bluuebunny/crossref_metadata_2025 huggingface dataset:
Valuation accuracy and spatial variations in the efficiency of the property market
Authors: Dunse Neil , Jones Colin , White Michael
Published: May 2010

Purpose

The purpose of this paper is to address the variation of efficiency of local office markets. It has long been argued that as data in the property market are based on valuations, it has a tendency toward smoothing or stickiness. The accuracy of valuations is shown to be partially dependent on local variable factors such as the extent of information, the variability of local cycles and the heterogeneity of the stock. This paper assesses the efficiency of local office markets in nine cities of the UK by estimating unsmoothed annual time series of rents and returns and comparing with the original valuations.

Design/methodology/approach

The paper uses an econometric approach to identify true unobserved returns from observed smoothed data. It uses desmoothing techniques and compares the volatility of smoothed and desmoothed underlying returns. It then looks for autocorrelation over time in the errors where the presence of autocorrelation rejects the assumption of market efficiency.

Findings

Examining, regional city office markets, the results suggest that financial centres have the least efficient markets because of their high level of variability. Other provincial cities are characterised by weak‐form efficiency. Market cyclicality is found to be a key factor affecting valuation accuracy.

Research limitations/implications

Research in regional markets is often constrained by shortness and low frequency of time series observations. This limits the analysis and the ways in which it could be developed. Issues also relate to the method of desmoothing adopted.

Practical implications

Key financial centre are found to be less efficient markets than other cities. Thus, price changes fully embody all previous information in regional centres but not in London or Edinburgh. Periods of significant cyclical volatility tend to cause valuation inaccuracy and pricing problems.

Social implications

There are spillovers from inefficiencies in property market pricing that can affect other sectors of society directly (through increased costs) or indirectly (by contributing to macroeconomic cyclicality).

Originality/value

This is the first paper to explicitly consider the efficiency of regional city office markets and to identify the true unobserved returns series in each city office market. Its findings, perhaps unexpectedly, suggest that most regional city office markets are more efficient at processing pricing information than London.
Significance of segment structures in the Portuguese and Iberian property markets
Authors: Manuel Vaz Pinto Almeida Vasques Filipe , Manuel Cardoso Teixeira José , Fernando Moreira Brandão Elísio
Published: May 2010

Purpose

A quite significant body of research regarding the effects of segment structures in direct property returns is available for the USA and the UK markets. There is also some research regarding the broad European context and for some individual countries, like Italy. However, this subject has not been specifically addressed for the Portuguese and Spanish property markets. The central aim of this research is the examination of the effectiveness of the main segmentation structures currently used in the Portuguese and Iberian property markets. Despite this being a starting point for most of the analysis and decision making in property portfolio construction, up to date and to the authors' knowledge, there is absolutely no research on this specific subject for these markets.

Design/methodology/approach

Subclass annual returns available from the 2005 IPD Iberian Digest were used in a cross‐sectional approach to test the segmentation structure of the IPD indexes. Two different analysis scopes were considered: the Portuguese market alone and the Iberian market as a whole, in a total of six segmentation structures tested for significance regarding total returns, capital returns, and income returns, thus resulting in 18 different evaluations using one and two factor analysis of variance tests.

Findings

Results show that the structures based on sector differentiation are generally significant both for Portugal and within an Iberian context and that regional spread does not condition property returns in the periods under study. This supports the argument of sector diversification in both situations, similarly to previous findings for the UK market. Addressing return components, results show that only for income returns do most of the structures describe enough systematic patterns to be worth using, while capital gains seem to be less sensitive to segmentation factors.

Originality/value

This is the first paper regarding effectiveness of segment structures in the Portuguese and Iberian markets. Also the consideration and differentiation of the analysis for return components is original and found to be rather important, despite being apparently disregarded in related literature.
Water savings through off‐farm employment?
Authors: Wachong Castro Veronica , Heerink Nico , Shi Xiaoping , Qu Wei
Published: May 2010

Purpose

The purpose of this paper is to gain more insight into the relationship between off‐farm employment of rural households and water‐saving investments and irrigation water use in rural China.

Design/methodology/approach

Data from a survey held among 317 households in Minle County, Zhangye City, Gansu Province, covering the year 2007, are used for a probit analysis explaining investments in land leveling and for an ordinary least squares regression explaining irrigation water use per mu.

Findings

Off‐farm employment is not significantly related to investments in land leveling, but is negatively associated with water use per mu. In addition, the paper finds that the share of migrant students in a household is positively related to investments in land leveling. The results indicate the presence of major factor market imperfections in the research area, and confirm that the new economics of labor migration (NELM) approach is more relevant for analyzing off‐farm employment and agricultural production in China than neoclassical economic theory.

Originality/value

The paper expands the NELM approach towards the analysis of water‐saving investments and water use. In addition, it distinguishes migrant students as an important category that should be taken into account in analyzing farm household decisions making.
The challenges facing young workers during rural labor transition
Authors: Li Xiaofei , Liu Chengfang , Luo Renfu , Zhang Linxiu , Rozelle Scott
Published: May 2010

Purpose

The paper aims to discuss whether the younger generation of China's rural labor force is prepared, in terms of education level or labor quality, for the future labor markets under China's industrial upgrading.

Design/methodology/approach

Using nationally representative survey data, the paper gives detailed discussions on the young rural laborers' education attainments, and their off‐farm employment status including job patterns, working hours, and hourly wage rates. The relationship between education and employment status is analyzed and tested. Through these discussions, an employment challenge is revealed, and some policy implications are made.

Findings

This paper finds that China's young rural laborers are generally poorly educated and mainly unskilled. They work long hours and are low paid. While they lack the labor quality that will be required to meet the industrial upgrading, an employment challenge may face them in the near future. This paper also finds a strong link between education levels and employment status for the young labor force, which implies the possible effect of policies such as improving rural education.

Originality/value

Based on a solid foundation of a national rural household survey, this paper updates the understanding of the education and employment situations of the young rural labor force in contemporary China. The concern about the employment challenges raised in the paper is related to the future of China's rural labor transition and the whole economy.
A comparison of rural and urban healthcare consumption and health insurance
Authors: Holly Wang H. , Huang Shaomin , Zhang Linxiu , Rozelle Scott , Yan Yuanyuan
Published: May 2010

Purpose

Since 1999, China has undergone reform of its healthcare system. City‐based social health insurance (SHI) is the primary form of current health insurance, supplemented by various commercial health insurance programs. The rural new cooperative medical system (NCMS) was introduced in 1993 and extended to cover the whole of rural China in 2003.

Design/methodology/approach

The paper developed a theoretical model for consumer demand of medical services and health insurance based on an expected utility framework with a two‐stage decision under uncertainty. The model is then applied to current health insurance systems in China for urban citizens and rural residents separately. Least square and logistic regressions are employed.

Findings

The major results are that although the factors driving the decisions on health insurance participation are basically the same for rural and urban citizens, the participation levels are quite different. The major difference is that urban SHI has higher coverage and urban citizens have higher income, resulting in a much larger urban medical expenditure.

Practical implications

The empirical analysis reveals that health insurance programs have played an important role in the healthcare expenditure for urban residents, while the NCMS has not made a significant impact towards increasing the ability of rural residents to seek more medical services, based on data at 2004.

Originality/value

This is the first paper employing a health production theory on China's new urban and rural healthcare programs.
Nucleotide changes related to hepatocellular carcinoma in the enhancer 1/x‐promoter of hepatitis B virus subgenotype C2 in cirrhotic patients
Authors: Cho Eun‐Young , Kim Haak‐Cheoul , Choi Chang‐Soo , Shin Sae Ron , Park Channy , So Hong‐Seob , Kim Hyung Jin , Park Raekil , Cho Ji Hyun , Moon Hyung Bae
Published: May 2010

Hepatocellular carcinoma (HCC) is widely known to develop more frequently in cirrhotic patients with a high expression of Hepatitis B virus X protein (HBx), which is controlled by the enhancer 1 (Enh1)/X‐promoter. To examine the effect of the mutations in the Enh1/X‐promoter region in hepatitis B virus (HBV) genomes on the development of HCC, we investigated the differences in HBV isolated from cirrhotic patients with or without HCC along with the promoter activities of certain specific mutations within the Enh1/X‐promoter. We examined 160 hepatitis B surface antigen (HBsAg)‐positive cirrhotic patients (80 HCC patients, 80 non‐HCC patients) by evaluating the biochemical, virological, and molecular characteristics. We evaluated the functional differences in certain specific mutations within the Enh1/X‐promoter. The isolated sequences included all of the subgenotypes C2. The sites that showed higher mutation rates in the HCC group were G1053A and G1229A, which were found to be independent risk factors through multiple logistic analysis (P < 0.05). Their promoter activities were elevated 2.38‐ and 4.68‐fold, respectively, over that of the wild type in the HepG2 cells. Similarly, both the mRNA and protein levels of HBx in these two mutants were much higher than that in wild type‐transfected HepG2 cells. Mutated nucleotides of the Enh1/X‐promoter, especially G1053A and G1229A mutations in the HBV subgenotype C2 of patients with cirrhosis, can be risk factors for hepatocarcinogenesis, and this might be due to an increase in the HBx levels through the transactivation of the Enh1/X‐promoter. (Cancer Sci 2010)
Sedation in digestive endoscopy: the Athens international position statements
Authors: Cohen L. B. , Ladas S. D. , Vargo J. J. , Paspatis G. A. , Bjorkman D. J. , Van der Linden P. , Axon A. T. R. , Axon A. E. , Bamias G. , Despott E. , Dinis‐Ribeiro M. , Fassoulaki A. , Hofmann N. , Karagiannis J. A. , Karamanolis D. , Maurer W. , O’Connor A. , Paraskeva K. , Schreiber F. , Triantafyllou K. , Viazis N. , Vlachogiannakos J.
Published: May 2010

Aliment Pharmacol Ther 2010; 32: 425–442

Background  Guidelines and practice standards for sedation in endoscopy have been developed by various national professional societies. No attempt has been made to assess consensus among internationally recognized experts in this field.

Aim  To identify areas of consensus and dissent among international experts on a broad range of issues pertaining to the practice of sedation in digestive endoscopy.

Methods  Thirty‐two position statements were reviewed during a 1 ½‐day meeting. Thirty‐two individuals from 12 countries and four continents, representing the fields of gastroenterology, anaesthesiology and medical jurisprudence heard evidence‐based presentations on each statement. Level of agreement among the experts for each statement was determined by an open poll.

Results  The principle recommendations included the following: (i) sedation improves patient tolerance and compliance for endoscopy, (ii) whenever possible, patients undergoing endoscopy should be offered the option of having the procedure either with or without sedation, (iii) monitoring of vital signs as well as the levels of consciousness and pain/discomfort should be performed routinely during endoscopy, and (iv) endoscopists and nurses with appropriate training can safely and effectively administer propofol to low‐risk patients undergoing endoscopic procedures.

Conclusions  While the standards of practice vary from country to country, there was broad agreement among participants regarding most issues pertaining to sedation during endoscopy.
All trans retinoic acid nanodisks enhance retinoic acid receptor mediated apoptosis and cell cycle arrest in mantle cell lymphoma
Authors: Singh Amareshwar T.K. , Evens Andrew M. , Anderson Reilly J. , Beckstead Jennifer A. , Sankar Natesan , Sassano Antonella , Bhalla Savita , Yang Shuo , Platanias Leonidas C. , Forte Trudy M. , Ryan Robert O. , Gordon Leo I.
Published: May 2010

Mantle cell lymphoma (MCL) is characterized by translocation t(11;14)(q13;q32), aggressive clinical behaviour, and poor patient outcomes following conventional chemotherapy. New treatment approaches are needed that target novel biological pathways. All trans retinoic acid (ATRA) is a key retinoid that acts through nuclear receptors that function as ligand‐inducible transcription factors. The present study evaluated cell killing effects of ATRA‐enriched nanoscale delivery particles, termed nanodisks (ND), on MCL cell lines. Results show that ATRA‐ND induced cell death more effectively than naked ATRA (dimethyl sulphoxide) or empty ND. ATRA‐ND induced reactive oxygen species (ROS) generation to a greater extent than naked ATRA. The antioxidant, N‐acetylcysteine, inhibited ATRA‐ND induced apoptosis. Compared to naked ATRA, ATRA‐ND enhanced G1 growth arrest, up‐regulated p21and p27, and down regulated cyclin D1. At ATRA concentrations that induced apoptosis, expression levels of retinoic acid receptor‐α (RARα) and retinoid X receptor‐γ (RXRγ) were increased. Compared to naked ATRA, ATRA‐ND significantly stimulated transcriptional activity of RARA in a model carcinoma cell line. Furthermore, the RAR antagonist, Ro 41‐5253, inhibited ATRA‐ND induced ROS generation and prevented ATRA‐ND induced cell growth arrest and apoptosis. In summary, incorporation of ATRA into ND enhanced the biological activity of this retinoid in cell culture models of MCL.
Regulation of inflammasome activity
Authors: Guarda Greta , So Alexander
Published: May 2010

Interleukin‐1β (IL‐1β) is a potent inflammatory cytokine, which is implicated in acute and chronic inflammatory disorders. The activity of IL‐1β is regulated by the proteolytic cleavage of its inactive precursor resulting in the mature, bioactive form of the cytokine. Cleavage of the IL‐1β precursor is performed by the cysteine protease caspase‐1, which is activated within protein complexes termed ‘inflammasomes’. To date, four distinct inflammasomes have been described, based on different core receptors capable of initiating complex formation. Both the host and invading pathogens need to control IL‐1β production and this can be achieved by regulating inflammasome activity. However, we have, as yet, little understanding of the mechanisms of this regulation. In particular the negative feedbacks, which are critical for the host to limit collateral damage of the inflammatory response, remain largely unexplored. Recent exciting findings in this field have given us an insight into the potential of this research area in terms of opening up new therapeutic avenues for inflammatory disorders.
CD34‐derived human Langerhans cells stimulate a T helper type 2 response independently of extracellular‐signal‐regulated kinase phosphorylation
Authors: Duraisingham Sai S. , Hornig Julia , Gotch Frances , Patterson Steven
Published: May 2010

Dendritic cell (DC) subsets can mediate diverse responses, but little is known about the Toll‐like receptor (TLR) signalling pathways in different human DC subsets. Despite expressing many TLRs in common, we found that in vitro‐derived Langerhans cells (LCs) and monocyte‐derived DCs (moDCs) undergo differential signalling events following TLR stimulation. TLR‐stimulated LCs did not secrete interleukin (IL)‐12p70 and thus induced a T helper type 2 (Th2)‐biased response. moDCs secrete high levels of IL‐12p70 and induce a Th1 response. Stimulation of moDCs through TLR2 or TLR7/8 was able to induce phosphorylation of the mitogen‐activated protein kinase (MAPK) extracellular‐signal‐regulated kinase (ERK). However, phosphorylated ERK was not induced in TLR‐stimulated LCs, suggesting an ERK‐independent method of Th2 cell induction. Inhibition of p38 MAPK suppressed moDC maturation, but was much less effective at inhibiting LC maturation. Phosphatidylinositol‐3 kinase (PI3K) was also found to play a greater role in moDC survival compared with the LCs. Polymerase chain reaction (PCR) arrays to compare the expression of signalling molecules in LCs and moDCs identified differences in TLR recognition molecules and cytokine response genes, suggesting that differential functional responses are probably mediated at the post‐transcriptional level. Thus we have described differences in LC and moDC responses to TLR stimulation, and have identified key differences in ERK phosphorylation and the involvement of MAPK and PI3K.
Prevalence of dietitian burnout
Authors: Gingras J. , De Jonge L.‐A. , Purdy N.
Published: May 2010

Background:  Burnout is the result of unmanaged stress that has been shown to affect those working in the healthcare professions. Although much research has been conducted on burnout among nurses, physicians and other health professionals, there is limited documentation on the phenomenon among dietitians. The purpose of this study was to establish the prevalence of burnout among dietitians in Ontario, Canada, determine the demographic variables associated with burnout, and compare these results with burnout data for other healthcare professionals.

Methods:  The Maslach Burnout Inventory–Human Services Survey and a demographic questionnaire were emailed to registered dietitians.

Results:  The dietitians surveyed experienced a moderate amount of emotional exhaustion (mean = 19.96), a low level of depersonalisation (mean = 4.31) and a moderate sense of personal accomplishment (mean = 38.61). Statistically significant relationships were found between years as a dietitian and personal accomplishment (r = 0.16; P = 0.05), age and personal accomplishment (r = 0.15; P = 0.01), hours worked per week and emotional exhaustion (r = 0.17; P = 0.01) and hours worked per week and depersonalisation (r = 0.14; P = 0.01). There were no significant differences in mean burnout scores across the five areas of practice. Over 57% of dietitians had scores indicative of moderate to high levels of burnout overall.

Conclusions:  Although dietitians have lower levels of burnout compared to other healthcare professionals, moderate levels of emotional exhaustion and only moderate levels of personal accomplishment remain workplace issues for this professional group.
Changes in food neophobia and dietary habits of international students
Authors: Edwards J. S. A. , Hartwell H. L. , Brown L.
Published: May 2010

Background:  International study is becoming more prevalent, yet aspects such as food neophobia often militate against visiting students consuming a nutritionally balanced diet. The present study aimed to evaluate the extent to which international post‐graduate students experience food neophobia, how this might vary by nationality and other demographic characteristics, and how acculturation might manifest itself in students’ dietary behaviour.

Methods:  International students (n = 228) attending a Masters course were invited to complete a validated food neophobia and dietary habits questionnaire during their first week at university. The questionnaire was subsequently re‐administered to the same students approximately 4 and 8 months later.

Results:  In total, 226 usable responses were analysed (124, 58 and 44, respectively) for the first, second and final data collection. Perhaps surprisingly, the overall food neophobia scores increased from an mean (SD) initial value of 27.95 (16.95) to 33.67 (33.67) after 3 months, although, when comparing European and Asian students, only the former were significantly different (P < 0.05). Both Asian and European students reported small but not significant changes in their eating habits, although, after 3 months, significantly (P = <0.05) fewer changes were reported. No significant changes were reported in students’ perceived healthiness of their diets either by nationality or over time.

Conclusions:  Understanding the complexities of food neophobia, other aspects of dietary change and at what point these changes might take place in the acculturation process when students arrive in the UK needs to be fully understood if a climate for positive learning is to be established.
An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce
Authors: Palermo C. , Hughes R. , McCall L.
Published: May 2010

Background:  Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On‐the‐job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness.

Methods:  An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty‐two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7‐month period. Pre‐ and post‐intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected.

Results:  The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self‐reported competence of 15% (range 3–48% change; P < 0.05) across a broad range of competency elements. Many participants described re‐orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post‐intervention.

Conclusions:  Mentoring supported service re‐orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.
Exploring assessment for learning during dietetic practice placements
Authors: Lennie S. C. , Juwah C.
Published: May 2010

Background:  Practice placement, which contributes to the development of professional skills and competencies, is an important component of dietetic pre‐registration education in the UK. The assessment of practice placement impacts on students’ experience and progression; however, currently, limited evidence‐based information about assessment methods and practice in dietetic placements exists. The present study aimed to investigate the assessment methods and practices utilised when providing pre‐registration dietetic practice placements.

Method:  Using an online questionnaire survey of dietitians within Scottish National Health Service (NHS) dietetic departments, and a follow‐on telephone interview with Lead Trainers, the present study explored the assessment methods utilised by dietitians as well as areas of variability within NHS Boards. Data were analysed using descriptive statistics and relationships were assessed using the chi‐square test, Kruskall–Wallis test and Spearmans’ correlation.

Results:  One hundred and eleven fully‐completed questionnaires were analysed and fourteen departments participated in the follow‐on telephone interview. Over 80% respondents had greater than 2 years of involvement in student training. To assess student performance, departments used between 5–16 and 6–16 assessment tools for placements B and C, respectively. Significant correlations between staff training and knowledge of how to apply assessment tools support a need for robust staff training in assessment matters. The majority (87%) of respondents positively favour standardisation of assessment via the development of national assessment tools.

Conclusions:  The findings obtained in the present study confirm that there is a wide variation in assessment practices by dietitians. The development of standardised assessments and tools within dietetic practice placements, in terms of parity in numbers and methods of assessment, would ensure equity and fairness for students.
Recent Discoveries on the Control of Gonadotrophin‐Releasing Hormone Neurones in Nonhuman Primates
Authors: Terasawa E. , Kurian J. R. , Guerriero K. A. , Kenealy B. P. , Hutz E. D. , Keen K. L.
Published: May 2010

Since Ernst Knobil proposed the concept of the gonadotrophin‐releasing hormone (GnRH) pulse‐generator in the monkey hypothalamus three decades ago, we have made significant progress in this research area with cellular and molecular approaches. First, an increase in pulsatile GnRH release triggers the onset of puberty. However, the question of what triggers the pubertal increase in GnRH is still unclear. GnRH neurones are already mature before puberty but GnRH release is suppressed by a tonic GABA inhibition. Our recent work indicates that blocking endogenous GABA inhibition with the GABAA receptor blocker, bicuculline, dramatically increases kisspeptin release, which plays an important role in the pubertal increase in GnRH release. Thus, an interplay between the GABA, kisspeptin, and GnRH neuronal systems appears to trigger puberty. Second, cultured GnRH neurones derived from the olfactory placode of monkey embryos exhibit synchronised intracellular calcium, [Ca2+]i, oscillations and release GnRH in pulses at approximately 60‐min intervals after 14 days in vitro (div). During the first 14 div, GnRH neurones undergo maturational changes from no [Ca2+]i oscillations and little GnRH release to the fully functional state. Recent work also shows GnRH mRNA expression increases during in vitro maturation. This mRNA increase coincides with significant demethylation of a CpG island in the GnRH 5′‐promoter region. This suggests that epigenetic differentiation occurs during GnRH neuronal maturation. Third, oestradiol causes rapid, direct, excitatory action in GnRH neurones and this action of oestradiol appears to be mediated through a membrane receptor, such as G‐protein coupled receptor 30.
Correlation of in planta endo‐beta‐1,4‐xylanase activity with the necrotrophic phase of the hemibiotrophic fungus Mycosphaerella graminicola
Authors: Siah A. , Deweer C. , Duyme F. , Sanssené J. , Durand R. , Halama P. , Reignault P.
Published: May 2010

The association of the cell wall degrading enzyme endo‐beta‐1,4‐xylanase (EC 3.2.1.8) with pathogenicity of Mycosphaerella graminicola was examined in planta. The enzyme production of two M. graminicola isolates (T0372 and T0491), as well as their ability to infect seedlings of susceptible wheat cv. Scorpion, was first compared. No significant difference was found between the two isolates regarding spore germination rates, mycelial growth on the leaf surface or direct and stomatal penetrations. However, restricted hyphal growth was observed inside leaves inoculated with T0372, whereas successful mesophyll colonization with a strong intercellular fungal growth was found in leaves infected with T0491. Likewise, T0372 was unable to induce lesions bearing pycnidia and to produce endo‐beta‐1,4‐xylanase activity until 22 days post‐inoculation (d.p.i.). On the other hand, significant high increases of both diseased leaf area bearing pycnidia and endo‐beta‐1,4‐xylanase activity were observed between 16 and 22 d.p.i. for T0491 (r = 0·98). The investigation of 24 additional isolates, including the IPO323 and IPO94269 reference isolates, highlighted a strong correlation between endo‐beta‐1,4‐xylanase activity and disease development levels (r = 0·94). This study demonstrates that differences in pathogenicity in M. graminicola are not linked to events on the leaf surface or to frequency of leaf penetration, but to the ability of the fungus to colonize the mesophyll and to produce the cell wall degrading enzyme endo‐1,4‐beta‐xylanase during the necrotrophic phase.
Sex dependence of brain size and shape in bipolar disorder: an exploratory study
Authors: Mackay Clare E , Roddick Elina , Barrick Thomas R , Lloyd Adrian J , Roberts Neil , Crow Tim J , Young Allan H , Ferrier I Nicol
Published: May 2010

Mackay CE, Roddick E, Barrick TR, Lloyd AJ, Roberts N, Crow TJ, Young AH, Ferrier IN. Sex dependence of brain size and shape in bipolar disorder: an exploratory study. Bipolar Disord 2010: 12: 306–311. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Objectives:  Anomalies of asymmetry and sex differences in brain structure have frequently been described in schizophrenic illnesses but have seldom been explored in bipolar disorder.

Methods:  We measured volumes of the left and right frontal, temporal, parietal, and occipital lobes and computed the magnitude of brain torque (i.e., rightward frontal and leftward occipital asymmetry) for 49 patients with bipolar disorder and 47 healthy controls and performed an exploratory analysis of sex differences in patients and controls.

Results:  Patients had significantly greater cerebrospinal fluid volume than controls, but no difference in total brain volume. There were no main effects of diagnosis in gray matter lobe volume or brain torque, but when analyses were performed separately for male and female subjects, significant sex‐by‐diagnosis interactions were found in the volume of the left frontal, left temporal, right parietal, and right occipital lobes, such that male patients with bipolar disorder tend toward larger, more symmetric brains than male controls, whereas female patients tend toward smaller, more asymmetric brains than female controls.

Conclusion:  The lateralised nature of these interactions was such that the normal sex difference in volume was significantly accentuated, whilst the normal sex difference in asymmetry tended to be diminished in patients with bipolar disorder. We conclude that bipolar disorder in part reflects an interaction between brain growth and sex along the anterior‐posterior axis of the human brain.
The longitudinal course of bipolar disorder as revealed through weekly text messaging: a feasibility study
Authors: Bopp Jedediah M , Miklowitz David J , Goodwin Guy M , Stevens Will , Rendell Jennifer M , Geddes John R
Published: May 2010

Bopp JM, Miklowitz DJ, Goodwin GM, Stevens W, Rendell JM, Geddes JR. The longitudinal course of bipolar disorder as revealed through weekly text messaging: a feasibility study. Bipolar Disord 2010: 12: 327–334. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Objectives:  To examine the feasibility of collecting course of illness data from patients with bipolar I and II disorder, using weekly text‐messaged mood ratings, and to examine the time trajectory of symptom ratings based on this method of self‐report.

Methods:  A total of 62 patients with bipolar I (n = 47) or II (n = 15) disorder provided mood data in response to weekly cell phone text messages (n = 54) or e‐mail prompts (n = 8). Participants provided weekly ratings using the Altman Self‐Rating Mania Scale and the Quick Inventory of Depressive Symptoms–Self Report. Patients with bipolar I and II disorder, and men and women, were compared on percentages of time in depressive or manic mood states over up to two years.

Results:  Participants provided weekly ratings over an average of 36 (range 1–92) weeks. Compliance with the procedure was 75%. Overall, participants reported depressive symptoms 47.7% of the time compared to 7% of entries reflecting manic symptoms, 8.8% reflecting both depressive and manic symptoms, and 36.5% reflecting euthymic mood. Participants with bipolar I disorder reported more days of depression and were less likely to improve with time than participants with bipolar II disorder. Gender differences observed at the beginning of the study were not observed at follow‐up.

Conclusions:  The results are similar to those of other longitudinal studies of bipolar disorder that use traditional retrospective, clinician‐gathered mood data. Text‐message‐based symptom monitoring during routine follow‐up may be a reliable alternative to in‐person interviews.
Retinal haemorrhages in inflicted traumatic brain injury: the ophthalmologist in court
Authors: Vincent Andrea L , Kelly Patrick
Published: May 2010

Abstract

Child abuse is a significant social and public health problem in many societies. One particular form of physical abuse is inflicted traumatic brain injury (ITBI) – the so‐called ‘Shaken Baby Syndrome‘. One of the key features associated with ITBI is characteristic ocular findings – only observed on fundal examination. It is crucial not to miss the diagnosis of ITBI as there may be implications for the safety of the child. The ophthalmologist is one key contributor to the process required to make the diagnosis of ITBI accurately and on the basis of all the relevant evidence. This article discusses some medicolegal implications of examining a child with retinal haemorrhages in the context of suspected ITBI, with practical advice for the ophthalmologist to be as objective and prepared as possible. The scientific validity of some alternative explanations advanced in court is discussed, with a strong emphasis on the literature.
Successful treatment of infantile haemangiomas of the orbit with propranolol
Authors: Li Yi‐Chiao , McCahon Emma , Rowe Neil A , Martin Peter A , Wilcsek Geoffrey A , Martin Frank J
Published: May 2010

Abstract

Background:  Propranolol is a novel therapeutic agent in the treatment of cutaneous infantile haemangiomas. We assessed the effect of propranolol therapy in infantile haemangiomas of the orbit.

Methods:  A case series of four patients with orbital infantile haemangiomas were referred for management in our tertiary referral hospitals. Two of the patients had inadequate responses to prior corticosteroid therapy. One of the patients was commenced on propranolol at 2.5 years of age when the lesion was not in the proliferative phase. This represented the first case report of propranolol treatment for infantile haemangioma outside infancy. The other three children were in their infancy when propranolol was commenced. The patients were treated with oral propranolol.

Results:  All patients had significant improvement in their physical appearance, ocular examination findings and size of their lesions on radiological evaluation. No side‐effects of propranolol treatment were observed.

Conclusions:  Propranolol is a promising treatment against infantile haemangiomas in the orbit, not only in infants but also in an older child with a stable lesion.
MULTICENTER QUESTIONNAIRE SURVEY ON THE CURRENT SITUATION OF COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION IN JAPAN
Authors: Tanaka Shinji , Tamegai Yoshiro , Tsuda Sumio , Saito Yutaka , Yahagi Naohisa , Yamano Hiro‐o
Published: May 2010

In order to understand the current use of endoscopic submucosal dissection (ESD) for the treatment of colorectal tumors in Japan, we administered a questionnaire survey to 1356 institutions all over the country. The subject of the survey was colorectal ESD performed from January 2000 to September 2008. Among the 1356 institutions, 391 (28.8%) responded to the questionnaire, and colorectal ESD was currently being performed in 194 institutions. The 194 institutions were almost equally distributed in Japan, that is, colorectal ESD has been performed all over the country. Among these 194 institutions, the procedure had been performed in 100 or more cases in 22 (11.3%) institutions and in 50–99 cases in 18 institutions (9.3%). The knives used in colorectal ESD were the Hook knife, Flush knife, and Flex knife. The average time required for colorectal ESD was 92.2 min, the rate of complete en bloc resection was 83.8%, the perforation rate was 4.8%, and no case of death from complications was reported.
ENDOSCOPIC MANAGEMENT OF BILE DUCT STONES
Authors: Itoi Takao , Wang Hsiu‐Po
Published: May 2010

Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) are endoscopic techniques that are used for the removal of bile duct stones. Although EST and EPBD have become established techniques, occasionally the management of bile duct stones may be difficult in cases of large stones, multiple stones, and tapering or tortuosity of the distal common bile duct. In such patients, extracorporeal shock wave lithotripsy, mechanical lithotripsy or electrohydraulic lithotripsy, laser lithotripsy, or surgical intervention may be necessary. Furthermore, recently EST plus a large papillary balloon dilation has been popular for the treatment of difficult bile duct stones. Currently, endoscopic lithotripsy for bile duct stones seems to be a promising standard technique.
EVALUATION OF RESIDUAL BILE DUCT STONES BY PERORAL CHOLANGIOSCOPY IN COMPARISON WITH BALLOON‐CHOLANGIOGRAPHY
Authors: Itoi Takao , Sofuni Atsushi , Itokawa Fumihide , Shinohara Yasushi , Moriyasu Fuminori , Tsuchida Akihiko
Published: May 2010

We evaluated the usefulness of peroral cholangioscopy (POCS) for residual bile duct stones in patients with complete bile duct clearance confirmed by balloon‐occluded cholangiography. A total of 108 patients with common bile duct stones who underwent POCS after extraction of stones via endoscopic sphincterotomy, resulting in complete bile duct extraction confirmed by balloon‐occluded cholangiography, were retrospectively evaluated. For the treatment of difficult stones, stones were fragmented by mechanical lithotripsy (ML) or electrohydraulic lithotripsy (EHL). In 26 patients (24%), residual stones were detected with POCS in the lower bile duct. In patients with residual stones, large bile duct stones, juxtapapillary diverticulum, and use of ML or EHL were significantly related to residual stones (P < 0.05). Although a prospective study is necessary to clarify whether this procedure is appropriate in aspects of cost and benefits, POCS appears to be a useful diagnostic tool for confirming complete extraction of bile duct stones. POCS may be useful, particularly when lithotripsy using ML or EHL is performed and a large pneumobilia exists in the bile duct.
SURVEILLANCE COLONOSCOPY USING A TRANSPARENT HOOD AND IMAGE‐ENHANCED ENDOSCOPY
Authors: Takeuchi Yoji , Inoue Takuya , Hanaoka Noboru , Chatani Rika , Uedo Noriya
Published: May 2010

Colonoscopists can miss adenomas during colonoscopy screening. A transparent hood attached to the tip of the colonoscope helps detection of colorectal adenomas, but as far as we are aware, there has been no trial indicating its statistically significant effectiveness. Total colonic dye spray might improve the adenoma detection rate but it is complicated and time‐consuming for routine clinical usage. Moreover, the efficacy of narrow band imaging for detection of colorectal adenoma is controversial and is still under debate. Autofluorescence imaging (AFI) might be better able to detect flat lesions than white light imaging (WLI), but its ability is influenced easily by the area of the observation. Therefore, we have attached a transparent hood to the tip of an AFI colonoscope during colonoscopy screening in clinical usage. AFI can detect a flat lesion, which is difficult to detect using WLI. A transparent hood can help to detect lesions behind the folds by pushing the colonic fold. We expect that mounting a transparent hood would work complimentary to AFI. Further improvements, including a combination of AFI and a transparent hood, are needed and they would provide optimal surveillance intervals.
ALTERNATIVE METHODS IN THE ENDOSCOPIC MANAGEMENT OF DIFFICULT COMMON BILE DUCT STONES
Authors: Lee Dong Ki , Jahng Jae Hoon
Published: May 2010

The endoscopic method is accepted as a first treatment modality in the management of extrahepatic bile duct. Most large stones can be removed with basket and mechanical lithotripsy after endoscopic sphincterotomy. Currently, in treating large extrahepatic bile duct stones, endoscopic papillary large balloon dilation with mid‐incision endoscopic sphincterotomy is actively performed instead of applying mechanical lithotripsy after full endoscopic sphincterotomy. Herein, we describe the conceptions, proper indications, methods and complications of endoscopic papillary large balloon dilation with regards to currently published reports. In addition, intracorporeal lithotripsy by peroral cholangioscopy with an ultra‐slim upper endoscope is introduced, which is more convenient than previous conventional intracorporeal lithotripsy methods using mother–baby endoscopy or percutaneous transhepatic cholangioscopy. Lastly, biliary stenting with the choleretic agent administration method is briefly reviewed as an alternative treatment option for frail and elderly patients with large impacted common bile duct stones.
CURRENT MANAGEMENTS AND OUTCOMES OF PEPTIC AND ARTIFICIAL ULCER BLEEDING IN JAPAN
Authors: Fujishiro Mitsuhiro , Abe Nobutsugu , Endo Masaki , Kawahara Yoshiro , Shimoda Ryo , Nagata Shinji , Homma Kiyoaki , Morita Yoshinori , Uedo Noriya
Published: May 2010

The recent trend of gastroduodenal ulcer bleeding in Japan has not been elucidated in detail and the data for a new categorized type, artificial ulcer bleeding, is completely lacking. The purpose of this paper is to elucidate current managements and outcomes of peptic and artificial ulcer bleeding in Japan. A retrospective multicenter study of consecutive case series was carried out during one year at nine departments of high‐volume hospitals in Japan. The study included 325 consecutive patients (239 with peptic ulcers and 86 with artificial ulcers) with bleeding nonmalignant gastroduodenal ulcers that were revealed by emergency endoscopy between January 2008 and December 2008. Hemostasis was carried out mainly using endoscopic treatments. Rates of successful initial hemostasis, rebleeding, transfer to surgery, and death were recorded according to peptic and artificial ulcer bleeding. Additionally, preferred endoscopic methods, concomitant use of antisecretory drugs, and timing of second‐look endoscopy were also measured. A total of 227 (99.1%) of 229 peptic ulcer patients with endoscopic treatment and all (100%) 84 artificial ulcer patients underwent successful tentative hemostasis. Rebleeding occurred in 23 peptic ulcer patients (10.1%) and 10 artificial ulcer patients (11.9%). One peptic ulcer patient and two artificial ulcer patients had final surgical rescue due to rebleeding. No death was observed. Monotherapy was predominant (around 65% of cases) in both types of ulcers. The coagulation forceps method was more frequently applied in artificial ulcers (P < 0.05). A per oral proton pump inhibitor was more frequently used in artificial ulcers (P < 0.05), although an intravenous proton pump inhibitor was used in the majority of patients in both types of ulcers. The frequency of second‐look endoscopy in peptic ulcers (88%) was significantly higher than that in artificial ulcers (71%) (P < 0.05). There seemed to be no rule as to the timing of second‐look endoscopy, although it was most frequently performed on the day after hemostasis. The recent outcomes of endoscopic treatment for nonmalignant gastroduodenal bleeding in Japan were excellent in both peptic and artificial ulcers with similar efficacies. Although they were minor findings, some differences in applied endoscopic methods, concomitant use of antisecretory drugs, and presence of second‐look endoscopy were observed.
RETROSPECTIVE MULTICENTER STUDY CONCERNING ELECTROCAUTERY FORCEPS WITH SOFT COAGULATION FOR NONMALIGNANT GASTRODUODENAL ULCER BLEEDING IN JAPAN
Authors: Fujishiro Mitsuhiro , Abe Nobutsugu , Endo Masaki , Kawahara Yoshiro , Shimoda Ryo , Nagata Shinji , Homma Kiyoaki , Morita Yoshinori , Uedo Noriya
Published: May 2010

Electrocautery forceps with soft coagulation are actively used for treatment of bleeding and nonbleeding visible vessels during endoscopic submucosal dissection, but the usefulness of gastroduodenal ulcer bleeding has not been elucidated so far. The purpose of this paper is to elucidate the outcomes of electrocautery forceps with soft coagulation for peptic and artificial gastroduodenal ulcer bleeding. A retrospective multicenter study of consecutive case series during one year involved nine departments of high‐volume hospitals in Japan. The study included 128 consecutive patients (62 with peptic ulcers and 66 with artificial ulcers) with bleeding nonmalignant gastroduodenal ulcers that were revealed using emergency endoscopy between January 2008 and December 2008. Hemostasis was carried out using electrocautery forceps with soft coagulation. Rates of successful initial hemostasis, rebleeding, transfer to surgery, and death according to peptic and artificial ulcer bleeding were recorded. Successful initial endoscopic hemostasis was obtained in 61 peptic ulcer patients (98.4%) and 66 artificial ulcer patients (100%). Rebleeding was observed in seven peptic ulcer patients (11.5%) and five artificial ulcer patients (7.6%). Rates of successful management with endoscopic methods alone were 96.8% (60/62) and 100% (66/66) in peptic ulcer patients and artificial ulcer patients, respectively. There were no severe complications or deaths related to the management of gastroduodenal ulcer bleeding. The novel endoscopic method using electrocautery forceps with soft coagulation for gastroduodenal ulcer bleeding seems to provide safety and efficacy that is comparable with that of endoscopic hemostasis with other established hemostatic techniques.
SUCCESSFUL RETRIEVAL OF AN IMPACTED MECHANICAL LITHOTRIPSY BASKET: A CASE REPORT
Authors: Ryozawa Shomei , Iwano Hirotoshi , Taba Kumiko , Senyo Manabu , Sakaida Isao
Published: May 2010

We report the successful retrieval of an impacted mechanical lithotripsy basket. In a patient with two large common bile duct stones, the basket with the entrapped stone was impacted within the mid‐common bile duct. We then attempted to use another mechanical lithotripter; however the central wire of the basket fractured at the handle portion. Grasping a few wires of the impacted basket with rat‐tooth forceps allowed the wires of the basket to slip away from the stone. The present report describes the safe and effective use of rat‐tooth forceps in the management of an impacted lithotripter basket.