bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of the meningococcal adhesin NadA is controlled by a transcriptional regulator of the MarR family
Authors: Schielke Stephanie , Huebner Claudia , Spatz Carolin , Nägele Virginie , Ackermann Nikolaus , Frosch Matthias , Kurzai Oliver , Schubert‐Unkmeir Alexandra
Published: April 2009

Two closely related pathogenic species have evolved in the genus Neisseria: N. meningitidis and N. gonorrhoeae, which occupy different host niches and cause different clinical entities. In contrast to the pathogen N. gonorrhoeae, N. meningitidis is a commensal and only rarely becomes invasive. Little is known about the genetic background of the entirely different lifestyles in these closely related species. Meningococcal NMB1843 encodes a transcriptional regulator of the MarR family. The gonococcal homologue FarR regulates expression of farAB, mediating fatty acid resistance. We show that NmFarR also directly interacts with NmfarAB. Yet, by contrast to N. gonorrhoeae, no significant sensitivity to fatty acids was observed in a ΔfarR mutant due to intrinsic resistance of meningococci. Further analyses identified an NmFarR‐repressed protein absent from N. gonorrhoeae. This protein is the meningococcus‐specific adhesin and vaccine component NadA that has most likely been acquired by horizontal gene transfer. NmFarR binds to a 16 base pair palindromic repeat within the nadA promoter. De‐repression of nadA resulted in significantly higher association of a ΔfarR strain with epithelial cells. Hence NmFarR has gained control over a meningococcus‐specific gene involved in host colonization and thus contributed to divergent niche adaptation in pathogenic Neisseriae.
Distribution of fasting plasma glucose and prevalence of impaired fasting glucose, impaired glucose tolerance and type 2 diabetes in the Mexican paediatric population
Authors: Guerrero‐Romero Fernando , Violante Rafael , Rodríguez‐Morán Martha
Published: April 2009

Published data on the distribution of fasting plasma glucose (FPG) in children are scarce. We therefore set out to examine the distribution of FPG and determine the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2‐DM) in Mexican children aged 6–18 years in a community‐based cross‐sectional study. A total of 1534 apparently healthy children were randomly enrolled and underwent an oral glucose tolerance test. IFG was defined by an FPG value between ≥100 and <126 mg/dL, IGT by glucose concentration 2‐h post‐load between ≥140 and <200 mg/dL, and T2‐DM by glucose concentration 2‐h post‐load ≥200 mg/dL.

The FPG level at the 75th percentile of distribution was 98.0, 100.0 and 99.0 mg/dL for children aged 6–9, 10–14 and 15–18 years, respectively; the 95th percentile of FPG was greater than 100 mg/dL for all the age strata. In the population overall, the prevalences of IFG, IGT, and T2‐DM were 18.3%, 5.2% and 0.6%, respectively. Among obese children and adolescents, the prevalences of IFG, IGT, IFG + IGT and T2‐DM were 19.1%, 5.7%, 2.5% and 1.3%. Our study shows a high prevalence of prediabetes and is the first that reports the distribution of FPG in Mexican children and adolescents.
Stratigraphic architecture and infill history of a deglaciated bedrock valley based on georadar, seismic profiling and drilling
Authors: HANSEN LOUISE , BEYLICH ACHIM , BURKI VALENTIN , EILERTSEN RAYMOND S. , FREDIN OLA , LARSEN EILIV , LYSÅ ASTRID , NESJE ATLE , STALSBERG KNUT , TØNNESEN JAN F.
Published: April 2009

The sediment fill of a silled bedrock valley in Western Norway has been investigated with respect to stratigraphy and infill history using a combination of mapping, georadar, seismic profiling and drilling. A small outlet glacier occupies the head of the valley that displays a stepwise down‐valley profile and terminates in a lake at 29 m above sea‐level. The valley is surrounded by high, steep bedrock slopes and is characterized by a series of filled basins each limited by sills of bedrock or moraine accumulations. Till, glacial outwash and/or rockslide deposits fill in the lower half of the two larger basins. (Fan) delta deposits fringed by the deposits of alluvial fans and colluvial cones dominate the upper fill of most basins. (Fan) delta deposits interfinger downstream with lake sediments in the larger basins and fluvial deposits comprise the top fill. The overall infill pattern was controlled by deglaciation as well as basin size and shape. An overall decreasing sediment supply following deglaciation is shown in the fill of a larger basin down‐valley, whereas a recently increasing sediment supply during glacier growth is reflected primarily in an upstream basin. Only the lowermost basin was exposed to a sea‐level drop from 75 m above sea‐level to the present lake level associated with incision and river migration. This observation is in contrast to the basins above marine influence where incision has been limited due to fixed downstream sills resulting in insignificant erosion except for some fan‐head entrenchment. It follows that the fills of these small valley basins display progradational and aggradational trends of deposition and paraglacial reworking has been limited. Additionally, the study demonstrates that georadar profiling, combined with other methods, is very useful for comprehensive investigation of valley basins.
Molecular mechanisms underlying large genomic deletions in ornithine transcarbamylase (OTC) gene
Authors: Quental R , Azevedo L , Rubio V , Diogo L , Amorim A
Published: April 2009

Ornithine transcarbamylase deficiency (OTCD) is an X‐linked urea cycle error causing hyperammonemia and orotic aciduria. Clinical diagnosis is generally confirmed by mutation detection. However, in ∼20% of the patients, no mutation is found by conventional mutation‐searching strategies, which fail to detect deletions spanning at least a whole exon, large rearrangements, or mutations at non‐coding regions. To detect large deletions or duplications, we have applied the multiplex ligation‐dependent probe amplification (MLPA) methodology to three OTCD patients (two females and one male). MLPA revealed copy number alterations of OTC exons in all of them. The two females were found to be heterozygous for deletions of either exon 2 or exons 6–9, and the male was confirmed to lack all OTC exons. Females’ characterization of the deletion breakpoints by long polymerase chain reaction and sequencing revealed the mutations c.78‐3544_217‐129del5921 and c.541‐600_1005 + 1880del10862 corresponding to exon 2 and exon 6–9 deletions, respectively. Examination of the deletion‐flanking regions suggests that exon 2 deletion probably resulted from replication slippage facilitated by a secondary structure formed by two inverted Alu repeats, whereas an Alu–Alu homologous recombination was probably responsible for the exon 6–9 deletion. This work contributes to the identification of novel disease‐causing mutations in OTCD and increases the knowledge on possible mutational mechanisms generating deletions in OTC.
A novel HLA‐Cw*07 variant, HLA‐Cw*0760, identified by sequence‐based typing in a bone marrow donor
Authors: Martínez‐Martínez L. , González‐Santesteban C. , Agustí‐Martí M. , Pérez‐Ranz E. , De La Calle‐Martín O.
Published: April 2009

We report the identification of the novel allele HLA‐Cw*0760 that was found during confirmatory high‐resolution sequence‐based typing of a bone marrow donor. The Cw*0760 allele has two nucleotide changes from Cw*070101 at positions 341 and 343 in exon 2, resulting in two amino acid changes from Asp to Ala (codon 90: GAC→GCC) and Gly to Arg (codon 91: GGG→AGG).
HLA‐DRB1 associations with disease susceptibility and clinical course in Australians with multiple sclerosis
Authors: Stankovich J. , Butzkueven H. , Marriott M. , Chapman C. , Tubridy N. , Tait B. D. , Varney M. D. , Taylor B. V. , Foote S. J. ,   The ANZgene Consortium, Kilpatrick T. J. , Rubio J. P.
Published: April 2009

Human leucocyte antigen (HLA)‐DRB1*1501 and other class II alleles influence susceptibility to multiple sclerosis (MS), but their contribution if any to the clinical course of MS remains uncertain. Here, we have investigated DRB1 alleles in a large sample of 1230 Australian MS cases, with some enrichment for subjects with primary progressive (PPMS) disease (n = 246) and 1210 healthy controls. Using logistic regression, we found that DRB1*1501 was strongly associated with risk (P = 7 × 10−45), as expected, and after adjusting for DRB1*1501, a predisposing effect was also observed for DRB1*03 (P = 5 × 10−7). Individuals homozygous for either DRB1*15 or DRB1*03 were considerably more at risk of MS than heterozygotes and non‐carriers. Both the DRB1*04 and the DRB1*01/DRB1*15 genotype combination, respectively, protected against PPMS in comparison to subjects with relapsing disease. Together, these data provide further evidence of heterogeneity at the DRB1 locus and confirm the importance of HLA variants in the phenotypic expression of MS.
An unusual cause of meconium peritonitis in a foetus
Authors: Basu Sriparna , Kumar Ashok , Pandey Nisha
Published: April 2009

Abstract:  Meconium peritonitis is a sterile chemical peritonitis resulting from intestinal perforation in‐utero. We present a preterm male neonate weighing 1820 g in whom foetal meconium peritonitis was diagnosed by antenatal utrasonogram. Examination of the newborn in the immediate postnatal period revealed a firm lump of size 5 × 3 cm in the right lumbar and umbilical area. Rest of the abdomen was normal without any clinical evidence of intestinal obstruction. X‐ray of abdomen done at 3 hours of life showed a cystic mass with calcified margin. Ultrasonography of abdomen ruled out any definite cause of intestinal obstruction and perforation. He was kept on conservative management. At 11 hours of life the neonate passed a small sticky white mucus plug per rectum followed by black colored meconium of normal consistency 2 hours later. The bowel habit remained regular thereafter. Screening for intrauterine infections and cystic fibrosis was negative. He is under regular follow‐up and is now 6 months old with normal bowel habit. A lump of size 2 × 2 cm is still palpable and a small calcified mass is persistent in x‐ray. Role of an intestinal mucus plug as the potential factor for intestinal obstruction and subsequent perforation has been highlighted in the present case.
25‐Hydroxyvitamin D levels in prevalent Australian dialysis patients
Authors: CLAYTON PHILIP , SINGER RICHARD
Published: April 2009

Aim:  Vitamin D deficiency is a common problem in the general population. A high frequency of vitamin D deficiency in the pre‐dialysis and dialysis populations has been observed overseas, but there is limited information regarding vitamin D levels in Australian dialysis patients.

Method:  We measured 25‐hydroxyvitamin D levels in 120 haemodialysis (HD) and 31 peritoneal dialysis (PD) patients. We defined vitamin D deficiency as a level <50 nmol/L and insufficiency as a level of 50–74 nmol/L. We assessed for correlation between vitamin D levels and markers of bone and mineral metabolism, age, sex, dialysis type, dialysis duration, haemoglobin and erythropoietin dose.

Results:  Of the HD patients, 59 (49%) were frankly deficient and 39 (33%) had insufficiency. Of the PD patients, 24 (77%) were frankly deficient and 6 (19%) had insufficiency. Overall, only 23 patients (19%) had sufficient levels of vitamin D. Vitamin D levels were significantly lower in PD patients (P = 0.001), in females (P = 0.002) and in those with diabetic nephropathy (P = 0.03). There was no correlation between vitamin D levels and markers of bone and mineral metabolism, age, dialysis duration, haemoglobin or erythropoietin dose.

Conclusion:  Vitamin D deficiency and insufficiency were very common in this cohort of prevalent Australian dialysis patients. Lower levels were associated with PD as treatment modality, female sex and diabetic nephropathy.
Review article: Bone biopsy in chronic kidney disease: Patient level end‐point or just another test?
Authors: JORGETTI VANDA
Published: April 2009

The reduction of renal function in chronic kidney disease leads to disturbed calcium and phosphorus metabolism, impaired action of calcitriol, increased parathyroid hormone, FGF‐23 levels and ultimately bone disorders. These disturbances have been traditionally termed renal osteodystrophy, which evaluation and diagnosis require a bone biopsy. In the last four decades, researchers from different countries have developed new techniques and have introduced concepts that allowed the development of bone histomorphometry, considered the key tool to study bone metabolism, remodelling and structure. In this review we focus on the relevance of bone biopsy and its respective histomorphometric analysis to help nephrologists to evaluate patients with chronic kidney disease.
Medication adherence and significant others' support of consumers with schizophrenia in Australia
Authors: McCann Terence V. , Lu Sai
Published: April 2009

Medication adherence is problematic in people with chronic illness. The purpose of this exploratory study was to examine the effects of the perceived support from significant others on the oral antipsychotic medication taking of consumers with schizophrenia. A convenience sample of 81 consumers took part in the study. The consumers were recruited by case managers from the community in the western region of Melbourne and in regional and rural Victoria, Australia. No difference was found in self‐reported medication adherence between the consumers with significant others' support and those without significant others' support. The perceived effect of having a supportive relationship with significant others was not associated with increased medication adherence. The findings indicated that the significant others' support did not influence the self‐reported medication adherence of the consumers with schizophrenia. The results highlighted the importance of considering medication adherence as a multidimensional concept.
Evaluation of the birthweight values of newborns presenting at the Mother–Child Health and Family Planning Center in Yenibosna, Istanbul, Turkey
Authors: Dolgun Gülümser , Cimen Saniye , Yazıcı Saadet , Savaşer Sevim
Published: April 2009

This study was conducted to examine the effect of a number of variables related to the mother (age, educational level, employment status, cigarette smoking during pregnancy) and to the baby (sex and birth order) on newborns' birthweight. The research was carried out in the province of Istanbul, one of Turkey's large metropolises, at the Mother–Child Health and Family Planning Center in the district of Yenibosna, where 0–1 month old infants had been brought in for phenylketonuria screening and vaccinations. The mean age of the mothers was 26.1 ± 4.8 years and the mean birthweight of the newborns was 3236.7 ± 542.2 g. Of the infants, 6.3% were classified as having a low birthweight and 8.3% were large infants. The mean birthweight showed a statistical significance depending upon the infants' sex and birth order. The mean birthweight of the infants of the working mothers, as opposed to the unemployed mothers and the mothers in nuclear families, as opposed to the mothers in extended families, was higher.
Effects of providing a nutrition education program for teenagers: Dietary and physical activity patterns
Authors: Tse Mimi M. Y. , Yuen Dorothy T. W.
Published: April 2009

This study enhanced nutritional knowledge in an education program and encouraged healthy dietary habits and regular physical activity among teenagers. A total of 203 adolescents from a secondary school in Hong Kong took part in the study. Their Body Mass Index, dietary habits, and physical exercise pattern were recorded and examined before and after the health education program. The prevalence of overweight and obesity, together with the fat composition, were high among the participants before the nutrition education program. There was a marked gain in knowledge upon its completion. A follow‐up action conducted 3 months later revealed positive outcomes in relation to the diet and physical activity level. The teenagers were able to take control of their health and requested the tuck shop to sell more healthy food and reduce the supply of unhealthy items. The educational initiatives in dietary habits and physical activities proved to be effective in encouraging the teenagers to eat more healthily and to adopt an active lifestyle.
Does diversity influence soil nitrate, light availability and productivity in the establishment phase of Australian temperate grassland reconstruction?
Authors: Gibson‐Roy By Paul , Delpratt John , Moore Greg , Hepworth Graham
Published: April 2009

Summary  The successful conservation and restoration of the temperate native grasslands of south‐eastern Australia is critical to reversing the decline in range and diversity of these threatened plant communities. Yet the goals of high native species diversity and weed management are difficult to achieve in grassland restoration projects. To increase our understanding of whether synergies exist between these goals (i.e. whether early introduction of a larger number of species might improve both outcomes in the reassembly of native grassland), we examined the relationships between plant species number, functional group number and resource use during the establishment phase of direct‐sown grassland. We did this by sowing a representative suite of species (at varying levels of species number and functional group number) into experimental plots and then measuring and analysing the extent to which the newly established assemblages captured available resources, i.e. used soil nitrate, absorbed light and produced biomass (vegetative cover). Statistically significant correlations were common between the predictor variables (species number, functional group number, percentage vegetative cover, plant number, presence of idiosyncratic (dominating) species) and responses (soil nitrate concentration, light reduction or ‘extinction’). Higher diversity was associated with lower soil nitrate, while percentage vegetative cover and the presence of idiosyncratic species best predicted light extinction. The relationship between diversity, and plant biomass (measured as vegetative cover) and plant number was positive in the first year of the study. The diversity/biomass relationship became negative in the second year due to the higher numbers and cover of ‘idiosyncratic’ species. The diversity/plant number relationship also became negative in the autumn of the second year and was reduced to a trend by the winter. We found that lower nitrate and increasing plant numbers and vegetative cover were most strongly linked to increasing species number in the early stages of this study. This suggests that introducing and maintaining high diversity early in a native grassland reassembly or enhancement project will improve the resistance (e.g. to weed) of these communities. At later stages of grassland development, this function may be provided by the more dominating idiosyncratic species. The maintenance of diversity, an important goal in its own right, will therefore necessitate managed disturbances to periodically reduce the vegetative dominance of idiosyncratic species, releasing resources for the diverse range of other species whose early introduction will have allowed them to persist in the soil seed bank or as suppressed rootstocks.
Re‐establishing a saltmarsh vegetation structure in a changing climate
Authors: Green Joanne , Reichelt‐Brushett Amanda , Jacobs Surrey W. L.
Published: April 2009

Summary  A major management decision in an ecological restoration or rehabilitation project is whether supplementary planting or natural vegetation regeneration is the better alternative or if a combination can be applied. Management decisions are further complicated when the project involves saltmarsh as tidal cycles, the effects of salinity and sea level rise add to the complexity of decisions. The ecological values of the saltmarsh community in Australia were only recognized relatively recently but the endangered ecological community listing in 1994 (under the New South Wales Threatened Species Conservation Act 1995) highlighted the need to protect, rehabilitate and restore saltmarsh.

This project measured vegetation change after soil profile reconstruction in saltmarsh surrounding Sponsors Lagoon, Fingal Peninsula in north coastal New South Wales, Australia. Restored sites (planted and non‐planted) were compared with nearby disturbed (control) and reference sites. The dominant species in the community to be restored were Saltwater Couch (Sporobolus virginicus), Suaeda (Suaeda australis), Sarcocornia (Sarcocornia quinqueflora ssp. quinqueflora and Sea Rush (Juncus kraussii ssp. australiensis). Changes in percentage cover of the species in the first three years after soil reconstruction work showed that the dominant Saltwater Couch established only from vegetative growth arising from remnant vegetation but there was strong seedling regeneration of several other species. It was concluded that planting is important for species that are less vagile, in larger, denuded parts of this site where their resilience is lower and natural regeneration potential is limited. An understanding of the biology of the individual species is therefore likely to be essential in saltmarsh restoration projects. A combination of techniques, incorporating planting of slower establishing species and encouragement of seed‐germinated colonizers is useful for initial site stabilization and progressive ecological recovery at this site. The inclusion of migration zones in the planning phase will allow for the long‐term viability of this restoration project.
The child who refuses to undergo anesthesia and surgery – a case scenario‐based discussion of the ethical and legal issues
Authors: WALKER HEIDI
Published: April 2009

Situations where children refuse to undergo anesthesia and surgery can be challenging for anesthetists. Clear legal guidelines are lacking and decisions often need to be made with a degree of urgency. When a child refuses to cooperate with the induction of anesthesia, it is important to consider the autonomous capacity of the child, the presence of a legally valid consent from a suitable guardian, the urgency with which the surgery needs to proceed and the practical implications of proceeding without the child’s cooperation. In this article, case scenarios are used to demonstrate how these considerations can be applied in practice.
The number of procedures required to achieve optimal competency with male circumcision: findings from a randomized trial in Rakai, Uganda
Authors: Kiggundu Valerian , Watya Stephen , Kigozi Godfrey , Serwadda David , Nalugoda Fred , Buwembo Denis , Settuba Absolom , Anyokorit Margaret , Nkale James , Kighoma Nehemiah , Ssempijja Victor , Wawer Maria , Gray Ronald H.
Published: April 2009

OBJECTIVE

To assess the number of procedures required to achieve optimal competency (time required for surgery with minimal adverse events) in Rakai, Uganda, and thus facilitate the development of guidelines for training providers, as male circumcision reduces the acquisition of human immunodeficiency virus (HIV) in men and is recommended for HIV prevention.

PATIENTS AND METHODS

In a randomized trial, 3011 men were circumcised, using the sleeve method, by six physicians who had completed training, which included 15–20 supervised procedures. The duration of surgery from local anaesthesia to wound closure, moderate or severe surgery‐related adverse events (AEs), and wound healing were assessed in relation to the number of procedures done by each physician.

RESULTS

The median age of the patients was 24 years. The number of procedures per surgeon was 20–981. The mean time required to complete surgery was ≈40 min for the first 100 procedures and declined to 25 min for the subsequent 100 circumcisions. After controlling for the number of procedures there was no significant difference in duration of the surgery by patient HIV status or age. The rate of moderate and severe AEs was 8.8% (10/114) for the first 19 unsupervised procedures after training, 4.0% for the next 20–99 (13/328) and 2.0% for the last 100 (P for trend, 0.003). All AEs resolved with management.

CONCLUSION

The completion of more than 100 circumcisions was required before newly trained physicians achieved the optimum duration of surgery. AEs were higher immediately after training and additional supervision is needed for at least the first 20 procedures after completing training.
Listening to the patient: a flexible approach to the use of antimuscarinic agents in overactive bladder syndrome
Authors: Chapple Christopher R. , Rosenberg Matt T. , Brenes Francisco J.
Published: April 2009

Several studies with modern antimuscarinics have used a flexible‐dosing strategy. We reviewed data from several studies with solifenacin, darifenacin and oxybutynin extended‐release that evaluated the impact of dose flexibility on clinical management. A strategy based on patient‐requested dose increases was found to be consistently effective in improving the symptoms of overactive bladder. Patients requesting a dose increase often had more severe symptoms at baseline than those who did not request a dose increase, and these patients derived most benefit from the increased dose. Specialists and family doctors should encourage open discussion with their patients about requesting dose titration so as to meet patients' individual needs.
Optimal management of metastatic renal cell carcinoma: an algorithm for treatment
Authors: Bellmunt Joaquim , Flodgren Per , Roigas Jan , Oudard Stéphane
Published: April 2009

The treatment of metastatic renal cell carcinoma (mRCC) has been changed by the introduction of targeted agents. Consideration of individual patient factors, such as previous treatment and prognostic risk, e.g. according to the Memorial Sloan‐Kettering Cancer Center (MSKCC) risk criteria), can assist in ensuring that patients receive appropriate targeted therapies. Available clinical evidence shows sunitinib to be the reference standard of care for the first‐line treatment of mRCC in patients at favourable or intermediate prognostic risk according to MSKCC criteria. Combined treatment with bevacizumab plus interferon‐α can also be considered for the first‐line treatment of mRCC in this setting. For the first‐line treatment of poor‐risk patients, temsirolimus has shown benefit in a phase III study, while sunitinib can also be considered. For second‐line treatment in cytokine‐refractory patients, sorafenib is recommended based on phase III trial results; sunitinib has also shown activity after failure of cytokine therapy or targeted agents. As well as antitumour activity, the tolerability of targeted agents should be evaluated in the context of individual patients, considering factors such as comorbidities and age. As our understanding of the activity of targeted agents for mRCC increases, we should ensure that these agents are used appropriately to provide patients with optimal treatment benefits.
Renal cell carcinoma with inferior vena caval extention: impact of tumour extent on surgical outcome
Authors: Al Otaibi Mohammed , Youssif Tamer Abou , Alkhaldi Abdulaziz , Sircar Kanishka , Kassouf Wassim , Aprikian Armen , Mulder David , Tanguay Simon
Published: April 2009

OBJECTIVE

To evaluate our experience with surgical resection of renal cell carcinoma (RCC) with inferior vena cava (IVC) involvement and examine the relationship between prognosis and tumour extent.

PATIENTS AND METHODS

A retrospective review of nephrectomy performed between 1985 and 2005 identified 50 patients presenting with tumour thrombus extension into the IVC. Clinical characteristics and outcome were evaluated.

RESULTS

Of the 50 patients evaluated, 7, 26, 10 and 7 presented with level I, II, III and IV thrombus, respectively. Major postoperative complications occurred in 16% of patients. Local or distant failure occurred in 25 (64%) patients. The mean time to recurrence was 10 months. Only supra‐diaphragmatic extension of the tumour thrombus was predictive of disease recurrence.

CONCLUSION

Locally advanced RCC with IVC thrombus remains associated with significant local and distant failure rate. The level of thrombus extension is significantly associated with disease recurrence. Effective adjuvant therapy is needed to improve outcome in this patient population.
The potential association between fruit intake and body weight – a review
Authors: Alinia S. , Hels O. , Tetens I.
Published: April 2009

Both national and international bodies recommend an increased intake of fruits and vegetables in order to decrease the risk of overweight and obesity. However, there is a rationale to investigate the separate role of fruits. The aim of this paper was to systematically review and analyse published human intervention, prospective observational and cross‐sectional studies on fruit intake and body weight in adults. We identified three intervention, eight prospective observational and five cross‐sectional studies that explored this relationship. Two of the intervention studies showed that fruit intake reduced body weight, five of the prospective observational studies showed that fruit consumption reduced the risk of developing overweight and obesity, and four of the cross‐sectional studies found an inverse association between fruit intake and body weight. Important methodological differences and limitations in the studies make it difficult to compare results. However, the majority of the evidence points towards a possible inverse association between fruit intake and overweight. Future intervention and prospective observational studies examining the direct and independent role of fruit in body‐weight management in free‐living individuals are needed. Moreover, important determinants such as energy density, energy content, fruit and vegetable consumption, physical form of fruit and preparation methods need to be included in future studies.
Individuality and epigenetics in obesity
Authors: Campión J. , Milagro F. I. , Martínez J. A.
Published: April 2009

Excessive weight gain arises from the interactions among environmental factors, genetic predisposition and the individual behavior. However, it is becoming evident that interindividual differences in obesity susceptibility depend also on epigenetic factors. Epigenetics studies the heritable changes in gene expression that do not involve changes to the underlying DNA sequence. These processes include DNA methylation, covalent histone modifications, chromatin folding and, more recently described, the regulatory action of miRNAs and polycomb group complexes. In this review, we focus on experimental evidences concerning dietary factors influencing obesity development by epigenetic mechanisms, reporting treatment doses and durations. Moreover, we present a bioinformatic analysis of promoter regions for the search of future epigenetic biomarkers of obesity, including methylation pattern analyses of several obesity‐related genes (epiobesigenes), such as FGF2, PTEN, CDKN1A and ESR1, implicated in adipogenesis, SOCS1/SOCS3, in inflammation, and COX7A1 LPL, CAV1, and IGFBP3, in intermediate metabolism and insulin signalling. The identification of those individuals that at an early age could present changes in the methylation profiles of specific genes could help to predict their susceptibility to later develop obesity, which may allow to prevent and follow‐up its progress, as well as to research and develop newer therapeutic approaches.
THE INSIGNIFICANCE OF PERSONAL IDENTITY FOR BIOETHICS
Authors: SHOEMAKER DAVID
Published: April 2009

It has long been thought that certain key bioethical views depend heavily on work in personal identity theory, regarding questions of either our essence or the conditions of our numerical identity across time. In this paper I argue to the contrary, that personal identity is actually not significant at all in this arena. Specifically, I explore three topics where considerations of identity are thought to be essential – abortion, definition of death, and advance directives – and I show in each case that the significant work is being done by a relation other than identity.
636. THE GENUS SELENIPEDIUM
Authors: Cribb Phillip
Published: April 2009

The five species of the genus Selenipedium Rchb. f. (Orchidaceae) are described and illustrated with line drawings. Possibilities for the cultivation of the genus are discussed. A painting of Selenipedium aequinoctiale Garay is included.
647. RONDELETIA BUXIFOLIA
Authors: Clubbe Colin , Hamilton Martin , Corcoran Marcella
Published: April 2009

Rondeletia buxifoliaVahl (Rubiaceae) a critically endangered shrub, restricted to the Caribbean Island of Montserrat, is described and illustrated. Its distribution and conservation status are reviewed.
IS THE GHOSH MODEL INTERESTING?*
Authors: De Mesnard Louis
Published: April 2009

ABSTRACTThe overall value of the Ghosh model is appraised. Its treatment of quantities and prices is scrutinized by examining the variant with data in quantities and prices, and the variant with data in value and price indexes. The methodology involves returning to the accounting equations and shows that: (i) the Ghosh model offers solutions of limited interest, being incapable of providing prices or price indexes separately from quantities; (ii) what is taken to be the equation of Ghosh's value model is actually that of Ghosh's physical model; (iii) the Ghosh model may serve for cost‐push exercises, but the dual of the Leontief model performs the same task in a much simpler and more natural way; and (iv) Cronin's mixed models do not actually mix Leontief and Ghosh hypotheses.
Multivariate Weibull Mixtures with Proportional Hazard Restrictions for Dwell-Time-Based Session Clustering with Incomplete Data
Authors: Mair Patrick , Hudec Marcus
Published: April 2009

Emanating from classical Weibull mixture models we propose a framework for clustering survival data with various more parsimonious models by imposing restrictions on the distributional parameters. We show that these restrictions on the Weibull mixtures correspond to different proportional hazard restrictions across mixture components and Web page areas. A parametric cluster approach based on the EM algorithm is carried out on a multivariate data set. Our model set-up encompasses incomplete-data structures as well as censoring observations. We apply the methodology on retail data stemming from a global e-commerce company. Sessions are clustered with respect to the dwell times that a user spends on certain page areas. The cluster solution that is found allows for a detailed examination of the navigation behaviour in terms of the hazard and survivor functions within each component.
Overcoming the Multiple-Testing Problem When Testing Randomness
Authors: Spencer Neil H.
Published: April 2009

We propose a new method for overcoming the problem of adjusting for the multiple-testing problem in the context of testing random-number generators. We suggest that it is to be used in conjunction with an existing method. More generally, the method can be useful in other situations where the multiple-testing issue is encountered and the tests involved are not independent of each other, and their exact joint distribution is not readily available. The method makes use of the Mahalanobis distance and simulation. An example of its implementation is given by using data from a roulette wheel.
Chinese patients with Machado‐Joseph disease presenting with complicated hereditary spastic paraplegia
Authors: Gan S.‐R. , Zhao K. , Wu Z.‐Y. , Wang N. , Murong S.‐X.
Published: April 2009

Background and purpose:  The clinical overlap between Machado‐Joseph disease (MJD) and autosomal dominant complicated hereditary spastic paraplegia (AD‐HSP) is extensive and the differentiation between them can be difficult on clinical ground. However, patients are seeking the right diagnosis and it is important for neurologists to distinguish them in the early stage.

Methods:  In recent 10 years, we have recruited and followed‐up three families which were initially diagnosed as complicated AD‐HSP based on the clinical criteria. Mutation analyses of SPG4, SPG3A and ATXN3 were performed in the index cases.

Results:  No mutations on SPG4 and SPG3A were found. Mutation analysis of ATXN3 showed that these cases have one expanded allele and one normal allele. The copy numbers of CAG repeats were 80/28, 86/28 and 83/33, respectively.

Conclusions:  The molecular diagnosis confirmed that they were MJD patients though they had been misdiagnosed as complicated AD‐HSP for many years. The copy numbers of expanded allele were more than 80 and the copy numbers of normal allele were more than 27, which could somewhat explain the earlier onset age of these cases and the anticipation of the pedigrees. Our data emphasize the necessity to perform the mutation analysis of ATXN3 in clinically diagnosed complicated AD‐HSP patients.
Deficits in facial expression recognition in male adolescents with early‐onset or adolescence‐onset conduct disorder
Authors: Fairchild Graeme , Van Goozen Stephanie H.M. , Calder Andrew J. , Stollery Sarah J. , Goodyer Ian M.
Published: April 2009

Background:  We examined whether conduct disorder (CD) is associated with deficits in facial expression recognition and, if so, whether these deficits are specific to the early‐onset form of CD, which emerges in childhood. The findings could potentially inform the developmental taxonomic theory of antisocial behaviour, which suggests that early‐onset and adolescence‐limited forms of CD are subject to different aetiological processes.

Method:  Male adolescents with either early‐onset CD (n = 42) or adolescence‐onset CD (n = 39), and controls with no history of serious antisocial behaviour and no current psychiatric disorder (n = 40) completed tests of facial expression and facial identity recognition. Dependent measures were: (a) correct recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and (b) the number of correct matches of unfamiliar faces.

Results:  Relative to controls, recognition of anger, disgust, and happiness in facial expressions was disproportionately impaired in participants with early‐onset CD, whereas recognition of fear was impaired in participants with adolescence‐onset CD. Participants with CD who were high in psychopathic traits showed impaired fear, sadness, and surprise recognition relative to those low in psychopathic traits. There were no group differences in facial identity recognition.

Conclusions:  Both CD subtypes were associated with impairments in facial recognition, although these were more marked in the early‐onset subgroup. Variation in psychopathic traits appeared to exert an additional influence on the recognition of fear, sadness and surprise. Implications of these data for the developmental taxonomic theory of antisocial behaviour are discussed.
Visual function in infants with non‐syndromic craniosynostosis
Authors: Ricci D , Vasco G , Baranello G , Salerni A , Amante R , Tamburrini G , Dickmann A , Di Rocco C , Velardi F , Mercuri E
Published: April 2009

The aim of this study was to assess various aspects of visual function in children with single‐suture, non‐syndromic craniosynostosis. Thirty‐eight infants (28 males, 10 females; age range 3.5–13mo, mean age 7mo, 11 with plagiocephaly, 12 with trigonocephaly, and 15 with scaphocephaly), were assessed with a battery of tests specifically designed to assess various aspects of visual function in infancy. Thirty‐two of the 38 infants had at least one abnormality on one of the aspects of visual function assessed. Abnormal eye movements were found in eight infants of the whole cohort and were mainly found in infants with plagiocephaly (6/11), who also had frequent visual field abnormalities (5/11). In contrast, fixation shift, an aspect of visual function related to the integrity of parietal lobes, was more frequently abnormal in patients with scaphocephaly. Our results suggest that the presence and severity of visual impairment is related to the type of craniosynostosis. Follow‐up studies after surgical correction are needed to evaluate the possible beneficial effects of reconstructive surgery on visual function.
Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestation
Authors: Marston Louise , Peacock Janet L , Calvert Sandra A , Greenough Anne , Marlow Neil
Published: April 2009

Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur‐Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7‐ 23); (2) sex (39 males, 44 females; 95% CI 0.4‐11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI ‐12 to ‐4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1–9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm.
Psychological functioning and health‐related quality of life in adulthood after preterm birth
Authors: Dalziel Stuart R , Lim Vanessa K , Lambert Anthony , McCarthy Dianne , Parag Varsha , Rodgers Anthony , Harding Jane E
Published: April 2009

The aim of this study was to determine if preterm birth is associated with socioeconomic status (SES), psychological functioning, and health‐related quality of life (HRQoL) in adulthood. We used prospective follow‐up of 192 adult offspring of mothers who took part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (66 born at term [33 males, 33 females] 126 born preterm [66 males, 60 females]). Cognitive functioning was assessed using the Wechsler Abbreviated Scale of Intelligence. Working memory and attention was assessed using the Benton Visual Retention Test, the Paced Auditory Serial Addition Test, and the Brown Attention Deficit Disorder Scale. Psychiatric morbidity was assessed using the Beck Depression Inventory II, the State‐Trait Anxiety Inventory, and the Schizotypy Traits Questionnaire. Handedness was assessed using the Edinburgh Handedness Inventory. HRQoL was assessed using the Short Form‐36 Health Survey. Moderately preterm birth (median gestation 34wks, mean birthweight 1946g [SD 463g]) was not related to later marital status, educational attainment, SES, cognitive functioning, working memory, attention, or symptoms of anxiety or schizotypy at 31 years of age. Preterm birth was associated with fewer symptoms of depression and higher levels of satisfaction in three of the eight HRQoL domains measured (bodily pain, general health perception, and social functioning). Adults who were born moderately preterm have SES, psychological functioning, and HRQoL consistent with those who were born at term. This good long‐term outcome cannot be extrapolated to those with early childhood disability or very low birthweights.
Effects of carbon fibre spring orthoses on gait in ambulatory children with motor disorders and plantarflexor weakness
Authors: Bartonek Åsa , Eriksson Marie , Gutierrez‐Farewik Elena M
Published: April 2009

A consecutive series of 17 children (six males, 11 females; mean age 11y 11mo [SD 4y 5mo]; range 3y 11mo‐17y 4mo) with plantarflexor weakness was assessed to compare gait differences between a carbon fibre spring orthosis (CFSO) and participants' regular orthoses. Twelve children had myelomeningocele, four children had arthrogryposis, and one child had neuropathy with peripheral muscle pareses. All participants underwent clinical examination and 3D gait analysis. Parents answered a questionnaire to assess subjective perceptions of the orthoses. Results from 3D gait analysis provided evidence that CFSOs enhance gait function in most participants by improving ankle plantarflexion moment (p<0.001), ankle positive work (p<0.001), and stride length (p<0.001). The CFSO did not suit all participants, which emphasizes the importance of analyzing each patient's needs.
Sedation with 50% nitrous oxide/oxygen for outpatient dental treatment in individuals with intellectual disability
Authors: Faulks Denise , Hennequin Martine , Albecker‐Grappe Sylvie , Manière Marie‐Cécile , Tardieu Corinne , Berthet Annie , Wolikow Maryse , Droz Dominique , Koscielny Serge , Onody Peter
Published: April 2009

Persons with intellectual disability have difficulty in cooperating with outpatient care, and many are referred for general anaesthesia. Intellectual disability has traditionally been a contraindication for conscious sedation. We evaluated the behavioural impact, effectiveness, and tolerance of sedation in this population using a fixed 50% nitrous oxide/oxygen mixture as a single agent. We used dental treatment as a model of outpatient care; 349 patients (192 males, 157 females; mean age 22y [SD 14]; range 3–81y) were recruited over a 12‐month period at seven centres. Sedation was deemed successful if planned dental treatment was completed. Behaviour was scored with the modified Venham scale. Out of 605 sessions, 91.4% were successful. No serious adverse effects occurred. Minor adverse events (such as nausea) occurred in 10.1% of sessions. We conclude that the use of safe and effective conscious sedation may reduce the indications for general anaesthesia.
Intravenous diazepam infusion in the management of planned intrathecal baclofen withdrawal
Authors: Cruikshank Mary , Eunson Paul
Published: April 2009

Intrathecal baclofen is used in the management of spasticity associated with cerebral palsy (CP). Sudden cessation of intrathecal baclofen may give rise to the potentially life‐threatening baclofen withdrawal syndrome. We report three cases in which intravenous diazepam is used effectively in the management of planned intrathecal withdrawal. All three patients had CP. In the first patient, a 19‐year‐old male with quadriplegia, the intrathecal catheter had to be removed. The other two patients, an 11‐year‐old female with diplegia and a 16‐year‐old male with quadriplegia, both required the entire device to be removed. The purpose of this case report is to illustrate the potential management for elective cases in a similar situation.