bluuebunny/crossref_metadata_2025 huggingface dataset:
A cost‐effective simulation curriculum for preclinical endodontics
Authors: Pileggi Roberta , Glickman Gerald N.
Published: September 2010

A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient‐care clinics in a cost‐effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment‐planning discussions. The specially designed stone typodont used has built‐in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self‐assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full‐time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic‐like teaching style is established by the faculty facilitator to create an environment for developing critical‐thinking and problem‐solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.
The role of historical factors and natural selection in the evolution of breeding systems of Oxalis alpina in the Sonoran desert ‘Sky Islands’
Authors: PÉREZ‐ALQUICIRA J. , MOLINA‐FREANER F. E. , PIÑERO D. , WELLER S. G. , MARTÍNEZ‐MEYER E. , ROZAS J. , DOMÍNGUEZ C. A.
Published: September 2010

Pleistocene climatic oscillations are known to influence the patterns of genetic diversity and the distribution of traits that are the target of selection. Here, we combine phylogeographical and ecological niche modelling (ENM) approaches to explore the influence of historical factors (Pleistocene climatic shifts) and natural selection on the evolution of distyly (two floral morphs) from tristyly (three floral morphs) of Oxalis alpina in the Sky Islands of the Sonoran Desert. Molecular data and ENM indicate that historical factors have had a strong influence on the genetic structure and the geographical distribution of reproductive systems of O. alpina. Moreover, genetic results suggest the possibility that distylous populations do not represent a monophyletic group. We propose that the combined effects of natural selection and genetic drift have influenced the tristyly–distyly transition.
Melanin coloration has temperature‐dependent effects on breeding performance that may maintain phenotypic variation in a passerine bird
Authors: SIRKIÄ P. M. , VIROLAINEN M. , LAAKSONEN T.
Published: September 2010

Fluctuating selection pressure may maintain phenotypic variation because of different types of individuals being adapted to different environmental conditions. We show that the extensive variation in the coloration of male pied flycatchers (Ficedula hypoleuca) can be maintained through differences in the reproductive success of male phenotypes under different conditions. The effects of weather conditions on the relative success of different male phenotypes varied between different phases of breeding. The reproductive output of black males was the highest when it was cold during egg‐laying but warm during the nestling period, whereas the fledgling production of brown males was highest when it was continuously warm. In addition, male forehead and wing patch sizes had context‐dependent effects on timing of breeding and nestling mortality, respectively. These results indicate that environmental heterogeneity plays a role in maintaining phenotypic variation. As melanin‐based coloration is heritable, climate change may alter phenotype frequencies depending on the patterns of warming.
Loggerhead sea turtles (Caretta caretta) as bioturbators in neritic habitats: an insight through the analysis of benthic molluscs in the diet
Authors: Lazar Bojan , Gračan Romana , Katić Jelena , Zavodnik Dušan , Jaklin Andrej , Tvrtković Nikola
Published: September 2010

Molluscs are a diverse and ubiquitous group of organisms which contribute to the formation of biogenic sediments and are one of the major prey taxa for the neritic‐stage loggerhead sea turtles (Caretta caretta) worldwide. Here we investigated to what degree molluscs contribute to the diet of individual turtles, and what role the feeding strategy of loggerheads might play in bioturbation, one of the key processes in nutrient transport in marine ecosystems. We performed a detailed analysis of benthic molluscs from the digestive tracts of 62 loggerhead sea turtles (curved carapace length: 25.0–85.4 cm) found in the Northern Adriatic Sea. From 50 of the turtles that contained benthic molluscs, we identified 87 species representing 40 families and three classes (Gastropoda, Bivalvia and Scaphopoda), including 72 new dietary records for loggerhead turtle. Most of the identified molluscs were small‐sized species (shell length ≤ 3 cm) and were often found in a subfossil condition. Their intake may be considered a byproduct of infaunal mining, while larger molluscs were mainly found crushed into smaller fragments. Through such foraging behaviour loggerheads actively rework sediments, increase the surface area of shells and the rate of shells disintegration, acting as bioturbators in this system. We conservatively estimate that loggerheads in the neritic zone of the Adriatic Sea bioturbate about 33 tonnes of mollusc shells per year, and hypothesize about the possible effects of bioturbation reduction on environmental changes in the Northern Adriatic ecosystem.
How Australian nephrologists view home dialysis: Results of a national survey
Authors: LUDLOW MARIE J , GEORGE CHARLES RP , HAWLEY CARMEL M , MATHEW TIMOTHY H , AGAR JOHN WM , KERR PETER G , LAUDER LYDIA A
Published: September 2010

Aim:  Australia's commitment to home dialysis therapies has been significant. However, there is marked regional variation in the uptake of home haemodialysis (HD) and peritoneal dialysis (PD) suggesting further scope for the expansion of these modalities.

Methods:  Between 1 April and 5 August 2009, Australian nephrologists were invited to complete an online survey. Seventy‐six questions were asked covering characteristics of the dialysis units, responders' experience, adequacy of facilities and support structures, attitudes to the use of home HD and PD and issues impeding the increased uptake of home dialysis.

Results:  Completed surveys were received and analysed from 71 respondents; 27 from Heads of Units (35% response rate) and 44 (16%) from other nephrologists. There was strong agreement that HD with long hours was advantageous and that this was most easily accomplished in the home. PD was not considered to be an inferior therapy. A ‘PD first’ policy existed in 34% of Renal Units. The most commonly reported impediments to expanding home dialysis services were financial disadvantage for home HD patients, and lack of physical infrastructure for training, support and education. Areas of concern for expanding home dialysis programmes included psychiatry support, access to respite care and home visits, and lack of support from medical administration and government. The majority of nephrologists would recommend home dialysis to more patients if these impediments could be overcome.

Conclusion:  This survey identified support from nephrologists for the expansion of home dialysis in Australia and highlighted important barriers to improving access to these therapies.
An exploratory, randomized controlled trial of adherence therapy for people with schizophrenia
Authors: Anderson Kathryn H. , Ford Stephanie , Robson Deborah , Cassis Jimmy , Rodrigues Cristina , Gray Richard
Published: September 2010

Poor adherence limits the effectiveness of antipsychotic treatment in people with psychosis. The aim of the pragmatic, exploratory, single‐masked trial conducted in the USA was to explore the efficacy, acceptability, and satisfaction with adherence therapy (AT) in a sample of people with schizophrenia. Twenty‐six patients (12 experimental and 14 controls) were randomly allocated to receive eight weekly sessions of AT or continue with their treatment as usual (TAU). Patients were assessed at baseline and follow up (after therapy completion). The primary outcome was psychiatric symptoms, assessed using the Positive and Negative Syndrome Scale (PANSS). The secondary outcome, medication adherence, was measured by The Personal Evaluation of Transitions in Treatment. Patients receiving AT did not significantly improve in overall psychiatric symptomatology (change in PANSS total scores: AT: −10.2, TAU: −8.6; mean difference, −1.6; P = ns) or with medication adherence (AT: −2.8, TAU 1.5; P = ns) compared with the TAU group at follow up. Using the Adherence Therapy Patient Satisfaction Questionnaire, a high degree of satisfaction with AT was reported. Although AT did not result in a statistically‐significant improvement in symptoms or medication adherence, evidence of active clinical engagement in treatment occurred.
Impact of Partnership in Coping in mental health recovery: An experimental study at the Federal Neuro‐Psychiatric Hospital, Kaduna
Authors: Gandi Joshua C. , Wai Paul S.
Published: September 2010

Almost everyone, at some point in life, experiences emotional and behavioural problems or psychiatric symptoms, but mental health services reflect only an orthodox medical model which emphasizes cure to the detriment of humanistic focus. Partnership in Coping is an emerging concept, based on recovery alliance theory, which emphasizes partnership to overcome such problems and symptoms. It is a collaboratively‐integrated system that provides opportunity for own problem solving, while one's coping strategies are being empowered. This study was designed to ascertain how Partnership in Coping impacts mental health recovery. It paves the way for remedying problems inherent in the orthodox medical model approach which provide pathological perspective to the detriment of humanistic focus. The participants were 56 service users at the Federal Neuro‐Psychiatric Hospital, Kaduna. The Professional Quality of Life Scale helped in selecting research assistants, while the Mental Health Recovery Measure was used in assessing the post‐treatment behaviour of participants. The experimental group had Partnership in Coping during a 3‐month clinical intervention period, while the control group only had medical treatment. The finding revealed that F (1, 56) = 2268.750, P < 001. Thus, partnership enhances complete recovery from mental illness. This reality changes perception and frees people from stigmatization and hopelessness, thereby influencing service systems.
An exploratory study of resilience and job satisfaction among psychiatric nurses working in inpatient units
Authors: Matos Patricia S. , Neushotz Lori A. , Griffin Mary T. Quinn , Fitzpatrick Joyce J.
Published: September 2010

The present exploratory study was designed to examine the relationship between resilience and job satisfaction in psychiatric nurses working in inpatient units in a large, urban medical centre. The long range goal was to understand the dimensions of job satisfaction in this inpatient environment in order to implement nurse retention programmes specifically targeted toward teaching nurses skills in developing resilience. The nurses (n = 32) reported a high level of resilience and high job satisfaction. The job satisfaction subscale of professional status had the highest mean rating among these nurses, and the physician–nurse interaction subscale had the lowest mean score. Implications for future practice and research are addressed.
Swedish registered psychiatric nurses' descriptions of presence when caring for women with post‐partum psychosis: An interview study
Authors: Engqvist Inger , Ferszt Ginete , Nilsson Kerstin
Published: September 2010

The concept of nursing presence has been widely used in nursing and is a significant component of nursing practice. In order to increase our understanding of nursing presence, it needs to be studied in different contexts. In this study, a secondary analysis of interviews with 10 registered psychiatric nurses (RPN) in Sweden was conducted to explore nurses' descriptions of presence when caring for women with post‐partum psychosis (PPP). Based on the research question: ‘How do RPN describe nursing presence in the context of caring for women with PPP?’ content analysis was used to analyze the data. Three categories emerged: the use of presence to protect, the use of presence to facilitate recovery, and the use of presence for learning. The findings underscore the importance of recognizing nursing presence as a strategy to improve psychiatric nursing for the benefit of the woman and her child, and as an important part of psychiatric nursing when providing compassionate and effective nursing care to this population.
Functional benefits of combined resistance training with nutritional interventions in older adults: A review
Authors: Breen Leigh , Stewart Claire Elizabeth , Onambélé Gladys Léopoldine
Published: September 2010

The demographics of an aging society are undeniable, with a predicted 88% increment in the number of people aged ≥85 by the year 2031. The UK government is facing up to the challenge through increased investment into research into factors associated with maintaining muscle mass and strength, the two main modulators of physical independence in healthy older age. Of these, nutrition and exercise interventions are of great importance as they tend to be relatively easy to implement. The current is therefore a review of available published work in an attempt to determine whether a coherent and/or cohesive message can be had. Recommendations for future studies are also expanded upon to provide a basis for focused research geared towards improving quality of later life.
Functional tooth number and 15‐year mortality in a cohort of community‐residing older people
Authors: Fukai Kakuhiro , Takiguchi Toru , Ando Yuichi , Aoyama Hitoshi , Miyakawa Youko , Ito Gakuji , Inoue Masakazu , Sasaki Hidetada
Published: September 2010

Background:  To study how dental status can become a predictor of overall mortality risk.

Methods:  Community residents (n = 5730) over 40 years old in the Miyako Islands, Okinawa Prefecture, Japan were followed up for 15 years, 1987–2002. Functional tooth numbers were examined by dentists and overall mortalities of subjects with functional tooth numbers of <10 and ≥10 were compared in the age groups 40–49, 50–59, 60–69, 70–79 and 80 years or more in both males and females.

Results:  Groups of 80 years or more showed a significantly higher rate of overall mortality in subjects with functional tooth numbers of less than 10 than 10 or more, and there was no significant difference in the other age groups.

Conclusion:  The present study suggests that systemic attention to dental status should be recommended in older males.
Dehydroepiandrosterone‐sulfate concentration in men from a Japanese longevity district
Authors: Matsumoto Masami , Ishizuka Tatsuo , Kajita Kazuo , Sugiyama Chiyo , Morita Hiroyuki , Uno Yoshihiro , Ikeda Takahide , Mori Ichiro , Matsubara Kenji , Takeda Noriyuki , Yamakita Noriyoshi , Yasuda Keigo
Published: September 2010

Background:  To clarify the effect of dehydroepiandrosterone (DHEA) on the association of DHEA with longevity in male adults in Japan, we measured DHEA‐sulfate (DHEA‐S) concentration in male adults from a Japanese longevity district.

Methods:  We measured serum DHEA‐S concentration, fasting plasma glucose (FPG), 2‐h plasma glucose after 75 g oral glucose loading (2hrPG), fasting insulin (FIRI) and HbA1c, adiponectin of 34 male adults in Kokufu‐cho, one of the highest longevity districts (mean lifespan in males, 80.4 years) and those of 559 male adults in Kasamatsu‐cho (mean lifespan, 77.6 years) as control.

Results:  There was a significant difference of mean age between Kokufu‐cho (72 ± 7 years) and Kasamatsu‐cho (51 ± 8 years) (P < 0.0001). FIRI levels in Kasamatsu‐cho (7.4 ± 3.3 μU/mL) were significantly higher than in Kokufu‐cho (5.3 ± 4.0 μU/mL) (P < 0.005). The quantative insulin sensitivity check index (QUICKI) was significantly higher and homeostasis model assessment was significantly lower in Kokufu‐cho than those in Kasamatsu‐cho (P < 0.001). Serum DHEA‐S concentrations of male adults in Kokufu‐cho, a longevity district of Japan, were significantly higher than in Kasamatsu‐cho as control, if adjusted for age, body mass index and blood glucose (P < 0.0001). Negative correlation of DHEA‐S with age was expectedly found (P < 0.0001) in a total of 593 male adults. Sixteen male adults in Kasamatsu‐cho and 22 male adults in Kokufu‐cho aged 68–73 years were selected. DHEA‐S concentrations of male adults in Kokufu‐cho were significantly higher than in Kasamatsu‐cho, if adjusted for body mass index, body fat composition, blood pressure, lipids values, FIRI and FPG (P < 0.036).

Conclusion:  DHEA may contribute to longevity in elderly men.
Daily living functions of the elderly requiring home visits: A study at a comprehensive assessment clinic for the elderly
Authors: Yamanaka Takashi , Takasugi Emiko , Hotta Norihiro , Kubo Yutaka , Otsuka Kuniaki
Published: September 2010

Background:  To elucidate the characteristics of daily living functions of the elderly requiring home visits.

Methods:  Fifty‐two elderly individuals (17 men and 35 women; age range, 72–95 years; average age, 82.2 ± 5.4 years) who visited a clinic for the elderly underwent comprehensive geriatric assessment. Activities of daily living were assessed using the Barthel Index and Lawton Scale. Cognitive function was assessed using the clock‐drawing test (modified Shulman method), Mini‐Mental State Examination, and the revised version of Hasegawa's Dementia Scale. Depression was assessed using the 15‐item Geriatric Depression Scale. Volition was assessed using the Vitality Index. The 52 participants were divided into two groups: 41 who continued clinic visits after assessment (clinic group: 15 men and 26 women; age range, 72–95 years; average age, 81.5 ± 5.4 years), and 11 who required home visits (visit group: two men and nine women; age range, 75–91 years; average age, 84.7 ± 4.5 years). Various daily living functions were compared between the two groups.

Results:  Barthel Index, Lawton Scale, Mini‐Mental State Examination, and Vitality Index scores were significantly lower in the home group. Moreover, Vitality Index score was low at the start of home visits.

Conclusions:  It is difficult for the elderly with cognitive and physical disorders to make periodical visits to medical institutions and they eventually require home visits. For effective prevention of dependence on nursing care, fragile elderly persons themselves must understand and actively participate in interventions, emphasizing the underlying difficulties associated with such interventions.
Binding and safety profile of novel benzoxazole derivative for in vivo imaging of amyloid deposits in Alzheimer's disease
Authors: Okamura Nobuyuki , Furumoto Shozo , Funaki Yoshihito , Suemoto Takahiro , Kato Motohisa , Ishikawa Yoichi , Ito Satoshi , Akatsu Hiroyasu , Yamamoto Takayuki , Sawada Tohru , Arai Hiroyuki , Kudo Yukitsuka , Yanai Kazuhiko
Published: September 2010

Background:  In vivo detection of amyloid deposits in the brain is potentially useful for early diagnosis of Alzheimer's disease (AD) and tracking the efficacy of anti‐amyloid therapy.

Methods:  To develop an amyloid‐binding agent for positron emission tomography, we screened over 2600 compounds.

Results:  We found benzoxazole derivatives as candidate compounds for in vivo amyloid imaging probes. One of these agents, 2‐(2‐[2‐dimethylaminothiazol‐5‐yl]ethenyl)‐6‐(2‐[fluoro]ethoxy)benzoxazole (BF‐227), displays high binding affinity to Aβ fibrils. BF‐227 binding increased linearly with increasing Aβ fibril formation. In temporal and hippocampal AD brain sections, BF‐227 selectively bound to amyloid plaques. In contrast, no staining was evident in the cerebellum. Compared with the previously reported compound BF‐168, 18F‐labeled BF‐227 displayed selective in vivo labeling of amyloid fibrils and rapid washout from white matter areas in an Aβ‐injected rat model. An acute and subacute toxicity study of BF‐227 indicated sufficient safety for clinical use as a positron emission tomography probe.

Conclusions:  These findings suggest that BF‐227 is feasible as an in vivo imaging probe of amyloid deposits in AD patients.
Case of pneumococcal meningoencephalitis with periodic synchronous discharge patterns on electroencephalogram
Authors: Guo Haiyan , Kawajiri Masakazu , Koizumi Youhei , Ochi Masayuki , Nagai Tokihisa , Nakamura Shunpei , Nagai Ayako , Igase Michiya , Kohara Katsuhiko , Miki Tetsuro
Published: September 2010

A 64‐year‐old man presented with high fever, deep coma, neck stiffness and decorticate rigidity on admission to our hospital. Laboratory findings revealed liver dysfunction, and serial brain computer tomography revealed a right cerebellar hematoma, a small hemorrhage in the left frontal lobe and ischemia of the left corona radiata. Electroencephalogram (EEG) showed periodic synchronous discharge (PSD) patterns on the first occasion, but these disappeared in later EEG. Based on the cerebrospinal fluid findings of increased total protein (1183 mg/dL), increased cells (71/μL) and decreased glucose concentration (1 mg/dL), and the culture result of pure growth of Streptococcus pneumoniae, he was diagnosed as having pneumococcal meningoencephalitis. PSD patterns, though seldom found in bacterial meningoencephalitis, presented in this case probably due to severe infection of the central nervous system and hepatic encephalopathy. We report this case to emphasize that PSD can emerge on EEG in the early stage of pneumococcal meningoencephalitis.
Myeloperoxidase antineutrophil cytoplasmic antibody‐positive bronchiectasis in an elderly patient
Authors: Kadowaki Toru , Hamada Hironobu , Ito Ryoji , Katayama Hitoshi , Sakai Kimiko , Irifune Kazunori , Higaki Jitsuo
Published: September 2010

A 76‐year‐old man with bronchiectasis was hospitalized for a 2‐month history of continuous fever due to exacerbation of the disease. The patient had suffered from bronchiectasis for approximately 50 years. Pseudomonas aeruginosa was persistently detected in his sputum. The patient's serum was positive for myeloperoxidase antineutrophil cytoplasmic antibody (MPO‐ANCA), but there were no symptoms of vasculitis. Antibiotic therapy effectively resolved the disease exacerbation leading to a decrease in the level of MPO‐ANCA.
Association of carotid atherosclerosis with genetic polymorphisms of the klotho gene in patients with hypertension
Authors: Oguro Ryosuke , Kamide Kei , Kokubo Yoshihiro , Shimaoka Izumi , Congrains Ada , Horio Takeshi , Hanada Hironori , Ohishi Mitsuru , Katsuya Tomohiro , Okamura Tomonori , Miyata Toshiyuki , Kawano Yuhei , Rakugi Hiromi
Published: September 2010

Aim:  Previous studies suggest that klotho gene polymorphisms may be associated with atherosclerosis, but did not assess the relationship between klotho gene polymorphisms and atherosclerosis parameters such as carotid artery intima‐media thickness (IMT). Here, we studied whether klotho single nucleotide polymorphisms (SNP) were associated with carotid atherosclerosis.

Methods:  All subjects were Japanese. Eight‐hundred and fifty‐three patients with hypertension (465 men and 388 women) in the outpatient clinic and 1783 subjects from the general population (821 men and 962 women) attending health check‐ups were analyzed in the present study. We measured mean IMT of the common carotid artery to evaluate carotid atherosclerosis. Four single nucleotide polymorphisms (SNP) (rs7323281; intron1, rs5644481; exon4, rs3752472; exon3, rs650439; intron4) of klotho were selected as representative SNP in haplotype blocks.

Results:  Multivariate logistic regression analysis adjusted by confounding factors showed a significant association of rs650439 with carotid atherosclerosis in hypertensive patients (TT vs TA vs AA, P < 0.01; TT + TA vs AA, P < 0.01). By ancova considering confounding factors, rs650439 was also significantly associated with mean IMT (TT + TA vs AA, P = 0.04) in the hypertensive population. However, there was no significant association between klotho SNP and carotid IMT in the general population. Compared to the general population, the subject group with hypertensive patients clearly had more atherosclerosis risk factors.

Conclusion:  Only in hypertensive patients was klotho rs650439 strongly associated with mean IMT thickening of the common carotid artery. Therefore, klotho SNP (rs650439) may influence on the progression of carotid atherosclerosis in patients with hypertension. Geriatr Gerontol Int 2010; 10: 311–318.
Alternative items for identifying hierarchical levels of physical disability by using physical performance tests in women aged 75 years and older
Authors: Kim Mi‐Ji , Yabushita Noriko , Kim Maeng‐Kyu , Matsuo Tomoaki , Okuno Junko , Tanaka Kiyoji
Published: September 2010

Aim:  To identify individuals at hierarchical levels of physical disability by using physical performance tests and to determine threshold values for the discriminating of levels of physical disability in women aged 75 years or older.

Methods:  A cross‐sectional observational study was conducted on 306 community‐dwelling women aged 75 years or order (range, 75–99 years). Physical disability was categorized into no disability, mobility disability and activities of daily living (ADL) disability, by evaluating selected ADL and mobility‐related functional tasks. Physical function tests comprised nine items (such as strength, balance, mobility and walking ability). To assess the observed threshold values, receiver–operator curves were prepared for all the scales.

Results:  The results revealed significant differences among all the pairwise group comparisons in all the performance tests, except in the one‐legged stance, tandem stance and tandem walk tests. The individuals with ADL disability were unable to perform the one‐legged stance (28.9%), tandem stance (32.5%), functional reach (19.3%), tandem walk (61.4%), alternate step (53.0%) and 5‐chair sit‐to‐stand (31.3%) tests. The observed thresholds for discriminating between the no disability and mobility disability groups and between the mobility disability and ADL disability groups were as follows: timed Up & Go test, 8.5 s and 12.7 s; usual gait speed, 1.05 m/s and 0.79 m/s; and grip strength, 19.5 kg and 16.3 kg, respectively.

Conclusion:  Tests for balance and lower extremity strength can be used together to identify or monitor the characteristics of the hierarchical levels of physical disability in women aged 75 years or older. Geriatr Gerontol Int 2010; 10: 302–310.
Final safety and efficacy analysis of the specific endothelin A receptor antagonist zibotentan (ZD4054) in patients with metastatic castration‐resistant prostate cancer and bone metastases who were pain‐free or mildly symptomatic for pain: a double‐blind, placebo‐controlled, randomized Phase II trial
Authors: James Nicholas D. , Caty Armelle , Payne Heather , Borre Michael , Zonnenberg Bernard A. , Beuzeboc Philippe , McIntosh Stuart , Morris Thomas , Phung De , Dawson Nancy A.
Published: September 2010

Study Type – Therapy (RCT) Level of Evidence 1b

OBJECTIVES

To report the final analysis of a Phase II trial, which investigated the safety and efficacy of the specific endothelin A receptor antagonist zibotentan (AstraZeneca, Macclesfield, UK) in patients with metastatic castration‐resistant prostate cancer (CRPC).

PATIENTS AND METHODS

Patients with CRPC and bone metastases who were pain free or mildly symptomatic for pain were randomized to receive once‐daily oral tablets of zibotentan 10 mg, 15 mg or placebo. The primary endpoint was the time to progression and secondary endpoints included overall survival, change in the number of bone metastases, and safety.

RESULTS

In total, 312 patients were randomized (placebo, n= 107; zibotentan 10 mg, n= 107; zibotentan 15 mg, n= 98). The median duration of study treatment and median follow‐up time were 4 and 22 months, respectively. At the final analysis, there were no statistical differences of the primary outcome of time to progression between treatment groups, although an improvement in overall survival was observed in the zibotentan groups compared to placebo. Consistent with the previous analyses for overall survival, hazard ratios (HRs) of less than one were sustained for both zibotentan 15 mg (HR, 0.76; 80% CI, 0.61–0.94; P= 0.103) and 10 mg (HR, 0.83; 80% CI, 0.67–1.02; P= 0.254). The most commonly reported adverse events considered to be related to zibotentan treatment were peripheral oedema, headache and nasal congestion.

CONCLUSIONS

The results obtained in the present study support endothelin A receptor antagonism as an approach for treating patients with CRPC. To confirm the survival signal observed in the present study, zibotentan is being investigated further in the ENdoTHelin A USE (ENTHUSE) Phase III clinical trial programme.
Controversial technology: the Chunnel and the laparoscopic retroperitoneal lymph node dissection (RPLND)
Authors: Schwartz Michael J. , Kavoussi Louis R.
Published: September 2010

• Laparoscopic retroperitoneal lymph node dissection (L‐RPLND) was first introduced in 1992, initially as a staging procedure.

• With advances in instrumentation and laparoscopic techniques, as well as improved understanding of laparoscopic anatomy, L‐RPLND has developed to duplicate open RPLND.

• Unlike the relatively rapid adoption of laparoscopy for other applications including nephrectomy and prostatectomy, L‐RPLND has been slow to be universally accepted.

• The limited numbers of patients requiring RPLND and technical challenges in performing the dissection have undoubtedly contributed to its delayed reception.

• This review will present available data on this technique and discuss issues potentially inhibiting acceptance by traditional surgeons.
Effect of RBP4 gene variants on circulating RBP4 concentration and Type 2 diabetes in a Chinese population
Authors: Hu C. , Jia W. , Zhang R. , Wang C. , Lu J. , Wu H. , Fang Q. , Ma X. , Xiang K.
Published: September 2010

Aims  Retinol binding protein 4 (RBP4) is a newly discovered adipokine, which plays a role in insulin resistance and obesity. The aim of this study was to determine the relationship between genetic variants of the RBP4 gene, circulating RBP4 concentrations and phenotypes related to glucose and lipid metabolism in the Chinese population.

Methods  We sequenced exons and the putative promoter region to identify single nucleotide polymorphisms (SNPs) in the RBP4 gene in 32 Chinese subjects. Additional SNPs were selected from a public database to increase marker density. Taking account of the pairwise linkage disequilibrium and minor allele frequencies, a subset of SNPs was further genotyped in 255 Type 2 diabetic patients and 372 normal control subjects. Circulating RBP4 concentrations and phenotypes related to glucose and lipid metabolism were measured.

Results  Ten SNPs were identified and five were further genotyped in the full sample. No individual SNP was significantly associated with Type 2 diabetes, but a rare haplotype CAA formed by +5388 C>T, +8201 T>A and +8204 T>A was more frequent in diabetic patients (P = 0.0343, empirical P = 0.0659 on 10 000 permutations). In both groups, non‐coding SNPs were associated with circulating RBP4 concentrations (P < 0.05). In the normal control subjects, the SNP +5388 C>T was associated with serum C‐peptide levels both fasting and 2 h after an oral glucose tolerance test (P = 0.0162 and P = 0.0075, respectively).

Conclusion  Our findings suggest that genetic variants in the RBP4 gene may be associated with circulating RBP4 concentration and phenotypes related to glucose metabolism.
Acute hyperglycaemia disturbs cardiac repolarization in Type 1 diabetes
Authors: Gordin D. , Forsblom C. , Rönnback M. , Groop P.‐H.
Published: September 2010

Aims  Patients with Type 1 diabetes have an increased risk of cardiovascular mortality. Notably, a prolonged heart rate adjusted QT interval (QTc) is a predictor of sudden cardiovascular death. Therefore, the objectives of this study were to investigate whether acute hyperglycaemia affects the QTc duration and the QTc dispersion in patients with Type 1 diabetes and in healthy volunteers.

Methods  Acute hyperglycaemia (15 mmol/l) for 120 min was induced in 35 males (22 men with Type 1 diabetes and 13 age‐matched non‐diabetic volunteers). All participants were non‐smokers without any diabetic complications. Electrocardiogram recordings were performed at normoglycaemia and at 0, 60 and 120 min of hyperglycaemia.

Results  Compared with normoglycaemia, acute hyperglycaemia increased the QTc interval in both patients with Type 1 diabetes (390 ± 6 vs. 415 ± 5 ms, P < 0.001) and in healthy volunteers (378 ± 5 vs. 412 ± 8 ms, P < 0.01). During hyperglycaemia, the QTc dispersion was prolonged in healthy volunteers (36 ± 4 ms vs. 54 ± 7 ms, P < 0.05) but not in patients with Type 1 diabetes (45 ± 3 ms at baseline vs. 48 ± 5 ms, NS).

Conclusions  Acute hyperglycaemia alters myocardial ventricular repolarization in patients with Type 1 diabetes and in healthy volunteers and might consequently be an additional risk factor for cardiovascular events.
Prediabetes and the big baby1
Authors: Hadden D. R.
Published: September 2010

The concept of prediabetes has come to the fore again with the worldwide epidemic of Type 2 diabetes. The careful observations of W. P. U. Jackson and his colleagues in Cape Town, South Africa 50 years ago still deserve attention. Maternal hyperglycaemia cannot be the only cause of fetal macrosomia, and the pathophysiological reason for the unexplained stillbirth in late diabetic pregnancy still eludes us. The biochemical concepts of ‘facilitated anabolism’ and ‘accelerated starvation’ were developed by Freinkel as explanations of the protective mechanisms for the baby during the stresses of pregnancy. Some of these nutritional stresses may also occur in the particular form of early childhood malnutrition known in Africa as kwashiorkor, where subcutaneous fat deposition, carbohydrate intolerance, islet hyperplasia and sudden death may follow a period of excess carbohydrate and deficient protein intake. Different feeding practices in different parts of the world make comparisons uncertain, but there is evidence for insulin resistance in both the macrosomic fetus of the hyperglycaemic mother and in the child with established kwashiorkor. These adaptive changes in early development may play both a physiological and a pathological role. Worldwide studies of hyperglycaemia in pregnancy are gradually establishing acceptable diagnostic criteria, appropriate screening procedures and an evidence base for treatment. Nevertheless the challenge of prediabetes and the big baby is still with us—in Jackson's words—‘diabetes mellitus is a fascinating condition—the more we know about it the less we understand it’.
The possible adaptive advantages of terrestrial egg deposition in some fluvial diadromous galaxiid fishes (Teleostei: Galaxiidae)
Authors: McDowall RM , Charteris SC
Published: September 2010

Several diadromous New Zealand and Australian species of Galaxias are now known, or suspected, to deposit their eggs amongst riparian vegetation or substrates either supratidally in estuaries or in forested streams in locations that are only temporarily submerged by elevated water levels. The eggs develop in a humid atmosphere and hatch when the egg deposition sites are resubmerged; a significant role for agitation in stimulating hatching seeming likely. There are risks from the eggs becoming dehydrated, and also from a failure by water to resubmerge the eggs before they have exhausted their energy resources. Hatching is triggered by elevated flows, perhaps being an outcome of agitation of the eggs. Elevated flows may also increase the rate of downstream transport of the larvae, facilitating survival during dispersal to sea from spawning sites in streams that may be long distances inland. Hatching during flood events may favour survival of the larvae because turbid flows may provide ‘cover’ for the larvae as they emigrate to sea. Risks from egg predation by aquatic predators may be replaced by risks from terrestrial predators.
VERTICAL RESTRAINTS UNDER ASYMMETRIC INFORMATION: ON THE ROLE OF PARTICIPATION CONSTRAINTS*
Authors: ACCONCIA ANTONIO , MARTINA RICCARDO , PICCOLO SALVATORE
Published: September 2010

The impact on vertical contracting of a type‐dependent reservation utility is investigated within a sequential monopolies environment with asymmetric information. The welfare and private properties of contracts controlling both the retail price and the sales level are compared with those restricting only sales. When firms choose contracts non‐cooperatively, retail price restrictions are desirable for the upstream supplier although detrimental to consumers, whenever the retailer reservation utility has a relevant impact on optimal contracts. If this impact is relatively weak and contracts are chosen cooperatively, vertical price control fails to maximize firms' joint‐profit although it would be beneficial to consumers.
The Challenges of Climate Policy
Authors: Brennan Timothy J.
Published: September 2010

Climate policy planners and the public should be aware of both economic challenges and arguments that may influence the intensity of the climate policies with which they have to cope. This article examines six economic challenges: cap‐and‐trade versus taxes, non‐price regulations, energy efficiency policies, mitigation versus adaptation, trade effects, and transmission planning. Three additional challenges affect the end itself: ‘fat tails’, discount rates, and whether environmental protection should be evaluated by willingness to pay. If future generations cannot compensate the present for climate policy costs, climate policy is inherently redistributive and cannot be evaluated through cost–benefit analysis alone.
WorkChoices and Howard's Defeat
Authors: Woodward Dennis
Published: September 2010

This article seeks to perform two tasks. It seeks to first detail the changes to the industrial relations system entailed in WorkChoices (set against the background of previous Howard government policies in this field), analyse the Australian Council of Trade Unions (ACTU's) campaign against it and the Australian Labor Party's (ALP's) industrial relations policy in response to it, and belated changes to WorkChoices. Second, it seeks to examine the extent to which WorkChoices (and the industrial relations issue) was decisive in Howard's defeat. This will be done by using Newspoll surveys to plot the revival of ALP electoral support against salient events leading up to the election, drawing upon early post election assessments and existing studies, and also examining the results of the Australian Election Study 2007 to see whether this new evidence confirms the importance of industrial relations in the election outcome.
Where Have All the Ministers Gone?
Authors: Mulgan Richard
Published: September 2010

The relationship between ministers and public servants has been a longstanding topic among students of Australian public administration. Recent debate has centred on issues of supposed politicisation and excessive responsiveness in the Australian Public Service (APS), caused, in part, by the weakened tenure of department heads (secretaries). The recent Moran report has little to say on this relationship. It endorses changes to the appointment processes for secretaries which are presumably designed to strengthen secretaries’ independence from their political masters. It adopts a view of citizen‐centred service and strategic leadership that appears to marginalise ministers. Its approach to public sector leadership is taken from international management theory that works well in a business context and in the United States (US) government system. It is less well‐suited to Westminster‐style systems.
New Millennium, New Public Management and the New Zealand Model
Authors: Duncan Grant , Chapman Jeff
Published: September 2010

Recently the much‐discussed ‘New Zealand model’ of new public management (NPM) has become significantly revised. It now lacks the theoretical coherence and the market‐led focus that it relied on between 1987 and 1996. Labour‐led governments since 1999 have undertaken gradual and pragmatic – yet significant – changes in public management structures and principles, refining and sometimes reversing the model implemented in the late 1980s and early 1990s. This article does a ‘stock‐take’ of public management developments in New Zealand from 1999 to 2008, and argues that New Zealand can no longer be viewed as a leading exponent of market‐led NPM. Some NPM principles have been refined, but others have been quietly abandoned. The new National‐led government appears unwilling to undertake radical reforms, and, while it may seek a greater role for the private sector, looks set to continue with the ‘gradual and pragmatic’ approach adopted since 1999.
Bridging the Gap: Solving Spatial Means–Ends Relations in a Locomotor Task
Authors: Berger Sarah E. , Adolph Karen E. , Kavookjian Alisan E.
Published: September 2010

Using a means–means–ends problem‐solving task, this study examined whether 16‐month‐old walking infants (N = 28) took into account the width of a bridge as a means for crossing a precipice and the location of a handrail as a means for augmenting balance on a narrow bridge. Infants were encouraged to cross from one platform to another over narrow and wide bridges located at various distances from a wooden handrail. Infants attempted to walk over the wide bridge more often than the narrow one and when the handrail was within reach. Infants demonstrated parallel problem solving by modifying exploratory behaviors and bridge‐crossing strategies that simultaneously accounted for the spatial and functional relations between body and bridge, body and handrail, and bridge and handrail.
Tolerance of Practices by Muslim Actors: An Integrative Social‐Developmental Perspective
Authors: Gieling Maike , Thijs Jochem , Verkuyten Maykel
Published: September 2010

Using social‐cognitive domain theory and social identity theory, tolerance judgments of practices by Muslim actors among Dutch adolescents (12–17) were investigated. The findings for Study 1 (N = 180) demonstrated that participants evaluated 4 practices using different types of reasons: personal, social‐conventional, and moral. In Study 2 (N = 970), participants were more tolerant of acts considered to be a personal issue than of acts that pertained to moral issues (social‐conventional acts were in the middle). Furthermore, participants were more tolerant of the particular practices than of campaigns for public support of co‐Muslims for these practices. Level of education, in‐group identification, and multiculturalism had much weaker effects in the moral than in the other domains. Age was negatively related to tolerance.
Gender Differences in Spatial Ability of Young Children: The Effects of Training and Processing Strategies
Authors: Tzuriel David , Egozi Gila
Published: September 2010

A sample of 116 children (M = 6 years 7 months) in Grade 1 was randomly assigned to experimental (n = 60) and control (n = 56) groups, with equal numbers of boys and girls in each group. The experimental group received a program aimed at improving representation and transformation of visuospatial information, whereas the control group received a substitute program. All children were administered mental rotation tests before and after an intervention program and a Global–Local Processing Strategies test before the intervention. The results revealed that initial gender differences in spatial ability disappeared following treatment in the experimental but not in the control group. Gender differences were moderated by strategies used to process visuospatial information. Intervention and processing strategies were essential in reducing gender differences in spatial abilities.
Do Adolescents and Parents Reconstruct Memories About Their Conflict as a Function of Adolescent Attachment?
Authors: Dykas Matthew J. , Woodhouse Susan S. , Ehrlich Katherine B. , Cassidy Jude
Published: September 2010

This study examined whether 17‐year‐old adolescents (n = 189) and their parents reconstructed their memory for an adolescent–parent laboratory conflict over a 6‐week period as a function of adolescent attachment organization. It also compared participants’ perceptions of conflict over time to observational ratings of the conflict to further characterize the nature of the attachment‐related memory biases that emerged. Secure adolescents reconstructed interactions with each parent more favorably over time, whereas insecure adolescents showed less favorable reconstructive memory. Likewise, mothers of secure girls reconstructed conflicts more favorably over time, whereas mothers of insecure boys showed less favorable reconstructive memory. Participant ratings were associated with observational ratings in theoretically consistent ways. Contrary to expectations, fathers showed no attachment‐related memory biases.
Maternal Discussions of Mental States and Behaviors: Relations to Emotion Situation Knowledge in European American and Immigrant Chinese Children
Authors: Doan Stacey N. , Wang Qi
Published: September 2010

This study examined in a cross‐cultural context mothers’ discussions of mental states and external behaviors in a story‐telling task with their 3‐year‐old children and the relations of such discussions to children’s emotion situation knowledge (ESK). The participants were 71 European American and 60 Chinese immigrant mother–child pairs in the United States. Mothers and children read a storybook together at home, and children’s ESK was assessed. Results showed that European American mothers made more references to thoughts and emotions during storytelling than did Chinese mothers, who commented more frequently on behaviors. Regardless of culture, mothers’ use of mental states language predicted children’s ESK, whereas their references to behaviors were negatively related to children’s ESK. Finally, mothers’ emphasis on mental states over behaviors partially mediated cultural effects on children’s ESK.
The Effects of Maltreatment and Neuroendocrine Regulation on Memory Performance
Authors: Cicchetti Dante , Rogosch Fred A. , Howe Mark L. , Toth Sheree L.
Published: September 2010

This investigation examined basic memory processes, cortisol, and dissociation in maltreated children. School‐aged children (age range = 6–13), 143 maltreated and 174 nonmaltreated, were administered the California Verbal Learning Test–Children (D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 1994) in a week‐long camp setting, daily morning cortisol levels were assessed throughout the duration of camp, and behavioral symptoms were evaluated. Maltreatment and cortisol regulation were not related to short‐ or long‐delay recall or recognition memory. However, children experiencing neglect and/or emotional maltreatment and low cortisol evinced heightened false recognition memory. Dissociative symptoms were higher in maltreated children; however, high dissociation was related to recognition inaccuracy only among nonmaltreated children. Results highlight the interplay between maltreatment and hypocortisolism in children’s recognition memory errors.