bluuebunny/crossref_metadata_2025 huggingface dataset:
Selective attention modulates implicit learning
Authors: Jiang Yuhong , Chun Marvin M.
Published: September 2011

The effect of selective attention on implicit learning was tested in four experiments using the “contextual cueing” paradigm (Chun & Jiang, 1998, 1999). Observers performed visual search through items presented in an attended colour (e.g., red) and an ignored colour (e.g., green). When the spatial configuration of items in the attended colour was invariant and was consistently paired with a target location, visual search was facilitated, showing contextual cueing (Experiments 1, 3, and 4). In contrast, repeating and pairing the configuration of the ignored items with the target location resulted in no contextual cueing (Experiments 2 and 4). We conclude that implicit learning is robust only when relevant, predictive information is selectively attended.
Mathematical modelling of avascular ellipsoidal tumour growth
Authors: Dassios G. , Kariotou F. , Tsampas M. , Sleeman B.
Published: September 2011

Breast cancer is the most frequently diagnosed cancer in women. From mammography, Magnetic Resonance Imaging (MRI), and ultrasonography, it is well documented that breast tumours are often ellipsoidal in shape. The World Health Organisation (WHO) has established a criteria based on tumour volume change for classifying response to therapy. Typically the volume of the tumour is measured on the hypothesis that growth is ellipsoidal. This is the Calliper method, and it is widely used throughout the world. This paper initiates an analytical study of ellipsoidal tumour growth based on the pioneering mathematical model of Greenspan. Comparisons are made with the more commonly studied spherical mathematical models.
A revised target strength–length estimate for blue whiting (Micromesistius poutassou): implications for biomass estimates
Authors: Pedersen Geir , Godø Olav Rune , Ona Egil , Macaulay Gavin J.
Published: September 2011

Pedersen, G., Godø, O. R., Ona, E., and Macaulay, G. J. 2011. A revised target strength–length estimate for blue whiting (Micromesistius poutassou): implications for biomass estimates. – ICES Journal of Marine Science, 68: 2222–2228. Acoustic abundance estimates of blue whiting have generally been higher than estimates based on catch data. One explanation has been that the relationship between acoustic target strength (TS) and length is too low and hence overestimates the number of fish. Measurements of TS were conducted during surveys of blue whiting in March/April 2003–2007 to the west of the British Isles from several different measurement platforms, and also during August 2005 in the Norwegian Sea. Results from these experiments confirm the view that the existing TS–length relationship is too low. A new TS–length relationship is proposed that is ∼5 dB higher. Blue whiting TS is considerably higher than observed and modelled for a similar species, southern blue whiting (Micromesistius australis).
Behaviour of Atlantic cod, a marine fish predator, during Atlantic salmon post-smolt migration
Authors: Hedger Richard D. , Uglem Ingebrigt , Thorstad Eva B. , Finstad Bengt , Chittenden Cedar M. , Arechavala-Lopez Pablo , Jensen Arne J. , Nilsen Rune , Økland Finn
Published: September 2011

Hedger, R. D., Uglem, I., Thorstad, E. B., Finstad, B., Chittenden, C. M., Arechavala-Lopez, P., Jensen, A. J., Nilsen, R., and Økland, F. 2011. Behaviour of Atlantic cod, a marine fish predator, during Atlantic salmon post-smolt migration. – ICES Journal of Marine Science, 68: 2152–2162. Acoustic telemetry was used to determine the behavioural strategies of Atlantic cod (Gadus morhua) during Atlantic salmon (Salmo salar) post-smolt migration within a Norwegian fjord (Eresfjord). In all, 38 adult cod captured in the inner fjord were tagged with acoustic transmitters in 2008 and 2009, and their behaviour was determined using a fixed hydrophone array. Cod tended to aggregate in the innermost part of the fjord, occupying distinct demersal home territories, showing horizontal movements consistent with foraging. Tidal influences were not observed; cod spent more time near the surface at night. Cod behaviour during peak post-smolt migration differed from that before and after migration. First, cod tended to have more-focused spatial distributions during peak post-smolt migration, consistent with them not having to forage so far when prey were available in abundance. Second, some half the cod were detected nocturnally (but rarely during daylight) near the river mouth during peak post-smolt migration, consistent with them feeding on nocturnally migrating post-smolts. Third, cod were more common near the surface, consistent with them feeding on post-smolts migrating through near-surface waters. These patterns, however, were not shown by all the cod, suggesting that this opportunistic feeder was also preying on other species.
Evidence for distinct chronic wasting disease (CWD) strains in experimental CWD in ferrets
Authors: Perrott Matthew R. , Sigurdson Christina J. , Mason Gary L. , Hoover Edward A.
Published: September 2011

Chronic wasting disease (CWD) is an evolving prion disease of cervids (deer, elk and moose) that has been recognized in North America and Korea. Infection of non-cervid reservoir or transport species in nature is not reported. However, the ferret (Mustela putorius furo) is susceptible to CWD after experimental inoculation. Here, we report that infection of ferrets with either of two ferret CWD isolates by various routes of exposure has revealed biologically distinct strain-like properties distinguished by different clinical progression and survival period. The isolates of ferret CWD were also differentiated by the distribution of the infectious prion protein (PrPCWD) in the brain and periphery, and by the proteinase K sensitivity of PrPCWD. These findings suggest that diversity in prion conformers exists in CWD-infected cervids.
Intermolecular interactions and unexpected isostructurality in the crystal structures of the dichlorobenzaldehyde isomers
Authors: Solanko Katarzyna A. , Bond Andrew D.
Published: September 2011

The crystal structures of the six dichlorobenzaldehyde isomers, four of them newly determined, are analyzed in terms of the geometry and energies of their intermolecular interactions, quantified using the semi-classical density sums (SCDS-PIXEL) method. A consistent feature in all six structures is molecular stacks propagating along a short crystallographic axis of ca 3.8 Å. The stacks have a closely comparable geometry in each isomer, but the interaction energies between stacked molecules are variable on account of the differing relative positions of the Cl substituents. In the majority of the isomers the stacking interactions are the most stabilizing in the structure. Exceptions are the 2,4- and 3,5-isomers, where more stabilizing interactions are made between stacks. In general, the most stabilizing non-stacking intermolecular interactions in the structures are those involving C—H...O contacts. Observed motifs based on Cl...Cl interactions appear to be largely imposed by the constraints of other more stabilizing intermolecular interactions. The isomeric series displays the following noteworthy features: (i) the 2,3- and 2,6-isomers are isostructural despite having different orientations of the Cl and aldehyde functionalities; (ii) the 2,5-isomer exhibits whole-molecule disorder; (iii) the 2,5- and 3,5-isomers have more than one molecule in the crystallographic asymmetric unit (Z′ > 1). These features in particular are considered on the basis of the intermolecular interaction energies.
Glucose‐regulated protein 58 modulates cell invasiveness and serves as a prognostic marker for cervical cancer
Authors: Liao Chia‐Jung , Wu Tzu‐I , Huang Ya‐Hui , Chang Ting‐Chang , Wang Chia‐Siu , Tsai Ming‐Ming , Lai Chyong‐Huey , Liang Ying , Jung Shih‐Ming , Lin Kwang‐Huei
Published: September 2011

Human papilloma virus infection is critical but not sufficient to cause cervical cancer. Molecular markers of cervical carcinogenesis are essential. The aim of this study was to identify aberrantly expressed proteins in cervical cancer and determine their clinical significance. A two‐dimensional polyacrylamide gel electrophoresis (2‐DE) proteomic strategy was used for screening candidate proteins. Immunoblotting and immunohistochemical (IHC) analyses were performed to confirm the results of 2‐DE, and the clinical significance was estimated. Glucose‐regulated protein 58 (Grp58) was overexpressed in 73% of cancers. The IHC staining showed that the Grp58 histoscore was significantly higher in patients with adenocarcinoma (AD) compared with squamous cell carcinoma (P < 0.05). Grp58 staining was intense in AD with a penetration depth greater than half of the cervical stroma (P = 0.033). High Grp58 expression was associated with low overall survival and recurrence‐free survival (RFS) rates (P = 0.007 and P = 0.013, respectively). In multivariate analysis, high Grp58 expression (P = 0.042) and lymph node metastasis (P = 0.026) were determined as independent prognostic factors for RFS. Patients exhibiting both high Grp58 expression and lymph node metastasis displayed poorer outcomes than the other patient groups. In functional studies, knockdown of Grp58 in HeLa cells led to decreased cell invasiveness and inhibition of lung metastasis in a xenograft mouse model. In conclusion, Grp58 serves as a potent prognostic factor of cervical AD. Estimation of the Grp58 index in conjunction with the lymph node metastasis status might aid in predicting the prognosis of cervical AD. (Cancer Sci 2011; 102: 2255–2263)
Cushing’s syndrome in multiple endocrine neoplasia type 1
Authors: Simonds William F. , Varghese Sarah , Marx Stephen J. , Nieman Lynnette K.
Published: September 2011

Objective  In patients with multiple endocrine neoplasia type 1 (MEN1), Cushing’s syndrome (CS) from endogenous hypercortisolism can result from pituitary, adrenal or other endocrine tumours. The purpose of this study was to characterize the range of presentations of CS in a large series of MEN1 patients.

Design  Retrospective review of NIH Clinical Center inpatient records over an approximately 40‐year period.

Patients  Nineteen patients (eight males, 11 females) with CS and MEN1.

Measurements  Biochemical, imaging, surgical and pathological findings.

Results  An aetiology was determined for 14 of the 19 patients with CS and MEN1: 11 (79%) had Cushing’s disease (CD) and three (21%) had ACTH‐independent CS owing to adrenal tumours, frequencies indistinguishable from sporadic CS. Three of 11 MEN1 patients with CD (27%) had additional non‐ACTH‐secreting pituitary microadenomas identified at surgery, an incidence 10‐fold higher than in sporadic CD. Ninety‐one per cent of MEN1 patients with CD were cured after surgery. Two of three MEN1 patients with ACTH‐independent CS (67%) had adrenocortical carcinoma. One patient with adrenal cancer and another with adrenal adenoma were cured by unilateral adrenalectomy. No case of ectopic ACTH secretion was identified in our patient cohort. The aetiology of CS could not be defined in five patients; in three of these, hypercortisolism appeared to resolve spontaneously.

Conclusions  The tumour multiplicity of MEN1 can be reflected in the anterior pituitary, MEN1‐associated ACTH‐independent CS may be associated with aggressive adrenocortical disease and an aetiology for CS in MEN1 may be elusive in a substantial minority of patients.
Socioeconomic status and children with intellectual disability in China
Authors: Zheng X. , Chen R. , Li N. , Du W. , Pei L. , Zhang J. , Ji Y. , Song X. , Tan L. , Yang R.
Published: September 2011

Background  Intellectual disability (ID) accounts for 70% of all disabilities among children in China's Second National Sampling Survey on Disability. Although studies have shown a relationship between social class and ID in children, none have investigated the association of socioeconomic variables in Chinese children with mild or severe ID.

Methods  Data for children aged 0–6 years with and without ID were abstracted from the Second National Sampling Survey on Disability in China, conducted in 2006. Crude odds ratios showed the effect of sociodemographic factors on mild and severe ID. Adjusted odds ratios (ORa) (95% confidence intervals) estimated the independent effects of these factors.

Results  For both mild and severe ID, risk of having ID increased with male sex, birth to a woman aged 35 years and older, lower maternal education, mother's older age at delivery, lower income and rural residence. After age, gender and parent disability were controlled, mothers aged 35 years and older were more likely to have a child with ID: mild ID, ORa 1.47 (1.15–1.88); severe ID, ORa 1.32 (1.00–1.73). There was an approximate increasing monotonic risk of severe ID with increasing socioeconomic disadvantage: lowest income, ORa 3.00 (2.19–4.12); low income, ORa 2.28 (1.63–3.19); lower middle income, ORa 1.72 (1.27–2.33); middle income, ORa 1.73 (1.28–2.36).

Conclusions  There is a significant relationship between sociodemographic factors and ID. Similar patterns were found for both mild and severe ID. Recommendations are given for preventing ID in Chinese children.
Models of care delivery in mental health nursing practice: a mixed method study
Authors: CARLYLE D. , CROWE M. , DEERING D.
Published: September 2011

Accessible summary

Mental health nursing care is usually delivered in multidisciplinary teams within inpatient and outpatient settings. This team approach to care delivery is underpinned by an assumption of a common set of values and a common model of care delivery among disciplines.

Mental health nurses appear to endorse a range of explanatory conceptual models as important in respect to aetiology, treatment, and factors influencing improvement, the role of the mental health service and the role of nurses. This study found that although the participants used a psychodynamic framework for understanding the causes of mental distress they described the presenting problems and the nursing interventions in terms of supporting a medical model of care.

Mental health nursing care is subjugated by a medical model which constrains the possibilities for mental health nursing interventions. This then potentially creates tension between what nurses believe to be the problem and the responses available for nurses in their clinical setting.

The aim of this study was to identify the conceptual models that underpin mental health nursing care in clinical settings. This study is a modification of a previous study which evaluated the influence of implicit models of mental disorder on processes of decision making within community‐based teams. Participants completed questionnaires in response to a scenario. A range of explanatory conceptual models were identified in respect to aetiology, treatment and recovery. In a forced choice the participants ranked a medical model of care above other models as underpinning care delivery. The content analysis found that the participants used a psychodynamic framework for understanding the causes of mental distress but described the nursing interventions in terms of supporting a medical model of care. Nursing care is dominated by a medical model which constrains mental health nursing. This potentially creates tension between what nurses believe to be the problem and the responses available for nurses in their clinical setting. A range of psychosocial approaches to mental health care delivery have been developed, but there seems to be problems with their implementation in practice. Further research is required to explore how broader therapeutic interventions can be implemented by nurses within multidisciplinary systems of mental health care delivery.
Meta‐barcoding of ‘dirt’ DNA from soil reflects vertebrate biodiversity
Authors: ANDERSEN KENNETH , BIRD KAREN LISE , RASMUSSEN MORTEN , HAILE JAMES , BREUNING‐MADSEN HENRIK , KJÆR KURT H. , ORLANDO LUDOVIC , GILBERT M. THOMAS P. , WILLERSLEV ESKE
Published: September 2011

DNA molecules originating from animals and plants can be retrieved directly from sediments and have been used for reconstructing both contemporary and past ecosystems. However, the extent to which such ‘dirt’ DNA reflects taxonomic richness and structural diversity remains contentious. Here, we couple second generation high‐throughput sequencing with 16S mitochondrial DNA (mtDNA) meta‐barcoding, to explore the accuracy and sensitivity of ‘dirt’ DNA as an indicator of vertebrate diversity, from soil sampled at safari parks, zoological gardens and farms with known species compositions. PCR amplification was successful in the full pH range of the investigated soils (6.2 ± 0.2 to 8.3 ± 0.2), but inhibition was detected in extracts from soil of high organic content. DNA movement (leaching) through strata was evident in some sporadic cases and is influenced by soil texture and structure. We find that DNA from the soil surface reflects overall taxonomic richness and relative biomass of individual species. However, one species that was recently introduced was not detected. Furthermore, animal behaviour was shown to influence DNA deposition rates. The approach potentially provides a quick methodological alternative to classical ecological surveys of biodiversity, and most reliable results are obtained with spatial sample replicates, while relative amounts of soil processed per site is of less importance.
The Contribution of NT‐gp96 as an Adjuvant for Increasing HPV16 E7‐Specific Immunity in C57BL /6 Mouse Model
Authors: Mohit E. , Bolhassani A. , Zahedifard F. , Taslimi Y. , Rafati S.
Published: September 2011

To control cervical cancer, efficient vaccination against human papillomavirus (HPV) is highly required. Despite the advantages and safety of the protein vaccines, additional strategies to enhance their immunogenicity are needed. E7 is a transforming protein which represents a perfect target antigen for vaccines or immunotherapies. Heat shock proteins (HSPs) facilitate cellular immune responses to antigenic peptides or proteins bound to them. Regarding to previous studies, vaccination with purified HSP/antigen complexes efficiently elicit antigen‐specific immune responses in mice model. The N‐terminal of glycoprotein 96 (NT‐gp96) has adjuvant effect and can induce effective cumulative immune response against clinical disorders, especially cancers. In this study, the recombinant HPV16 E7 and E7 linked to NT‐gp96 (E7‐NT‐gp96) proteins were generated in prokaryotic expression system. Mice were vaccinated twice with this recombinant proteins and the immunogenicity of the fusion protein was determined. The preventive efficacy of E7‐NT‐gp96 fusion protein was also evaluated and compared to E7 protein after challenging with cancerous TC‐1 cell line.In vitrore‐stimulated splenocytes of mice vaccinated with rE7‐NT‐gp96 protein induced higher IFN‐γ response in comparison with E7 protein immunization. Moreover, immunization with E7‐NT‐gp96 protein displayed low but stable humoral responses at post‐challenge time. The data showed that vaccination with fused E7‐NT‐gp96 protein delayed the tumour occurrence and growth as compared to protein E7 alone. These results suggest that fused adjuvant‐free E7‐NT‐gp96 protein vaccination could direct the immune responses towards Th1 immunity. Furthermore, the linkage of NT‐gp96 to E7 could enhance protective anti‐tumour immunity.
Copy number variation in CCL3L1 gene is associated with susceptibility to acute rejection in patients after liver transplantation
Authors: Li Hong , Xie Hai‐Yang , Zhou Lin , Feng Xiao‐Wen , Wang Wei‐Lin , Liang Ting‐Bo , Zhang Min , Zheng Shu‐Sen
Published: September 2011

Li H, Xie H‐Y, Zhou L, Feng X‐W, Wang W‐L, Liang T‐B, Zhang M, Zheng S‐S. Copy number variation in CCL3L1 gene is associated with susceptibility to acute rejection in patients after liver transplantation.  Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01486.x.  © 2011 John Wiley & Sons A/S.

Abstract:  Copy number variation (CNV) in gene was a novel type of genetic diversity in human that affect the pathogenesis, progress, and prognosis of disease. The aim of this study was to determine the associations between CNV in CCL3L1 gene and the rejection risk in liver‐transplant recipients. The 266 Han‐Chinese patients and 135 volunteers were enrolled in this study. Genomic DNA and mRNA samples were obtained from the whole peripheral blood; a quantitative real‐time PCR‐based assay was carried out to determine the copy number of CCL3L1, and real‐time PCR was carried out to calculate the CCL3L1/CCL3 mRNA ratio. The CNV distributions in patients and health controls had no significant differences. Copy number in acute rejection group (AR) shifted to higher number compared with non‐acute rejection group (4.74 ± 1.87 vs. 3.88 ± 2.13, p = 0.017). Moreover, patients with higher CCL3L1 copies (≥3 copies) had a significantly higher rejection risk than patients lower copies CCL3L1 (OR = 3.85, 95% CI, 1.14–13.04; p = 0.021). No association was found between CNV and rejection grades. In conclusion, liver transplant recipients with high copy number of CCL3L1 gene had a significant higher risk of AR. CNV might be a novel genetic diversity that correlated with allograft rejection.
Microscopic Anatomy of the Lower Respiratory Tract of the Grey Short‐Tailed Opossum (Monodelphis domestica)
Authors: Cope L. A. , Henry R. W. , Reed R. B.
Published: September 2011

With 14 figures

The respiratory tracts of seven grey short‐tailed opossums were histologically examined. Six opossums were prepared by perfusion with buffered formalin. Opossum seven was perfused with gluteraldehyde. Samples taken from the respiratory passages and lungs of specimens 1–6 were stained with haematoxylin and eosin. A mixture of methylene and azure blue was used for specimen 7. The trachea and right and left principal bronchi are lined with a pseudostratified ciliated columnar epithelium with occasional goblet cells. The secondary and tertiary bronchi and the primary and secondary bronchioles are lined by a simple ciliated columnar epithelium. The terminal bronchioles and a portion of the respiratory bronchioles are lined by a simple ciliated cuboidal epithelium. The terminal portion of the respiratory bronchioles and the alveolar ducts are lined with simple squamous epithelium. Alveoli are lined by type I and II pneumocytes. Tracheal glands are present in the tela submucosa. The fibromusculocartilaginous tunic of the trachea consists of c‐shaped cartilage rings and the trachealis muscle. A lamina muscularis mucosa begins in the intrapulmonary portion of the principal bronchus and continues into the respiratory bronchioles. Bronchial glands are present in the propria submucosa and tela submucosa of the principal bronchi. The musculocartilaginous tunic is localized to the extrapulmonary portion of the principal bronchus. The bronchial cartilages are irregular shaped plates and limited to the extrapulmonary portion of the principal bronchus. The visceral pleura is a simple squamous mesothelium covering the outer surface of the lung.
Ten‐day sequential therapy is more effective than proton pump inhibitor‐based therapy in Korea: A prospective, randomized study
Authors: Oh Hong Sang , Lee Dong Ho , Seo Ji Yeon , Cho Yu Ri , Kim Nayoung , Jeoung Sook Hyang , Kim Jin Wook , Hwang Jin Hyeok , Park Young Soo , Lee Sang Hyub , Shin Cheol Min , Cho Hyun Jin , Jung Hyun Chae , Song In Sung
Published: September 2011

Background and Aims:  The eradication rate of proton pump inhibitor (PPI)‐based triple therapy for Helicobacter pylori (H. pylori) infection has decreased, mainly due to increasing antibiotic resistance, especially against clarithromycin. It has been reported that a 10‐day sequential strategy can produce good outcomes. The aim of this prospective study was to assess the efficacy of sequential therapy as the first‐line treatment for the eradication of H. pylori in Korea.

Methods:  A total of 116 patients with proven H. pylori infection received 10‐day sequential therapy (20 mg rabeprazole and 1 g amoxicillin, twice daily for the first 5 days, followed by 20 mg rabeprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily for the remaining 5 days); 130 patients received 7‐day triple therapy (20 mg rabeprazole, 500 mg clarithromycin, and 1 g amoxicillin, twice daily for 7 days). Eradication was evaluated by the 13C‐urea breath test, 4 weeks after the completion of treatment. Compliance and adverse events were assessed.

Results:  The eradication rates of 10‐day sequential therapy and PPI‐based triple therapy were 79.3% (92/116) and 63% (82/130) by intention‐to‐treat analysis, respectively (P = 0.005), and 81.9% (91/111) and 64.5% (82/127) by per protocol analysis, respectively (P = 0.003). Mild adverse events occurred in both therapy groups (27.5% vs 23.8%), but both treatments were well tolerated.

Conclusion:  The eradication rate of the 10‐day sequential therapy regimen was significantly higher than that of PPI‐based triple therapy in the Korean population. Ten‐day sequential therapy might be effective as a first‐line treatment for H. pylori infection in Korea.
Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2011 edition
Authors: Minakami Hisanori , Hiramatsu Yuji , Koresawa Mitsuhiko , Fujii Tomoyuki , Hamada Hiromi , Iitsuka Yoshinori , Ikeda Tomoaki , Ishikawa Hiroshi , Ishimoto Hitoshi , Itoh Hiroaki , Kanayama Naohiro , Kasuga Yoshio , Kawabata Masakiyo , Konishi Ikuo , Matsubara Shigeki , Matsuda Hideo , Murakoshi Takeshi , Ohkuchi Akihide , Okai Takashi , Saito Shigeru , Sakai Masato , Satoh Shoji , Sekizawa Akihiko , Suzuki Masaaki , Takahashi Tsuneo , Tokunaga Akiteru , Tsukahara Yuki , Yoshikawa Hiroyuki
Published: September 2011

Clinical guidelines for obstetrical practice were first published by the Japan Society of Obstetrics and Gynecology (JSOG) and the Japan Association of Obstetricians and Gynecologists (JAOG) in 2008, and a revised version was published in 2011. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction in burdens associated with medico‐legal and medico‐economical problems, and a better understanding between pregnant women and maternity‐service providers. These guidelines include a total of 87 Clinical Questions followed by several Answers (CQ&A), a Discussion, a List of References, and some Tables and Figures covering common problems and questions encountered in obstetrical practice. Each answer with a recommendation level of A, B or C has been prepared based principally on ‘evidence’ or a consensus among Japanese obstetricians in situations where ‘evidence’ is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 87 CQ&A are presented herein to promote a better understanding of the current standard care practices for pregnant women in Japan.
A randomized crossover comparison between the Laryngeal Mask Airway‐Unique™ and the air‐Q Intubating Laryngeal Airway in children*
Authors: Jagannathan Narasimhan , Sohn Lisa E. , Mankoo Ravinder , Langen Kenneth E. , Mandler Tessa
Published: September 2011

Objectives:  The purpose of this randomized crossover study was to evaluate the feasibility of the air‐Q intubating laryngeal airway (ILA) in clinical practice when compared with the Laryngeal Mask Airway‐Unique™ (LMA‐U), the current standard of care for primary airway maintenance.

Aim:  We hypothesized that the ILA would have better airway seal pressures and laryngeal alignment than the LMA‐U in anesthetized nonparalyzed children.

Background:  The ILA is a newer supraglottic airway for children with design features that allow it to be used for primary airway maintenance and as a conduit for tracheal intubations.

Methods:  Fifty healthy children, 6–36 months of age, 10–15 kg, who were scheduled for elective surgery in which the use of a size two LMA‐U and size 1.5 ILA would be appropriate for airway maintenance, were enrolled into this randomized crossover study. Primary outcome measures were airway leak pressures and fiberoptic grades of view. Secondary outcome measures included ease and time for successful insertion, incidence of gastric insufflation, ventilation parameters, and complications.

Results:  There were no statistically significant differences in regard to the ease of device insertion, time to ventilation, gastric insufflation, and ventilation parameters between the ILA and the LMA‐U. All devices were successfully placed on the first attempt, and there were no instances of failure. There were statistically significant differences in the airway leak pressure between the ILA (19.0 ± 5.4 cmH2O) and the LMA‐U (16.1 ± 4.9 cmH2O), P = 0.001. There were also statistically significant differences in the fiberoptic grades of view between the ILA and LMA‐U, P = 0.004.

Conclusions:  The ILA had higher airway leak pressures and superior fiberoptic grades of view when compared with the LMA‐U and can be a suitable alternative to the LMA‐U in children weighing 10–15 kg.
Concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci
Authors: Mathes Rachel L. , Burdette Erin L. , Moore Phillip A. , Myrna Kathern E.
Published: September 2011

Objective  To report concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci and to document any correlation with equine recurrent uveitis (ERU).

Procedure  Records of 131 horses (241 eyes) examined at the University of Georgia Veterinary Teaching hospital from 2001 to 2010 were reviewed with either clinically normal fundi or depigmented punctate chorioretinal foci in the absence of other fundic pathology. Data collected included patient signalment, concurrent clinical ocular findings and follow‐up information. Sex, presence of no other intraocular findings, presence of ERU, presence of cataracts, and presence of vitreal disease were compared between normal and foci groups using chi‐squared analysis. Age and length of follow‐up time were compared using a student’s t‐test.

Results  Ninety‐one horses (167 eyes) with chorioretinal foci and forty horses (74 eyes) with clinically normal ocular fundi were examined. Fifty‐eight (64%) horses with chorioretinal foci and 20 (50%) horses with clinically normal fundi had a normal intraocular examination. There was no significant difference in any of the criteria examined between groups.

Conclusions  Horses with depigmented punctate chorioretinal foci, in the absence of other fundic pathology, are not more likely to have intraocular disease or ERU than horses with clinically normal ocular fundi. These findings suggest that depigmented punctate fundic foci in horses are not indicative of or associated with ERU.
Cost‐analysis comparison of robot‐assisted laparoscopic radical cystectomy (RC) vs open RC
Authors: Lee Richard , Chughtai Bilal , Herman Michael , Shariat Shahrokh F. , Scherr Douglas S.
Published: September 2011

What's known on the subject? and What does the study add?

The cost performance of RC has been studied in single institution series, each with its own particular clinical pathway and perioperative parameters. Given the relatively new technique, groups have reported different outcomes based on their unique experience. Most groups have demonstrated an increased materials cost associated with RC but a lower LOS.

The study systematically examines and summarizes the cost performance data of RC vs. OC. It reviews all relevant studies and presents them in a succinct overview of the current peer‐reviewed literature.

OBJECTIVE

To systematically review and compare the economic burden of open radical cystectomy (ORC) vs robot‐assisted laparoscopic radical cystectomy (RALRC) with pelvic lymph node dissection and urinary diversion.

PATIENTS AND METHODS

A Medline search was conducted to identify English language articles regarding RC with urinary diversion. The resulting articles were then further restricted by the terms ‘laparoscopic’, ‘robotic’, or ‘robotic‐assisted’.In all, three articles were identified.

Data from each of these articles were then collected on cost performance in addition to relevant clinical variables, such as length of stay (LOS), operative duration, and complication rates.

When possible, data were subdivided by ileal conduit (IC), continent cutaneous diversion (CCD), and orthotopic neobladder (ON) subgroups.

Direct costs resulting from ORC or RALRC with accompanying hospitalization were identified. The indirect costs of complications were considered.

RESULTS

Despite an increased materials cost, RALRC was less expensive than ORC when the cost of complications was considered.

RALRC was less expensive than ORC for IC and CCD, but the cost advantage deteriorated for ON.

The largest cost drivers cited in the published data were LOS, operative durations, and daily hospitalizations costs.

RALRC demonstrated shorter LOS compared with ORC, although this effect was insufficient to offset the increased cost of robotic surgery.

Complications materially affected cost performance.

CONCLUSIONS

Despite an increased materials cost, RALRC can be more cost efficient than ORC as a treatment for bladder cancer when the impact of complications are considered.

This effect is most pronounced for patients undergoing IC.
Current status of robotic partial nephrectomy (RPN)
Authors: Cha Eugene K. , Lee Daniel J. , Del Pizzo Joseph J.
Published: September 2011

What's known on the subject? and What does the study add?

Nephron‐sparing surgery is now the gold standard for the treatment of small renal masses. Robotic partial nephrectomy represents an emerging minimally‐invasive option for nephron‐sparing surgery. Initial case series have described the evolution of technique and perioperative outcomes.

This review summarizes recent case series regarding robotic partial nephrectomy and provides an analysis of studies comparing robotic partial nephrectomy to laparoscopic partial nephrectomy. Exciting technical advances are centered around reducing ischemia time. Finally, future directions for robotic partial nephrectomy include options for cold ischemia, real‐time integration of radiographic imaging, and advancements in robotic technology.

OBJECTIVE

Robotic partial nephrectomy (RPN) is a minimally invasive option for patients undergoing nephron‐sparing surgery (NSS). As the technique of RPN develops and matures, intraoperative and perioperative outcomes continue to be reported. In the current review, we discuss safety, efficacy, and recent technical advances in RPN.

METHODS

A Medline search using the keywords ‘partial nephrectomy’, ‘robotic partial nephrectomy’, ‘robot partial nephrectomy’, ‘robot‐assisted laparoscopic partial nephrectomy’, and ‘laparoscopic partial nephrectomy’ was conducted to identify original articles, review articles, and editorials on RPN.

RESULTS

There have been multiple recent retrospective studies comparing RPN with laparoscopic PN (LPN). These comparisons suggest a shorter learning curve for RPN and confirm the safety and feasibility of RPN, even for select complex renal masses.

Novel techniques have been developed in efforts to decrease warm ischaemia time. These include use of sliding‐clip renorrhaphy, selective renal parenchymal clamping, and ‘early unclamping’ or ‘no‐clamp’ techniques.

CONCLUSIONS

RPN appears to be a viable minimally invasive option for NSS. RPN may reduce some of the technical challenges associated with LPN, and thus, extend the potential benefits of minimally invasive NSS to a larger population.

Further studies of the long‐term renal functional outcomes and oncological efficacy of RPN are needed before fully advocating this technique.
Understanding issues associated with attending a young adult diabetes clinic: a case study
Authors: Snow R. , Fulop N.
Published: September 2011

Diabet. Med. 29, 257–259 (2012)

Aims  To study the reasons for attendance behaviour from the patient viewpoint at a young adult diabetes outpatient clinic.

Methods  Attendance rates for 231 clinic appointments over 19 months for 102 patients were calculated. Semi‐structured interviews were conducted with a purposive sample of 17 of the 102. The interviews encouraged participants to describe routines, thoughts and feelings around clinic appointments. Observations were made of the clinic system. Themes arising from patients’ emotional and practical issues around attendance were generated from the data.

Results  ‘Did not attend’ rates for the clinic over the study period were 15.7%. However, bureaucratic problems created many ‘missed’ appointments; most instances of ‘did not attend’ investigated were attributable to communication failures. Participants did not divide neatly into ‘attenders’/’non‐attenders’; many had complex mixed attendance records. Most weighed the value of attendance against immediate obstacles such as incompatible work/clinic hours. Reminders were seen as important, particularly for this age group. Respondents identified fear of being judged for ‘poor control’ as a major factor in attendance decisions, suggesting that having a high HbA1c level may lead to non‐attendance, rather than vice versa.

Conclusions  Health professionals’ supportive, non‐judgemental attitude is important to patients considering clinic attendance. In this study, improved communication, reminders and flexible hours might reduce ‘did not attend’ rates.
Self‐reported facilitators of, and impediments to maintenance of healthy lifestyle behaviours following a supervised research‐based lifestyle intervention programme in patients with type 2 diabetes
Authors: Wycherley T. P. , Mohr P. , Noakes M. , Clifton P. M. , Brinkworth G. D.
Published: September 2011

Diabet. Med. 29, 632–639 (2012)

Introduction  Sustainability of healthy lifestyle behaviours following participation in a research‐based supervised lifestyle intervention programme is often poor. This study aimed to document factors reported by overweight and obese individuals with Type 2 diabetes as enhancing or impeding sustainability of lifestyle behaviours following participation in such a programme.

Methods  Thirty patients who completed a 16‐week research‐based supervised lifestyle intervention programme, incorporating a structured energy restricted diet with or without supervised resistance‐exercise training underwent a semi‐structured qualitative interview about their experiences in maintaining programme components after 1 year.

Results  Participants maintained 8.8 ± 8.9 kg of the 13.9 ± 6.6 kg weight loss achieved with the research‐based supervised lifestyle intervention programme. Only 23% of participants indicated continuation of the complete diet programme. Desire for ‘variety’ (33%) and increased portion size (27%) were the most commonly reported reasons for discontinuation. Participants who undertook supervised exercise training during the programme indicated access to appropriate programmes/facilities (38%), more affordable gym membership (21%) and having a personal trainer/motivator (17%) would have facilitated exercise continuation.

Conclusion  In overweight and obese individuals with Type 2 diabetes, success of the research‐based supervised lifestyle intervention programme was perceived as being primarily due to high levels of professional support and supervision, the discontinuation of which subsequently presented difficulties. The interview data provide insight into what people experience following the completion of a research‐based intensive lifestyle intervention programme and suggest that programmes assembled for research purposes with the emphasis on compliance may not necessarily promote sustainable change.
Order at the Edge of Chaos: Meanings from Netdom Switchings across Functional Systems
Authors: Fontdevila Jorge , Opazo M. Pilar , White Harrison C.
Published: September 2011

The great German theorist Niklas Luhmann argued long ago that meaning is the central construct of sociology. We agree, but our scheme of stochastic processes—evolved over many years as identity and control—argues for switchings of intercalated bits of social network and interpretive domain (i.e., netdom switchings) as the core of meaning processes. We thus challenge Luhmann's central claim that modern society's subsystems are based on communicative self-closure. We assert that there is refuting evidence from sociolinguistics, from how languages are put together and how languages' indexical and reflexive devices (e.g., metapragmatics, heteroglossia, genres) are used in social action. Communication is about managing indexicalities, which entail great ambiguity and openness as they are anchored in myriad netdom switchings across social times and spreads. In contrast, Luhmann's concept of communication revolves around binary codes governed recursively and algorithmically within systems in efforts to reduce complexity from the environment. We conclude that systems closure does not solve the problem of uncertainty in social life. In fact, lack of uncertainty is itself a problem. Order is necessary, but order at the edge of chaos.
Domestic Embeddedness and the Dynamics of Multilevel Venue Shopping in Four EU Member States
Authors: BEYERS JAN , KERREMANS BART
Published: September 2011

This article describes and explains the variable extent to which domestic interest organizations seek access to the multiple venues provided by the European system of governance. A multivariate analysis of data collected in four member states—France, Belgium, the Netherlands, and Germany—reveals substantial variance in multilevel venue shopping, differences that disconfirm some descriptive accounts reported in the Europeanization literature. Surprising is that French organizations develop extensive multilevel strategies while the strategies of Dutch organizations are rather weakly Europeanized. Our analyses offer a better understanding of the factors that stimulate domestic interest groups to seek access to European Union‐level policy venues. Factors such as the nature of policy issues in which groups are involved, the group's relation with domestic parties, and overall domestic embeddedness significantly explains multilevel venue‐shopping. In contrast, other factors such as policy sector or the group's resources generate little explanatory power.
Sulfoglucuronosyl paragloboside promotes endothelial cell apoptosis in inflammation: elucidation of a novel glycosphingolipid‐signaling pathway
Authors: Dasgupta Somsankar , Wang Guanghu , Yu Robert K.
Published: September 2011

J. Neurochem. (2011) 119, 749–759.

Sulfoglucuronosyl paragloboside (SGPG), a minor glycosphingolipid of endothelial cells, is a ligand for L‐selectin and has been implicated in neuro‐inflammatory diseases, such as Guillian‐Barré syndrome. Inflammatory cytokines, such as TNFα and IL‐1β, up‐regulate SGPG expression by stimulating gene expression for glucuronosyltransferases, both P and S forms (GlcATp and GlcATs), and the human natural killer antigen (HNK‐1) sulfotransferase (HNK‐1 ST). Transfection of a human cerebromicrovascular endothelial cell (SV‐HCEC) line with HNK‐1 ST siRNA down‐regulated SGPG expression, inhibited cytokine‐stimulated T‐cell adhesion, and offered protection against apoptosis. However, the precise mechanisms of SGPG elevation in endothelial cell apoptosis and the maintenance of blood–brain or blood–nerve barrier integrity in inflammation have not been elucidated. Blocking SGPG expression inhibited cytokine‐mediated stimulation of NF‐κB activity but stimulated MAP kinase activity. Furthermore, elevation of SGPG by over‐expression of GlcATp and GlcATs triggered endothelial cell apoptosis, with GlcATs being more potent than GlcATp. Although SGPG‐mediated endothelial cell apoptosis was preceded by inhibiting the intracellular NF‐κB activity, interfering with Akt and ERK activation and stimulating caspase 3 in SV‐HCECs, HNK‐1ST siRNA transfection also interfered with IκB phosphorylation but stimulated ERK activation. Our data indicate that SGPG is a critical regulatory molecule for maintaining endothelial cell survival and blood–brain or blood–nerve barrier function.
Congenital Lower Limb Enlargement in a Newborn
Authors: PEREZ‐CRESPO MARÍA , BETLLOCH ISABEL , MARTINEZ‐MIRAVETE MARIA TERESA , BALLESTER IRENE , LUCAS ANA , MATAIX JAVIER
Published: September 2011

Abstract:  A full‐term newborn presented with swelling of his right leg soon after birth. There was no alteration in Doppler. The grandmother and other relatives were said to have shown a similar history at birth. Milroy’s disease was then diagnosed and compressive massage was advised.
Birth Cohort Effects and Gender Differences in Alcohol Epidemiology: A Review and Synthesis
Authors: Keyes Katherine M. , Li Guohua , Hasin Deborah S.
Published: September 2011

Background: Alcohol consumption has demonstrated substantial temporal trends, with some evidence suggesting strong birth cohort effects. The identification of at‐risk birth cohorts can inform the interpretation of alcohol trends across age, time, and demographic characteristics such as gender. The present literature review has 2 objectives. First, we conduct a cross‐national review of the literature on birth cohort differences in alcohol consumption, disorder, and mortality. Second, we determine the consistency of evidence for birth cohort effects on gender differences.

Methods: A search was conducted and key data on population characteristics, presence and direction of cohort effects, and interactions with gender compiled. Thirty‐one articles were included.

Results: Evidence suggests that younger birth cohorts in North America, especially those born after World War II, are more likely than older cohorts to engage in heavy episodic drinking and develop alcohol disorders, but this cohort effect is not found in Australia and western Europe. Cross‐nationally, substantial evidence indicates that women in younger cohorts are at especially high risk for heavy episodic drinking and alcohol disorders.

Discussion: Younger birth cohorts in North America and Europe are engaging in more episodic and problem drinking. The gender gap in alcohol problems is narrowing in many countries, suggesting shifting social norms surrounding gender and alcohol consumption. These trends suggest that public health efforts to specifically target heavy drinking in women are necessary.
Specific Subjective Memory Complaints in Older Persons May Indicate Poor Cognitive Function
Authors: Amariglio Rebecca England , Townsend Mary K. , Grodstein Francine , Sperling Reisa A. , Rentz Dorene M.
Published: September 2011

OBJECTIVES: To examine the association between the type and number of subjective memory complaints (SMCs) and performance on objective cognitive tests.

DESIGN: Cross‐sectional.

SETTING: Nurses' Health Study.

PARTICIPANTS: Sixteen thousand nine hundred sixty‐four women (mean age 74) who provided information on SMCs.

MEASUREMENTS: Telephone cognitive assessments and seven questions regarding SMCs were administered. Cognitive impairment was defined as a score of less than 31 on the Telephone Interview for Cognitive Status (TICS) and below the 10th percentile on other cognitive measures. To assess associations with SMCs, multivariable logistic regression was used to calculate odds ratios for cognitive impairment and multivariable linear regression to calculate mean differences in cognitive test scores, adjusting for age and depressive symptoms.

RESULTS: Some SMCs, such as trouble following a group conversation or finding one's way around familiar streets, were more highly associated than others with odds of cognitive impairment. The complaint of forgetting things from one second to the next, generally considered part of normal aging, was not associated with cognitive impairment. In addition, there were strong, linear trends of increasingly worse scores on cognitive tests with increasing numbers of memory complaints. For each additional SMC endorsed, the odds of cognitive impairment increased approximately 20% when each SMC was weighted equally.

CONCLUSION: SMCs are associated with objective cognitive status and may be considered by primary care physicians in determining whether follow‐up is warranted.