bluuebunny/crossref_metadata_2025 huggingface dataset:
High-risk prescribing and monitoring in primary care: how common is it, and how can it be improved?
Authors: Dreischulte Tobias , Guthrie Bruce
Published: April 2012

The safety of medication use in primary care is an area of increasing concern for health systems internationally. Systematic reviews estimate that 3–4% of all unplanned hospital admissions are due to preventable drug-related morbidity, the majority of which have been attributed to shortcomings in the prescribing and monitoring stages of the medication use process. We define high-risk prescribing as medication prescription by professionals, for which there is evidence of significant risk of harm to patients, and which should therefore either be avoided or (if avoidance is not possible) closely monitored and regularly reviewed for continued appropriateness. Although prevalence estimates vary depending on the instrument used, cross-sectional studies conducted in primary care equivocally show that it is common and there is evidence that it can be reduced. Quality improvement strategies, such as clinical decision support, performance feedback and pharmacist-led interventions have been shown to be effective in reducing prescribing outcomes but evidence of improved patient outcomes remains limited. The increasing implementation of electronic medical records in primary care offer new opportunities to combine different strategies to improve medication safety in primary care and to integrate services provided by different stakeholders. In this review article, we describe the spectrum of high-risk medication use in primary care, review approaches to its measurement and summarize research into its prevalence. Based on previously developed interventions to change professional practice, we propose a systematic approach to improve the safety of medication use in primary care and highlight areas for future research.
Still Here
Authors: Sinanan Allison N.
Published: April 2012

This study explores perceptions of the academic, social, and institutional forces that shape success for African American male students attending a 4-year, predominately White public college in southern New Jersey. This study utilized an interview-based qualitative research method to examine African American male students’ social and academic experiences at a small, predominantly White, liberal arts college in southern New Jersey. Attention to the experiences of African American male students attending White colleges is particularly important because issues surrounding social receptivity (i.e., the general acceptance of an individual or group’s presence) are factors that play a significant part of the students’ learning experience. This study found that in 21st-century America, the African American male students’ perceptions of and experiences with social receptivity at a predominantly White institution (PWI) can have a significant impact on the students’ learning experience. The major themes of this study that emerged were “Level of Preparation for College Life at a PWI,” “Lack of Belonging in a New Social Environment,” “Feelings of Social and Personal Isolation,” and “Feelings of Negativity Toward the Faculty.”
They Only Talk to Me When They’re Drunk
Authors: Frazier Denise
Published: April 2012

This article tackles the issue of diversity programming and social identification for African American studies at predominately White institutions. As opposed to a specific argument, the author offers solutions and/or distinct ways of viewing diversity education in a majority-White institution. As a former diversity coordinator, the author proposes ways to mentor African American students and provide White administrative and faculty support for diversity programming. The central reason for this is that students of all races at these institutions need to realize that diversity education is not just therapy for “the others” but an experience that enriches everyone’s lives. And the biggest proponents of that attitude of learning need to also come from White people in higher education, not just people of color.
Sister Mary Joseph Nodule
Authors: Gibbs Timothy S.
Published: April 2012

A Sister Mary Joseph nodule (SMJN) is a malignancy located in the periumbilical region. Often misinterpreted as a simple hernia, it is associated with advanced metastatic cancer. First reported in 1846, its primary sources include the gastrointestinal system and female reproductive sites. The most common origins include gastrointestinal (52%), gynecologic (28%), stomach (23%), and ovarian (16%). The presence of SMJN usually indicates widespread disease and is associated with a poor prognosis and complex therapeutic implications, with average patient survival of only 10 to 11 months after diagnosis. This report demonstrates the capability of sonography to evaluate soft tissue periumbilical masses, describes their sonographic appearance, and evaluates the utility of sonography to accurately locate the SMJN for biopsy.
Trisomy 5p Syndrome
Authors: Hill Jennifer
Published: April 2012

Trisomy 5p syndrome is a rare chromosomal abnormality with about 40 documented cases. This abnormality is a result of a duplication of the short arm of chromosome 5. Most Trisomy 5p cases are the result of an unbalanced translocation between the duplicated material of chromosome 5 and another chromosome. This case study demonstrates the sonographic features found on a fetus affected with trisomy 5p. It also discusses how genetics play a role in fetuses affected by chromosome abnormalities and why it is important for sonographers to be aware of the contributing factors that can lead to anomalies.
Route duration improvement in wireless sensor and actuator networks based on mobility parameters and flooding control
Authors: Reina Daniel G , Toral Sergio L , Johnson Princy , Barrero Federico J
Published: April 2012

Mobility of nodes is one of the main causes of broken links in wireless networks. Although several theoretical models for links and routes selection have been proposed in the literature, so far little effort has been made to apply them to the existing routing protocols. In this article, a decision tree has been incorporated in a reactive routing protocol in order to select the most long-lived routes. The decision tree is based on nodes' mobility parameters typically considered by the theoretical models, such as distance between nodes, relative speed, and nodes' directions. The flooding techniques used within the routing protocols for the routing discovery procedures cause a massive usage of control packets which in turn has negative impact on the performance of the networks. So, an improved flooding control is presented in this article that enhances the performance of the proposed route selection based on a decision tree, in turn reducing overheads and the power consumption caused by the control packets. These two proposed approaches have been implemented over a widely used reactive routing protocol such as Ad Hoc On-Demand Distance Vector (AODV) to obtain performance results using Network Simulator 2 simulation tool. The performances of the proposed approaches have been compared with that of the AODV implementation in terms of general performance and path duration. The simulation results show that the proposed route selection significantly improves the results of AODV.
Docosahexaenoic acid ameliorates palmitate-induced lipid accumulation and inflammation through repressing NLRC4 inflammasome activation in HepG2 cells
Authors: Luo Xiaoqin , Yang Yan , Shen Tianran , Tang Xilan , Xiao Yunjun , Zou Tangbin , Xia Min , Ling Wenhua
Published: April 2012

Background

N-3 polyunsaturated fatty acids, such as docosahexaenoic acid (DHA; 22:6n-3), has clinical significance in the prevention and reversal of nonalcoholic steatohepatitis (NASH). However, the precious mechanism underlying remains unclear. The inflammasome, a multiprotein complex formed by NOD-like receptor (NLR) family members, has been recently shown to be activated in NASH and promote the cleavage of the pro-inflammatory cytokines to their maturation forms.

Methods

HepG2 cells were exposed to different dose of PA for 24 h with or without the preincubation of 50 μM DHA for another 24 h and then lipid deposition was assessed with Oil red O staining and intracellular triglyceride (TG) determination. Secretory levels of inflammatory cytokines and Caspase-1 activity were determined by ELISA assays. Gene expression and protein levels were determined by quantitative RCR and western blotting, respectively.

Results

Palmitate (PA) dose-dependently increased lipid accumulation, TG content and induced the secretion of interleukin-1β (IL-1β), IL-18, TNF-α and MCP-1 from HepG2 cells. Preincubation with DHA significantly alleviated PA-induced lipid accumulation and inflammatory agents. DHA was also found to attenuate PA-induced NOD-like receptor protein 4 (NLRC4) mRNA expression. Furthermore, PA induced caspase-1 activation in a dose-dependent manner, resulting in exacerbating of procaspase-1 and pro-IL-1β processing. Knockdown of NLRC4 partially abrogated PA-induced caspase-1 activation and IL-1β maturation and completely abolished these events in the presence of DHA.

Conclusions

Our findings indicate DHA attenuates PA-induced lipid accumulation and inflammation through suppressing NLRC4 inflammasome activation, caspase-1 activation and IL-1β cleavage.
Quantitative comparison of immunohistochemical staining measured by digital image analysis versus pathologist visual scoring
Authors: Rizzardi Anthony E , Johnson Arthur T , Vogel Rachel Isaksson , Pambuccian Stefan E , Henriksen Jonathan , Skubitz Amy PN , Metzger Gregory J , Schmechel Stephen C
Published: April 2012

Immunohistochemical (IHC) assays performed on formalin-fixed paraffin-embedded (FFPE) tissue sections traditionally have been semi-quantified by pathologist visual scoring of staining. IHC is useful for validating biomarkers discovered through genomics methods as large clinical repositories of FFPE specimens support the construction of tissue microarrays (TMAs) for high throughput studies. Due to the ubiquitous availability of IHC techniques in clinical laboratories, validated IHC biomarkers may be translated readily into clinical use. However, the method of pathologist semi-quantification is costly, inherently subjective, and produces ordinal rather than continuous variable data. Computer-aided analysis of digitized whole slide images may overcome these limitations. Using TMAs representing 215 ovarian serous carcinoma specimens stained for S100A1, we assessed the degree to which data obtained using computer-aided methods correlated with data obtained by pathologist visual scoring. To evaluate computer-aided image classification, IHC staining within pathologist annotated and software-classified areas of carcinoma were compared for each case. Two metrics for IHC staining were used: the percentage of carcinoma with S100A1 staining (%Pos), and the product of the staining intensity (optical density [OD] of staining) multiplied by the percentage of carcinoma with S100A1 staining (OD*%Pos). A comparison of the IHC staining data obtained from manual annotations and software-derived annotations showed strong agreement, indicating that software efficiently classifies carcinomatous areas within IHC slide images. Comparisons of IHC intensity data derived using pixel analysis software versus pathologist visual scoring demonstrated high Spearman correlations of 0.88 for %Pos (p < 0.0001) and 0.90 for OD*%Pos (p < 0.0001). This study demonstrated that computer-aided methods to classify image areas of interest (e.g., carcinomatous areas of tissue specimens) and quantify IHC staining intensity within those areas can produce highly similar data to visual evaluation by a pathologist.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1649068103671302
A rare case of malignant triton tumor in the cerebellopontine angle
Authors: Gong Li , Liu Xiao-Yan , Zhang Wen-Dong , Han Xiu-Juan , Yao Li , Zhu Shao-Jun , Lan Miao , Li Yan-Hong , Zhang Wei
Published: April 2012

Malignant triton tumor (MTT) is defined as malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. Intracranial MTT is extremely rare, and only four cases have been reported in the literature. Here, we report a case of MTT occurring in the cerebellopontine angle, and describe its histopathological characteristics, immunohistochemical features, and prognosis.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1336227313684480
Expression features of SOX9 associate with tumor progression and poor prognosis of hepatocellular carcinoma
Authors: Guo Xiaodong , Xiong Lu , Sun Ting , Peng Ruiyun , Zou Lin , Zhu Haiyan , Zhang Jing , Li Hanwei , Zhao Jingmin
Published: April 2012

Background

SOX9 as a member of the SOX (SRY [sex determining region Y] box) gene superfamily has been previously demonstrated to be a proto-oncogene in a variety of malignancies. However, the clinical significance of SOX9 expression in hepatocellular carcinoma (HCC) remains unclear. The aim of this study was to investigate the expression of SOX9 in HCC and determine its correlation with tumor progression and prognosis.

Methods

One-hundred and thirty HCC patients who had undergone curative liver resection were selected and immunohistochemistry, Western blotting, and quantitative real time polymerase chain reaction (Q-PCR) were performed to analyze SOX9 expression in the respective tumors.

Results

Immunohistochemistry, Western blotting, and Q-PCR consistently confirmed SOX9 overexpression in HCC tissues compared with their adjacent nonneoplastic tissues (P ≪ 0.01). Additionally, immunostaining showed more SOX9 positive cells in the higher tumor stage (T3 ~ 4) and tumor grade (G3) than in the lower tumor stage (T1 ~ 2, P = 0.03) and tumor grade (G1 ~ 2, P = 0.01), respectively. Moreover, HCC patients with high SOX9 expression were significantly associated with lower 5-year overall survival (P ≪ 0.01) and lower 5-year disease-free survival (P ≪ 0.01), respectively. The Cox proportional hazards model further showed that SOX9 over-expression was an independent poor prognostic factor for both 5-year disease-free survival (hazards ratio [HR] = 2.621, 95% confidence interval[CI] = 1.548-5.829, P = 0.01) and 5-year overall survival (HR = 3.825, CI = 1.638-7.612, P = 0.003) in HCC.

Conclusion

Our data suggest for the first time that the overexpression of SOX9 protein in HCC tissues is of predictive value on tumor progression and poor prognosis.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9029740396926377.
Copper and bezafibrate cooperate to rescue cytochrome c oxidase deficiency in cells of patients with sco2 mutations
Authors: Casarin Alberto , Giorgi Gianpietro , Pertegato Vanessa , Siviero Roberta , Cerqua Cristina , Doimo Mara , Basso Giuseppe , Sacconi Sabrina , Cassina Matteo , Rizzuto Rosario , Brosel Sonja , M Davidson Mercy , DiMauro Salvatore , Schon Eric A , Clementi Maurizio , Trevisson Eva , Salviati Leonardo
Published: April 2012

Background

Mutations in SCO2 cause cytochrome c oxidase deficiency (COX) and a fatal infantile cardioencephalomyopathy. SCO2 encodes a protein involved in COX copper metabolism; supplementation with copper salts rescues the defect in patients’ cells. Bezafibrate (BZF), an approved hypolipidemic agent, ameliorates the COX deficiency in mice with mutations in COX10, another COX-assembly gene.

Methods

We have investigated the effect of BZF and copper in cells with SCO2 mutations using spectrophotometric methods to analyse respiratory chain activities and a luciferase assay to measure ATP production..

Results

Individual mitochondrial enzymes displayed different responses to BZF. COX activity increased by about 40% above basal levels (both in controls and patients), with SCO2 cells reaching 75-80% COX activity compared to untreated controls. The increase in COX was paralleled by an increase in ATP production. The effect was dose-dependent: it was negligible with 100 μM BZF, and peaked at 400 μM BZF. Higher BZF concentrations were associated with a relative decline of COX activity, indicating that the therapeutic range of this drug is very narrow. Combined treatment with 100 μM CuCl2 and 200 μM BZF (which are only marginally effective when administered individually) achieved complete rescue of COX activity in SCO2 cells.

Conclusions

These data are crucial to design therapeutic trials for this otherwise fatal disorder. The additive effect of copper and BZF will allow to employ lower doses of each drug and to reduce their potential toxic effects. The exact mechanism of action of BZF remains to be determined.
Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis
Authors: Jayawardena R , Ranasinghe P , Galappatthy P , Malkanthi RLDK , Constantine GR , Katulanda P
Published: April 2012

The number of people with diabetes and pre-diabetes are exponentially increasing. Studies on humans have shown the beneficial effects of Zinc supplementation in patients with diabetes. The present study aims to systematically evaluate the literature and meta-analyze the effects of Zinc supplementation on diabetes. A systematic review of published studies reporting the effects of Zinc supplementations on diabetes mellitus was undertaken. The literature search was conducted in the following databases; PubMed, Web of Science and SciVerse Scopus. A meta-analysis of studies examining the effects of Zinc supplementation on clinical and biochemical parameters in patients with diabetes was performed. The total number of articles included in the present review is 25, which included 3 studies on type-1 diabetes and 22 studies on type-2 diabetes. There were 12 studies comparing the effects of Zinc supplementation on fasting blood glucose in patients with type-2 diabetes. The pooled mean difference in fasting blood glucose between Zinc supplemented and placebo groups was 18.13mg/dl (95%CI:33.85,2.41; p<0.05). 2-h post-prandial blood sugar also shows a similar distinct reduction in (34.87mg/dl [95%CI:75.44; 5.69]) the Zinc treated group. The reduction in HbA1c was 0.54% (95%CI:0.86;0.21) in the Zinc treated group. There were 8 studies comparing the effects of Zinc supplementation on lipid parameters in patients with type-2 diabetes. The pooled mean difference for total cholesterol between Zinc supplemented and placebo groups was 32.37mg/dl (95%CI:57.39,7.35; p<0.05). Low-density lipoprotein cholesterol also showed a similar distinct reduction in the Zinc treated group, the pooled mean difference from random effects analysis was 11.19mg/dl (95%CI:21.14,1.25; p<0.05). Studies have also shown a significant reduction in systolic and diastolic blood pressures after Zinc supplementation. This first comprehensive systematic review and meta-analysis on the effects of Zinc supplementation in patients with diabetes demonstrates that Zinc supplementation has beneficial effects on glycaemic control and promotes healthy lipid parameters. Further studies are required to identify the exact biological mechanisms responsible for these results.
The development of Brazilian agriculture: future technological challenges and opportunities
Authors: Pereira Pedro A Arraes , Martha Geraldo B , Santana Carlos AM , Alves Eliseu
Published: April 2012

Ensuring food security for the worlds population over the coming decades will face the challenges of a larger world population, greater urbanization, limited natural resources, higher levels of income, and stronger links between the agricultural and biofuel markets. Overcoming the challenges these represent will require, among other efforts, promoting sustainable expansion of agricultural production through higher productivity and greater cropping intensity. In this paper, we examine the role of Brazils agriculture industry in the domestic and world markets; first, we review the countrys agricultural development experience, and second, we address some key issues that will play a pivotal role in Brazilian agriculture in the future. The paper highlights the main aspects of the modernization process experienced by Brazils national agriculture industry, presents the style of agricultural growth followed by the country, and discusses selected technologies that have played a major role in transforming the sector over the past four decades. We also analyze income from different farm sizes, and provide an overview of key agricultural research challenges and technologies that will be pursued by Brazil in the near future.
RLR-mediated production of interferon-β by a human dendritic cell subset and its role in virus-specific immunity
Authors: Szabo Attila , Bene Krisztián , Gogolák Péter , Réthi Bence , Lányi Árpád , Jankovich István , Dezső Balázs , Rajnavölgyi Éva
Published: April 2012

Identification of the CD1a+ moDC as an inflammatory subset with specialized activation of RLR and associated cytokine and functional activities.

Cytosolic RIG-I-like helicases (RLR) are PRRs involved in type I IFN production and antiviral immunity. This study focuses to the comparison of the expression, function, and signaling cascades associated to RLR in the previously identified CD14−DC-SIGN+PPARγlowCD1a+ and CD14lowDC-SIGN+PPARγhighCD1a− human moDC subsets. Our results revealed that the expression of RLR genes and proteins as well as the activity of the coupled signaling pathways are significantly higher in the CD1a+ subset than in its phenotypically and functionally distinct counterpart. Specific activation of RLR in moDCs by poly(I:C) or influenza virus was shown to induce the secretion of IFN-β via IRF3, whereas induction of proinflammatory cytokine responses were predominantly controlled by TLR3. The requirement of RLR-mediated signaling in CD1a+ moDCs for priming naïve CD8+ T lymphocytes and inducing influenza virus-specific cellular immune responses was confirmed by RIG-I/MDA5 silencing, which abrogated these functions. Our results demonstrate the subset-specific activation of RLR and the underlying mechanisms behind its cytokine secretion profile and identify CD1a+ moDCs as an inflammatory subset with specialized functional activities. We also provide evidence that this migratory DC subset can be detected in human tonsil and reactive LNs.
Rp58 is essential for the growth and patterning of the cerebellum and for glutamatergic and GABAergic neuron development
Authors: Baubet Valérie , Xiang Chaomei , Molczan Aliah , Roccograndi Laura , Melamed Svetlana , Dahmane Nadia
Published: April 2012

Cerebellum development depends on the correct differentiation of progenitors into neurons, a process controlled by a transcriptional program that remains poorly understood. Here we show that neural-specific deletion of the BTB/POZ zinc-finger transcription factor-encoding gene Rp58 (Znf238, Zfp238) causes severe cerebellar hypoplasia and developmental failure of Purkinje neurons, Bergmann glia and granule neurons. Deletion of Rp58 in mouse embryonic Atoh1+ progenitors leads to strong defects in growth and foliation owing to its crucial role in the differentiation of granule neurons. Analysis of the Rp58 mutant at E14.5 demonstrates that Rp58 is required for the development of both glutamatergic and GABAergic neurons. Rp58 mutants show decreased proliferation of glutamatergic progenitors at E14.5. In addition, Rp58 ablation results in a reduced number of GABAergic Pax2+ neurons at E16.5 together with defects in the transcriptional program of ventricular zone progenitors. Our results indicate that Rp58 is essential for the growth and organization of the cerebellum and regulates the development of both GABAergic and glutamatergic neurons.
The floral homeotic protein APETALA2 recognizes and acts through an AT-rich sequence element
Authors: Dinh Thanh Theresa , Girke Thomas , Liu Xigang , Yant Levi , Schmid Markus , Chen Xuemei
Published: April 2012

Cell fate specification in development requires transcription factors for proper regulation of gene expression. In Arabidopsis, transcription factors encoded by four classes of homeotic genes, A, B, C and E, act in a combinatorial manner to control proper floral organ identity. The A-class gene APETALA2 (AP2) promotes sepal and petal identities in whorls 1 and 2 and restricts the expression of the C-class gene AGAMOUS (AG) from whorls 1 and 2. However, it is unknown how AP2 performs these functions. Unlike the other highly characterized floral homeotic proteins containing MADS domains, AP2 has two DNA-binding domains referred to as the AP2 domains and its DNA recognition sequence is still unknown. Here, we show that the second AP2 domain in AP2 binds a non-canonical AT-rich target sequence, and, using a GUS reporter system, we demonstrate that the presence of this sequence in the AG second intron is important for the restriction of AG expression in vivo. Furthermore, we show that AP2 binds the AG second intron and directly regulates AG expression through this sequence element. Computational analysis reveals that the binding site is highly conserved in the second intron of AG orthologs throughout Brassicaceae. By uncovering a biologically relevant AT-rich target sequence, this work shows that AP2 domains have wide-ranging target specificities and provides a missing link in the mechanisms that underlie flower development. It also sets the foundation for understanding the basis of the broad biological functions of AP2 in Arabidopsis, as well as the divergent biological functions of AP2 orthologs in dicotyledonous plants.
Spindle assembly checkpoint signalling is uncoupled from chromosomal position in mouse oocytes
Authors: Gui Liming , Homer Hayden
Published: April 2012

The spindle assembly checkpoint (SAC) averts aneuploidy by coordinating proper bipolar chromosomal attachment with anaphase-promoting complex/cyclosome (APC/C)-mediated securin and cyclin B1 destruction required for anaphase onset. The generation of a Mad2-based signal at kinetochores is central to current models of SAC-based APC/C inhibition. During mitosis, kinetochores of polar-displaced chromosomes, which are at greatest risk of mis-segregating, recruit the highest levels of Mad2, thereby ensuring that SAC activation is proportionate to aneuploidy risk. Paradoxically, although an SAC operates in mammalian oocytes, meiosis I (MI) is notoriously error prone and polar-displaced chromosomes do not prevent anaphase onset. Here we find that Mad2 is not preferentially recruited to the kinetochores of polar chromosomes of wild-type mouse oocytes, in which polar chromosomes are rare, or of oocytes depleted of the kinesin-7 motor CENP-E, in which polar chromosomes are more abundant. Furthermore, in CENP-E-depleted oocytes, although polar chromosomal displacement intensified during MI and the capacity to form stable end-on attachments was severely compromised, all kinetochores nevertheless became devoid of Mad2. Thus, it is possible that the ability of the SAC to robustly discriminate chromosomal position might be compromised by the propensity of oocyte kinetochores to become saturated with unproductive attachments, thereby predisposing to aneuploidy. Our data also reveal novel functions for CENP-E in oocytes: first, CENP-E stabilises BubR1, thereby impacting MI progression; and second, CENP-E mediates bi-orientation by promoting kinetochore reorientation and preventing chromosomal drift towards the poles.
Transition to total one-stop wideawake hand surgery service-audit: a retrospective review
Authors: Bismil Msk , Bismil Qmk , Harding David , Harris Phillip , Lamyman Elaine , Sansby Lizzie
Published: April 2012

Summary

Objectives

To document the transition to a totally one-stop (patient seen and treated in one appointment) wide-awake (local anaesthesia only) hand surgery service.

Design

Retrospective review of 10 year service with detailed analysis of last 1000 cases including process and cost-effectiveness and efficiency analysis.

Setting

Purpose-built CQC-certified day-case surgical facility where we have pioneered the UK's first totally one-stop wide-awake orthopaedic service.

Participants

Approximately five thousand orthopaedic patients treated in the last ten years.

Main outcome measures

Surgical outcomes, patient satisfaction and cost-effectiveness and efficiency.

Results

The OSWA model is safe, efficient and effective; with a low complication rate, extremely high patient satisfaction; and cost-savings to the NHS of 50-75% of the national tariff. The service saved the NHS approximately £750,000 for the 1000 cases presented; and over £2 million since the inception of the service.

Conclusions

A totally one-stop wide-awake hand surgery service is a practicable and feasible alternative to the conventional treatment pathway with benefits in terms of efficiency and cost-effectiveness.
Social Learning Through Endogenous Information Acquisition: An Experiment
Authors: Çelen Boğaçhan , Hyndman Kyle
Published: April 2012

This paper provides a test of a theory of social learning through endogenous information acquisition. A group of subjects face a decision problem under uncertainty. Subjects are endowed with private information about the fundamentals of the problem and make decisions sequentially. The key feature of the experiment is that subjects can observe the decisions of predecessors by forming links at a cost. The model predicts that the average welfare is enhanced in the presence of a small cost. Our experimental results support this prediction. When the informativeness of signals changes across treatments, behavior changes in accordance with the theory. However, within treatments, there are important deviations from rationality such as a tendency to conform and excessive link formation. Given these biases, our results indicate that subjects would, except when faced with a small cost, have been better off not forming any links.

This paper was accepted by Teck Ho, behavioral economics.
How Near-Miss Events Amplify or Attenuate Risky Decision Making
Authors: Tinsley Catherine H. , Dillon Robin L. , Cronin Matthew A.
Published: April 2012

In the aftermath of many natural and man-made disasters, people often wonder why those affected were underprepared, especially when the disaster was the result of known or regularly occurring hazards (e.g., hurricanes). We study one contributing factor: prior near-miss experiences. Near misses are events that have some nontrivial expectation of ending in disaster but, by chance, do not. We demonstrate that when near misses are interpreted as disasters that did not occur, people illegitimately underestimate the danger of subsequent hazardous situations and make riskier decisions (e.g., choosing not to engage in mitigation activities for the potential hazard). On the other hand, if near misses can be recognized and interpreted as disasters that almost happened, this will counter the basic “near-miss” effect and encourage more mitigation. We illustrate the robustness of this pattern across populations with varying levels of real expertise with hazards and different hazard contexts (household evacuation for a hurricane, Caribbean cruises during hurricane season, and deep-water oil drilling). We conclude with ideas to help people manage and communicate about risk.

This paper was accepted by Teck Ho, decision analysis.
Developmental Trajectories in Syndromes With Intellectual Disability, With a Focus on Wolf-Hirschhorn and Its Cognitive–Behavioral Profile
Authors: Fisch Gene S. , Carpenter Nancy , Howard-Peebles Patricia N. , Holden Jeanette J. A. , Tarleton Jack , Simensen Richard , Battaglia Agatino
Published: April 2012

Few studies exist of developmental trajectories in children with intellectual disability, and none for those with subtelomeric deletions. We compared developmental trajectories of children with Wolf-Hirschhorn syndrome to other genetic disorders. We recruited 106 children diagnosed with fragile X, Williams-Beuren syndrome, or Wolf-Hirschhorn syndrome, assessing their intellectual and adaptive behavior abilities. We retested 61 children 2 years later. We compared Time 1 and Time 2 difference scores related to genetic disorder, age, initial IQ, or adaptive behavior composite. Results show genetic disorder and initial IQ score were significant factors for IQ differences, but only genetic disorder affected adaptive behavior differences. Results suggest different gene-brain-behavior pathways likely exist for these genetic disorders. Different developmental trajectories will influence the type and intensity of intervention implemented by caregivers.
Overexpression of Sigma1 Receptor and Its Positive Associations With Pathologic TNM Classification in Esophageal Squamous Cell Carcinoma
Authors: Xu Qing-Xia , Li En-Min , Zhang Yong-Fa , Liao Lian-Di , Xu Xiu-E , Wu Zhi-Yong , Shen Jin-Hui , Xu Li-Yan
Published: April 2012

Sigma1 receptor (sigma1R), a significant protein, has been found to be frequently upregulated in human tumor cells and tissues. It has been demonstrated that sigma1R is involved in proliferation and adhesion of cancer cells. However, the significance of sigma1R expression in esophageal squamous cell carcinoma (ESCC) remains unclear. In this article, by a series of methods, the authors examined the expression of sigma1R protein in ESCC cell lines and tissues. Flow cytometry indicated intense staining of sigma1R in ESCC cells. Immunocytochemistry staining demonstrated that sigma1R was mainly distributed in cytoplasm and nucleus in ESCC cell lines. Western blotting was performed to characterize the relative expression of sigma1R in different ESCC cell lines. Moreover, different levels of sigma1R were presented from normal epithelium to carcinoma by immunohistochemistry analysis, which demonstrated that sigma1R was highly expressed in tumors. Association analysis showed significant correlations between total sigma1R protein levels and pathologic TNM (pTNM) classification of tumors ( r=0.216, p=0.011). Furthermore, the sigma1R in the nucleus was significantly correlated with pTNM classification and lymph node metastasis ( r=0.263, p=0.002, and r=0.269, p=0.002, respectively). These data indicated that sigma1R may serve as a potential predictive factor for pTNM classification and tumor development in ESCC.
Altered Expression of Key Players in Vitamin D Metabolism and Signaling in Malignant and Benign Thyroid Tumors
Authors: Clinckspoor Isabelle , Hauben Esther , Verlinden Lieve , Van den Bruel Annick , Vanwalleghem Lieve , Vander Poorten Vincent , Delaere Pierre , Mathieu Chantal , Verstuyf Annemieke , Decallonne Brigitte
Published: April 2012

1,25-DihydroxyvitaminD3 (1,25(OH)2D3), the active form of vitamin D, mediates antitumor effects in various cancers. The expression of key players in vitamin D signaling in thyroid tumors was investigated. Vitamin D receptor (VDR) and CYP27B1 and CYP24A1 (respectively activating and catabolizing vitamin D) expression was studied (RT-PCR, immunohistochemistry) in normal thyroid, follicular adenoma (FA), differentiated thyroid cancer (DTC) consisting of the papillary (PTC) and follicular (FTC) subtype, and anaplastic thyroid cancer (ATC). VDR, CYP27B1, and CYP24A1 expression was increased in FA and DTC compared with normal thyroid. However, in PTC with lymph node metastasis, VDR and CYP24A1 were decreased compared with non-metastasized PTC. In ATC, VDR expression was often lost, whereas CYP27B1/CYP24A1 expression was comparable to DTC. Moreover, ATC with high Ki67 expression (>30%) or distant metastases at diagnosis was characterized by more negative VDR/CYP24A1/CYP27B1 staining. In conclusion, increased expression of key players involved in local 1,25(OH)2D3 signaling was demonstrated in benign and differentiated malignant thyroid tumors, but a decrease was observed for local nodal and especially distant metastasis, suggesting a local antitumor response of 1,25(OH)2D3 in early cancer stages. These findings advocate further studies with 1,25(OH)2D3 and analogs in persistent and recurrent iodine-refractory DTC.
Intravénás glutamin és korai nasojejunalis táplálás együttes alkalmazása súlyos acut pancreatitisben – prospektív randomizált kettős vak kontrollált klinikai vizsgálat
Authors: Hajdú Nóra , Belágyi Tibor , Issekutz Ákos , Bartek Péter , Gartner Béla , Oláh Attila
Published: April 2012

Absztrakt

Bevezetés: A súlyos acut pancreatitis a gastroenterologiai sebészet nagy kihívást jelentő területe. A legújabb kutatások szerint a teljes parenteralis táplálás kiegészítéseként intravénásan adott glutamin segíthet a septicus szövődmények megelőzésében, és csökkentheti a halálozási rátát, azt azonban még nem vizsgálták, vajon az enteralis táplálás eredményeit is képes-e javítani a glutamin. Célkitűzés: A korai jejunalis táplálás és az intravénás glutamin-dipeptid együttes alkalmazásának vizsgálata súlyos acut pancreatitisben, prospektív randomizált kettős vak kontrollált klinikai vizsgálat során. Beteganyag és módszerek: Vizsgálatunkban 45 súlyos acut pancreatitis miatt kezelt beteg vett részt, akiknél felvételkor a Glasgow score legalább 3 volt, és/vagy a CRP 150 mg/ml feletti. A glutamincsoport (n = 24) tagjai napi 0,5 g/kg i.v. glutamint, a kontrollcsoport (n = 21) tagjai azonos mennyiségben a kórházi gyakorlatban alkalmazott, egyéb aminosavakból álló infúziót kaptak 7 napig. A felvételt követő 48 órán belül minden betegnél elkezdtük a nasojejunalis táplálást, és kezelésük minden egyéb szempontból is azonos irányelvek szerint történt. A vizsgálat elsődleges végpontjaként a pancreasspecifikus septicus szövődmények és a szervi elégtelenségek gyakoriságát, másodlagos végpontokként a radiológiai és sebészeti intervenciók szükségességét, a kórházi tartózkodás időtartamát és a mortalitást jelöltük meg. Eredmények: A glutamincsoportban 4 betegnél alakult ki fertőzött acut peripancreaticus folyadékgyülem, 2 betegnél fertőzött postnecroticus folyadékgyülem, 2 esetben fertőzött pseudocysta és 2 betegnél fertőzött necrosis. Tíz esetben UH-, illetve CT-vezérelt punkcióval és drainage-zsal sikerült megszüntetni a folyadékgyülemet, műtétre egy betegnél sem volt szükség. A kontrollcsoportban 4 betegnél alakult ki fertőzött acut peripancreaticus folyadékgyülem, 2 betegnél fertőzött postnecroticus folyadékgyülem, 3 esetben fertőzött pseudocysta és 3 esetben fertőzött necrosis. Kilenc esetben sikeres volt a radiológiai intervenció, három betegnél sebészi beavatkozásra kényszerültünk. A kontrollcsoport mortalitása 14% (3 beteg) volt, szemben a glutamincsoport 0%-os mortalitásával. A glutamincsoport átlagos ápolási ideje 10,6 nap volt, ami szignifikánsan rövidebb a kontrollcsoport 15,9 napjánál (p = 0,00104). Összefoglalás: A glutamincsoport eredményei minden vizsgált paraméter esetén valamivel jobbnak bizonyultak a kontrollcsoportéinál, de statisztikailag kimutatható különbséget csak az ápolási napok számában sikerült igazolni.
XTEM characterization of modulated ion implantation through self-organized anodic aluminum oxide (AAO) membranes
Authors: Guan Wei , Ghatak Jay , Peng Nianhua , Peng Yong , Jeynes Chris , Möbus Günter
Published: April 2012

Penetration of a nanochannel mask by 190keV Co+ ions is tested for the purpose of achieving laterally modulated ion implantation into a SiO2 thin film on a Si substrate. A 2D-nanoporous membrane of anodic aluminum oxide (AAO) is chosen as the mask. Criteria and challenges for designing the mask are presented. Implantation experiments through a mask with pore diameter of 125 nm and inter-pore distance of 260 nm are carried out. Cross-sectional TEM (XTEM) is shown as an ideal tool to assess depth distribution and lateral distribution of implanted ions at the same time, complemented by Rutherford backscattering spectroscopy. Using energy dispersive x-ray spectroscopy linescans, a Co distribution with lateral modulation is found at 120 nm below the oxide surface. First experiments in converting the atomic distribution of Co to discrete nanoparticles by in-situ TEM annealing are presented.
Microarray and Growth Analyses Identify Differences and Similarities of Early Corn Response to Weeds, Shade, and Nitrogen Stress
Authors: Moriles Janet , Hansen Stephanie , Horvath David P. , Reicks Graig , Clay David E. , Clay Sharon A.
Published: April 2012

Weed interference with crop growth is often attributed to water, nutrient, or light competition; however, specific physiological responses to these stresses are not well described. This study's objective was to compare growth, yield, and gene expression responses of corn to nitrogen (N), low light (40% shade), and weed stresses. Corn vegetative parameters from V2 to V12 stages, yield parameters, and gene expression using transcriptome (2008) and quantitative polymerase chain reaction (qPCR) (2008/09) analyses at V8 were compared among the stresses and with nonstressed corn. N stress did not affect vegetative parameters, although grain yield was reduced by 40% compared with nonstressed plants. Shade, present until V2, reduced biomass and leaf area > 50% at V2, and recovering plants remained smaller than nonstressed plants at V12. However, grain yields of shade-stressed and nonstressed plants were similar, unless shade remained until V8. Weed stress reduced corn growth and yield in 2008 when weeds remained until V6. In 2009, weed stress until V2 reduced corn vegetative growth, but yield reductions occurred only if weed stress remained until V6 or later. Principle component analysis of differentially expressed genes indicated that shade and weed stress had more similar gene expression patterns to each other than they did to nonstressed or N-stressed tissues. However, corn grown in N-stressed conditions shared 252 differentially expressed genes with weed-stressed plants. Ontologies associated with light/photosynthesis, energy conversion, and signaling were down-regulated in response to all three stresses. Shade and weed stress clustered most tightly together, based on gene expression, but shared only three ontologies, O-METHYLTRANSFERASE activity (lignification processes), POLY(U)-BINDING activity (posttranscriptional gene regulation), and stomatal movement. Based on morphologic and genomic observations, weed stress to corn was not explained by individual effects of N or light stress. Therefore, we hypothesize that these stresses share limited signaling mechanisms.
Changes in the Prevalence of Weed Species in the Major Agronomic Crops of the Southern United States: 1994/1995 to 2008/2009
Authors: Webster Theodore M. , Nichols Robert L.
Published: April 2012

Changes in the weed flora of cropping systems reflect the impacts of factors that create safe sites for weed establishment and facilitate the influx and losses to and from the soil seedbank. This analysis of the annual surveys of the Southern Weed Science Society documents changes in the weed flora of the 14 contiguous southern states since the advent of transgenic, herbicide-resistant crops. In 1994 and 2009, the top five weeds in corn were morningglories, Texas millet, broadleaf signalgrass, johnsongrass, and sicklepod; in this same period Palmer amaranth, smartweeds, and goosegrass had the greatest increases in importance in corn. In cotton, morningglories and nutsedges were among the top five most troublesome weeds in 1995 and 2009. Palmer amaranth, pigweeds, and Florida pusley were also among the five most troublesome species in 2009; the weeds with the largest increases in importance in cotton were common ragweed and two species with tolerance to glyphosate, Benghal dayflower and Florida pusley. In soybean, morningglories, nutsedges, and sicklepod were among the top five weed species in 1995 and 2009. Two species with glyphosate resistance, Palmer amaranth and horseweed, were the second and fourth most troublesome weeds of soybean in 2009. In wheat, the top four weeds in 2008 were the same as those in 1994 and included Italian ryegrass, wild garlic, wild radish, and henbit. Crop production in the southern region is a mosaic of various crop rotations, soil types, and types of tillage. During the interval between the surveys, the predominant change in weed management practices in the region and the nation was the onset and rapid dominance of the use of glyphosate in herbicide-resistant cultivars of corn, cotton, and soybean. Because of the correspondence between the effects of glyphosate on the respective weed species and the observed changes in the weed flora of the crops, it is likely the very broad use of glyphosate was a key component shaping the changes in weed flora. Only eight of the top 15 most troublesome weeds of cotton and soybean, the crops with the greatest use of glyphosate, were the same in 1995 and 2009. In contrast, in corn and wheat where adoption of glyphosate-resistant cultivars lags or is absent, 12 of the 15 most troublesome weeds were the same in 1994 and 2008. These findings show on a regional scale that weeds adapt to recurrent selection from herbicides, currently the predominant weed management tool. Future research should seek methods to hinder the rapid spread of herbicide-tolerant and evolution of herbicide-resistant weed species. As new tools are developed, research should focus on ways to preserve the efficacy of those tools through improved stewardship.
Modeling Weed Emergence in Italian Maize Fields
Authors: Masin Roberta , Loddo Donato , Benvenuti Stefano , Otto Stefan , Zanin Giuseppe
Published: April 2012

A hydrothermal time model was developed to simulate field emergence for three weed species in maize (common lambsquarters, johnsongrass, and velvetleaf). Models predicting weed emergence facilitate well-timed and efficient POST weed control strategies (e.g., chemical and mechanical control methods). The model, called AlertInf, was created by monitoring seedling emergence from 2002 to 2008 in field experiments at three sites located in the Veneto region in northeastern Italy. Hydrothermal time was calculated using threshold parameters of temperature and water potential for germination estimated in previous laboratory studies with seeds of populations collected in Veneto. AlertInf was validated with datasets from independent field experiments conducted in Veneto and in Tuscany (west central Italy). Model validation resulted in both sites in efficiency index values ranging from 0.96 to 0.99. AlertInf, based on parameters estimated in a single region, was able to predict the timing of emergence in several sites located at the two extremes of the Italian maize growing area.
Mechanisms of Yield Loss in Maize Caused by Weed Competition
Authors: Cerrudo Diego , Page Eric R. , Tollenaar Matthijs , Stewart Greg , Swanton Clarence J.
Published: April 2012

The physiological process underlying grain yield (GY) loss in maize as a result of weed competition is not understood clearly. We designed an experiment to test the hypotheses that early season stress caused by the presence of neighboring weeds will increase plant-to-plant variability (PPV) of individual plant dry matter (PDM) within the population. This increase in PPV will reduce GY through a reduction in harvest index (HI). Field experiments were conducted in 2008, 2009, and 2010. A glyphosate-resistant maize hybrid was cropped at a density of 7 plants m−2. As a model weed, winter wheat was seeded at the same time as maize and controlled with glyphosate at the 3rd or 10th to 12th leaf-tip stage of maize. Weed competition early in the development of maize decreased PDM and GY. This reduction in PDM, which occurred early in the development of maize, was attributed initially to a delay in rate of leaf appearance. Reductions in PDM were accompanied by an increase in PPV of PDM. This increase in PPV, however, did not reduce HI and did not contribute to the GY reductions created by weed competition, as hypothesized. As weed control was delayed, a reduction in fraction of photosynthetically active radiation (fIPAR) accounted for a further reduction in PDM and notably, a reduction in DMA from 17th leaf-tip stage through to maturity. The rapid loss of PDM and the subsequent inability to accumulate dry matter during maturation accounted for a rapid decline in kernel number (KN) and kernel weight (KW).