bluuebunny/crossref_metadata_2025 huggingface dataset:
Integration of spintronic interface for nanomagnetic arrays
Authors: Lyle Andrew , Harms Jonathan , Klein Todd , Lentsch August , Klemm Angeline , Martens Daniel , Wang Jian-Ping
Published: December 2011

An experimental demonstration utilizing a spintronic input/output (I/O) interface for arrays of closely spaced nanomagnets is presented. The free layers of magnetic tunnel junctions (MTJs) form dipole coupled nanomagnet arrays which can be applied to different contexts including Magnetic Quantum Cellular Automata (MQCA) for logic applications and self-biased devices for field sensing applications. Dipole coupled nanomagnet arrays demonstrate adaptability to a variety of contexts due to the ability for tuning of magnetic response. Spintronics allows individual nanomagnets to be manipulated with spin transfer torque and monitored with magnetoresistance. This facilitates measurement of the magnetic coupling which is important for (yet to be demonstrated) data propagation reliability studies. In addition, the same magnetic coupling can be tuned to reduce coercivity for field sensing. Dipole coupled nanomagnet arrays have the potential to be thousands of times more energy efficient than CMOS technology for logic applications, and they also have the potential to form multi-axis field sensors.
Remodeling of actin filaments by ADF/cofilin proteins
Authors: Galkin Vitold E. , Orlova Albina , Kudryashov Dmitri S. , Solodukhin Alexander , Reisler Emil , Schröder Gunnar F. , Egelman Edward H.
Published: December 2011

Cofilin/ADF proteins play key roles in the dynamics of actin, one of the most abundant and highly conserved eukaryotic proteins. We used cryoelectron microscopy to generate a 9-Å resolution three-dimensional reconstruction of cofilin-decorated actin filaments, the highest resolution achieved for a complex of F-actin with an actin-binding protein. We show that the cofilin-induced change in the filament twist is due to a unique conformation of the actin molecule unrelated to any previously observed state. The changes between the actin protomer in naked F-actin and in the actin-cofilin filament are greater than the conformational changes between G- and F-actin. Our results show the structural plasticity of actin, suggest that other actin-binding proteins may also induce large but different conformational changes, and show that F-actin cannot be described by a single molecular model.
Rational design of an evolutionary precursor of glutaminyl-tRNA synthetase
Authors: O’Donoghue Patrick , Sheppard Kelly , Nureki Osamu , Söll Dieter
Published: December 2011

The specificity of most aminoacyl-tRNA synthetases for an amino acid and cognate tRNA pair evolved before the divergence of the three domains of life. Glutaminyl-tRNA synthetase (GlnRS) evolved later and is derived from the archaeal-type nondiscriminating glutamyl-tRNA synthetase (GluRS), an enzyme with relaxed tRNA specificity capable of forming both Glu-tRNA
Glu
and Glu-tRNA
Gln
. The archaea lack GlnRS and use a specialized amidotransferase to convert Glu-tRNA
Gln
to Gln-tRNA
Gln
needed for protein synthesis. We show that the
Methanothermobacter thermautotrophicus
GluRS is active toward tRNA
Glu
and the two tRNA
Gln
isoacceptors the organism encodes, but with a significant catalytic preference for

. The less active

responds to the less common CAA codon for Gln. From a biochemical characterization of
M. thermautotrophicus
GluRS variants, we found that the evolution of tRNA specificity in GlnRS could be recapitulated by converting the
M. thermautotrophicus
GluRS to a tRNA
Gln
specific enzyme, solely through the addition of an acceptor stem loop present in bacterial GlnRS. One designed GluRS variant is also highly specific for the

isoacceptor, which responds to the CAG codon, and shows no activity toward

. Because it is now possible to eliminate particular codons from the genome of
Escherichia coli
, additional codons will become available for genetic code engineering. Isoacceptor-specific aminoacyl-tRNA synthetases will enable the reassignment of more open codons while preserving accurate encoding of the 20 canonical amino acids.
A genre, collocational, and constructional analysis of RISK
Authors: Hardy Donald E. , Colombini Crystal Broch
Published: December 2011

Scholars of language have begun to explore the popular academic topic that is “risk” and to establish the viability of corpus linguistics for such analysis. We extend existing scholarship by analyzing the noun lemma RISK over the last two decades of contemporary American discourse with recourse to the Corpus of Contemporary American English. Using the corpus procedures of frequency analysis, concordance contextual analysis, collocational analysis, and a variation on distinctive-collexeme analysis, we revisit the often under-supported assertion that RISK is semantically negative, and then investigate the semantic potential for good risk, a phenomenon associated with economic and adventuring sectors. Data suggest that RISK is genre sensitive, predominantly negative, and heavily medical in shared meaning across genres, and further, that evidence for good risk is minimal. A phrase of interest in recent corpus work — RISK worth taking — is shown to be sensitive perhaps more to constructional constraints than to semantic prosody.
Endurance and sprint benefits of high‐intensity and supramaximal interval training
Authors: Cicioni‐Kolsky Daniel , Lorenzen Christian , Williams Morgan David , Kemp Justin Guy
Published: December 2011

This study examined the effect of two different interval training programs–high‐intensity interval training (HIT) and supramaximal interval training (SMIT)–on measures of sprint and endurance performance. Physically active individuals (Females: n=32; age 19.3, s=2.2 years; mass 67.6, s=9.1 kg; stature 172.7, s=6.6 cm. Males: n=23; age 20.0, s=2.7 years; mass 71.3, s=8.3 kg; stature 176.6, s=5.8 cm) completed pre‐testing that comprised (1) 3000 m time‐trial, (2) 40 m sprint, and (3) repeated sprint ability (RSA–6×40 m sprints, 24 s active recovery) performance. Participants were then matched for average 3000 m running velocity (AV) and randomly assigned to one of three groups: (i) HIT, n=19, 4 min at 100% AV, 4 min passive recovery, 4–6 bouts per session; (ii) SMIT, n=20, 30 s at 130% AV, 150 s passive recovery, 7–12 bouts per session; and (iii) control group, n=16, 30 min continuous running at 75% AV. Groups trained three times per week for six weeks. When time to complete each test were compared among groups: (i) improvements in 3000 m time trial performance were greater following SMIT than continuous running, and (ii) improvements in 40 m sprint and RSA performance were greater following SMIT than HIT and continuous running. In addition, a gender effect was observed for the 3000 m time trial only, where females changed more following the training intervention than males. In summary, for concurrent improvements in endurance, sprint and repeated sprint performance, SMIT provides the greatest benefits for physically active individuals.
Reduced fat oxidation during high intensity, submaximal exercise: is the availability of carnitine important?
Authors: Wall Benjamin T. , Stephens Francis B. , van Loon Luc J.C. , Constantin‐Teodosiu Dumitru , Macdonald Ian A. , Greenhaff Paul L.
Published: December 2011

The increased energy demand that occurs with incremental exercise intensity is met by increases in the oxidation of both endogenous fat and carbohydrate stores up to an intensity of ~70% V˙O2max in trained individuals. However, when exercise intensity increases beyond this workload, fat oxidation rates decline, both from a relative and absolute perspective. As endogenous glycogen use is accelerated, glycogen stores can become depleted, ultimately resulting in fatigue and the inability to maintain high intensity, submaximal exercise (>70% V˙O2max). Despite a considerable accumulation of knowledge that has been gained over the past half century, the precise mechanism(s) regulating muscle fuel selection and underpinning the aforementioned decline in fat oxidation remain largely unclear. A greater understanding would undoubtedly lead to novel strategies to increase fat utilization and, as such, improve exercise capacity. The present review primarily addresses one of the most prominent theories to explain the phenomenon of diminished fat oxidation during high intensity, submaximal exercise; a reduced availability of muscle free carnitine for mitochondrial fat translocation. This is discussed in the light of recent work in this area taking advantage of the discovery that muscle carnitine content can be increased in vivo in humans. Furthermore, the evidence supporting the recently proposed theory that reduced muscle co‐enzyme A availability to several key enzymes in the fat oxidation pathway may also exert a degree of control over muscle fuel selection during exercise is also considered. Strong correlational evidence exists that muscle free carnitine availability is likely to be a key limiting factor to fat oxidation during high intensity, submaximal exercise. However, it is concluded that further intervention studies manipulating the muscle carnitine pool in humans are required to establish a direct causal role. In addition, it is concluded that while a depletion of muscle coenzyme A availability during exercise also offers a viable mechanism for impairing fat oxidation, at present, this remains speculative.
Live imaging of apoptosis in a novel transgenic mouse highlights its role in neural tube closure
Authors: Yamaguchi Yoshifumi , Shinotsuka Naomi , Nonomura Keiko , Takemoto Kiwamu , Kuida Keisuke , Yosida Hiroki , Miura Masayuki
Published: December 2011

Many cells die during development, tissue homeostasis, and disease. Dysregulation of apoptosis leads to cranial neural tube closure (NTC) defects like exencephaly, although the mechanism is unclear. Observing cells undergoing apoptosis in a living context could help elucidate their origin, behavior, and influence on surrounding tissues, but few tools are available for this purpose, especially in mammals. In this paper, we used insulator sequences to generate a transgenic mouse that stably expressed a genetically encoded fluorescence resonance energy transfer (FRET)–based fluorescent reporter for caspase activation and performed simultaneous time-lapse imaging of apoptosis and morphogenesis in living embryos. Live FRET imaging with a fast-scanning confocal microscope revealed that cells containing activated caspases showed typical and nontypical apoptotic behavior in a region-specific manner during NTC. Inhibiting caspase activation perturbed and delayed the smooth progression of cranial NTC, which might increase the risk of exencephaly. Our results suggest that caspase-mediated cell removal facilitates NTC completion within a limited developmental window.
Omnidirectional photonic bangap in dielectric mirrors: a comparative study
Authors: Ariza-Flores David , Gaggero-Sager L M , Agarwal V
Published: December 2011

We report the theoretical comparison of the omnidirectional photonic band gap (OPBG) of one-dimensional dielectric photonic structures, using three different refractive index profiles: sinusoidal, Gaussian and Bragg. For different values of optical thickness, the tunability of the OPBG of each profile is shown to depend on the maximum, minimum and the difference of the refractive indices. An experimental verification was carried out with a multilayered dielectric porous silicon structure for all the three profiles. The optimal combination of refractive indices for each structure which generates the maximum OPBG has also been calculated. Such study can be useful to design the required OPBG structures for photonic applications.
Experimental and theoretical study of dynamic effects in low-frequency capacitively coupled discharges
Authors: Braginsky O , Kovalev A , Lopaev D , Proshina O , Rakhimova T , Vasilieva A , Voloshin D , Zyryanov S
Published: December 2011

A low-frequency capacitively coupled radio-frequency (rf) discharge in Ar excited at 1.76 MHz is studied both experimentally and theoretically. Experimental measurements of electron concentration, discharge voltage and current are presented for a wide range of rf input powers. The rf current shape is nonsinusoidal, close to the triangle one. The evolution of Ar(2p1) emission excitation function in the interelectrode gap during an rf cycle is measured using the phase-resolved optical emission spectroscopy technique. Theoretical study is based on the particle-in-cell Monte Carlo collision numerical simulation. Specific dynamic features of the low-frequency discharge are discussed. The important role of secondary electrons in discharge maintenance and power balance is shown. This study is crucial for understanding dual-frequency discharges with a corresponding value of low frequency.
Graphene field-effect transistors
Authors: Reddy Dharmendar , Register Leonard F , Carpenter Gary D , Banerjee Sanjay K
Published: December 2011

Our discussions on pages 11 and 12 of our recently published review paper in this journal were influenced in part by the discussions within an earlier work on the same subject by F Schwierz [1], including, in particular, the observations on lines 41–43 of the body text in the right column of page 11 and lines 17–19 and 30–33 in left column of page 12. The citation was lost during preparation of the manuscript. We sincerely apologize for this oversight.

Reference

[1] Schwierz F 2010Nat.Nano.5487–96
Pyrophosphate-Dependent Fructose-6-Phosphate 1-Phosphotransferase Induction and Attenuation of Hsp Gene Expression during Endosperm Modification in Quality Protein Maize
Authors: Guo Xiaomei , Ronhovde Kyla , Yuan Lingling , Yao Bo , Soundararajan Madhavan P. , Elthon Thomas , Zhang Chi , Holding David R.
Published: December 2011

Quality Protein Maize (QPM) is a hard-endosperm version of the high-lysine opaque2 (o2) maize (Zea mays) mutant, but the genes involved in modification of the soft o2 endosperm are largely unknown. Pyrophosphate-dependent fructose-6-phosphate 1-phosphotransferase (PFP) catalyzes the ATP-independent conversion of fructose-6-phosphate to fructose-1,6-bisphosphate in glycolysis. We found a large increase in transcript and protein levels of the α-regulatory subunit of PFP (PFPα) in QPM endosperm. In vitro enzyme assays showed a significant increase in forward PFP activity in developing endosperm extracts of QPM relative to the wild type and o2. An expressed retrogene version of PFPα of unknown function that was not up-regulated in QPM was also identified. The elevated expression levels of a number of ATP-requiring heat shock proteins (Hsps) in o2 endosperm are ameliorated in QPM. PFPα is also coinduced with Hsps in maize roots in response to heat, cold, and the unfolded protein response stresses. We propose that reduced ATP availability resulting from the generalized Hsp response in addition to the reduction of pyruvate, orthophosphate dikinase activity in o2 endosperm is compensated in part by increased PFP activity in QPM.
Automatic sample changer for the analysis of powder samples on an X-ray single-crystal diffractometer equipped with an area detector
Authors: Rodriguez-Navarro Alejandro B. , Kudlacz Krzysztof , Ortega-Huertas Miguel
Published: December 2011

A low-budget automatic sample changer that allows the rapid analysis of powder or polycrystalline samples using an X-ray single-crystal diffractometer equipped with an area detector is here described. It uses control software that synchronizes the movement of a linear stage with the collection of frames by the diffractometer. Small pieces of thin solid samples are directly attached to a 30 cm ruler, which is used as a disposable magazine, while loose powder samples are loaded into holes on an acetate strip covered on both sides with Kapton tape and attached to the ruler. The use of this type of diffractometer with a sample changer is a simple, low cost and effective solution for studies requiring the analysis of a large number of samples by X-ray powder diffraction. With the current design up to 30 samples can be measured in a single experiment. The current sample changer was designed so that it can be fitted into a Bruker SMART APEX X-ray single-crystal diffractometer. However, it can be easily adapted to diffractometers from other makers.
Investigation of indirect structural and chemical parameters of GeSi nanoparticles in a silica matrix by combined synchrotron radiation techniques
Authors: Gasperini Antonio , Malachias Angelo , Fabbris Gilberto , Kellermann Guinther , Gobbi Angelo , Avendaño Esteban , Azevedo Gustavo de Medeiros
Published: December 2011

The formation of GeSi nanoparticles on an SiO2matrix is studied here by synchrotron-based techniques. The shape, average diameter and size dispersion were obtained from grazing-incidence small-angle X-ray scattering data. X-ray diffraction measurements were used to obtain crystallite sizes and compositionviaresonant (anomalous) measurements. By using these techniques as input for extended X-ray absorption fine structure analysis, the local composition surrounding the Ge atoms is investigated. Although the results for each of the methods above are commonly analyzed separately, the combination of such techniques leads to an improved understanding of nanoparticle structural and chemical properties. Crucial indirect parameters that cannot be quantified by other means are accessed in this work, such as local strain, the possibility of forming core–shell structures, the fraction of Ge atoms diluted in the matrix (not forming nanoparticles), the amorphous and crystalline Ge fractions, and the relative population of nanoparticles with single and multiple crystalline domains.
Twelve‐Step attendance trajectories over 7 years among adolescents entering substance use treatment in an integrated health plan
Authors: Chi Felicia W. , Campbell Cynthia I. , Sterling Stacy , Weisner Constance
Published: December 2011

Aims  This study examines 12‐Step attendance trajectories over 7 years, factors associated with the trajectories, and relationships between the trajectories and long‐term substance use outcomes among adolescents entering out‐patient substance use treatment in a private, non‐profit integrated managed‐care health plan.

Design  Longitudinal observational study.

Setting  Four Kaiser Permanente Northern California substance use treatment programs.

Participants  A total of 391 adolescents entering treatment between 2000 and 2002 who completed at least one follow‐up interview in year 1, and at least one during years 3–7, after treatment entry.

Measurements  Alcohol and drug use, 12‐Step meeting attendance and activity involvement and post‐treatment medical service utilization.

Findings  Semiparametric group‐based modeling identified three distinct 12‐Step attendance trajectory groups over 7 years: low/no attendance (60%), early but not continued (26%) and continued (14%). There were lower proportions of males and of adolescents with prior substance use treatment experience in the low/no attendance group (P = 0.019 and P = 0.003, respectively). In addition, those in the low/no attendance group had lower perception on circumstances, motivation and readiness for treatment at baseline (P = 0.023). Multivariate logistic generalized estimating equation analyses found that those in the continued group were more likely to be abstinent from both alcohol and drugs during follow‐ups than those in the low/no attendance group [odds ratio (OR) = 2.40, P = 0.003 and OR = 1.96, P = 0.026, respectively]. However, no differences in long‐term outcomes were found between those in the other two groups.

Conclusion  Robust connection with 12‐Step groups appears to be associated with better long‐term outcomes among adolescents with substance use disorders.
Management of proximal femoral fractures 2011
Authors:   Membership of the Working Party, Griffiths R , Alper J , Beckingsale A , Goldhill D , Heyburn G , Holloway J , Leaper E , Parker M , Ridgway S , White S , Wiese M , Wilson I
Published: December 2011

1. There should be protocol‐driven, fast‐track admission of patients with hip fractures through the emergency department.

 2. Patients with hip fractures require multidisciplinary care, led by orthogeriatricians.

 3. Surgery is the best analgesic for hip fractures.

 4. Surgical repair of hip fractures should occur within 48 hours of hospital admission.

 5. Surgery and anaesthesia must be undertaken by appropriately experienced surgeons and anaesthetists.

 6. There must be high‐quality communication between clinicians and allied health professionals.

 7. Early mobilisation is a key part of the management of patients with hip fractures.

 8. Pre‐operative management should include consideration of planning for discharge from hospital.

 9. Measures should be taken to prevent secondary falls.

10. Continuous audit and targeted research is required in order to inform and improve the management of patients with hip  fracture.
The ratio of glycated albumin to glycated haemoglobin correlates with insulin secretory function
Authors: Kim Daham , Kim Kwang J. , Huh Ji H. , Lee Byung‐Wan , Kang Eun S. , Cha Bong S. , Lee Hyun C.
Published: December 2011

Objective  Although glycated haemoglobin (A1c) levels are similar among patients with type 2 diabetes, the glycated albumin (GA)/A1c ratio varies considerably. On the basis of the hypothesis that endogenous insulin secretion might be correlated with the GA/A1c ratio, we investigated whether insulin secretory function or insulin resistance has different effects on the GA/A1c ratio in patients with type 2 diabetes using the standardized liquid meal test.

Design  A clinical, retrospective study.

Patients and measurements  A total of 758 patients with type 2 diabetes ingested a standardized liquid meal (i.e. 500 kcal, 17·5 g fat, 68·5 g carbohydrate and 17·5 g protein). The subjects were divided into two groups: those with GA/A1c ratio <2·5 (n = 414) and those with GA/A1c ratio ≥2·5 (n = 344). We compared the A1c and GA levels, and the GA/A1c ratio and evaluated the relationships between the glycaemic indices and other parameters. Effects of β‐cell function [homeostasis model assessment (HOMA‐β), insulinogenic index (IGI)] and insulin resistance (HOMA‐IR) on the GA/A1c ratio were also examined.

Results  The GA/A1c ratio was significantly correlated with HOMA‐β, IGI and body mass index (BMI) but not with HOMA‐IR. Furthermore, after adjusting for age, gender, BMI, haemoglobin and albumin levels, the GA/A1c ratio was still inversely correlated with both HOMA‐β and IGI.

Conclusions  The GA/A1c ratio is significantly correlated with insulin secretory function but not with insulin resistance.
Treatment of haemophilia A and B and von Willebrand’s disease: summary and conclusions of a systematic review as part of a Swedish health‐technology assessment
Authors: BERNTORP E. , ASTERMARK J. , BAGHAEI F. , BERGQVIST D. , HOLMSTRÖM M. , LJUNGBERG B. , NORLUND A. , PALMBLAD J. , PETRINI P. , STIGENDAL L. , SÄWE J.
Published: December 2011

Summary.  In an ongoing health‐technology assessment of haemophilia treatment in Sweden, performed by the governmental agency Dental and Pharmaceutical Benefits Agency (TLV; tandva˚rds‐och lākemedelsförma˚nsverket), the Swedish Council on Health Technology Assessment (SBU; statens beredning för medicinsk utvārdering) was called upon to evaluate treatment of haemophilia A and B and von Willebrand’s disease (VWD) with clotting factor concentrates. To evaluate the following questions: What are the short‐term and long‐term effects of different treatment strategies? What methods are available to treat haemophilia patients that have developed inhibitors against factor concentrates? Based on the questions addressed by the project, a systematic database search was conducted in PubMed, NHSEED, Cochrane Library, EMBASE and other relevant databases. The literature search covered all studies in the field published from 1985 up to the spring of 2010. In most instances, the scientific evidence is insufficient for the questions raised in the review. Concentrates of coagulation factors have good haemostatic effects on acute bleeding and surgical intervention in haemophilia A and B and VWD, but conclusions cannot be drawn about possible differences in the effects of different dosing strategies for acute bleeding and surgery. Prophylaxis initiated at a young age can prevent future joint damage in persons with haemophilia. The available treatment options for inhibitors have been insufficiently assessed. The economic consequences of various treatment regimens have been insufficiently analysed. Introduction of national and international registries is important.
Pressure ulcers in older hospitalised patients and its impact on length of stay: a retrospective observational study
Authors: Theisen Silke , Drabik Anna , Stock Stephanie
Published: December 2011

Objective.  To examine the effect of pressure ulcers in older patients on the length of stay in hospital.

Background.  Previous research on this topic did not focus solely on older people. A growing number of older people require hospital admission.

Design.  A retrospective observational study.

Methods.  Data of 3198 patients age 75 years and older were included. The setting was a 1350‐bed German University Hospital. Data were drawn from quality indicator data recorded by nurses. The independent effect of pressure ulcers was analysed using a multivariate Poisson–Regression model.

Results.  Of the participants, 7·1% had an ulcer during their hospitalisation. 87·3% were classified as categories I and II. Mean age was 81·6 years for all patients and 83·2 years for pressure ulcer patients. Pressure ulcer patients had a longer overall hospital stay (19·0 vs. 9·9 days) and a higher excess length of stay (2·6 vs. 0·3 days). Pressure ulcers had a statistically significant effect (p = 0·0011) on the increase in length of stay. The impact of hospital acquired pressure ulcers on length of stay was more pronounced compared to those ulcers being present on admission. The pressure ulcer category was not significant.

Conclusions.  Pressure ulcers during hospitalisation are an independent and significant predictor of a prolonged inpatient stay for elderly patients. This study indicates that besides complications and co‐morbidities social factors, as well as the hospital’s internal processes of patient care, also can play a significant role.

Relevance to clinical practice.  To evaluate the distinct role of hospital acquired pressure ulcers further research is needed. The elderly patients in this study were a heterogeneous group. The implementation of clinical and nursing processes for both the ‘fit’ and the ‘sick’ geriatric patients is an important challenge.
Nurse‐led education and counselling to enhance adherence to phosphate binders
Authors: Van Camp Yoleen P , Huybrechts Sofie A , Van Rompaey Bart , Elseviers Monique M
Published: December 2011

Aims and objectives.  To investigate whether nurse‐led education and counselling enhance phosphate binder adherence in chronic dialysis patients.

Background.  One in two chronic dialysis patients experiences difficulties in adhering to phosphate binders. The reasons for non‐adherence are multifactorial and accordingly require a multifaceted strategy. To date, investigations have been confined primarily to single interventions to promote adherence. This study examines the effect of a multifaceted approach.

Design.  The design was interventional.

Method.  Adherence to phosphate binders was blindly and electronically monitored for 17 consecutive weeks with the Medication Event Monitoring System (MEMS®). After four weeks baseline monitoring, the effects of the intervention were studied for an additional 13 weeks. In week 5, the study nurse gave all 41 participating patients education on phosphate binders. Thereafter, the study nurse gave bi‐weekly personalised counselling to enhance adherence to phosphate binders. The evolution of adherence over time was assessed and compared with historical control data. Secondary outcome variables included serum values of phosphate, calcium and parathyroid hormone and phosphate binder knowledge.

Results.  In week 1, mean adherence was 83% in this study (intervention group), compared with 86% in the historical control group. In the intervention group, mean adherence increased from 83–94% after 13 weeks. By contrast, in the historical control group, mean adherence declined from 86–76%. In the intervention group, serum phosphate values decreased from 4·9–4·3 mg/dl and phosphate binder knowledge increased from a mean score of 53–75%.

Conclusions.  Combining education and continuous counselling holds promise in enhancing phosphate binder adherence. Large‐scaled and long‐term field studies are indicated to determine which nurse‐led practices lead to an integral and sustained medication adherence management.

Relevance to clinical practice.  Nursing strategies to scale up adherence should at least include educating patients and regularly reinforcing adherence behaviour.
Actualistic snapshot of the early Oligocene Alps: the Alps–Apennines knot disentangled
Authors: Malusà Marco G. , Garzanti Eduardo
Published: December 2011

Terra Nova, 24, 1–6, 2012

The geological framework of eastern Papua New Guinea allows us to obtain direct insight into how the Alpine region might have looked like during its earliest stages of tectonic growth, and to shed light on the spatial and temporal relationships between subduction and formation of relief before tightening of the Alps–Apennines junction. In both Alpine and Papuan cases, exhumation of high‐pressure rocks was not associated with any significant erosion, but took place while adjacent sedimentary basins were virtually starved of orogenic sediments and largely characterized by slow accumulation of deep‐water mudrocks and limestones. The subduction and exhumation stages were thus well distinct and separated in time from the genesis of topographic relief, which did not take place until many millions years later.
XIAO is involved in the control of organ size by contributing to the regulation of signaling and homeostasis of brassinosteroids and cell cycling in rice
Authors: Jiang Yunhe , Bao Liang , Jeong So‐Yoon , Kim Seong‐Ki , Xu Caiguo , Li Xianghua , Zhang Qifa
Published: December 2011

Organ size is determined by cell number and size, and involves two fundamental processes: cell proliferation and cell expansion. Although several plant hormones are known to play critical roles in shaping organ size by regulating the cell cycle, it is not known whether brassinosteroids (BRs) are also involved in regulating cell division. Here we identified a rice T‐DNA insertion mutant for organ size, referred to as xiao, that displays dwarfism and erect leaves, typical BR‐related phenotypes, together with reduced seed setting. XIAO is predicted to encode an LRR kinase. The small stature of the xiao mutant resulted from reduced organ sizes due to decreased cell numbers resulting from reduced cell division rate, as supported by the observed co‐expression of XIAO with a number of genes involved in cell cycling. The xiao mutant displayed a tissue‐specific enhanced BR response and greatly reduced BR contents at the whole‐plant level. These results indicated that XIAO is a regulator of BR signaling and cell division. Thus, XIAO may provide a possible connection between BRs and cell‐cycle regulation in controlling organ growth.
Low dose intrathecal morphine effects on post‐hysterectomy pain: a randomized placebo‐controlled study
Authors: HEIN A. , RÖSBLAD P. , GILLIS‐HAEGERSTRAND C. , SCHEDVINS K. , JAKOBSSON J. , DAHLGREN G.
Published: December 2011

Background

Spinal anesthesia with different doses of intrathecal morphine has been shown to relieve post‐operative pain. We studied in a prospective randomized, double‐blind fashion the effects of morphine 0, 100, 200, or 300 μg added to intrathecal bupivacaine on first post‐operative 24 h patient‐controlled analgesia morphine (PCA‐morphine) consumption after abdominal hysterectomy under general anesthesia.

Methods

One hundred and forty‐four American Society of Anesthesiologists I‐II women were assigned to receive spinal anesthesia with 12 mg of hyperbaric bupivacaine combined with 100, 200, and 300 μg morphine or saline before standardized general anesthesia was induced. Low transverse incision abdominal hysterectomy was performed. Post‐operative outcome measures were recorded at 1, 2, 4, 6, 12, and 24 h. Primary outcome was 24 h PCA‐morphine. Secondary outcomes were pain by visual analogue scale (0–10), nausea, pruritus, sedation, and respiratory depression.

Results

Intrathecal morphine reduced accumulated 24 h post‐operative morphine consumption. Morphine 100 μg significantly reduced morphine consumption vs. placebo at 0–6 h, 6–12 h, and for the entire 0–24 h time interval post‐operation. Morphine 200 μg further significantly reduced morphine consumption vs. morphine 100 μg at 0–6 h and for the entire 0–24 h post‐operation. There was no further reduction of morphine consumption seen with morphine 300 μg. No serious side effects were seen. Emesis was similar in all groups, and pruritus was experienced only in the morphine groups.

Conclusion

Intrathecal morphine supplementation to bupivacaine reduces first 24 h PCA‐morphine consumption after abdominal hysterectomy under general anesthesia, and we found no benefit from increasing the dose over 200 μg.
Role of renal medullary oxidative and/or carbonyl stress in salt‐sensitive hypertension and diabetes
Authors: Mori Takefumi , Ogawa Susumu , Cowely Allen W , Ito Sadayoshi
Published: December 2011

1. Salt‐sensitive hypertension is commonly associated with diabetes, obesity and chronic kidney disease. The present review focuses on renal mechanisms involved in the development of this type of hypertension.

2. The renal medullary circulation plays an important role in the development of salt‐sensitive hypertension. In vivo animal studies have demonstrated that the balance between nitric oxide (NO) and reactive oxygen species (ROS) in the renal medulla is an important element of salt‐sensitive hypertension. The medullary thick ascending limb (mTAL) in the outer medulla is an important source of NO and ROS production and we have explored the mechanisms that stimulate their production, as well as the effects of NO superoxide and hydrogen peroxide on mTAL tubular sodium reabsorption and the regulation of medullary blood flow.

3. Angiotensin II‐stimulated NO produced in the mTAL is able to diffuse from the renal mTAL to the surrounding vasa recta capillaries, providing a mechanism by which to increase medullary blood flow and counteract the direct vasoconstrictor effects of angiotensin II. Enhanced oxidative stress attenuates NO diffusion in this region.

4. Carbonyl stress, like oxidative stress, can also play an important role in the pathogenesis of chronic kidney disease, such as insulin resistance, salt‐sensitive hypertension and renal vascular complications.

5. Despite the large number of studies undertaken in this area, there is as yet no drug available that directly targets renal ROS. Oxidative and/or carbonyl stress may be the next target of drug discovery to protect against salt‐sensitive hypertension and associated end‐organ damage.
Robotic resection compared with laparoscopic rectal resection for cancer: systematic review and meta‐analysis of short‐term outcome
Authors: Trastulli S. , Farinella E. , Cirocchi R. , Cavaliere D. , Avenia N. , Sciannameo F. , Gullà N. , Noya G. , Boselli C.
Published: December 2011

Aim  The study aimed to compare robotic rectal resection with laparoscopic rectal resection for cancer. Robotic surgery has been used successfully in many branches of surgery but there is little evidence in the literature on its use in rectal cancer.

Methods  We performed a systematic review of the available literature in order to evaluate the feasibility, safety and effectiveness of robotic versus laparoscopic surgery for rectal cancer. We compared robotic and laparoscopic surgery with respect to twelve end‐points including operative and recovery outcomes, early postoperative mortality and morbidity, and oncological parameters. A subgroup analysis of patients undergoing full‐robotic or robot‐assisted rectal resection and robotic total mesorectal excision was carried out. All aspects of Cochrane Handbook for systematic reviews and Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) statement were followed to conduct this systematic review. Comprehensive electronic search strategies were developed using the following electronic databases: PubMed, EMBASE, OVID, Medline, Cochrane Database of Systematic Reviews, EBM reviews and CINAHL. Randomized and nonrandomized clinical trials comparing robotic and laparoscopic resection for rectal cancer were included. No language or publication status restrictions were imposed. A data‐extraction sheet was developed based on the data extraction template of the Cochrane Group. The statistical analysis was performed using the odd ratio (OR) for categorical variables and the weighted mean difference (WMD) for continuous variables.

Results  Eight non randomized studies were identified that included 854 patients in total, 344 (40.2%) in the robotic group and 510 (59.7%) in the laparoscopic group. Meta‐analysis suggested that the conversion rate to open surgery in the robotic group was significantly lower than that with laparoscopic surgery (OR = 0.26, 95% CI: 0.12–0.57, P = 0.0007). There were no significant differences in operation time, length of hospital stay, time to resume regular diet, postoperative morbidity and mortality, and the oncological accuracy of resection.

Conclusion  Robotic surgery for rectal cancer has a lower conversion rate and a similar operative time compared with laparoscopic surgery, with no difference in recovery, oncological and postoperative outcomes.
Administrative Assumptions in Top‐Down Selection: A Test in Graduate School Admission Decisions
Authors: Colarelli Stephen M. , Monnot Matthew J. , Ronan George F. , Roscoe Anne M.
Published: December 2011

Although top‐down selection is the gold standard for making personnel decisions, several administrative assumptions must be met for it to be effective. We discuss three of these assumptions and test two of them: (1) top applicants will accept an offer, and (2) the time organisations give applicants to consider an offer will not influence the availability of next‐tier applicants. We also examine the effectiveness of top‐down selection by comparing it to an administratively simpler procedure, random selection above a threshold. Using archival admissions data from three university graduate psychology programs, we found that top applicants were less likely to accept an offer; however, waiting time did not influence applicant availability. In comparing the quality of applicants actually selected (with a top‐down procedure) with the quality of applicants selected at random (from above five progressively stringent thresholds), we found that at higher admission thresholds, random selection resulted in better or equal quality applicants as top‐down selection, depending on the criteria. We discuss implications for future research and practice.
Safer urethral catheters: how study of catheter balloon pressure and force can guide design
Authors: Wu Alex K. , Blaschko Sarah D. , Garcia Maurice , McAninch Jack W. , Aaronson David S.
Published: December 2011

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

The urethal catheter is a ubiquitous device that has not been modified or improved for safety in the last 20 years, although it can be associated with significant patient harm. This study utilizes force and pressure measurements of the urethral catheter in order to aid in future safety modifications.

OBJECTIVES

To better define urethral catheter balloon pressures and extraction forces during traumatic placement and removal of urethral catheters.

To help guide design for safer urethral catheters.

MATERIALS AND METHODS

Measurements of balloon pressure were made upon filling within the urethra vs the bladder.

Extraction forces were measured upon removal of a catheter with a filled balloon from the bladder.

Models for the bladder and urethra included an ex vivo model (funnel, ‘bladder’, attached to a 30 F tube, ‘urethra’) and fresh human male cadavers.

The mean (sem) balloon pressures and extraction forces were calculated.

RESULTS

In the ex vivo model, the mean (sem) pressures upon filling the balloon with 10 mL were on average three‐times higher within the ex vivo‘urethra’ (177 [6] kPa) vs ‘bladder’ (59 [2] kPa) across multiple catheter types.

In the human cadaver, the mean balloon pressure was 1.9‐times higher within the urethra (139 [11] kPa) vs bladder (68 [4] kPa).

Balloon pressure increased non‐linearly during intraurethral filling of both models, resulting in either balloon rupture (silicone catheters) or ‘ballooning’ of the neck of the balloon filling port (latex catheters).

Removal of a filled balloon per the ex vivo model ‘urethra’ and cadaveric urethra, similarly required increasing force with greater balloon fill volumes (e.g. 9.34 [0.44] N for 5 mL vs 41.37 [8.01] N for 10 mL balloon volume).

CONCLUSIONS

Iatrogenic complications from improper urethral catheter use is common.

Catheter balloon pressures and manual extraction forces associated with urethral injury are significantly greater than those found with normal use.

The differences in pressure and force may be incorporated into a safer urethral catheter design, which may significantly reduce iatrogenic urethral injury associated with catheterization.
Does the transrectal ultrasound probe influence prostate cancer detection in patients undergoing an extended prostate biopsy scheme? Results of a large retrospective study
Authors: Raber Marco , Scattoni Vincenzo , Gallina Andrea , Freschi Massimo , De Almeyda Eduardo Pedroso , Girolamo Valerio Di , Montorsi Francesco , Rigatti Patrizio
Published: December 2011

Study Type – Diagnostic (exploratory cohort)

Level of Evidence 2b

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

The influence of transrectal probe system, end‐fire and side‐fire, has not been studied in detail. Using a sextant biopsy template it has been demonstrated a difference between end‐fire and side‐fire modes in 4–10 ng/mL PSA interval population. No studies evaluated the results in extended biopsy templates before.

This study adds the knowledge that end‐fire and side‐fire transrectal probe, which are the two probe systems to perform transrectal prostate biopsy, have similar results in terms of prostate cancer detection rate and can be indifferently employed in extended prostate biopsy templates used in daily practice.

OBJECTIVE

To compare the prostate cancer detection rate and tolerance profile between a transrectal biopsy made with a ‘side fire’ (SF) and an ‘end fire’ (EF) ultrasound probe.

PATIENTS AND METHODS

We selected patients undergoing first biopsy and re‐biopsy of the prostate with a 14‐ and 18‐core template using EF and SF transrectal probes, respectively.

We compared the cancer detection rate between the two probes on first biopsy and re‐biopsy and gauged patient tolerance using a visual analogue scale (VAS).

RESULTS

A total of 1705 patients were included in the first biopsy group, while 487 were in the re‐biopsy group.

The overall detection rate of first biopsy was 37.2%; the overall detection rate of re‐biopsy was 10.1%.

No significant difference was found between the two probes in the first biopsy and re‐biopsy sets (38% vs 36.5%, P= 0.55; 10.8% vs 9.3%, P= 0.7).

The lack of any significant association between the type of probe used and prostate cancer detection was confirmed by univariable and multivariable analyses in both the first biopsy and re‐biopsy sets after accounting for prostate‐specific antigen values, per cent free prostate‐specific antigen, digital rectal examination, and prostate and transition zone volumes.

The patient tolerance profile of the SF group was significantly better than that of the EF group (mean VAS 1.78 ± 2.01 vs 1.45 ± 2.21; P= 0.02).

CONCLUSION

The prostate cancer detection rate does not depend on the type of probe used. However, the SF transrectal probe is associated with a better patient tolerance profile.
Estimated morbidity and mortality in adolescents and young adults diagnosed with Type 2 diabetes mellitus
Authors: Rhodes E. T. , Prosser L. A. , Hoerger T. J. , Lieu T. , Ludwig D. S. , Laffel L. M.
Published: December 2011

Diabet. Med. 29, 453–463 (2012)

Aims  To estimate remaining life expectancy (RLE), quality‐adjusted life expectancy (QALE), causes of death and lifetime cumulative incidence of microvascular/macrovascular complications of diabetes for youths diagnosed with Type 2 diabetes.

Methods  A Markov‐like computer model simulated the life course for a hypothetical cohort of adolescents/young adults in the USA, aged 15–24 years, newly diagnosed with Type 2 diabetes following either conventional or intensive treatment based on the UK Prospective Diabetes Study. Outcomes included RLE, discounted QALE in quality‐adjusted life years (QALYs), cumulative incidence of microvascular/macrovascular complications and causes of death.

Results  Compared with a mean RLE of 58.6 years for a 20‐year‐old in the USA without diabetes, conventional treatment produced an average RLE of 43.09 years and 22.44 discounted QALYs. Intensive treatment afforded an incremental 0.98 years and 0.44 discounted QALYs. Intensive treatment led to lower lifetime cumulative incidence of all microvascular complications and lower mortality from microvascular complications (e.g. end‐stage renal disease (ESRD) death 19.4% vs. 25.2%). Approximately 5% with both treatments had ESRD within 25 years. Lifetime cumulative incidence of coronary heart disease (CHD) increased with longer RLE and greater severity of CHD risk factors. Incorporating disutility (loss in health‐related quality of life) of intensive treatment resulted in net loss of QALYs.

Conclusions  Adolescents/young adults with Type 2 diabetes lose approximately 15 years from average RLE and may experience severe, chronic complications of Type 2 diabetes by their 40s. The net clinical benefit of intensive treatment may be sensitive to preferences for treatment. A comprehensive management plan that includes early and aggressive control of cardiovascular risk factors is likely needed to reduce lifetime risk of CHD.