bluuebunny/crossref_metadata_2025 huggingface dataset:
Telomere shortening distinguishes inverted urothelial neoplasms
Authors: Williamson Sean R , Zhang Shaobo , Lopez‐Beltran Antonio , Montironi Rodolfo , Wang Mingsheng , Cheng Liang
Published: September 2012

Aims

To investigate relative telomere length in inverted urothelial neoplasms, including inverted papilloma and urothelial carcinoma with an inverted growth pattern. Telomere shortening has been implicated as an early event in the development of epithelial malignancies in a number of organ systems.

Methods and results

Formalin‐fixed, paraffin‐embedded tissue sections from 77 cases were studied, including 26 cases of inverted papilloma, 26 urothelial carcinomas with inverted growth, and 25 cases of cystitis glandularis. Quantitative fluorescence in‐situ hybridization (FISH) was performed on interphase nuclei, utilizing a telomere‐specific peptide nucleic acid probe to assess telomeric signal intensity. Relative telomere lengths for urothelial carcinoma with inverted growth, cystitis glandularis and inverted papilloma were 29%, 84%, and 91%, respectively. A statistically significant reduction in relative telomere length was present between urothelial carcinoma with inverted growth and inverted papilloma (P < 0.001); no significant difference was detected between normal urothelium, cystitis glandularis, and inverted papilloma.

Conclusions

Significant telomere shortening in urothelial carcinoma with inverted growth as compared with inverted papilloma distinguishes the two lesions, and supports the notion that inverted papilloma is a benign neoplasm with a distinct pathogenetic mechanism of development. Telomeric FISH analysis may be a useful biomarker in distinguishing inverted papilloma from urothelial carcinoma with inverted growth.
Peritumoral hyperplasia of the liver: a response to portal vein invasion by hypervascular neoplasms
Authors: Arnason Thomas , Fleming Kirsten E , Wanless Ian R
Published: September 2012

Aims

Several cases of focal nodular hyperplasia (FNH) or similar hyperplastic lesions have been reported adjacent to hepatic neoplasms, including hepatocellular carcinoma, epithelioid haemangioendothelioma and hepatoblastoma. We refer to this hyperplastic response as peritumoral hyperplasia (PTH). Here, we report eight cases of PTH adjacent to primary hepatocellular carcinomas (two) and metastatic neuroendocrine tumours (three), gastrointestinal stromal tumour (one) and colon carcinomas (two).

Methods and results

Sections were stained with H&E and trichrome, and for glutamine synthetase, CD34 and cytokeratin 7. PTH was composed of a peritumoral rim of hyperplastic hepatocytes up to 7.0 mm wide, delimited by adjacent hepatocellular atrophy. PTH had altered plate architecture, strong glutamine synthetase expression and variable sinusoidal endothelial cell CD34 expression. The central tumour deposit typically invaded portal veins and was markedly hypervascular with CD34‐positive capillaries.

Conclusions

We suggest that PTH is a hyperplastic response to increased blood flow in the peritumoral parenchyma. The increased flow occurs when portal vein invasion by a hypervascular tumour causes arterio‐portal shunting. While PTH shares some morphological features with FNH, it lacks the defining nodular architecture, central scar and bile ductules. PTH may be related pathophysiologically to FNH, but should be classified as a separate entity because of its distinct morphology and peritumoral location.
Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma
Authors: del Pino Marta , Rodriguez‐Carunchio Leonardo , Ordi Jaume
Published: September 2012

Vulvar squamous cell carcinoma (VSCC) accounts for >90% of the malignant tumours of the vulva. Most VSCCs originate in intraepithelial lesions, named vulvar intraepithelial neoplasia (VIN), that precede the development of VSCC by a variable period of time. Strong evidence has accumulated showing that there are two different aetiopathogenic pathways for the development of VSCC and VIN, one associated with infection by human papillomavirus (HPV), and a second independent of HPV infection. These two different types of VSCC have different epidemiological, pathological and clinical characteristics, and should therefore be considered as two separate entities. Histologically, HPV‐associated VSCCs are of the basaloid or warty type, and arise from VIN of the usual type. Inactivation of p53 and the retinoblastoma tumour suppressor gene product by the viral gene products E6 and E7 is involved in the process of malignant transformation. HPV‐independent VSCCs are histologically keratinizing, are associated with differentiated VIN and lichen sclerosus, and frequently show mutations of p53. p16INK4a and p53 immunostaining can be useful for classifying VSCC into HPV‐associated or HPV‐independent. Although large, multicentre studies are needed to definitively assess the involvement of HPV in the prognosis of VSCC, most studies have not found clear differences in survival between HPV‐associated and HPV‐independent tumours.
Effects of natural mating and CO2 narcosis on biogenic amine receptor gene expression in the ovaries and brain of queen honey bees, Apis mellifera
Authors: Vergoz Vanina , Lim Julianne , Duncan Michael , Cabanes Guénaël , Oldroyd Benjamin P.
Published: September 2012

A queen honey bee mates at ∼6 days of age, storing the sperm in her spermatheca for life. Mating is associated with profound changes in the behaviour and physiology of the queen but the mechanisms underlying these changes are poorly understood. What is known is that the presence of semen in the oviducts and spermatheca is insufficient to initiate laying, and that copulation or CO2 narcosis is necessary for ovary activation. In this study we use real‐time quantitative PCR to investigate the expression of biogenic amine receptor genes in the brain and ovarian tissue of queens in relation to their reproductive status. We show that dopamine, octopamine and serotonin receptor genes are expressed in the ovaries of queens, and that natural mating, CO2 narcosis, and the presence of semen in the spermatheca differentially affect their expression. We suggest that these changes may be central to the hormonal cascades that are necessary to initiate oogenesis.
Ecotope effect in Triatoma brasiliensis (Hemiptera: Reduviidae) suggests phenotypic plasticity rather than adaptation
Authors: BATISTA V. S. P. , FERNANDES F. A. , CORDEIRO‐ESTRELA P. , SARQUIS O. , LIMA M. M.
Published: September 2012

Triatoma brasiliensis (Hemiptera: Reduviidae) is an important vector of Chagas' disease in both sylvatic and peridomestic ecotopes. Discriminating between these populations of Triatominae has been proposed as a means of investigating re‐infestation rates of human dwellings. Geometric morphometrics have been widely applied in the study of Triatominae polymorphisms at species and population levels. This study characterizes morphometric differences between sylvatic and peridomestic populations, as well as between sexes in T. brasiliensis specimens from Jaguaruana, Ceará, in northeastern Brazil. No differences in either the shape or size of the cephalic capsule were apparent between sexes or ecotopes. However, the wings showed differentiation in shape and size. Sexual dimorphism was detected, with females presenting significantly higher values and conformations. Size differentiation was also evident, with sylvatic specimens being generally larger than peridomestic examples. These results indicate that differences in the wings of T. brasiliensis may be related to the existence of phenotypic plasticity, and variations in size and shape may be associated with different ecotopes, possibly as a result of conditions in each micro‐habitat, such as temperature, relative humidity, food supply and density.
Recombinant hybrids retain heterozygosity at many loci: new insights into the genomics of reproductive isolation inPopulus
Authors: Lindtke Dorothea , Buerkle C. A. , Barbará Thelma , Heinze Berthold , Castiglione Stefano , Bartha Denes , Lexer Christian
Published: September 2012

The maintenance of species barriers in the face of gene flow is often thought to result from strong selection against intermediate genotypes, thereby preserving genetic differentiation. Most speciation genomic studies thus aim to identify exceptionally divergent loci between populations, but divergence will be affected by many processes other than reproductive isolation (RI) and speciation. Through genomic studies of recombinant hybrids sampled in the wild, genetic variation associated withRIcan be observedin situ, because selection against incompatible genotypes will leave detectable patterns of variation in the hybrid genomes. To better understand the mechanisms directly involved inRI, we investigated three natural ‘replicate’ hybrid zones between two divergentPopulusspecies via locus‐specific patterns of ancestry across recombinant hybrid genomes. As expected, genomic patterns in hybrids and their parental species were consistent with the presence of underdominant selection at several genomic regions. Surprisingly, many loci displayed greatly increased between‐species heterozygosity in recombinant hybrids despite striking genetic differentiation between the parental genomes, the opposite of what would be expected with selection against intermediate genotypes. Only a limited, reproducible set of genotypic combinations was present in hybrid genomes across localities. In the absence of clearly delimited ‘hybrid habitats’, our results suggest that complex epistatic interactions within genomes play an important role in advanced stages ofRIbetween these ecologically divergent forest trees. This calls for more genomic studies that test for unusual patterns of genomic ancestry in hybridizing species.
Testing hypotheses for genealogical discordance in a rainforest lizard
Authors: Singhal Sonal , Moritz Craig
Published: September 2012

Genealogical discordance, or when different genes tell distinct stories although they evolved under a shared history, often emerges from either coalescent stochasticity or introgression. In this study, we present a strong case of mito‐nuclear genealogical discordance in the Australian rainforest lizard species complex of Saproscincus basiliscus and S. lewisi. One of the lineages that comprises this complex, the Southern S. basiliscus lineage, is deeply divergent at the mitochondrial genome but shows markedly less divergence at the nuclear genome. By placing our results in a comparative context and reconstructing the lineages' demography via multilocus and coalescent‐based approximate Bayesian computation methods, we test hypotheses for how coalescent variance and introgression contribute to this pattern. These analyses suggest that the observed genealogical discordance likely results from introgression. Further, to generate such strong discordance, introgression probably acted in concert with other factors promoting asymmetric gene flow between the mitochondrial and nuclear genomes, such as selection or sex‐biased dispersal. This study offers a framework for testing sources of genealogical discordance and suggests that historical introgression can be an important force shaping the genetic diversity of species and their populations.
Differential effects of landscape‐level environmental features on genetic structure in three codistributed tree species in Central America
Authors: Poelchau Monica F. , Hamrick J. L.
Published: September 2012

Landscape genetic studies use spatially explicit population genetic information to determine the physical and environmental causes of population genetic structure on regional scales. Comparative studies that identify common barriers to gene flow across multiple species within a community are important to both understand the evolutionary trajectories of populations and prioritize habitat conservation. Here, we use a comparative landscape genetic approach to ask whether gradients in temperature or precipitation seasonality structure genetic variation across three codistributed tree species in Central America, or whether a simpler (geographic distance) or more complex, species‐specific environmental niche model is necessary to individually explain population genetic structure. Using descriptive statistics and causal modelling, we find that different factors best explain genetic distance in each of the three species: environmental niche distance in Bursera simaruba, geographic distance in Ficus insipida and historical barriers to gene flow or cryptic reproductive barriers for Brosimum alicastrum. This study confirms suggestions from previous studies of Central American tree species that imply that population genetic structure of trees in this region is determined by complex interactions of both historical and current barriers to gene flow.
Primary and secondary metabolism in the sun‐exposed peel and the shaded peel of apple fruit
Authors: Li Pengmin , Ma Fengwang , Cheng Lailiang
Published: September 2012

The metabolism of carbohydrates, organic acids, amino acids and phenolics was compared between the sun‐exposed peel and the shaded peel of apple fruit. Contents of sorbitol and glucose were higher in the sun‐exposed peel, whereas those of sucrose and fructose were almost the same in the two peel types. This was related to lower sorbitol dehydrogenase activity and higher activities of sorbitol oxidase, neutral invertase and acid invertase in the sun‐exposed peel. The lower starch content in the sun‐exposed peel was related to lower sucrose synthase activity early in fruit development. Dark respiratory metabolism in the sun‐exposed peel was enhanced by the high peel temperature due to high light exposure. Activities of most enzymes in respiratory metabolism were higher in the sun‐exposed peel, but the concentrations of most organic acids were relatively stable, except pyruvate and oxaloacetate. Due to the different availability of carbon skeletons from dark respiration in the two peel types, amino acids with higher C/N ratios are accumulated in the sun‐exposed peel whereas those with lower C/N ratios are accumulated in the shaded peel. Contents of anthocyanins and flavonols and activities of phenylalanine ammonia‐lyase, UDP‐galactose:flavonoid 3‐O‐glucosyltransferase and several other enzymes were higher in the sun‐exposed peel than in the shaded peel, indicating the entire phenylpropanoid pathway is upregulated in the sun‐exposed peel. Comprehensive analyses of the metabolites and activities of enzymes involved in primary metabolism and secondary metabolism have allowed us to gain a full picture of the metabolic network in the two peel types under natural light exposure.
Transfusion‐related acute lung injury after intravenous immunoglobulin treatment in a lung transplant recipient
Authors: Stoclin A. , Delbos F. , Dauriat G. , Brugière O. , Boeri N. , Métivier A. C. , Thabut G. , Camus P. , Mal H.
Published: September 2012

Three weeks after single‐lung transplantation for pulmonary fibrosis, a patient with high serum levels of de novo donor‐specific antibodies received high‐dose intravenous immunoglobulin (IVIG) infusion (scheduled dose: 2 g/kg on 2 days) to prevent antibody‐mediated rejection. Within the first hours after completion of infusions, he experienced acute lung injury involving the transplanted lung. Given the clinical evolution and the absence of an alternative diagnosis, transfusion‐related acute lung injury (TRALI) was diagnosed. The IVIG administered on each day was from the same batch. At day 110, because of an increase in the serum titers of donor‐specific antibodies, IVIG therapy was reintroduced but from a different batch, with excellent clinical tolerance. The lung injury was explored biologically, but no mechanism was revealed. Given the increasing use of IVIG in solid‐organ recipients, clinicians should be aware of possible TRALI after IVIG infusion.
Chronic alcohol‐induced hepatic insulin resistance and endoplasmic reticulum stress ameliorated by peroxisome‐proliferator activated receptor‐δ agonist treatment
Authors: Ramirez Teresa , Tong Ming , Chen William Cy , Nguyen Quynh‐Giao , Wands Jack R , de la Monte Suzanne M
Published: September 2012

Background and Aim

Chronic alcoholic liver disease is associated with hepatic insulin resistance, dysregulated lipid metabolism with increased toxic lipid (ceramide) accumulation, lipid peroxidation, and oxidative and endoplasmic reticulum (ER) stress. Peroxisome‐proliferator activated receptor (PPAR) agonists are insulin sensitizers that can restore hepatic insulin responsiveness in both alcohol and non‐alcohol‐related steatohepatitis. Herein, we demonstrate that treatment with a PPAR‐δ agonist enhances insulin signaling and reduces the severities of ER stress and ceramide accumulation in an experimental model of ethanol‐induced steatohepatitis.

Methods

Adult male Long Evans rats were pair fed with isocaloric liquid diets containing 0% or 37% ethanol (caloric) for 8 weeks. After 3 weeks on the diets, rats were treated with vehicle or PPAR‐δ agonist twice weekly by i.p. injection.

Results

Ethanol‐fed rats developed steatohepatitis with inhibition of signaling through the insulin and insulin‐like growth factor‐1 receptors, and Akt activated pathways. Despite continued ethanol exposure, PPAR‐δ agonist co‐treatments increased Akt activation, reduced multiple molecular indices of ER stress and steatohepatitis.

Conclusions

These results suggest that PPAR‐δ agonist rescue of chronic alcoholic liver disease is mediated by enhancement of insulin signaling through Akt/metabolic pathways that reduce lipotoxicity and ER stress.
Lactase persistence/non‐persistence genetic variants in irritable bowel syndrome in an endemic area for lactose malabsorption
Authors: Kumar Sunil , Ranjan Prabhat , Mittal Balraj , Singh Rajan , Ghoshal Uday C
Published: September 2012

Background and Aim

Lactase non‐persistence is common in India. We evaluated: (i) frequency of lactase gene (C/T‐13910 and G/A‐22018) polymorphisms in irritable bowel syndrome (IBS) and healthy controls (HC), (ii) association between these polymorphisms and IBS‐subtypes and symptoms.

Methods

A total of 150 IBS patients (Rome‐III criteria) and 252 age and gender‐matched HC were evaluated for C/T‐13910 and G/A‐22018 genotypes using polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP).

Results

Totals of 79 (52%), 52 (35%) and 19 (13%) patients had diarrhea‐predominant IBS (D‐IBS), constipation predominant IBS (C‐IBS) and alternating diarrhea and constipation IBS (A‐IBS), respectively (Rome‐III). Frequency of C/T‐13910 [genotypes: CC 102 (68%), CT 43 (29%), TT 5 (3%) vs CC 155 (61%), CT 83 (33%), TT 14 (6%), P > 0.05] and G/A‐22018 [GG 97 (65%), GA 41 (27%), AA 12 (8%) vs GG 154 (61%), GA 78 (31%), AA 20 (8%), P > 0.05] were similar among IBS and HC. Patients with D‐IBS more often had C/T‐13910 and G/A‐22018 genotypes than C‐IBS (CC 71 [90%], CT 6 [8%], TT 2 [2%]) versus (24 [46%], 25 [48%], 3 [6%]), A‐IBS (7 [39%], 12 [63%], 0, [0%]) and HC (155 [61%], 83 [33%], 14 [6%]), P < 0.0001 and (GG 69 [87%], GA 6 [8%], AA 4 [5%]) vs (22 [42%], 24 [46%], 6 [12%]) vs (6 [32%], 11 [58%], 2 [10%]), P < 0.0001. IBS with CC and GG genotypes more often had abdominal pain (P = 0.005), distension (P = 0.031) and higher stool frequency (P = 0.003) and reported symptoms following dairy products than non‐CC (P < 0.0001).

Conclusion

Though C/T‐13910 and G/A‐22018 polymorphisms were comparable among IBS and HC, these were more common among D‐IBS and reported some symptoms like abdominal pain, bloating and exacerbation by dairy products.
Risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts
Authors: Ohashi Taku , Wakai Toshifumi , Kubota Masayuki , Matsuda Yasunobu , Arai Yuhki , Ohyama Toshiyuki , Nakaya Kengo , Okuyama Naoki , Sakata Jun , Shirai Yoshio , Ajioka Yoichi
Published: September 2012

Background and Aim

The aim of this study was to elucidate the risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts.

Methods

A retrospective analysis of 94 patients who had undergone cyst excision for congenital choledochal cysts was conducted. The median age at the time of cyst excision and median follow‐up time after cyst excision were 7 years and 181 months, respectively.

Results

Biliary tract cancer developed in four patients at 13, 15, 23, and 32 years after cyst excision. The cumulative incidences of biliary tract cancer at 15, 20, and 25 years after cyst excision were 1.6%, 3.9%, and 11.3%, respectively. The sites of biliary tract cancer were the intrahepatic (n = 2), hilar (n = 1), and intrapancreatic (n = 1) bile ducts. Of the four patients with biliary tract cancer after cyst excision, three patients underwent surgical resection and one patient received chemo‐radiotherapy. The overall cumulative survival rates after treatment in the four patients with biliary tract cancer were 50% at 2 years and 25% at 3 years, with a median survival time of 15 months.

Conclusions

The risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts seems to be relatively high in the long‐term. The risk of biliary malignancy in the remnant bile duct increases more than 15 years after cyst excision. Despite an aggressive treatment approach for this condition, subsequent biliary malignancy following cyst excision for congenital choledochal cysts shows an unfavorable outcome.
Characteristics of esophageal proper muscle in patients with non‐cardiac chest pain using high‐frequency intraluminal ultrasound
Authors: Kim Jeong Hwan , Choi Yong Sung , Kim Jae J , Rhee Jong Chul , Rhee Poong‐Lyul
Published: September 2012

Background and Aim

It is unclear which mechanisms play a predominant role in the pathogenesis of esophageal non‐cardiac chest pain (NCCP). We aimed to examine the features of esophageal proper muscle and esophageal contractility using a high‐frequency intraluminal ultrasound (HFIUS) in patients with NCCP.

Methods

A total of 68 patients with NCCP were classified into two groups according to the results of typical reflux symptoms and/or esophagogastroduodenoscopy and/or 24‐h esophageal pH monitoring: gastroesophageal reflux disease (GERD)‐positive NCCP (n = 34) and GERD‐negative NCCP groups (n = 34). Additionally 16 asymptomatic healthy subjects were included as controls. Using HFIUS, we analyzed the esophageal proper muscle thickness and cross‐sectional area (CSA) at 3 cm above lower esophageal sphincter (LES) and 9 cm above LES during baseline rest and peak contraction periods among the control, GERD‐positive NCCP and GERD‐negative NCCP groups, and examined the completeness of three phases of esophageal action during five wet swallows in the three groups.

Results

The muscle thickness and CSA tended to be larger in GERD‐negative NCCP than in GERD‐positive NCCP and in control groups at esophageal body during both periods. All of the controls and patients with GERD‐positive NCCP presented the complete peristaltic type. Whereas, 11 of 34 patients with GERD‐negative NCCP presented the incomplete peristaltic type.

Conclusions

Using HFIUS, patients with GERD‐negative NCCP had increased muscle thickness and CSA. Some GERD‐negative NCCP had the incomplete peristaltic type.
Attenuation of hepatic fibrosis by an imidazolium salt in thioacetamide‐induced mouse model
Authors: Ding Zhaobing , Zhuo Lang
Published: September 2012

Background and Aim

Hepatic fibrosis is a worldwide healthy burden associated with significant morbidity and mortality. It is caused by a variety of chronic liver injuries. There is currently no effective treatment for liver fibrosis. In this report, we tested an imidazolium salt, 1,3‐diisopropylimidazolium tetrafluoroborate (DPIM), for its anti‐fibrotic properties in the thioacetamide‐induced mouse model.

Methods

DPIM was orally delivered to the thioacetamide‐treated mice via drinking water for 12 weeks at the onset of thioacetamide treatment at a concentration of 0.1% (prevention group), and for 4 weeks starting at the 8th week at a concentration of 0.1% or 0.2% (attenuation group), respectively. Messenger RNA and protein were determined by real‐time polymerase chain reaction and Western blotting, matrix metalloproteinase (MMP) activities were measured by fluorogenic peptide substrate and zymography. Mitogen‐activated protein kinase (MAPK) and PI3K inhibitors were applied in HSC‐T6 cells in combination of DPIM to probe possible signal pathways underlying the compound's action.

Results

We observed a significant reduction in collagen deposition in both prevention and attenuation groups. The α‐smooth muscle actin (SMA) and transforming growth factor (TGF)‐β gene expressions were also reduced in both groups. The reduction of collagen deposition could be in part attributed to the suppression of CCR‐2 expression and the enhanced matrix protein remodeling by metalloproteinases, especially MMP‐3. MAPK and PI3K signaling pathways may be partially participated in DPIM's molecular action.

Conclusion

DPIM reduced fibrosis in the thioacetamide‐induced mouse liver fibrosis model, and warranted further studies for possible clinical application in the future.
Impact of long‐term treatment with low‐dose inhaled corticosteroids on the bone mineral density of chronic obstructive pulmonary disease patients: Aggravating or beneficial?
Authors: MATHIOUDAKIS ALEXANDROS G. , AMANETOPOULOU STAVROULA G. , GIALMANIDIS IOANNIS P. , CHATZIMAVRIDOU‐GRIGORIADOU VICTORIA , SIASOS GERASIMOS , EVANGELOPOULOU EFSTATHIA , MATHIOUDAKIS GEORGIOS A.
Published: September 2012

Background and objective:  Chronic obstructive pulmonary disease (COPD) is characterized by a low‐level systemic chronic inflammatory activity that is responsible for many of the disease's extra‐pulmonary manifestations, including osteoporosis and fragility fractures. These manifestations are also well‐documented side‐effects of oral corticosteroids. It was hypothesized that low levels of inhaled corticosteroids, due to their anti‐inflammatory properties and their low circulating levels, might preserve the bone mineral density (BMD) of COPD patients.

Methods:  Two hundred and fifty‐one male ex‐smokers with COPD patients grouped on the basis of their diffusion capacity value as predominantly bronchitic or predominantly emphysematic and 313 male controls with similar age and smoking history were enrolled in the study. Each of the patient's categories was randomized into two separate subgroups. Patients enrolled in subgroups Bneg(n = 91, 36%) and Eneg(n = 37, 14.7%) were treated with long‐acting β2‐agonists and anticholinergics, while subgroups BICS(n = 87, 35%) and EICS(n = 38, 15.1%) were additionally receiving low‐dose inhaled corticosteroids. Patients and controls were evaluated by clinical examination, lung function testing and BMD measurement every 6 months for 4 years.

Results:  According to the findings, emphysematic patients demonstrated an increased rate of BMD loss compared with bronchitic patients (P = 0.01). Furthermore, a reduction of the annual BMD loss in bronchitic patients on inhaled corticosteroids (P = 0.02) was measured, without a corresponding benefit for the emphysematics (P = not significant).

Conclusions:  Long‐term administration of low‐dose inhaled corticosteroids decelerates the annual BMD loss in bronchitic patients, possibly by reducing both pulmonary and systemic chronic inflammation caused by COPD.
Recurrent laryngeal nerve injury in thyroid surgery: a review
Authors: Hayward Nathan James , Grodski Simon , Yeung Meei , Johnson William R. , Serpell Jonathan
Published: September 2012

Recurrent laryngeal nerve palsy (RLNP) is an important and potentially catastrophic complication of thyroid surgery. Permanent RLNP occurs in 0.3–3% of cases, with transient palsies in 5–8%. A literature review and analysis of recent data regarding RLNP in thyroid surgery was performed, with particular focus on the identification of high‐risk patients, the role of intraoperative identification and dissection of the nerve, and the role of intraoperative neuromonitoring (IONM) and optimal perioperative nerve assessment. In conjunction with the review, data from the Monash University/Alfred Hospital Endocrine Surgery Unit between January 2007 and October 2011 were retrospectively analysed, including 3736 consecutive nerves at risk (NAR). The current literature and our data confirm that patients undergoing re‐operative thyroid surgery and thyroid surgery for malignancies are at increased risk of RLNP. Intraoperative visualization and capsular dissection of the RLN remain the gold standard for intraoperative care during thyroid surgery for reducing RLNP risk. IONM should not be used as the sole mechanism for identifying and preserving the nerve, although it can be used to aid in the identification and dissection of the nerve, and may aid in nerve protection in high‐risk cases including cancer surgery and re‐operative surgery.
Association between hospital volume and outcomes of elderly and non‐elderly patients with acute biliary diseases: A national administrative database analysis
Authors: Murata Atsuhiko , Matsuda Shinya , Kuwabara Kazuaki , Ichimiya Yukako , Matsuda Yasufumi , Kubo Tatsuhiko , Fujino Yoshihisa , Fujimori Kenji , Horiguchi Hiromasa
Published: September 2012

Aim:  This study aimed to investigate the relationship between hospital volume and clinical outcomes of elderly and non‐elderly patients with acute biliary diseases using data from a national administrative database.

Methods:  Overall, 26 720 elderly and 33 774 non‐elderly patients with acute biliary diseases were referred to 820 hospitals in Japan. Hospital volume was categorized into three groups based on the case numbers during the study period: low‐volume, medium‐volume and high‐volume. We compared the risk‐adjusted length of stay (LOS) and in‐hospital mortality in relation to hospital volume. These analyses were stratified according to the presence of invasive treatments for acute biliary diseases.

Results:  Multiple linear regression analyses showed that increased hospital volume was significantly associated with shorter LOS in both elderly and non‐elderly patients with and without invasive treatments. Increased hospital volume was significantly associated with decreased relative risk of in‐hospital mortality in elderly patients. The odds ratio for high‐volume hospitals was 0.672 in elderly patients without invasive treatments (95% confidence interval [CI] 0.533–0.847, P = 0.001) and 0.715 in those with invasive treatments (95% C, 0.566–0.904, P = 0.005). However, no significant differences for in‐hospital mortality were seen in non‐elderly patients with and without invasive treatments.

Conclusion:  This study has highlighted that higher volume hospitals significantly reduced LOS and in‐hospital mortality for elderly patients with acute biliary diseases, but not non‐elderly patients. The current results are of value for elderly healthcare policy decision‐making, and highlight the need for further studies into the quality of care for elderly patients. Geriatr Gerontol Int 2013; 13: 731–740.
Campus‐based student experiences of learning technologies in a first‐year science course
Authors: Ellis Robert , Weyers Mark , Hughes Jane
Published: September 2012

This study reports on an investigation into the campus‐based experience of university students studying mammalian physiology that was significantly supported with learning technologies. The design of the course enabled the students to interrogate the key ideas that they came across in their lectures and laboratories through online activities which prepared the students for practical classes. Close‐ended questionnaires were used to uncover qualitative variation in the population sample, particularly the differences in the concepts of learning technologies and approaches to learning technologies. Qualitative variation in concepts of, and approaches to, learning technologies was found to be significantly associated with variation in academic achievement. The outcomes have important implications for the approaches to teaching of campus‐based experiences of learning supported by learning technologies when we seek to support all students to realise their learning outcomes in technology‐mediated processes
CEO Compensation and Corporate Governance in China
Authors: Conyon Martin J. , He Lerong
Published: September 2012

Manuscript Type

Empirical

Research Questions

This study investigates the determination of Chinese CEO pay. We focus on three related questions: (1) Is Chinese CEO pay related to firm performance? (2) Are CEO pay dynamics important? (3) Does corporate governance affect CEO pay and equity incentives in China?

Research Findings

Using data on CEO compensation in China's public traded firms from 2000 to 2010, we document significant changes in CEO pay, ownership and board structure. We document that CEO pay is positively correlated to both accounting and stock market performance, although the link to accounting performance is more robust. We find that CEO pay dynamics are important as pay in the current year is significantly positively correlated to CEO pay the previous year. We also find that CEO equity ownership and equity grants are influenced by board and ownership structure.

Theoretical/Academic Implications

This study supplements the standard agency theory approach to executive compensation with insights gained from the dynamics of wage setting theory developed in the labor economics field. It predicts that incomplete information and learning lead to adjustment costs and non‐instantaneous changes in CEO pay.

Practitioner/Policy Implications

This study offers insights to policy makers interested in enhancing the design of executive compensation and internal corporate governance within transition economies.
The influence of teacher practice placement on one's beliefs about intellectual disability: a student's reflection
Authors: DOODY OWEN , CONNOR MORGAN O
Published: September 2012

Education for people with a disability has changed over the years, moving from a philosophy of integration to inclusion. This philosophy requires a whole school approach spanning issues such as access, opportunities for learning, social experiences and developing a culture of acceptance. While this poses many challenges for individuals, schools and communities, it is a right for all citizens to be educated within their local school in a supportive manner. This article presents a reflection on a teacher practice placement, as through reflecting on one's experience one can promote desirable practice, develop understanding and learning from one's experience. To facilitate the reflection Gibbs' reflective cycle was used, addressing the description, feelings, evaluation, analysis, conclusion and action plan.
Large‐System Transformation in Health Care: A Realist Review
Authors: BEST ALLAN , GREENHALGH TRISHA , LEWIS STEVEN , SAUL JESSIE E. , CARROLL SIMON , BITZ JENNIFER
Published: September 2012

Context:An evidence base that addresses issues of complexity and context is urgently needed for large‐system transformation (LST) and health care reform. Fundamental conceptual and methodological challenges also must be addressed. The Saskatchewan Ministry of Health in Canada requested a six‐month synthesis project to guide four major policy development and strategy initiatives focused on patient‐ and family‐centered care, primary health care renewal, quality improvement, and surgical wait lists. The aims of the review were to analyze examples of successful and less successful transformation initiatives, to synthesize knowledge of the underlying mechanisms, to clarify the role of government, and to outline options for evaluation.

Methods:We used realist review, whose working assumption is that a particular intervention triggers particular mechanisms of change. Mechanisms may be more or less effective in producing their intended outcomes, depending on their interaction with various contextual factors. We explain the variations in outcome as the interplay between context and mechanisms. We nested this analytic approach in a macro framing of complex adaptive systems (CAS).

Findings:Our rapid realist review identified five “simple rules” of LST that were likely to enhance the success of the target initiatives: (1) blend designated leadership with distributed leadership; (2) establish feedback loops; (3) attend to history; (4) engage physicians; and (5) include patients and families. These principles play out differently in different contexts affecting human behavior (and thereby contributing to change) through a wide range of different mechanisms.

Conclusions:Realist review methodology can be applied in combination with a complex system lens on published literature to produce a knowledge synthesis that informs a prospective change effort in large‐system transformation. A collaborative process engaging both research producers and research users contributes to local applications of universal principles and mid‐range theories, as well as to a more robust knowledge base for applied research. We conclude with suggestions for the future development of synthesis and evaluation methods.
Off the Hamster Wheel? Qualitative Evaluation of a Payment‐Linked Patient‐Centered Medical Home (PCMH) Pilot
Authors: BITTON ASAF , SCHWARTZ GREGORY R. , STEWART ELIZABETH E. , HENDERSON DANIEL E. , KEOHANE CAROL A. , BATES DAVID W. , SCHIFF GORDON D.
Published: September 2012

Context: Many primary care practices are moving toward the patient‐centered medical home (PCMH) model and increasingly are offering payment incentives linked to PCMH changes. Despite widespread acceptance of general PCMH concepts, there is still a pressing need to examine carefully and critically what transformation means for primary care practices and their patients and the experience of undergoing such change in a practice.

Methods: We used a qualitative case study approach to explore the underlying dynamics of change at five practices participating in PCMH transformation efforts linked to payment reform. The evaluation consisted of structured site visits, interviews, observations, and artifact reviews followed by a structured review of transcripts and documents for patterns, themes, and insights related to PCMH implementation.

Findings: We describe both the detailed components of each practice's transformation efforts and a grounded taxonomy of eight insights stemming from the experiences of these medical homes. We identified specific contextual factors related to wide variations in change tactics. We also observed widely varying approaches to catalyzing change using (or not) external consultants, specific challenges regarding health information technology implementation, team and staff role restructuring, compensation, and change fatigue, and several unexpected potential confounders or alternative explanations for practice success.

Conclusions: Our evaluation affirms the value and necessity of qualitative methods for understanding primary care practice transformation, and it should encourage ongoing and future pilots to include assessments of the PCMH change process beyond clinical markers and claims data. The results raise insights into the heterogeneity of medical home transformation, the central but complex role of payment reform in creating a space for change, the ability of small practices to achieve substantial change in a short time period, and the challenges of sustaining it.
Asymmetric trade protection leading not to productivity but to export share change
Authors: Shin Hochul , Lee Keun
Published: September 2012

This article revisits a classical theme in economics, that is, the relationship between trade protection and economic performance, with an improved treatment of the endogeneity of tariffs and with consideration of alternative performance criteria. This paper also considers the effects of asymmetric protection, such as higher tariffs on consumer goods and lower tariffs on producer goods. Using sectoral data on Korean manufacturing during the period from 1967 to 1993, this study finds that the effect of trade protection by tariff tends to show up not in terms of total factor productivity but in terms of revealed comparative advantage and export shares of sectors. Such an effect tends to be greater in consumer goods, which are the main targets of promotion by higher tariffs. This study verifies the potentially positive role of tariffs under certain conditions, especially under discipline from world markets.
Local governments’ fiscal balance and privatization in transition countries1
Authors: Crivelli Ernesto
Published: September 2012

Several transition economies have undertaken fiscal decentralization reforms over the past two decades along with liberalization, privatization and stabilization reforms. Theory predicts that decentralization may aggravate fiscal imbalances, unless the right incentives are in place to promote fiscal discipline. This study uses a panel of 20 transition countries over 19 years to address a central question of fact: Did privatization help to promote local governments’ fiscal discipline? The answer is clearly ‘no’ for privatization considered in isolation. However, privatization and subnational fiscal autonomy along with reforms to the banking system – restraining access to soft financing – may prove effective at improving fiscal balances among local governments.
Plumage polymorphism in a newly colonized black sparrowhawk population: classification, temporal stability and inheritance patterns
Authors: Amar A. , Koeslag A. , Curtis O.
Published: September 2012

Persistent plumage polymorphism occurs in around 3.5% of bird species, although its occurrence is not distributed equally across bird families or genera. Raptors show a disproportionately high frequency of polymorphism, and among raptors it is particularly frequent among theAccipiterhawks. However, no systematic study of polymorphism in this genus exists. Using a long‐term study of the black sparrowhawk (Accipiter melanoleucus), a widespread polymorphicAfricanAccipiter, we first demonstrate that the species shows discrete polymorphism (cf. continuous polymorphism), occurring as either dark or light morph adults, and that morph type and plumage pattern are invariant with age. We then demonstrate that adult morph type follows a typicalMendelian inheritance pattern, suggesting a one‐locus, two‐allele system within which the allele coding for the light morph is dominant. This inheritance pattern provides further support for classifying polymorphism in this species as discrete. In most of the species' range the dark morph is the rarer morph; however, in our study population where the species is a recent colonist, over 75% of birds were dark and this remained fairly constant over the 10 years of our study. This reversal in morph ratio may represent an adaptive response to different environmental conditions or could be a founder effect with colonizing individuals having been mostly dark morph birds simply by chance. The extreme differences in environment conditions (seasonality of rainfall) that occur across the species' range inSouthAfrica provide support for an adaptive explanation, but further work is needed to test this hypothesis.
Maternal hypertension and intrapartum fever are associated with increased risk of ischemic stroke during infancy
Authors: MANN JOSHUA R , MCDERMOTT SUZANNE , PAN CHUN , HARDIN JAMES W
Published: September 2012

Aim  To examine maternal hypertension, diabetes, and intrapartum fever as potential risk factors for ischemic stroke in infants.

Method  We conducted a retrospective cohort study of 226 117 children born from January 2000 to December 2007 who were enrolled in the South Carolina Medicaid program. We linked maternal and child Medicaid billing records and birth certificate data. Children with ischemic stroke were identified based on the International Classification of Diseases, Ninth Revision (ICD‐9), code 434 in the child’s billing data. Independent variables and covariates were identified using ICD‐9 codes and birth certificate data. We modeled the odds of ischemic stroke diagnosis in infants, either before 30 days of life or before 365 days.

Results  Forty‐three children were diagnosed with ischemic stroke before 30 days and 161 before 365 days. Maternal hypertension (odds ratio 2.31 before 30d) and intrapartum fever (odds ratio 3.36 <30d) were significantly associated with odds of ischemic stroke before 30 days and before 365 days; maternal diabetes was not.

Interpretation  Maternal hypertension and intrapartum fever appear to be risk factors for ischemic stroke in infants. Additional research is needed to determine the mechanism(s) underlying these associations and to develop effective preventive methods for high‐risk infants.
Measures used in assessing outcomes of school‐wide positive behaviour support
Authors: Brandt Rachel C. , Chitiyo Morgan , May Michael E.
Published: September 2012

School‐Wide Positive Behaviour Support (SWPBS) is increasingly becoming a popular approach to managing challenging behaviour in schools. However, several issues still have to be addressed facilitate successful implementation of this approach in schools. One of these issues pertains to the appropriateness of the different measures used to determine the efficacy of the approach. Because many schools are using indirect measures to assess the effects of SWPBS implementation, determining which measures more accurately reflect the effectiveness of the SWPBS components may increase the effectiveness of school measurement systems. The purpose of this study was to examine the measures used in evaluating the efficacy of positive behaviour support. The paper discusses the strengths and weaknesses of outcome measures regarding problem behaviour, prosocial behaviour, and implementation fidelity.
Daily variation in markers of nutritional condition in wintering Black‐capped Chickadees Poecile atricapillus
Authors: Mandin Clément , Vézina François
Published: September 2012

The plasma metabolites triglycerides (TRIG) and β‐hydroxybutyrate (BUTY) are used as indices of nutritional condition in migrating birds during refuelling and can provide a measure of relative fattening rates in individual birds. Because non‐migratory birds wintering at northern latitudes also fatten on a daily basis to support their overnight fast, blood metabolites could provide a useful tool to measure individual performance in energy acquisition. However, daily patterns of metabolite change may differ between species and could be affected by thermoregulatory requirements. We studied daily variation in TRIG and BUTY over a complete winter in Black‐capped Chickadees to determine the pattern of daily and seasonal change in these markers. We also assessed how short‐term variation (up to 7 days) in weather parameters that influence heat exchange may affect TRIG and BUTY levels. In contrast to a linear gain of body mass, TRIG increased non‐linearly during the day, with a rapid increase in the morning that levelled off in the afternoon, whereas BUTY did not change significantly. Metabolites varied with sampling time and the seasonal change in day length, suggesting higher fat catabolism and fattening rates in mid‐winter. TRIG and BUTY also differed between capture sites, possibly due to differences in shelter quality. Weather variation did not affect TRIG levels and had a significant but marginal effect on BUTY, explaining at best 3% of the variation. Our results suggest that these markers can be used as indicators of energy turnover in resident wintering passerines.