bluuebunny/crossref_metadata_2025 huggingface dataset:
Exam‐indicated cerclage in patients with fetal membranes at or beyond external os: A retrospective evaluation
Authors: Curti Alessandra , Simonazzi Giuliana , Farina Antonio , Mehmeti Hilda , Facchinetti Fabio , Rizzo Nicola
Published: May 2012

Aim:  To evaluate pregnancy outcome in women with fetal membranes at or beyond external os who underwent exam‐indicated cerclage or conservative management.

Material and Methods:  Retrospective cohort study including 52 patients with fetal membranes at or beyond external os between 17 and 27 weeks of gestation, treated in two third‐level hospitals, between January 2001 and April 2009. The outcomes of interest of the study, prolongation of pregnancy and neonatal survival rate, were stratified according to type of management, parity, clinical conditions and blood tests at admission and calculated using the Kaplan–Meier algorithm.

Results:  Of 52 women, 37 received exam‐indicated cerclage and 15 were managed conservatively. The rate of patients still pregnant beyond 180 days within the cerclage group differed significantly from those of the conservative management group (80% vs 0%, respectively) (P‐value < 0.001). No difference has been found according to neonatal survival (82% versus 53%, respectively).

Conclusion:  Exam‐indicated cerclage appears to prolong gestation compared to expectant management.
Value of serum urocortin concentration in the prediction of preterm birth
Authors: Kashanian Maryam , Bahasadri Shohreh , Ghasemi Afsaneh , Bathaee Saeedesadat
Published: May 2012

Aim:  Preterm delivery is a serious problem during pregnancy with remarkable neonatal adverse effects. Prediction of preterm delivery in women with preterm uterine contractions or signs of preterm labor is critical because if these women are identified they can be referred to tertiary centers. The present study aimed to evaluate the value of maternal serum urocortin concentration for predicting preterm delivery in women with signs of spontaneous preterm labor.

Material and Methods:  A cohort study was conducted on pregnant women at a gestational age of 28–36 weeks who were admitted to the labor ward with spontaneous preterm labor. A blood sample was obtained from all participants to measure serum urocortin. The women were monitored up to delivery and serum urocortin was compared between women with preterm delivery and those who delivered at term (37 weeks of gestation). Receiver Operating Characteristic (ROC) curve analysis was used to determine sensitivity and specificity if applicable.

Results:  One hundred and sixty pregnant women finished the study. One hundred and forty‐eight (92.5%) of the women delivered preterm. Mean serum urocortin in the preterm delivery group was higher than in the term group, but without statistical significant difference (392.6 ± 29.23 vs 113.2 ± 11.0. pg/mL, respectively, P = 0.252). Area under the ROC curve was 0.6, which shows that this test is not appropriate for predicting preterm delivery in women with preterm labor.

Conclusion:  Serum urocortin could not predict women who delivered preterm among women with signs of preterm labor.
Outcome of Prolift mesh repair in treatment of pelvic organ prolapse and its effect on lower urinary tract symptoms: 5‐year retrospective case study
Authors: Gad Nader , Duvvuru Amulya , Burchgart Brook
Published: May 2012

Aim:  To assess the outcome of the Prolift Gynecare (Ethicon, Somerville, NJ, USA) mesh repair in the treatment of pelvic organ prolapse. This includes the anatomical success, complication rate and effect on associated lower urinary tract symptoms.

Material and Methods:  Retrospective case analysis of the above outcomes of 41 Prolift mesh repairs performed on 40 women over a 5‐year period by a single surgeon in a private hospital in Australia.

Results:  Successful anatomical correction and bulge symptom resolution were observed in 100% (2/2), 91.6% (11/12) and 100% (27/27) of anterior, posterior and total Prolift, respectively. Prolapse in a non‐treated compartment occurred in one woman. Two patients developed postoperative hematomas requiring surgical evacuation; one of whom developed urinary retention for 2 weeks. Preoperative urinary symptoms were reported in 35/40 (92%) of women, 8 of whom reported only urge symptoms and experienced complete resolution after Prolift. Resolution of stress urinary incontinence in women who had urodynamic stress incontinence with and without urge symptoms was reported in 60% (12/20) and 20% (1/5), respectively. This represented 62.5% (10/16) and 33.3% (3/9) of women who had total Prolift and posterior Prolift respectively. Average follow‐up periods were 7 and 39 weeks in 38 and 18 women, respectively.

Conclusion:  This study shows that Prolift procedure is safe and effective in women with severe pelvic organ prolapse with resolution of most of the bulge and urinary urge symptoms. Total Prolift was effective in the treatment of associated mixed urinary incontinence.
Exogenous vascular endothelial growth factor supplementation can restore the podocyte barrier‐forming capacity disrupted by sera of preeclamptic women
Authors: Henao Daniel E. , Cadavid Ángela P. , Saleem Moin A.
Published: May 2012

Aim:  To determine whether exogenous vascular endothelial growth factor (VEGF) supplementation to sera from women with preeclampsia can restore the podocyte barrier‐forming capacity disrupted after stimulation with sera from these women.

Material and Methods:  Enzyme‐linked immunosorbent assays (ELISAs) for sFlt‐1 (soluble VEGF receptor 1) and VEGF were performed in the sera of preeclamptic and healthy pregnant women. VEGF‐enriched preeclamptic serum was used to evaluate the capacity of such sera to restore the diminished podocyte barrier capacity secondary to stimulation with untreated preeclamptic sera.

Results:  Two groups, preeclampsia (n = 15) and healthy (n = 15) pregnant women, were established. Median serum levels (pg/mL) of sFlt‐1 and VEGF were significantly different between groups: 3987 versus 1432 and 6 versus 15.6 (P < 0.001). Altered resistance values of podocytes stimulated with sera from women with preeclampsia were recovered after exogenous VEGF supplementation.

Conclusion:  The mean resistance value of cultured podocytes, an indicator of the integrity of the cytoskeleton and the capacity of these cells to form layers, is altered in women with preeclampsia. High levels of sFlt‐1, an inhibitor of VEGF observed in high concentrations in the serum of these patients, could be the underlying cause of this alteration. We provide evidence that exogenous VEGF supplementation of the sera of these women could recover this indicator.
Robotic surgery and standard laparoscopy: A surgical hybrid technique for use in colorectal endometriosis
Authors: Vitobello Domenico , Fattizzi Nicola , Santoro Giuseppe , Rosati Riccardo , Baldazzi Gianandrea , Bulletti Cinzia , Palmara Vittorio
Published: May 2012

Aim:  The aim of our work was to assess the feasibility and possible benefits of a novel hybrid surgical technique in rectosigmoidal resection in patients with bowel endometriosis.

Material and Methods:  A total of seven symptomatic and infertile women with severe bowel endometriosis underwent segmental bowel resection using the da Vinci surgical system and conventional laparoscopy. Statistical analysis was performed by Friedman test for non‐parametric multiple comparisons.

Results:  The surgical procedure has a determined short mean operative time (210 min) and short postoperative hospitalization (five days). In 100% of patients, the resected area showed disease‐free margins. Follow‐up, carried out at three, six and 12 months after operation, showed a regression of painful symptoms in all operated patients (100%). Two patients (28.6%) aged ≥ 35 years eventually had natural pregnancies.

Conclusion:  To the best of our knowledge, this report is the first concerning the use of a hybrid technique for intestinal resection in severe endometriosis, and comparing our data with that in the literature, its methodological and clinical advantages are evident. Moreover, the complete removal of endometriotic implants seems to offer good results in terms of postoperative fertility, although the study data do not allow us to draw definitive conclusions on the management of fertility.
Analysis of cases with cesarean scar pregnancy
Authors: Zhang Yu , Gu Yan , Wang Jian‐Mei , Li Yi
Published: May 2012

Aim:  To discuss the early diagnosis and effective treatment strategy of cesarean scar pregnancy (CSP).

Material and Methods:  We reviewed 17 patients in our department diagnosed with CSP between 2005 and 2010, including clinical characteristics, early diagnosis, treatment methods, side‐effects and prognosis.

Results:  The average duration of gestation at diagnosis was 46 days (range 37–82) and the interval between CSP and last cesarean scar was 6 years (range 2–15). Fourteen (82%) patients presented with slight vaginal bleeding and two (12%) complained of abdominal discomfort. Fourteen patients were diagnosed with CSP by transvaginal color Doppler ultrasonography (TVCDUS). Magnetic resonance imaging (MRI) was performed in two cases of CSP when the diagnosis by TVCDUS was difficult. One patient was diagnosed by histological examination of hysterectomy specimens due to life‐threatening bleeding during curettage. Seven patients initially diagnosed with CSP before pregnancy termination were treated conservatively to preserve the uterus without causing maternal complications, ten patients underwent curettage due to incorrect diagnosis, eight patients had excessive vaginal bleeding during curettage and three patients underwent emergency hysterectomy due to hypovolemic shock.

Conclusion:  CSP does not have any specific symptoms and can be easily diagnosed incorrectly. Confirmation of a portion of gestational sac in the uterus is important and TVCDUS is the first‐line tool for early diagnosis of CSP. Physicians never perform curettage at diagnosis with CSP, but curettage after uterine artery embolism or methotrexate are better treatments of choice to terminate CSP.
Three‐dimensional conformal brachytherapy boost in locally recurrent or residual cervical carcinoma: Does it impact clinical outcome?
Authors: Bansal Vivek , Kumar Gaurav , Bhutani Ritu , Venkadamanickam Gurusamy , Sharma Surender Kumar , Sigamani Ashok Kumar , Shekhon Rupinder , Rawal Sudhir Kumar
Published: May 2012

Aim:  To analyze the influence of computed tomography (CT)‐guided 3D conformal interstitial brachytherapy (3D‐IBT) boost for better coverage of target volumes and study the diametric impact to organ at risk in patients with post‐surgery recurrent and residual cervical cancer.

Material and Methods:  Fourteen consecutive patients with recurrent or residual cervical cancer who were treated with interstitial brachytherapy as a boost were included in the study. All patients received 50.4 Gy external radiation (EBRT) to whole pelvis with conformal technique to reduce the dose to bowel. The clinical target volume (CTV) and organs at risk were contoured on CT scan with gold seeds being a surrogate marker of initial tumor extent implanted before commencing treatment. The median dose of prescription was 10.5–12 Gy in 3 fractions. Dose volume histogram was calculated to evaluate the dose that covers 100% and 90% of the target volume and dose to the bladder, rectum and bowel (2 mL, 1 mL volume).

Results:  The median follow‐up was 12 months (range 6–18). The doses to CTV (D90, D100) ranged from 1141 to 2014 cGy, and 585 to 969 cGy, respectively. The mean cumulative 2‐mL rectal, bladder and bowel doses were 66.70, 73.15 and 61.01 Gy, respectively. Rectal toxicity of grade 2 or more had a strong correlation with the dose delivered (Spearman's correlation, 0.950). The local control rate at one year was 92% with failure seen in one patient only.

Conclusion:  Conformal EBRT supplemented with 3D‐IBT seems to be a practical and appropriate approach to give the most optimal therapeutic benefit with the least side‐effects in postoperative recurrent and residual cervical cancer patients.
Corpus luteum hemorrhage in a patient with aplastic anemia
Authors: Sun Wen‐Chao , Li Wei , Chen Qi‐Hui , Tong Jin‐Yi
Published: May 2012

Corpus luteum hemorrhage may lead to a life‐threatening intraperitoneal hemorrhage in women with bleeding disorders. A 17‐year‐old girl with aplastic anemia presented to the emergency ward with complaints of severe abdominal pain for the last 24 h. On examination, she was noted to be pale with circulatory compromise. Transabdominal pelvic ultrasonography revealed a left complex adnexal mass, 6.9 × 5.1 × 5.1 cm3 in size, with a large anechoic area of fluid in the abdomen. On laparoscopic exploration, there was a massive hemoperitoneum (2.6 L) with a ruptured corpus luteum on the surface of the left ovary. Hemostatic electric coagulation was successfully applied to the bleeding surface. The patient recovered without incident and was transferred to a special hospital for blood disease treatment one week after surgery. We concluded that corpus luteum hemorrhage in women with aplastic anemia can cause therapeutic difficulties. Laparoscopy is feasible for the management of a massive intraperitoneal hemorrhage secondary to a ruptured corpus luteum in such patients.
Migratory pathways of GABAergic interneurons when they enter the neocortex
Authors: Tanaka Daisuke H. , Nakajima Kazunori
Published: May 2012

Inhibitory gamma‐aminobutyric‐acid‐containing interneurons play important roles in the functions of the neocortex. During rodent development, most neocortical interneurons are generated in the subpallium and migrate tangentially toward the neocortex. They migrate through multiple pathways to enter the neocortex. Failure of interneuron migration through these pathways during development leads to an abnormal distribution and abnormal functions of interneurons in the postnatal brain. Because of recent discoveries regarding the novel origins and migratory pathways of neocortical interneurons, in this article we review the literature on the migratory pathways of interneurons when they enter the neocortex.
Mild activation of poly(ADP‐ribose) polymerase (PARP) is neuroprotective in rat hippocampal slice models of ischemic tolerance
Authors: Gerace Elisabetta , Scartabelli Tania , Formentini Laura , Landucci Elisa , Moroni Flavio , Chiarugi Alberto , Pellegrini‐Giampietro Domenico E.
Published: May 2012

Ischemic tolerance is a phenomenon in which exposure to a mild preconditioning stress results in resistance to a subsequent lethal ischemic insult. Here we investigated the role of poly(ADP‐ribose) polymerase (PARP) in the development of ischemic tolerance by using organotypic rat hippocampal slices exposed to 30 min oxygen‐glucose deprivation (OGD), which leads to selective injury of the CA1 subregion 24 h later. We developed models of pharmacological preconditioning by exposing slices to subtoxic concentrations of either N‐methyl‐d‐aspartate (NMDA) or (S)‐3,5‐dihydroxyphenylglycine (DHPG) and then, 24 h later, to 30 min OGD. Under these conditions, we observed a significant reduction in OGD‐induced CA1 damage. Exposure of slices to the PARP‐1 and ‐2 inhibitors TIQ‐A, PJ‐34 and UPF 1069 during preconditioning prevented the development of OGD tolerance in a concentration‐dependent manner. NMDA and DHPG preconditioning increased the activity of PARP, as detected by immunoblots using antibodies against the poly(ADP‐ribose) polymer product, but was not associated with consumption of cellular NAD+ or ATP. Neuroprotection induced by preconditioning was also prevented by the caspase inhibitor Z‐VAD‐FMK. The modest but significant increase in caspase‐3/7 induced by preconditioning, however, was not associated with PARP‐1 cleavage, as occurred with staurosporine. Finally, TIQ‐A prevented the activation of ERK1/2 and Akt induced by NMDA preconditioning, suggesting that the protective mechanism evoked by PARP requires activation of these prosurvival mediators. Our results suggest that preconditioning with appropriate pharmacological stimuli may promote neuroprotective mechanisms triggered by the sublethal activation of two otherwise deleterious executioners such as PARP and caspase‐3/7.
Intermediate fragmentation per se provides stable predator‐prey metapopulation dynamics
Authors: Cooper Jennifer K. , Li Jiqiu , Montagnes David J. S.
Published: May 2012

The extent to which a landscape is fragmented affects persistence of predator‐prey dynamics. Increasing fragmentation concomitantly imposes conditions that stabilise and destabilise metapopulations. For the first time, we explicitly assessed the hypothesis that intermediate levels provide optimal conditions for stability. We examine four structural changes arising from increased fragmentation: increased fragment number; decreased fragment size; increased connectedness (corridors scaled to fragment); increased fragment heterogeneity (based on connectedness). Using the model predator‐prey system (Didinium‐Paramecium) we support our hypothesis, by examining replicated metapopulations dynamics at five fragmentation levels. Although both species became extinct without fragmentation, prey survived at low and high levels, and both survived at intermediate levels. By examining time to extinction, maximum abundances, and population asynchrony we conclude that fragmentation produces structural heterogeneity (independent of environmental heterogeneity), which influences stability. Our analysis suggests why some theoretical, field and microcosm studies present conflicting views of fragmentation effects on population persistence.
Water–sediment niche differentiation in ancient marine lineages of Exiguobacterium endemic to the Cuatro Cienegas Basin
Authors: Rebollar Eria A. , Avitia Morena , Eguiarte Luis E. , González‐González Andrea , Mora Lucy , Bonilla‐Rosso Germán , Souza Valeria
Published: May 2012

The evolutionary history and ecological differentiation of the genus Exiguobacterium was characterized within natural communities from the Cuatro Cienegas Basin, Mexico. Exiguobacterium comprises both halophilic and alkaliphilic bacteria that are abundant among the aquatic systems of the Cuatro Cienegas Basin. We obtained complete sequences of the 16srRNA gene and partial sequences of four housekeeping genes (citC, rpoB, recA and hsp70) in 183 Exiguobacterium isolates retrieved from distinct aquatic systems. We defined three main phylogroups that are closely related to marine and thermophilic species of the genus. These phylogroups were neither specific to a given aquatic system nor to a particular salinity. Phylogenetic reconstruction indicated the presence of several small clusters within the phylogroups. These clusters consisted of isolates predominantly retrieved from sediment or water. Unifrac and AdaptML analyses confirmed this observation, pointing towards a clear pattern of differentiation linked to either sediment or water habitats. Our results are in line with the concept that niche differentiation is one of the main factors shaping prokaryotic populations and leading to evolutionary divergence.
Low‐ammonia niche of ammonia‐oxidizing archaea in rotating biological contactors of a municipal wastewater treatment plant
Authors: Sauder Laura A. , Peterse Francien , Schouten Stefan , Neufeld Josh D.
Published: May 2012

The first step of nitrification is catalysed by both ammonia‐oxidizing bacteria (AOB) and archaea (AOA), but physicochemical controls on the relative abundance and function of these two groups are not yet fully understood, especially in freshwater environments. This study investigated ammonia‐oxidizing populations in nitrifying rotating biological contactors (RBCs) from a municipal wastewater treatment plant. Individual RBC stages are arranged in series, with nitrification at each stage creating an ammonia gradient along the flowpath. This RBC system provides a valuable experimental system for testing the hypothesis that ammonia concentration determines the relative abundance of AOA and AOB. The results demonstrate that AOA increased as ammonium decreased across the RBC flowpath, as indicated by qPCR for thaumarchaeal amoA and 16S rRNA genes, and core lipid (CL) and intact polar lipid (IPL) crenarchaeol abundances. Overall, there was a negative logarithmic relationship (R2 = 0.51) between ammonium concentration and the relative abundance of AOA amoA genes. A single AOA population was detected in the RBC biofilms; this phylotype shared low amoA and 16S rRNA gene homology with existing AOA cultures and enrichments. These results provide evidence that ammonia availability influences the relative abundances of AOA and AOB, and that AOA are abundant in some municipal wastewater treatment systems.
MRSA infections following colorectal surgery in an enhanced recovery programme
Authors: Phillips A. W. , Cranfield K. J. , Horgan A. F.
Published: May 2012

Aim  The aim of this study was to evaluate the incidence of methicillin‐resistant Staphylococcus aureus (MRSA) infections in a cohort of patients undergoing elective colorectal resections within an enhanced recovery programme.

Method  A prospective database of all patients undergoing colorectal resections by a single surgical team over a 3.5‐year period was reviewed. Demographics including age, gender, body mass index, American Society of Anesthesiologists classification, type of surgery (abdominal or pelvic) and whether or not the procedure was laparoscopic or open were analysed. All patients were screened preoperatively and postoperatively and on discharge for MRSA. Patients found preoperatively to be MRSA positive were excluded from the study.

Results  In all, 186 patients underwent colorectal resection over the time reviewed. There were 113 laparoscopic resections, 70 open resections and three laparoscopic converted to open resections. Five patients (2.7%) were found to be MRSA positive postoperatively. All of these had open rather than laparoscopic surgery (P < 0.01). Length of stay for patients that had MRSA infections was significantly longer than those remaining MRSA free (P < 0.05).

Conclusion  These results suggest that patients who successfully undergo laparoscopic colorectal resections within an enhanced recovery programme have a lower incidence of postoperative MRSA infections.
Characterization of structure and function of the mouse retina using pattern electroretinography, pupil light reflex, and optical coherence tomography
Authors: Mohan Kabhilan , Harper Matthew M. , Kecova Helga , Ye Eun‐Ah , Lazic Tatjana , Sakaguchi Donald S. , Kardon Randy H. , Grozdanic Sinisa D. ,   CR: BioMed Vision Technologies, Neuroptics Inc.
Published: May 2012

Objective  To perform in vivo analysis of retinal functional and structural parameters in healthy mouse eyes.

Animal Studied  Adult C57BL/6 male mice (n = 37).

Procedures  Retinal function was evaluated using pattern electroretinography (pERG) and the chromatic pupil light reflex (cPLR). Structural properties of the retina and nerve fiber layer (NFL) were evaluated using spectral‐domain optical coherence tomography (SD‐OCT).

Results  The average pERG amplitudes were found to be 11.2 ± 0.7 μV (P50‐N95, mean ± SEM), with an implicit time for P50‐N95 interval of 90.4 ± 5.4 ms. Total retinal thickness was 229.5 ± 1.7 μm (mean ± SEM) in the area centralis region. The thickness of the retinal nerve fiber layer (mean ± SEM) using a circular peripapillary retinal scan centered on the optic nerve was 46.7 ± 0.9 μm (temporal), 46.1 ± 0.9 μm (superior), 45.8 ± 0.9 μm (nasal), and 48.4 ± 1 μm (inferior). The baseline pupil diameter was 2.1 ± 0.05 mm in darkness, and 1.1 ± 0.05 and 0.56 ± 0.03 mm after stimulation with red (630 nm, luminance 200 kcd/m2) or blue (480 nm, luminance 200 kcd/m2) light illumination, respectively.

Conclusions  Pattern electroretinography, cPLR and SD‐OCT analysis are reproducible techniques, which can provide important information about retinal and optic nerve function and structure in mice.
Pre‐school children creating and communicating with digital technologies in the home
Authors: McPake Joanna , Plowman Lydia , Stephen Christine
Published: May 2012

There is a limited literature on pre‐school children's experiences withdigital technologiesat home and little discussion of the ways in which children harness these technologies for their own purposes. This paper discusses findings drawn from three studies that investigated the role ofdomestic technologiesanddigital toys and gamesin young children's lives. Specifically, it focuses on children's early communicative and creative experiences, concluding that digital technologies have the potential to expand young children's repertoire of activities in this context. It is therefore important that pre‐school and early years specialists recognise and respond to the expertise children will have already developed by the time they enter formal education, given the increasing technologisation of communicative and creative activities, likely to continue over the life course of those born at the start of the 21st century.

Practitioner notes

What is already known about this topic

Young children's emergent communicative and creative competences in the early years represent valuable starting points for their more formal development—particularly in the context of early literacy—when they start school.

What this paper adds

This paper explores ways in which these developing competences are supported bydomestic digital technologies—the wide and increasing range of technological tools, ranging from computers and mobile phones to MP3 players and technological toys and games available in the home.

It concludes that digital technologies have the potential both to facilitate communicative and creative tasks and to expand young children's repertoires.

Implications for practice and/or policy

Early years policy in the UK already draws attention to the need to build on the experiences children bring with them from home, including their experiences of using domestic digital technologies.

Practitioners need to develop imaginative ways of responding to what children already know and can do with technology, in the context of communicating and creating, given the growing significance of digital technologies in these fields.
The role of corticosteroids in the management of chronic subdural hematoma: a systematic review
Authors: Berghauser Pont L. M. E. , Dirven C. M. F. , Dippel D. W. J. , Verweij B. H. , Dammers R.
Published: May 2012

The role of corticosteroids in the management of chronic subdural hematoma (CSDH) remains a matter of debate. Standard surgical treatment has recurrence rates reported between 4 and 26%. We reviewed the safety and effectiveness of corticosteroids both as a monotherapy and as an adjunct to surgery in patients with CSDH. PubMed‐MEDLINE, EMBASE and Cochrane databases were searched in July 2011 for randomized controlled trials and for prospective and retrospective cohort studies, reporting on 10 or more adult patients with CSDH. Quality was assessed according to the STROBE checklist. Corticosteroid monotherapy and surgery with corticosteroids as an adjunct were compared with no treatment or surgery only, with regard to lethality, neurological outcome, secondary intervention and complications. Five observational studies were included in this review. There was no randomized allocation of treatment in any study. Secondary intervention rates ranged from 3 to 28%, lethality rates ranged from 0 to 13%, and good outcome was seen in 83–100%. Hyperglycemia occurred more often in patients treated with corticosteroids. In only two studies, one case of gastrointestinal bleeding was observed. Five observational studies suggest that corticosteroids might be beneficial in the treatment of CSDH; however, there is a lack of well‐designed trials that support or refute the use of corticosteroids in CSDH. These results encourage further randomized clinical trials to establish the role of corticosteroids in CSDH.
Exposure to environmental toxins and the risk of sporadic motor neuron disease: an expanded Australian case–control study
Authors: Pamphlett R.
Published: May 2012

Background and purpose

It remains unclear what role environmental toxins play in sporadic motor neuron disease (SMND) and its most common subtype, amyotrophic lateral sclerosis (SALS). Most previous studies of this issue have contained only small numbers of SMND cases. We sought to re‐examine possible associations between toxins and SMND in a large Australian case–control study.

Methods

Questionnaire data were available from 787 patients with SMND (614 with SALS) and 778 non‐related controls. Individuals were asked whether they had been exposed to metals or chemicals/solvents at work or to herbicides/pesticides. Chi‐square tests with odds ratios and 95% confidence intervals were calculated for responses, and significance levels were corrected for multiple testing.

Results

Men were more likely to acquire SALS if they worked with metals (OR = 1.95, 95% CI = 1.24–3.07) or chemicals/solvents (OR = 1.96, 95% CI = 1.46–2.61) or if they had been exposed to herbicides or pesticides (OR = 1.77, 95% CI = 1.30–2.39). Women who had worked with chemicals or solvents also appeared to be at increased risk of acquiring SALS (OR = 1.71, 95% CI = 1.22–2.40).

Conclusions

These results support previous reports that exposures to metals or chemicals are associated with SMND. A suggested protocol for future multinational studies of environmental toxins and SMND is presented.
Detection of microbleeds in post‐mortem brains of patients with frontotemporal lobar degeneration: a 7.0‐Tesla magnetic resonance imaging study with neuropathological correlates
Authors: De Reuck J. , Deramecourt V. , Cordonnier C. , Auger F. , Durieux N. , Bordet R. , Maurage C. A. , Leys D. , Pasquier F.
Published: May 2012

Background

Microbleeds (MBs) are frequently detected in brains of patients with Alzheimer dementia and rare in those with frontotemporal lobar degeneration (FTLD). This study investigates for the first time the topographic distribution of MBs on a T2*‐weighted gradient‐echo 7.0‐T magnetic resonance imaging (MRI) in post‐mortem FTLD brains.

Patients and methods

The neuropathological and MRI findings in 12 FTLD brains were compared with eight age‐matched controls. The presence of cerebrovascular lesions was evaluated on a coronal section of a cerebral hemisphere at the level of the mamillary body and on a horizontal section through pons and cerebellum. On MRI, the distribution and the number of cortical focal signal intensity losses, representing MBs, were assessed on coronal sections at the frontal, the central and the occipital level of a cerebral hemisphere.

Results

Overall, cerebrovascular lesions were rare. Only white matter damage was significantly more severe in FTLD brains compared with controls (P = 0.03). On MRI, MBs were only significantly prevalent in the deep cortical layers (P < 0.01) and borderline increased in the middle cortical layers (P = 0.07) of the frontal section.

Conclusions

Cerebrovascular lesions are rare in FTLD. The white matter damage has to be considered as part of the neurodegenerative process. MBs prevail in the frontal regions with the most severe neuronal damage and probably represent associated disruption of the blood–brain barrier.
Reduced release and binding of perforin at the immunological synapse underlies the age‐related decline in natural killer cell cytotoxicity
Authors: Hazeldine Jon , Hampson Peter , Lord Janet M.
Published: May 2012

Physiological aging is accompanied by a marked reduction in natural killer (NK) cell cytotoxicity (NKCC) at the single cell level, but the underlying mechanisms are unknown. To address this issue, we isolated NK cells from healthy young (≤ 35 years) and old (≤ 60 years) subjects and examined the effect of age on events fundamental to the process of NKCC. Simultaneous assessment of NKCC and NK cell–target cell conjugate formation revealed a marked age‐associated decline in NK cell killing but comparable conjugate formation, indicating a post‐target cell binding defect was responsible for impaired NKCC. Despite a reduction in the proportion of NK cells expressing the activatory receptor NKp46, NK cells from old donors were not hyporesponsive to stimulation, as no age‐associated difference was observed in the expression of the early activation marker CD69 following target cell coculture. Furthermore, intracellular levels of the key cytotoxic effector molecules perforin and granzyme B, and the fusion of secretory lysosomes with the NK cell membrane were also similar between the two groups. However, when we examined the binding of the pore‐forming protein perforin to the surface of its target cell, an event that correlated strongly with target cell lysis, we found the percentage of perforin positive target cells was lower following coculture with NK cells from old subjects. Underlying this reduction in binding was an age‐associated impairment in perforin secretion, which was associated with defective polarization of lytic granules towards the immunological synapse. We propose that reduced perforin secretion underlies the reduction in NKCC that accompanies physiological aging.
The geodemographics of access and participation in Geography
Authors: SINGLETON ALEX D
Published: May 2012

Geography is not a compulsory subject of study beyond the age of 14 in English schools and this has had an impact on both absolute and relative participation rates over recent years. Geodemographic analysis reveals that pupils domiciled within more affluent and less ethnically diverse areas record the highest rates of participation and attainment in GCSE Geography, and that the stratified patterns of participation have increased between 2005 and 2009. Within this period, those schools that have stopped supplying successful GCSE Geography entries by 2009 were found to have overall low aggregate attainment and to draw pupils from more deprived areas. The profile of schools visited by the Royal Geographical Society (with the Institute of British Geographers) (RGS‐IBG) Ambassador Scheme was also considered to assess the extent that the schools visited are representative of pupils who are most at risk of non‐participation.
Characterising urban sprawl on a local scale with accessibility measures
Authors: SOHN JUNGYUL , CHOI SONGHYUN , LEWIS REBECCA , KNAAP GERRIT
Published: May 2012

Although measuring sprawl based on morphology is conceptually simple and easy to implement, it is of limited use for deriving implications for urban planning. However, measuring sprawl based on accessibility enables us to observe the impact of development and establish a customised place‐based policy by examining the spatial variation within the region. This study aims to develop and operationalise accessibility‐based sprawl indicators. For this purpose, it employs two accessibility‐based sprawl indicator categories and develops their measures: accessibilities to urban functions and open space. From the case study, the findings reveal that the accessibility‐based sprawl index shows a clear difference from the morphology‐based ones, suggesting that the judgement on sprawl may be wrong if it is purely based on morphology.
Extracorporeal shock wave therapy (ESWT) for wound healing: Technology, mechanisms, and clinical efficacy
Authors: Mittermayr Rainer , Antonic Vlado , Hartinger Joachim , Kaufmann Hanna , Redl Heinz , Téot Luc , Stojadinovic Alexander , Schaden Wolfgang
Published: May 2012

For almost 30 years, extracorporeal shock wave therapy has been clinically implemented as an effective treatment to disintegrate urinary stones. This technology has also emerged as an effective noninvasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Delayed/nonhealing or chronic wounds constitute a burden for each patient affected, significantly impairing quality of life. Intensive wound care is required, and this places an enormous burden on society in terms of lost productivity and healthcare costs. Therefore, cost‐effective, noninvasive, and efficacious treatments are imperative to achieve both (accelerated and complete) healing of problematic wounds and reduce treatment‐related costs. Several experimental and clinical studies show efficacy for extracorporeal shock wave therapy as means to accelerate tissue repair and regeneration in various wounds. However, the biomolecular mechanism by which this treatment modality exerts its therapeutic effects remains unclear. Potential mechanisms, which are discussed herein, include initial neovascularization with ensuing durable and functional angiogenesis. Furthermore, recruitment of mesenchymal stem cells, stimulated cell proliferation and differentiation, and anti‐inflammatory and antimicrobial effects as well as suppression of nociception are considered important facets of the biological responses to therapeutic shock waves. This review aims to provide an overview of shock wave therapy, its history and development as well as its current place in clinical practice. Recent research advances are discussed emphasizing the role of extracorporeal shock wave therapy in soft tissue wound healing.
Antipathogenic properties of Lactobacillus plantarum on Pseudomonas aeruginosa: The potential use of its supernatants in the treatment of infected chronic wounds
Authors: Ramos Alberto N. , Sesto Cabral María E. , Noseda Diego , Bosch Alejandra , Yantorno Osvaldo M. , Valdez Juan C.
Published: May 2012

Pathogenic bacteria delay wound healing through several different mechanisms such as persistent production of inflammatory mediators or maintenance of necrotic neutrophils, which release cytolytic enzymes and free oxygen radicals. One of the most frequent pathogens isolated from infections in chronic wounds is Pseudomonas aeruginosa. This bacterium is extremely refractory to therapy and to host immune attack when it forms biofilms. Therefore, antibiotics and antiseptics are becoming useless in the treatment of these infections. In previous works, we demonstrated that Lactobacillus plantarum has an important antipathogenic capacity on P. aeruginosa. The aim of the present work was to elucidate the mechanism involved in the control of growth of P. aeruginosa on different surfaces by L. plantarum. For this purpose, we investigated the effects of L. plantarum supernatants on pathogenic properties of P. aeruginosa, such as adhesion, viability, virulence factors, biofilm formation, and quorum sensing signal expression. L. plantarum supernatants were able to inhibit pathogenic properties of P. aeruginosa by a quorum quenching mechanism. The antipathogenic properties mentioned above, together with the immunomodulatory, tissue repair, and angiogenesis properties in the supernatants of L. plantarum, make them an attractive option in infected chronic wound treatment.
Chlorhexidine‐Associated Transient Hyperchloremia in an Infant
Authors: Celik İstemi Han , Oguz Serife Suna , Dilmen Ugur
Published: May 2012

Abstract:  An infant was cleansed with 2% clorhexidine gluconate (CHG) because of repeated sepsis episodes from skin colonization. Asymptomatic hyperchloremia ensued, most likely associated with CHG therapy. Fourty‐eight hours after CHG therapy withdrawal, serum chloride levels returned to normal. Hyperchloremia may be a reversible adverse effect of extensive use of CHG.
Subjectivity as Encounter: Feminine Ethics in the Work of Bracha Lichtenberg‐Ettinger and Anne Enright
Authors: Smith Mariëlle
Published: May 2012

The fragility of the subject is a recurring issue in the work of Anne Enright, one of Ireland's most remarkable and innovative writers. It is this specific interest, together with her attempt to make women into subjects, that inevitably links her work to Bracha Lichtenberg‐Ettinger's theory of the matrixial borderspace, a feminine sphere that coexists with the Lacanian symbolic order and that, even before our entrance into this linguistic system, informs our subjectivity. By turning to a point in time before language—the encounter between “self” and “other” during pregnancy—both Enright and Ettinger test the boundaries of and the gaps within the linguistic system. It is the going before language that ultimately enables both to go beyond some of the most persistent dualisms present within the linguistic system and to create room for an alternative—a feminine—understanding of the ethical relationality between self and other.
Feminist Phenomenology and the Film World of Agnès Varda
Authors: Ince Kate
Published: May 2012

Through a discussion of Agnès Varda's career from 1954 to 2008 that focuses particularly onLa Pointe Courte(1954),L'Opéra‐Mouffe(1958), The Gleaners and I(2000), andThe Beaches of Agnes(2008), this article considers the connections between Varda's filmmaking and her femaleness. It proposes that two aspects of Varda's cinema—her particularly perceptive portrayal of a set of geographical locations, and her visual and verbal emphasis on female embodiment—make a feminist existential‐phenomenological approach to her films particularly fruitful. Drawing both directly on the work of Maurice Merleau‐Ponty and on some recent film‐ and feminist‐theoretical texts that have employed his insights, it explores haptic imagery and feminist strategy inThe Gleaners and I, the materialization of space characterizing Varda's blurring of fiction and documentary, and the dialectical relationship of people with their environment often observed in her cinema. It concludes that both Varda's female protagonists and the director herself may be said to perform feminist phenomenology in her films, in their actions, movement, and relationship to space, and in the carnality of voice and vision with which Varda's own subjectivity is registered within her film‐texts.
Epi4K: Gene discovery in 4,000 genomes
Authors:   The Epi4K Consortium
Published: May 2012

A major challenge in epilepsy research is to unravel the complex genetic mechanisms underlying both common and rare forms of epilepsy, as well as the genetic determinants of response to treatment. To accelerate progress in this area, the National Institute of Neurological Disorders and Stroke (NINDS) recently offered funding for the creation of a “Center without Walls” to focus on the genetics of human epilepsy. This article describes Epi4K, the collaborative study supported through this grant mechanism and having the aim of analyzing the genomes of a minimum 4,000 subjects with highly selected and well‐characterized epilepsy.
Effect of Guided Relaxation and Imagery on Falls Self‐Efficacy: A Randomized Controlled Trial
Authors: Kim Bang Hyun , Newton Roberta A. , Sachs Michael L. , Glutting Joseph J. , Glanz Karen
Published: May 2012

Objectives

To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self‐efficacy in older adults who report having a fear of falling.

Design

Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice.

Setting

General community.

Participants

Ninety‐one men and women aged 60 to 92.

Intervention

Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session.

Measurements

Primary outcome measure was the Short Falls Efficacy Scale—International (FES‐I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test.

Results

GRI participants reported greater improvements on the Short FES‐I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music‐of‐choice group.

Conclusion

GRI was more effective at increasing falls self‐efficacy and self‐reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low‐cost tool for older adults to improve falls self‐efficacy and leisure time exercise behaviors.
Addressing the Aging Crisis in U.S. Criminal Justice Health Care
Authors: Williams Brie A. , Goodwin James S. , Baillargeon Jacques , Ahalt Cyrus , Walter Louise C.
Published: May 2012

The U.S. criminal justice population is aging at a significantly more rapid rate than the overall U.S. population, with the population of older adults in prison having more than tripled since 1990. This increase is at the root of a prison healthcare crisis that is spilling into communities and public healthcare systems because nearly 95% of prisoners are eventually released. The graying prison population is also straining state and local budgets. In prison, older prisoners cost approximately three times as much as younger prisoners to incarcerate, largely because of healthcare costs. In the community, older former prisoners present the least risk of recidivism yet are vulnerable to serious and costly social and medical challenges such as housing instability, poor employability, multiple chronic health conditions, and health‐related mortality; however older current and former prisoners are largely ignored in the current geriatrics evidence base. Knowledge about the health, functional, and cognitive status of older prisoners is limited, with even less known about risk factors for long‐term poor health outcomes during and after incarceration. This article provides an overview of aging in the criminal justice system. It then describes how geriatric models of care could be adapted to address the mounting older prisoner healthcare crisis and identifies areas where additional research is needed to explore prison‐specific models of care for older adults.
Nocturnal Hypokinesia and Sleep Quality in Parkinson's Disease
Authors: Louter Maartje , Munneke Marten , Bloem Bastiaan R. , Overeem Sebastiaan
Published: May 2012

Objectives

To study the relationship between nocturnal hypokinesia and sleep quality in Parkinson's disease (PD).

Design

Questionnaire study using intergroup analysis.

Setting

Parkinson Centre Nijmegen, a tertiary university referral center.

Participants

Two hundred forty individuals with Parkinson's disease.

Measurements

Clinical and demographic data were obtained. Nocturnal hypokinesia was assessed using Question 35 of the Parkinson's Disease Quality of Life Questionnaire and rated on a 5‐point Likert scale (1 = all of the time to 5 = never). The Pittsburgh Sleep Quality Index (PSQI) was used to quantify sleep quality, higher scores indicating poorer sleep quality.

Results

One hundred thirty‐five of 240 participants had difficulties turning over in bed. Mean PSQI scores were significantly higher in participants with nocturnal hypokinesia (7.7 ± 4.1) than in those without (6.1 ± 3.4, P = .001). A regression model correcting for age, disease duration, and Hoehn and Yahr stage showed a significant influence of nocturnal hypokinesia on sleep quality (coefficient of determination = 0.042, standardized‐beta = 0.163, P = .03). There was a linear relationship between frequency of nocturnal hypokinesia and sleep quality.

Conclusion

This is the first study that documents that nocturnal hypokinesia negatively affects sleep quality in PD. Nocturnal hypokinesia therefore merits therapeutic attention, including optimal nighttime dopaminergic treatment and education about turning strategies in bed.