bluuebunny/crossref_metadata_2025 huggingface dataset:
Ablation of supraventricular tachycardia allows more liberal therapy in some children with attention‐deficit–hyperactivity disorder
Authors: Shetty Ira , Silver Eric S. , Hordof Allan J. , Goldberg Pablo H. , Liberman Leonardo
Published: January 2011

Background:  First‐line therapy for children with attention‐deficit–hyperactivity disorder (ADHD) is stimulant medication, which may have potential cardiovascular side‐effects. In patients with supraventricular tachycardia or Wolf‐Parkinson‐White syndrome (WPW), therapy for ADHD could become challenging. The purpose of the present study was to review the authors' experience of performing electrophysiologic study (EPS) with or without ablation to determine how it affected ADHD therapy.

Methods:  Retrospective chart review of patients who underwent EPS between 2002 and 2009 was carried out. All patients under 21 years of age who had prior diagnosis of ADHD were included.

Results:  Twenty patients met the inclusion criteria. The mean age was 12.1 ± 2.7 years (range: 5.6–16.8 years). The patients were diagnosed with ADHD on average 3.9 ± 2.7 years (range: 6 months–9 years) prior to the EPS. All patients had a structurally normal heart. Sixteen patients had cardiac symptoms. Seventeen patients underwent ablation of the arrhythmia substrate (16/17, 94% successful). Three patients with asymptomatic WPW were at low risk for life‐threatening arrhythmias and did not have ablation. After the EPS, two patients had increased doses of their ADHD medications, and two patients whose health‐care providers stopped the stimulant medication prior to EPS because of recurrent tachycardia were restarted on medications. All other patients on ADHD medications continued therapy.

Conclusions:  EPS for risk stratification and ablation of arrhythmia substrate is safe and effective, allowing more liberal therapy in patients with ADHD and supraventricular tachycardia or WPW.
Seizure‐modifying potential of histamine H1 antagonists: A clinical observation
Authors: Miyata Ippei , Saegusa Hirokazu , Sakurai Michiro
Published: January 2011

Background:  The widely used histamine H1 antagonists have a potential to induce seizures, although clinical evaluation is scarce except for a few case reports.

Methods:  The medical records of all pediatric consultations at Enshu General Hospital due to seizures during two successive winter seasons were collected. Cases involving known convulsive background were excluded. Seizures were categorized into two types: generalized seizures ceasing within 5 min (“typical”); and others (“atypical”). Eligible subjects were classified based on type of seizure and whether they were receiving histamine H1 antagonists or not; the association between these classifications was examined using Fisher's exact test.

Results:  There were 66 eligible consultations among 95 consultations due to seizures. A significantly increased incidence of atypical seizures among patients receiving histamine H1 antagonists was found (P= 0.041; 95% confidence interval: 1.028–16.40; Fisher's exact test).

Conclusion:  Clinical doses of histamine H1 antagonists have the potential to adversely modify seizures in children.
DNA‐, rRNA‐ and mRNA‐based stable isotope probing of aerobic methanotrophs in lake sediment
Authors: Dumont Marc G. , Pommerenke Bianca , Casper Peter , Conrad Ralf
Published: January 2011

A stable isotope probing (SIP) approach was used to study aerobic methane‐oxidizing bacteria (methanotrophs) in lake sediment. Oligotrophic Lake Stechlin was chosen because it has a permanently oxic sediment surface. 16S rRNA and the pmoA gene, which encodes a subunit of the methane monooxygenase enzyme, were analysed following the incubation of sediment with 13CH4 and the separation of 13C‐labelled DNA and RNA from unlabelled nucleic acids. The incubation with 13CH4 was performed over a 4‐day time‐course and the pmoA genes and transcripts became progressively labelled such that approximately 70% of the pmoA genes and 80% of the transcripts were labelled at 96 h. The labelling of pmoA mRNA was quicker than pmoA genes, demonstrating that mRNA‐SIP is more sensitive than DNA‐SIP; however, the general rate of pmoA transcript labelling was comparable to that of the pmoA genes, indicating that the incorporation of 13C into ribonucleic acids of methanotrophs was a gradual process. Labelling of Betaproteobacteria was clearly seen in analyses of 16S rRNA by DNA‐SIP and not by RNA‐SIP, suggesting that cross‐feeding of the 13C was primarily detected by DNA‐SIP. In general, we show that the combination of SIP approaches provided valuable information about the activity and growth of the methanotrophic populations and the cross‐feeding of methanotroph metabolites by other microorganisms.
Multidimensional NMR analysis reveals truncated lignin structures in wood decayed by the brown rot basidiomycete Postia placenta
Authors: Yelle Daniel J. , Wei Dongsheng , Ralph John , Hammel Kenneth E.
Published: January 2011

Lignocellulose biodegradation, an essential step in terrestrial carbon cycling, generally involves removal of the recalcitrant lignin barrier that otherwise prevents infiltration by microbial polysaccharide hydrolases. However, fungi that cause brown rot of wood, a major route for biomass recycling in coniferous forests, utilize wood polysaccharides efficiently while removing little of the lignin. The mechanism by which these basidiomycetes breach the lignin remains unclear. We used recently developed methods for solubilization and multidimensional 1H–13C solution‐state NMR spectroscopy of ball‐milled lignocellulose to analyse aspen wood degraded by Postia placenta. The results showed that decay decreased the content of the principal arylglycerol‐β‐aryl ether interunit linkage in the lignin by more than half, while increasing the frequency of several truncated lignin structures roughly fourfold over the level found in sound aspen. These new end‐groups, consisting of benzaldehydes, benzoic acids and phenylglycerols, accounted for 6–7% of all original lignin subunits. Our results provide evidence that brown rot by P. placenta results in significant ligninolysis, which might enable infiltration of the wood by polysaccharide hydrolases even though the partially degraded lignin remains in situ. Recent work has revealed that the P. placenta genome encodes no ligninolytic peroxidases, but has also shown that this fungus produces an extracellular Fenton system. It is accordingly likely that P. placenta employs electrophilic reactive oxygen species such as hydroxyl radicals to disrupt lignin in wood.
Economic evaluation of new targeted therapies for the first‐line treatment of patients with metastatic renal cell carcinoma
Authors: Benedict Ágnes , Figlin Robert A. , Sandström Per , Harmenberg Ulrika , Ullén Anders , Charbonneau Claudie , Sandin Rickard , Remák Edit , Hariharan Subramanian , Négrier Sylvie
Published: January 2011

Study Type – Therapy (economic)

Level of Evidence 2b

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

Cost‐effectiveness of new targeted molecular therapies in patients with mRCC have been examined compared to interferon‐α.

This study compares cost‐effectiveness of three new targeted therapies in mRCC head‐to‐head based on indirect comparison of clinical efficacy. The study shows that sunitinib is a cost‐effective therapy in first line treatment for patients with mRCC in the USA and Sweden compared to sorafenib and bevacizumab+interferon‐α.

OBJECTIVE

• To assess the economic value of targeted therapies as first‐line metastatic renal cell carcinoma (mRCC) treatment in the US and Sweden by indirect comparison of survival data.

METHODS

• A Markov model simulated disease progression, adverse events and survival with sunitinib vs sorafenib in the US and bevacizumab plus interferon‐α (IFN‐α) in both countries.

• Results, in life‐years (LYs), progression‐free LYs (PFLYs), quality‐adjusted LYs (QALYs) gained and treatment costs (2008 USD) were obtained through deterministic and probabilistic analyses over the patient’s lifetime.

RESULTS

• Sunitinib was more effective and less costly than sorafenib (gains of 0.52 PFLYs, 0.16 LYs and 0.17 QALYs and savings/patient of $13 576 in the US) and bevacizumab plus IFN‐α (gains of 0.19 PFLYs, 0.23 LYs and 0.16 QALYs in both countries and savings/patient of $67 798 and $47 264 in the US and Sweden, respectively).

• Results were most influenced by hazard ratios for progression‐free and overall survival and treatment costs, making results generalizable across other countries if relative costs were to fall within the ranges of those in the US and Sweden.

CONCLUSION

• The present analyses suggest that first‐line mRCC treatment with sunitinib is a cost‐effective alternative to sorafenib and bevacizumab plus IFN‐α.
Risk stratification for benign prostatic hyperplasia (BPH) treatment
Authors: Emberton Mark , Fitzpatrick John M. , Rees Jon
Published: January 2011

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

Patients with BPH have traditionally been managed with ‘sequential monotherapy’ or effectively an intent to treat to failure. Thus watchful waiting strategies, α‐blockers, 5α‐reductase inhibitors and surgical intervention have been seen as a stepwise progression based on failure of symptom control at each level.

This paper reviews the evidence from large randomized trials which suggest a new approach of risk stratification, allowing the identification of higher risk patients for whom medical management can be optimised at an early stage. If this can be done at a primary care level, this could lead to a dramatic improvement in outcomes in men with BPH.

• Benign prostatic hyperplasia (BPH) is a common cause of bothersome lower urinary tract symptoms. In the past, the aim of drug treatment was to relieve symptoms until surgery became necessary, predominantly using an α‐blocker or a 5α‐reductase inhibitor (5ARI) as monotherapy.

• Together with improving knowledge about the pathogenesis of BPH, there is now strong evidence from large randomized trials that risk stratification and appropriate treatment with combined α‐blocker/5ARI therapy can significantly reduce the risk of disease progression and avoid long‐term complications such as acute urinary retention and surgery.

• BPH will increasingly be managed in primary care in the future and, if new management strategies based on this evidence are to be implemented cost effectively, there is a need to introduce shared care between the primary and secondary care sectors to optimise use of resources and expertise.
An empirical comparison of cost‐sensitive decision tree induction algorithms
Authors: Lomax Susan , Vadera Sunil
Published: January 2011

Abstract:Decision tree induction is a widely used technique for learning from data, which first emerged in the 1980s. In recent years, several authors have noted that in practice, accuracy alone is not adequate, and it has become increasingly important to take into consideration the cost of misclassifying the data. Several authors have developed techniques to induce cost‐sensitive decision trees. There are many studies that include pair‐wise comparisons of algorithms, but the comparison including many methods has not been conducted in earlier work. This paper aims to remedy this situation by investigating different cost‐sensitive decision tree induction algorithms. A survey has identified 30 cost‐sensitive decision tree algorithms, which can be organized into 10 categories. A representative sample of these algorithms has been implemented and an empirical evaluation has been carried. In addition, an accuracy‐based look‐ahead algorithm has been extended to a new cost‐sensitive look‐ahead algorithm and also evaluated. The main outcome of the evaluation is that an algorithm based on genetic algorithms, known as Inexpensive Classification with Expensive Tests, performed better over all the range of experiments thus showing that to make a decision tree cost‐sensitive, it is better to include all the different types of costs, that is, cost of obtaining the data and misclassification costs, in the induction of the decision tree.
Skin ageing
Authors: Kohl E. , Steinbauer J. , Landthaler M. , Szeimies R.‐M.
Published: January 2011

Similar to the entire organism, skin is subject to an unpreventable intrinsic ageing process. Additionally, skin ageing is also influenced by exogenous factors. Ultraviolet radiation in particular results in premature skin ageing, also referred to as extrinsic skin ageing or photoageing, which is the main cause of the changes associated with the ageing process in sun‐exposed areas. Despite their morphological and pathophysiological differences, intrinsic and extrinsic ageing share several molecular similarities. The formation of reactive oxygen species and the induction of matrix metalloproteinases reflect the central aspects of skin ageing. Accumulation of fragmented collagen fibrils prevents neocollagenesis and accounts for the further degradation of the extracellular matrix by means of positive feedback regulation. The importance of extrinsic factors in skin ageing and the detection of its mechanisms have furthered the development of various therapeutic and preventive strategies.
Teaching staff knowledge, attributions and confidence in relation to working with children with an intellectual disability and challenging behaviour
Authors: Rae Helen , Murray George , McKenzie Karen
Published: January 2011

Accessible summary

We looked at how much teachers knew about helping children with a learning disability who had behaviour that was challenging in school. We found that:

 Some teachers knew very little about challenging behaviour and all the different ways to help children with this.

 Some teachers had beliefs about challenging behaviour that can be unhelpful.

We need to find ways to help teachers find out more about challenging behaviour  and to think about it in different ways. One way to do this could be to give them  training about it.

The present study examined Scottish teaching staff knowledge about the definition and management of challenging behaviour displayed by children with an intellectual disability. Knowledge levels were relatively low, and participants were most likely to define challenging behaviour by function or topography. Teaching staff were largely unaware of positive programming strategies, suggesting that they may not be properly equipped to manage challenging behaviour effectively in the longer term. The teaching staff were found to hold attributions which research suggests are associated with reduced helping behaviour and increased anger. This indicates a continuing need to identify effective ways of promoting more accurate knowledge and positive attributions in teaching staff.
Assessment of mental health problems in people with Down syndrome: key considerations
Authors: Spendelow Jason S.
Published: January 2011

Accessible summary

 People with Down syndrome can have problems with the way they think, feel, and act.

 Those who help people understand these difficulties need to have information about the factors that can contribute to such problems.

 This knowledge is important so difficulties can be found early, and help given.

The dual disability literature is marked by a lack of reviews with respect to assessment of specific aetiological groups. The current review summarises the wide body of literature relevant to the assessment of psychiatric and behavioural problems in people with Down syndrome. Adequate assessment within this population requires knowledge, not only of epidemiological findings with respect to psychiatric and behavioural problems, but also an understanding of other important areas including psychometrics, neurocognitive functioning, dementia and other medical issues. These areas are reviewed, and directions for future research are proposed.
Mechanisms underlying the left visual‐field advantage in the dual stream RSVP task: Evidence from N2pc, P3, and distractor‐evoked VEPs
Authors: Verleger Rolf , Śmigasiewicz Kamila , Möller Friderike
Published: January 2011

When two letter streams containing two targets (T1 and T2) are presented left and right, T2 is better identified in the left hemifield. This study on 16 healthy participants used evidence from ERPs to decide whether this advantage is due to better processing in the right hemisphere or to overload of the left one. N2pc and P3 components evoked by T1 and T2 were measured, as well as the VEPs evoked by the stream of distractor stimuli. Already at the onset of the stream, these VEPs peaked earlier at the right than at the left hemisphere. N2pc was evoked earlier and P3 amplitudes were larger with left than with right T2. Previously reported side differences in T1‐evoked N2pc were no longer obtained after correcting for constant hemispheric differences. The faster VEP latencies at the right hemisphere from the very beginning of the stimulus series may reflect an advantage in structuring fast sequences, which may cause the left visual‐field advantage.
Distinct cognitive mechanisms in a gambling task share neural mechanisms
Authors: Steffen Astrid , Rockstroh Brigitte , Wienbruch Christian , Miller Gregory A.
Published: January 2011

Distinct psychological processes have been proposed to unfold in decision‐making. The time course of neural mechanisms supporting these processes has not been fully identified. The present MEG study examined spatio‐temporal activity related to components of decision‐making proposed to support reward valuation, reward prediction, and outcome evaluation. Each trial presented information on reward value (10 or 50 cents) and reward probability (10%, 50%, or 90%). Brain activity related to those inputs and to outcome feedback was evaluated via electromagnetic responses in source space. Distributed dipole activity reflected reward value and reward probability 150–350 ms after information arrival. Neural responses to reward‐value information peaked earlier than those to reward‐probability information. Results suggest that valuation, prediction, and outcome evaluation share neural structures and mechanisms even on a relatively fine time scale.
Embedded spirituality: gardening in daily life and stressful life experiences
Authors: Unruh Anita , Hutchinson Susan
Published: January 2011

Scand J Caring Sci; 2011; 25; 567–574
 
Embedded spirituality: gardening in daily life and stressful life experiences

Background:  There is a limited body of research examining the relationship between spirituality and leisure, or the impact of leisure in the context of daily life, and life with stressful events.

Aim:  To examine the meaning of gardens and gardening across different life experiences using hermeneutic phenomenology to focus on the lived experience of leisure gardening.

Methods:  Most participants were interviewed once in each season over a 1 year period usually in their home. There were 42 participants (27 women and 15 men) in this study. Fifteen individuals had been diagnosed with cancer and were in varying stages of diagnosis and treatment. Three people had a chronic and progressive disease. Four women were grieving the death of their spouse. Participants ranged in age from 32 to 80 years.

Results:  In this paper, we focus on the spirituality‐related themes in this study: spirituality as connectedness; spirituality as an expression of inner being; the garden as a spiritual place and gardening as spiritual activity; gardening as a spiritual journey; and, stewardship. Participants with religious views saw their garden as an extension of their spirituality and a confirmation of their beliefs. Participants with secular or sacred views of spirituality that was not related to any religious beliefs were more likely to embed their spirituality in their relationship with nature as manifested in their garden.

Conclusion:  This study extends current theory regarding leisure and its contribution to meaning focused coping, and spirituality as a significant component of leisure in living with stressful health and life events.
Cellular Neurothekeomas Arising on a Café‐au‐Lait Macule
Authors: HERNÁNDEZ‐MARTÍN ANGELA , COLMENERO ISABEL , TORRELO ANTONIO
Published: January 2011

Abstract:  Neurothekeoma is a tumor probably derived from the nerve sheath, which usually appears during the first 2 decades of life as a solitary papule or nodule; multiple neurothekeomas are very unusual. We present a case of multiple cellular neurothekeomas arising on a café‐au‐lait macule in a child, a situation that has not been reported to our knowledge.
Case Report: Congenital Dacryocystocele and Dacryocystitis
Authors: FUSSELL J. NICOLE F. , WILSON THOMAS , PRIDE HOWARD
Published: January 2011

Abstract:  Congenital dacryocystocele is a uncommon type of nasolacrimal duct obstruction. Differential diagnosis for masses in the medial canthal region of a newborn include encephalocele, hemangioma, nasal glioma, and dermoid cyst. Because of the risk of becoming infected (acute dacryocystitis) and potentially lethal due to septicemia, aggressive management, including admission for intravenous antibiotics and surgical removal, is now advocated by many pediatric ophthalmologists if the cyst cannot be decompressed. Because of the commonly associated nasal cyst, infants with nasolacrimal dacryocyctocele may also experience respiratory distress especially when breast‐feeding. The following case of dacryocystocele, which had progressed to dacryocystitis, was misdiagnosed as an infantile hemangioma. It is important to diagnose this entity quickly and refer for appropriate antibiotic and surgical management to avoid more serious sequelae of sepsis and possible death.
THE TOXIC CYANOBACTERIUM NOSTOC SP. STRAIN 152 PRODUCES HIGHEST AMOUNTS OF MICROCYSTIN AND NOSTOPHYCIN UNDER STRESS CONDITIONS1
Authors: Kurmayer Rainer
Published: January 2011

The understanding of how environmental factors regulate toxic secondary metabolite production in cyanobacteria is important to guarantee water quality. Very little is known on the regulation of toxic secondary metabolite production in benthic cyanobacteria. In this study, the physiological regulation of the production of the toxic heptapeptide microcystin (MC) and the nontoxic related peptide nostophycin (NP) in the benthic cyanobacterium Nostoc sp. strain 152 was studied under contrasting environmental conditions. A 2k levels factorial design was used, where k is the number of four factors that have been tested: reduction in temperature (20°C vs. 12°C), irradiance (50 vs. 1 μmol · m−2 · s−1), P‐PO4 (144 vs. 0.14 μM P‐PO4), and N‐NO3 (5.88 mM versus N‐NO3 free). While the growth rate was reduced >100‐fold under most severe conditions of temperature, irradiance, and phosphate reduction, the production of MC and NP never ceased. The MC and NP contents per cell varied at maximum 5‐ and 10.6‐fold each; however, the physiological variation did not outweigh the highly significant linear relationship between the daily cell division rate and the MC and NP net production rates. Surprisingly, the MC and NP contents per cell showed a maximum under P‐PO4‐reduced and irradiance‐reduced conditions. Both intra‐ and extracellular MC and NP concentrations were negatively related to P‐PO4 and irradiance. It is concluded that the proximate factor behind maximal cellular MC and NP contents is physiological stress.
Peer Group Intervention Reduces Personal HIV Risk for Malawian Health Workers
Authors: Mbeba Mary M. , Kaponda Chrissie P. N. , Jere Diana L. , Kachingwe Sitingawawo I. , Crittenden Kathleen S. , McCreary Linda L. , Norr James L. , Norr Kathleen F.
Published: January 2011

Purpose: To test a peer group intervention to address personal HIV prevention needs of rural health workers in Malawi.

Design: Using a quasi‐experimental design, we compared district health workers in two districts of Malawi that were randomly assigned to either the intervention or delayed control condition. We used independent sample surveys at baseline, 15 months, and 30 months postintervention. Intervention district workers received a peer group intervention after the baseline; control district workers received the delayed intervention after final data collection.

Methods: The 10‐session intervention for primary prevention of HIV infection was based on the primary healthcare model, behavioral change theory, and contextual tailoring based on formative evaluation. Differences in HIV‐related knowledge, attitudes, self‐efficacy, and behaviors were analyzed using t tests and multiple regression controlling for baseline differences.

Findings: Health workers in the intervention district had higher general HIV knowledge, more positive attitudes about condoms, higher self‐efficacy for safer sex, and more involvement in community HIV prevention at both the 15‐month and 30‐month postintervention survey. At 30 months, intervention district workers also reported less stigmatizing attitudes toward persons living with AIDS, more HIV tests, and lower risky sexual behaviors.

Conclusion: The intervention should be sustained in current sites and scaled up for health workers throughout Malawi as part of a multisectoral response to HIV prevention.

Clinical Relevance: Incorporating a peer group intervention focused on personal as well as work‐related HIV prevention can reduce health workers’ risky behaviors in their personal lives, potentially reducing morbidity and mortality and enhancing workforce retention. Reducing stigmatizing attitudes may also improve the quality of health services.
Discriminant Function Analysis for Sex Assessment in Pelvic Girdle Bones: Sample from the Contemporary Mexican Population
Authors: Gómez‐Valdés Jorge Alfredo , Ramírez Guillermo Torres , Molgado Socorro Báez , Sain‐Leu Patricia Herrera , Caballero José Luis Castrejón , Sánchez‐Mejorada Gabriela
Published: January 2011

Abstract:  Sex assessment of skeletal remains plays an important role in forensic anthropology. The pelvic bones are the most studied part of the postcranial skeleton for the assessment of sex. It is evident that a population‐specific approach improves rates of accuracy within the group. The present study proposes a discriminant function method for the sex assessment of skeletal remains from a contemporary Mexican population. A total of 146 adult human pelvic bones (61 females and 85 males) from the skeletal series pertaining to the National Autonomous University of Mexico were evaluated. Twenty‐four direct metrical parameters of coxal and sacral bones were measured and subsequently, sides and sex differences were evaluated, applying a stepwise discriminant function analysis. Coxal and sacra functions achieved accuracies of 99% and 87%, respectively. These analyses follow a population‐specific approach; nevertheless, we consider that our results are applicable to any other Hispanic samples for purposes of forensic human identification.
Fatal Suicidal Crossbow Injury—The Ability to Act
Authors: Zátopková Lenka , Hejna Petr
Published: January 2011

Abstract:  We report a case of a 58‐year‐old man who committed suicide using a modern crossbow. The victim shot himself in the chest with a conical field‐tip arrow from close proximity. We first presumed that this was a case of homicide committed with a firearm. We were, however, subsequently proved wrong. The reasons for the primary statement were as follows: the external morphology of the entrance wound being typical of a firearm discharged from long distance; the perforation found on the victim’s clothing; the absence of the firearm at the place of death; the absence of the arrow in the wound. All of these reasons forced us initially to conclude that the case was one of homicide. In the reported case, the man, after having been shot with an arrow, was further able to act, even though the abdominal aorta and liver were seriously injured. While the arrow was in the wound, the injuries may not have led to massive bleeding because of incomplete tamponade of the defects by the arrow shaft. Pulling the arrow out of the victim’s wound track initiated massive bleeding. Despite all these injuries, the man was capable of pulling the bow string again and reloading the crossbow with the arrow used in the first attempt. This case demonstrates that forensic investigations into crossbow injuries can be very difficult, especially when the bolt has been removed from the body.
Expression and Function of C5a Receptor in a Fatal Anaphylaxis After Honey Bee Sting*
Authors: Törő Klára , Borka Katalin , Kardos Magdolna , Kristóf István , Sótonyi Péter
Published: January 2011

Abstract:  The mechanisms leading to death from anaphylaxis after insect sting involve antigen cross‐linkage of antibody molecules that activate immunoglobulin receptors on inflammatory cells. The aim of our study was to investigate the pathomorphology and the expression of C5aR in fatal anaphylaxis in a patient after a fatal insect sting. A 38‐year‐old women was stung by a honeybee. C5R1 expression was detected in many dilated capillaries in the lungs. Pulmonary epithelial cells did not bind the monoclonal antibody for C5R1; however, intensive cytoplasmic staining was detected in endothelial cells. The findings of this case provide evidence for an active role of complement in fatal anaphylaxis elicited by bee venom. C5aR detection could be useful in the identification of sudden death cases because of unwitnessed fatal insect sting cases. Authors can recommend this immunohistochemical analysis on all sudden unexpected deaths outdoors where a possible bee sting might occur.
Periodontal disease in gestational and type 1 diabetes mellitus pregnant women
Authors: Ruiz DR , Romito GA , Dib SA
Published: January 2011

Oral Diseases (2011) 17, 515–521

Objective:  The present study evaluated the relationship between periodontal disease and its clinical variables in Brazilian non‐diabetic pregnant women (C), gestational diabetes mellitus (GDM), or type 1 diabetes mellitus (T1DM).

Subjects and methods:  A periodontal exam was performed in one hundred and sixty‐one pregnant women (GDM:80; T1DM:31; C:50) by a single‐blinded calibrated examiner who recorded plaque index (PI), gingival index (GI), bleeding index (BI), gingival margin location (GM), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and tooth mobility index (MI). The medical variables were age, pregestational body mass index (pre‐BMI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c).

Results:  The GI, GM, PD, CAL, BOP, and MI were significantly higher (P < 0.01) among GDM and T1DM than for C. The PI was higher in GDM and similar between C and T1DM. The Adjusted Final Model for medical variables to evaluate the effects of groups on periodontal parameters confirmed these results.

Conclusions:  The presence of periodontal disease was significantly higher in Brazilian diabetic pregnancies (GDM and T1DM) when compared to non‐diabetic pregnant women (C). The degree of periodontal disease was similar between the GDM and T1DM groups. Age, pregestational BMI, and HbA1c were factors related to CAL development in these two types of diabetes mellitus.
Who's Afraid of Population Decline? A Critical Examination of Its Consequences
Authors: Coleman David , Rowthorn Robert
Published: January 2011

In the multitude of people is the king's honour; but in the want of people is the destruction of the prince—Proverbs 14: 28
Factors related to the continuation of employment during pregnancy among Japanese women
Authors: MATSUZAKI Masayo , HARUNA Megumi , OTA Erika , MURAYAMA Ryoko , MURASHIMA Sachiyo
Published: January 2011

Aim:  To determine the relationship between the working situation (full‐time housewife, stopped working during pregnancy, or currently employed) and the lifestyle factors, reasons for stopping work during pregnancy, and effects of working conditions in order to identify the factors that are related to the continuation of employment among pregnant Japanese women.

Methods:  In a cross‐sectional study, a questionnaire was administered to pregnant women who visited an obstetrics clinic in a Tokyo suburb for an outpatient medical check‐up during July and August 2004.

Results:  The data of 530 healthy pregnant women were analyzed. The pregnant women who stopped working during their pregnancy had lower mental health scores than the full‐time housewives and employed pregnant women. In each trimester, the employed pregnant women reported a shorter daytime sleep duration than the pregnant women who stopped working during their pregnancy and the full‐time housewives. The reasons for stopping work during pregnancy were categorized as somatic symptoms due to pregnancy, working conditions, and a sense of values or social reasons. The employed women in the third trimester more often reported the availability of, and access to, a rest area in their company, compared to those in the first and second trimesters.

Conclusion:  The lifestyle factors of the pregnant women were different, based on their work situation. In particular, the employed pregnant women had a shorter daytime sleep duration. The pregnant women who stopped working during their pregnancy could have benefited from mental health support. In addition, the reasons for stopping work during pregnancy were different in the three trimesters. A flexible system is needed for working women that adapts to the physical changes that occur during pregnancy.
Decrease in Reduced‐Form Albumin Among Chronic Kidney Disease Patients: New Insights in Cardiovascular Complications
Authors: Terawaki Hiroyuki , Era Seiichi , Nakayama Masaaki , Hosoya Tatsuo
Published: January 2011

From the perspective of free cysteine residue (Cys‐34), human serum albumin (HSA) comprises a mixture of human mercaptoalbumin (HMA), in which the Cys‐34 is not oxidized, human non‐mercaptoalbumin (HNA)‐1, which has a disulfide bond that can be reversibly oxidized, mainly by cysteine, and HNA‐2, which is strongly oxidized to form sulfinic (‐SO2H) or sulfonic (‐SO3H) species. We have developed a convenient high‐performance liquid chromatographic (HPLC) system for the clear separation of HSA into HMA, HNA‐1 and HNA‐2, and we have studied the dynamic changes of HSA‐redox under various states of chronic kidney disease, in both a clinical and an experimental setting. In this article, we discuss the relationship between HSA‐redox (especially the decrease of the reduced form), dialyzable uremic toxins and incident cardiovascular disease based on our recent investigations.
Vitamin D Receptor Activator Reduces Oxidative Stress in Hemodialysis Patients With Secondary Hyperparathyroidism
Authors: Tanaka Motoko , Tokunaga Koki , Komaba Hirotaka , Itoh Kazuko , Matsushita Kazutaka , Watanabe Hiroshi , Kadowaki Daisuke , Maruyama Toru , Otagiri Masaki , Fukagawa Masafumi
Published: January 2011

Treatment with a vitamin D receptor activator (VDRA) has survival benefits probably related to its effects beyond the traditional role in mineral metabolism. We hypothesized that VDRA reduces oxidative stress in hemodialysis (HD) patients. To test this hypothesis, we investigated the effect of VDRA on the oxidative status of albumin in HD patients with secondary hyperparathyroidism. Eleven HD patients with secondary hyperparathyroidism were treated with calcitriol at an intravenous dose of 1.5 µg/week for four weeks. Serum intact parathyroid hormone, calcium and phosphorus were monitored and we measured the amount of oxidized albumin and albumin hydroperoxides form before and after calcitriol treatment. The ratio of oxidized to un‐oxidized albumin was determined as a representative marker of oxidative stress. The radical scavenging activity of albumin was also evaluated. After four weeks of calcitriol therapy, there were no significant changes in serum intact parathyroid hormone, calcium, or phosphorus levels; however, the ratio of oxidized to un‐oxidized albumin was markedly decreased and serum thiol content was significantly increased after calcitriol treatment. Furthermore, the radical scavenging activity of albumin was greater after calcitriol treatment compared with that of untreated albumin. Our data suggest that intravenous calcitriol treatment reduces oxidative stress and strengthens antioxidant defenses by inhibiting albumin oxidation in HD patients with secondary hyperparathyroidism.
Claudin‐6 is of Limited Sensitivity and Specificity for the Diagnosis of Atypical Teratoid/Rhabdoid Tumors
Authors: Antonelli Manila , Hasselblatt Martin , Haberler Christine , Di Giannatale Angela , Garrè Maria L. , Donofrio Vittoria , Lauriola Libero , Ridola Vita , Arcella Antonella , Frühwald Michael , Giangaspero Felice
Published: January 2011

Recent gene expression microarray analyses have indicated that claudin‐6 is specifically expressed in atypical teratoid rhabdoid tumors (AT/RTs), suggesting a role as a positive diagnostic marker in addition to SMARCB1 (INI1) loss, which is encountered in the majority of AT/RTs. In order to investigate the potential of claudin‐6 as a diagnostic marker, expression was investigated in 59 AT/RTs and 60 other primary central nervous system (CNS) tumors, including primitive neuroectodermal tumors, medulloblastomas, choroid plexus tumors, and both pediatric and adult low‐ and high‐grade gliomas using immunohistochemistry. Claudin‐6 was expressed in 17/59 AT/RTs (29%), but also in a variety of other primary CNS tumors, including 60% of medulloblastomas and 21% of malignant gliomas. Even though high staining scores (2+ or 3+) were more often encountered in AT/RTs (Chi‐square 4.177; P = 0.041), the overall frequency of claudin‐6 staining was not significantly higher in AT/RTs as compared with the other tumors (17/59 vs. 16/60; Chi‐square = 0.328; P = 0.567). In a subgroup of 43 AT/RT patients, of which follow‐up data were available, claudin‐6 expression did not show any correlation with survival. In conclusion, claudin‐6 immunohistochemistry is of limited sensitivity and specificity for the diagnosis of AT/RT and does not correlate with clinical behavior.
Blood Pressure Effects of Naproxcinod in Hypertensive Patients
Authors: Townsend Raymond , Bittar Neville , Rosen Jeffrey , Smith William , Ramsay Andrea , Chrysant Steven G. , Weiss Robert , Pivodic Aldina , Duquesroix Brigitte , Djian Jacques
Published: January 2011

The blood pressure (BP) effects of naproxcinod and naproxen were assessed in an 8‐week, double‐blind, crossover study in 131 hypertensive patients aged 50 to 74 years. Patients received naproxcinod 750 mg twice daily or naproxen 500 mg twice daily, then the alternate treatment, each for 14 days, with placebo run‐in/washout before each active treatment period and 24‐hour ambulatory BP monitoring conducted before and after each active treatment period. Mean change from baseline in average 24‐hour systolic BP (SBP) after 2 weeks of treatment numerically favored naproxcinod 750 mg twice daily (least‐squares [LS] mean for naproxcinod minus naproxen: −1.6 mm Hg; P=.12). Post hoc analyses showed statistically significant SBP differences favoring naproxcinod for the 8 elapsed hours (LS mean: −4.4 mm Hg; P<.0001) and the 24 hours following morning dosing (LS mean: −2.4 mm Hg; P=.006). Naproxcinod may be a beneficial alternative for patients with osteoarthritis requiring nonsteroidal anti‐inflammatory drugs. J Clin Hypertens (Greenwich). 2011;13:376–384. ©2011 Wiley Periodicals, Inc.
First report of chromosome numbers and karyotypes of two monotypic genera endemic to eastern Asia: Brachystemma (Caryophyllaceae) and Craspedolobium (Fabaceae)
Authors: Xu Jin , Yin Zhi‐Jian , Funamoto Tsuneo , Peng Hua
Published: January 2011

The chromosome numbers and karyotypes of Brachystemma and Craspedolobium, two monotypic genera endemic to eastern Asia, are reported here for the first time. The somatic chromosome numbers are 2n=40 for Brachystemma calycinum and 2n=22 for Craspedolobium unijugum. A karyotype of 2n=2x=40=28m+12sm was found in B. calycinum and that of 2n=2x=22=12m+10sm in C. unijugum, both of them have a moderately symmetrical karyotype type 2B and small‐sized chromosomes. Brachystemma has a unique basic chromosome number in Alsinoideae, which may support its isolated taxonomic position. As do some morphological characters, the basic chromosome number x=11 suggests that Craspedolobium belongs in the Millettioid clade.
A taxonomic revision of the Sempervivum davisii complex (Crassulaceae)
Authors: Karaer Fergan , Celep Ferhat , Eggli Urs
Published: January 2011

A revision of four Sempervivum species (S. artvinense, S. brevipetalum, S. davisii and S. furseorum) based on field observation and examination of herbarium specimens (including the type specimens of all names) is presented. Examination of critical diagnostic characters showed that S. artvinense, S. brevipetalum and S. furseorum fall within the variability of S. davisii and should be subsumed as synonyms under this name. Sempervivum furseorum shows minor but consistent morphological and ecological differences as well as a disjunct distribution and is therefore treated as S. davisii ssp. furseorum. Moreover, an amended and expanded description of the species is presented, with notes on distribution, phenology and ecology.
Coping and disability: evidence from a developing country
Authors: SLIM Zeinab N. , DOWLI Alexander , CHAAYA Monique , MAHFOUD Ziyad , UTHMAN Imad
Published: January 2011

Aim:  In view of the increasing burden of musculoskeletal‐related disability, the growing number of older persons and the scarcity of research on musculoskeletal conditions in the Eastern Mediterranean region, coping with musculoskeletal problems deserves special attention. This paper examines how good coping links to musculoskeletal‐related disability among Lebanese citizens aged 15 years and older.

Methods:  The sample included 200 people living in southern Lebanon and who participated in the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) survey. Disability and coping were assessed using self‐reported questions. Covariates included demographics, musculoskeletal pain variables, and body mass index (BMI).

Results:  Around one‐third of the sample had lifetime functional disability due to musculoskeletal problems and 62% were coping well with their problems. Adjusted data showed that the odds of musculoskeletal‐related disability among individuals who were not coping well was 2.35 times the odds of disability among individuals who were coping well with 95% CI = 1.10–5.02.

Conclusion:  This study provides evidence of the importance of complementing pharmacological treatment with a cognitive‐behavioral approach for management of musculoskeletal problems.
Rheumatic‐musculoskeletal manifestations in type 2 diabetes mellitus patients in south India
Authors: MATHEW Ashish J. , NAIR Jayakumar B. , PILLAI Saran S.
Published: January 2011

Aim:  To determine the prevalence of rheumatic musculoskeletal disorders (RMSD) in type 2 diabetes mellitus (T2DM) and study their risk factors.

Methods:  Diagnosed patients of T2DM attending the diabetic clinic in a premier teaching institution in south India were interviewed and requested to mark their RMS pain sites on a mannequin and intensity of pain on a visual analogue scale (VAS). A complete RMS examination was done and diagnoses were noted. These RMSDs were compared with those in age‐ and sex‐matched, non‐diabetic individuals from the general population. Association of RMSD with variables was determined using Chi‐square test and multiple logistic regression models for risk factors were created using SPSS 17.0 software.

Results:  Prevalence of RMSD in 310 cases and controls was 42.58%; 95% CI: 37.08–48.08 and 31.61%; 95% CI: 26.43–36.79, respectively. RMS pain was marked by 194 individuals. Knee was the most common site of pain (33.4%). Prevalence of common RMSD was osteoarthritis knee (20.64%; 95% CI 16.14–25.16), frozen shoulder (16.45%; 95% CI: 12.32–20.58), diffuse idiopathic skeletal hyperostosis (14.52%; 95% CI: 10.6–18.44) and limited joint mobility (8.06%; 95% CI: 5.03–11.09). Age (P = 0.046), duration of T2DM (P < 0.001) and glycosylated hemoglobin (P < 0.001) were found to have significant associations with RMSD. In logistic regression analysis, duration (OR: 1.467; 95% CI: 1.210–1.779) and severity (OR: 1.354; 95% CI: 1.169–1.569) of T2DM were identified as the risk factors.

Conclusion:  Thorough RMS examination should be included as an integral part of care in T2DM patients.
A qualitative investigation into the effects of brief training in solution‐focused therapy in a social work team
Authors: Smith Ian C.
Published: January 2011

Objectives.  Previous research into the effectiveness of brief training in psychological therapies for non‐therapist health and social services workers has found mixed results regarding transferring learning into practice. Very few published studies have assessed the impact of such training in Solution‐Focused Brief Therapy (SFBT), despite such training being popular. This study explored the impact of brief SFBT training for a group of community‐based social workers.

Design.  A qualitative interview‐based design was used, with the researcher adopting an ethnographic stance to obtain a rich, detailed and focused account of events.

Methods.  Six social workers working with adults with intellectual disabilities took part in the study. All had attended a 2‐day workshop in SFBT 9 months previously. The interviews were transcribed and subjected to thematic analysis.

Results and Conclusions.  Factors affecting skill transfer included being able to practise, peer and organizational support, and perceived conflicts between SFBT and work role. Whilst specific trained techniques were not consistently adopted, most workers changed the style of their interaction with clients in simple ways which they reported resulted in benefits including improved communication, collaboration, and increased feelings of control and self‐efficacy for clients and workers. The findings suggest that in addition to peer and organizational support, trainees’ perceptions of the fit of the training with their work role may be a key factor in determining transfer. Recommendations are made for developing training for non‐therapists that focuses on helping change the style of their interactions rather than on learning to implement specific psychological therapy techniques.
Functional and developmental expression of a zebrafish Kir1.1 (ROMK) potassium channel homologue Kcnj1
Authors: Abbas Leila , Hajihashemi Saeed , Stead Lucy F. , Cooper Gordon J. , Ware Tracy L. , Munsey Tim S. , Whitfield Tanya T. , White Stanley J.
Published: January 2011

Non‐technical summary  Due to the conservation of developmental pathways and genetic material over the course of evolution, non‐mammalian ‘model organisms’ such as the zebrafish embryo are emerging as valuable tools to explore causes and potential treatments for human diseases. Ion channels are proteins that form pores and help to establish and control electrical gradients by allowing the flow of ions across biological membranes. A diverse range of key physiological mechanisms in every organ in the body depends on the activity of ion channels. In this paper, we show that a potassium‐selective channel that underlies salt reabsorption and potassium excretion in the human kidney is also expressed in zebrafish in cells that are important regulators of salt balance. Disruption of the channel's expression in zebrafish leads to effects on the activity of the heart, consistent with a role for this channel in the control of potassium balance in the embryo.