bluuebunny/crossref_metadata_2025 huggingface dataset:
Studies in haemoglobin E beta‐thalassaemia
Authors: Olivieri Nancy F. , Muraca Giulia M. , O’Donnell Angela , Premawardhena Anuja , Fisher Christopher , Weatherall David J.
Published: June 2010

Haemoglobin E β‐thalassaemia is the commonest form of severe thalassaemia in many Asian countries, but little is known about its natural history, the reasons for its clinical diversity, or its optimal management. Despite its frequency, haemoglobin E β‐thalassaemia is often managed in an ill‐defined and haphazard way, usually by demand transfusion. We studied a cohort of Sri Lankan patients with haemoglobin E β‐thalassaemia over 5 years, and identiﬁed several genetic and environmental factors possibly contributing to the phenotypic diversity of the disorder. These included modiﬁers of haemoglobin F production, malaria and age‐related changes in adaptation to anaemia. Our ﬁndings suggest that in many patients, haemoglobin E β‐thalassaemia can be managed without transfusion, even with low haemoglobin levels. Age‐related changes in the pattern of adaptation to anaemia suggest that more cost‐effective approaches to management should be explored.
Multiple bacteria contribute to intraplaque T‐cell activation in atherosclerosis
Authors: Van Der Meer J. J. , Van Der Wal A. C. , Teeling P. , Idu M. M. , Van Der Ende A. , De Boer O. J.
Published: June 2010

Background  Infection with microorganisms is considered a pathogenic factor in atherogenesis. Several studies have shown the presence of a broad spectrum of bacterial species in atherosclerotic plaques, which could trigger local inflammation. Because T cells contribute to atherosclerotic plaque inflammation, we studied the responsiveness of human plaque derived T‐cell cultures to bacteria of different species.

Materials and methods  Primary polyclonal T‐cell cultures were generated from both carotid endarterectomy tissue and peripheral blood of nine patients, and the peripheral blood of eight matched controls. The in vitro proliferative responses of the T‐cell cultures against H. pylori, N. meningitidis, N. lactamica, S. aureus, S. pneumoniae, S. epidermidis and E. coli were analysed. T‐cell proliferation was measured by 3H‐thymidine incorporation and expressed as a stimulation index. Selective outgrowth of intraplaque microbial specific T cells was studied by calculating the ratio of plaque T‐cell SI and peripheral blood T‐cell SI in each patient.

Results  All patients showed T‐cell responsiveness to multiple bacteria in their plaque tissue. Stimulation indices were in the range of 0·3–30, and this degree of reactivity with the different species was heterogeneous among patients. Selective outgrowth (plaque/peripheral blood ratio) of T cells against multiple bacteria was observed in six out of nine patients.

Conclusions  T cells in atherosclerotic plaques have the capacity to selectively respond to antigens of a wide variety of microbial antigens. This supports the view that such mechanisms could contribute to the atherosclerotic inflammatory response.
Effects of telmisartan and enalapril on renoprotection in patients with mild to moderate chronic kidney disease
Authors: Nakamura Tsukasa , Fujiwara Nobuharu , Kawagoe Yasuhiro , Sugaya Takeshi , Ueda Yoshihiko , Koide Hikaru
Published: June 2010

Eur J Clin Invest 2010; 40 (9): 790–796

Background  Blocking the renin–angiotensin system (RAS) with angiotensin receptor blockers or angiotensin‐converting enzyme inhibitors protects against renal injury in patients with chronic kidney disease (CKD). The aim of this study was to compare the chronic effects of telmisartan and enalapril on proteinuria, urinary liver‐type fatty acid‐binding protein (L‐FABP) and endothelin (ET)‐1 levels in patients with mild CKD.

Materials and methods  Thirty CKD patients with mild to moderate renal insufficiency (20 men and 10 women; mean age, 37 years; estimated glomerular filtration rate (eGFR) > 60 mL min−1 and blood pressure > 130/85 mmHg) were included in the study. Patients were randomly assigned to receive telmisartan at 80 mg day−1 (n = 15) or enalapril at 10 mg day−1 (n = 15). We measured blood pressure, serum creatinine, eGFR, urinary protein, L‐FABP and ET‐1 before the start of treatment and 6 and 12 months after the start of treatment.

Results  The blood pressure reduction rate was similar between the two groups. Urinary protein, L‐FABP and ET‐1 levels were significantly reduced in both groups 6 and 12 months (P < 0·001) after treatment, but the reduction rates were more pronounced in patients receiving telmisartan than in those receiving enalapril (P < 0·001). Estimated glomerular filtration rate was increased similarly in both groups at 12 months.

Conclusions  The study results suggest that telmisartan results in a greater reduction of urinary markers than does enalapril and that this effect occurs by a mechanism independent of blood pressure reduction. It would be needed to investigate whether the differences may be distinct or not the same when other dosages are used.
Local exposure shapes spatial patterns in infectivity and community structure of Daphnia parasites
Authors: Jansen Mieke , Stoks Robby , Decaestecker Ellen , Coors Anja , Van De Meutter Frank , De Meester Luc
Published: June 2010

1. Spatial patterns in parasite community structure are probably driven by the availability of infectious stages. This is because hosts become infected through picking up infectious stages from their environment. Several studies have, however, reported strong genotype by genotype interactions and parasite‐mediated selection in hosts. This leads to the prediction of a parasite by host population interaction with respect to infection rates and intensities, which may also shape spatial patterns in parasite community structure.

2. Using the water flea Daphnia magna and its microparasites as a model, we carried out a laboratory experiment to test explicitly to what extent parasite community structure in host populations is determined by the availability of infectious stages in the sediment they are exposed to, and to what extent host population identity and location play a role.

3. We exposed 10 D. magna host populations each to sediment of their own habitat and sediment of the other nine habitats, and monitored the parasite community of the resulting experimental populations.

4. Sediment seems to be a strong determinant of parasite infection rates, while there was no overall effect of host population. Sympatric parasite and host population combinations did in most cases not result in significantly different infection rates than allopatric parasite and host combinations. Our results indicate that spore availability could be the key variable determining parasite community structure in natural Daphnia populations.
Oxylipin channelling in Nicotiana attenuata: lipoxygenase 2 supplies substrates for green leaf volatile production
Authors: ALLMANN SILKE , HALITSCHKE RAYKO , SCHUURINK ROBERT C. , BALDWIN IAN T.
Published: June 2010

Lipoxygenases (LOXs) are key enzymes in the biosynthesis of oxylipins, and catalyse the formation of fatty acid hydroperoxides (HPs), which represent the first committed step in the synthesis of metabolites that function as signals and defences in plants. HPs are the initial substrates for different branches of the oxylipin pathway, and some plant species may express different LOX isoforms that supply specific branches. Here, we compare isogenic lines of the wild tobacco Nicotiana attenuata with reduced expression of NaLOX2 (irlox2) or NaLOX3 (irlox3) to determine the role of these different LOX isoforms in supplying substrates for two different pathways: green leaf volatiles (GLVs) and jasmonic acid (JA). Reduced NaLOX2 expression strongly decreased the production of GLVs without influencing the formation of JA and JA‐related secondary metabolites. Conversely, reduced NaLOX3 expression strongly decreased JA biosynthesis, without influencing GLV production. The temporal expression of NaLOX2 and NaLOX3 also differed after elicitation; NaLOX3 was rapidly induced, attaining highest transcript levels within 1 h after elicitation, whereas NaLOX2 transcripts reached maximum levels after 14 h. These results demonstrate that N. attenuata channels the flux of HPs through the activities of different LOXs, leading to different direct and indirect defence responses mediating the plant's herbivore resistance.
Role of inositol 1,4,5‐triphosphate signalling in gravitropic and phototropic gene expression
Authors: SALINAS‐MONDRAGON RAUL E. , KAJLA JYOTI D. , PERERA IMARA Y. , BROWN CHRISTOPHER S. , SEDEROFF HEIKE WINTER
Published: June 2010

Plants sense light and gravity to orient their direction of growth. One common component in the early events of both phototropic and gravitropic signal transduction is activation of phospholipase C (PLC), which leads to an increase in inositol 1,4,5‐triphosphate (InsP3) levels. The InsP3 signal is terminated by hydrolysis of InsP3 through inositolpolyphosphate‐5‐phosphatases (InsP 5‐ptases). Arabidopsis plants expressing a heterologous InsP 5‐ptase have low basal InsP3 levels and exhibit reduced gravitropic and phototropic bending. Downstream effects of InsP3‐mediated signalling are not understood. We used comparative transcript profiling to characterize gene expression changes in gravity‐ or light‐stimulated Arabidopsis root apices that were manipulated in their InsP3 metabolism either through inhibition of PLC activity or expression of InsP 5‐ptase. We identified InsP3‐dependent and InsP3‐independent co‐regulated gene sets in response to gravity or light stimulation. Inhibition of PLC activity in wild‐type plants caused similar changes in transcript abundance in response to gravitropic and phototropic stimulation as in the transgenic lines. Therefore, we conclude that changes in gene expression in response to gravitropic and phototropic stimulation are mediated by two signal transduction pathways that vary in their dependence on changes in InsP3.
Serum allergen‐specific immunoglobulin E in atopic and healthy cats: comparison of a rapid screening immunoassay and complete‐panel analysis
Authors: Diesel Alison , DeBoer Douglas J.
Published: June 2010

Feline and canine atopic dermatitis are thought to have a similar immunopathogenesis. As with dogs, detection of allergen‐specific IgE in cat serum merely supports a diagnosis of feline atopy based on compatible history, clinical signs and elimination of other pruritic dermatoses. In this study, a rapid screening immunoassay (Allercept® E‐Screen 2nd Generation; Heska AG, Fribourg, Switzerland; ES2G) was compared with a complete‐panel serum allergen‐specific IgE assay (Allercept®; Heska AG; CP) in healthy cats with no history of skin disease and in atopic cats. The latter had no diagnosis of external parasitism, infection, food hypersensitivity or other skin disease explaining their pruritus, and expressed cutaneous reaction patterns typically associated with feline allergic skin disease (head, neck or pinnal pruritus, miliary dermatitis, self‐induced alopecia, eosinophilic granuloma complex). The proportion of cats positive on either the ES2G or the CP assays was not significantly different between the atopic and healthy cat groups. There was, however, strong agreement between the results of the ES2G and CP assay; overall, the two tests were in agreement for 43 of 49 (88%) serum samples. There was also strong agreement when individual allergen groups were evaluated (agreement noted: indoor, 41 of 49 samples; grasses/weeds, 37 of 49 samples; and trees, 41 of 49 samples). These results indicate that although neither test is diagnostic for feline atopic dermatitis, the screening assay is beneficial for predicting the results of a complete‐panel serum allergen‐specific IgE assay in cats.
Discrimination between moderate and severe disease may be used in patients with either treated or untreated allergic rhinitis
Authors: Valero A. , Ferrer M. , Baró E. , Sastre J. , Navarro A. M. , Martí‐Guadaño E. , Dávila I. , Del Cuvillo A. , Colás C. , Antépara I. , Alonso J. , Mola O. , Izquierdo I. , Mullol J.
Published: June 2010

To cite this article: Valero A, Ferrer M, Baró E, Sastre J, Navarro AM, Martí‐Guadaño E, Dávila I, del Cuvillo A, Colás C, Antépara I, Alonso J, Mola O, Izquierdo I, Mullol J. Discrimination between moderate and severe disease may be used in patients with either treated or untreated allergic rhinitis. Allergy 2010; 65: 1609–1613.

Background:  Allergic rhinitis (AR) is a common disease with major socioeconomic burden and a significant impact on quality of life.

Objective:  The aim of this study was to discriminate between moderate and severe AR patients whether receiving treatment or not, using a modified criterion of allergic rhinitis and its impact on asthma (ARIA) classification.

Methods:  The modified ARIA severity classification (J Allergy Clin Immunol, 120, 2007, 359) categorizes AR as mild (no items affected), moderate (1–3 items affected), and severe (all four items affected). We applied these criteria to 1666 treated and 1058 untreated AR patients and compared their symptoms total four‐symptom score (T4SS) and quality of life (ESPRINT‐15), according to their clinical severity.

Results:  Allergic rhinitis clinical status was significantly worse (P < 0.001) in treated than in untreated patients. For both treated and untreated patients, T4SS and ESPRINT‐15 Quality of life scores were significantly worse (P < 0.001) in severe than in moderate patients.

Conclusions:  The modified ARIA severity classification is a useful clinical tool to discriminate moderate from severe AR among both treated and untreated patients.
Management of anaphylaxis in primary care: Canadian expert consensus recommendations
Authors: Waserman S. , Chad Z. , Francoeur M. J. , Small P. , Stark D. , Vander Leek T. K. , Kaplan A. , Kastner M.
Published: June 2010

To cite this article: Waserman S, Chad Z, Francoeur MJ, Small P, Stark D, Vander Leek TK, Kaplan A, Kastner M. Management of anaphylaxis in primary care: Canadian expert consensus recommendations. Allergy 2010; 65: 1082–1092.

Background:  Anaphylaxis is often managed inadequately. We used findings from a systematic review of gaps in anaphylaxis management to develop evidence‐based recommendations for gaps rated as clinically important by a panel of Canadian allergy experts.

Methods:  The nominal group technique (NGT) consensus methodology was used to develop evidence‐based recommendations for the management of anaphylaxis in primary care. Physician‐specific gaps from our systematic review were prioritized by consensus meeting participants in two rounds, which involved the rating, discussion, and re‐rating of gaps. Using current anaphylaxis guidelines, recommendations were then developed for each category of gaps that were identified by the panel as clinically important.

Results:  Thirty unique physician gaps from the systematic review were categorized according to gaps of knowledge and anaphylaxis practice behaviors. The panel rated diagnosis of anaphylaxis, and when and how to use epinephrine auto‐injectors as clinically important knowledge gaps; and rated infrequent or delayed epinephrine administration, low rate of auto‐injector prescription, and infrequent or no referrals to allergy specialists after a reaction as important practice behavior gaps. Evidence from four guidelines was used to support the consensus recommendation statements for three resulting categories of gap themes: anaphylaxis management, epinephrine use, and follow‐up care.

Conclusion:  We used an NGT consensus methodology to develop an educational resource for primary care physicians and allergists to better understand how to manage patients with anaphylaxis. Next steps include testing our findings against observed data in primary care settings and to develop other strategies or tools to overcome gaps in anaphylaxis management.
Allergen cross reactions: a problem greater than ever thought?
Authors: Pfiffner P. , Truffer R. , Matsson P. , Rasi C. , Mari A. , Stadler B. M.
Published: June 2010

To cite this article: Pfiffner P, Truffer R, Matsson P, Rasi C, Mari A, Stadler BM. Allergen cross reactions: a problem greater than ever thought? Allergy 2010; 65: 1536–1544.

Background:  Cross reactions are an often observed phenomenon in patients with allergy. Sensitization against some allergens may cause reactions against other seemingly unrelated allergens. Today, cross reactions are being investigated on a per‐case basis, analyzing blood serum specific IgE (sIgE) levels and clinical features of patients suffering from cross reactions. In this study, we evaluated the level of sIgE compared to patients’ total IgE assuming epitope specificity is a consequence of sequence similarity.

Methods:  Our objective was to evaluate our recently published model of molecular sequence similarities underlying cross reactivity using serum‐derived data from IgE determinations of standard laboratory tests.

We calculated the probabilities of protein cross reactivity based on conserved sequence motifs and compared these in silico predictions to a database consisting of 5362 sera with sIgE determinations.

Results:  Cumulating sIgE values of a patient resulted in a median of 25–30% total IgE. Comparing motif cross reactivity predictions to sIgE levels showed that on average three times fewer motifs than extracts were recognized in a given serum (correlation coefficient: 0.967). Extracts belonging to the same motif group co‐reacted in a high percentage of sera (up to 80% for some motifs).

Conclusions:  Cumulated sIgE levels are exaggerated because of a high level of observed cross reactions. Thus, not only bioinformatic prediction of allergenic motifs, but also serological routine testing of allergic patients implies that the immune system may recognize only a small number of allergenic structures.
The Influence of Maternal Quality on Brood Sex Allocation in the Small Carpenter Bee, Ceratina calcarata
Authors: Rehan Sandra M. , Richards Miriam H.
Published: June 2010

In the twig‐nesting carpenter bee, Ceratina calcarata, body size is an important component of maternal quality, smaller mothers producing significantly fewer and smaller offspring than larger mothers. As mothers precisely control the sex and size of each offspring, smaller mothers might compensate by preferentially allocating their investment towards sons. We investigated whether variation in maternal quality leads to variation in sex allocation patterns. At the population level, the numerical sex ratio was 57% male‐biased (1.31 M/F), but the investment between the sexes was balanced (1.02 M/F), because females are 38% larger than males (1.28 F/M). Maternal body size explained both sex allocation pattern and size variation among offspring: larger mothers invested more in individual progeny and produced more female offspring than smaller mothers. Maternal investment in offspring of both sexes decreased throughout the season, probably as a result of increasing maternal wear and age. The exception to this pattern was the curious production of dwarf females in the first two brood cell positions. We suggest that the sex ratio distribution reflects the maternal body size distribution and a constraint on small mothers to produce small broods. This leads to male‐biased allocation by small females, to which large mothers respond by biasing their allocation towards daughters.
Retinal haemorrhage in abusive head trauma
Authors: Morad Yair , Wygnansky‐Jaffe Tamara , Levin Alex V
Published: June 2010

Abstract

Paediatric abusive head injury may have grave consequences, especially when characterized by repetitive acceleration–deceleration forces (shaken baby syndrome). Death occurs in approximately 30% and permanent neurologic damage in up to 80% of the victims. Retinal haemorrhages are a cardinal sign seen in approximately 85% of cases. In most cases haemorrhages are preretinal, intraretinal and subretinal, too numerous to count, and involving the entire retinal surface extending to the ora serrata. Traumatic macular retinoschisis is a lesion with important diagnostic significance. Vitreoretinal traction appears to be the mechanism of haemorrhage and schisis formation along with a possible role of orbital tissue trauma from repetitive acceleration–deceleration forces. Ophthalmologists must carefully document ocular findings. Appropriate autopsy examination should include ocular and orbital tissue removal. Although there is a wide differential diagnosis for retinal haemorrhages, clinical appearance, when considered in the context of systemic and laboratory findings, usually leads to the correct diagnosis.
Abiotic effects predominate under prolonged livestock‐induced disturbance
Authors: ELDRIDGE DAVID J. , VAL JAMES , JAMES ALEX I.
Published: June 2010

Despite the widespread recognition that disturbance by livestock affects multiple indices of landscape health, few studies have examined their effects on both biotic and abiotic processes. We examined the effects of livestock disturbance on soil, vascular plants and reptiles across a disturbance gradient in a semi‐arid Australian woodland. Our gradient ranged from long‐ungrazed water remote sites, through intermediately grazed recovering sites, to currently grazed sites close to water. Our aim was to examine the nature of the effects of grazing‐induced disturbance on biotic and abiotic processes along the gradient. We detected small biotic effects, but no abiotic effects, at low levels of disturbance (intermediate sites). We could not detect a consistent biotic effect on plants or reptiles along the gradient, except between the extreme disturbances. In contrast, we recorded substantial reductions in abiotic structure and function at the most disturbed sites. Structural changes included reductions in the cover of shrub hummocks and increases in bare soil, and reductions in cryptogamic soil crusts. Structural changes were associated with declines in function (soil stability and nutrient indices). Our data are consistent with the notion that abiotic effects predominate at high levels of disturbance in rangelands. Given the extent of abiotic modification at currently grazed sites, the cover of abiotic elements such as hummocks and soil surfaces would seem a better indicator of the long‐term effect of grazing‐induced disturbance than biotic components. The extent of disturbance at currently grazed sites across large areas of rangeland suggests that autogenic recovery will be protracted.
Advanced age is a significant determinant of poor prognosis in patients treated with surgery plus postoperative radiotherapy for endometrial cancer
Authors: Okuma Kae , Yamashita Hideomi , Kawana Kei , Nakagawa Shunsuke , Oda Katsutoshi , Nakagawa Keiichi
Published: June 2010

Aim:  A review was conducted in which the effect of age on survival was assessed in a population of endometrial cancer patients treated with surgery and adjuvant radiation therapy in our institution.

Methods:  From 1988 to 2008, 111 endometrial cancer patients underwent total abdominal hysterectomy and adjuvant whole pelvic radiation therapy (RT). After surgery, for patients with low or intermediate risk without lymph node metastasis, no postoperative adjuvant therapy was performed. For patients with high risk or positive cytology from the abdominal cavity, postoperative radiation therapy was performed. A total dose of 50–50.4 Gy of RT was delivered sequentially. Forty‐four patients (44%) were given chemotherapy consisting of epirubicin/cisplatin/carboplatin or paclitaxel/carboplatin. Univariate and multivariate analyses were performed to identify significant prognostic clinicopathological factors.

Results:  With a median follow‐up time of 59.2 months, the 5‐year overall survival was 74% for those 60 years or older versus 90% for those younger than 60 years (P = 0.044). For disease‐free survival, it was 65% for those 60 years or older, versus 85% for those younger than 60 years (P = 0.013). On multivariate analysis, poor disease‐free survival was associated with age ≥ 60 years (P = 0.035).

Conclusions:  Older patients (age ≥ 60 years) with endometrial cancer had significantly lower overall survival and disease‐free survival following postoperative RT independent of other prognostic factors and/or treatment technique.
Splenic metastasis from cervical cancer: Case report and review of the literature
Authors: Di Donato Violante , Palaia Innocenza , Perniola Giorgia , Polidori Nicoletta , Burratti Moira , Besharat Aris , Benedetti Panici Pierluigi
Published: June 2010

Cervical cancer isolated splenic recurrence is a rare event. We report a case of splenic cervical cancer metastasis treated with salvage surgery 30 months after supralevator anterior pelvic exenteration. In this patient the plasmatic level of squamous cell carcinoma antigen increased in the absence of any evidence of disease at the instrumental examination 24 months after surgery. Surgery had a high impact on quality of life.
Single nedaplatin treatment as salvage chemotherapy for platinum/taxane‐resistant/refractory epithelial ovarian, tubal and peritoneal cancers
Authors: Goto Tomoko , Takano Masashi , Ohishi Rie , Iwasa Norihiro , Shimizu Motohiro , Hasegawa Kosei , Nagao Shoji , Fujiwara Keiichi
Published: June 2010

Aim:  To evaluate toxicity, response and progression‐free survival of single nedaplatin chemotherapy in women with platinum/taxane‐resistant/refractory epithelial ovarian, tubal and peritoneal cancer.

Methods:  Seventeen patients with platinum/taxane‐resistant/refractory epithelial ovarian, fallopian tube or primary peritoneal cancer who were treated with a single nedaplatin regimen at 90 mg/m2 administration on day 1 of a 28‐day cycle in our institution between 2005 and 2007 were retrospectively investigated.

Results:  Ten of 17 patients (59%) had measurable disease. Seven patients were evaluated according to cancer antigen (CA) 125 levels. The overall response was 24% (complete response, 2 patients; partial response, 2 patients). Two of these 4 patients had measurable disease. Stable disease and progressive disease was noted in 6 (35%) and 7 (41%) patients. Median progression‐free survival was 8 months (range 3–11) in patients who responded to therapy and 4 months (range 2–6) in patients with stable disease. Mean platinum‐free interval due to treatment without using platinum analogues after developing platinum‐resistant/refractory disease was 11 months (range 8–12) in patients who responded to nedaplatin regimen and 3 months (range 1–11) in patients who did not (P < 0.01), whereas mean treatment‐free interval was 3 months (range 1–5) in responders and 1 month (range 1–3) in non‐responders, which did not show a significant difference. Grade 4 hematological toxicity was observed in 2 of 17 patients (12%). No grade 3 or 4 non‐hematological toxicity occurred. All toxicities were managed on an outpatient basis.

Conclusions:  Single nedaplatin treatment for platinum/taxane‐resistant/refractory ovarian, tubal and peritoneal cancer patients is the candidate of salvage chemotherapy with comparable effectiveness and less toxicity to other approved regimens.
Optimizing the detection of subclinical inguinal hernias in men undergoing open radical retropubic prostatectomy
Authors: Marien Tracy , Taouli Bachir , Telegrafi Shpetim , Babb James , Lepor Herbert
Published: June 2010

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b

OBJECTIVE

To evaluate the role of magnetic resonance imaging (MRI) and up‐standing ultrasonography (USUS) for the detection of inguinal hernias (IHs) before open radical retropubic prostatectomy (ORRP) and to assess factors associated with the presence of IHs in these men.

PATIENTS AND METHODS

From 1 July 2007 to 1 February 2009, 164 men underwent preoperative evaluation for ORRP by one surgeon. Of these men 113 (69%) were evaluated for IHs by physical examination (PE), USUS and MRI. In all 226 groins were examined. Any IH diagnosed by any method was considered a true positive. The sensitivity, negative predictive value (NPV), and concordance were calculated for the three diagnostic methods. Possible predictive factors of IHs were evaluated.

RESULTS

Of the 226 groins evaluated, 72 (32%) IHs were diagnosed. USUS had the greatest sensitivity (69.4%) and the highest NPV (87.5%). MRI had fair agreement with PE and USUS, while USUS and PE had moderate agreement with each other. No factor was associated with an increased likelihood of preoperative diagnosis of IH.

CONCLUSIONS

This study was limited by the lack of a reference standard to diagnose IH. USUS was the most sensitive method for the detection of IH. We recommend that all men undergoing ORRP should be evaluated for IHs by PE and at least one imaging method and that IHs be repaired at the time of ORRP, obviating the need for a second surgical procedure.
Urinary incontinence in persons with Prader‐Willi Syndrome
Authors: Von Gontard Alexander , Didden Robert , Sinnema Margje , Curfs Leopold
Published: June 2010

Study Type – Symptom prevalence (non‐consecutive cohort) Level of Evidence 3b

OBJECTIVE

To assess and identify the frequency and type of urinary incontinence (UI), as well as associated symptoms in persons with Prader‐Willi syndrome (PWS). PWS is characterized by mental retardation, short stature, obesity and hypogonadism. The behavioural phenotype includes eating problems, temper outbursts, affective disorders, stereotypies and speech abnormalities. UI is common in children with mental retardation in general, but has not been reported systematically in children with PWS so far.

MATERIALS AND METHODS

The Dutch version of the ‘Parental Questionnaire: Enuresis/Urinary Incontinence’ was completed by 118 parents of children with PWS. This questionnaire includes items referring to day‐ and night‐time wetting, toilet habits, observable voiding behaviours and reactions, urinary tract infections, stool habits and behavioural symptoms.

RESULTS

The rate of nocturnal enuresis in persons with PWS was 13.6% (16) at a mean age of 15.1 years. 3.8% (5) had additional daytime urinary incontinence, and 3.3% (4) had faecal incontinence. Lower urinary tract symptoms were commonly indicative of overactive bladder, dysfunctional voiding and postponement. Also, the rate of internalizing and externalizing behavioural problems was high.

CONCLUSION

Urinary incontinence is more common in persons with PWS than in typically developing children, adolescents and adults. As lower urinary tract symptoms are common, detailed assessment and specific treatment of UI should be part of the care of all persons with PWS.
Relationship between lower urinary tract symptoms and serum levels of sex hormones in men with symptomatic benign prostatic hyperplasia
Authors: Favilla Vincenzo , Cimino Sebastiano , Castelli Tommaso , Madonia Massimo , Barbagallo Ignazio , Morgia Giuseppe
Published: June 2010

Study Type – Aetiology (case series) Level of Evidence 4

OBJECTIVES

To investigate a possible association between the severity of lower urinary tract symptoms (LUTS) and the serum levels of sex hormones in men with symptomatic benign prostatic hyperplasia (BPH) that underwent surgery for severe benign prostatic obstruction.

PATIENTS AND METHODS

In all, 127 selected men with symptomatic BPH attending our urology clinic were recruited. The clinical conditions of BPH were assessed by digital rectal examination, serum prostate‐specific antigen (PSA) determination, International Prostate Symptom Score (IPSS), transrectal ultrasonography and maximum urinary flow rate (Qmax) value at uroflussimetry. Before surgery, we measured the serum concentrations of total testosterone (TT) and free testosterone (FT), oestradiol, prolactin, luteinizing hormone and follicle‐stimulating hormone. We excluded men with endocrine diseases, those with prostate disease who were receiving antiandrogen therapy and those with psychological diseases. The relationships between the IPSS score and serum sex hormone levels were determined.

RESULTS

The final study population consisted of 122 men (mean age of 70.66 years), as five were excluded (three due to incomplete evaluation and two who were diagnosed with prostate cancer). On statistical analysis, the total IPSS was significantly associated with age (r= 0.405, P < 0.001) and TT (r= 0.298, P= 0.020) but not with FT or the serum levels of the other sex hormones. The serum levels of testosterone and IPSS did not correlate with prostate volume and Qmax. PSA level and age correlated with prostate volume (r= 0.394, P < 0.001; r = 0.374, P < 0.001, respectively). We distinguished two subgroups of patients: the first group of 40 men with an IPSS of <19 and the second group of 82 with an IPSS of >19, and we evaluated the median levels of TT in each group. There was an increased risk of LUTS in men with a greater serum concentration of TT (P= 0.042), although the mean TT level was in the normal range.

CONCLUSIONS

In the present study, the severity of LUTS was associated with age and serum levels of TT but only age correlated with the measures of BPH, especially prostate volume. The potential effects of testosterone on LUTS may well be indirect. Additional large studies are needed to confirm these preliminary results.
THE LONG GAME
Authors: CRAINER STUART
Published: June 2010

Alibaba puts its mission, vision and values at centre stage. David Wei (CFE98), CEO of Alibaba.com, talks to Stuart Crainer about playing a unique long game.
IDEAS AT WORK: THE REALITY OF COSTS
Authors: GODDARD JULES
Published: June 2010

If you think that cost cutting is the surest way to business success, Jules Goddard wants to challenge every assumption you hold. Costs are an outcome of a sound strategy, he argues, never the goal of a strategy. Here, he offers a new perspective on what counts when it comes to costs.
Face Values: Responsibility Inc.
Authors: CONNOLLY JOHN
Published: June 2010

Investment and growth in emerging markets will bring new opportunities, but with them added responsibility. Will companies be able to rise to meet the new responsibility agenda? Deloitte's John Connolly thinks so and argues that the business case is overwhelming.
Financial Research in the European Region: a Long‐Term Assessment (1990–2008)
Authors: Chan Kam C. , Chang Chih‐Hsiang , Chen Carl R.
Published: June 2010

We provide a long‐term comprehensive assessment of financial research in the European region. As with earlier findings in Chan et al. (2004), the European academic institutions, as a group, perform very well during the 1990–2008 period. Specifically, European institutions exhibit a steady increase in the share of global financial research. During the sample period, the top five institutions were London Business School, INSEAD, Sir John Cass Business School, London School of Economics, and Erasmus University Rotterdam. Subperiod analysis shows that some universities, such as Oxford University, increased their research output substantially. Many of the leading European scholars received their training and had prior experience in North American institutions. We find that a high ranking of the scholars’ affiliated and doctoral granting institutions is correlated with finance research productivity.
One World, Two Cultures? Alfred Zimmern, Julian Huxley and the Ideological Origins of UNESCO
Authors: TOYE JOHN , TOYE RICHARD
Published: June 2010

Against the background of revival of interest in the ‘two cultures’ controversy of the 1960s, this article examines an earlier episode in the struggle between literary intellectuals and scientists for cultural leadership – the choice of a British candidate for the leadership of UNESCO. Why was Sir Alfred Zimmern, the obvious choice for the post of founding Director‐General, not selected? This article argues that Zimmern was ousted as front‐runner because he had failed to gather the support of the burgeoning British scientific establishment, which had mounted its own successful agitation to have science included explicitly in the new organization's remit. It examines the actions and motivations of Ellen Wilkinson and John Maud, whose joint decision it was to replace the classicist Zimmern with the biologist Julian Huxley. It concludes that the main factor behind the replacement of Zimmern was his failure to bridge the two cultures of arts and science. Nevertheless, these events should not be viewed merely as a prologue to the two cultures debate as Huxley and Zimmern's attitudes to science and culture cannot easily be separated from their respective approaches to broader international political questions.
Orientalism and the Failure of British Policy in the Middle East: The Case of Aden
Authors: MAWBY SPENCER
Published: June 2010

Historical writing on the end of the British empire has been dominated by two traditions: diplomatic history and post‐colonial theory. The critique of Orientalism provided by Edward Said has generated a markedly different approach from the older tradition of diplomatic history and there are theoretical obstacles to any reconciliation. Nevertheless, it is possible to identify historiographical precedents for applying some Orientalist ideas to diplomatic source material in the study of the end of the British empire. One territory to which this approach has not been applied is Britain's only formal colony in the Middle East, Aden. The last twenty years of British rule in Aden provide evidence of intelligence being interpreted in a way which underestimated the potency of local agents and exaggerated the influence of external manipulation. There is also corroboration for the notion that British military strategy at the end of empire was characterized by a punitive policy designed to discipline the subject population. Lastly, British political strategy was predicated on a series of stereotypes about the role of leadership in Arab society and the overestimation of the effectiveness of the local rulers as agents of British influence. This evidence suggests that a study of the diplomatic record can substantiate many of the propositions presented in Said's original work.
Synchronous monitoring of vulture movements with satellite telemetry and avian radar
Authors: Beason R. C. , Humphrey J. S. , Myers N. E. , Avery M. L.
Published: June 2010

Radar and satellite global positioning system‐platform transmitter terminal (GPS‐PTT) transmitters provide complementary information on the movements and behaviors of individual birds. The GPS‐PTT tag provides a snapshot of altitude and location of a specific individual of an identified species at predefined intervals. The history of the individual is known because each transmitter has a unique identification code. The radar cannot identify individuals or even species but it provides continuous position reports (altitude and location) of birds within its detection range. By integrating data from the two sources, the behavior and movements of identified individuals (not possible with radar) can be continuously monitored (not possible with satellite tags). In this study the radar detected 40% of the locations of vultures carrying GPS‐PTT tags that were within 5 km of the radar. Most (75%) of the locations that were not detected were calculated to be above or below the radar's antenna beam. Speed and direction values recorded by the GPS‐PTT tags and the radar were poorly correlated because the vultures were soaring and circling, which produced rapid changes in both azimuth and ground speed of the targets. Nevertheless, our findings show that combining these two techniques can allow monitoring of species that are of conservation concern where it is otherwise difficult to follow identified individual birds.
Suppression of antibody‐mediated arthritis in mice by Fab fragments of the mediating antibodies
Authors: Yoshino S , Sasahara M , Hutamekalin Pilaiwanwadee , Yamaki K , Mizutani N , Kuramoto H
Published: June 2010

BACKGROUND AND PURPOSE Fab fragments (Fabs) of antibodies maintain the ability to bind specific antigens, but lack the binding site for complement as well as the site for binding to receptors on effector cells, such as macrophages that play an important role in inflammation. In the present study, we investigated whether Fabs specific for ovalbumin (OVA) were specifically able to suppress anti‐OVA antibody‐mediated arthritis (AOA‐MA) in mice.

EXPERIMENTAL APPROACH AOA‐MA was induced by i.v. injection of purified anti‐OVA antibodies into naïve mice followed by intra‐articular (left ankle) challenge with the antigen. Anti‐OVA Fabs prepared by digestion of anti‐OVA antibodies with papain were injected i.v. immediately after administration of the intact antibodies. Normal Fabs were used as a control. Arthritis was assessed by thickness of the joints (caliper) and by histology of paw sections, stained with haematoxylin and eosin.

KEY RESULTS AOA‐MA was markedly suppressed by anti‐OVA Fabs, but not by control Fabs. Histologically, mice treated with control Fabs showed marked oedema of synovial tissues with a large number of inflammatory cells including neutrophils, whereas animals given anti‐OVA Fabs had mild oedema of the synovium and sparse infiltration of such cells. The antigen‐specific suppression of joint inflammation by anti‐OVA Fabs was associated with reduced consumption of complement. In vitro studies showed that anti‐OVA Fabs significantly blocked the binding of intact anti‐OVA antibodies to OVA.

CONCLUSIONS AND IMPLICATIONS Antibody‐mediated arthritis appears to be specifically down‐regulated by Fabs that competitively inhibit the binding of antibodies to antigens.
Principles of antidote pharmacology: an update on prophylaxis, post‐exposure treatment recommendations and research initiatives for biological agents
Authors: Ramasamy S , Liu CQ , Tran H , Gubala A , Gauci P , McAllister J , Vo T
Published: June 2010

The use of biological agents has generally been confined to military‐led conflicts. However, there has been an increase in non‐state‐based terrorism, including the use of asymmetric warfare, such as biological agents in the past few decades. Thus, it is becoming increasingly important to consider strategies for preventing and preparing for attacks by insurgents, such as the development of pre‐ and post‐exposure medical countermeasures. There are a wide range of prophylactics and treatments being investigated to combat the effects of biological agents. These include antibiotics (for both conventional and unconventional use), antibodies, anti‐virals, immunomodulators, nucleic acids (analogues, antisense, ribozymes and DNAzymes), bacteriophage therapy and micro‐encapsulation. While vaccines are commercially available for the prevention of anthrax, cholera, plague, Q fever and smallpox, there are no licensed vaccines available for use in the case of botulinum toxins, viral encephalitis, melioidosis or ricin. Antibiotics are still recommended as the mainstay treatment following exposure to anthrax, plague, Q fever and melioidosis. Anti‐toxin therapy and anti‐virals may be used in the case of botulinum toxins or smallpox respectively. However, supportive care is the only, or mainstay, post‐exposure treatment for cholera, viral encephalitis and ricin – a recommendation that has not changed in decades. Indeed, with the difficulty that antibiotic resistance poses, the development and further evaluation of techniques and atypical pharmaceuticals are fundamental to the development of prophylaxis and post‐exposure treatment options. The aim of this review is to present an update on prophylaxis and post‐exposure treatment recommendations and research initiatives for biological agents in the open literature from 2007 to 2009.
Creative Destruction, Economic Insecurity, Stress, and Epidemic Obesity
Authors: Wisman Jon D. , Capehart Kevin W.
Published: June 2010

Abstract

The percentage of Americans who are obese has doubled since 1980. Most attempts to explain this “obesity epidemic” have been found inadequate, including the “Big Two” (the increased availability of inexpensive food and the decline of physical exertion). This article explores the possibility that the obesity epidemic is substantially due to growing insecurity, stress, and a sense of powerlessness in modern society where high‐sugar and high‐fat foods are increasingly omnipresent. Those suffering these conditions may suffer less control over other domains of their lives. Insecurity and stress have been found to increase the desire for high‐fat and high‐sugar foods. After exploring the evidence of a link between stress and obesity, the increasing pace of capitalism's creative destruction and its generation of greater insecurity and stress are addressed. The article ends with reflections on how epidemic obesity is symptomatic of a social mistake—the seeking of maximum efficiency and economic growth even in societies where the fundamental problem of material security has been solved.

I confess I am not charmed with the ideal of life held out by those who think that the normal state of human beings is that of struggling to get on; that the trampling, crushing, elbowing, and treading on each other's heels, which form the existing type of social life, are the most desirable lot of humankind, or anything but the disagreeable symptoms of one of the phases of industrial progress. (Mill 1848: 748)

Thus we have been expressly evolved by nature—with all our impulses and deepest instincts—for the purpose of solving the economic problem [“the struggle for subsistence”]. If the economic problem is solved, mankind will be deprived of its traditional purpose . . . Will this be a benefit? If one believes at all in the real values of life, the prospect at least opens up the possibility of benefit. Yet I think with dread of the readjustment of the habits and instincts of the ordinary man, bred into him for countless generations, which he may be asked to discard within a few decades. (Keynes 1932: 366)
Charitable Donations and the Estate Tax: A Tale of Two Hypotheses
Authors: Beranek William , Kamerschen David R. , Timberlake Richard H.
Published: June 2010

Abstract

Regression studies have suggested that reducing estate‐tax rates would lead to a net reduction in total charitable donations distributed at death. Not only is this notion counterintuitive, our empirical analysis yields the contrary conclusion: overall donations would increase. In rationalizing this donation‐decline outcome, investigators have pointed to the tax deductibility of donations in assessing estate‐tax liability. These efforts, we show, are dubious. The view that donations will decline is also shown to be inconsistent with axioms of generally accepted economic theory. Two distinct sets of indifference curves that imply these two antithetical views are suggested, their observable predictions derived and compared to the relevant evidence, showing that the increasing‐donation hypothesis is confirmed, offering overall a clear challenge to the decline‐in‐donation position. Our empirical results suggest that most estate‐tax payers possess indifference curves consistent with those that embody the increasing‐donation hypothesis.
The Effect of Income Distribution on the Ability of Growth to Reduce Poverty: Evidence from Rural and Urban African Economies
Authors: Fosu Augustin Kwasi
Published: June 2010

Abstract

The present study examines the extent to which income distribution affects the ability of economic growth to reduce poverty, based on 1990s data for a sample of rural and urban sectors of African economies. Using the basic‐needs approach, an analysis‐of‐covariance model is derived and estimated, with the headcount, gap, and squared gap poverty ratios serving as the respective dependent variables, and the Gini coefficient and PPP‐adjusted incomes as explanatory variables. The study finds that the responsiveness of poverty to income growth is a decreasing function of inequality, albeit at varying rates for the three poverty measures: lowest for the headcount, followed by the gap and fastest for the squared gap. The ranges for the income elasticity in the sample are estimated at: 0.02–0.68, 0.11–1.05, and 0.10–1.35, respectively, for these poverty measures. Furthermore while, on average, the responsiveness of poverty to income growth appears to be the same between the rural and urban sectors, there are substantial sectoral differences across countries. The results suggest the need for country‐specific emphases on growth relative to inequality.