bluuebunny/crossref_metadata_2025 huggingface dataset:
Up-regulation of fas and fasL pro-apoptotic genes expression in type 1 diabetes patients after autologous haematopoietic stem cell transplantation
Authors: de Oliveira G L V , Malmegrim K C R , Ferreira A F , Tognon R , Kashima S , Couri C E B , Covas D T , Voltarelli J C , de Castro F A
Published: March 2012

Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by T cell-mediated destruction of pancreatic β cells, resulting in insulin deficiency and hyperglycaemia. Recent studies have described that apoptosis impairment during central and peripheral tolerance is involved in T1D pathogenesis. In this study, the apoptosis-related gene expression in T1D patients was evaluated before and after treatment with high-dose immunosuppression followed by autologous haematopoietic stem cell transplantation (HDI-AHSCT). We also correlated gene expression results with clinical response to HDI-AHSCT. We observed a decreased expression of bad, bax and fasL pro-apoptotic genes and an increased expression of a1, bcl-xL and cIAP-2 anti-apoptotic genes in patients' peripheral blood mononuclear cells (PBMCs) compared to controls. After HDI-AHSCT, we found an up-regulation of fas and fasL and a down-regulation of anti-apoptotic bcl-xL genes expression in post-HDI-AHSCT periods compared to pre-transplantation. Additionally, the levels of bad, bax, bok, fasL, bcl-xL and cIAP-1 genes expression were found similar to controls 2 years after HDI-AHSCT. Furthermore, over-expression of pro-apoptotic noxa at 540 days post-HDI-AHSCT correlated positively with insulin-free patients and conversely with glutamic acid decarboxylase autoantibodies (GAD65) autoantibody levels. Taken together, the results suggest that apoptosis-related genes deregulation in patients' PBMCs might be involved in breakdown of immune tolerance and consequently contribute to T1D pathogenesis. Furthermore, HDI-AHSCT modulated the expression of some apoptotic genes towards the levels similar to controls. Possibly, the expression of these apoptotic molecules could be applied as biomarkers of clinical remission of T1D patients treated with HDI-AHSCT therapy.
Oceanographic gradients and seabird prey community dynamics in glacial fjords
Authors: ARIMITSU MAYUMI L. , PIATT JOHN F. , MADISON ERICA N. , CONAWAY JEFFREY S. , HILLGRUBER NICOLA
Published: March 2012

Glacial fjord habitats are undergoing rapid change as a result of contemporary global warming, yet little is known about how glaciers influence marine ecosystems. These ecosystems provide important feeding, breeding and rearing grounds for a wide variety of marine organisms, including seabirds of management concern. To characterize ocean conditions and marine food webs near tidewater glaciers, we conducted monthly surveys of oceanographic variables, plankton, fish and seabirds in Kenai Fjords, Alaska, from June to August of 2007 and 2008. We also measured tidal current velocities near glacial features. We found high sediment load from glacial river runoff played a major role in structuring the fjord marine ecosystem. Submerged moraines (sills) isolated cool, fresh, stratified and silt‐laden inner fjord habitats from oceanic influence. Near tidewater glaciers, surface layers of turbid glacial runoff limited availability of light to phytoplankton, but macrozooplankton were abundant in surface waters, perhaps due to the absence of a photic cue for diel migration. Fish and zooplankton community structure varied along an increasing temperature gradient throughout the summer. Acoustic measurements indicated that low density patches of fish and zooplankton were available in the surface waters near glacial river outflows. This is the foraging habitat occupied most by Kittlitz’s murrelet (Brachyramphus brevirostris), a rare seabird that appears to be specialized for life in glacially influenced environments. Kittlitz’s murrelets were associated with floating glacial ice, and they were more likely to occur near glaciers, in deeper water, and in areas with high acoustic backscatter. Kittlitz’s murrelet at‐sea distribution was limited to areas influenced by turbid glacial outflows, and where prey was concentrated near the surface in waters with low light penetration. Tidewater glaciers impart unique hydrographic characteristics that influence marine plankton and fish communities, and this has cascading effects on marine food webs in these ecosystems.
Securing intensive care: towards a better understanding of intensive care nurses’ perceived work pressure and turnover intention
Authors: van Dam Karen , Meewis Mauk , van der Heijden Beatrice I.J.M.
Published: March 2012

Aim.  To provide insight into the individual and contextual factors that are related to intensive care nursing staff perceptions of work pressure and turnover.

Background.  Hospitals are facing a shortage of intensive care nurses that will only become more pressing owing to demographic changes. Nurses’ sickness absence and turnover are considered important threats to the supply of intensive care.

Design.  A quantitative, cross‐sectional research design was used that was preceded by a qualitative, explorative study.

Method.  First, interviews and observations took place to better understand intensive care nurses’ work situation. Next, quantitative data were obtained in 2010 from 461 Dutch qualified intensive care nurses who completed a questionnaire.

Findings.  The outcomes of multiple regression analyses indicated that nurses’ perceptions of work pressure were predicted by emotional demands, physical demands, threats from patients’ relatives, social support and autonomy. Turnover intention was predicted by age, ability to deal with night shifts, social support and development opportunities.

Conclusions.  Given the importance of the availability of staff to secure intensive care, this study indicates that hospitals should pay more attention to intensive care nurses’ work situation. Decreasing emotional and physical demands and increasing nurses’ development opportunities are some of the measures hospitals can take to create a work environment that better accommodates the needs of their intensive care nursing staff.
Creating user‐generated content for location‐based learning: an authoring framework
Authors: FitzGerald E.
Published: March 2012

Two recent emerging trends are that of Web 2.0, where users actively create content and publish it on the Web, and also location awareness, where a digital device utilizes a person's physical location as the context to provide specific services and/or information. This paper examines how these two phenomena can be brought together so that user‐generated content on mobile devices is used to provide informal learning opportunities relevant to a person's location. However, the generative process of such media does not always have much guidance on how or what to create, so the quality of such information can be highly variable. To overcome this, a framework has been designed to guide the authoring of user‐generated content so that it can be used for informal learning about one's immediate surroundings (particularly in an outdoor setting), combining pedagogical aspects with those from human–computer interaction and environmental aesthetics. The framework consists of six dimensions that include aspects such as curriculum area (e.g. science, art), type of communication, use of language/media related to the landscape, knowledge level of content, contextual aspects, and types of interaction. In order to test the framework before it could be used to scaffold new content, it was first used to analyse and evaluate over 200 items of existing user‐generated content, to investigate the appropriateness of the proposed dimensions and the items contained therein or if any were missing. This paper presents the findings of this initial testing phase, together with a discussion of how the framework can be improved, in order to help scaffold the creation of new user‐generated content in the future.
Working with words: exploring textual analysis in medical education research
Authors: Park Sophie , Griffin Ann , Gill Deborah
Published: March 2012

Medical Education 2012: 46: 372–380

Context  Text is familiar to us all. This paper offers an introduction to, and an exploration of, the range of methodological possibilities open to the education researcher who has chosen to use text as a research data source. It encourages a purposeful deliberation of the different textual sources available as data, the range of methodological approaches possible and the types of interpretation that can be adopted when embarking on an empirical study using textual data.

Methods  Approaches to interpreting text are varied and utilise a range of analytical and interpretative strategies. To illustrate the theoretical points raised within this paper, two contrasting methods were applied to the same text. Tag cloud analysis and performative narrative analysis (PNA) were employed to analyse Chapter 4 of the UK government’s 2010 White Paper Equity and excellence: Liberating the NHS.

Results  The adoption of these contrasting methodologies, which are not currently used extensively in medical education research, revealed that some common issues were identified by both tag clouds and PNA, but, in addition, each approach was able to unveil something unique about the text.

Conclusions  These two methods highlight the range of affordances, or possibilities, that textual analysis will have on the results. We suggest that medical education researchers should be encouraged to move away from the current dominant and privileged methodologies that seek to provide answers and explore other methods and approaches to textual data that encourage us to question and reflect more deeply.
The role of collaborative interactivity in the observational practice of clinical skills
Authors: Grierson Lawrence E M , Barry Maureen , Kapralos Bill , Carnahan Heather , Dubrowski Adam
Published: March 2012

Medical Education 2012: 46: 409–416

Context  Video‐based observational practice can extend simulation‐based learning outside the training space. This study explores the value of collaborative feedback provided during observational practice to the acquisition of clinical skills.

Methods  Nursing students viewed a video demonstrating the proper ventrogluteal injection technique before performing a videotaped pre‐test trial on a simulator. They were then assigned randomly to one of three observational practice groups: a group that observed the expert demonstration (EO group); a group that viewed the expert demonstration, self‐assessed their individual pre‐test and contrasted their self‐assessments with expert feedback (ESO group), and a group that observed the expert demonstration, self‐assessed and contrasted their assessments with those of an expert, and formed a community that engaged in peer‐to‐peer feedback (ESPO group). The observation of all videos, the provision of assessments and all networking occurred via an Internet‐mediated network. After 2 weeks, participants returned for post‐tests and transfer tests.

Results  The pre‐test–post‐test analyses revealed significant interactions (global rating scale: F(2,22) = 4.00 [p = 0.033]; checklist: F(2,22) = 4.31 [p = 0.026]), which indicated that post‐test performance in the ESPO group was significantly better than pre‐test performance. The transfer analyses revealed main effects for both the global rating scale (F(2,23) = 6.73; p = 0.005) and validated checklist (F(2,23) = 7.04; p = 0.004) measures. Participants in the ESPO group performed better on the transfer test than those in the EO group.

Conclusions  The results suggest that video‐based observational practice can be effective in extending simulation‐based learning, but its effectiveness is mediated by the amount of time the learner spends engaged in the practice and the type of learning activities the learner performs in the observational practice environment. We speculate that increasing collaborative interactivity supports observational learning by increasing the extent to which the educational environment can accommodate learners’ specific needs.
Opsin gene sequence variation across phylogenetic and population histories in Mysis (Crustacea: Mysida) does not match current light environments or visual‐pigment absorbance spectra
Authors: AUDZIJONYTE ASTA , PAHLBERG JOHAN , VILJANEN MARTTA , DONNER KRISTIAN , VÄINÖLÄ RISTO
Published: March 2012

The hypothesis that selection on the opsin gene is efficient in tuning vision to the ambient light environment of an organism was assessed in 49 populations of 12 Mysis crustacean species, inhabiting arctic marine waters, coastal littoral habitats, freshwater lakes (‘glacial relicts’) and the deep Caspian Sea. Extensive sequence variation was found within and among taxa, but its patterns did not match expectations based on light environments, spectral sensitivity of the visual pigment measured by microspectrophotometry or the history of species and populations. The main split in the opsin gene tree was between lineages I and II, differing in six amino acids. Lineage I was present in marine and Caspian Sea species and in the North American freshwater Mysis diluviana, whereas lineage II was found in the European and circumarctic fresh‐ and brackish‐water Mysis relicta, Mysis salemaai and Mysis segerstralei. Both lineages were present in some populations of M. salemaai and M. segerstralei. Absorbance spectra of the visual pigment in nine populations of the latter three species showed a dichotomy between lake (λmax = 554–562 nm) and brackish‐water (Baltic Sea) populations (λmax = 521–535 nm). Judged by the shape of spectra, this difference was not because of different chromophores (A2 vs. A1), but neither did it coincide with the split in the opsin tree (lineages I/II), species identity or current light environments. In all, adaptive evolution of the opsin gene in Mysis could not be demonstrated, but its sequence variation did not conform to a neutral expectation either, suggesting evolutionary constraints and/or unidentified mechanisms of spectral tuning.
nMAT1, a nuclear‐encoded maturase involved in the trans‐splicing of nad1 intron 1, is essential for mitochondrial complex I assembly and function
Authors: Keren Ido , Tal Liat , des Francs‐Small Catherine C. , Araújo Wagner L. , Shevtsov Sofia , Shaya Felix , Fernie Alisdair R. , Small Ian , Ostersetzer‐Biran Oren
Published: March 2012

Mitochondrial genomes (mtDNAs) in angiosperms contain numerous group II‐type introns that reside mainly within protein‐coding genes that are required for organellar genome expression and respiration. While splicing of group II introns in non‐plant systems is facilitated by proteins encoded within the introns themselves (maturases), the mitochondrial introns in plants have diverged and have lost the vast majority of their intron‐encoded ORFs. Only a single maturase gene (matR) is retained in plant mtDNAs, but its role(s) in the splicing of mitochondrial introns is currently unknown. In addition to matR, plants also harbor four nuclear maturase genes (nMat 1 to 4) encoding mitochondrial proteins that are expected to act in the splicing of group II introns. Recently, we established the role of one of these proteins, nMAT2, in the splicing of several mitochondrial introns in Arabidopsis. Here, we show that nMAT1 is required for trans‐splicing of nad1 intron 1 and also functions in cis‐splicing of nad2 intron 1 and nad4 intron 2. Homozygous nMat1 plants show retarded growth and developmental phenotypes, modified respiration activities and altered stress responses that are tightly correlated with mitochondrial complex I defects.
Molecular background of D‐negative phenotype in the Tunisian population
Authors: Moussa H. , Tsochandaridis M. , Chakroun T. , Jridi S. , Abdelneji B. , Hmida S. , Silvy M. , Bailly P. , Gabert J. , Levy‐Mozziconacci A. , Jemni‐Yacoub Saloua
Published: March 2012

Background: Most studies of the molecular basis of Rhesus D‐negative phenotype have been conducted in Caucasian and African populations. A comprehensive survey of RHD alleles was lacking in people from North Africa (Tunisians, Moroccans and Algerians) which could be very efficient for managing donors and patients carrying an RHD molecular variant. We analyse the molecular background of D‐negative population in Tunisia in the present study.

Materials and methods: Blood samples were collected from native Tunisians. A total of 448 D‐negative donors from different regions of Tunisia were analysed by RHD genotyping according to an adopted strategy using real‐time PCR, ASP‐PCR and sequencing.

Results: Among the 448 D‐negative samples, 443 were phenotyped unequivocally as true D‐negative including three molecular backgrounds which were RHD gene deletion (n = 437), RHDψ pseudogene (n = 2) and RHD‐CE‐D hybrid gene (n = 4) with the respective frequencies of 0·9900, 0·0023 and 0·0046. The remaining five samples, in discordance with the serological results, were identified as two weak D type 11, one weak D type 29, one weak D type 4·0 and one DBT‐1 partial D.

Conclusion: This study showed that the Tunisian population gets closer to Caucasians, given that the RHD gene deletion is the most prevalent cause of D‐negative phenotype, but it is slightly different by the presence of the RHDψ pseudogene which was found with a very low frequency compared with that described in the African population. Nevertheless, the relative occurrence of weak D variants among studied serologically D‐negative samples make necessary the adaptation of RHD genotyping strategy to the spectrum of prevalent alleles.
An Improved Growth Medium to Assess Mycelial Compatibility Groups in Sclerotium rolfsii
Authors: Remesal Efrén , Navas‐Cortés Juan A.
Published: March 2012

Mycelial compatibility is assayed mainly by pairing mycelial plugs of field isolates on Petri dishes with agar media. Although methodologically simple, mycelial compatibility testing requires an artificial growth medium that permits the identification of compatible and incompatible interactions. In this work, several growth media were studied to assess consistently mycelial interactions between Sclerotium rolfsii isolates. A modification of Patterson’s medium with an increment of 25% glucose from the original concentration at a rate of 23.4 g/l and amended with 180 μl/l of red food colouring was the most effective combination for enhancing the size, density and distinctiveness of the aversion zone between incompatible isolates. This medium allowed the unequivocal identification of compatible and incompatible reactions of a set of five S. rolfsii isolates, which could be determined quickly after 5 days of incubation in the dark at 25°C. This new formulation improved significantly and consistently the assessment of the aversion zone reaction that was visible as a red line on the colony reverse as compared to that assessed using previous media formulations, for which the visualization of aversion zones was scarcely discernible. The utility of the improved growth medium was validated by microscopic observations of the contact area of hyphal pairings between isolates of S. rolfsii in microscope slide cultures.
Diagnosis of invasive fungal infections using real‐time PCR assay in paediatric acute leukaemia induction
Authors: Mandhaniya Sushil , Iqbal Sobuhi , Sharawat Surender Kumar , Xess Immaculata , Bakhshi Sameer
Published: March 2012

Invasive fungal infections (IFI) lead to morbidity and mortality in neutropenic patients and in allogenic stem cell transplantation. Serum‐based fungal detection assays have limitation of specificity or sensitivity. Studies on fungal DNA detection using real‐time PCR in childhood leukaemia are lacking. The aim of this study was to develop sensitive and specific diagnostic tools for IFI in paediatric acute leukaemia patients using real‐time PCR. Of 100 randomised paediatric acute leukaemia patients receiving antifungal prophylaxis with voriconazole/amphotericin B, single peripheral whole blood sample in EDTA was used for Pan‐AC real‐time PCR assay (detects nine Candida and six Aspergillus species) in patients who failed prophylaxis due to proven, probable, possible or suspected fungal infections. PCR results were retrospectively correlated with clinical profile. Real‐time PCR test was positive in 18/29 (62%) patients who failed prophylaxis. The only patient with proven IFI (mucormycosis), real‐time PCR assay was negative. Real‐time PCR was positive in 2/4 (50%) patients with possible and 16/24 (66.6%) suspected IFI and 5/10 (50%) patients with pneumonia. By applying method A/B, sensitivity and positive predictive value could not be commented due to unproven Aspergillus or Candida infections; specificity and negative predictive values (NPV) were 41% and 100% respectively; by method C (included episodes of possible IFI as true positive), sensitivity, specificity, PPV and NPV were 50%, 36%, 11% and 81% respectively. In those with suspected IFI, 8/24 (33.3%) were PCR negative and unnecessarily received empirical antifungal therapy (EAFT). Real‐time PCR is a practical, rapid, non‐invasive screening test for excluding IFI in paediatric leukaemia. The high NPV makes real‐time PCR a promising tool to use this prior to initiating EAFT in antibiotic‐resistant febrile neutropenic patients; this would avoid toxicity, cost and hospitalisation for EAFT (ClinicalTrials.gov identifier:NCT00624143).
Clinical characterization of gastric lesions initially diagnosed as low‐grade adenomas on forceps biopsy
Authors: Kasuga Akiyoshi , Yamamoto Yorimasa , Fujisaki Junko , Okada Kazuhisa , Omae Masami , Ishiyama Akiyoshi , Hirasawa Toshiaki , Chino Akiko , Tsuchida Tomohiro , Igarashi Masahiro , Hoshino Etsuo , Yamamoto Noriko , Kawaguchi Minoru , Fujita Rikiya
Published: March 2012

Aim:  The aim of this study was to elucidate characteristics of gastric lesions that are initially diagnosed as low‐grade adenomas and to establish appropriate treatment.

Methods:  We retrospectively reviewed 231 lesions initially diagnosed as gastric adenomas. All forceps biopsy samples were histologically diagnosed as category 3 low‐grade adenomas according to the revised Vienna Classification. All patients underwent endoscopic resection with endoscopic findings and post‐resection diagnoses evaluated subsequently.

Results:  Sixty‐three lesions were initially diagnosed as depressed adenomas, and 168 lesions were diagnosed as protruding adenomas. The depressed lesions were significantly smaller (11.6 ± 5.0 mm) than the protruding lesions (17.0 ± 10.8 mm) (P < 0.001). Diagnoses reclassified to category 4 mucosal high‐grade neoplasia (i.e. high‐grade adenoma, adenocarcinoma in adenoma and adenocarcinoma) were more frequent among depressed lesions (52.4%) than among protruding lesions (31.0%) (P = 0.004). Multivariate analysis of all 231 lesions showed that lesion size larger than 20 mm (P < 0.001) and depressed appearance (including central depression) (P < 0.001) were significant independent factors suggesting cancer. For the 168 protruding lesions, lesion size larger than 20 mm (P < 0.001) and central depression (P < 0.001) were significant independent factors suggesting cancer. For the 63 depressed lesions, lesion size larger than 15 mm (P = 0.016) and a moth‐eaten appearance (P = 0.017) were significant independent factors in the pre‐treatment diagnosis of cancer.

Conclusions:  Adenocarcinoma lesions were often found in depressed lesions and protruding lesions with central depression. Endoscopic resection for total biopsy is recommended, even if forceps biopsy indicates low‐grade adenoma, as pre‐treatment biopsy may be inadequate for an accurate histological diagnosis.
Efficacy of acetic acid‐spraying method in diagnosing extension of barrett's cancer under the squamous epithelium
Authors: Yamagata Taku , Hirasawa Dai , Fujita Naotaka , Obana Takashi , Sugawara Toshiki , Ohira Tetsuya , Harada Yoshihiro , Maeda Yuki , Koike Yoshiki , Suzuki Kenjiro , Yamamoto Yasuchika , Kusaka Jun , Tanaka Megumi , Noda Yutaka
Published: March 2012

Aim:  Endoscopic diagnosis of the lateral extension of Barrett's cancer under the squamous epithelium (BCUS) is sometimes difficult because the cancer is unobservable in the esophageal lumen. The aim of the present study was to clarify the endoscopic features of the extension of BCUS and verify the usefulness of the acetic acid‐spraying method (AAS) for diagnosis.

Methods:  A total of 25 patients with Barrett's cancer who had undergone endoscopic resection were included in this study. Histological examination of patients' resected specimens was performed to identify the presence of BCUS. Then, the endoscopic images of the BCUS cases were reviewed to summarize the findings and to evaluate the feasibility of diagnosing the extent of BCUS with each imaging technique.

Results:  Of the 25 patients, 10 (40%) had BCUS. With white‐light imaging, subtle reddish change was observed in the area of BCUS in 80% of the patients, and a flat elevated lesion was recognized in 30%. With narrow band imaging, slight brownish change was observed in the area of BCUS in 86% of the patients. Slight white changes were visualized in all cases with AAS. The extension of BCUS was correctly diagnosed by white‐light imaging, narrow band imaging and AAS in 50%, 43% and 100% of the cases, respectively. Histology verified the opening of cancerous glands, which extended under the squamous epithelium, into the esophagus in the area showing slight white changes by AAS.

Conclusion:  AAS can be useful for diagnosing the extension of BCUS.
Relationship between vomiting reflex during esophagogastroduodenoscopy and dyspepsia symptoms
Authors: Enomoto Shotaro , Watanabe Mika , Yoshida Takeichi , Mukoubayashi Chizu , Moribata Kosaku , Muraki Yosuke , Shingaki Naoki , Deguchi Hisanobu , Ueda Kazuki , Inoue Izumi , Maekita Takao , Iguchi Mikitaka , Tamai Hideyuki , Kato Jun , Fujishiro Mitsuhiro , Oka Masashi , Mohara Osamu , Ichinose Masao
Published: March 2012

Aim:  Although frequent vomiting reflexes during esophagogastroduodenoscopy (EGD) causes suffering in patients, very few studies have investigated the characteristics of subjects who frequently develop vomiting reflexes. This study examined the incidence of the vomiting reflex and related factors, especially upper gastrointestinal symptoms, among individuals undergoing transoral EGD.

Methods:  Subjects included 488 consecutive adults (mean age, 56.1 ± 8.9 years) who underwent transoral EGD for gastric cancer screening between February 2010 and March 2011. All procedures were performed by an endoscopist with 15 years of experience. Based on a questionnaire survey using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), symptoms (dyspepsia and acid reflux symptoms) and the number of vomiting reflexes during EGD were recorded.

Results:  Of the 488 subjects, 271 (56%) developed vomiting reflexes (mean, 4.2 times). This reflex‐positive group was younger (54.3 ± 9.5 years) than the reflex‐negative group (58.3 ± 7.7 years, P < 0.001). The number of subjects in the reflex‐positive group with a high FSSG dyspepsia score (2.27 ± 2.57 vs 1.23 ± 1.84; P < 0.001), acid reflux symptom score (1.96 ± 2.22 vs 1.34 ± 2.14; P < 0.01) or an esophageal hiatal hernia (14.8% vs 4.6%; P < 0.001) was significantly higher than in the reflex‐negative group. Multivariate analysis also showed a significant correlation between these four factors and the occurrence of vomiting reflexes. Using an FSSG dyspepsia score of 1 as the cut‐off offered 68% sensitivity and 57% specificity for predicting the occurrence of vomiting reflexes.

Conclusion:  Based on FSSG questionnaire responses on upper gastrointestinal symptoms, dyspepsia symptoms, in particular, are related to presence of vomiting reflexes during EGD.
Flicking method: A novel colonoscope insertion method for surveillance colonoscopy in ulcerative colitis patients
Authors: Sato Toru , Miyawaki Tetsumaru , Katsuno Tatsuro , Nakagawa Tomoo , Inoue Masahito , Watanabe Yoshiyuki , Hishikawa Etsuo , Arai Makoto , Yokosuka Osamu
Published: March 2012

Aim:  Periodic surveillance colonoscopy is required for patients with ulcerative colitis to detect colitis‐associated dysplasia at an early stage. However, sometimes colonoscopy may damage the fragile mucosa of patients with ulcerative colitis. The aim of this study was to devise a new method of surveillance colonoscopy for patients with mild to moderate ulcerative colitis.

Methods:  The ‘flicking method’ of colonoscope insertion was recently developed by our team. It is a completely novel method that involves using the elastic force of the colonoscope to introduce it into the deeper regions while using colon mucosa patterns as a guide. The subjects were 66 hospital outpatients with ulcerative colitis who underwent colonoscopies during a 2‐year period, from April 2006 to March 2008, with both the conventional insertion method and the flicking method.

Results:  Cecal intubation rate, insertion time, patient pain level, change in number of defecations pre‐ and post‐colonoscopy, and change in severity pre‐ and post‐colonoscopy were compared between the conventional and flicking methods. The flicking method was superior in all respects.

Conclusions:  The flicking method is a novel colonoscope insertion method that is regarded as particularly useful in cases when the intestinal mucosa is fragile, as is the case with ulcerative colitis patients.
Risk Management of Large RC Structures within Spatial Information System
Authors: Qin Jianjun , Faber Michael Havbro
Published: March 2012

Abstract:  The present article addresses the development of a spatial information system (SIS), which aims to facilitate risk management of large‐scale concrete structures. The formulation of the SIS is based on ideas developed in the context of indicator‐based risk modeling for concrete structures subject to corrosion and geographical information system based risk modeling concerning large‐scale risk management. The term “risk management” here refers in particular to the process of condition assessment and optimization of the inspection and repair activities. The SIS facilitates the storage and handling of all relevant information to the risk management. The probabilistic modeling utilized in the condition assessment takes basis in a Bayesian hierarchical modeling philosophy. It facilitates the updating of risks as well as optimizing inspection plans whenever new information about the condition of the structure becomes available. In the SIS, the various data of relevance for the risk management can be visualized in three dimensions. This feature and the other functionalities of the SIS are illustrated in an example considering the Danish Farø bridges.
Robust Detection and Identification of Sparse Segments in Ultrahigh Dimensional Data Analysis
Authors: Tony Cai T. , Jessie Jeng X. , Li Hongzhe
Published: March 2012

Copy number variants (CNVs) are alternations of DNA of a genome that result in the cell having less or more than two copies of segments of the DNA. CNVs correspond to relatively large regions of the genome, ranging from about one kilobase to several megabases, that are deleted or duplicated. Motivated by CNV analysis based on next generation sequencing data, we consider the problem of detecting and identifying sparse short segments hidden in a long linear sequence of data with an unspecified noise distribution. We propose a computationally efficient method that provides a robust and near optimal solution for segment identification over a wide range of noise distributions. We theoretically quantify the conditions for detecting the segment signals and show that the method near optimally estimates the signal segments whenever it is possible to detect their existence. Simulation studies are carried out to demonstrate the efficiency of the method under various noise distributions. We present results from a CNV analysis of a HapMap Yoruban sample to illustrate the theory and the methods further.
Sexual behaviours, knowledge and attitudes regarding safe sex, and prevalence of non‐viral sexually transmitted infections among attendees of youth clinics in St. Petersburg, Russia
Authors: Shipitsyna E. , Krasnoselskikh T. , Zolotoverkhaya E. , Savicheva A. , Krotin P. , Domeika M. , Unemo M.
Published: March 2012

Background  Adolescents and young adults are at increased risk of sexually transmitted infections (STIs). Knowledge of STI prevalence and risk factors are essential tools to elaborate preventive strategies. However, internationally reported studies on epidemiology of STIs among the youth in Russia are mainly lacking.

Objectives  To ascertain sexual behaviours, knowledge and attitudes about safe sex and prevalence and correlates with STIs in attendees of youth clinics in St. Petersburg, Russia.

Methods  A total of 301 women and 131 men, who self‐referred for STI testing, completed a questionnaire and were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using nucleic acid amplification tests.

Results  The overall STI prevalence was 16.9%, and similar in the female patients and male patients (15.6% and 19.8% respectively). C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were detected in 13%, 2.5%, 4.6% and 1.2% of the attendees respectively. The men displayed riskier sexual behaviours and worse knowledge and attitudes regarding safe sex compared to the women, with the most distinguishing features being younger age at first intercourse (P < 0.0005), higher numbers of sex partners during lifetime (P = 0.001) and latest 6 months (P < 0.0005), more frequently consuming alcohol (P < 0.0005), poorer knowledge of STI/HIV prevention measures (P < 0.0005), and less positive attitudes towards safe sex (P = 0.001). However, no significant predictors of STI positivity were found in the men. In the women, the strongest predictors of STI positivity were young age (15–19 years) and multiple sex partners (≥2) during latest 6 months.

Conclusions  The overall prevalence of STIs among users of STI services at youth clinics in St. Petersburg was high. Comprehensive epidemiological data on STI prevalence and sexual behaviour correlates are necessary to initiate new and strengthen existing STI prevention programmes for the youth, in Russia as well as in many other settings.
HOW TO ADDRESS THE ETHICS OF REPRODUCTIVE TRAVEL TO DEVELOPING COUNTRIES: A COMPARISON OF NATIONAL SELF‐SUFFICIENCY AND REGULATED MARKET APPROACHES
Authors: CROZIER G.K.D. , MARTIN DOMINIQUE
Published: March 2012

One of the areas of concern raised by cross‐border reproductive travel regards the treatment of women who are solicited to provide their ova or surrogacy services to foreign consumers. This is particularly troublesome in the context of developing countries where endemic poverty and low standards for both medical care and informed consent may place these women at risk of exploitation and harm. We explore two contrasting proposals for policy development regarding the industry, both of which seek to promote ethical outcomes and social justice: While one proposal advocates efforts to minimize cross‐border demand for female reproductive resources through the pursuit of national self‐sufficiency, the other defends cross‐border trade as a means for meeting the needs of vulnerable groups. Despite the conflicting objectives of the proposed strategies, the paper identifies common values and points of agreement between the two, including the importance of regulations to safeguard those providing ova or surrogacy services.
Anticipatory objects and uncertain imminence: cattle grids, landscape and the presencing of climate change on the Lizard Peninsula, UK
Authors: Leyshon (née Brace) Catherine , Geoghegan Hilary
Published: March 2012

In this paper we show how a seemingly unremarkable object – a cattle grid – has come to presence climate change in partial and contingent ways on the Lizard Peninsula, Cornwall, UK. We identify the cattle grid as an ‘anticipatory object’ through which conservation organisations seek to manage the future and adapt to climate change, but which at the same time presences that unthought‐of future for others in the landscape. We explore the ways in which the cattle grid acts to presence something that is not only absent – climate change – but has uncertain imminence. We investigate the ways in which the cattle grid make climate relevant as an embodied and experiential process, a physical and intellectual artefact, and the means to imagine climate and the ways it might change. Drawing upon interpretative approaches informed by theorisations of materiality, presence and absence to understand climate change as a social phenomenon, we go beyond a consideration of this ordinary object defined by its function to consider how the object is experienced, the processes and practices through which people relate to it, and the ways in which social meaning accumulates around it. The empirical basis for this argument is provided by in‐depth interviews with local representatives of Natural England, residents and farmers.
Ecological benefits of creating messy rivers
Authors: Everall Nicholas C , Farmer Andrew , Heath Andrew F , Jacklin Timothy E , Wilby Robert L
Published: March 2012

This study explores the ecological effects of a woody bank revetment in an upper reach of the River Manifold, Staffordshire, UK. Significantly higher abundances of macroinvertebrates were recorded immediately downstream of the deciduous bank revetment compared with a reference site, in 3 out of 4 months surveyed. The watercourse at the revetment also had significantly higher species richness of aquatic fauna than the reference site in some months. While there was no evidence of spatial or temporal variation in aquatic species richness within the reference site during the study period, the species biodiversity of the sub‐sample collected from the deciduous revetment zone was more varied: there was significantly higher Ephemeroptera/Plecoptera/Trichoptera (EPT) richness close to the woody bank. Additionally, three relatively rare mayfly species were exclusively associated with the woody revetment (Baetis niger, Ameletus inopinatus and Siphlonorus alternatus). Water temperatures were also found to be lower in close proximity to the revetment. These micro‐scale effects suggest that revetments could deliver a range of conservation benefits, not least habitat creation and mitigation of rising river temperatures under climate change.
Monoacylglycerol lipase – a target for drug development?
Authors: Fowler CJ
Published: March 2012

The endocannabinoid (eCB) system is involved in processes as diverse as control of appetite, perception of pain and the limitation of cancer cell growth and invasion. The enzymes responsible for eCB breakdown are attractive pharmacological targets, and fatty acid amide hydrolase inhibitors, which potentiate the levels of the eCB anandamide, are now undergoing pharmaceutical development. ‘Drugable’ selective inhibitors of monoacylglycerol lipase, a key enzyme regulating the levels of the other main eCB, 2‐arachidonoylglycerol, were however not identified until very recently. Their availability has resulted in a large expansion of our knowledge concerning the pharmacological consequences of monoacylglycerol lipase inhibition and hence the role(s) played by the enzyme in the body. In this review, the pharmacology of monoacylglycerol lipase will be discussed, together with an analysis of the therapeutic potential of monoacylglycerol lipase inhibitors as analgesics and anticancer agents.
Pericardial Patch Tracheoplasty for the Repair of a Long, Multisegmental Postintubation Tracheal Damage
Authors: Foroulis Christophoros N. , Karapanagiotidis Georgios , Papakonstantinou Christos
Published: March 2012

A 64‐year‐old man was admitted with a postintubation, multisegmental tracheal damage comprising of two stenotic lesions, below and above a tracheotomy. The patient underwent resection of the damaged anterolateral tracheal wall through a combined collar‐cuff and median sternotomy incision and tracheoplasty with autologous pericardium around a Silastic T‐tube that was fixed to the cricoid cartilage, healthy distal trachea, and the remaining membranous wall. The postoperative period was complicated with a deep sternal wound infection that was successfully treated with vacuum‐assisted closure for 2 weeks. Removal of the T‐tube 9 months later resulted in a patent and well‐functioning airway. Pericardial patch tracheoplasty and T‐tube stenting of the repair for several months is a good alternative to extended tracheal resection for the treatment of the rare long, postintubation multisegmental tracheal damage. The pericardial patch is highly resistant to infection and allows the formation of a neotrachea.
Interictal psychotic episodes in epilepsy: Duration and associated clinical factors
Authors: Adachi Naoto , Akanuma Nozomi , Ito Masumi , Okazaki Mitsutoshi , Kato Masaaki , Onuma Teiichi
Published: March 2012

Purpose:  There have been few reports showing the distribution of the duration of interictal psychosis (IIP) episodes and their association with clinical characteristics. To clarify the nature of IIP, we studied the duration of IIP episodes and their related factors.

Methods:  One hundred fifty‐five patients with epilepsy exhibited 320 IIP episodes during our follow‐up period (mean 16.9 years). The duration of all the episodes and the longest episode in each patient during the follow‐up periods were studied. Characteristics of the patients (e.g., epilepsy type, age of onset, and family history of psychosis) and episode‐specific factors (e.g., age of the episode, seizure frequency, administrations of antiepileptic drugs [AEDs] and antipsychotic drugs [APDs]) were analyzed in association with the duration of the episodes.

Key Findings:  Mean duration of the 320 IIP episodes was 82.7 weeks and that of the longest IIP episodes was 150.1 weeks. During the follow‐up period, 17 patients (11.0%) showed all episodes remitting within a month and 54 (34.8%) showed all episodes lasting for 6 months or longer. The IIP episodes that occurred at a younger age were often prolonged. Patients with a family history of psychosis or with early onset of psychosis tended to have more prolonged IIP episodes. Among the episodes treated with APDs, early administration of APDs was significantly associated with shorter IIP duration.

Significance:  The distribution of the duration of IIP episodes indicated the broad spectrum and heterogeneity of the IIP phenomena. The individual vulnerability to psychosis may be associated with prolonged episodes. Administration of APDs soon after onset of the episodes appeared to be effective in controlling them. These findings support empirical treatment principles for IIP to administer APDs at an early stage of its development.
Receipt of Monitoring of Diabetes Mellitus in Older Adults with Comorbid Dementia
Authors: Thorpe Carolyn T. , Thorpe Joshua M. , Kind Amy J. H. , Bartels Christie M. , Everett Christine M. , Smith Maureen A.
Published: March 2012

Objectives

To examine the extent to which receipt of recommended monitoring of diabetes mellitus (DM) differed for participants with and without comorbid dementia, as well as the effect of other comorbidities on monitoring of DM in individuals with comorbid dementia.

Design

Retrospective cohort study.

Setting

Secondary analysis of 2005/2006 claims and enrollment data for a 5% national random sample of Medicare beneficiaries.

Participants

Two hundred eighty‐eight thousand eight hundred five Medicare fee‐for‐service beneficiaries with a diagnosis of DM before 2006, 44,717 (16%) of whom had evidence of comorbid dementia in claims.

Measurements

Established algorithms were used to determine whether patients received at least one glycosylated hemoglobin (HbA1c) test, one low‐density lipoprotein cholesterol (LDL‐C) test, and one annual eye examination in 2006 and to construct variables representing comorbidities common in DM, sociodemographic characteristics, and patterns of healthcare utilization.

Results

In unadjusted and fully adjusted models, the presence of dementia reduced the likelihood of receiving HbA1c tests, LDL‐C tests, and eye examinations, with effects being smallest for HbA1c tests. The effects of other comorbidities on DM monitoring in participants with dementia varied according to the nature of the comorbidity and the specific test.

Conclusion

Dementia reduces the likelihood that individuals with DM will receive recommended annual monitoring for DM. More research is needed to understand reasons for lower monitoring in this subgroup and how this affects functioning, adverse events, and quality of life.
Parent Training in Nonviolent Resistance for Adult Entitled Dependence
Authors: Lebowitz Eli , Dolberger Dan , Nortov Efi , Omer Haim
Published: March 2012

“成年子女依赖”(AED)主要表现为成年子女对家庭极度依赖,以及从活动能力看机能障碍水平明显过高的一种状况。家庭与有依赖的成年人之间形成了一种越想努力缓解这个问题,这个问题越严重的互动关系。为父母提供的非暴力抵制(NVR)培训是一种干预治疗,这种治疗已显示出对有行为困难子女家长的极大帮助。对家长进行的非暴力抵制培训为他们提供方法,使其从一种无助状态转向无需子女合作即可实现的切实可行的目标。我们的研究对27名成年不独立子女的家长作了报告,这些家长都参与了家长非暴力抵制培训。此外,我们还以两个详实的个案研究举例说明这个问题及其治疗过程。治疗前,不独立的成年子女既无工作也未读书,严重依赖父母(财政上或其它方面),并抗拒父母为改变这种状况作出的种种努力。大多数父母成功地克服了这种无助状况,并减轻了负担。相当大一部分成年子女开始工作或学习或搬去独立居住了。
Parenting as Relationship: A Framework for Assessment and Practice
Authors: Tuttle Amy R. , Knudson‐Martin Carmen , Kim Lana
Published: March 2012

养育常被框架为导向儿童的一组行为,而不是一种关系。本文帮助治疗师、养育教育者以及学者把养育作为嵌入社会文化的一种关系看待。本文作者把关系倾向类型学(Silverstein, Bass, Tuttle, Knudson‐Martin, & Huenergardt, 2006)应用于父母——子女关系中。该类型学讨论两个方面的问题,即:重心是在子女达到父母期望上还是在相互间的期望上,以及期望父母与子女间的权力是平衡的还是非平衡的。本文讲述了四种关系导向:(1)规则导向,(2)位置导向,(3)独立导向,(4)关系导向。这些关系导向描述了父母与子女间相互关系的性质,并提出解决养育问题的一个框架。本文通过个案说明关系导向框架如何帮助治疗师将更广范围的系统/关系视角纳入以往主要界定为儿童行为问题的框架里去。
Combatant Ship Engineering, A Different Approach
Authors: GALLAGHER CHARLES
Published: March 2012

In 1989, Ingalls Shipbuilding contracted to design and construct three Sa'ar V Class corvettes for the Government of Israel. The available funding was considerably less than would have been needed to design and build equivalent ships for the US Navy. As a result, the Israeli Navy (IN) and Ingalls Shipbuilding, working closely together, implemented significant innovative systems engineering and design practices and the ships were delivered within the budget. Some of the key innovative design and engineering methods used during that program are described in this paper.
Parametric Models for Aircraft Engine Removals Resulting from Foreign Object Damage
Authors: MILLAR RICHARD C. , OLWELL DAVID H.
Published: March 2012

An earlier nonparametric statistical study of GE F414 engine removals from operational F/A‐18 aircraft in US Navy service provided insights into the lifetime patterns of engine removals for various causes. Inspection of the estimated hazard function for engine removals for foreign object damage (FOD) suggested that a parametric analysis using Erlang distributions might be fruitful, bolstered by a hypothesized relevance to the maintenance procedures governing engine removals for this cause, and their outcomes. The objective was both a better model to forecast engine removals and to provide insight into the number of FOD incidents it took to drive an engine removal. Gamma and Erlang distributions did better fit the removals data and provide a tool for predicting engine removals, aircraft availability impact, and the resultant maintenance workload. A parametric model using a cascade of Erlang functions was developed to simulate the combined FOD/line maintenance process, which provides insight into the outcomes expected under reasonable simplifying assumptions. This model predicts that the key research issue, the probability that a typical FOD event prompts a removal, cannot be estimated from engine removals data alone. Field data must be collected to gain understanding of the underlying frequency of FOD and the utility of the present inspection criteria.