bluuebunny/crossref_metadata_2025 huggingface dataset:
Additional specimen of
Microraptor
provides unique evidence of dinosaurs preying on birds
Authors: O'Connor Jingmai , Zhou Zhonghe , Xu Xing
Published: November 2011

Preserved indicators of diet are extremely rare in the fossil record; even more so is unequivocal direct evidence for predator–prey relationships. Here, we report on a unique specimen of the small nonavian theropod
Microraptor gui
from the Early Cretaceous Jehol biota, China, which has the remains of an adult enantiornithine bird preserved in its abdomen, most likely not scavenged, but captured and consumed by the dinosaur. We provide direct evidence for the dietary preferences of
Microraptor
and a nonavian dinosaur feeding on a bird. Further, because Jehol enantiornithines were distinctly arboreal, in contrast to their cursorial ornithurine counterparts, this fossil suggests that
Microraptor
hunted in trees thereby supporting inferences that this taxon was also an arborealist, and provides further support for the arboreality of basal dromaeosaurids.
Release of serine/threonine-phosphorylated adaptors from signaling microclusters down-regulates T cell activation
Authors: Lasserre Rémi , Cuche Céline , Blecher-Gonen Ronnie , Libman Evgeny , Biquand Elise , Danckaert Anne , Yablonski Deborah , Alcover Andrés , Di Bartolo Vincenzo
Published: November 2011

Antigen recognition within immunological synapses triggers and sustains T cell activation by nucleating protein microclusters that gather T cell receptors (TCRs), kinases, and adaptors. Dissipation of these microclusters results in signal termination, but how this process is regulated is unclear. In this paper, we reveal that release of the adaptors SLP76 and GADS from signaling microclusters is induced by the serine/threonine protein kinase HPK1 and that phosphorylation of GADS plays a major role in this process. We found that HPK1 was recruited into microclusters and triggered their dissipation by inducing the phosphorylation of a threonine-containing motif of GADS, together with the previously described serine phosphorylation of SLP76. These events induced the cooperative binding of 14-3-3 proteins to SLP76–GADS complexes, leading to their uncoupling from the transmembrane adaptor LAT and consequently reducing microcluster persistence and activation-induced gene transcription. These results demonstrate that serine/threonine phosphorylation of multiple TCR-proximal effectors controls the stability of signaling microclusters, thereby determining the intensity of T cell responses.
E–N-cadherin heterodimers define novel adherens junctions connecting endoderm-derived cells
Authors: Straub Beate K. , Rickelt Steffen , Zimbelmann Ralf , Grund Christine , Kuhn Caecilia , Iken Marcus , Ott Michael , Schirmacher Peter , Franke Werner W.
Published: November 2011

Intercellular junctions play a pivotal role in tissue development and function and also in tumorigenesis. In epithelial cells, decrease or loss of E-cadherin, the hallmark molecule of adherens junctions (AJs), and increase of N-cadherin are widely thought to promote carcinoma progression and metastasis. In this paper, we show that this “cadherin switch” hypothesis does not hold for diverse endoderm-derived cells and cells of tumors derived from them. We show that the cadherins in a major portion of AJs in these cells can be chemically cross-linked in E–N heterodimers. We also show that cells possessing E–N heterodimer AJs can form semistable hemihomotypic AJs with purely N-cadherin–based AJs of mesenchymally derived cells, including stroma cells. We conclude that these heterodimers are the major AJ constituents of several endoderm-derived tissues and tumors and that the prevailing concept of antagonistic roles of these two cadherins in developmental and tumor biology has to be reconsidered.
Ketamine Activates Breathing and Abolishes the Coupling between Loss of Consciousness and Upper Airway Dilator Muscle Dysfunction
Authors: Eikermann Matthias , Grosse-Sundrup Martina , Zaremba Sebastian , Henry Mark E. , Bittner Edward A. , Hoffmann Ulrike , Chamberlin Nancy L.
Published: November 2011

Background

Procedural sedation is frequently performed in spontaneously breathing patients, but hypnotics and opioids decrease respiratory drive and place the upper airway at risk for collapse.

Methods

In a randomized, controlled, cross-over, pharmaco-physiologic study in 12 rats, we conducted acute experiments to compare breathing and genioglossus electromyogram activity at equianesthetic concentrations of ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist that combines potent analgesic with hypnotic action effects, versus propofol. In 10 chronically instrumented rats resting in a plethysmograph, we measured these variables as well as electroencephalography during five conditions: quiet wakefulness, nonrapid-eye-movement sleep, rapid eye movement sleep, and low-dose (60 mg/kg intraperitoneally) and high-dose ketamine anesthesia (125 mg/kg intraperitoneally).

Results

Ketamine anesthesia was associated with markedly increased genioglossus activity (1.5 to fivefold higher values of genioglossus electromyogram) compared with sleep- and propofol-induced unconsciousness. Plethysmography revealed a respiratory stimulating effect: higher values of flow rate, respiratory rate, and duty-cycle (effective inspiratory time, 1.5-to-2-fold higher values). During wakefulness and normal sleep, the δ (f = 6.51, P = 0.04) electroencephalogram power spectrum was an independent predictor of genioglossus activity, indicating an association between electroencephalographic determinants of consciousness and genioglossus activity. Following ketamine administration, electroencephalogram power spectrum and genioglossus electroencephalogram was dissociated (P = 0.9 for the relationship between δ/θ power spectrum and genioglossus electromyogram).

Conclusions

Ketamine is a respiratory stimulant that abolishes the coupling between loss-of-consciousness and upper airway dilator muscle dysfunction in a wide dose-range. Ketamine compared with propofol might help stabilize airway patency during sedation and anesthesia.
Comparison of muscle strength and in‐vivo muscle morphology in young children with haemophilia and those of age‐matched peers
Authors: STEPHENSEN D. , DRECHSLER W. , SCOTT O.
Published: November 2011

Summary.  Recent advances in imaging have enhanced our understanding of the morphological adaptations of muscle in response to disease and altered use. Adaptation in muscle morphology has been linked to changes in muscle strength. To date, no studies have compared muscle morphology and strength in young children with haemophilia to that of typically developing children. This study explored differences in muscle strength and morphology between typically developing and age and size‐matched boys aged 6–12 years with haemophilia and a history of recurrent haemorrhage in the ankle joint. Maximum muscle strength of the knee flexors (KF), extensors (KE), ankle dorsi (ADF) and plantar flexors (APF) was measured in 19 typically developing boys (Group 1) and 19 boys with haemophilia (Group 2). Ultrasound images of vastus lateralis (VL) and lateral gastrocnemius (LG) were recorded to determine muscle cross‐sectional area (CSA), thickness, width, fascicle length and pennation angle. Muscle strength of the KE, ADF and APF were significantly (P < 0.05) lower in Group 2 when compared with Group 1. Muscle CSA and width of VL were significantly smaller and pennation angles significantly larger in Group 2 (P < 0.05). Muscle CSA and thickness of LG were significantly (P < 0.05) smaller in Group 2. Linear regression showed that LG muscle CSA and thickness were significant (P < 0.01) predictors of APF muscle strength. Following ankle joint bleeding in young boys with haemophilia, secondary adaptations in muscle strength and morphology were observed, suggesting that muscle function is more impaired than current clinical evaluations imply.
The effects of repetitive alkaline/acid extractions of Saccharomyces cerevisiae cell wall on antioxidative and bifidogenic efficacy
Authors: Laugier Olga B. , Spasić Snezana D. , Mandić Vesna , Jakovljević Dragica , Vrvić Miroslav M.
Published: November 2011

The aim of our study was to investigate the effects of consecutive alkaline/acid extraction of cell wall of baker’s yeast (Saccharomyces cerevisiae) on products digestibility and antioxidative and bifidogenic activity. Fractions with different glucan content (49.30%, 75.54%, 93.15% and 99.54%) were isolated by alkaline/acid extraction. The digestibility of fractions in artificial saliva, gastric or pancreatic juice was low and inversely proportional to (1→3),(1→6)‐β‐d‐glucan content. Surprisingly, high (1→3),(1→6)‐β‐d‐glucan content extracts did not show any antioxidative activity, while fractions low with glucan scavenged hydroxyl radicals. This indicates that previously suggested good antioxidative capacities of similar extracts are not based on the capability of glucans to remove free radicals. In contrast, bifidogenic effects were most prominent for extract showing the highest glucan content. In conclusion, S. cerevisiae cell wall extract with high (1→3),(1→6)‐β‐d‐glucan content may represent a candidate for a food additive with prebiotic but not antioxidative effects.
Reasons for living among older male Chinese residents of veterans’ homes
Authors: Tsai Yun‐Fang , Wong Thomas K.S. , Ku Yan‐Chiou , Liu Wen‐Chien
Published: November 2011

tsai y‐f., wong t.k.s., ku y‐c. & liu w‐c. (2012) Reasons for living among older male chinese residents of veterans’ homes. Journal of Advanced Nursing68(9), 1978–1987.

Aim.  The purpose of this paper was to report a study of reasons for living among older male residents of veterans’ homes in Taiwan.

Background.  Suicide rates are high for older persons worldwide. Little is known about protective factors against suicide among elderly Chinese populations.

Method.  A qualitative descriptive design was used. Two veterans’ homes, one government paid and one self‐paid, were randomly selected from 18 institutions throughout Taiwan. Participants were 36 residents (≥65 years) who had expressed suicidal ideas in the past 6 months but had never shown suicidal behaviours. Data were collected in individual interviews from 2006 to 2007 and analysed by content analysis.

Results.  Five major themes related to reasons for living were identified: fear of death, comparative improvement in health condition, maintaining self‐dignity, family related concerns and concerns for staff.

Conclusion.  Fear of death, maintaining self‐dignity and family related concerns are similar to reasons for living found in western studies, but not comparatively better health and concerns for staff. These differences may be due to our sample being veterans’ home residents rather than community‐dwelling elders and residents’ perceived social support from staff. Since most healthcare providers are nurses and nurses’ aides, they may consider promoting/maintaining older people’s health, promoting their self‐dignity, and strengthening relationships with family members and staff to strengthen protective factors against suicide in older Chinese/Asians. Given the aging population worldwide, nurses should become aware of protective factors related to suicide among older people to improve care for this population.
A comparison between micro‐CT and histology for the evaluation of cortical bone: effect of polymethylmethacrylate embedding on structural parameters
Authors: PARTICELLI F. , MECOZZI L. , BERAUDI A. , MONTESI M. , BARUFFALDI F. , VICECONTI M.
Published: November 2011

Cortical bone microstructure is an important parameter in the evaluation of bone strength. The aim of this study was to validate the characterization of human cortical bone microarchitecture using microcomputed tomography. In order to do this, microcomputed tomography structural measurements were compared with those obtained through histological examination (the gold standard). Moreover, to calculate structural parameters, microcomputed tomography images have to be binarized with the separation between bone and nonbone structures throughout a global thresholding. As the effect of the surrounding medium on the threshold value is not clear, an easy procedure to find the global uniform threshold for a given acquisition condition is applied. This work also compared the structural parameters of microcomputed tomography cortical sample scan in air or embedded in polymethylmethacrylate; histology was used as a reference. For each acquisition condition, a fixed threshold value was found and was applied on the corresponding microcomputed tomography image for the parameters assessment.

Twenty cortical bone samples were collected from human femur and tibia diaphyses. All samples were microcomputed tomography scanned in air, embedded in polymethylmethacrylate, rescanned by microcomputed tomography, examined by histology and finally compared.

A good correspondence between the microcomputed tomography images and the histological sections was found. Paired comparisons in cortical porosity, Haversian canal diameter and Haversian canal separation between histological sections and microcomputed tomography cross sections, first in air and then embedded in PolyMethylMethAcrylate, were made: no significant differences were found. None of the comparisons showed significant differences for cortical porosity, Haversian canal diameter and Haversian separation over a three‐dimensional volume of interest, between microcomputed tomography scans in air and with samples embedded in PolyMethylMethAcrylate.

The very good correlation between bone structural measures obtained from microcomputed tomography datasets and from two‐dimensional histological sections confirms that microcomputed tomography may be an efficient tool for the characterization of cortical bone microstructure. Moreover, when the corresponding threshold value for each condition is used, structural parameters determined by microcomputed tomography are not affected by the surrounding medium (PolyMethylMethAcrylate).
Estimating selfing rates from reconstructed pedigrees using multilocus genotype data
Authors: WANG JINLIANG , EL‐KASSABY YOUSRY A. , RITLAND KERMIT
Published: November 2011

Several methods have been developed to estimate the selfing rate of a population from a sample of individuals genotyped for several marker loci. These methods can be based on homozygosity excess (or inbreeding), identity disequilibrium, progeny array (PA) segregation or population assignment incorporating partial selfing. Progeny array–based method is generally the best because it is not subject to some assumptions made by other methods (such as lack of misgenotyping, absence of biparental inbreeding and presence of inbreeding equilibrium), and it can reveal other facets of a mixed‐mating system such as patterns of shared paternity. However, in practice, it is often difficult to obtain PAs, especially for animal species. In this study, we propose a method to reconstruct the pedigree of a sample of individuals taken from a monoecious diploid population practicing mixed mating, using multilocus genotypic data. Selfing and outcrossing events are then detected when an individual derives from identical parents and from two distinct parents, respectively. Selfing rate is estimated by the proportion of selfed offspring in the reconstructed pedigree of a sample of individuals. The method enjoys many advantages of the PA method, but without the need of a priori family structure, although such information, if available, can be utilized to improve the inference. Furthermore, the new method accommodates genotyping errors, estimates allele frequencies jointly and is robust to the presence of biparental inbreeding and inbreeding disequilibrium. Both simulated and empirical data were analysed by the new and previous methods to compare their statistical properties and accuracies.
Assessment of gastric motor function in childhood functional dyspepsia and obesity
Authors: Hoffman I. , Tack J.
Published: November 2011

Background  The aim was to compare gastric emptying rate and nutrient tolerance during a satiety drinking test in children with functional dyspepsia (FD) and obesity and to study the relationship between daily caloric intake and the satiety drinking test.

Methods  A total of 28 dyspeptic children (22 girls, mean age 12.5 ± 3.1 years) and 15 obese children (five girls, 13.3 ± 1.8 years) were studied. The patients underwent an octanoic acid gastric emptying breath test and a satiety drinking test. Prior to both tests, a dyspepsia questionnaire was filled out to calculate the mean calorie intake.

Key Results  The most prevalent dyspeptic symptoms were early satiety (96.4%), postprandial fullness (89.2%), and epigastric pain (78.6%), followed by nausea (50%). All dyspeptic and obese children (n = 43) started the satiety drinking test and 41 children completed the test until a score of 5 was reached. The maximum ingested volume in FD was significantly lower than in obesity or in age‐matched healthy controls (252 ± 85 vs 479 ± 199 and 359 ± 29 mL respectively, both P < 0.05). As a group, dyspeptic children had significantly slower gastric emptying than obese children (89.7 ± 54.8 min vs 72.5 ± 26.0 min, P = 0.05). Daily calorie intake was significantly higher in obese children than that in dyspeptic children (2325 ± 469 vs 1503 ± 272 cal, P < 0.0001). The endpoint of the satiety drinking test was significantly correlated with body weight or BMI (both R = 0.41, P = 0.04), but not with daily calorie intake, gastric emptying rate or age.

Conclusions & Inferences  The satiety drinking test is a potentially useful non‐invasive tool in the investigation of children with FD and obesity.
Role of new bacterial surfactins in the antifungal interaction between Bacillus amyloliquefaciens and Fusarium oxysporum
Authors: Vitullo D. , Di Pietro A. , Romano A. , Lanzotti V. , Lima G.
Published: November 2011

The aim of this work was to investigate the major mechanisms involved in antagonism of BO7, a novel strain of Bacillus amyloliquefaciens isolated from orchard soil, against the vascular wilt fungus Fusarium oxysporum f. sp. lycopersici (Fol). BO7 markedly reduced the incidence of Fol vascular wilt on tomato plants and displayed strong in vitro inhibitory activity against Fol. Scanning electron microscopy demonstrated the ability of BO7 cells to adhere to fungal hyphae and to efficiently colonize tomato roots. The low molecular weight fraction of BO7 culture filtrate displayed high antifungal activity against Fol, resulting in growth inhibition and dramatic alterations of hyphal morphology. Three structurally related surfactin lipopeptides, identified as the major components of the bioactive fraction, were assayed for their inhibitory activity against Fol. One of these compounds exerted a strong and uncommon antifungal activity for lipopeptides of the surfactin family, accounting for most of the inhibitory activity of the BO7 culture filtrate. Among a collection of Fol knockout isolates tested, mutants altered in cell wall structure showed increased sensitivity to the bacterial compounds. These results suggest that the fungal cell wall might have a key role in the sensitivity of Fol towards bacterial surfactins from B. amyloliquefaciens.
Eosinophilic airway inflammation is increased in children with asthma and food allergies
Authors: Kulkarni Neeta , Ragazzo Vincenzo , Costella Silvia , Piacentini Giorgio , Boner Attilio , O’Callaghan Christopher , Fiocchi Alessandro , Kantar Ahmad
Published: November 2011

To cite this article: Kulkarni N, Ragazzo V, Costella S, Piacentini G, Boner A, O’Callaghan C, Fiocchi A, Kantar A. Eosinophilic airway inflammation is increased in children with asthma and food allergies. Pediatric Allergy Immunology 2012: 23: 28–33.

Background:  Asthma is associated with food allergies in a significant number of children, with evidence linking allergies to asthma severity and morbidity. In this study, we tested our hypothesis that the eosinophilic lower airway inflammation is higher in asthmatic children with food allergies.

Aims:  The aims of the study were to compare the eosinophilic inflammatory markers in asthmatic children with and without food allergies.

Materials and Methods:  Children with asthma, with (n = 22) and (n = 53) without food allergies were included. All subjects were classified according to the GINA guidelines (2009) and had received at least 3 months of anti‐inflammatory therapy prior to testing. Fractional exhaled nitric oxide and sputum differential counts were performed using standard techniques.

Results:  Children with asthma and food allergies had significantly higher fractional exhaled nitric oxide median (range) [(22.4 (6.1–86.9) vs. 10.3 (2.7–38.7) (p = 0.01)] and sputum eosinophil percentage [15.5 (5.0–53.0) vs. 2.0 (0–20) (p < 0.001)] compared with asthmatic children without allergies.

Conclusion:  These results suggest that the children with asthma and food allergies have increased eosinophilic inflammation of the airways.
The IgE repertoire in children and adolescents resolved at component level: A cross‐sectional study
Authors: Melioli Giovanni , Marcomini Laura , Agazzi Alessia , Bazurro Gyada , Tosca Mariangela , Rossi Giovanni A. , Minale Paola , Rossi Renato , Reggiardo Giorgio , Canonica Giorgio W. , Passalacqua Giovanni
Published: November 2011

To cite this article: Melioli G, Marcomini L, Agazzi A, Bazurro G, Tosca M, Rossi GA, Minale P, Rossi R, Reggiardo G, Canonica GW, Passalacqua G. The IgE repertoire in children and adolescents resolved at component level: A cross‐sectional study.  Pediatr Allergy Immunol 2012: 23: 433–440.

Background:  It is well known that allergy evolves at clinical level from the birth to adulthood, and this has been clearly demonstrated also at a level of sensitization. However, little information is available on the evolution of the IgE repertoire directed to single allergenic components. In this cross‐sectional, observational study, the evolution of the IgE repertoire was analysed at component level.

Methods:  Serum samples from 901 allergic patients, stratified in 6 groups according to age, were analysed by ImmunoCAP ISAC, a microarray chip that allows to identify the presence of specific IgE towards 103 different allergen components. Total IgE were also evaluated.

Results:  The behaviour of total IgE according to age strictly paralleled that of the sum of specific IgE directed to molecular components. As expected, food‐related components (in particular those of milk and egg) were the most frequently recognized in the earliest ages, whereas specific IgE to plant allergens appeared invariably later. Nonetheless, IgE specific to mite components was the most represented in all age classes. Of note, specific IgE against cross‐reacting allergens was virtually absent in the first years and tended to appear only after the age of 6.

Conclusion:  Despite this was not a study performed on a cohort of patients followed up from birth to adolescence, the molecular patterns of allergen recognition resulted modified according to age. These findings may support, at molecular level, the clinical features of the allergic march.
Exuberant Mucometra Associated with Atresia of the Cervix in a Queen
Authors: Batista‐Arteaga M , Santana M , Espinosa‐de‐los‐Monteros A , Déniz S , Alamo D , Herráez P
Published: November 2011

Contents

This short communication reports the clinical, ultrasonographic and histopathological findings in a cat with atresia of the uterine cervix and mucometra. After 6 months of continuous oestrous behaviour, a remarkable abdominal enlargement was observed in a 14‐year‐old queen. A presumptive diagnosis of mucometra was concluded after the ultrasound evaluation and based on clinical signs and blood analyses. Ovariohysterectomy revealed a notable symmetrical distension (4–5 cm in diameter) of both uterine horns that were filled with fluid (690 ml); microbiological analyses confirmed the aseptic nature of the uterine fluid. Ovarian follicular cysts and cystic subsurface epithelial structures, >1.5 cm in diameter, were present in both ovaries and no corpora lutea were observed. Gross and microscopic evaluation of the uterus confirmed the development of cystic endometrial hyperplasia and the absence of an internal cervical os. The endometrial hyperplasia and mucometra could have developed as a consequence of repeated oestrogenic stimulation.
A comparison of nurses' perceptions of elective laparoscopic or elective open colorectal resections
Authors: Richardson Gillian , Whiteley Ian
Published: November 2011

Richardson G, Whiteley I. International Journal of Nursing Practice 2011; 17: 621–627

A comparison of nurses' perceptions of elective laparoscopic or elective open colorectal resections

The purpose of this study was to develop an instrument to measure the perceived benefits nurses observe in the recovery of patients who have undergone elective laparoscopic colorectal resections vs. traditional open elective colorectal resections. Secondly, to determine if there are perceived differences in the intensity of nursing required to care for these patients. A twenty‐three‐point questionnaire was developed and distributed to 23 colorectal nurses working in a single tertiary referral hospital. There was an 83.6% response rate. The findings demonstrate that the participants believe there are significantly better outcomes for the laparoscopic patients in the postoperative period. These benefits include more rapid resumption of independence, decreased pain and fewer complications. The nurses also perceived less time and effort was required when caring for these patients.
Effect of Scotch broom, Cytisus scoparius, pod size and patch density on Exapion fuscirostre (Coleoptera, Apionidae) seed weevil oviposition
Authors: Rodriguez Erik , Peco Begoña , Gurrea M Pilar
Published: November 2011

Cytisus scoparius (L) Link (Fabaceae) is a broom species of European origin introduced both accidentally and as an ornamental plant to Australia, New Zealand and America, where it is classified as a noxious invasive species. One of its main seed predators is Exapion (Exapion) fuscirostre (Fabricius), a weevil with a Palearctic distribution and which has been introduced to United States and New Zealand as a biological control agent. Factors influencing the insect's choice of oviposition location are crucial for the plant's reproductive success. We examined E. fuscirostre oviposition on the host plant, C. scoparius, in the European Mediterranean region. We analysed the effect of pod size, seed abortion rate and host plant patch density on seed infestation rate. Oviposition was greater in patches with low‐medium plant densities. Oviposition was also negatively related with seed abortion rate per pod and the rate of infestation by other seed‐eating insects. Pod dimensions, particularly width, were positively related with E. fuscirostre oviposition.
Invasive colorectal cancer within 5 years of negative colonoscopy in a Japanese population
Authors: Horiuchi A. , Nakayama Y. , Kajiyama M. , Kamijima T. , Tanaka N.
Published: November 2011

Aim  Colonoscopy provides imperfect protection against colorectal cancer (CRC).

In an attempt to improve cancer detection we evaluated the clinical features of invasive CRC detected within 5 years of a negative colonoscopy.

Method  The details of colonoscopies performed in a rural hospital in Japan were prospectively recorded at the time of the examination. The patients were followed over 5 years for the subsequent occurrence of cancer.

Results  In a 5‐year period, 10 148 patients underwent colonoscopy and 202 without previous colonoscopy were diagnosed with invasive CRC. Of 3212 patients with a colonoscopy negative for cancer, nine developed invasive cancer within 5 years. The ratios for invasive CRC detected without/with previous colonoscopy were 60:1 in the rectum, 54:1 in the sigmoid colon, 15:1 in the descending colon, 28:0 in the transverse colon, 31:5 in the ascending colon and 14:1 in the caecum (P = 0.041). The ratio between left‐ and right‐sided colonic cancer was also significantly different (129:3 and 45:6, P = 0.0078). Six (67%) of the invasive CRCs were in the ascending colon or caecum. Five of six patients with invasive CRC in the ascending colon and caecum had right‐sided small adenomas at prior colonoscopy.

Conclusion  The majority of early/missed CRCs were right‐sided and associated with prior right‐sided colonic adenomas. Repeated colonoscopy of patients with right‐sided adenomas at a shorter surveillance interval deserves consideration.
A 10‐year experience of total pelvic exenteration for primary advanced and locally recurrent rectal cancer based on a prospective database
Authors: Nielsen M. B. , Rasmussen P. C. , Lindegaard J. C. , Laurberg S.
Published: November 2011

Aim  The study was conducted in a dedicated centre treating the majority of Danish patients with intended curative total pelvic exenteration for primary advanced (PARC) or locally recurrent (LRRC) rectal cancer. We compared PARC and LRRC and analysed postoperative morbidity and mortality, and long‐term outcome.

Method  There were 90 consecutive patients (PARC/LRRC 50/40) treated between January 2001 and October 2010, recorded on a prospectively maintained database.

Results  The median age was 63 (32–75) years with a gender ratio of 7 women to 83 men. All patients were American Society of Anesthesiologists level I or II. Sacral resection was performed in five patients with PARC and 15 with LRRC (P = 0.002). R0 resection was achieved in 33 (66%) patients with PARC and in 15 (38%) with LRRC, R1 resection in 17 (34%) with PARC and 20 (50%) with LRRC and R2 resection in five (13%) with LRRC. R0 resection was more frequent in PARC (P = 0.007). Forty‐four (49%) patients had no postoperative complications. Fifty‐five major complications were registered. Two (2.2%) patients died within 30 days, and the total in‐hospital mortality was 5.6%. The median follow‐up was 12 (0.4–91) months. The 5‐year survival was 46% for PARC and 17% for LRRC (P = 0.16).

Conclusion  Pelvic exenteration is associated with considerable morbidity but low mortality in an experienced centre. Pelvic exenteration can improve long‐term survival, especially for patients with PARC. However, pelvic exenteration is also justified for patients with LRRC.
Local recurrence of rectal cancer: a population‐based cohort study of diagnosis, treatment and outcome
Authors: Kodeda K. , Derwinger K. , Gustavsson B. , Nordgren S.
Published: November 2011

Aim  Local recurrence is an important endpoint of rectal cancer treatment, but details of this form of treatment failure are less well described. The aim of this study was to acquire deeper knowledge of local recurrence regarding symptoms, diagnostic work‐up, clinical management, health‐care utilization and outcome.

Method  Of 671 patients with rectal cancer, 57 were diagnosed with local recurrence within 5 years after surgery. Their records were analysed.

Results  At diagnosis of local recurrence 49 (86%) of 57 patients were symptomatic and 40 (70%) were diagnosed between scheduled follow‐up visits. The predominant symptom was pain. Forty‐five of the 57 (79%) had a palpable tumour. Most were deemed incurable at presentation and 10 (18%) were operated on with curative intent. Five years after the initial rectal cancer surgery, two patients were alive, with one free of disease. Despite the need for multiple interventions, including surgery, only four out of 40 patients were classified as being well‐palliated in the terminal stage.

Conclusion  Follow‐up after rectal cancer surgery by annual clinical examination is not sufficient to detect local recurrence when it is asymptomatic. Local recurrence of rectal cancer is often associated with intractable symptoms. These patients require frequent interventions and can rarely be cured if diagnosed at an advanced stage. Strategies for early detection of local recurrence and the management thereof require improvement.
Patterns of School Readiness Forecast Achievement and Socioemotional Development at the End of Elementary School
Authors: Sabol Terri J. , Pianta Robert C.
Published: November 2011

A person‐oriented approach examined patterns of functioning in social and executive function domains at 54 months and in turn forecasted 5th‐grade socioemotional and achievement outcomes for 944 children. Six distinct profiles of 54‐month school readiness patterns predicted outcomes in 5th grade with indications of cross‐domain association between 54‐month performance and later functioning. A group of children at 54 months characterized by low working memory exhibited elevated levels of socioemotional problems and low achievement in 5th grade. Patterns in which high social competence or high working memory were prominent predicted high 5th‐grade achievement. Unexpectedly, a group distinguished by attention problems performed well on later achievement outcomes. After controlling for children’s early demographics, readiness profiles accounted for math achievement in 5th grade.
Effects of in utero antiretroviral exposure on mitochondrial DNA levels, mitochondrial function and oxidative stress
Authors: Ross AC , Leong T , Avery A , Castillo‐Duran M , Bonilla H , Lebrecht D , Walker UA , Storer N , Labbato D , Khaitan A , Tomanova‐Soltys I , McComsey GA
Published: November 2011

Objectives

HIV and antiretroviral (ART) exposure in utero may have deleterious effects on the infant, but uncertainty still exists. The objective of this study was to evaluate aspects of mitochondrial DNA (mtDNA) content, mitochondrial function and oxidative stress simultaneously in placenta, umbilical cord blood and infant blood in HIV/ART‐exposed infants compared with uninfected controls.

Methods

HIV‐1‐infected pregnant women and HIV‐1‐uninfected healthy pregnant controls were enrolled in the study prospectively. Placenta and umbilical cord blood were obtained at delivery and infant blood was obtained within 48 h of delivery. mtDNA content was determined for each specimen. Nuclear [subunit IV of cytochrome c‐oxidase (COX IV)]‐ and mitochondrial (COX II)‐encoded polypeptides of the oxidative phosphorylation enzyme cytochrome c‐oxidase were quantified in cord and infant blood. Placental mitochondria malondialdehyde (MDA) concentrations were measured as a marker of oxidative stress.

Results

Twenty HIV‐positive/HIV‐exposed and 26 control mother–infant pairs were enrolled in the study. All HIV‐infected women and their infants received ART. Placental MDA concentration and mtDNA content in placenta and cord blood were similar between groups. The cord blood COX II:IV ratio was lower in the HIV‐positive group than in the controls, whereas the infant peripheral blood mtDNA content was higher in the HIV‐exposed infants, but the infant peripheral blood COX II:IV ratio was similar. No infant had clinical evidence of mitochondrial disease or acquired HIV infection. In multivariable regression analyses, the significant findings in cord and infant blood were both most associated with HIV/ART exposure.

Conclusions

HIV‐exposed infants showed reduced umbilical cord blood mitochondrial enzyme expression with increased infant peripheral blood mitochondrial DNA levels, the latter possibly reflecting a compensatory mechanism to overcome HIV/ART‐associated mitochondrial toxicity.
Incentivized recruitment of a population sample to a mobile HIV testing service increases the yield of newly diagnosed cases, including those in need of antiretroviral therapy
Authors: Kranzer K , Govindasamy D , van Schaik N , Thebus E , Davies N , Zimmermann MA , Jeneker S , Lawn SD , Wood R , Bekker L‐G
Published: November 2011

Objective

The aim of the study was to compare the yields of newly diagnosed cases of HIV infection and advanced immunodeficiency between individuals attending a mobile HIV counselling and testing (HCT) service as participants in a population‐based HIV seroprevalence survey and those accessing the same service as volunteers for routine testing.

Methods

The study was conducted in a peri‐urban township within the Cape Metropolitan Region, South Africa. Survey participants (recruited testers) were randomly selected, visited at home and invited to attend the mobile HCT service. They received 70 South African Rand food vouchers for participating in the survey, but could choose to test anonymously. The yield of HIV diagnoses was compared with that detected in members of the community who voluntarily attended the same HIV testing facility prior to the survey and did not receive incentives (voluntary testers).

Results

A total of 1813 individuals were included in the analysis (936 recruited and 877 voluntary testers). The prevalence of newly diagnosed HIV infection was 10.9% [95% confidence interval (CI) 9.0–13.1%] among recruited testers and 5.0% (3.7–6.7%) among voluntary testers. The prevalence of severe immune deficiency (CD4 count ≤200 cells/μL) among recruited and voluntary testers was 17.8% (10.9–26.7%) and 4.6% (0.0–15.4%), respectively. Linkage to HIV care in recruited testers with CD4 counts ≤350 cells/μL was 78.8%.

Conclusion

Compared with routine voluntary HCT, selection and invitation in combination with incentives doubled the yield of newly diagnosed HIV infections and increased the yield almost fourfold of individuals needing antiretroviral therapy. This may be an important strategy to increase community‐based HIV diagnosis and access to care.
Cardiopulmonary effects of a new inspiratory impedance threshold device in acute hemorrhagic shock in dogs
Authors: Vigani Alessio , Shih Andre C. , Buckley Gareth J. , Londoño Leonel , Bandt Carsten
Published: November 2011

Objective

To compare cardiovascular and respiratory effects of an inspiratory impedance threshold device (ITD) in dogs before and after induction of acute hemorrhagic shock.

Study Design

Prospective experimental randomized study.

Animals

Eight healthy adult dogs.

Methods

Dogs were anesthetized and maintained on spontaneous ventilation. Tidal volume (VT), systolic, mean and diastolic arterial blood pressure (SAP, MAP, DAP), central venous pressure (CVP), gastric PCO2 (GBF) as an indicator of gastric perfusion, cardiac index (CI), systemic vascular resistance (SVR), oxygen delivery (DO2), and plasma lactate were monitored. To monitor respiratory compliance (RC) and respiratory resistance (ResR), animals were briefly placed on mechanical ventilation. Dogs were studied under 4 different conditions: (1) baseline (euvolemic state) (MAP > 60 mm Hg) with and without the ITD and (2) acute hemorrhagic shock (hypovolemic state) (target MAP of 40 mm Hg) with and without ITD. These 4 conditions were performed during one anesthetic period, allowing time for stabilization of parameters for each condition. Data were analyzed by ANOVA for repeated measure mixed models.

Results

No cardiovascular changes were detected between groups with and without use of ITD during euvolemic states. During acute hemorrhagic hypovolemic state, CI and DO2 were higher with the ITD (2.9 ± 0.6 L/min/m2) and (326.5 ± 86.8 mL/min) compared with no ITD (1.8 ± 0.6 L/min/m2) and (191.3 ± 58.1 mL/min), respectively. The use of ITD during hypovolemia also increased SAP and MAP. There was an increase in ResR and decreased RC with the ITD in both euvolemic and hypovolemic states.

Conclusion and clinical relevance

The use of an ITD in dogs during acute hemorrhagic hypovolemic shock improved cardiovascular parameters but had negative effects on RC and ResR.
Evaluation of coagulation status in dogs with naturally occurring canine hyperadrenocorticism
Authors: Klose Tyler C. , Creevy Kate E. , Brainard Benjamin M.
Published: November 2011

Objective

To determine whether or not there are differences in coagulation parameters (eg, thrombelastography [TEG], activated partial thromboplastin time [aPTT], prothrombin time [PT], and fibrinogen) among dogs with naturally occurring hyperadrenocorticism (HAC), dogs withHACundergoing medical management, and dogs withoutHAC.

Design

Prospective, observational study.

Setting

Veterinary teaching hospital.

Animals

Forty‐six client‐owned dogs undergoing adrenal function testing.

Interventions

None.

Measurements and Main Results

Nine dogs were diagnosed withHACde novo, 19 dogs were presented for therapeutic monitoring of previously diagnosedHAC, and 18 dogs did not haveHAC. Variables compared between groups were age, body weight, platelet count, mean platelet volume, serum concentrations of cholesterol, triglycerides, antithrombin,PT, aPTT, fibrinogen, andTEGparameters (eg, alpha angle,R,K, and maximum amplitude [MA]). Dogs withHACand dogs treated forHAChad higher serum cholesterol than dogs withoutHAC(P< 0.05). All groups had meanMAgreater than the institutional reference interval. There was a weak, positive correlation between hematocrit andMAthat was independent of diagnosis (r2= 0.266,P= 0.004).

Conclusions

The results of this study do not support the supposition that a significant difference exists in coagulation tendencies between dogs withHACprior to treatment, dogs withHACduring treatment, and dogs withoutHAC. This disagreement with the classically accepted notion thatHACleads to a hypercoagulable state could be due to a couple of possibilities. Namely, the link betweenHACand hypercoagulability may be relatively weak, or our findings may be the result of a typeIIerror either as a result of a small sample size or the use of coagulation assays that are insensitive to the effects ofHACon the hemostatic system.
YKL‐40 genetic polymorphisms and the risk of liver disease progression in patients with advanced fibrosis due to chronic hepatitis C
Authors: Fontana Robert J. , Litman Heather J. , Dienstag Jules L. , Bonkovsky Herbert L. , Su Grace , Sterling Richard K. , Lok Anna S. ,   for the HALT‐C Trial Group
Published: November 2011

Background/Aims

The aim of this study was to explore the association of a functional YKL‐40 promoter polymorphism (rs4950928) with baseline disease stage, response to antiviral therapy and risk of liver disease progression in a group of patients with chronic hepatitis C (CHC).

Methods

YKL‐40 promoter polymorphisms were determined in 456 Hepatitis C Antiviral Long‐term Treatment against Cirrhosis (HALT‐C) Trial patients with bridging fibrosis or cirrhosis entering a prerandomization lead‐in peginterferon/ribavirin 24‐week treatment phase and in 462 patients followed for a mean of 3.8 years after randomization to maintenance peginterferon or observation.

Results

Mean patient age was 49.5 years, 70.4% were men and 71.2% were Caucasian. The 17% frequency of the YKL‐40 minor allele (T) was similar to that reported in the general population. YKL‐40 genotype was associated significantly with baseline serum YKL‐40 levels but was not associated with the likelihood of a virological response following 24–48 weeks of peginterferon/ribavirin therapy. Serum YKL‐40 levels remained significantly lower during follow‐up in the randomized TT homozygotes compared with CT heterozygotes and CC homozygotes (P < 0.001). Despite this association, YKL‐40 genotype was not associated with the risk of clinical or histological liver disease progression.

Conclusions

A reduced frequency of the protective YKL‐40 promoter polymorphism was not observed in the HALT‐C Trial patient population. The absence of an association between YKL‐40 promoter polymorphisms and baseline liver disease severity as well as with the risk of liver disease progression over time suggests that this polymorphism is not associated with disease progression in CHC patients with established fibrosis.
Efficacy and Safety of MAP0004, Orally Inhaled DHE in Treating Migraines With and Without Allodynia
Authors: Tepper Stewart J. , Kori Shashidhar H. , Borland Scott W. , Wang Min H. , Hu Bin , Mathew Ninan T. , Silberstein Stephen D.
Published: November 2011

Background.— Central sensitization develops once migraine attacks become established and can be clinically detected by the development of cutaneous allodynia. The efficacy of triptans for migraine resolution has been shown to be markedly reduced when administered in patients with established cutaneous allodynia.

Objective.— The study aimed to evaluate the efficacy and safety of MAP0004, a novel, orally inhaled, form of dihydroergotamine, in patients with and without cutaneous allodynia at the time of treatment.

Methods.— This evaluation was a post hoc subanalysis of a randomized, double‐blind, placebo‐controlled, 2‐arm, phase 3, multicenter study. The presence or absence of baseline cutaneous allodynia at the time of drug administration was based on the response to a standard questionnaire. Treatment efficacy at 2 hours posttreatment was compared in patients with and without baseline allodynia.

Results.— At the time of treatment, allodynia was present in 216 patients treated with MAP0004 and 202 patients treated with placebo. MAP0004 treatment efficacy was superior to placebo, as measured by 2‐hour pain relief for patients with and without allodynia (P < .0001) and as measured by 2‐hour pain freedom for patients with (P < .0001) and without (P < .0002) allodynia. No significant within‐treatment differences after treatment with MAP0004 in patients with and without allodynia at baseline were observed. Patients were more likely to be allodynia‐free after treatment with MAP0004 compared with placebo (73% vs 66%, P = .0013). Furthermore, treatment with MAP0004 prevented the development of allodynia in patients not experiencing allodynia at baseline (P = .0057). MAP0004 was generally well tolerated.

Conclusions.— This post hoc subanalysis shows that MAP0004 was similarly effective in patients whether or not allodynia was present at treatment baseline. Patients were also more likely to be allodynia‐free following treatment of a migraine with MAP0004.
Investigation of Nonmechanical Findings during Spinal Movement Screening for Identifying and/or Ruling Out Metastatic Cancer
Authors: Cook Chad , Ross Michael D. , Isaacs Robert , Hegedus Eric
Published: November 2011

Study design:  Retrospective cohort study.

Objective:  To investigate the diagnostic accuracy of lumbar movement restrictions and pain in patients with metastatic bone cancer.

Background:  When evaluating patients with low back pain, physical therapists have used the presence of nonmechanical findings during a spinal movement screen as 1 factor in determining whether physician referral is necessary. There are no studies that have investigated the accuracy of this strategy in a situation of diagnostic uncertainty.

Methods:  This study included 1,109 patients (655 women) with low back pain (mean age = 54.8 ± 16.3 years) seen at a spine surgery center who received a clinical movement screen and an imaging‐supported diagnosis by an orthopedic surgeon. No report of pain during movement and no limitation of movement were considered the 2 targeted findings as these are associated with nonmechanical findings.

Results:  Sixty‐six patients were diagnosed with metastatic cancer, 61 with metastatic bone cancer and concomitant diagnoses. Pain‐free lumbar movements in all directions for patients with metastatic bone cancer without concomitant diagnoses were associated with a posttest probability of 0.00 (+likelihood ratio = 2.4; −likelihood ratio = 0.0), which may be useful in ruling out spinal cancer. In situations where a concomitant diagnosis was present with cancer, the value of a movement screen was poor.

Conclusion:  Nonmechanical findings during a traditional movement screen are not specific to sinister conditions such as metastatic spinal cancer. Clinicians should expect concomitant conditions to exhibit painful or limited findings in patients with and without cancer.