bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Acidic Sesquiterpenoids Constitute a Dominant Class of Pathogen-Induced Phytoalexins in Maize
Authors: Huffaker Alisa , Kaplan Fatma , Vaughan Martha M. , Dafoe Nicole J. , Ni Xinzhi , Rocca James R. , Alborn Hans T. , Teal Peter E.A. , Schmelz Eric A.
Published: June 2011

Nonvolatile terpenoid phytoalexins occur throughout the plant kingdom, but until recently were not known constituents of chemical defense in maize (Zea mays). We describe a novel family of ubiquitous maize sesquiterpenoid phytoalexins, termed zealexins, which were discovered through characterization of Fusarium graminearum-induced responses. Zealexins accumulate to levels greater than 800 μg g−1 fresh weight in F. graminearum-infected tissue. Their production is also elicited by a wide variety of fungi, Ostrinia nubilalis herbivory, and the synergistic action of jasmonic acid and ethylene. Zealexins exhibit antifungal activity against numerous phytopathogenic fungi at physiologically relevant concentrations. Structural elucidation of four members of this complex family revealed that all are acidic sesquiterpenoids containing a hydrocarbon skeleton that resembles β-macrocarpene. Induced zealexin accumulation is preceded by increased expression of the genes encoding TERPENE SYNTHASE6 (TPS6) and TPS11, which catalyze β-macrocarpene production. Furthermore, zealexin accumulation displays direct positive relationships with the transcript levels of both genes. Microarray analysis of F. graminearum-infected tissue revealed that Tps6/Tps11 were among the most highly up-regulated genes, as was An2, an ent-copalyl diphosphate synthase associated with production of kauralexins. Transcript profiling suggests that zealexins cooccur with a number of antimicrobial proteins, including chitinases and pathogenesis-related proteins. In addition to zealexins, kauralexins and the benzoxazinoid 2-hydroxy-4,7-dimethoxy-1,4-benzoxazin-3-one-glucose (HDMBOA-glucose) were produced in fungal-infected tissue. HDMBOA-glucose accumulation occurred in both wild-type and benzoxazine-deficient1 (bx1) mutant lines, indicating that Bx1 gene activity is not required for HDMBOA biosynthesis. Together these results indicate an important cooperative role of terpenoid phytoalexins in maize biochemical defense.
‘She’s Weird!’— The Social Construction of Bullying in School: A Review of Qualitative Research
Authors: Thornberg Robert
Published: June 2011

Qualitative research provides opportunities to study bullying and peer harassment as social processes, interactions and meaning‐making in the everyday context of particular settings. It offers the possibility of developing a deep understanding of the culture and group processes of bullying and the participants’ perspectives on peer harassment as well. It gives participants opportunities to discuss their own understanding and experiences of bullying in their own words. This article reviews qualitative studies on bullying or peer harassment in school (including some studies in which qualitative and quantitative methods — so‐called mixed methods — have been used).
Bullying, Social Power and Heteronormativity: Girls’ Constructions of Popularity
Authors: Duncan Neil , Owens Larry
Published: June 2011

Literature on girls’ popularity posits a strong association between popularity, social power and bullying behaviours, some of which conflate the concepts ‘bully’ and ‘popular’. This study explores that association through links to concepts of popularity among girls in two demographically different high schools. Data are presented that were derived from the application of Q methodology to the problem of comparing girls’ attributions of popularity. Twenty‐eight girls sorted items relating to attributes of popular girls. Despite the profound differences between the schools, all loaded heavily on one single factor: attractiveness to boys. The findings and the process have relevance for developing anti‐bullying work in classrooms.
Bullying in Context: Stories of Bullying on an Internet Discussion Board
Authors: Osvaldsson Karin
Published: June 2011

The paper examines how young people describe experiences of bullying when participating in an Internet community dedicated to young people experiencing mental health problems. The micro‐analytic focus demonstrates how young people construct their identities in relation to their telling about their experiences of being victims of bullying, reporting on two distinct ways that they framed their postings. The posters either disclosed their experiences about bullying in relation to a wider self‐presentation of experiences of bullying (bullying being part of their past and a partial reason for their problems), or more straightforwardly asked for help and advice from other participants to find ways of dealing with ongoing bullying. Finally, the paper demonstrates how contributors orient to the Internet community, and calls for more research based on unsolicited naturalistic data for such issues as bullying.
Working hours and alcohol problems in early adulthood
Authors: Gibb Sheree J. , Fergusson David M. , Horwood L. John
Published: June 2011

Aims  To examine the associations between working hours and alcohol‐related problems during early adulthood.

Design and setting  Longitudinal study of a birth cohort born in Christchurch, New Zealand in 1977 and studied to age 30.

Participants  A total of 1019 participants with data available for working hours and alcohol‐related problems at either age 25 or 30.

Measurements  Weekly working hours in paid employment; frequent alcohol use; diagnosis of alcohol abuse/dependence; number of symptoms of alcohol abuse/dependence. Associations between working hours and alcohol‐related problems were adjusted for covariates including measures of: parental and family background; personality and behaviour; IQ and educational achievement; recent negative life events; recent mental health problems; and current partner and family circumstances.

Findings  Longer work hours were associated significantly with more frequent alcohol use (P < 0.0001), higher rates of alcohol abuse/dependence (P = 0.0001) and a greater number of alcohol abuse/dependence symptoms (P = 0.01). These associations were adjusted for a wide range of confounding factors. After adjustment there remained significant (P < 0.05) associations between working hours and alcohol‐related problems, with those working 50 or more hours per week having rates of alcohol‐related problems 1.8–3.3 times higher than those who were not working. The associations between work hours and alcohol use were similar for males and females.

Conclusions  Longer work hours appear to be associated with higher rates of alcohol‐related problems, including more frequent alcohol use, higher rates of alcohol abuse/dependence and a greater number of alcohol abuse/dependence symptoms. These associations remain even after extensive adjustment for confounding.
Building a mutant resource for the study of disease resistance in rice reveals the pivotal role of several genes involved in defence
Authors: DELTEIL AMANDINE , BLEIN MÉLISANDE , FAIVRE‐RAMPANT ODILE , GUELLIM AMIRA , ESTEVAN JOAN , HIRSCH JUDITH , BEVITORI ROSANGELA , MICHEL CORINNE , MOREL JEAN‐BENOIT
Published: June 2011

In Arabidopsis, gene expression studies and analysis of knock‐out (KO) mutants have been instrumental in building an integrated view of disease resistance pathways. Such an integrated view is missing in rice where shared tools, including genes and mutants, must be assembled. This work provides a tool kit consisting of informative genes for the molecular characterization of the interaction of rice with the major fungal pathogen Magnaporthe oryzae. It also provides for a set of eight KO mutants, all in the same genotypic background, in genes involved in key steps of the rice disease resistance pathway. This study demonstrates the involvement of three genes, OsWRKY28, rTGA2.1 and NH1, in the establishment of full basal resistance to rice blast. The transcription factor OsWRKY28 acts as a negative regulator of basal resistance, like the orthologous barley gene. Finally, the up‐regulation of the negative regulator OsWRKY28 and the down‐regulation of PR gene expression early during M. oryzae infection suggest that the fungus possesses infection mechanisms that enable it to block host defences.
Effectiveness of three times daily lansoprazole/amoxicillin dual therapy for Helicobacter pylori infection in Korea
Authors: Kim Seung Young , Jung Sung Woo , Kim Jeong Han , Koo Ja Seol , Yim Hyung Joon , Park Jong Jae , Chun Hoon Jai , Lee Sang Woo , Choi Jai Hyun
Published: June 2011

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Triple therapy using a proton pump inhibitor with two antibiotics is the standard treatment for H. pylori infection. However, the increasing prevalence of antibiotic resistance has eroded the high success rates initially reported for the standard triple therapy.

WHAT THIS STUDY ADDS

• Compared with standard triple therapy, amoxicillin/lansoprazole dual therapy, given three times daily for H. pylori had a similar eradication rate with fewer side effects.

AIM

We compared three times daily dual therapy with standard triple therapy for effectiveness and safety in H. pylori infection.

METHODS

Two hundred and four H. pylori positive patients with peptic ulcer were randomly assigned to one of two regimens: (i) triple therapy with amoxicillin, clarithromycin and lansoprazole twice daily for 2 weeks or (ii) dual therapy with amoxicillin and lansoprazole three times daily for 2 weeks. The success of eradication was evaluated 4 to 5 weeks after completing treatment.

RESULTS

The eradication rate was 82.8% in the triple therapy group and 78.4% in the dual therapy group by per protocol analysis. This difference was not significant (P= 0.573). Adverse events were more frequent in the triple therapy group than in the dual therapy group (P= 0.002).

CONCLUSIONS

Because dual therapy had fewer side effects than triple therapy and a similar eradication rate, dual therapy may provide an acceptable alternative first line therapy for H. pylori eradication in Korea.
Cross-reactivity among some metals in a murine metal allergy model
Authors: Kinbara M. , Nagai Y. , Takano-Yamamoto T. , Sugawara S. , Endo Y.
Published: June 2011

Background Information concerning cross-reactivity among metal allergens is scarce. We previously devised a murine metal allergy model using lipopolysaccharide (LPS) as an adjuvant. LPS reduces the minimum allergy-inducing concentration (MAIC) of metals at both the sensitization and the elicitation steps.

Objectives Here, we examined allergic cross-reactivity among some metals in this murine model, and compared the effects of ultrapure (99·99% or more) and low purity (93–99%) metal salts.

Methods A mixture of a metal salt and Escherichia coli LPS was injected intraperitoneally into BALB/c mice (0·25 mL per mouse). Ten days later, metal salts (with or without LPS) were challenged to ear pinnas (20 μL per ear), and ear swelling was measured.

Results Among the ultrapure metals tested (Ni, Pd, Co, Cr, Cu and Au), only Ni and Pd cross-reacted. In this cross-reaction, their MAICs were at the same level. Combined challenge with Ni and Pd at sub-MAICs (but not at higher concentrations) produced an additive effect. Surprisingly, mice sensitized with low purity Ni reacted to all the tested low purity metals (Ni, Pd, Co and Cr), and the low purity metals were shown to contain contaminant metals.

Conclusions In our model: (i) Ni and Pd (members of the same group in the periodic table of elements) cross-react with each other, (ii) this cross-reaction may depend on true and false antigens forming metal–protein complexes with similar spatial geometries, (iii) Co, Cr, Cu and Au do not cross-react with each other, (iv) in low purity materials, trace contaminant metals may be sufficient to evoke allergy, and thus (v) high purity metal salts should be considered for use in clinical patch testing.
Tyrosine kinase inhibitor insensitivity of non‐cycling CD34+ human acute myeloid leukaemia cells with FMS‐like tyrosine kinase 3 mutations
Authors: Alvares Caroline L. , Schenk Tino , Hulkki Sanna , Min Toon , Vijayaraghavan Gowri , Yeung Jenny , Gonzalez David , So Chi W. E. , Greaves Mel , Titley Ian , Bartolovic Kerol , Morgan Gareth
Published: June 2011

The efficacy of tyrosine kinase (TK) inhibitors on non‐cycling acute myeloid leukaemia (AML) cells, previously shown to have potent tumourigenic potential, is unknown. This pilot study describes the first attempt to characterize non‐cycling cells from a small series of human FMS‐like tyrosine kinase 3 (FLT3) mutation positive samples. CD34+ AML cells from patients with FLT3 mutation positive AML were cultured on murine stroma. In expansion cultures, non‐cycling cells were found to retain CD34+ expression in contrast to dividing cells. Leukaemic gene rearrangements could be detected in non‐cycling cells, indicating their leukaemic origin. Significantly, the FLT3‐internal tandem duplication (ITD) mutation was found in the non‐cycling fraction of four out of five cases. Exposure to the FLT3‐directed inhibitor TKI258 clearly inhibited the growth of AML CD34+ cells in short‐term cultures and colony‐forming unit assays. Crucially, non‐cycling cells were not eradicated, with the exception of one case, which exhibited exquisite sensitivity to the compound. Moreover, in longer‐term cultures, TKI258‐treated non‐cycling cells showed no growth impairment compared to treatment‐naive non‐cycling cells. These findings suggest that non‐cycling cells in AML may constitute a disease reservoir that is resistant to TK inhibition. Further studies with a larger sample size and other inhibitors are warranted.
Cardiac iron overload in transfusion‐dependent patients with myelodysplastic syndromes
Authors: Roy Noémi B. A. , Myerson Saul , Schuh Anna H. , Bignell Patricia , Patel Roger , Wainscoat Jim S. , McGowan Simon , Marchi Emanuele , Atoyebi Wale , Littlewood Tim , Chacko Joseph , Vyas Paresh , Killick Sally B.
Published: June 2011

Transfusion‐dependent myelodysplastic (MDS) patients are prone to iron overload. We evaluated 43 transfused MDS patients with T2* magnetic resonance imaging scans. 81% had liver and 16·8% cardiac iron overload. Liver R2* (1000/T2*), but not cardiac R2*, was correlated with number of units transfused (r = 0·72, P < 0·0001) and ferritin (r = 0·53, P < 0·0001). The area under the curve of a time‐ferritin plot was found to be much greater in patients with cardiac iron loading (median 53·7 × 105 Megaunits vs. 12·2 × 105 Megaunits, P = 0·002). HFE, HFE2, HAMP or SLC40A1 genotypes were not predictors of iron overload in these patients.
Histiocytoid and signet-ring cell carcinoma of the axilla: a type of cutaneous apocrine carcinoma equivalent to histiocytoid lobular carcinoma of the breast?
Authors: Misago N. , Shinoda Y. , Okawa T. , Aoki S. , Toda S. , Koike K. , Narisawa Y.
Published: June 2011

There is a histopathological similarity between cutaneous apocrine carcinoma (CAC) and breast carcinoma. Cutaneous histiocytoid or signet-ring cell (SRC) carcinoma is a rare neoplasm, which usually occurs on the eyelid, and less commonly on the axilla. The precise histogenesis of this carcinoma remains controversial. We report the case of a man with a cutaneous histiocytoid SRC carcinoma of the axilla having histopathological and immunohistochemical features that were quite similar to histiocytoid lobular carcinoma (histiocytoid LC) of the breast, which is a subtype of classic invasive lobular carcinoma of the breast with apocrine differentiation. We consider this case to be a type of CAC equivalent to histiocytoid LC of the breast, based on the features and the occurrence on the axilla. The patient was treated with adjuvant chemotherapy according to the general guidelines for the treatment of breast carcinoma.
Cutaneous larva migrans induced by swallowing live pond loaches
Authors: Kuo Y.-L. , Wu Y.-H. , Su K.-E.
Published: June 2011

Freshwater fish, specifically loaches, are potential hosts of Gnathostoma species. Consumption of uncooked freshwater loaches may result in cutaneous larva migrans. We report the case of a 70-year-old Taiwanese man who presented with a serpiginous skin rash on his abdomen. He had eaten live loaches intermittently (sometimes daily) for 5 months before his presentation. On histopathological examination, a transected parasite body and a headbulb were found in the mid-dermis. The parasite was confirmed as belonging to the genus Gnathostoma, most likely Gnathostoma doloresi. The patient recovered uneventfully without treatment, and had no symptoms at his 12-month follow-up visit.
Reductions in daily soil temperature variability increase soil microbial biomass C and decrease soil N availability in the Chihuahuan Desert: potential implications for ecosystem C and N fluxes
Authors: van Gestel Natasja C. , Schwilk Dylan W. , Tissue David T. , Zak John C.
Published: June 2011

Maximum and minimum soil temperatures affect belowground processes. In the past 50 years in arid regions, measured reductions in the daily temperature range of air (DTRair) most likely generated similar reductions in the unmeasured daily temperature range of soil (DTRsoil). However, the role of DTRsoil in regulating microbial and plant processes has not been well described. We experimentally reduced DTRsoil in the Chihuahuan Desert at Big Bend National Park over 3 years. We used shade cloth that effectively decreased DTRsoil by decreasing daily maximum temperature and increasing nighttime minimum temperature. A reduction in DTRsoil generated on average a twofold increase in soil microbial biomass carbon, a 42% increase in soil CO2 efflux and a 16% reduction in soil NO3−–N availability; soil available NH4+–N was reduced by 18% in the third year only. Reductions in DTRsoil increased soil moisture up to 15% a few days after a substantial rainfall. Increased soil moisture contributed to higher soil CO2 efflux, but not microbial biomass carbon, which was significantly correlated with DTRsoil. Net photosynthetic rates at saturating light (Asat) in Larrea tridentata were not affected by reductions in DTRsoil over the 3 year period. Arid ecosystems may become greater sources of C to the atmosphere with reduced DTRsoil, resulting in a positive feedback to rising global temperatures, if increased C loss is not eventually balanced by increased C uptake. Ultimately, ecosystem models of N and C fluxes will need to account for these temperature‐driven processes.
Presurgical pharmacokinetic analysis of a von Willebrand factor/factor VIII (VWF/FVIII) concentrate in patients with von Willebrand’s disease (VWD) has limited value in dosing for surgery
Authors: DI PAOLA J. , LETHAGEN S. , GILL J. , MANNUCCI P. , MANCO‐JOHNSON M. , BERNSTEIN J. , NICHOLS W. L. , BERGMAN G. E.
Published: June 2011

Summary.  Optimal doses of von Willebrand Factor/Factor VIII (VWF/FVIII) concentrates for surgical procedures in patients with VWD need to be determined. A prospective, multicenter study was performed that included an initial pharmacokinetic (PK) assessment following a standard dose of VWF/FVIII concentrate (Humate‐P®) to determine individual PK parameters and guide therapeutic dosing during surgery. Forty one subjects received 60 IU kg−1 VWF: RCo. Median plasma levels, half‐life, mean change from baseline and in vivo recovery (IVR) values were determined for VWF:RCo, VWF:Ag, and FVIII: C, and area under the plasma time‐concentration curve (AUC), mean residence time (MRT), clearance, volume of distribution and dose linearity were also assessed for VWF:RCo at various time points. Median baseline VWF:RCo level was 13 IU dL−1 (range, 6–124); with a mean change from baseline >100 IU dL−1 immediately after the infusion, decreasing to 10 IU dL−1 at 48 h postinfusion. The group median incremental in vivo recovery (IVR) for VWF:RCo was 2.4 IU dL−1 per IU kg−1, for VWF:Ag 2.3 IU dL−1 kg−1 and for FVIII:C was 2.7 IU dL−1 per IU kg−1. When analysing individual recovery values on repeated infusions, a very weak correlation was observed between presurgery IVR and IVR for both VWF:RCo and FVIII, measured at various times just prior to and after the surgical procedure. Although group median values were fairly consistent among repeated IVR measurements, the intra‐individual IVR values for FVIII and VWF:RCo with repeated infusions showed a large degree of variability. IVR values obtained from pharmacokinetic analyses performed in advance of anticipated surgery do not reliably predict postinfusion circulating levels of VWF:RCo or FVIII attained preoperatively or with subsequent peri‐operative infusions.
The burden of HCV treatment in patients with inherited bleeding disorders
Authors: FRANSEN VAN DE PUTTE D. E. , FISCHER K. , POSTHOUWER D. , MAUSER‐BUNSCHOTEN E. P.
Published: June 2011

Summary.  Many patients with inherited bleeding disorders are infected with hepatitis C virus (HCV). Antiviral treatment, consisting of pegylated interferon and ribavirin, has many side‐effects. The aim of the study was to prospectively assess the occurrence and course of side‐effects and changes in health‐related quality of life (HRQoL) during antiviral treatment in patients with inherited bleeding disorders and chronic HCV. Forty‐seven patients were followed during antiviral treatment. Side‐effects of treatment were recorded, and the Beck Depression Inventory and the RAND‐36 HRQoL questionnaire were administered at regular intervals. Frequently reported side‐effects were fatigue (100%), headache (94%), pruritus and skin rash (94%), concentration problems (89%), decreased appetite (89%), fever, irritability and hair loss (all 85%). Many side‐effects disappeared soon after end of treatment, but 4 weeks after cessation fatigue, concentration problems and sleeping problems were still present in more than 30% of patients. Dose reduction was necessary in 21 patients (45%), mostly because of decreasing weight or haemoglobin levels. Two patients stopped treatment prematurely because of side‐effects. Depression was present in 28 patients (60%). HRQoL decreased significantly during treatment in all RAND‐36 domains, and increased again within 4 weeks after treatment. Major side‐effects were similar in patients with successful (n = 31, 66%) and unsuccessful antiviral treatment. In patients with inherited bleeding disorders and chronic HCV, antiviral treatment has many, but mostly transient side‐effects and a significant impact on quality of life. Careful follow‐up and management of side‐effects will ensure optimal compliance and treatment results.
The erosion and abrasion‐inhibiting effect of TiF4 and NaF varnishes and solutions on enamel in vitro
Authors: LEVY FLÁVIA MAUAD , MAGALHÃES ANA CAROLINA , GOMES MARINA FRANCISCON , COMAR LIVIA PICCHI , RIOS DANIELA , BUZALAF MARÍLIA AFONSO RABELO
Published: June 2011

International Journal of Paediatric Dentistry 2011; 22: 11–16

Objective.  Previous in vitro study has shown that TiF4 varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF4 compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion.

Methods.  Enamel specimens were pre‐treated with experimental‐TiF4 (2.45% F), experimental‐NaF (2.45% F), NaF‐Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF4 (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (μm).

Results.  Kruskal–Wallis/Dunn tests showed that all fluoridated varnishes (TiF4–ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF‐ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat‐ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF‐ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF4‐ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other.

Conclusion.  Based on the results, it can be concluded that the TiF4 varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.
Coronary stent use in New York State in the drug‐eluting stent era
Authors: Qian Feng , Hannan Edward L. , Glance Laurent G. , Phelps Charles E. , Ling Frederick S. , Veazie Peter J.
Published: June 2011

Objectives  The drug‐eluting stent (DES) was perceived as a revolutionary medical technology because of the lower risk of restenosis compared with bare metal stent (BMS). However, the safety of DES use was called into question in 2006 due to increased incidence of catastrophic late stent thrombosis. This study aims to describe coronary stent use in the DES era in New York State.

Methods  Using New York State statewide hospital discharge database, we conducted descriptive analysis and logistic regression to examine the independent impacts of the introduction of DES and of the DES safety concern on DES utilization, controlling for patient demographics, co‐morbidities and hospital effects.

Results  In the first year following the introduction of DES technology, there was a 10‐fold increase in the odds of DES use versus BMS use (AOR: 10.86, 95% CI: 9.84–11.99, P < 0.001). When the safety of DES use was called into question, the odds of DES utilization decreased by 75% over a 9‐month period (AOR: 0.23, 95% CI: 0.20–0.26, P < 0.001).

Conclusions  Following the introduction of DES, there was a rapid adoption of DES by interventional cardiologists, followed by a rapid abandonment of DES when significant safety issues were raised. After the safety of DES was called into question, there was a reduction in the use of DES and in the use of stents in general.
Bias in recruitment to cluster randomized trials: a review of recent publications
Authors: Brierley Gwen , Brabyn Sally , Torgerson David , Watson Judith
Published: June 2011

Objectives  To assess recruitment bias and the techniques employed to counter this problem in a recent selection of published cluster randomized trials.

Design  Review of 24 cluster trials published in 2008 in four leading medical journals.

Data extraction  Studies were assessed by four reviewers to identify if an alternative design could have been employed using individual randomization. Data were also extracted on the randomization procedure and the likelihood of this introducing bias to the selection of participants into the study.

Results  Of the 24 trials, eight could have used individual randomization as an alternative to cluster allocation. Seven studies could have recruited participants prior to cluster randomization but did not. In eight studies where recruitment bias was possible, more than half (five) demonstrated some evidence of differential recruitment rates.

Conclusions  Many cluster trials published in leading medical journals are not clear in their justification for the design. We also found significant proportions of cluster trials used suboptimal designs that increase their risk of introducing selection bias. Better design of cluster trials is possible and should be adopted.
Electronic health record identification of prediabetes and an assessment of unmet counselling needs
Authors: Zimmermann Laura J. , Thompson Jason A. , Persell Stephen D.
Published: June 2011

Rationale, aims and objectives  Large clinical trials demonstrate that lifestyle modification can prevent or delay the onset of diabetes in those with prediabetes. However, recent National Health and Nutrition Survey data suggest that prediabetes often goes unrecognized, and the majority of prediabetic individuals do not report having received lifestyle advice from physicians. We explored whether electronic health record (EHR) query of glucose measurements can identify prediabetic patients, and we estimated rates of prediabetic lifestyle counselling in a large, urban, primary care practice.

Methods  Electronic search identified patients with plasma glucose levels of 100 to 199 mg dL−1 between 1 June 2007 and 1 June 2009, excluding those with diabetes or diabetic medications/supplies. From these 5366 patients, 100 randomly selected patients underwent classification into provisional categories based on available EHR data: likely prediabetes, likely diabetes, glucose abnormality in the setting of acute illness, or normal glucose metabolism. In those likely to have prediabetes, we assessed lifestyle modification counselling.

Results  Fifty‐eight per cent (95% CI 48% to 68%) of patients sampled were likely to have prediabetes. Fourteen per cent of those sampled were likely to have diabetes. Thirty‐one per cent of prediabetics (95% CI 22% to 42%) had documented lifestyle counselling. Counselled patients had a significantly higher baseline mean body mass index compared to those not counselled (34.1 versus 29.9, P = 0.037).

Conclusions  EHR query using glucose measurements can identify prediabetic patients and those requiring further glucose metabolism evaluation, including those with undiagnosed diabetes. Future research should investigate EHR‐based, population‐level interventions to facilitate prediabetes recognition and counselling.
Clinical instruments: reliability and validity critical appraisal
Authors: Brink Yolandi , Louw Quinette A.
Published: June 2011

Rationale, aim and objectives  There is a lack of health care practitioners using objective clinical tools with sound psychometric properties. There is also a need for researchers to improve their reporting of the validity and reliability results of these clinical tools. Therefore, to promote the use of valid and reliable tools or tests for clinical evaluation, this paper reports on the development of a critical appraisal tool to assess the psychometric properties of objective clinical tools.

Method  A five‐step process was followed to develop the new critical appraisal tool: (1) preliminary conceptual decisions; (2) defining key concepts; (3) item generation; (4) assessment of face validity; and (5) formulation of the final tool.

Results  The new critical appraisal tool consists of 13 items, of which five items relate to both validity and reliability studies, four items to validity studies only and four items to reliability studies. The 13 items could be scored as ‘yes’, ‘no’ or ‘not applicable’.

Conclusion  This critical appraisal tool will aid both the health care practitioner to critically appraise the relevant literature and researchers to improve the quality of reporting of the validity and reliability of objective clinical tools.
Physician adherence to asthma treatment guidelines in Japan: focus on inhaled corticosteroids
Authors: Morishima Toshitaka , Otsubo Tetsuya , Gotou Etsu , Kobayashi Daisuke , Lee Jason , Imanaka Yuichi
Published: June 2011

Objectives  Asthma treatment guidelines recommend inhaled corticosteroids (ICS) as the first‐line therapy. However, ICS are prescribed to lower percentages of asthmatic patients in Japan than in other developed countries. The aim of this study was to reveal factors affecting the prescription of ICS for asthmatic adults.

Methods  Using insurance claims data in Kyoto Prefecture, Japan, we performed a cross‐sectional study. We assessed whether outpatients aged 15 years or older who were diagnosed with asthma had received ICS or not, and conducted logistic regression analyses to identify patients' and facilities' factors associated with ICS use.

Results  We analysed 13 428 asthmatic adults, of which 51% were prescribed ICS. Patients receiving asthma care at facilities with respiratory or allergy specialists were more likely to receive ICS than facilities without specialists (adjusted odds ratio 2.70; 95% confidence interval 2.46–2.97). Those aged 75 years or older were less likely to receive ICS than those aged 15 to 64 (adjusted odds ratio 0.71; 95% confidence interval 0.64–0.78). An examination of the interaction between the presence or absence of specialists and facility training status suggested that whether asthmatic adults received ICS depended on the former factor rather than the latter.

Conclusion  The presence of specialists in facilities and the age of patients were strong factors affecting ICS prescription. Increases in ICS therapy for the elderly and ICS prescription by non‐specialists would lead to an overall increase in patients receiving ICS and consequently achieving the goal of asthma control.
Using vote cards to encourage active participation and to improve critical appraisal skills in evidence‐based medicine journal clubs
Authors: Tam Ka‐Wai , Tsai Lung‐Wen , Wu Chien‐Chih , Wei Po‐Li , Wei Chou‐Fu , Chen Soul‐Chin
Published: June 2011

Rationale, aims and objectives  Evidence‐based medicine (EBM) journal clubs are used by health care practitioners to critique and remain updated on relevant health literature. Vote cards, in three different colours (green/yellow/red), allow participants to express their opinions (agree/doubt/reject) on the quality and possibility of clinical application regarding the article being reviewed. Our aim is to assess the efficacy of using vote cards in EBM journal clubs.

Methods  Evidence‐based medicine journal club is held on a weekly basis in the Department of Surgery in Taipei Medical University Hospital, Taiwan. The participants of EBM journal clubs include medical students, resident doctors and primary care faculty members. After the presentation, participants use their vote cards to critically appraise the literature and decide if the rationales could be applied in their own practice. After a 12‐week period, we evaluated the effectiveness of the vote cards based on survey findings of the participants.

Results  The majority of 66 respondents agreed that vote cards can improve the overall quality of EBM journal clubs, may encourage active participation and improve critical appraisal skills. They also rated the vote cards more favourably than traditional hand voting and agree that vote cards should be used in future EBM journal clubs.

Conclusion  We suggest the regular and routine use of vote cards in EBM journal clubs.
An autodissemination station for the transfer of an insect growth regulator to mosquito oviposition sites
Authors: GAUGLER R. , SUMAN D. , WANG Y.
Published: June 2011

A prototype autodissemination station to topically contaminate oviposition‐seeking container‐dwelling mosquitoes with the insect growth regulator, pyriproxyfen, was developed and tested in the laboratory. Our test subject was the Asian tiger mosquito, Aedes albopictus (Skuse) (Diptera: Culicidae), an urban species that colonizes small‐volume cryptic larval habitats and is a skip ovipositor that visits multiple containers. The station consists of a water reservoir to attract gravid females, which is joined to a transfer chamber designed to contaminate visiting mosquitoes. The unit is easily constructed by moulding wet shredded cardboard using corn starch as a binder. The essential criteria that must be met to prove the efficacy of an autodissemination station require it to demonstrate effectiveness in attracting the target insect, in transferring the toxicant to the insect that will disperse the agent, and in facilitating the subsequent transfer of the toxicant from the insect to target habitats at a lethal concentration. Cage experiments demonstrated that the unit was readily accepted by gravid females as an oviposition site. A powder formulation of pyriproxyfen‐impregnated silica particles adhered to visiting Ae. albopictus females (mean: 66 particles/female), although particles were lost over time. In cage (2.2 m3) trials, pyriproxyfen‐charged stations resulted in 100% inhibition of adult emergence, whereas in small‐room (31.1 m3) trials, 81% emergence inhibition was recorded. The venereal transfer of pyriproxyfen from contaminated males to virgin females was also observed, and pyriproxyfen was subsequently transferred to water‐holding containers at concentrations that inhibited emergence. Key autodissemination station features include lack of maintenance requirements, biodegradable construction, low cost and low risk.
Designing prospective cohort studies for assessing reproductive and developmental toxicity during sensitive windows of human reproduction and development – the LIFE Study
Authors: Buck Louis Germaine M. , Schisterman Enrique F. , Sweeney Anne M. , Wilcosky Timothy C. , Gore‐Langton Robert E. , Lynch Courtney D. , Boyd Barr Dana , Schrader Steven M. , Kim Sungduk , Chen Zhen , Sundaram Rajeshwari ,   on behalf of the LIFE Study
Published: June 2011

Buck Louis GM, Schisterman EF, Sweeney AM, Wilcosky TC, Gore‐Langton RE, Lynch CD, Boyd Barr D, Schrader SM, Kim S, Chen Z, Sundaram R, on behalf of the LIFE Study. Designing prospective cohort studies for assessing reproductive and developmental toxicity during sensitive windows of human reproduction and development – the LIFE Study. Paediatric and Perinatal Epidemiology 2011; 25: 413–424.

The relationship between the environment and human fecundity and fertility remains virtually unstudied from a couple‐based perspective in which longitudinal exposure data and biospecimens are captured across sensitive windows. In response, we completed the LIFE Study with methodology that intended to empirically evaluate a priori purported methodological challenges:

• implementation of population‐based sampling frameworks suitable for recruiting couples planning pregnancy;

• obtaining environmental data across sensitive windows of reproduction and development;

• home‐based biospecimen collection; and

• development of a data management system for hierarchical exposome data.

We used two sampling frameworks (i.e. fish/wildlife licence registry and a direct marketing database) for 16 targeted counties with presumed environmental exposures to persistent organochlorine chemicals to recruit 501 couples planning pregnancies for prospective longitudinal follow‐up while trying to conceive and throughout pregnancy. Enrolment rates varied from <1% of the targeted population (n = 424 423) to 42% of eligible couples who were successfully screened; 84% of the targeted population could not be reached, while 36% refused screening. Among enrolled couples, ∼85% completed daily journals while trying; 82% of pregnant women completed daily early pregnancy journals, and 80% completed monthly pregnancy journals. All couples provided baseline blood/urine samples; 94% of men provided one or more semen samples and 98% of women provided one or more saliva samples. Women successfully used urinary fertility monitors for identifying ovulation and home pregnancy test kits.

Couples can be recruited for preconception cohorts and will comply with intensive data collection across sensitive windows. However, appropriately sized sampling frameworks are critical, given the small percentage of couples contacted found eligible and reportedly planning pregnancy at any point in time.
Characterization of bacterial isolates from rotting potato tuber tissue showing antagonism to Dickeya sp. biovar 3 in vitro and in planta
Authors: Czajkowski R. , de Boer W. J. , van Veen J. A. , van der Wolf J. M.
Published: June 2011

Possibilities for biocontrol of biovar 3 Dickeya sp. in potato were investigated, using bacteria from rotting potato tissue isolated by dilution plating on nonselective agar media. In a plate assay, 649 isolates were screened for antibiosis against Dickeya sp. IPO2222 and for the production of siderophores. Forty‐one isolates (6·4%) produced antibiotics and 112 isolates (17·3%) produced siderophores. A selection of 41 antibiotic‐producing isolates and 41 siderophore‐producing isolates were tested in a potato slice assay for control of the Dickeya sp. Isolates able to reduce rotting of potato tuber tissue by at least 50% of the control were selected. Isolates were characterized by 16S rDNA analysis as Bacillus, Pseudomonas, Rhodococcus, Serratia, Obesumbacterium and Lysinibacillus genera. Twenty‐three isolates belonging to different species and genera, 13 producing antibiotics and 10 producing siderophores, were further characterized by testing acyl‐homoserine lactone (AHL) production, quorum quenching, motility, biosurfactant production, growth at low (4·0) and high (10·0) pH, growth at 10°C under aerobic and anaerobic conditions and auxin production. In replicated greenhouse experiments, four selected antagonists based on the in vitro tests were tested in planta using wounded or intact minitubers of cv. Kondor subsequently inoculated by vacuum infiltration with an antagonist and a GFP (green fluorescent protein)‐tagged biovar 3 Dickeya sp. strain. A potato endophyte A30, characterized as S. plymuthica, protected potato plants by reducing blackleg development by 100% and colonization of stems by Dickeya sp. by 97%. The potential use of S. plymuthica A30 for the biocontrol of Dickeya sp. is discussed.
Effect of phenology on susceptibility of Norway spruce (Picea abies) to fungal pathogens
Authors: Krokene P. , Lahr E. , Dalen L. S. , Skrøppa T. , Solheim H.
Published: June 2011

Ceratocystis polonica and Heterobasidion parviporum are important fungal pathogens in Norway spruce (Picea abies). Tree susceptibility to these pathogens with respect to phenology was studied using artificial fungal inoculations at six stages of bud development, and assessed by measuring phloem necroses in the stems of 2‐ and 8‐year‐old trees. Tree capacity for resistance was assessed by measuring phloem nonstructural carbohydrates at each stage. Phloem necroses were significantly larger in trees with fungal versus control inoculations and increased significantly over time. Changes in nonstructural carbohydrates occurred in the trees; a significant decline in starch and a slight but significant increase in total sugars occurred over time. These results suggest that susceptibility to fungal pathogens and carbohydrate levels in the stems of the trees were related to fine‐scale changes in bud development. A trade‐off may occur between allocation of starch (the major fraction of the stem carbohydrate pool) to bud development/shoot growth versus defence of the stem. Previous tests of plant defence hypotheses have focused on herbivory on plants growing under different environmental conditions, but the role of phenology and the effect of pathogens are also important to consider in understanding plant resource allocation patterns.
Risk factors for Pneumocystis jirovecii pneumonia in kidney transplant recipients and appraisal of strategies for selective use of chemoprophylaxis
Authors: de Boer M.G.J. , Kroon F.P. , le Cessie S. , de Fijter J.W. , van Dissel J.T.
Published: June 2011

M.G.J. de Boer, F.P. Kroon, S. le Cessie, J.W. de Fijter, J.T. van Dissel. Risk factors for Pneumocystis jirovecii pneumonia in kidney transplant recipients and appraisal of strategies for selective use of chemoprophylaxis. Transpl Infect Dis 2011: 13: 559–569. All rights reserved

Abstract: Risk stratification‐based duration of trimethoprim‐sulfamethoxazole (TMP‐SMX) chemoprophylaxis to prevent Pneumocystis pneumonia (PCP) in kidney transplant recipients is not a universally adapted strategy and supporting evidence‐based sources are limited. We performed a large retrospective study to identify risk factors for PCP in kidney transplant recipients and to define parameters for use in clinical prophylaxis guidelines. Fifty consecutive patients with confirmed PCP and 2 time‐matched controls per case were enrolled. All patients were participants of the kidney transplantation program of the Leiden University Medical Center, a tertiary care hospital in the Netherlands. Potential risk factors were compared between groups by uni‐ and multivariate matched analyses. At transplantation, age >55 years (adjusted odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3–5.9) and not receiving basiliximab induction therapy (adjusted OR 4.3, 95% CI 1.1–17.1) predicted development of PCP. In the final multivariate analysis, only cytomegalovirus infection (adjusted OR 3.0, 95% CI 1.2–7.9) and rejection treatment (adjusted OR 5.8, 95% CI 1.9–18) were found to be independently associated with PCP. Using the variables identified by the multivariate analyses, effects of different hypothetical chemoprophylaxis strategies were systematically evaluated. Exploring different scenarios showed that chemoprophylaxis in the first 6 months for all renal transplant patients – and during the first year posttransplantation for patients >55 years of age or those treated for rejection – would result in very low PCP incidence and optimal avoidance of TMP‐SMX toxicity. The results provide a rationale for further prospective study on targeted provision of chemoprophylaxis to prevent PCP in kidney transplant patients.
Physiological and blood biochemical variables in horses exercising on a treadmill submerged in water
Authors: Lindner A. , Wäschle S. , Sasse H. H. L.
Published: June 2011

The blood lactate concentration (LA) and heart rate (HR) of 10 horses exercising in water on a treadmill were examined. With the water at 10 and 50% of the withers height (WH), the blood LA increased up to mean values around 1.9 mmduring the standardized exercise test (SET) until after step 3 of 5 (each step lasted 5 min, speed increasing step by step). Thereafter, blood LA of horses remained constant, while with the water at 80% of WH, the blood LA decreased from the mean peak of 2.16 ± 0.62 mmafter the 4th step. The HR of the horses increased to 132 ± 14 beats/min until the 3rd step of SET with the water at 10% of WH, up to the 2nd step with the water at 50% (134 ± 10 beats/min) and up to the 1st step only with the water at 80% of WH (134 ± 10 beats/min). In another SET, horses were exercised five times for 5 min at the maximal attainable speed of 5.5 m/s in water at 20% of the withers height in step 1, 35% in step 2, 49% in step 3, 63% in step 4 and 77% in step 5. On using this SET, blood LA increased to 1.91 ± 0.25 mmuntil after the 2nd step and decreased after the 3rd step. The HR increased between before commencing SET and the 1st step (143 ± 13 beats/min) and remained constant thereafter. In conclusion, increasing water height and speed of exercise does not augment continuously blood LA and HR of horses exercising in water treadmills.
Predictive factors of depression among Asian female marriage immigrants in Korea
Authors: Kim Jung A. , Yang Sook Ja , Kwon Kyoung Ja , Kim Jee Hee
Published: June 2011

This study investigated the prevailing rate of depression in female marriage immigrants in Korea and the predictive factors of their rates of depression. The study included 316 foreign female marriage immigrant participants. Four instruments yielded the data: the Center for Epidemiologic Studies Depression Scale and Multidimensional Scale of Perceived Social Support and questionnaires regarding the participants' Korean language ability and demographic data. The survey scales were translated into Korean, Vietnamese, Chinese, and English. The data collection was conducted by a face‐to‐face interview and translators were used when needed. The female marriage immigrants were found to have higher depression rates than women in the general Korean population. The predictive factors of depression for the female marriage immigrants included their country of origin, Korean speaking ability, and family support. Far more depression was found to occur in the Chinese participants, while the rate of depression was lower in those with competent Korean speaking ability and family support. An exploration of strategies to improve the speaking ability and family support of female marriage immigrants will be necessary in order to decrease their incidence of depression and the strategies should be differentiated based on the female marriage immigrants' country of origin.