bluuebunny/crossref_metadata_2025 huggingface dataset:
Relatedness and social organization of coypus in the Argentinean pampas
Authors: TÚNEZ J. I. , GUICHÓN M. L. , CENTRÓN D. , HENDERSON A. P. , CALLAHAN C. , CASSINI M. H.
Published: December 2008

Behavioural and trapping studies of the social organization of coypus have suggested the occurrence of kin groups and a polygynous mating system. We used 16 microsatellite markers to analyse parentage and relatedness relationships in two populations (Jáuregui and Villa Ruiz) in the Argentinean Pampas. At Jáuregui, a dominant male monopolized most paternities, leading to a high variance in reproductive success between males and a high level of polygyny. At Villa Ruiz, variance in reproductive success was low among resident males and males were the fathers of zero to four offspring each. For females, no significant differences were found. Two different social groups in each study site were used to assess genetic relatedness within and between groups. These groups were neighbouring at Jáuregui but not at Villa Ruiz. At Villa Ruiz, coypus were significantly more related within than between groups, suggesting that behavioural groups were also genetic ones, and adult females were more related within than between groups, as should be expected for kin groups. This relationship was not found at Jáuregui. Our results provide support to previous studies based on behavioural and trapping data, which indicate that coypus form social groups and have a polygynous mating system. However, we found differences in social organization between the two populations. This is the first study to determine parentage and/or relatedness in coypus.
Invasion genetics of the Eurasian round goby in North America: tracing sources and spread patterns
Authors: BROWN JOSHUA E. , STEPIEN CAROL A.
Published: December 2008

The Eurasian round gobyNeogobius melanostomus(Apollonia melanostoma) invaded the North American Great Lakes in 1990 through ballast water, spread rapidly, and now is widely distributed and moving through adjacent tributaries. We analyse its genetic diversity and divergence patterns among 25 North American (N = 744) and 22 Eurasian (N = 414) locations using mitochondrial DNA cytochromebgene sequences and seven nuclear microsatellite loci in order to: (i) identify the invasion's founding source(s), (ii) test for founder effects, (iii) evaluate whether the invasive range is genetically heterogeneous, and (iv) determine whether fringe and central areas differ in genetic diversity. Tests includeFSTanalogues, neighbour‐joining trees, haplotype networks, Bayesian assignment, Monmonier barrier analysis, and three‐dimensional factorial correspondence analysis. We recovered 13 cytochromebhaplotypes and 232 microsatellite alleles in North America and compared these to variation we previously described across Eurasia. Results show: (i) the southern Dnieper River population was the primary Eurasian donor source for the round goby's invasion of North America, likely supplemented by some alleles from the Dniester and Southern Bug rivers, (ii) the overall invasion has high genetic diversity and experienced no founder effect, (iii) there is significant genetic structuring across North America, and (iv) some expansion areas show reduced numbers of alleles, whereas others appear to reflect secondary colonization. Sampling sites in Lake Huron's Saginaw Bay and Lake Ontario significantly differ from all others, having unique alleles that apparently originated from separate introductions. Substantial genetic variation, multiple founding sources, large number of propagules, and population structure thus likely aided the goby's ecological success.
Spatio‐temporal variation in the strength and mode of selection acting on major histocompatibility complex diversity in water vole (Arvicola terrestris) metapopulations
Authors: OLIVER MATTHEW K. , LAMBIN XAVIER , CORNULIER THOMAS , PIERTNEY STUART B.
Published: December 2008

Patterns of spatio‐temporal genetic variation at a class II major histocompatibility complex (MHC) locus and multiple microsatellite loci were analysed within and between three water vole metapopulations in Scotland, UK. Comparisons of MHC and microsatellite spatial genetic differentiation, based on standardised tests between two demographically asynchronous zones within a metapopulation, suggested that spatial MHC variation was affected by balancing selection, directional selection and random genetic drift, but that the relative effects of these microevolutionary forces vary temporally. At the metapopulation level, between‐year differentiation for MHC loci was significantly correlated with that of microsatellites, signifying that neutral factors such as migration and drift were primarily responsible for overall temporal genetic change at the metapopulation scale. Between metapopulations, patterns of genetic differentiation implied that, at large spatial scales, MHC variation was primarily affected by directional selection and drift. Levels of MHC heterozygosity in excess of Hardy–Weinberg expectations were consistent with overdominant balancing selection operating on MHC variation within metapopulations. However, this effect was not constant among all samples, indicating temporal variation in the strength of selection relative to other factors. The results highlight the benefit of contrasting variation at MHC with neutral markers to separate the effects of stochastic and deterministic microevolutionary forces, and add to a growing body of evidence showing that the mode and relative strength of selection acting on MHC diversity varies both spatially and temporally.
Dysregulation of the stress response in asthmatic children
Authors: Priftis K. N. , Papadimitriou A. , Nicolaidou P. , Chrousos G. P.
Published: December 2008

The stress system co‐ordinates the adaptive responses of the organism to stressors of any kind. Inappropriate responsiveness may account for increased susceptibility to a variety of disorders, including asthma. Accumulated evidence from animal models suggests that exogenously applied stress enhances airway reactivity and increases allergen‐induced airway inflammation. This is in agreement with the clinical observation that stressful life events increase the risk of a new asthma attack. Activation of the hypothalamic–pituitary–adrenal (HPA) axis by specific cytokines increases the release of cortisol, which in turn feeds back and suppresses the immune reaction. Data from animal models suggest that inability to increase glucocorticoid production in response to stress is associated with increased airway inflammation with mechanical dysfunction of the lungs. Recently, a growing body of evidence shows that asthmatic subjects who are not treated with inhaled corticosteroids (ICS) are likely to have an attenuated activity and/or responsiveness of their HPA axis. In line with this concept, most asthmatic children demonstrate improved HPA axis responsiveness on conventional doses of ICS, as their airway inflammation subsides. Few patients may experience further deterioration of adrenal function, a phenomenon which may be genetically determined.
Lower levels of plasmacytoid dendritic cells in peripheral blood are associated with a diagnosis of asthma 6 yr after severe respiratory syncytial virus bronchiolitis
Authors: Silver Eli , Yin‐DeClue Huiqing , Schechtman Ken B. , Grayson Mitchell H. , Bacharier Leonard B. , Castro Mario
Published: December 2008

Plasmacytoid dendritic cells (pDC) play a crucial role in antiviral immunity and promoting Th1 polarization, possibly protecting against development of allergic disease. Examination of the relationship between peripheral blood plasmacytoid DC levels and manifestations of asthma and atopy early in life. We have isolated peripheral blood mononuclear cells (PBMC) from 73 children (mean age ± SD: 6.6 ± 0.5 yr old) participating in the RSV Bronchiolitis in Early Life (RBEL) study. Flow cytometry was performed on PBMC detecting DC surface‐markers: Blood Dendritic Cell Antigens (BDCA) 1, 3, and 2 which identify myeloid type 1, type 2, and plasmacytoid cells, respectively. Total serum IgE, peripheral eosinophil count, and allergy skin tests were documented. About 45% (n = 33) of study participants had physician‐diagnosed asthma by 6 yr of age. These children had significantly lower quantities (mean ± SD) of plasmacytoid DC than their non‐asthmatic counterparts (1020 ± 921 vs. 1952 ± 1170 cells per 106 PBMC, p = 0.003). We found significantly lower numbers of myeloid dendritic cells in children with asthma (3836 ± 2472 cells per 106 PBMC) compared with those without asthma (4768 ± 2224 cells per 106 PBMC, p = 0.02); however, this divergence was not significant after adjusting for covariates of age, gender, race, skin test reactivity, smoke exposure, and daycare attendance. We did not identify any direct association between DC levels and markers of atopy: skin test reactivity, peripheral eosinophilia, and IgE level. Children who are diagnosed with asthma after severe RSV bronchiolitis appear to have a relative deficiency of plasmacytoid DC in peripheral blood.
Arabidopsis Chy1 null mutants are deficient in benzoic acid‐containing glucosinolates in the seeds
Authors: Ibdah M. , Pichersky E.
Published: December 2008

The specific set of reactions that lead to the synthesis of benzoic acid in plants is still unclear, and even the subcellular compartment in which these reactions occur is unknown. Biosynthesis of both vegetative tissues and seeds of Arabidopsis thaliana contain a class of defense compounds termed glucosinolates, but only the seeds synthesize and store high levels of two glucosinolate compounds that contain a benzoic acid moiety. To identify genes involved in the synthesis of benzoic acid (directly or via benzaldehyde) in Arabidopsis, we analysed the levels of benzoylated glucosinolates in several lines that carry mutations in genes with homology to Pseudomonas fluorescens feruloyl‐CoA hydratase, an enzyme that converts feruloyl‐CoA to vanillin and acetyl‐CoA, a reaction analogous to the conversion of cinnamoyl‐CoA to benzaldehyde. We show here that mutations in the gene At5g65940, previously shown to encode a peroxisomal protein with β‐hydroxyisobutyryl‐CoA hydrolase activity and designated as Chy1, lead to a deficiency of benzoic acid‐containing glucosinolates in the seeds. Furthermore, Chy1 exhibits cinnamoyl‐CoA hydrolase activity with a Km of 2.9 μm. Our findings suggest that at least a part of benzoic acid biosynthesis occurs in the peroxisomes, although the specific pathway that leads to benzoic acid and the specific biochemical role of Chy1 remain unclear.
Yield QTL affected by heading date in Mediterranean grown barley
Authors: Cuesta‐Marcos A. , Casas A. M. , Hayes P. M. , Gracia M. P. , Lasa J. M. , Ciudad F. , Codesal P. , Molina‐Cano J. L. , Igartua E.
Published: December 2008

Knowledge regarding quantitative trait loci (QTL) has led to remarkable advances in breeding for a variety of traits, some of which have an effect on yield under particular environmental conditions. However, the same yield QTL are not usually found, even in the same population tested in different environments, as a result of large genotype‐by‐environment interactions. In this study, we aimed at identifying yield QTL in a series of experiments carried out in Spain. We used a barley doubled haploid population derived from a spring by winter cross. The relationship between heading date and yield, and between the principal heading date QTL and yield, changed depending on the environment. Allelic combinations causing early or late heading dates usually did not favour high yield, whereas intermediate heading dates were associated with not only higher variability but also higher yield potential. To identify QTL for grain yield independent of heading date, the population was divided into three classes: Early, Intermediate and Late. We found three new QTL affecting yield only at specific maturity groups. The implications of these findings in relation to barley breeding are discussed.
Effects of l‐Ascorbic Acid, α‐Tocopherol and Co‐culture on In Vitro Developmental Potential of Porcine Cumulus Cells Free Oocytes
Authors: Tao Y , Chen H , Tian NN , Huo DT , Li G , Zhang YH , Liu Y , Fang FG , Ding JP , Zhang XR
Published: December 2008

Contents

The maturation and developmental potential on cumulus‐cell‐free oocytes is of great importance theoretically and practically. The present study was to investigate the effects of l‐ascorbic acid, α‐tocopherol and co‐culture on in vitro developmental potential of porcine denuded oocytes (DOs). Porcine DOs were cultured in maturation medium supplemented with vitamin C (0, 50, 100, 250, 500, 750 μM) and vitamin E (0, 10, 20, 50, 100, 250 μm), respectively. And they were also co‐cultured with dispersed cumulus cells (group CCscoculture), intact cumulus cells oocyte complexes (COCs) (group COCscoculture), and COCs whose oocytes were removed (group OOXcoculture), respectively. After 44 h incubation, the maturation rates, cleavage rates and blastocyst rates after parthenogenetic activation in three experiments mentioned above were collected and analysed, respectively. L‐Ascorbic acid promoted porcine DOs in vitro maturation and blastocyt development after parthenogenetic activation while α‐tocopherol did not increase the in vitro maturation rates, but improved the blastocyst rate. None of the three co‐culture manner promoted the in vitro maturation and the cleavage of porcine DOs after parthenogenetic activation, but all the co‐culture manners improved the blastocyst rates. Both Vitamin C and E enhance the in vitro developmental potential of porcine DOs. Co‐culture increases the developmental potential of porcine DOs.
ENDOSCOPIC RETRIEVAL OF MIGRATED PLASTIC STENT INTO BILE DUCT OR PANCREATIC PSEUDOCYST
Authors: Okabe Yoshinobu , Tsuruta Osamu , Kaji Ryohei , Ishida Yusuke , Yasumoto Makiko , Mitsuyama Keiichi , Suga Hideya , Toyonaga Atsushi , Sata Michio
Published: December 2008

Proximally migrated biliary plastic stent and migrated stent in the pancreatic pseudocyst are relatively rare complications. A migrated stent causes poor drainage conditions, which leads to secondary complications such as infection, abscess, perforation and, moreover, becomes a foreign object in the body, and retrieval or re‐stenting is therefore necessary. The retrieval of a migrated stent includes surgical, percutaneous and endoscopic approaches, and the most non‐invasive method is endoscopic retrieval. However, because very few devices are exclusively designed for retrieval, the current situation is that the available devices are used while taking advantage of various ideas and techniques. From previously reported cases and our experiences of such cases, we herein describe the methods of endoscopic retrieval for stents that have migrated into a bile duct or pancreatic pseudocysts.
RE‐EPITHELIALIZATION OF SQUAMOUS EPITHELIUM FOR A RADIATION‐INDUCED RECTAL ULCER WHILE GIVING AN ECABET SODIUM ENEMA
Authors: Chino Akiko , Kishihara Teruhito , Uragami Naoyuki , Ishiyama Akiyoshi , Ogawa Taishi , Hoshino Etsuo , Igarashi Masahiro , Fujita Rikiya
Published: December 2008

The present patient developed a severe rectal ulcer more than 1 month after having received external beam radiation therapy for prostate cancer. Surveillance endoscopy every 3 months demonstrated healing of this rectal ulcer using a novel therapy. He was given enemas with ecabet sodium, which provides physical protection and promotes healing by increasing prostaglandin E2, and this process induced squamous metaplasia that halted the progression of the ulcer of radiation proctitis as a late‐phase reaction. Intrapapillary capillary loops were visualized with magnified narrow band imaging at the healing ulcer site as seen via the esophagus and, moreover, demonstrated histologically.
NEW OBJECTIVE EVALUATION METHOD FOR FUNCTIONAL BOWEL DISORDER USING VIDEO CAPSULE ENDOSCOPY
Authors: Nakamura Masanao , Niwa Yasumasa , Yagihashi Makoto , Ohmiya Naoki , Miyahara Ryoji , Ando Takafumi , Watanabe Osamu , Kawashima Hiroki , Itoh Akihiro , Hirooka Yoshiki , Fujimoto Hideo , Goto Hidemi
Published: December 2008

Aim:  The aim of the present study was to use video capsule endoscopy (VCE) to objectively evaluate bowel movements in patients with irritable bowel syndrome (IBS) compared with healthy volunteers.

Methods:  Subjects were nine healthy volunteers (group A) and five IBS patients (group B) whose VCE reached the cecum within the examination time. As the darkest component in an image of VCE is the lumen, we regarded real movements of the intestine observed in the images as the changes of luminal movement, and analyzed them. We trimmed the luminal edge, counted pixels in the lumen and the low brightness area (LBA), of all VCE images and compared them between the groups.

Results:  There was no difference in the frequency observed in the LBA corresponding to the luminal area between the groups. As for the average volume of the LBA found in an image, it was 1702 pixels in healthy persons versus 305 in IBS patients (P = 0.21) and in healthy persons it tends to be larger. We drew a graph of LBA by time–course. A periodic change in the volume of LBA was found in eight of nine (88.9%) healthy persons over time, but in only two of five (40.0%) IBS patients (P = 0.62). Using endoscopy, a difference in the bowel movement between groups A and B could be evaluated objectively.

Conclusion:  The present study presents the possibility of a new technique to evaluate functional bowel disorders objectively using an endoscopic procedure.
NOVEL CHROMOENDOSCOPIC METHOD USING AN ACETIC ACID–INDIGOCARMINE MIXTURE FOR DIAGNOSTIC ACCURACY IN DELINEATING THE MARGIN OF EARLY GASTRIC CANCERS
Authors: Kawahara Yoshiro , Takenaka Ryuta , Okada Hiroyuki , Kawano Seiji , Inoue Masafumi , Tsuzuki Takao , Tanioka Daisuke , Hori Keisuke , Yamamoto Kazuhide
Published: December 2008

Background and Aim:  Recent endoscopic imaging techniques for recognition of unclear lesions in the stomach (e.g. narrow band imaging, magnifying endoscopy) require special equipment and therefore are not commonly used. The aim of the present study was to estimate the accuracy of a new chromoendoscopic method using an acetic acid–indigo carmine mixture (AIM) in diagnosing early gastric cancers (EGC).

Methods:  Studied were 108 EGC lesions in 104 patients. EGC were initially observed by white light (WL) after which indigo carmine (IC) solution was sprinkled onto the gastric mucosa. Images by WL and IC observation were recorded by a digital filing system. After washing away IC solution with water, AIM solution was sprinkled onto the gastric mucosa and images were recorded. Margin lines of EGC determined by each observation were drawn on recorded images by graphic software for comparison with resected specimens. After lines were similarly drawn on images of resected specimens, the extent of the lesions was compared with that determined by endoscopic images.

Results:  Diagnostic accuracy of WL, IC, and AIM observations were 50.0%, 75.9% and 90.7%, respectively. No adverse events occurred with the AIM method.

Conclusions:  This chromoendoscopic method can be used to delineate the margin of EGC accurately, easily, safely and inexpensively.
ENDOSCOPIC HEMOSTASIS WITH METALLIC HEMOCLIPS FOR IATROGENIC MALLORY‐WEISS TEAR CAUSED BY ENDOSCOPIC EXAMINATION
Authors: Shimoda Ryo , Iwakiri Ryuichi , Sakata Hiroyuki , Ogata Shinichi , Ootani Hibiki , Sakata Yasuhisa , Fujise Takehiro , Yamaguchi Kanako , Mannen Kotaro , Arima Seichiro , Shiraishi Ryosuke , Noda Takahiro , Ono Akihiro , Tsunada Seiji , Fujimoto Kazuma
Published: December 2008

Aim: Applied endoscopic techniques including mucosal resection, sclerotherapy and endoscopic retrograde cholangiopancreatography (ERCP) have been advanced and iatrogenic complications including Mallory‐Weiss tear (MWT) occasionally occur in daily endoscopic procedures. The present study aimed to examine the advantages of clipping for MWT complications that occur during endoscopic examination.

Methods: Over 10 years, we experienced 47 patients with bleeding caused by MWT. Metallic hemoclips were applied for 38 patients for hemostasis. These patients were categorized into two groups: 18 patients in group A whose bleeding tear occurred during endoscopic examination in an iatrogenic condition, and 20 patients in group B visited the emergency unit due to other etiology of MWT.

Results: The background characteristics, including length of tears, were not different between the two groups. Initial hemostasis was 100% in groups A and B. Rebleeding was 0/18 (0%) in group A and 1/20 (5 %) in group B. Number of patients who received blood transfusion was significantly higher in group B (group A: 0/18, group B: 4/20). Hemoglobin level before hemostasis was 12.5 g/dL in group A which was not different to that in group B, 10.9 g/dL.

Conclusion: Application of hemoclips was effective for bleeding MWT during endoscopic procedures, which warranted prophylactic application of hemoclips on MWT during endoscopic examination.
Engineering angiogenesis following spinal cord injury: a coculture of neural progenitor and endothelial cells in a degradable polymer implant leads to an increase in vessel density and formation of the blood–spinal cord barrier
Authors: Rauch Millicent Ford , Hynes Sara Royce , Bertram James , Redmond Andy , Robinson Rebecca , Williams Cicely , Xu Hao , Madri Joseph A. , Lavik Erin B.
Published: December 2008

Angiogenesis precedes recovery following spinal cord injury and its extent correlates with neural regeneration, suggesting that angiogenesis may play a role in repair. An important precondition for studying the role of angiogenesis is the ability to induce it in a controlled manner. Previously, we showed that a coculture of endothelial cells (ECs) and neural progenitor cells (NPCs) promoted the formation of stable tubes in vitro and stable, functional vascular networks in vivo in a subcutaneous model. We sought to test whether a similar coculture would lead to the formation of stable functional vessels in the spinal cord following injury. We created microvascular networks in a biodegradable two‐component implant system and tested the ability of the coculture or controls (lesion control, implant alone, implant + ECs or implant + NPCs) to promote angiogenesis in a rat hemisection model of spinal cord injury. The coculture implant led to a fourfold increase in functional vessels compared with the lesion control, implant alone or implant + NPCs groups and a twofold increase in functional vessels over the implant + ECs group. Furthermore, half of the vessels in the coculture implant exhibited positive staining for the endothelial barrier antigen, a marker for the formation of the blood–spinal cord barrier. No other groups have shown positive staining for the blood–spinal cord barrier in the injury epicenter. This work provides a novel method to induce angiogenesis following spinal cord injury and a foundation for studying its role in repair.
Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation
Authors: Soares F. A. , Regadas F. S. P. , Murad‐Regadas S. M. , Rodrigues L. V. , Silva F. R. S. , Escalante R. D. , Bezerra R. F.
Published: December 2008

Objective  The study aimed to verify the role of parity, age and bowel function in the pathogenesis of anorectocele.

Method  A cross‐sectional study was conducted regarding age, obstetrical history, Cleveland Clinic Constipation Score (CCCS), cinedefecography and anal manometry findings. Forty‐five adult women complaining of obstructed defecation were evaluated; the median age was 46 years and median CCCS, 13. Fifteen patients were nulliparous and 23 multiparous (median parity 2). Eighteen had a history of episiotomy, fourteen delivered large babies and two had forceps‐assisted delivery. Statistical analysis was performed using Spearman’s correlation test and Fisher’s exact test.

Results  Anal hypertonia was found in 14 (31.1%) patients, anal hypotonia in eight (17.8%), anismus in 13 (28.9%) and anorectoceles in 34 (75.6%) [median size 2.8 cm (0–6.4)]. There were no correlations between anorectocele and anal hypertonia (P = 0.7171), anismus (P = 0.4666), parity comparing nulliparous and multiparous patients (P = 1.000), episiotomy (P = 1.0000), forceps assistance (P = 1.0000), delivery of a large baby (P = 1.0000) anal resting pressure (P = 0.0883), anal voluntary pressure (P = 0.7327), parity (P = 0.4987) and age (P = 0.8603). There were correlations between anorectocele and the CCCS (P = 0.0082) and anal hypotonia (P = 0.0141).

Conclusion  Anorectocele is not correlated with parity, age, episiotomy, delivery of a large baby and anismus. It was more frequent in patients with severe constipation and less common in patients with anal hypotonia.
RBP‐to‐retinol ratio, but not total RBP, is elevated in patients with type 2 diabetes
Authors: Erikstrup C. , Mortensen O. H. , Nielsen A. R. , Fischer C. P. , Plomgaard P. , Petersen A. M. , Krogh‐Madsen R. , Lindegaard B. , Erhardt J. G. , Ullum H. , Benn C. S. , Pedersen B. K.
Published: December 2008

Aim:  It was recently reported that serum retinol‐binding protein (RBP), also known as retinol‐binding protein 4 (RBP4), was positively associated with systemic insulin resistance. We hypothesized that an imbalance between RBP and retinol might be the underlying cause for this association.

Methods:  We studied the ratio between RBP and retinol in 233 humans divided into groups depending on normal glucose tolerance (NGT), impaired glucose tolerance (IGT), type 2 diabetes (T2DM) and presence or absence of obesity.

Results:  Plasma RBP and retinol levels were lower in patients with T2DM than in individuals with NGT (p < 0.05 and p < 0.0001 respectively). In contrast, RBP‐to‐retinol ratio was higher in individuals with T2DM (p < 0.0001) and IGT (p < 0.05). Following multivariate adjustment, RBP and retinol correlated positively with low‐density lipoprotein (LDL) and triglycerides (p < 0.0001, except retinol and LDL: p < 0.001). RBP‐to‐retinol ratio correlated positively with glucose 2 h after an oral glucose tolerance test (p < 0.0001) and with C‐reactive protein (p < 0.001). Retinol, RBP and adipose tissue RBP messenger RNA (mRNA) levels shared an inverse relationship with plasma interleukin‐6, and adipose tissue RBP mRNA levels correlated positively with plasma tumour necrosis factor‐α (TNF‐α) and skeletal muscle TNF‐α mRNA levels.

Conclusions:  Our results suggest that the excess of RBP relative to retinol, assessed as the RBP‐to‐retinol ratio, is more indicative of T2DM than RBP itself. Hence, the previously reported insulin resistance in mice induced by overexpression or injection of RBP could be because of higher levels of RBP relative to retinol rather than higher total levels of RBP. Moreover, TNF‐α may have a role in RBP‐mediated adipose to muscle crosstalk.
Once‐daily insulin detemir is comparable to once‐daily insulin glargine in providing glycaemic control over 24 h in patients with type 2 diabetes: a double‐blind, randomized, crossover study
Authors: King A. B.
Published: December 2008

Once‐daily dosing with insulin detemir and insulin glargine were compared in a double‐blind, randomised, crossover study in type 2 diabetes subjects previously treated with other antihyperglycaemic medications. Blood glucose was measured through continuous glucose monitoring (CGM). Insulin dose was adjusted daily during the titration phase to achieve target blood glucose values of (70‐120 mg/dL) during the basal period, defined as 2400–0600 hours. The last meal of the day started at 1800 h and basal insulin was injected at 2000 h. The CGM data for a 24‐h period on the second consecutive day after achieving target blood glucose levels were compared between treatments. Twenty‐nine subjects completed the study. Over a 24‐h measurement period, once‐daily dosing with insulin detemir provided glycaemic control very similar to that of once‐daily insulin glargine in patients with type 2 diabetes after both had been titrated to the same glucose target. Insulin detemir‐ and insulin glargine‐treated subjects had similar mean 24‐h glucose values (133 ± 21 mg/dL compared with 126±20 mg/dL respectively, p = 0.385) and similar glucose values during the basal period (105 ± 23 mg/dL compared with 98 ± 19 mg/dL, respectively p = 0.204).Target basal glycaemic control was achieved in all subjects in a mean of 3.8 days for detemir and 3.5 days for glargine (p = 0.360). The mean dose of detemir was similar to that of glargine (26.3 and 26.6 units/day, respectively, p = 0.837). In this study, once‐daily dosing of insulin detemir provided 24‐h glycaemic control similar to that of insulin glargine in patients with type 2 diabetes.
Mentorship in urological laparoscopic surgery: lessons learned
Authors: Keeley Jr Francis X. , Timoney Anthony G. , Rané Abhay , Tolley David A.
Published: December 2008

OBJECTIVE

To review the results of our experience with a mentorship programme in laparoscopic nephrectomy, set up in 1999 by the British Association of Urological Surgeons Section of Endourology.

METHODS

Mentors were contacted in 2007 to submit data on the number of visits and the outcome, which included whether a urologist was able to establish an independent laparoscopic practice and sustain it.

RESULTS

Four urologists acting as mentors reported a total of 164 procedures carried out in the training of 39 urologists during 148 visits. There were no conversions to open surgery and only one major complication. Overall, 29 of 39 mentored consultants were able to establish an independent laparoscopic practice and 23 continue to do so. The number of visits was associated with initial success, although this was not statistically significant. Working in a large department was associated with being able to sustain a laparoscopic practice. More experienced consultants were less likely to have initial success, but were more likely to sustain a successful practice.

CONCLUSIONS

Mentorship for laparoscopic nephrectomy has been carried out safely thus far. Sustaining a laparoscopic practice requires a critical volume of cases. Future efforts should be focused on trainees rather than consultants.
Src as a therapeutic target in men with prostate cancer and bone metastases
Authors: Saad Fred
Published: December 2008

While responsive to androgen ablation in its early stages, prostate cancer eventually becomes castration‐resistant and metastasizes preferentially to bone. Once this happens, the disease carries considerable morbidity and is incurable. The process of bone metastasis involves a complex interplay between tumour and bone tissue. The eventual characteristic clinical presentation of disorganized osteoblastic bone lesions is preceded by a facilitatory osteoblastic phase; an osteoblastic component then continues to underlie the process. Increasing evidence has shown a ubiquitous role for Src (a proto‐oncogene tyrosine‐protein kinase) in multiple tumour and bone‐signalling processes involved in prostate tumour progression, driving proliferation, survival, migration and transition to androgen‐independent growth. It is also intimately involved in positively regulating osteoclast physiology. As such, this molecule represents an attractive target for managing progressing prostate cancer. Encouraging results have been obtained in preclinical and clinical studies using Src inhibitors like AZD0530 and dasatinib. Both compounds reduced markers of bone resorption, in patients with cancer and those with advanced castration‐resistant prostate cancer, respectively. Moreover, because Src is central to many mechanisms thought to be responsible for the development of castration resistance, adding Src inhibitors to a treatment regimen might reverse this phenomenon. As a result, many Src inhibitors are in preclinical development. This review explores Src inhibition as a strategy for managing bone metastasis in prostate cancer, with a particular focus on targeting the critical osteoclastic response. Other emerging and novel approaches are also considered.
Favourable outcomes of patients with clinical stage T3N0M0 bladder cancer treated with induction low‐dose chemo‐radiotherapy plus partial or radical cystectomy vs immediate radical cystectomy: a single‐institutional retrospective comparative study
Authors: Koga Fumitaka , Kihara Kazunori , Fujii Yasuhisa , Yoshida Soichiro , Saito Kazutaka , Masuda Hitoshi , Kageyama Yukio , Kawakami Satoru
Published: December 2008

OBJECTIVES

To address the role of neoadjuvant concurrent chemo‐radiotherapy (CRT) in muscle‐invasive bladder cancer, by comparing retrospectively the oncological outcomes between a low‐dose CRT (LCRT) plus partial cystectomy (PC) or radical cystectomy (RC) protocol and an immediate RC protocol.

PATIENTS AND METHODS

From 1997 to 2007, 119 patients with clinical stage T2–4aN0M0 bladder cancer received LCRT consisting of RT of 40 Gy in 4 weeks concurrently with two cycles of chemotherapy with cisplatin (20 mg/day for 5 days) during the first and fourth week of RT. Subsequently, 24 (20%) and 65 patients (55%) had PC and RC, respectively, while 30 (25%) had no curative surgery; the median follow‐up was 36 months. From 1983 to 1997, 73 patients had an immediate RC; 29 (41%) received cisplatin‐based adjuvant chemotherapy, and the median follow‐up was 46 months. Oncological outcomes were compared retrospectively between these groups.

RESULTS

The cancer‐specific survival (CSS) rate at 5 years was 75% and 61% for the LCRT protocol and immediate RC protocol, respectively (P = 0.11). In patients with clinical stage T3N0M0 the LCRT protocol gave significantly better survival rates than the immediate RC protocol, with 5‐year CSS rates of 62% vs 27% (P = 0.006), while being comparable in those with clinical stage T2N0M0 disease (89% vs 88%, P = 0.84). In patients with clinical stage T3N0M0 the LCRT protocol provided a lower 5‐year recurrence rate at distant sites than the immediate RC protocol (31% vs 62%, P = 0.09).

CONCLUSIONS

The LCRT plus PC or RC protocol gave significantly better survival rates than the historical, immediate RC protocol in patients with clinical stage T3N0M0 bladder cancer, suggesting that neoadjuvant CRT possibly has survival benefits for such patients.
Implementation of a systematic approach to diabetes in primary care in Bahia, Brazil improves metabolic outcomes: PRODIBA—Programa de Interiorização da Assistência ao Diabetes na Bahia (Project for Dissemination of Diabetes Care in the State of Bahia)
Authors: Chaves‐Fonseca R. M. , Matos O. S. , Lordelo Roberta A. , Abreu M. , Farias M. G. , Coutinho J. F. , Ribeiro M. N. , Matteoni‐Athayde L. , Lessa I. , Pousada J. , Oliveira M. , Lopes C. , Strock E. , Mazze R.
Published: December 2008

Background  Staged Diabetes Management (SDM) improves glycaemic control and reduces diabetes‐related complications in primary care.

Methods  An 18‐month randomized controlled cohort study was conducted in two municipalities in the state of Bahia, Brazil, involving 100 patients with Type 2 diabetes in each municipality. In one municipality, healthcare professionals were trained to use SDM customized protocols for clinical decisions and, in the other municipality, no protocols for diabetes care were implemented. We hypothesized that, in the municipality with SDM trained professionals, patients would have better outcomes, including a fall in glycated haemoglobin (HbA1c).

Results  Improvements in some metabolic parameters were observed in the SDM group, including a 22% decrease in mean random glucose, a significant 15% decrease in mean HbA1c, a 6% decrease in systolic blood pressure and an 11% decrease in diastolic blood pressure. There were no differences in body mass index and lipid profile.

Conclusions  SDM customized algorithms are effective, practical and easy to use in primary healthcare teams with very limited resources.
The relationship between second‐order false belief and display rules reasoning: the integration of cognitive and affective social understanding
Authors: Naito Mika , Seki Yoshimi
Published: December 2008

To investigate the relation between cognitive and affective social understanding, Japanese 4‐ to 8‐year‐olds received tasks of first‐ and second‐order false beliefs and prosocial and self‐presentational display rules. From 6 to 8 years, children comprehended display rules, as well as second‐order false belief, using social pressures justifications decreasingly and motivational justifications with embedded perspectives increasingly with age. Although not related to either type of display across ages, second‐order tasks were associated with both types of display tasks only at 8 years when examined in each age group. Results suggest that children base their second‐order theory of mind and display rules understanding on distinct reasoning until middle childhood, during which time the originally distinct aspects of social understanding are integrated.
Programmed to learn? The ontogeny of mirror neurons
Authors: Giudice Marco Del , Manera Valeria , Keysers Christian
Published: December 2008

Mirror neurons are increasingly recognized as a crucial substrate for many developmental processes, including imitation and social learning. Although there has been considerable progress in describing their function and localization in the primate and adult human brain, we still know little about their ontogeny. The idea that mirror neurons result from Hebbian learning while the child observes/hears his/her own actions has received remarkable empirical support in recent years. Here we add a new element to this proposal, by suggesting that the infant's perceptual‐motor system is optimized to provide the brain with the correct input for Hebbian learning, thus facilitating the association between the perception of actions and their corresponding motor programs. We review evidence that infants (1) have a marked visual preference for hands, (2) show cyclic movement patterns with a frequency that could be in the optimal range for enhanced Hebbian learning, and (3) show synchronized theta EEG (also known to favour synaptic Hebbian learning) in mirror cortical areas during self‐observation of grasping. These conditions, taken together, would allow mirror neurons for manual actions to develop quickly and reliably through experiential canalization. Our hypothesis provides a plausible pathway for the emergence of mirror neurons that integrates learning with genetic pre‐programming, suggesting new avenues for research on the link between synaptic processes and behaviour in ontogeny.
CHALLENGES OF MIXED‐ECONOMY SOLUTIONS IN HEALTHCARE: THE EXAMPLES OF SWITZERLAND AND SINGAPORE
Authors: Bessard Pierre
Published: December 2008

In the search for improved healthcare systems able to cope with rising costs, policy‐makers are likely to turn to mixed‐economy solutions. The lure of integrating ‘the best of both worlds’ generally leads to a blend of public and private providers, high regulation density as well as legal constraints on consumers based on top‐down political prerogatives. The Swiss and Singaporean healthcare systems perfectly exemplify this strategy. Both combine market features and government planning. They differ significantly, however, when it comes to the specific policies being implemented and the scope of private sector involvement in each country. This article discusses the Swiss and Singaporean healthcare systems and highlights the dissimilarities between the two countries.
NHS AS STATE FAILURE: LESSONS FROM THE REALITY OF NATIONALISED HEALTHCARE
Authors: Evans Helen
Published: December 2008

The British National Health Service is often held up as a beacon of egalitarian healthcare, funded through general taxation and free at the point of use. Instituted by arguably the most socialist government in British history after World War II, it has manifested all the flaws that might be expected from a state monopoly: waste, inefficiency, under‐investment, rationing and constant political interference. The result has been poor health outcomes for British citizens compared with other wealthy countries, and a failure by the NHS to live up to its founding principles of comprehensive, unlimited healthcare and egalitarianism.
FREEHOLDS AND FREEDOM: THE IMPORTANCE OF PRIVATE PROPERTY IN PROMOTING AND SECURING LIBERTY
Authors: Johnson Paul
Published: December 2008

In the seventeenth annual IEA Hayek Memorial Lecture, the author examines the historical connection between individual property and individual liberty. Freehold ownership has been essential to the progress of freedom among the English‐speaking peoples. Accordingly, the protection of private property should be given high priority in our system of law.
PENSION REFORM, POLITICAL PRESSURE AND PUBLIC CHOICE – THE CASE OF FRANCE
Authors: Thompson Laura
Published: December 2008

An ageing population and generous public sector pensions have put significant pressure on the funding of the French pension system making a reduction in the scope of state pension schemes imperative. Yet, as public‐choice theory would predict, lobbying by interest groups has made reform difficult to achieve.
Multilevel Governance and Shared Sovereignty: European Union, Member States, and the FCTC
Authors: MAMUDU HADII M. , STUDLAR DONLEY T.
Published: December 2008

The Westphalian idea of sovereignty in international relations has undergone recent transformation. “Shared sovereignty” through multilevel governance describes the responsibility of the European Union (EU) and its Member States in tobacco control policy. We examine how this has occurred on the EU level through directives and recommendations, accession rules for new members, tobacco control campaigns, and financial support for antitobacco nongovernmental organizations. In particular, the negotiation and ratification of the Framework Convention on Tobacco Control (FCTC) and the participation in the FCTC Conference of the Parties illustrates shared sovereignty. The EU Commission was the lead negotiator for Member States on issues over which it had jurisdiction, while individual Member States, through the EU presidency, could negotiate on issues on which authority was divided or remained with them. Shared sovereignty through multilevel governance has become the norm in the tobacco control policy area for EU members, including having one international organization negotiate within the context of another.
The Effects of Administrative Professionals on Contracting Out
Authors: BHATTI YOSEF , OLSEN ASMUS LETH , PEDERSEN LENE HOLM
Published: December 2008

An often‐debated subject in the public administration literature concerns why some units contract out more than others. The present article decomposes the influence of public employees on municipal contracting as different types of employees have different skills and incentives and must be treated accordingly. First, the analysis shows that the apparent negative relationship between public employees in general and municipal contracting is partly reflecting the fact that the number of public employees is endogenous to contracting. Second, we suggest that administrative professionals and not bureaucrats in general have a positive impact on contracting. This is because administrative professional skills are vital for carrying out a tender and because contracting is essentially a part of administrative professionals' bureau‐shaping interests. Finally, we find support for two often‐discussed claims in the literature, namely, the influence of prosperity and ideology.
Differences in clinical course between dementia with Lewy bodies and Alzheimer’s disease
Authors: Hanyu H. , Sato T. , Hirao K. , Kanetaka H. , Sakurai H. , Iwamoto T.
Published: December 2008

Background and purpose:  To investigate whether there may be differences in the clinical course and changes in cognitive progression between dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD).

Methods:  We compared the time from the first visit to endpoints (discontinuation of visits because of admission, death, or institutionalization) between 56 patients with DLB and 111 patients with AD. Mini‐Mental State Examination (MMSE) scores of patients were every 12 months examined up to 60 months.

Results:  Dementia with Lewy bodies had a significantly shorter time to reaching endpoints than those with AD (median time; 40 months vs. 52 months, P < 0.0001). The proportion of admission (or death) was significantly higher in DLB than in AD (30% vs. 14%, P < 0.05), while the difference in institutionalization in nursing homes did not reach statistical significance (25% vs. 17%). Rates of longitudinal MMSE score decline for DLB and AD groups were equivalent.

Conclusion:  Dementia with Lewy bodies had a greater risk of admission (or death) because of most commonly fall‐related injuries and bronchopneumonia than AD, but the two groups did not differ in rate of cognitive decline.
Extending health care coverage: Potential linkages between statutory social security and community‐based social protection
Authors: Schremmer Jens , Coheur Alain , Jacquier Christian , Schmitt‐Diabaté Valérie
Published: December 2008

Abstract  The extension of social health protection in developing countries is widely recognized as a priority. Various financing and institutional methods can be used in pursuing this objective, but none of them can achieve universal coverage in the short term. Based on an analysis of the respective strengths and weaknesses of social health insurance and community‐based health care schemes, this article demonstrates the high potential of coverage extension strategies that use a pluralistic institutional approach to establish linkages and exploit complementarities optimally. A typology of potential linkages among different methods is presented and their value added illustrated using country examples.
A school‐based, teacher‐mediated prevention program (ERASE‐Stress) for reducing terror‐related traumatic reactions in Israeli youth: a quasi‐randomized controlled trial
Authors: Gelkopf Marc , Berger Rony
Published: December 2008

Background:  Since September 2000 Israeli children have been exposed to a large number of terrorist attacks. A universal, school‐based intervention for dealing with the threat of terrorism as well as with terror‐related symptoms, ERASE‐Stress (ES), was evaluated in a male religious middle school in southern Israel. The program was administered by the homeroom teachers as part of the school curriculum. It consists of 12 classroom sessions each lasting 90 minutes, and included psycho‐educational material, skill training and resiliency strategies delivered to the students by homeroom teachers.

Methods:  One hundred and fourteen 7th and 8th grade students were randomly assigned to the ES intervention or were part of a waiting list (WL). They were assessed on measures of posttraumatic symptomatology, depression, somatic symptoms and functional problems before and 3 months after the intervention or the WL period.

Results:  Three months after the program ended, students in the experimental group showed significant reduction in all measures compared to the waiting‐list control group.

Conclusions:  The ERASE‐Stress program may help students suffering from terror‐related posttraumatic symptoms and mitigate the negative effects of future traumatic experiences. Furthermore, a school‐based universal program such as the ERASE‐Stress may potentially serve as an important and effective component of a community mental health policy for communities affected by terrorism.