bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring the success of an objective structured clinical examination for dietetic students
Authors: Hawker J. A. , Walker K. Z. , Barrington V. , Andrianopoulos N.
Published: March 2010

Background:  Growing requirements to train more dietetic students greatly increase the teaching burden on clinical supervisors. This may be reduced if students can develop basic nutrition assessment skills before they commence clinical placement. To test achievement of these skills by Australian dietetic students, a preclinical objective structured clinical examination (OSCE) was developed. Performance at this OSCE was then compared with the performance at first clinical placement.

Methods:  An OSCE was developed to test preclinical skills during the third year of a 4‐year dietetic degree. Learning outcomes relating to nutritional assessment skills were assessed via a 1‐h preclinical examination. Student application of these skills was then assessed after the first clinical placement, when performance was compared with the results at the preclinical OSCE.

Results:  One hundred and ninety‐three students completed the preclinical OSCE and first clinical placement during the period 2002–2007. A strong relationship was observed for individual student scores at the OSCE and the score achieved at the end of clinical placement (β = 0.66; 95% confidence interval = 0.46–0.86; P < 0.0001). This relationship was maintained even when outliers were removed. No specific year effect was apparent.

Conclusions:  A third‐year preclinical dietetic OSCE was found to be a valuable method of formative assessment for assisting dietetic students with the preparation for their first clinical placement. It aided the early identification of those students who are likely to do less well on their first clinical placement.
Trends in energy and sugar intakes and body mass index between 1983 and 1997 among children in Great Britain
Authors: Gibson S.
Published: March 2010

Background:  It has been suggested that rising obesity among children is partly attributable to sugary foods and soft drinks driving an increase in energy intake (EI). Yet historical data on sugar intake are sparse. The present study calculated total sugar intake de novo among 3296 children aged 10–11 and 14–15 years in 1983 and compared EI, macronutrients and sugar sources with data from 459 children of same age in the 1997 National Diet and Nutrition Survey.

Methods:  Secondary analysis of 7‐day weighed diet records and anthropometric data from two British surveys. Compositional data on sugars applied to individual food codes to calculate sugar intake and sources for 1983. Trends examined before/after adjustment for low/high energy reporting (LHER) defined as EI : basal metabolic rate <1.16 or >2.65.

Results:  Mean EI (kJ day−1) was 7% lower in 1997 than in 1983, mainly as a result of lower fat intake. After excluding LHER, mean EI was 3% lower in 1997. Mean body mass index (BMI) increased by 0.7–1 kg m−2 (2–3 kg). Total sugar intake averaged 115 g day−1 in 1983 and 113 g day−1 in 1997 (122 versus 127 g day−1 excluding LHER, P = 0.08). Excluding LHER, fat energy was lower in 1997 (35.4% versus 37.8%) and sugars slightly higher (23.6% versus 22.3%). Sugar sources showed a marked shift away from table sugar with smaller falls in milk, biscuits and cakes, counterbalanced by an significant increase in sugar from soft drinks and, to a lesser extent, fruit juice and breakfast cereals.

Conclusions:  Althugh the study design precludes drawing causal inferences regarding nutrient intake and obesity, a higher prevalence of under‐reporting and lower levels of physical activity in 1997 could explain the paradox of lower reported EI and rising BMI.
Effects of opioids in the formalin test in the Speke’s hinged tortoise (Kinixy’s spekii)
Authors: WAMBUGU S. N. , TOWETT P. K. , KIAMA S. G. , ABELSON K. S. P. , KANUI T. I.
Published: March 2010

Wambugu, S.N., Towett, P.K., Kiama, S.G., Abelson, K.S.P., Kanui, T.I. Effects of opioids in the formalin test in the Speke’s hinged tortoise (Kinixy’s spekii). J. vet. Pharmacol. Therap.doi: 10.1111/j.1365‐2885.2009.01148.x.

Little is known about analgesia in lower vertebrates such as the Speke’s hinged tortoise (Kinixy’s spekii), yet of late they are increasingly being adopted as pets. The effects of morphine (5, 7.5, 10 and 20 mg/kg), pethidine (10, 20, and 50 mg/kg) and naloxone (5 mg/kg) on nociception induced by the formalin test (12.5%, 100 μL) were studied in the Speke’s hinged tortoise. Formalin induced a monophasic limb retraction behavioural response and its duration was recorded. The behaviour lasted for 16.4 ± 0.8 min. Morphine (7.5, 10 and 20 mg/kg) and pethidine (20 and 50 mg/kg) induced significant decrease in the duration of limb retraction in the formalin test. The anti‐nociceptive effects were naloxone (5 mg/kg) reversible. The data suggest that the formalin test is a good test for studying nociception and anti‐nociception in tortoises and that the opioidergic system plays a role in the control of nociception in these animals.
The genetics of adaptation to novel environments: selection on germination timing in Arabidopsis thaliana
Authors: MOYERS BROOK T. , KANE NOLAN C.
Published: March 2010

When studying selection during adaptation to novel environments, researchers have often paid little attention to an organism’s earliest developmental stages. Despite this lack of attention, early life history traits may be under strong selection during colonization, as the expression of adaptive phenotypes at later points is contingent upon early survival. Moreover, the timing of early developmental transitions can constrain the timing of later transitions, with potentially large effects on fitness. In this issue, Huang et al. (2010) underscore the importance of early life history traits in the adaptation of Arabidopsis thaliana to old‐field sites in North America. Using a new population of mapped recombinant inbred lines, the authors examined germination timing and total lifetime fitness of A. thaliana while varying site latitude, dispersal season, and maternal photoperiod. Huang et al. (2010) discovered several Quantitative Trait Loci (QTL) with large effects on fitness that colocalized with QTL for field germination timing and seed dormancy—demonstrating that fitness is genetically associated with these early life history traits, and that these loci are likely under strong selection during adaptation to novel environments. In the epistatic interactions of some loci, recombinant genotypes outperformed parental genotypes, supporting the potentially adaptive role of recombination. This study provides elegant evidence that traits expressed early in an organism’s development can play an important role during adaptive evolution.
Active Immunization with Glucose‐Dependent Insulinotropic Polypeptide Vaccine Influences Brain Function and Behaviour in Rats
Authors: Tian J.‐Q. , Wang Y. , Lin N. , Guo Y.‐J. , Sun S.‐H. , Zou D.‐J.
Published: March 2010

Glucose‐dependent insulinotropic polypeptide (GIP) is involved in the aetiology of obesity induced by overnutrition, and blocking GIP activity may be valuable to anti‐obesity treatment. However, GIP and GIP receptor are closely related to various brain functions which have caused very little data to be published concerning this cerebral functionality after blocking GIP activity. Here, we showed that active vaccination of mature rats with GIP immunoconjugates [GIP‐keyhole limpet haemocyanin (KLH)] was associated with changes in body weight. Furthermore, we also observed significant changes in brain function and behaviour. Data indicated that GIP‐KLH‐immunized rats showed decreased spontaneous activity in the open field test, decreased cerebral glucose utilization assessed by 18F‐fluorodeoxyglucose‐positron emission tomography/computed tomography (PET/CT), and increased apoptosis and proliferation of hippocampal granule cells marked by the terminal deoxynucleotidyl transferase–mediated dUTP nick end labelling (TUNEL) or proliferating cell nuclear antigen method. In conclusion, we have shown that vaccine‐induced antibodies inhibited GIP activity in vivo and led to significant changes in brain function and behaviour, which underscore the need to address any potential problems GIP‐targeted immunotherapy may involve in further research.
High mortality in orthotopic liver transplant recipients who require hemodialysis
Authors: Zand Martin S. , Orloff Mark S. , Abt Peter , Patel Siddharth , Tsoulfas George , Kashyap Randeep , Jain Ashok , Safadjou Saman , Bozorgzadeh Adel
Published: March 2010

Zand MS, Orloff MS, Abt P, Patel S, Tsoulfas G, Kashyap R, Jain A, Safadjou S, Bozorgzadeh A. High mortality in orthotopic liver transplant recipients who require hemodialysis.  Clin Transplant 2011: 25: 213–221. © 2010 John Wiley & Sons A/S.

Abstract:  Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri‐transplant dialysis on the long‐term mortality of liver transplant recipients. We performed a single‐center, retrospective cohort study of 743 adult liver transplants; patients who received first liver transplants were divided into four groups: those who received more than one dialysis treatment (hemodialysis [HD], continuous veno‐venous hemodialysis [CVVH]) pre‐orthotopic liver transplantation (OLT), post OLT, pre‐ and post OLT, and those not dialyzed. There was no statistically significant difference in the mean survival time for patients who were not dialyzed or dialyzed only pre‐OLT. Mean survival times were markedly reduced in patients dialyzed post OLT or both pre‐ and post OLT compared with those never dialyzed. Mortality risk in a Cox proportional hazards model correlated with hemodialysis post OLT, intra‐operative vasopressin or neosynephrine, donor age >50 yr, Cr >1.5 mg/dL at transplant, and need for subsequent retransplant. Risk of post‐OLT dialysis was correlated with pre‐OLT dialysis, intra‐operative levophed, pre‐OLT diabetes, African American race, pre‐OLT Cr >1.5, and male gender. We conclude that renal failure requiring hemodialysis post liver transplant, irrespective of pre‐transplant dialysis status, is a profound risk factor for death in liver transplant recipients.
Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post‐transplant outcomes
Authors: Singh Rajinder P. , Farney Alan C. , Rogers Jeffrey , Zuckerman Jack , Reeves‐Daniel Amber , Hartmann Erica , Iskandar Samy , Adams Patricia , Stratta Robert J.
Published: March 2010

Singh RP, Farney AC, Rogers J, Zuckerman J, Reeves‐Daniel A, Hartmann E, Iskandar S, Adams P, Stratta RJ. Kidney transplantation from donation after cardiac death donors: lack of impact of delayed graft function on post‐transplant outcomes.  Clin Transplant 2011: 25: 255–264. © 2010 John Wiley & Sons A/S.

Abstract:  Introduction:  Delayed graft function (DGF) is more common in recipients of kidney transplants from donation after cardiac death (DCD) donors compared to donation after brain death (DBD) donors.

Methods:  Single‐center retrospective study to evaluate the impact of DGF on controlled (Maastricht category III) DCD donor kidney transplant outcomes.

Results:  From 10/01 to 6/08, 578 adult deceased donor kidney transplants were performed including 70 (12%) from DCD and 508 (88%) from DBD donors. Mean follow‐up was 36 months. DCD donor kidney transplants had significantly greater rates of DGF (57% DCD vs. 21% DBD, p < 0.0001)) and acute rejection (29% DCD vs. 16% DBD, p = 0.018) compared to DBD donor kidney transplants, but patient and graft survival rates were similar. DBD donor kidney transplants with DGF (n = 109) had significantly greater rates of death‐censored graft loss (12.5% DCD vs. 31% DBD), primary non‐function (0 DCD vs. 10% DBD) and higher 2 year mean serum creatinine levels (1.4 DCD vs. 2.7 mg/dL DBD) compared to DCD donor kidney transplants with DGF (n = 40, all p < 0.04). On univariate analysis, the presence of acute rejection and older donor age were the only significant risk factors for death‐censored graft loss in DCD donor kidney transplants, whereas DGF was not a risk factor.

Conclusion:  Despite higher rates of DGF and acute rejection in DCD donor kidney transplants, subsequent outcomes in DCD donor kidney transplants with DGF are better than in DBD donor kidney transplants experiencing DGF, and similar to outcomes in DCD donor kidney transplants without DGF.
HHV‐8‐related visceral Kaposi’s sarcoma following allogeneic HSCT: Report of a pediatric case and literature review
Authors: Sala Ilaria , Faraci Maura , Magnano Gian M. , Sementa Angela , di Marco Eddi , Garaventa Alberto , Micalizzi Concetta , Lanino Edoardo , Morreale Giuseppe , Moroni Cristina , Castagnola Elio
Published: March 2010

Sala I, Faraci M, Magnano GM, Sementa A, di Marco E, Garaventa A, Micalizzi C, Lanino E, Morreale G, Moroni C, Castagnola E. HHV‐8‐related visceral Kaposi’s sarcoma following allogeneic HSCT: Report of a pediatric case and literature review. Pediatr Transplantation 2011: 15:E8–E11. © 2010 John Wiley & Sons A/S.

Abstract:  An HHV‐8‐related visceral KS was diagnosed in a 10‐yr‐old boy after partially matched allogeneic HSCT. This complication occurred 463 days after HSCT and involved tonsils, lymph nodes, hard palate, lung, skin, and paranasal sinuses. Treatment with pegylated liposomal doxorubicin induced long‐term remission (33 months) of this disease. HHV‐8 infection is quite frequent after HSCT, but KS, and especially its visceral form, is a very rare complication, and its association with HHV‐8 has been documented even less frequently. However, our observation suggests that HHV‐8‐related KS should be taken into consideration in the differential diagnosis of late post‐HSCT complications.
Hepatocyte Growth Factor Receptor, c‐Met, in Human Embryo Salivary Glands. An Immunohistochemical Study
Authors: Loreto C. , Caltabiano R. , Musumeci G. , Caltabiano C. , Greco M. G. , Leonardi R.
Published: March 2010

With 3 figures and 1 table

Salivary gland morphogenesis involves complex, coordinated events that include epithelial–mesenchymal interactions. Mesenchymal–epithelial transition factor (c‐Met) is the hepatocyte growth factor (HGF) receptor. The latter is a hepatotropic factor originally identified in rat serum and platelets. It is essential in fetal tissue development, where it regulates complex morphogenetic processes including extracellular matrix invasion, cell migration, cell polarization and tubulogenesis. The c‐Met/HGF system is believed to participate in epithelial–mesenchymal interactions during development. Twelve human embryonic minor salivary glands were studied by immunohistochemistry to investigate the role of c‐Met in human salivary gland development. Strong c‐Met immunopositivity in the glands demonstrated that the molecule is involved in their development and suggested a role for the c‐Met/HGF system in this process.
A New Case of Consensual Decision: Collective Movement in Earthworms
Authors: Zirbes Lara , Deneubourg Jean‐Louis , Brostaux Yves , Haubruge Eric
Published: March 2010

Collective movements are reported for many species from microorganisms to humans. But except for a few soil‐inhabiting species, intra‐specific interactions in soil are poorly studied. Some intra‐specific interactions occur in earthworms. Most of them are negative, concerning parameters like the rate of survival, maturation, food ingestion or growth. Virtually nothing is known about collective movement in earthworms that represent the dominant biomass of the soil. This study, the first one on annelids, highlights a consensual decision phenomenon based only on contact between followers. Using an olfactometer set‐up and modelling, we show that earthwormsEisenia fetidainfluence each other to select a common direction during their migration. Experiments in a binary choice test showed that contacts between individuals are responsible for collective movement. This coordination in movement could allow earthworms to benefit from forming clusters. The resulting local higher densities, enhancing individual survival and favouring the cooperation, may be at the origin of Allee effects reported for these species.
Biallele Expression of PEG10 Gene in Primordial Germ Cells Derived from Day 27 Porcine Fetuses
Authors: Wen J , Liu L , Song G , Tang B , Li Z
Published: March 2010

Contents

Primordial germ cells (PGCs) from day 27 porcine fetuses have often been isolated to establish pluripotent embryonic germ (EG) cell lines, but little is known regarding their imprinted gene status. In our study, we attempted to detect the imprinted gene expression of cloned embryos and EG cells derived from individual PGC of day 27 and day 35, using single nucleotide polymorphism (SNP) analysis of the paternally expression gene 10 (PEG10) as a sign of parental‐origin‐specific expression. The results showed biallelic gene expression of the SNP that occurred in EG cell colonies and almost all of the cloned blastocysts, demonstrating that aberrant imprinted gene expression of PEG10 occurs in the day 27 porcine PGCs, whereas monoallelic expression of the PEG10 gene occurs in all the PGC clones derived from day 35 PGCs. In addition, the same imprinted gene status was observed for blastocysts derived from both male and female PGCs, indicating that the parental genomic imprinting is erased in male and female germlines.
Germ plasm‐like Dot cells maintain their wound regenerative function after in vitro expansion
Authors: Kong Wuyi , Li Shaowei , Lorenz H. Peter
Published: March 2010

1. Wounds in fetal skin heal without scarring; however, the mechanism for this is unknown. We have identified a novel group of protein and nucleotides‐positive particles in fetal and adult mouse blood and in human blood, and termed them ‘Dot cells’. Freshly isolated Dot cells regenerate wounds with less scarring and can be cultured without feeder layers.

2. Because the morphology of Dot cells has never been described, in the present study we describe the specific characterizations of Dot cells, including their growth pattern in vitro, and their expressions of stem cell markers using fluorescent cell sorting analyses and immunofluorescent histology. Our data indicates that cultured Dot cells express stem cell surface markers and embryonic stem cell transcription markers, such as Oct4, Nanog and Sox‐2. In addition, Dot cells express VASA, the germ plasm specific marker.

3. To confirm whether Dot cells maintain their wound regenerative activity after in vitro expansion, in vitro cultured Dot cells were transplanted to wounded mice. Dot cells from albino mice maintain their wound regenerative activities after intravenous transplantation to black‐background diabetic mice. In addition, Dot cells regenerate both the epithelial and dermal cells in the wounds of wild‐type mice. The regenerated hair follicles, smooth muscle and dermal tissues express transiently to VASA.

4. Our data demonstrate that Dot cells are newly identified organisms located in the blood and bone marrow of mammals. They express germ cell, embryonic stem cell and adult stem cell markers. Dot cells maintain their regenerative function after in vitro expansion.
Review: Endothelial‐myofibroblast transition, a new player in diabetic renal fibrosis
Authors: LI JINHUA , BERTRAM JOHN F
Published: March 2010

Diabetic nephropathy (DN) is the most common cause of chronic kidney failure and end‐stage renal disease in the Western world. Studies from diabetic animal models and clinical trials have shown that inhibition of the renin‐angiotensin system delays the progression of advanced DN. However, a recent large‐scale clinical trial has revealed that inhibition of renin‐angiotensin system in early phases of DN does not slow the decline of renal function or the development of morphological lesions, suggesting that different mechanism(s) may be involved in the different stages of DN. The role of epithelial‐mesenchymal transition in renal fibrosis has been intensively investigated. Recently, endothelial‐mesenchymal transition, or endothelial‐myofibroblast transition (EndoMT) has emerged as another mechanism involved in both developmental and pathological processes. The essential role of EndoMT in cardiac development has been thoroughly studied. EndoMT also exists and contributes to the development and progression of cardiac fibrosis, lung fibrosis, liver fibrosis and corneal fibrosis. EndoMT is a specific form of epithelial‐mesenchymal transition. During EndoMT, endothelial cells lose endothelial markers and obtain mesenchymal markers. Recent evidence from our laboratory and others suggests that EndoMT plays an important role in the development of renal fibrosis in several pathological settings, including experimental DN. This review considers the evidence supporting the occurrence of EndoMT in normal development and in pathology, as well as the latest findings suggesting EndoMT contributes to fibrosis in DN. Whether experimental findings of EndoMT will be reproduced in human studies remains to be determined.
Injured kidney cells express SM22α (transgelin): Unique features distinct from α‐smooth muscle actin (αSMA)
Authors: SAKAMAKI YUICHI , SAKATSUME MINORU , WANG XINGZHI , INOMATA SHIGERU , YAMAMOTO TADASHI , GEJYO FUMITAKE , NARITA ICHIEI
Published: March 2010

Aim:  SM22α (transgelin) has been focused upon as a player in the process of phenotypic changes of types of cells. The SM22α expression in the rat anti‐glomerular basement membrane (GBM) nephritis model and differences from an established phenotypic marker for the myofibroblast, α‐smooth muscle actin (αSMA), were investigated.

Methods:  The rat kidney tissues were processed for histological studies, immunohistochemical and immunoelectronmicroscopy analyses on days 0, 7, 28, 42 and 56 after injection of rabbit anti‐GBM serum for the disease induction.

Results:  Immunohistochemistry with anti‐SM22α antibodies (Ab) revealed that kidneys of the nephritic rats on day 7 expressed SM22α in podocytes, crescentic cells and epithelial cells of Bowman's capsule. After 28 days, SM22α was also expressed in peritubular interstitial cells. Double immunofluorescence with anti‐SM22α Ab and anti‐αSMA Ab showed that SM22α was preferentially expressed in podocytes, whereas αSMA was positive in mesangial cells on day 7. After day 28, both molecules became positive in peritubular interstitial cells.

Conclusion:  SM22α was expressed in epithelial cells of inflamed glomeruli in the early phase, and then also in peritubular interstitial cells in the later phase of anti‐GBM nephritis model. SM22α presented unique kinetics of expression distinct from αSMA.
Uninterrupted suturing of renal parenchyma in laparoscopic partial nephrectomy decreases renal ischemic time and intraoperative blood loss
Authors: Kawa Gen , Kinoshita Hidefumi , Komai Yoshihiro , Inoue Takaaki , Masuda Junko , Matsuda Tadashi
Published: March 2010

We examined factors affecting renal ischemic time and intraoperative blood loss in laparoscopic partial nephrectomy and attempted to determine which method of suture for parenchymal closure is effective in this operation. Fifty‐seven patients who underwent laparoscopic partial nephrectomy were studied. Some variables and methods of suture for parenchymal closure were tested for independent effects on ischemic time and bleeding volume. Mean renal ischemic time and estimated blood loss were 38 min and 175 mL, respectively. Method of suture for parenchymal closure was the only factor independently associated with intraoperative blood loss less than 100 mL. Furthermore, uninterrupted suture for parenchymal closure was a significant factor associated with renal ischemic time less than 30 min. Renal ischemic time or intraoperative blood loss can be decreased by using uninterrupted suture for parenchymal defect.
Trends in the incidence of benign pathological lesions at partial nephrectomy for presumed renal cell carcinoma in renal masses on preoperative computed tomography imaging: A single institute experience with 290 consecutive patients
Authors: Lee Seung Hwan , Park Sang Un , Rha Koon Ho , Choi Young Deuk , Hong Sung Joon , Yang Seung Choul , Mah Sang Yol , Chung Byung Ha
Published: March 2010

Objective:  The aim of this study was to determine trends in the incidence of benign lesions in patients undergoing surgery for suspicious renal masses on preoperative computed tomography scan.

Methods:  The records of 1065 patients who underwent open consecutive partial nephrectomy (PN) or radical nephrectomy (RN) between January 2001 and December 2008 were reviewed. Patients who underwent PN during the periods 2001–2002, 2003–2004, 2005–2006, and 2007–2008 were assigned to groups 1, 2, 3 and 4, respectively. The frequencies of benign and malignant lesions in these groups were assessed according to size and histology subtypes.

Results:  The ratio of PN to RN was 12.4%, 18.3%, 24.3% and 37.2% in groups 1, 2, 3 and 4, respectively (P < 0.05). The mean size of resected lesions was 2.6 cm (range 0.8–6.2 cm). Of the 290 cases, histopathology revealed benign findings in 52 (17.9%). Benign pathology was found in three of 18 cases (16.7%) in group 1, seven of 36 cases (19.4%) in group 2, 12 of 63 cases (19.0%) in group 3 and 30 of 173 cases (17.3%) in group 4. There was no significant difference in the frequency of benign histology among groups.

Conclusion:  PN, as opposed to RN, has shown a rising tendency over time. The frequency of benign pathology findings after PN for suspicious renal masses on preoperative computed tomography imaging has not decreased. Proper management should favor nephron‐sparing surgery for renal lesions if such lesions can be removed satisfactorily with PN.
The role of peribiliary cysts in biliary obstruction
Authors: Pang Tony , Kuo Samuel , Hugh Thomas J. , Davidson Trent , Eckstein Robert P. , Bell Cameron , Samra Jaswinder S.
Published: March 2010

Peribiliary cysts are cystic dilatations of the extramural glands of the intrahepatic biliary tree. This disorder is uncommon and is usually asymptomatic. However, it may cause extrinsic biliary compression and consequently, obstructive jaundice. This paper describes 2 such cases presenting with jaundice. The etiology, natural history, investigation findings and treatment of this disorder are also discussed.
Survey of trends in minimally invasive intervention for necrotizing pancreatitis
Authors: Loveday Benjamin P. T. , Rossaak Jeremy I. , Mittal Anubhav , Phillips Anthony , Windsor John A.
Published: March 2010

Background:  Minimally invasive techniques to manage infected pancreatic necrosis have been recently developed and changes in their pattern of use are unknown. The aims of this survey were to determine the trends in the role of minimally invasive techniques to manage infected complications of necrotizing pancreatitis and the barriers to performing minimally invasive necrosectomy in Australia and New Zealand.

Methods:  Members of the Australian and New Zealand Hepatic Pancreatic and Biliary Association were surveyed. Participant demographics and necrotizing pancreatitis caseload were determined. The perceived role of percutaneous catheter drainage and minimally invasive necrosectomy for pancreatic abscess, infected pseudocyst and infected pancreatic necrosis were scored on Likert scales, comparing 2002 with 2007. Barriers to performing minimally invasive necrosectomy were scored.

Results:  The response rate was 49% (44/90). Between 2002 and 2007, the role of percutaneous catheter drainage became more important as primary (P= 0.05) and secondary (P= 0.01) treatment for pancreatic abscess, and prior to minimally invasive necrosectomy for abscess, pseudocyst and necrosis (P < 0.01). Minimally invasive necrosectomy became increasingly important as primary treatment for infected necrosis (P < 0.01) and had been used by 47% of respondents. The greatest barriers to performing minimally invasive necrosectomy were lack of training and experience in the techniques, and the anatomical position and complexity of the target lesion.

Conclusion:  Minimally invasive techniques have an increasingly important perceived role in the management of pancreatic abscess, infected pseudocyst and infected pancreatic necrosis. Further evidence is required to determine the best techniques for treating each form of infection associated with necrotizing pancreatitis.
Liver resection: a regional hospital experience
Authors: Yong Tuck Leong , Bohmer Robert , Pande Girish Kumar , Birks Sarah Emily , Loh Damien Chee Kuen , Hewitt Peter MacDonald
Published: March 2010

Background:  Liver resection is a significant operation usually limited to large metropolitan hospitals. Liver resections were first performed at the Launceston General Hospital (LGH), a regional centre (bed capacity 280), in May 2000. This is a summary of liver resection at LGH.

Methods:  Data of liver resections performed between May 2000 and March 2008 at LGH were collected retro‐prospectively and reviewed with attention to patient survival, post‐operative complications and mortality.

Results:  There were 102 consecutive liver resections during the study period. Metastatic colorectal adenocarcinoma was the most frequent pathology (n = 61). Six patients had metastases from primaries other than colorectal cancer. There were 13 resections for primary liver malignancy, 2 from invasion by gallbladder carcinoma, 1 for contiguous invasion by gastric cancer and 19 were for benign conditions. Thirteen patients had post‐operative wound infections and six had significant bile leaks. There were five deaths in‐hospital (surgical mortality 4.9%). At the end of the study period, 51 cancer patients were still alive (14 with disease recurrences) and 30 have died (23 from recurrent diseases). Patients operated for colorectal cancer metastases achieved a 44% 5‐year survival rate (median survival = 46 months). Patients with hepatocellular carcinoma had 3‐year survival rate of 15% (median survival = 24 months).

Conclusion:  Resection provides the best hope of cure for patients with primary or secondary hepatic malignancy. With adequate expertise, liver resections can be performed safely in a regional hospital.
PH‐Domain‐driven targeting of collybistin but not Cdc42 activation is required for synaptic gephyrin clustering
Authors: Reddy‐Alla Suneel , Schmitt Bertram , Birkenfeld Jörg , Eulenburg Volker , Dutertre Sebastien , Böhringer Christian , Götz Magdalena , Betz Heinrich , Papadopoulos Theofilos
Published: March 2010

Collybistin (Cb) is a brain‐specific guanine nucleotide exchange factor (GEF) that is essential for the synaptic clustering of gephyrin and GABAA receptors in selected regions of the mammalian central nervous system. It has been previously proposed that Cb regulates gephyrin clustering by activating Cdc42, and thus acts as a signal transducer in a membrane activation process which labels postsynaptic membrane domains for inhibitory synapse formation. Here, we dissected the functional roles of the Dbl‐homology (DH) and pleckstrin homology (PH) domains of the constitutively active splice variant Cb II by substituting conserved amino acid residues that are required for GEF activity towards Cdc42 and phosphoinositide binding, respectively. A Cb II mutant lacking any detectable GEF activity towards Cdc42 was still fully active in inducing gephyrin scaffold formation, both in transfected NIH‐3T3 cells and in cultured hippocampal neurons. Furthermore, mice with a forebrain‐specific inactivation of the Cdc42 gene displayed normal densities of gephyrin and GABAA receptor clusters in the hippocampus. In contrast, substitution of Cb II PH‐domain residues essential for phosphoinositide binding abolished gephyrin recruitment to synaptic sites. Our results provide evidence that the formation of gephyrin scaffolds at inhibitory synapses requires an intact Cb II PH‐domain but is Cdc42‐independent.
Transient viral‐mediated overexpression of α‐calcium/calmodulin‐dependent protein kinase II in the nucleus accumbens shell leads to long‐lasting functional upregulation of α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate receptors: dopamine type‐1 receptor and protein kinase A dependence
Authors: Singer B. F. , Loweth J. A. , Neve R. L. , Vezina P.
Published: March 2010

Calcium/calmodulin‐dependent protein kinase II (CaMKII) activity is necessary for the long‐lasting expression of locomotor sensitization and enhanced drug‐taking observed in rats previously exposed to psychostimulants. Exposure to these drugs also transiently increases αCaMKII levels in the nucleus accumbens (NAcc), an effect that, when mimicked by transient viral‐mediated overexpression of αCaMKII in NAcc shell neurons, leads to long‐lasting enhancement in locomotor responding to amphetamine and NAcc α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate (AMPA). The present experiments characterized the dopamine (DA) dependence of the functional AMPA receptor upregulation observed long after transient overexpression of αCaMKII. Rats infected with herpes simplex virus‐αCaMKII in the NAcc shell showed a transient increase in αCaMKII levels that peaked at 4 days post‐infection and returned to baseline 8 days later. When challenged with AMPA (0.8 nmol/side) in the NAcc shell at 20 days post‐infection, these rats showed enhanced locomotion compared with controls. This sensitized locomotor response was blocked when AMPA was coinfused with either the DA type‐1 receptor antagonist SCH23390 (0.8 nmol/side) or the protein kinase A inhibitor Rp‐cAMPS (80 nmol/side). Neither SCH23390 nor Rp‐cAMPS produced locomotor effects when infused by itself into the NAcc shell. Furthermore, these antagonists did not block the acute non‐sensitized locomotor response to AMPA observed in control rats. These findings show that transient viral‐mediated overexpression of αCaMKII in neurons of the NAcc shell leads to long‐lasting functional upregulation of AMPA receptors that is DA type‐1 receptor and protein kinase A dependent. Thus, transient increases in levels of αCaMKII in the NAcc shell produce long‐lasting changes in the way that DA and glutamate interact in this site to generate locomotor behavior.
Substance P modulation of TRPC3/ 7 channels improves respiratory rhythm regularity and ICAN‐dependent pacemaker activity
Authors: Ben‐Mabrouk Faiza , Tryba Andrew K.
Published: March 2010

Neuromodulators, such as substance P (SubP), play an important role in modulating many rhythmic activities driven by central pattern generators (e.g. locomotion, respiration). However, the mechanism by which SubP enhances breathing regularity has not been determined. Here, we used mouse brainstem slices containing the pre‐Bötzinger complex to demonstrate, for the first time, that SubP activates transient receptor protein canonical (TRPC) channels to enhance respiratory rhythm regularity. Moreover, SubP enhancement of network regularity is accomplished via selective enhancement of ICAN (inward non‐specific cation current)‐dependent intrinsic bursting properties. In contrast to INaP (persistent sodium current)‐dependent pacemakers, ICAN‐dependent pacemaker bursting activity is TRPC‐dependent. Western Blots reveal TRPC3 and TRPC7 channels are expressed in rhythmically active ventral respiratory group island preparations. Taken together, these data suggest that SubP‐mediated activation of TRPC3/7 channels underlies rhythmic ICAN‐dependent pacemaker activity and enhances the regularity of respiratory rhythm activity.
Community heterogeneity and single‐cell digestive activity of estuarine heterotrophic nanoflagellates assessed using lysotracker and flow cytometry
Authors: Sintes Eva , Del Giorgio Paul A.
Published: March 2010

Heterotrophic nanoflagellates (HNFs) are an essential component of all aquatic microbial food webs, and yet the exploration of the numerical and single‐cell responses of these organisms in mixed assemblages still represents a major technical challenge. LysoTracker Green staining combined with flow cytometry was recently proposed for the enumeration of aquatic HNFs. Here we show that LysoTracker Green not only allows the enumeration of HNFs in estuarine samples with a wide range of HNF abundances, but also allows the discrimination of distinct HNF populations in mixed assemblages. In addition, the resulting cytometric parameters can be used to characterize cell size and the level of activity of the cells in the different populations that are detected. LysoTracker Green accumulates preferentially in lysosomes, and we demonstrate that the green fluorescence emission from HNF cells stained with LysoTracker strongly correlates with cell‐specific β‐glucosaminidase (β‐Gam) activity, a key digestive enzyme of lysosomal origin in eukaryotic cells. Our results further show that different populations that develop in estuarine regrowth cultures are characterized by different intrinsic ranges of size and of feeding activity, and that there is a wide range of single‐cell responses within these HNF populations. We found a large degree of uncoupling between cell size and feeding activity, both between and within HNF populations, and there appears to be no clear allometric scaling of feeding activity. We were able to reconstruct the succession of distinct HNF populations that developed during the regrowth experiments, and explore the complex interactions that occurred between numerical (change in abundance of the cytometric populations) and single‐cell HNF responses.
Effect of pioglitazone on endothelial function in impaired glucose tolerance
Authors: Quinn C. E. , Lockhart C. J. , Hamilton P. K. , Loughrey C. M. , McVeigh G. E.
Published: March 2010

Aim: Flow‐mediated dilation (FMD) is a surrogate marker of endothelial function, which has been proposed as a barometer of vascular health. Impaired microvascular response to reactive hyperaemia is thought to be the mechanism behind reduced shear stress and subsequently impaired FMD, which has been associated with cardiovascular events. This study aims to assess the effect of pioglitazone on the vasculature of patients with impaired glucose tolerance (IGT).

Materials and Methods: Forty IGT patients with no cardiovascular disease were compared with 24 healthy age‐ and sex‐matched controls. Endothelial function was assessed using FMD of the brachial artery. Adiponectin (ADN) levels were measured and insulin sensitivity was calculated using homeostasis model assessment of insulin resistance (HOMA‐IR). A randomised double‐blind placebo‐controlled trial of the IGT subjects was then performed, with subjects receiving either pioglitazone 30 mg od or matched placebo for 12 weeks before the measurements were repeated.

Results: The IGT subjects had a significantly impaired FMD compared with the controls (p < 0.001). Diastolic shear stress (DSS) was also significantly reduced in IGT (p = 0.04). High molecular weight (HMW) ADN was significantly lower in the IGT group than in controls (p = 0.03). On analysis of the IGT group after 12 weeks treatment, FMD was significantly increased in the pioglitazone group compared with placebo (p = 0.03) as was endothelium‐independent dilation (EID) (p = 0.03). A significant increase in total ADN (p < 0.001), HMW ADN (p < 0.001) and HMW/total ratio (p = 0.001) occurred in the pioglitazone group compared with placebo.

Conclusions: Pioglitazone improved endothelial function in IGT. Treatment with pioglitazone may reduce the risk of cardiovascular disease in this patient group.
In vivo microwave‐induced porcine kidney thermoablation: results and perspectives from a pilot study of a new probe
Authors: Bartoletti Riccardo , Cai Tommaso , Tosoratti Nevio , Amabile Claudio , Crisci Alfonso , Tinacci Galliano , Mondaini Nicola , Gontero Paolo , Gelsomino Sandro , Nesi Gabriella
Published: March 2010

OBJECTIVE

To test the in vivo effects (toxicity, completeness of necrosis, dimensions of the lesion) of microwave thermoablation on porcine kidneys, using the Amica Probe v3 (Hospital Service SpA, Aprilia, Italy), in a refrigerated 17‐G microwave applicator, that can be used to induce a spherical necrotic area.

PATIENTS AND METHODS

Six pigs were used; each kidney was treated, with no kidney pedicle clamping, by microwave thermoablation at least in three different zones with different exposure times and power, during open surgery. Twelve kidneys had 32 microwave thermoablations overall. The kidneys were then surgically removed, and necrotic lesions measured and evaluated microscopically. The sphericity index (SI) was also calculated to evaluate lesion reproducibility. Areas of renal tissue that were missed were then microscopically evaluated by NADH in vivo staining.

RESULTS

In all, 32 thermoablations were applied; the mean (sd) lesion diameter ranged from 1.2 (0.3) to 4.2 (0.1) cm and changed in relation to both power and time of exposure. The 50‐W power particularly induced necrotic renal lesions ranging from 1.9 (0.2) to 4.2 (0.1) cm as a function of the time of exposure and the optimal SI (1.04). Pathological evaluation showed no skipped areas in the context of the lesion, or healthy kidney tissue damage close to necrotic lesions.

CONCLUSIONS

Thermoablation with the Amica probe is safe and showed excellent in vivo effects in this porcine model. Increasing the exposure time at 50 W power could be a useful percutaneous minimally invasive treatment for small solid masses (<4.2 cm), avoiding the risk of missing tumour areas or kidney parenchymal damage from microwave treatment.
New Italian guidelines on bladder cancer, based on the World Health Organization 2004 classification
Authors: Puppo Paolo , Conti Giario , Francesca Francesco , Mandressi Alberto , Naselli Angelo ,   the AURO.it guideline committee
Published: March 2010

OBJECTIVE

To provide evidence‐based recommendations on bladder cancer management

METHODS

A multidisciplinary guideline panel composed of urologists, medical oncologists, radiotherapists, general practitioners, radiologists, epidemiologists and methodologists conducted a structured review of previous reports, searching the Medline database from 1 January 2004 to 31 December 2008. The milestone papers published before January 2004 were accepted for analysis. The level of evidence and the grade of the recommendations were established using the GRADE system.

RESULTS

In all, 15 806 references were identified, 1940 retrieved, 1712 eliminated (specifying the reason for their elimination) and 971 included in the analysis, as well as 241 milestone reports. A consensus conference held to discuss the discrepancies between the scientific evidence and the clinical practice was then attended by 122 delegates of various specialities.

CONCLUSION

Recommendations on bladder cancer management are provided.
Phylogenetic, spatial and environmental components of extinction risk in carnivores
Authors: Safi Kamran , Pettorelli Nathalie
Published: March 2010

Aim Extinction risk is non‐randomly distributed across phylogeny and space and is influenced by environmental conditions. We quantified the relative contribution of these factors to extinction risk to unveil the underlying macroecological processes and derive predictive models.

Location Global.

Methods Based on the IUCN global assessments, we divided 192 carnivore species into two dichotomous classes representing different levels of extinction risk. We used spatial proximity, phylogenetic relationship and environmental variables together with phylogenetic eigenvector regression and spatial eigenvector filters to model and predict threat status.

Results Our full models explained between 57% and 96% of the variance in extinction risk. Phylogeny and spatial proximity roughly explained between 21% and 70% of the total variation in all analyses, while the explanatory power of environmental conditions was relatively weaker (up to 15%). Phylogeny and spatial proximity contributed equally to the explained variance in the lower threat level, while spatial proximity was the most important factor in the models of the higher threat level. Prediction of threat status achieved 97% correct assignments.

Main conclusions Our approach differs fundamentally from current studies of extinction risk because it does not necessarily rely on life‐history information. We clearly show that instead of treating phylogenetic inertia and spatial signal as statistical nuisances, space and phylogeny should be viewed as very useful in explaining a wide range of phenomena in comparative studies.
Disaster response preparedness coordination through social networks
Authors: Hossain Liaquat , Kuti Matthew
Published: March 2010

Studies of coordination in human networks have typically presented models that require stable working relationships. These models cannot be applied to emergency response management, which demands distributed coordination in volatile situations. This paper argues that changes to interconnectedness of nodes in a network may have implications for the potential to coordinate. A social network‐based coordination model is proposed to explore an organizational actor's state of readiness in extreme conditions. To test this hypothesis, the study investigates survey data from state law enforcement, state emergency services and local law enforcement, presenting agency‐based (macro) and cross‐agency (micro) analysis on 224 completed questionnaires. The main findings are: (i) there is a positive correlation between network connectedness and the potential to coordinate; (ii) the concept of tiers within an emergency response network may exist and be characterized by the sub‐network with which an organization associates; (iii) a range or threshold characterizes how interconnected an organization at a given tier should be.
The Effect of Insider Control and Global Benchmarks on Chinese Executive Compensation
Authors: Chen Jean J. , Liu Xuguang , Li Weian
Published: March 2010

Manuscript Type: Empirical

Research Question/Issue: We investigate the effect of insider control from the managerial power perspective and the global pay benchmarks from the behavioral approach on Chinese executive compensation.

Research Findings: Based on a balanced panel sample of 502 Chinese listed firms between 2001 and 2006, we find that both CEO duality and CEO ownership exert significant influence on Chinese executive compensation contracting and they contribute to the high level of executive compensation. We support the managerial power hypothesis by arguing that CEO duality and CEO shareholding tend to entrench insider managers further to collude with government officials and extract a firm's assets. Shareholdings appear to actively restrain managers from serving their self‐interests as to their pay levels, including on the board independence and the supervisory board levels. However, private institutional shareholdings perform actively in restraining managerial influence on the executive pay setting. There is an upward increase in the executive pay levels due to the global pay benchmark effects introduced by foreign investment. The compensation committees' decisions on executive pay levels are largely influenced by the global peer group's pay levels, rather than linking to firm performance as predicted by the optimal contracting model.

Theoretical Implications: We extend the optimal contracting model by incorporating the managerial power hypothesis to demonstrate how insider control affects the Chinese executive pay setting. We also add a behavioral approach to reflect how the global pay benchmarks affect the Chinese executive compensation setting via the negotiation between a firm's compensation committee and its managers.

Practitioner/Policy Implications: The Chinese government should consider exerting rigorous restrictions on executive shareholding and management buy‐out as an incentive for managers. In addition, the Chinese Code of Corporate Governance should explicitly restrict CEO duality. The government should be aware of the potential influence of behavioral bias in human decisions departing from rational economical criteria, and set policies to balance the benefits of introduction of foreign investment against the costs of resultant excessive executive compensation, and the benefits of setting a compensation committee as a corporate governance control device against the costs of the compensation committees working with the executives together to increase the executive pay level.