bluuebunny/crossref_metadata_2025 huggingface dataset:
Statewide Collaboration to Evaluate the Effects of Blood Loss and Transfusion on Surgical Site Infection after Hysterectomy
Authors: Young Heather , Berumen Crystal , Knepper Bryan , Miller Amber , Silverman Morgan , Gilmartin Heather , Wodrich Elizabeth , Alexander Sandy , Price Connie S.
Published: December 2011

We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL.

Infect Control Hosp Epidemiol 2012;33(1):90-93
A Decrease in the Number of Cases of Necrotizing Enterocolitis Associated with the Enhancement of Infection Prevention and Control Measures during aStaphylococcus aureusOutbreak in a Neonatal Intensive Care Unit
Authors: Lemyre Brigitte , Xiu Wenlong , Bouali Nicole Rouvinez , Brintnell Janet , Janigan Jo-Anne , Suh Kathryn N. , Barrowman Nicholas
Published: December 2011

Objective.

Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.

Design.

Retrospective chart review.

Setting.

A 24-bed, university-affiliated, inborn level 3 NICU.

Participants.

Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.

Interventions.

Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.

Results.

Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).

Conclusion.

Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.

Infect Control Hosp Epidemiol2012;33(1):29-33
Temporary Central Venous Catheter Utilization Patterns in a Large Tertiary Care Center Tracking the “Idle Central Venous Catheter”
Authors: Tejedor Sheri Chernetsky , Tong David , Stein Jason , Payne Christina , Dressler Daniel , Xue Wenqiong , Steinberg James P.
Published: December 2011

Objectives.

Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed (“idle”). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.

Design.

A retrospective observational study.

Setting.

A 579-bed acute care, academic tertiary care facility.

Methods.

A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.

Results.

We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P< .001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P< .001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P = .0013).

Conclusions.

Significant proportions of ward CVC-days were unjustified. Reducing “idle CVC-days” and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.

Infect Control Hosp Epidemiol 2012;33(1):50-57
Virtual pull-backs
Authors: Manolache Cristina
Published: December 2011

We propose a generalization of Gysin maps for DM-type morphisms of stacks

F
→
G

F\to G

that admit a perfect relative obstruction theory

E

F

/

G

∙

E_{F/G}^{\bullet }

, which we call a “virtual pull-back”. We prove functoriality properties of virtual pull-backs. As applications, we analyze Gromov-Witten invariants of blow-ups and projective bundles.
The Rab21-GEF activity of Varp, but not its Rab32/38 effector function, is required for dendrite formation in melanocytes
Authors: Ohbayashi Norihiko , Yatsu Ayaka , Tamura Kanako , Fukuda Mitsunori
Published: December 2011

Vacuolar protein sorting 9 (VPS9)–ankyrin-repeat protein (Varp) has recently been identified as an effector molecule for two small GTPases—Rab32 and Rab38—in the transport of a melanogenic enzyme tyrosinase-related protein 1 (Tyrp1) to melanosomes in melanocytes. Although Varp contains a Rab21–guanine nucleotide exchange factor (GEF) domain (i.e., VPS9 domain), since Rab21-GEF activity is not required for Tyrp1 transport, nothing is known about the physiological significance of the Rab21-GEF activity in melanocytes. Here we show by knockdown-rescue experiments that the Rab21-GEF activity of Varp, but not its Rab32/38 effector function, is required for forskolin-induced dendrite formation of cultured melanocytes. We found that Varp-deficient cells are unable to extend dendrites in response to forskolin stimulation and that reexpression of wild-type Varp or a Rab32/38-binding–deficient mutant Varp(Q509A/Y550A) in Varp-deficient cells completely restores their ability to form dendrites. By contrast, VPS9 mutants (D310A and Y350A) and a vesicle-associated membrane protein 7 (VAMP7)-binding–deficient mutant were unable to support forskolin-induced dendrite formation in Varp-deficient cells. These findings indicate that the Rab21-GEF activity and Rab32/38 binding activity of Varp are required for different melanocyte functions, that is, Rab21 activation by the VPS9 domain is required for dendrite formation, and the Rab32/38 effector function of the ankyrin repeat 1 domain is required for Tyrp1 transport to melanosomes, although VAMP7-binding ability is required for both functions.
MTBindingSim: simulate protein binding to microtubules
Authors: Philip Julia T. , Pence Charles H. , Goodson Holly V.
Published: December 2011

Summary: Many protein–protein interactions are more complex than can be accounted for by 1:1 binding models. However, biochemists have few tools available to help them recognize and predict the behaviors of these more complicated systems, making it difficult to design experiments that distinguish between possible binding models. MTBindingSim provides researchers with an environment in which they can rapidly compare different models of binding for a given scenario. It is written specifically with microtubule polymers in mind, but many of its models apply equally well to any polymer or any protein–protein interaction. MTBindingSim can thus both help in training intuition about binding models and with experimental design.

Availability and implementation: MTBindingSim is implemented in MATLAB and runs either within MATLAB (on Windows, Mac or Linux) or as a binary without MATLAB (on Windows or Mac). The source code (licensed under the GNU General Public License) and binaries are freely available at http://mtbindingsim.googlecode.com.

Contact:  jphilip@nd.edu; cpence@nd.edu
Opposing role of condensin hinge against replication protein A in mitosis and interphase through promoting DNA annealing
Authors: Akai Yuko , Kurokawa Yumiko , Nakazawa Norihiko , Tonami-Murakami Yuko , Suzuki Yuki , Yoshimura Shige H. , Iwasaki Hiroshi , Shiroiwa Yoshiharu , Nakamura Takahiro , Shibata Eri , Yanagida Mitsuhiro
Published: December 2011

Condensin is required for chromosome dynamics and diverse DNA metabolism. How condensin works, however, is not well understood. Condensin contains two structural maintenance of chromosomes (SMC) subunits with the terminal globular domains connected to coiled-coil that is interrupted by the central hinge. Heterotrimeric non-SMC subunits regulate SMC. We identified a novel fission yeast SMC hinge mutant,cut14-Y1, which displayed defects in DNA damage repair and chromosome segregation. It contains an amino acid substitution at a conserved hinge residue of Cut14/SMC2, resulting in diminished DNA binding and annealing. A replication protein A mutant,ssb1-418, greatly alleviated the repair and mitotic defects ofcut14-Y1. Ssb1 protein formed nucleolar foci incut14-Y1cells, but the number of foci was diminished incut14-Y1 ssb1-418double mutants. Consistent with the above results, Ssb1 protein bound to single-strand DNA was removed by condensin or the SMC dimer through DNA reannealingin vitro. Similarly, RNA hybridized to DNA may be removed by the SMC dimer. Thus, condensin may wind up DNA strands to unload chromosomal components after DNA repair and prior to mitosis. We show that 16 suppressor mutations ofcut14-Y1were all mapped within the hinge domain, which surrounded the original L543 mutation site.
The role of immunoglobulin A in prolonged and relapsing hepatitis A virus infections
Authors: Dotzauer Andreas , Heitmann Alke , Laue Thomas , Kraemer Leena , Schwabe Kerstin , Paulmann Dajana , Flehmig Bertram , Vallbracht Angelika
Published: December 2011

Hepatitis A virus (HAV) infections result in different courses of the disease, varying between normal, prolonged and relapsing. However, the reason for these heterogeneous clinical appearances is not understood. As HAV–anti-HAV IgA immunocomplexes (HAV–IgA) infect hepatocytes, IgA was postulated as a carrier supporting hepatotropic transport of HAV, and it was speculated that this carrier mechanism contributes to the various clinical outcomes. In this study, the IgA-carrier mechanism was investigated in a mouse model. We show that HAV–IgA immunocomplexes efficiently reached the liver not only in HAV-seronegative mice, but also, and this is in contrast to free-HAV particles, in immunized HAV-seropositive animals. This IgA-mediated transport of HAV to the liver in the presence of immunity depended on the stage of development of the immune response. We conclude that over a period of several weeks after infection, anti-HAV IgA is able to promote an enterohepatic cycling of HAV, resulting in continuous endogenous reinfections of the liver. Our experiments indicate that highly avid IgG antibodies, which are present at later times of the infection, can terminate the reinfections. However, the endogenous reinfections in the presence of a developing neutralizing immunity might contribute to prolonged as well as to relapsing courses of HAV infections. Furthermore, the results show that serum IgA may act as an infection protracting factor.
Participation of Chromatin-Remodeling Proteins in the Repair of Ultraviolet-B-Damaged DNA
Authors: Campi Mabel , D’Andrea Lucio , Emiliani Julia , Casati Paula
Published: December 2011

The genome of plants is organized into chromatin, affecting the rates of transcription, DNA recombination, and repair. In this work, we have investigated the consequences of reduced expression of some chromatin-remodeling factors and histone acetylation in maize (Zea mays) and Arabidopsis (Arabidopsis thaliana) in their participation in DNA repair after ultraviolet (UV)-B irradiation. Plants deficient in NFC102/NFC4 or SDG102/SDG26 showed more damaged DNA than wild-type plants; however, the Arabidopsis chc1 mutant showed similar accumulation of cyclobutane pyrimidine dimers as wild-type plants, in contrast to the increased DNA damage measured in the maize chc101 RNA interference line. In Arabidopsis, plants deficient in chromatin remodeling are also affected in the accumulation of pigments by UV-B. Plants treated with an inhibitor of histone acetyltransferases, curcumin, previous to the UV-B treatment show deficiencies in DNA repair; in addition, the chromatin remodeling-deficient plants have altered levels of acetylated histones after the UV-B treatment, demonstrating that histone acetylation is important during DNA repair in these two plant species. Arabidopsis mutants ham1 and ham2 also showed increased DNA damage after UV-B, suggesting that the role of these proteins in DNA damage repair has been conserved through evolution. However, cyclobutane pyrimidine dimer accumulation was higher in ham1 than in ham2; suggesting that HAM1 has a major role in DNA repair after UV-B. In summary, in this work, we have demonstrated that chromatin remodeling, and histone acetylation in particular, is important during DNA repair by UV-B, demonstrating that both genetic and epigenetic effects control DNA repair in plants.
Rab30 is required for the morphological integrity of the Golgi apparatus
Authors: Kelly Eoin E. , Giordano Francesca , Horgan Conor P. , Jollivet Florence , Raposo Graça , McCaffrey Mary W.
Published: December 2011

Background information

Rab GTPases are key coordinators of eukaryotic intracellular membrane trafficking. In their active states, Rabs localise to the cytoplasmic face of intracellular compartments where they regulate membrane trafficking processes. Many Rabs have been extensively characterised whereas others, such as Rab30, have to date received relatively little attention.

Results

Here, we demonstrate that Rab30 is primarily associated with the secretory pathway, displaying predominant localisation to the Golgi apparatus. We find by time‐lapse microscopy and fluorescence recovery after photobleaching studies that Rab30 is rapidly and continuously recruited to the Golgi. We also show that Rab30 function is required for the morphological integrity of the Golgi. Finally, we demonstrate that inactivation of Rab30 does not impair anterograde or retrograde transport through the Golgi.

Conclusions

Taken together, these data illustrate that Rab30 primarily localises to the Golgi apparatus and is required for the structural integrity of this organelle.
Role of the nuclear envelope in calcium signalling
Authors: Mauger Jean‐Pierre
Published: December 2011

The endoplasmic reticulum (ER) is the major Ca2+ store inside the cell. Its organisation in specialised subdomains allows the local delivery of Ca2+ to specific cell areas on stimulation. The nuclear envelope (NE), which is continuous with the ER, has a double role: it insulates the nucleoplasm from the cytoplasm and it stores Ca2+ around the nucleus. Furthermore, all the constituents of the signalling cascade leading to Ca2+ mobilisation are found in the NE; this allows the nuclear Ca2+ to be regulated autonomously. On the other hand, cytosolic Ca2+ transients can propagate within the nucleus via the nuclear pore complex. The variations in nuclear Ca2+ concentration are important for controlling gene transcription and progression in the cell cycle. Recent data suggest that invaginations of the NE modify the morphology of the nucleus and may affect Ca2+ dynamics in the nucleus and regulate transcriptional activity.
Regulation of the nucleocytoplasmic trafficking of viral and cellular proteins by ubiquitin and small ubiquitin‐related modifiers
Authors: Wang Yao E. , Pernet Olivier , Lee Benhur
Published: December 2011

Nucleocytoplasmic trafficking of many cellular proteins is regulated by nuclear import/export signals as well as post‐translational modifications such as covalent conjugation of ubiquitin and small ubiquitin‐related modifiers (SUMOs). Ubiquitination and SUMOylation are rapid and reversible ways to modulate the intracellular localisation and function of substrate proteins. These pathways have been co‐opted by some viruses, which depend on the host cell machinery to transport their proteins in and out of the nucleus. In this review, we will summarise our current knowledge on the ubiquitin/SUMO‐regulated nuclear/subnuclear trafficking of cellular proteins and describe examples of viral exploitation of these pathways.
Prenatal diagnosis of xeroderma pigmentosum group A in Japan
Authors: MORIWAKI Shinichi , YAMASHITA Yoshiki , NAKAMURA Sachiko , FUJITA Daisuke , KOHYAMA Jun , TAKIGAWA Masahiro , OHMICHI Masahide
Published: December 2011

We performed a prenatal diagnosis for 10 fetuses from nine unrelated Japanese xeroderma pigmentosum complementation group A (XP‐A) families. All parents had at least one XP‐A child (proband) with a homozygous founder mutation (IVS3‐1G>C) in the XPA gene. A genetic analysis was performed by a restriction enzyme; AlwNI fragment length polymorphism of polymerase chain reaction (PCR)‐amplified DNA, mostly from amniotic fluid (AF) and cultured cells established from AF. However, for the first family, we tried amniocentesis as well as chorionic villus sampling (CVS). Among the 10 cases, we confirmed the results of PCR‐based genetic diagnosis by post‐ultraviolet survival of amniotic cells in eight cases. Unfortunately, 6 weeks after CVS and 4 days after the amniocentesis in the first case we examined, the fetus died in utero, the reason for which remains unexplained. We prenatally determined two XP‐A cases, six XP‐A carriers and two wild‐type fetuses, which appears to be consistent with Mendel’s law.
Mouse models for studying pain in sickle disease: effects of strain, age, and acuteness
Authors: Cain David M. , Vang Derek , Simone Donald A. , Hebbel Robert P. , Gupta Kalpna
Published: December 2011

The clinical management of severe pain associated with sickle cell disease (SCD) remains challenging. Development of an optimal therapy would be facilitated by use of murine model(s) with varying degrees of sickling and pain tests that are most sensitive to vaso‐occlusion. We found that young (≤3 months old) NY1DD and S+SAntilles mice (having modest and moderate sickle phenotype, respectively) exhibited evidence of deep tissue/musculoskeletal pain. Deep tissue pain and cold sensitivity in S+SAntilles mice increased significantly with both age and incitement of hypoxia/reoxygenation (H/R). C57/BL6 mice (genetic background strain of NY1DD and S+SAntilles) were hypersensitive to mechanical and heat stimuli, even without the sickle transgene. H/R treatment of HbSS‐BERK mice with severe sickle phenotype resulted in significantly decreased withdrawal thresholds and enhanced mechanical, thermal and deep tissue hyperalgesia. Deep hyperalgesia incited by H/R in HbSS‐BERK was ameliorated by CP 55940, a cannabinoid receptor agonist. Thus, assessment of deep tissue pain appears to be the most sensitive measure for studying pain mechanisms across mouse models of SCD, and HbSS‐BERK mice may be the best model for vaso‐occlusive and chronic pain of SCD.
Evolutionary islands in the Andes: persistence and isolation explain high endemism in Andean dry tropical forests
Authors: Särkinen Tiina , Pennington R. Toby , Lavin Matt , Simon Marcelo F. , Hughes Colin E.
Published: December 2011

Aim  The tropical Andes are a world biodiversity hotspot. With diverse biomes and dramatic, geologically recent mountain uplift, they offer a system to study the relative contributions of geological and biome history to species richness. There are preliminary indications that historical species assembly in the Andes has been influenced by physiographical heterogeneity and that distinct biomes have evolved in relative isolation despite physical proximity. Here we test this ‘Andean biotic separation hypothesis’ by focusing on the low‐elevation, seasonally dry tropical forest (SDTF) biome to determine whether patterns of plant diversification within the SDTF differ from those in mid‐ and high‐elevation biomes.

Location  Tropical Andes, South America.

Methods  Densely sampled time‐calibrated phylogenies for five legume genera (Amicia, Coursetia, Cyathostegia, Mimosa and Poissonia) containing species endemic to the Andean SDTF biome were used to investigate divergence times and levels of geographical structure. Geographical structure was measured using isolation‐by‐distance methods. Meta‐analysis of time‐calibrated phylogenies of Andean plant groups was used to compare the pattern and tempo of endemic species diversification between the major Andean biomes.

Results  Long‐term persistence of SDTF in the Andes is suggested by old stem ages (5–27 Ma) of endemic genera/clades within genera, and deep divergences coupled with strong geographical structure among and within species. Comparison of species diversification patterns among different biomes shows that the relatively old, geographically confined pattern of species diversification in SDTF contrasts with the high‐elevation grasslands that show rapid and recent radiations driven by ecological opportunities.

Main conclusions  The SDTF biome has a long history in the Andes. We suggest that the diverse SDTF flora has been assembled gradually over the past c. 19 Ma from lineages exhibiting strong phylogenetic niche conservatism. These patterns suggest that Andean SDTFs have formed stable and strongly isolated ‘islands’ despite the upheavals of Andean uplift. Indeed, the Andean SDTFs may represent some of the most isolated and evolutionarily persistent continental plant communities, similar in many respects to floras of remote oceanic islands.
Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses
Authors: Hinno Saima , Partanen Pirjo , Vehviläinen‐Julkunen Katri
Published: December 2011

Aim.  To investigate the relationships between nursing activities, nurse staffing and adverse patient outcomes in hospital settings as perceived by registered nurses in Finland and the Netherlands and to compare the results obtained in the two countries.

Background.  Previous research indicates that a higher proportion of registered nurses in the staff mix results in better patient outcomes. Knowledge of the relationship between nurse staffing and adverse patient outcomes is crucial to optimise the management of professional nursing resources and patient care.

Design.  A cross‐sectional, descriptive questionnaire survey.

Methods.  Registered nurses employed in hospitals in Finland (n = 535) and the Netherlands (n = 334), with overall response rates of 44·9% and 33·4%, respectively, participated.

Results.  The patient‐to‐nurse ratio was on average 8·74:1 and did not vary significantly between the countries. However, there were fewer registered nurses and significantly more licensed practical nurses among the Dutch hospital staff than the Finnish staff. In addition, Finnish nurses performed non‐nursing and administrative activities more frequently than the Dutch nurses and reported more dissatisfaction with the availability of support services. Frequencies of patient falls were related to the patient‐to‐nurse ratio in both countries. Finnish participants reported the occurrence of adverse patient outcomes more frequently.

Conclusions.  Significant associations were found between nurse staffing and adverse patient outcomes in hospital settings. Compared with the Netherlands, in Finland, nurses appear to have higher workloads, there are higher patient‐to‐nurse ratios, and these adverse staffing conditions are associated with higher rates of adverse patient outcomes.

Relevance to clinical practice.  The findings provide valuable insights into the potential effects of major changes or reductions in nursing staff on the occurrence of adverse patient outcomes in hospital settings.
Dynamics of spore coat morphogenesis in Bacillus subtilis
Authors: McKenney Peter T. , Eichenberger Patrick
Published: December 2011

Spores of Bacillus subtilis are encased in a protective coat made up of at least 70 proteins. The structure of the spore coat has been examined using a variety of genetic, imaging and biochemical techniques; however, the majority of these studies have focused on mature spores. In this study we use a library of 41 spore coat proteins fused to the green fluorescent protein to examine spore coat morphogenesis over the time‐course of sporulation. We found considerable diversity in the localization dynamics of coat proteins and were able to establish six classes based on localization kinetics. Localization dynamics correlate well with the known transcriptional regulators of coat gene expression. Previously, we described the existence of multiple layers in the mature spore coat. Here, we find that the spore coat initially assembles a scaffold that is organized into multiple layers on one pole of the spore. The coat then encases the spore in multiple co‐ordinated waves. Encasement is driven, at least partially, by transcription of coat genes and deletion of sporulation transcription factors arrests encasement. We also identify the trans‐compartment SpoIIIAH–SpoIIQ channel as necessary for encasement. This is the first demonstration of a forespore contribution to spore coat morphogenesis.
The impact of light intensity on shade‐induced leaf senescence
Authors: BROUWER BASTIAAN , ZIOLKOWSKA AGNIESZKA , BAGARD MATTHIEU , KEECH OLIVIER , GARDESTRÖM PER
Published: December 2011

Plants often have to cope with altered light conditions, which in leaves induce various physiological responses ranging from photosynthetic acclimation to leaf senescence. However, our knowledge of the regulatory pathways by which shade and darkness induce leaf senescence remains incomplete. To determine to what extent reduced light intensities regulate the induction of leaf senescence, we performed a functional comparison between Arabidopsis leaves subjected to a range of shading treatments. Individually covered leaves, which remained attached to the plant, were compared with respect to chlorophyll, protein, histology, expression of senescence‐associated genes, capacity for photosynthesis and respiration, and light compensation point (LCP). Mild shading induced photosynthetic acclimation and resource partitioning, which, together with a decreased respiration, lowered the LCP. Leaf senescence was induced only under strong shade, coinciding with a negative carbon balance and independent of the red/far‐red ratio. Interestingly, while senescence was significantly delayed at very low light compared with darkness, phytochrome A mutant plants showed enhanced chlorophyll degradation under all shading treatments except complete darkness. Taken together, our results suggest that the induction of leaf senescence during shading depends on the efficiency of carbon fixation, which in turn appears to be modulated via light receptors such as phytochrome A.
A new screening technique for salinity resistance in rice (Oryza sativa L.) seedlings using bypass flow
Authors: FAIYUE BUALUANG , AL‐AZZAWI MOHAMMED J. , FLOWERS TIMOTHY J.
Published: December 2011

A lack of screening techniques delays progress in research on salinity resistance in rice. In this study, we report our test of the hypothesis that an apoplastic pathway (the so‐called bypass flow) causes a difference in salt resistance between rice genotypes and can be used in screening for salinity resistance. Fourteen‐day‐old seedlings of low‐ and high‐Na+‐transporting recombinant inbred lines (10 of each) of rice IR55178 were treated with 50 mm NaCl and 0.2 mm trisodium‐8‐hydroxy‐1,3,6‐pyrenetrisulphonic acid (PTS), a bypass flow tracer, for short (4 d) and long (90 d) periods of time. The results showed that the average shoot Na+ concentration and bypass flow for high‐Na+‐transporting lines were 1.4 and 2.4 times higher than those of low‐Na+‐transporting lines, respectively. There was a positive linear correlation between the percentage of bypass flow and Na+ concentrations in the shoots, suggesting that the difference in Na+ transport in rice is a consequence of different degrees of bypass flow. Moreover, a high correlation was found between bypass flow and seedling survival after prolonged salt stress: the lower the magnitude of bypass flow, the greater the seedling survival. We conclude that bypass flow could be used as a new screening technique for salt resistance in rice.
Severe infection in a lung transplant recipient caused by donor‐transmitted carbapenem‐resistant Acinetobacter baumannii
Authors: Martins N. , Martins I.S. , de Freitas W.V. , de Matos J.A. , Magalhães A.C.G. , Girão V.B.C. , Dias R.C.S. , de Souza T.C. , Pellegrino F.L.P.C. , Costa L.D. , Boasquevisque C.H.R. , Nouér S.A. , Riley L.W. , Santoro‐Lopes G. , Moreira B.M.
Published: December 2011

We describe a case of proven donor transmission of carbapenem‐resistant Acinetobacter baumannii, which resulted in severe infectious complications after lung transplantation. A single blaOXA‐23 positive strain, belonging to a new multilocus sequence type (ST231), was isolated from donor and recipient, who died 65 days after transplantation. This report highlights the current challenges associated with the potential transmission of multidrug‐resistant infections through organ transplantation.
Gallbladder cancer: Can newer insights improve the outcome?
Authors: Dutta Usha
Published: December 2011

Gallbladder cancer (GBC) is the leading cause of cancer related mortality in certain geographic areas. Most of the patients with GBC have advanced disease at presentation, precluding curative resection resulting in a dismal prognosis. However, recent advances in the understanding of its epidemiology and pathogenesis coupled with development of newer diagnostic tools and therapeutic options, has resulted in enhanced optimism towards the management of the disease. The leading risk factors are gallstones, advancing age, female gender, anomalous pancreaticobiliary ductal junction, certain ethnic groups and geographic populations. Advances in radiological imaging and the advent of endoscopic ultrasound have facilitated early detection and accurate staging of the tumor. A high index of suspicion in high risk groups is necessary to pick up incidental and early GBC, as surgical resection is curative. In patients with suspected GBC, an open surgical resection that is appropriate for that stage is advocated. Adjuvant combination chemotherapy and molecular targeted therapy are emerging as effective therapeutic options in those with advanced GBC. Endoscopic palliation of biliary and gastric outlet obstruction with metallic stents has improved their quality of life. Prevention remains the hitherto less explored option to reduce GBC related mortality. Prophylactic cholecystectomy in high risk groups is a cost‐effective option. A multi‐disciplinary systematic global approach to initiate collaborative ventures to understand epidemiology, standardize management strategies, conduct multi‐centric trials with newer therapeutic agents and initiate preventive measures, would pave way for the future conquest of the disease.
Viral response at 6 months is associated with treatment outcome of adefovir add‐on therapy for lamivudine‐resistance
Authors: Kim Yu Jin , Paik Seung Woon , Sinn Dong Hyun , Gwak Geum‐Youn , Choi Moon Seok , Lee Joon Hyeok , Koh Kwang Cheol , Yoo Byung Chul
Published: December 2011

Background and Aim:  Adefovir add‐on therapy is recommended for patients infected with lamivudine‐resistant hepatitis B virus (HBV). We aimed to describe the long‐term treatment outcome and predictors for good response of adefovir add‐on therapy.

Methods:  A total of 559 chronic hepatitis B (CHB) patients who had been treated for at least 12 months with adefovir add‐on therapy due to resistance to lamivudine were retrospectively included. Complete virologic response (CVR) was defined as serum HBV DNA < 9 IU/mL. Viral responses at 6 months were classified as PCR negativity, partial virologic response (PVR, HBV DNA < 2000 IU/mL), or inadequate virologic response (IVR, HBV DNA ≥ 2000 IU/mL).

Results:  The median duration of follow‐up was 31.5 months (range, 12–56). The cumulative probabilities of CVR during adefovir add‐on therapy were 58%, 70%, 78%, and 80% at 12, 24, 36, and 43 months, respectively. The cumulative rates of resistance to adefovir were 0.4%, 0.8%, and 3.1% at 12, 24, and 36 months, respectively. The only baseline factor associated with CVR (hazard ratio 0.83, 95% confidence interval 0.62–0.91, P ≤ 0.001) and resistance to adefovir (hazard ratio 1.925, 95% confidence interval 1.13–3.30, P = 0.017) was serum HBV DNA level. Comparison of the cumulative rates of CVR and resistance to adefovir according to viral response at 6 months showed significant differences among the three groups (P < 0.0001 and P = 0.0005, respectively).

Conclusions:  Pre‐treatment HBV DNA level and viral response at 6 months is associated with treatment outcome for adefovir‐add on therapy in lamivudine resistance.
Knowledge, beliefs and attitudes of kidney transplant recipients regarding their risk of cancer
Authors: WILLIAMS NARELLE C , TONG ALLISON , HOWARD KIRSTEN , CHAPMAN JEREMY R , CRAIG JONATHAN C , WONG GERMAINE
Published: December 2011

Aim:  Despite an increased risk of cancer post transplant, little is known about the knowledge, beliefs of and attitudes to cancer and its prevention among kidney transplant recipients. This study aims to explore these beliefs and attitudes, to better understand patient motives and potential barriers to early detection of cancer.

Methods:  Semi‐structured interviews were conducted with 14 kidney and eight kidney–pancreas transplant recipients based at a single transplant centre in Sydney, Australia, between October 2009 and February 2010.

Results:  Thematic data analysis identified four major themes: (1) skin cancer‐focused: participants were generally only aware about their increased risk of skin cancer and available prevention strategies for that cancer alone; (2) limited awareness: participants knew little about their excess risk for non‐skin cancers and possible preventative and screening strategies; (3) fear of cancer: cancer fears were heightened by prior experiences; some felt vulnerable to cancer and perceived that cancer outcomes were worse than kidney disease; and (4) prioritizing present health issues: participants believed cancer was not imminent and had limited capacity to absorb information about long‐term risks, particularly as current health concerns appeared pressing and important.

Conclusion:  Awareness of increased cancer risk and cancer screening among kidney transplant recipients is focused narrowly on skin cancer, with limited awareness for other cancers. Recipients prioritized current health issues rather than future risks to health such as cancer. Transplant care providers should provide evidence‐based information on cancer risk and screening, being sensitive to the timing and needs of the patient. Improved knowledge may empower patients to minimize their risk of cancer by participating in screening and cancer prevention programmes.
Validity of self‐reported body mass index of Japanese children and adolescents
Authors: Yoshitake Norikazu , Okuda Masayuki , Sasaki Satoshi , Kunitsugu Ichiro , Hobara Tatsuya
Published: December 2011

Background:  Self‐reported body mass index (BMI) has been widely used in epidemiological studies, but no study thus far has validated the self‐reported BMI of Japanese children and adolescents. The aim of the present study was to assess the accuracy of self‐reported BMI and its use for classification into weight categories.

Methods:  Fifth‐ and eighth‐grade students (n= 358) from all schools in Shunan City, Japan, from 2006 to 2010 were included. BMI was calculated from both self‐reported and measured data. Pearson's correlation, Kappa statistics and the number of overweight children, and Bland–Altman plots with 95% limits of agreement were calculated to assess the agreement.

Results:  Pearson's correlation between self‐reported and measured data ranged between 0.946 and 0.987 for height, 0.978 and 0.992 for weight, and 0.930 and 0.964 for BMI, depending on gender or age. Kappa was excellent: 0.949 for boys, 0.867 for girls, 0.897 for 10–11‐year‐old children, 0.928 for 13–14‐year‐old adolescents. The number of overweight children based on self‐reported BMI was not significantly different from that based on measured BMI. The 95% limits of agreement were −3.62 and 2.90 cm for height, −2.80 and 2.38 kg for weight, and −1.42 and 1.44 kg/m2 for BMI.

Conclusions:  Self‐reported BMI was generally reliable for predicting the number of overweight Japanese children and adolescents. There is slight discrepancy, however, between self‐reported BMI and measured BMI, and self‐reported BMI should be used with caution, keeping the variance and concordance rate in mind.
Japanese clinical guidelines for chronic pain in children and adolescents
Authors: Ishizaki Yuko , Yasujima Hidehiro , Takenaka Yoshito , Shimada Akira , Murakami Katsumi , Fukai Yoshimitsu , Inouwe Nario , Oka Takakazu , Maru Mitsue , Wakako Rie , Shirakawa Miyako , Fujita Mitsue , Fujii Yuri , Uchida Yuko , Ogimi Yoshio , Kambara Yukiko , Nagai Akira , Nakao Ryota , Tanaka Hidetaka
Published: December 2011

Chronic pain is a common problem in pediatric practice. The prevalence of chronic pain in children is >30%. Because pain indicates emotional expression as well as the physiological reaction toward infection, injury, and inflammation, both physiological and psychological assessments are essential to determine primary interventions for chronic pain. The Japanese Society of Psychosomatic Pediatrics Task Force of clinical practice guidelines for chronic pain in children and adolescents compiled clinical evidence and opinions of specialists associated with the primary care of pediatric chronic pain in the Japanese ‘clinical guidelines for chronic pain in children and adolescents’ in 2009, which are presented herein. The guidelines consist of three domains: general introduction to chronic pain; chronic abdominal pain; and chronic headache. Each section contains information on the physiological mechanism, psychological aspects, assessment methods, and primary interventions for pediatric chronic pain. These guidelines are expected to help disseminate knowledge on primary interventions for chronic pain in children and adolescents.
Short‐term and long‐term mortality following pediatric intensive care
Authors: Volakli Eleni A , Sdougka Maria , Drossou‐Agakidou Vasiliki , Emporiadou Maria , Reizoglou Melpomeni , Giala Maria
Published: December 2011

Background:  The aim of the present study was to examine short‐term and long‐term mortality following discharge from the pediatric intensive care unit (PICU).

Methods:  This was a prospective observational study. Data collected consisted of demographics, severity scores, procedures, treatment, need for and duration of mechanical ventilation (MV), length of PICU and hospital stay, and mortality at PICU and hospital discharge, at 3 and 6 months and at 1 and 2 years.

Results:  A total of 300 patients (196 boys and 104 girls), aged 54.26 ± 49.93 months, were included in the study. Median (interquartile range) Pediatric Risk of Mortality (PRISM III‐24) score was 7 (3–11) and predicted mortality rate was 11.16%. MV rate was 67.3% (58.3% at admission) for 6.54 ± 14.15 days, and length of PICU and hospital stay was 8.85 ± 23.28 days and 20.69 ± 28.64 days, respectively. Mortality rate at discharge was 9.7% and cumulative mortality rate thereafter was 12.7%, 15.0%, 16.7%, 19.0%, and 19.0% at hospital discharge, 3 months, 6 months, 1 year and 2 years, respectively. Significant risk factors of PICU mortality were inotrope use, PRISM III‐24 score >8, MV, arterial and central venous catheterization, nosocomial infection, complications, and cancer. Independent predictors of mortality at discharge were inotrope use and PRISM III‐24 score, whereas predictors of mortality at 2 years were comorbidity and cancer.

Conclusions:  A 2 year follow‐up period seems sufficient for a comprehensive mortality analysis of PICU patients. Severity of critical illness is the key factor of short‐term mortality, whereas comorbidity is the major determinant of long‐term mortality.
Transumbilical approach for laparo‐endoscopic single‐site adrenalectomy: Initial experience and short‐term outcome
Authors: Miyajima Akira , Hattori Seiya , Maeda Takahiro , Hasegawa Masanori , Takeda Toshikazu , Kikuchi Eiji , Asanuma Hiroshi , Nakagawa Ken , Oya Mototsugu
Published: December 2011

Objectives:  To report our initial experience with transumbilical laparo‐endoscopic single‐site adrenalectomy for adrenal tumors by using a single port with a multichannel cannula and bent laparoscopic instrumentation.

Methods:  Between December 2009 and December 2010, 30 patients underwent transumbilical laparo‐endoscopic single‐site adrenalectomy at our hospital. The procedure was carried out for adrenal cortical adenoma in 17 patients, adrenal pheochromocytoma in seven patients and other types of tumors in six patients. A multichannel port, bent laparoscopic instruments and Opti4 laparoscopic electrodes were used in all patients. The intraperitoneal space was approached through the umbilicus. The multichannel port was placed through a 2‐cm incision at the inner edge of the umbilicus. A 5‐mm flexible laparoscope was introduced to maintain an adequate laparoscopic view, and surgical specimens were extracted using an Endocatch bag.

Results:  All procedures were successfully completed, with only one incision through the umbilicus, and without conversion to a standard laparoscopic approach. Mean operative time was 120.1 ± 34.7 min. Tumor laterality and patient body mass index did not affect surgical morbidity. The initial 15 patients had a significantly longer mean pneumoperitoneum time (95.8 ± 37.5 min) than the last 15 patients (70.5 ± 18.7 min). Only one postoperative complication was observed (postoperative hematoma).

Conclusions:  A transumbilical approach for laparo‐endoscopic single‐site adrenalectomy is safe and feasible, and it results in superior cosmesis. Improvements in surgical devices might facilitate further development of this approach.
Kidney transplantation in diabetic recipients with iliac atherosclerosis: Arterial anastomosis with Nakayama's ring pin stapler after endarterectomy
Authors: Yuan Xiao‐Peng , Gao Wei , Jiao Wei‐Hua , Wang Chang‐Xi
Published: December 2011

Objectives:  To report our experience of arterial anastomosis with Nakayama's ring pin staplers (titanium staplers) after an endarterectomy in kidney transplantation of diabetic recipients with iliac atherosclerosis.

Methods:  In a series of 2126 kidney transplantations carried out between January 1998 and December 2008, 62 recipients received an endarterectomy during transplantation before renal arterial anastomoses as a result of severe iliac atherosclerosis. The renal arteries were anatomosed to hypogastric arteries through titanium staplers in 32 patients (group 1), or to external/common iliac arteries with conventional suturing in 30 patients (group 2). Perioperative outcomes of the two groups have been compared.

Results:  The mean artery anastomosis time in group 1 was considerably shorter than in the group 2 (6.4 min vs 17.3 min, P < 0.001). Group 1 showed a lower rate of delayed graft function (4.8% vs 27.5%, P = 0.004). No difference in Kaplan–Meier patient survival rate was found between group 1 and group 2 after follow up of 67 ± 28 months (P = 0.58). Graft survival rate (patient deaths included) was higher in group 1 than in group 2 (P = 0.04).

Conclusions:  Arterial anastomosis with a titanium stapler is more rapid than conventional suture. It can diminish the rate of delayed graft function and improve the graft survival rate in diabetic recipients with severe iliac atherosclerosis.
Estimation of axon counts in a rat model of glaucoma: comparison of fixed‐pattern sampling with targeted sampling
Authors: Ebneter Andreas , Casson Robert J , Wood John PM , Chidlow Glyn
Published: December 2011

Abstract

Background:  Full axon counting of optic nerve cross‐sections represents the most accurate method to quantify axonal damage, but such analysis is very labour intensive. Recently, a new method has been developed, termed targeted sampling, which combines the salient features of a grading scheme with axon counting. Preliminary findings revealed the method compared favourably with random sampling. The aim of the current study was to advance our understanding of the effect of sampling patterns on axon counts by comparing estimated axon counts from targeted sampling with those obtained from fixed‐pattern sampling in a large collection of optic nerves with different severities of axonal injury.

Methods:  Chronic ocular hypertension was induced in adult Sprague‐Dawley rats for 1–7 weeks by translimbal laser photocoagulation of the trabecular meshwork. Axonal damage on resin‐embedded cross‐sections was estimated using three different methods: (i) semi‐quantitative damage grading; (ii) semi‐quantitative, automated axon counting using targeted sampling; and (iii) semi‐quantitative, automated axon counting using fixed‐pattern sampling.

Results:  Estimated axon counts, as generated by targeted sampling and fixed‐pattern sampling, correlated equally well with the semi‐quantitative grading scheme. Estimated counts obtained with targeted sampling were not statistically different from those yielded by fixed‐pattern sampling. Bland–Altman analysis showed a good agreement between the two methods.

Conclusions:  The results of our study validate the use of both fixed‐pattern sampling and targeted sampling for estimation of axonal damage but do not indicate that the latter method is superior for detection of axon loss in animals with minor damage.
Anatomy of Tenons capsule
Authors: Kakizaki Hirohiko , Takahashi Yasuhiro , Nakano Takashi , Asamoto Ken , Ikeda Hiroshi , Ichinose Akihiro , Iwaki Masayoshi , Selva Dinesh , Leibovitch Igal
Published: December 2011

Abstract

Background:  The microscopic and macroscopic anatomy of the anterior and posterior Tenons capsule is described.

Methods:  An observational anatomic study of twelve orbits of 6 cadavers (mean age 79.5 years) were examined microscopically and 8 orbits of 4 cadavers (mean age 76.8 years) were examined macroscopically. After orbital exenteration, an X‐shaped incision was made in the specimens to include the posterior part of the globe. The sections were divided into four parts: superomedial; inferomedial; superolateral; and inferolateral. In the macroscopically examined specimens, the eyelids and globes were removed from the exenterated tissues and the appearance of Tenons capsule was studied.

Results:  In the microscopic study, Tenons capsule covered the sclera beneath the conjunctiva and contained smooth muscle fibres in the anterior area. This anterior fascia, which had a thick appearance, reached the globe equator. From there, the capsule of the orbital fat, which contained no smooth muscle fibres, enveloped the sclera and reached the optic nerve. This was defined as the posterior capsule. In the macroscopic specimens, Tenons capsule had a thick and fibrous white appearance in the anterior area. More posteriorly, the capsule was thinner and more translucent. This thin capsular part was generally larger in the lateral area than in the medial area.

Conclusions:  Tenons capsule is composed of an anterior thick fibrous tissue comprising the orbital smooth muscle network and the posterior thin fibrous capsule of the orbital fat.