive ADHD in grade four, while parental reports were less predictive.
The role of allergy in severe asthma
Authors: Kennedy J. L. , Heymann P. W. , Platts‐Mills T. A. E.
Published: April 2012

The classification of asthma to identify forms which have different contributing causes is useful for all cases in which the disease requires regular treatment, but it is essential for the management of severe asthma. Many forms of the disease can occur, and complex mixtures are not uncommon; here we artificially separated the cases into four groups: (i) inhalant allergy, (ii) fungal sensitization with or without colonization (including ABPA); (iii) severe sinusitis with or without aspirin‐exacerbated respiratory disease (AERD), and (iv) non‐inflammatory cases, including those associated with severe obesity and vocal cord dysfunction (VCD). The reason for focusing on these groups is because they illustrate how much the specific management depends upon correct classification. Inhalant allergy can present as chronically severe asthma. However, severe attacks of asthma requiring hospital admission can occur in cases which are generally only mild or moderate. The best recognized and probably the most common cause of these acute episodes is acute infection with a rhinovirus. Recent evidence suggests that high titre IgE, particularly to dust mite, correlates to exacerbations of asthma related to rhinovirus infection. Although it is well recognized that the fungus Aspergillus can colonize the lungs and cause severe disease, it is less well recognized that those cases may not have full criteria for diagnosis of ABPA or may involve other fungi. Identifying fungal cases is important, because treatment with imidazole antifungals can provide significant benefit. Taken together, specific treatment using allergen avoidance, immunotherapy, anti‐IgE, or antifungal treatment is an important part of the successful management of severe asthma, and each of these requires correctly identifying specific sensitization.
Metabolic syndrome and all‐cause mortality in older men and women
Authors: Forti Paola , Pirazzoli Gian L. , Maltoni Benedetta , Bianchi Giampaolo , Magalotti Donatella , Muscari Antonio , Mariani Erminia , Ravaglia Giovanni , Zoli Marco
Published: April 2012

Eur J Clin Invest 2012; 42 (9): 1000–1009

Background  Prevalence of metabolic syndrome (MetS) increases with age, but its association with all‐cause mortality in older persons remains uncertain. This study investigated the association of all‐cause mortality with MetS and its individual components in older men and women.

Methods  A total of 917 men and 1043 women aged 65 years and older from two Italian population‐based cohorts were included in the study. MetS was defined according to four different definitions: National Cholesterol Education Program (NCEP), NCEP revised according to the American Heart Association and National Heart Lung Blood Institute (NCEP‐R), International Diabetes Organization (IDF) and Joint Interim Statement (JIS). All of these definitions include abdominal obesity, hyperglycaemia, hypertriglyceridaemia, low high‐density lipoprotein cholesterol and hypertension. Hazard Ratios (HR) and their corresponding 95% confidence interval (95%CI) estimated from multivariable‐adjusted Cox regression models were used to investigate the associations of all‐cause mortality with baseline MetS status and individual MetS components.

Results  After 6·5 ± 1·8 years of follow‐up, there were 179 deaths among women and 193 among men. Mortality risk was increased in women with MetS by any definition, regardless of individual components, but limited to age 70–79 years (NCEP, HR = 2·02, 95%CI, 1·16–3·53; NCEP‐R, HR = 2·51, 95%CI, 1·45–4·34; IDF, HR = 2·16, 95%CI, 1·26–3·72; JIS, HR = 2·16, 95%CI, 1·26–3·72). Mortality risk of men was associated with hypertriglyceridaemia below age 70 years (HR = 2·50, 95%CI, 1·19–5·25), but unrelated to MetS status.

Conclusions  Metabolic Syndrome is associated with all‐cause mortality in older women but not in men. The association, however, is limited to a narrow age range.
Do landscape barriers affect functional connectivity of populations of an endangered damselfly?
Authors: KELLER DANIELA , VAN STRIEN MAARTEN J. , HOLDEREGGER ROLF
Published: April 2012

1. Landscape genetic approaches were used to assess functional connectivity of populations of the endangered damselfly Coenagrion mercuriale in a fragmented agricultural landscape in Switzerland. Spatial genetic clustering methods combined with interpolation by kriging and landscape genetic corridor analysis were applied to identify landscape elements that enhance or hinder dispersal and gene flow.

2. Spatial genetic clustering analysis divided the sampled populations into a northern and a southern genetic group. The boundary between the two groups coincided with a hill ridge intersecting the study area. Landscape corridor analysis identified five landscape elements that significantly affected gene flow. Elevation change, Euclidian distance, patches of forest and flowing waterbodies acted as barriers, whereas open agricultural land enhanced gene flow between populations of C. mercuriale.

3. This study showed that movement of C. mercuriale was not restricted to its preferred habitat (i.e. streams). Populations linked via continuous open agricultural land were functionally well connected if they were not more than about 1.5–2 km apart. In contrast, substantial elevation change and larger forest patches separated populations. These findings may serve as a basis to define conservation units and should be considered when planning connectivity measures, such as determining the locations of stepping stones, or the restoration of streams.
Angiomyolipoma of the liver: a reappraisal of morphological features and delineation of new characteristic histological features from the clinicopathological findings of 55 tumours in 47 patients
Authors: Nonomura Akitaka , Enomoto Yasunori , Takeda Maiko , Takano Masato , Morita Kohei , Kasai Takahiko
Published: April 2012

Nonomura A, Enomoto Y, Takeda M, Takano M, Morita K & Kasai T  (2012) Histopathology 61, 863–880

Angiomyolipoma of the liver: a reappraisal of morphological features and delineation of new characteristic histological features from the clinicopathological findings of 55 tumours in 47 patients

Aims:  The aim of this study was to characterize and delineate the broad histological spectrum of hepatic angiomyolipoma (AML) and to obtain a better understanding of its clinicopathological diagnosis by reviewing a large series of AMLs.

Methods and results:  According to the proportions of three histological components, AML could be classified into 10 types; 36 of 55 tumours (65%) were classified as myomatous, eight as myoangiomatous, six as mixed (conventional), two as lipomatous, two as myolipomatous, and one as lipomyomatous. The morphology of smooth muscle cells (SMCs) in AML was quite variable, giving a wide variety of growth patterns. Fourteen (25%) of 55 tumours showed severe cellular atypia, and invasive growth of tumour cells was found in 69% of the tumours. However, except for two autopsy cases, all of the patients were in good health at follow‐up, without metastases. Immunostaining for HMB‐45 was positive in all cases. We found frequent lymphocyte infiltration, and the occasional presence of abnormally large blood vessels around the tumour at the tumour–background liver interface, features which have not been reported previously.

Conclusions:  The majority of hepatic AMLs were myomatous in type, showing variable cellular morphology and growth patterns. Cellular atypia and invasive growth were frequent, indicating that hepatic AMLs often show malignancy‐like histological features. Although the majority of cases behave as benign tumours, AML should be considered to have uncertain malignant potential, and careful follow‐up of patients is recommended. Immunostaining for HMB‐45 is specific for AML, and establishes the diagnosis. The occasional presence of abnormally large blood vessels around the tumour may give new insights into the evaluation of findings from imaging.
VEGF‐C, VEGF‐D and VEGFR‐3 expression in peripheral neuroblastic tumours
Authors: Ramani Pramila , Nash Rachel , Radevsky Lucy , Patel Ameesh , Luckett Michael , Rogers Chris
Published: April 2012

Ramani P, Nash R, Radevsky L, Patel A, Luckett M & Rogers C  (2012) Histopathology VEGF‐C, VEGF‐D and VEGFR‐3 expression in peripheral neuroblastic tumours

Aims:  More than 50% of neuroblastomas (NBs) present with haematogenous and/or lymphatic metastasis; however, little is known about the clinicopathological significance in NBs of the key lymphangiogenesis growth factors vascular endothelial growth factor (VEGF)‐C and VEGF‐D and the receptor VEGFR‐3.

Methods and results:  Ninety‐three NBs and nine ganglioneuromas (GNs) were immunostained for VEGF‐C, VEGF‐D and VEGFR‐3. VEGF‐C and VEGF‐D were present in 76% and 82% of the NBs, respectively. There was no significant difference in VEGF‐C expression between NBs and GNs. VEGF‐D expression was significantly higher in NBs compared with GNs and in MYCN‐amplified NBs. VEGFR‐3 tumoral cell expression (VEGFR‐3c), present in 48% of the NBs, was significantly higher in NBs from children ≥18 months at presentation and those belonging to a high‐risk group. VEGFR‐3 lymphovascular density was increased significantly in NBs compared with GNs and in NBs associated with adverse clinicopathological and biological factors. Lymphovascular invasion, assessed in VEGFR‐3‐stained vessels, was present in ∼50% of NBs. Cox regression analyses demonstrated that VEGFR‐3c expression was associated with a significantly shorter event‐free survival and that its effect was independent of the important pathological variable, mitosis–karyorrhexis index.

Conclusions:  VEGF‐D and VEGFR‐3 up‐regulation support tumour progression in NB and VEGFR‐3c may provide a useful prognostic marker in NBs.
Vasectomy reversal using a microsurgical three‐layer technique: one surgeon’s experience over 18 years with 1300 patients
Authors: Schwarzer J. U.
Published: April 2012

The technique and the results of microsurgical vasectomy reversal in a single‐centre study over 18 years are presented. Both vasovasostomy (VV) and epididymovasostomy (EV) were carried out in a three‐layer technique. With strict adherence to the strategy, end‐to‐end VV was only performed if spermatozoa had been demonstrated at the epididymal stump of the vas. In all other cases, EV was carried out in a preocclusive region of the epididymal tubule. The outpatient procedure of refertilization was associated with a very low complication rate, which underlines its minimal‐invasive character. The follow‐up rate was 71%, the overall patency rate was 89% and the pregnancy rate was 59%. Secondary azoospermia was only observed in 1% of the patients. In relation to the intervals of obstruction, the patency and pregnancy rates were higher after short‐term obstruction than after long‐term obstruction. Correspondingly, higher success rates were found after VV than after EV. This is understandable because the probability for indication of EV increases with longer periods of obstruction. There is a significant discrepancy between patency and pregnancy rates that is likely to be caused by a relevant number of patients with post‐operative asthenozoospermia. The duration of obstruction is an important factor concerning epididymal damage, but it only disproportionately affects the results of refertilization if the technology of EV is implemented consistently in case of an epididymal granuloma. Good clinical results are achieved with this strategy, as evidenced by pregnancy rates and semen analyses.
Asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and L‐arginine in patients with arteriogenic and non‐arteriogenic erectile dysfunction
Authors: Paroni R. , Barassi A. , Ciociola F. , Dozio E. , Finati E. , Fermo I. , Ghilardi F. , Colpi G. M. , Corsi M. M. , Melzi d’Eril G. V.
Published: April 2012

The plasma concentration of asymmetrical dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, has been linked to endothelial dysfunction. We investigated the relation between ADMA, symmetric dimethylarginine (SDMA) and L‐arginine concentrations and erectile dysfunction. We compared plasma levels of ADMA, SDMA and L‐arginine in 61 men in good health with erectile dysfunction of arteriogenic and non‐arteriogenic origin. Diagnosis of erectile dysfunction was based on the International Index of Erectile Function Score and its aetiology was classified with penile echo‐colour‐Doppler in basal condition and after intracavernous injection of prostaglandin E1. The ADMA and SDMA concentrations were significantly higher in men with arteriogenic erectile dysfunction compared with those with erectile dysfunction of non‐arteriogenic origin (p < 0.05) and the concentrations in both subgroups were significantly higher than in controls (p < 0.001). There was a negative correlation between ADMA and International Index of Erectile Function Score only in arteriogenic erectile dysfunction subgroup. L‐arginine did not differ significantly neither between the two erectile dysfunction subgroups (p > 0.05) nor between each of the two erectile dysfunction subgroups and controls (p > 0.05). The L‐arginine/ADMA and the L‐arginine/SDMA ratios in arteriogenic erectile dysfunction subgroups were significantly lower than both in controls (p < 0.05) and in non‐arteriogenic erectile dysfunction patients (p < 0.05); the two ratios in non‐arteriogenic erectile dysfunction patients did not differ from those in the controls (p > 0.05). We conclude that ADMA and SDMA concentrations are significantly higher and L‐arginine/ADMA ratio lower in patients who have arteriogenic erectile dysfunction compared with both patients with non‐arteriogenic erectile dysfunction and controls. The negative correlation between ADMA and severity of erectile dysfunction is present only in patients with arteriogenic erectile dysfunction. This study supports the importance to always distinguish arteriogenic from non‐arteriogenic erectile dysfunction patients to study the complicate erectogenic mechanisms that lead to erectile dysfunction and also to provide potential therapeutic agents for patients with arteriogenic erectile dysfunction.
Pilot scale inulin extraction from chicory roots assisted by pulsed electric fields
Authors: Zhu Zhenzhou , Bals Olivier , Grimi Nabil , Vorobiev Eugene
Published: April 2012

A pilot study for the pulsed electric fields (PEF) assisted countercurrent diffusion of inulin from chicory roots is presented. The influence of PEF parameters (electric field intensity E = 600 V cm−1, treatment duration tPEF = 10–50 ms) and diffusion temperature (varied between 30 and 80 °C) on soluble matter extraction kinetics, inulin content of juice, and pulp exhaustion are investigated. The draft (liquid to solid mass ratio) was fixed at 140%, similar to the industrial conditions. PEF treatment facilitates extraction of inulin at conventional diffusion temperature (70–80 °C), and diffusion temperature can even be reduced by 10–15 °C with comparable juice inulin concentration. Less energy consumption can be achieved by reducing PEF treatment duration to 10 ms, which is observed sufficient for effective extraction.
Stability of polyhydroxylated 1,4‐naphthoquinone pigment recovered from spines of sea urchin Strongylocentrotus nudus
Authors: Zhou Da‐Yong , Zhu Bei‐Wei , Wang Xiao‐Dong , Qin Lei , Li Dong‐Mei , Miao Li , Murata Yoshiyuki
Published: April 2012

The stability of polyhydroxylated 1,4‐naphthoquinone pigment recovered from sea urchin (Strongylocentrotus nudus) spines was observed by spectrophotometer. When pH values changed from 2.0 to 10.0, the pigment showed colour variations. Meanwhile, pH values affected the stability of the pigment. After 24 h of storage, the pigment remained 95.64%, 79.68% and 46.15% of the initial absorbance at pH 3.0, 7.0 and 10.0, respectively. The pigment was prone to degrade on exposure to light. It remained 40.11% of the initial absorbance under natural light after 14 days of storage. Whereas the corresponding value in the dark was 65.14%. Degradation rate of the pigment increased with increasing temperature. The pigment remained 90.49% of the initial absorbance at 20 °C after 24 h of storage. However, the corresponding value decreased to 66.61% at 80 °C. Additives, including antioxidant, oxidising and reducing agents, and some metal ions all affected the stability of the pigment.
Tackling perinatal loss, a participatory action research approach: research protocol
Authors: Pastor‐Montero Sonia María , Romero‐Sánchez José Manuel , Paramio‐Cuevas Juan Carlos , Hueso‐Montoro César , Paloma‐Castro Olga , Lillo‐Crespo Manuel , Castro‐Yuste Cristina , Toledano‐Losa Ana Cristina , Carnicer‐Fuentes Concepción , Ortegón‐Gallego José Alejo , Frandsen Anna J
Published: April 2012

pastor‐montero s.m., romero‐sánchez j.m., paramio‐cuevas j.c., hueso‐montoro c., paloma‐castro o., lillo‐crespo m., castro‐yuste c., toledano‐losa a.c., carnicer‐fuentes c., ortegón‐gallego j.a. & frandsen a.j. (2012) Tackling perinatal loss, a participatory action research approach: research protocol. Journal of Advanced Nursing68(11), 2578–2585.

Aim.  The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research.

Background.  The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations.

Design.  Participatory action research is the methodology proposed to achieve the purpose of this study.

Methods.  Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3 years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health.

Discussion.  Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.
Association between fatigue and Internet addiction in female hospital nurses
Authors: Lin Shih‐Chun , Tsai Kun‐Wei , Chen Miao‐Wen , Koo Malcolm
Published: April 2012

lin s.‐c., tsai k.‐w., chen m.‐w. & koo m. (2012) Association between fatigue and Internet addiction in female hospital nurses. Journal of Advanced Nursing69(2), 374–383. doi: 10.1111/j.1365‐2648.2012.06016.x

Aims.  To report a study conducted to examine the association between fatigue and Internet addiction among female hospital nurses.

Background.  The Internet provides unprecedented convenience for social interaction and information retrieval. Although excessive Internet use has been demonstrated to correlate with fatigue in adolescents, no studies have examined whether it is associated with fatigue in nurses.

Design.  Cross‐sectional survey.

Methods.  The study was conducted in August 2010. Female Registered Nurses working in a regional teaching hospital in southern Taiwan were asked to complete a paper‐based questionnaire. The questionnaire included questions on demographics, the Chen Internet Addiction Scale and the Chalder Fatigue Scale. Multiple linear regression analysis was performed using Chalder fatigue scale as the dependent variable.

Results.  Of the 564 (79% response) valid questionnaires returned, 6 and 10% of the participants were classified as diagnostic cases and possible cases of Internet addiction, respectively. Fatigue levels, adjusting for other potential confounders including work unit, shift work, regular self‐medication, and self‐perceived health status, was significantly associated with both possible cases of Internet addiction and diagnostic cases of Internet addiction.

Conclusion.  This study is the first in reporting a statistically significant association between fatigue levels and Internet addiction in female hospital nurses.

Relevance to clinical practice.  Nurses should pay attention to their Internet activity and whether it adds to their fatigue levels. Addictive behaviour should promptly be dealt with to ensure that the best care is provided to patients.
Environmental conditions associated with bat white‐nose syndrome mortality in the north‐eastern United States
Authors: Flory Abigail R. , Kumar Sunil , Stohlgren Thomas J. , Cryan Paul M.
Published: April 2012

1. White‐nose syndrome (WNS) is an emerging disease of hibernating North American bats that is caused by the cold‐growing fungus Geomyces destructans. Since first observed in the winter of 2007, WNS has led to unprecedented mortality in several species of bats and may threaten more than 15 additional hibernating bat species if it continues across the continent. Although the exact means by which fungal infection causes mortality are undetermined, available evidence suggests a strong role of winter environmental conditions in disease mortality.

2. By 2010, the fungus G. destructans was detected in new areas of North America far from the area it was first observed, as well as in eight European bat species in different countries, yet mortality was not observed in many of these new areas of North America or in any part of Europe. This could be because of the differences in the fungus, rates of disease progression and/or in life‐history or physiological traits of the affected bat species between different regions. Infection of bats by G. destructans without associated mortality might also suggest that certain environmental conditions might have to co‐occur with fungal infection to cause mortality.

3. We tested the environmental conditions hypothesis using Maxent to map and model landscape surface conditions associated with WNS mortality. This approach was unique in that we modelled possible requisite environmental conditions for disease mortality and not simply the presence of the causative agent.

4. The top predictors of WNS mortality were land use/land cover types, mean air temperature of wettest quarter, elevation, frequency of precipitation and annual temperature range. Model results suggest that WNS mortality is most likely to occur in landscapes that are higher in elevation and topographically heterogeneous, drier and colder during winter, and more seasonally variable than surrounding landscapes.

5. Synthesis and applications. This study mapped the most likely environmental surface conditions associated with bat mortality owing to WNS in the north‐eastern United Sates; maps can be used for selection of priority monitoring sites. Our results provide a starting point from which to investigate and predict the potential spread and population impacts of this catastrophic emerging disease.
Which factors predict unsuccessful outcome in a weight management intervention for obese children?
Authors: Fassihi M. , McElhone S. , Feltbower R. , Rudolf M
Published: April 2012

Background:  Many obese children attending weight management interventions experience positive changes; however, not all are successful and little is known about what factors influence treatment outcome. The present study aimed to assess which baseline characteristics may predict unsuccessful treatment outcome in a weight management intervention for obese children.

Methods:  WATCH IT is a community weight management intervention for obese children and their families. Data collected during the pilot phase were visited retrospectively and secondary analysis was performed on the dataset. Inclusion criterion prioritised independent variables for the statistical model aiming to detect those that were exerting a significant effect. Logistic regression was used to assess the ability of these independent variables to predict unsuccessful treatment outcome.

Results:  Seventy‐eight children (mean age 11.9 years) who attended the WATCH IT weight management intervention for at least 6 months were included in the analysis. Multivariable regression analysis showed that children from families where both parents reported having a weight problem were six times more likely to be unsuccessful compared to children from families where neither parent reported weight problems (odds ratio = 6.1; 95% confidence interval = 1.2–32.0; P = 0.032). Age, gender, severity of obesity and duration of previous weight management attempts were not predictive of treatment outcome.

Conclusions:  To increase the overall success rate of children’s weight management interventions such as WATCH IT, current approaches to behaviour change may need to be adapted or tailored for those families who are less likely to be successful. Supporting overweight parents to make their own successful lifestyle changes may be one way of improving the child’s likelihood of weight management success.