bluuebunny/crossref_metadata_2025 huggingface dataset:
Loss of BubR1 acetylation causes defects in spindle assembly checkpoint signaling and promotes tumor formation
Authors: Park Inai , Lee Hae-ock , Choi Eunhee , Lee Yoo-Kyung , Kwon Mi-Sun , Min Jaewon , Park Pil-Gu , Lee Seonju , Kong Young-Yun , Gong Gyungyub , Lee Hyunsook
Published: July 2013

BubR1 acetylation is essential in mitosis. Mice heterozygous for the acetylation-deficient BubR1 allele (K243R/+) spontaneously developed tumors with massive chromosome missegregations. K243R/+ mouse embryonic fibroblasts (MEFs) exhibited a weakened spindle assembly checkpoint (SAC) with shortened mitotic timing. The generation of the SAC signal was intact, as Mad2 localization to the unattached kinetochore (KT) was unaltered; however, because of the premature degradation of K243R-BubR1, the mitotic checkpoint complex disassociated prematurely in the nocodazole-treated condition, suggesting that maintenance of the SAC is compromised. BubR1 acetylation was also required to counteract excessive Aurora B activity at the KT for stable chromosome–spindle attachments. The association of acetylation-deficient BubR1 with PP2A-B56α phosphatase was reduced, and the phosphorylated Ndc80 at the KT was elevated in K243R/+ MEFs. In relation, there was a marked increase of micronuclei and p53 mutation was frequently detected in primary tumors of K243R/+ mice. Collectively, the combined effects of failure in chromosome–spindle attachment and weakened SAC cause genetic instability and cancer in K243R/+ mice.
Coordinated waves of actomyosin flow and apical cell constriction immediately after wounding
Authors: Antunes Marco , Pereira Telmo , Cordeiro João V. , Almeida Luis , Jacinto Antonio
Published: July 2013

Epithelial wound healing relies on tissue movements and cell shape changes. Our work shows that, immediately after wounding, there was a dramatic cytoskeleton remodeling consisting of a pulse of actomyosin filaments that assembled in cells around the wound edge and flowed from cell to cell toward the margin of the wound. We show that this actomyosin flow was regulated by Diaphanous and ROCK and that it elicited a wave of apical cell constriction that culminated in the formation of the leading edge actomyosin cable, a structure that is essential for wound closure. Calcium signaling played an important role in this process, as its intracellular concentration increased dramatically immediately after wounding, and down-regulation of transient receptor potential channel M, a stress-activated calcium channel, also impaired the actomyosin flow. Lowering the activity of Gelsolin, a known calcium-activated actin filament–severing protein, also impaired the wound response, indicating that cleaving the existing actin filament network is an important part of the cytoskeleton remodeling process.
Chromatin insulator bodies are nuclear structures that form in response to osmotic stress and cell death
Authors: Schoborg Todd , Rickels Ryan , Barrios Josh , Labrador Mariano
Published: July 2013

Chromatin insulators assist in the formation of higher-order chromatin structures by mediating long-range contacts between distant genomic sites. It has been suggested that insulators accomplish this task by forming dense nuclear foci termed insulator bodies that result from the coalescence of multiple protein-bound insulators. However, these structures remain poorly understood, particularly the mechanisms triggering body formation and their role in nuclear function. In this paper, we show that insulator proteins undergo a dramatic and dynamic spatial reorganization into insulator bodies during osmostress and cell death in a high osmolarity glycerol–p38 mitogen-activated protein kinase–independent manner, leading to a large reduction in DNA-bound insulator proteins that rapidly repopulate chromatin as the bodies disassemble upon return to isotonicity. These bodies occupy distinct nuclear territories and contain a defined structural arrangement of insulator proteins. Our findings suggest insulator bodies are novel nuclear stress foci that can be used as a proxy to monitor the chromatin-bound state of insulator proteins and provide new insights into the effects of osmostress on nuclear and genome organization.
Rab GTPases and membrane identity: Causal or inconsequential?
Authors: Barr Francis A.
Published: July 2013

Rab GTPases are highly conserved components of vesicle trafficking pathways that help to ensure the fusion of a vesicle with a specific target organelle membrane. Specific regulatory pathways promote kinetic proofreading of membrane surfaces by Rab GTPases, and permit accumulation of active Rabs only at the required sites. Emerging evidence indicates that Rab activation and inactivation are under complex feedback control, suggesting that ultrasensitivity and bistability, principles established for other cellular regulatory networks, may also apply to Rab regulation. Such systems can promote the rapid membrane accumulation and removal of Rabs to create time-limited membrane domains with a unique composition, and can explain how Rabs define the identity of vesicle and organelle membranes.
Unexpectedly high catch-and-release rates in European marine recreational fisheries: implications for science and management
Authors: Ferter Keno , Weltersbach Marc Simon , Strehlow Harry Vincent , Vølstad Jon Helge , Alós Josep , Arlinghaus Robert , Armstrong Mike , Dorow Malte , de Graaf Martin , van der Hammen Tessa , Hyder Kieran , Levrel Harold , Paulrud Anton , Radtke Krzysztof , Rocklin Delphine , Sparrevohn Claus Reedtz , Veiga Pedro
Published: July 2013

Ferter, K., Weltersbach, M. S., Strehlow, H. V., Vølstad, J. H., Alós, J., Arlinghaus, R., Armstrong, M., Dorow, M., de Graaf, M., van der Hammen, T., Hyder, K., Levrel, H., Paulrud, A., Radtke, K., Rocklin, D., Sparrevohn, C. R., and Veiga, P. 2013. Unexpectedly high catch-and-release rates in European marine recreational fisheries: implications for science and management. – ICES Journal of Marine Science, 70: 1319–1329. While catch-and-release (C&R) is a well-known practice in several European freshwater recreational fisheries, studies on the magnitude and impact of this practice in European marine recreational fisheries are limited. To provide an overview of the practice and magnitude of C&R among marine recreational anglers in Europe, the existing knowledge of C&R and its potential associated release mortality was collected and summarized. The present study revealed that in several European countries over half of the total recreational catch is released by marine anglers. High release proportions of >60% were found for Atlantic cod (Gadus morhua), European sea bass (Dicentrarchus labrax), pollack (Pollachius pollachius), and sea trout (Salmo trutta) in at least one of the studied European countries. In the case of the German recreational Baltic Sea cod fishery, release proportions varied considerably between years, presumably tracking a strong year class of undersized fish. Reasons for release varied between countries and species, and included legal restrictions (e.g. minimum landing sizes and daily bag limits) and voluntary C&R. Considering the magnitude of C&R practice among European marine recreational anglers, post-release mortalities of released fish may need to be accounted for in estimated fishing mortalities. However, as the survival rates of European marine species are mostly unknown, there is a need to conduct post-release survival studies and to identify factors affecting post-release survival. Such studies could also assist in developing species-specific, best-practice guidelines to minimize the impacts of C&R on released marine fish in Europe.
Species distribution, molecular characteristics and vancomycin resistance gene profiles of Enterococcus sp. isolates from farmhouse cheeses in western Turkey
Authors: Buyukyoruk Sadik , Ayaz Naim D , Gencay Yilmaz E , Beyaz Devrim , Kocak Pelin
Published: July 2013

Species distribution, virulence traits and vancomycin resistance gene profiles of Enterococcus isolated from 43 home‐made artisan cheese samples collected from open markets, located in Aydin region of Turkey, were investigated. Of the 129 isolates, 95 were identified as Enterococcus sp.; Enterococcus faecium being the most prevalent species (82.1%), followed by Enterococcus faecalis (13.6%) and Enterococcus durans (1.0%). None of the enterococci were harbouring vanA or vanC, while seven isolates (7.3%) were shown to harbour vanB gene by multiplex PCR. gelE (49.4%) being the most prevalent virulence factor was followed by asa1 (27.3%), esp (22.1%), cylA (4.2%) and hyl (3.1%).
Academic emergency medicine in India
Authors: Pothiawala Sohil , Anantharaman Venkataraman
Published: July 2013

Objectives

Emergency medicine (EM) was recognized as a specialty by the Medical Council of India (MCI) in July 2009. As India undergoes urbanisation, cost‐effective transition from managing infectious diseases to emergency management of trauma and cardio‐respiratory diseases is crucial. Trained emergency healthcare workers are needed to respond effectively to these challenges. The objective was to determine the current status of academic EM training and related issues in India, and to discuss those that need to be addressed.

Methods

The authors conducted electronic literature searches for articles published over an 18 year period from January 1994 to February 2013 using PubMed, Google and Yahoo databases. The references listed in the publications identified from these databases were also reviewed.

Results

Electronic literature searches revealed a multitude of 1 to 3 year training programmes, many affiliated with various foreign universities. The majority of these training programmes are offered in private healthcare institutions. MCI recognition has opened the doors for medical colleges to set up Indian specialty training programmes. Two separate Academic Councils are currently looking at EM training.

Conclusion

The variety of programmes and separate efforts on academic development begets a need to address the issues of short‐term courses being passed off as specialty training programmes, and a need for working together on national curriculum development, certification, accreditation systems and common examinations. The different organisations and academic councils could collaborate to give EM a unified scope for development.
Timing of appropriate antibiotics in patients with septic shock: A retrospective cohort study
Authors: Cullen Martin , Fogg Toby , Delaney Anthony
Published: July 2013

Objective

The objective of the present study was to describe the factors associated with delays in the delivery of appropriate antibiotics to patients admitted to the intensive care unit (ICU) from the ED or wards with septic shock.

Methods

All adult patients admitted to the ICU, at a single centre who had presented via the ED within the previous 48 h and who had septic shock were included. Data regarding the cause of sepsis, timing of administration of antibiotics, the appropriateness of antibiotics, results of cultures and features potentially related to delay in the administration of appropriate antibiotics were collected by a single investigator, onto specifically designed data forms. Descriptive statistics and univariate analysis were undertaken to determine the timing of appropriate antibiotics administration.

Results

Eighty‐nine patients who developed septic shock within 48 h of hospital presentation were admitted to the ICU at Royal North Shore between 2005 and 2008. The median time to administration of antibiotics was 120 min (interquartile range [IQR], 40–225) and the median time to administration of appropriate antibiotics was 188 min (IQR, 65–440 min). Patients who did not have sepsis as their initial diagnosis (90 vs 268 min; P < 0.002), those who waited until investigations were performed (88 vs 320 min; P < 0.001) and younger patients (β = −5.6; P = 0.04) had longer time delays to receive antibiotic therapy. Patients who were assessed by an emergency physician after developing septic shock were given antibiotics that were appropriate in a median of 20 min (IQR, 10–160 min), those assessed initially by a resident medical officer after developing septic shock in a median of 180 min (IQR, 78–563 min).

Conclusions

This retrospective cohort study found that there were significant delays associated with the administration of appropriate antibiotics in patients admitted to the ICU from the ED or the wards with septic shock. Delays were greater in patients who were not seen by an emergency physician, those in whom the diagnosis of sepsis was not considered initially and in those whose therapy was delayed while awaiting the performance of investigations.
‘To teach or not to teach?’ Factors that motivate and constrain Australian emergency medicine physicians to teach medical students
Authors: Cochran Ward Elizabeth , Kwan James , Garlan Karen , Bassett Elizabeth , Klein Linda
Published: July 2013

Objective

Clinical teaching in the ED is crucial to the education of medical students. We attempted to identify and describe Australian emergency physicians who are currently clinical teachers and to elicit the factors that motivate and constrain them to teach.

Methods

An online survey was emailed to all Advanced Trainee and Emergency Physician (Fellow) members of the ACEM.

Results

Our response rate was 28%. The 639 survey respondents were broadly representative of the total ACEM membership in level of training, gender and geographic distribution across all Australian states and territories. Although only 30% of survey respondents had a university teaching position, 74% were actively teaching medical students. Ninety per cent of all respondents agreed they would either commence teaching or increase the amount of time they contributed if they had protected teaching time. Other important facilitators were feelings of personal satisfaction and receiving continuing medical education credits. Written comments were received from 162 respondents. Qualitative analysis identified three main themes: personal, systemic and university‐related factors. Systemic and university factors were most frequently cited as barriers to teaching, whereas personal factors were motivators.

Conclusions

Although most emergency physicians are willing to teach, systemic and university factors associated with teaching medical students acted against success of this outcome.
Oxidants, antioxidants and mitochondrial function in non‐proliferative diabetic retinopathy (在非增殖性糖尿病视网膜病变中的氧化剂、抗氧化剂以及线粒体功能)
Authors: Rodríguez‐Carrizalez Adolfo Daniel , Castellanos‐González José Alberto , Martínez‐Romero Esaú César , Miller‐Arrevillaga Guillermo , Villa‐Hernández David , Hernández‐Godínez Pedro Pablo , Ortiz Genaro Gabriel , Pacheco‐Moisés Fermín Paul , Cardona‐Muñoz Ernesto Germán , Miranda‐Díaz Alejandra Guillermina
Published: July 2013

Background

Diabetic retinopathy (DR) is a preventable cause of visual disability. The aims of the present study were to investigate levels and behavior oxidative stress markers and mitochondrial function in non‐proliferative DR (NPDR) and to establish the correlation between the severity of NPDR and markers of oxidative stress and mitochondrial function.

Methods

In a transverse analysis, type 2 diabetes mellitus (T2DM) patients with mild, moderate and severe non‐proliferative DR (NPDR) were evaluated for markers of oxidative stress (i.e. products of lipid peroxidation (LPO) and nitric oxide (NO) catabolites) and antioxidant activity (i.e. total antioxidant capacity (TAC), catalase, and glutathione peroxidase (GPx) activity of erythrocytes). Mitochondrial function was also determined as the fluidity of the submitochondrial particles of platelets and the hydrolytic activity of F0/F1‐ATPase.

Results

Levels of LPO and NO were significantly increased in T2DM patients with severe NPDR (3.19 ± 0.05 μmol/mL and 45.62 ± 1.27 pmol/mL, respectively; P < 0.007 and P < 0.0001 vs levels in health volunteers, respectively), suggesting the presence of oxidative stress. TAC had significant decrease levels with minimum peak in severe retinopathy with 7.98 ± 0.48 mEq/mL (P < 0.0001). In contrast with TAC, erythrocyte catalase and GPx activity was increased in patients with severe NPDR (139.4 ± 4.4 and 117.13 ± 14.84 U/mg, respectively; P < 0.0001 vs healthy volunteers for both), suggesting an imbalance between oxidants and antioxidants. The fluidity of membrane submitochondrial particles decreased significantly in T2DM patients with mild, moderate, or severe NPDR compared with that in healthy volunteers (P < 0.0001 for all). Furthermore, there was a significant increase in the hydrolytic activity of the F0/F1‐ATPase in T2DM patients with mild NPDR (265.07 ± 29.55 nmol/PO4; P < 0.0001 vs healthy volunteers), suggesting increased catabolism.

Conclusions

Patients with NPDR exhibit oxidative deregulation with decreased membrane fluidity of submitochondrial particles and increased systemic catabolism (mitochondrial dysfunction) with the potential for generalized systemic damage in T2DM.
Use of flat panel DynaCT myelography to locate the site of CSF leak
Authors: Chu Eric , McAuliffe William
Published: July 2013

Spontaneous intracranial hypotension is often treated conservatively or with epidural blood patch. Patients who are resistant to these treatments require accurate imaging localisation of the site of cerebrospinal fluid (CSF) leak for surgical repair. We describe two patients where MRI, CT myelography and MRI gadolinium myelography showed evidence of a large volume of epidural CSF, but failed to identify the pressure site of leak. Subsequently, DynaCT (Siemens, Erlangen, Germany) accurately identified the site with confidence in both cases, confirmed at surgery. This technique of using a flat panel detector‐based, angiographic system to produce high quality, high‐contrast multiplanar CT images for detecting the source of rapid CSF leak is detailed.
Tea Bag Index: a novel approach to collect uniform decomposition data across ecosystems
Authors: Keuskamp Joost A. , Dingemans Bas J. J. , Lehtinen Taru , Sarneel Judith M. , Hefting Mariet M.
Published: July 2013

Changes in the balance between soil carbon storage and release can significantly amplify or attenuate global warming. Although a lot of progress has been made in determining potential drivers of carbon release through large‐scale decomposition experiments, climate predictions are still hampered by data limitation at a global scale as a result of high effort and measurement costs of comparative litter decomposition studies.

We introduce an innovative, cost‐effective, well‐standardised method to gather data on decomposition rate and litter stabilisation using commercially available tea bags as standardised test kits. By using two tea types with contrasting decomposability, we can construct a decomposition curve using a single measurement in time. The acquired Tea Bag Index (TBI) consists of two parameters describing decomposition rate (k) and litter stabilisation factor (S).

The method was tested for its sensitivity and robustness in contrasting ecosystems and biomes, confirming that the TBI is sensitive enough to discriminate between these systems. Within an ecosystem, TBI is responsive to differences in abiotic circumstances such as soil temperature and moisture content. The collected k and S values are in accordance with expectations based on decomposition process literature. They are therefore interpretable within the current knowledge framework.

Tea Bag Index is a unique, multifunctional method requiring few resources and minimal prior knowledge. The standardisation and simplicity of the method make it possible to collect comparable, globally distributed data through crowdsourcing. TBI can further provide an excellent decomposition reference and has the potential to increase reliability of soil carbon flux estimates based on extrapolations of decomposition data.
Functional characterization of human CTC1 mutations reveals novel mechanisms responsible for the pathogenesis of the telomere disease Coats plus
Authors: Gu Peili , Chang Sandy
Published: July 2013

Coats plus is a rare recessive disorder characterized by intracranial calcifications, hematological abnormalities, and retinal vascular defects. This disease results from mutations in CTC1, a member of the CTC1–STN1–TEN1 (CST) complex critical for telomere replication. Telomeres are specialized DNA/protein structures essential for the maintenance of genome stability. Several patients with Coats plus display critically shortened telomeres, suggesting that telomere dysfunction plays an important role in disease pathogenesis. These patients inherit CTC1 mutations in a compound heterozygous manner, with one allele encoding a frameshift mutant and the other a missense mutant. How these mutations impact upon telomere function is unknown. We report here the first biochemical characterization of human CTC1 mutations. We found that all CTC1 frameshift mutations generated truncated or unstable protein products, none of which were able to form a complex with STN1–TEN1 on telomeres, resulting in progressive telomere shortening and formation of fused chromosomes. Missense mutations are able to form the CST complex at telomeres, but their expression levels are often repressed by the frameshift mutants. Our results also demonstrate for the first time that CTC1 mutations promote telomere dysfunction by decreasing the stability of STN1 to reduce its ability to interact with DNA Polα, thus highlighting a previously unknown mechanism to induce telomere dysfunction.
Combining Naltrexone and Prazosin in a Single Oral Medication Decreases Alcohol Drinking More Effectively Than Does Either Drug Alone
Authors: Froehlich Janice C. , Hausauer Brett J. , Rasmussen Dennis D.
Published: July 2013

Background

Naltrexone (NTX) is underutilized in clinical treatment settings because its efficacy is modest, and it is not effective for all alcoholics and, when it is effective, a significant number of alcoholics fail to maintain initial treatment gains and subsequently relapse to heavy drinking. This has slowed acceptance of NTX by the treatment community, and there is a clear need for additional treatments for alcoholism and alcohol use disorders. Given that NTX and prazosin can each reduce alcohol drinking in rats selectively bred for alcohol preference and high voluntary alcohol drinking (alcohol‐preferring “P” rats), we tested whether a combination of NTX + prazosin is more effective in decreasing alcohol drinking than is either drug alone.

Methods

P rats were given access to a 15% (v/v) alcohol solution for 2 hours daily. Rats were fed NTX and prazosin, alone or in combination, prior to onset of the daily 2‐hour alcohol access period for 4 weeks and the effect of drug treatment on alcohol and water intake was assessed.

Results

During the first week of treatment, neither a low dose of NTX, nor prazosin, was effective in decreasing alcohol intake when each drug was administered alone, but combining the 2 drugs in a single medication significantly reduced alcohol intake. The combination was as effective as was a higher dose of NTX. Using a low dose of NTX in combination with prazosin may reduce the potential for undesirable side effects early in treatment which, in turn, may improve patient compliance and result in a more successful outcome when NTX is used for treating alcoholism and alcohol use disorders.

Conclusions

Combining low‐dose NTX and prazosin in a single medication may be more useful than is either drug alone for treating both inpatient and outpatient alcoholics and heavy drinkers early in the treatment process.
Floristic composition, structure and regeneration status of Masha forest, south‐west Ethiopia
Authors: Assefa Abreham , Demissew Sebsebe , Woldu Zerihun
Published: July 2013

The natural forest of Masha was studied to determine the species composition and population structure of woody species in the area. A total of 130 plant species belonging 61 families were recorded, in which family Acanthaceae was represented by 11 species followed by Rubiaceae (10) and Asteraceae (9). The composition and population structure of woody species, with diameter at breast height (DBH) >2.5 cm and height >2 m, and their regeneration were assessed in 65 sample plots of 400 m2 each. The density for trees and shrubs with DBH >2.5 cm was 1681 ind.ha−1, and the basal area of the study area was 142.6 m2 ha−1. Four community types were recognized. This forest is of international and national conservation importance given its high biodiversity. Managing the remaining forest would be an appropriate option for sustainable management of biodiversity.
Benefit finding and resilience in child caregivers
Authors: Cassidy Tony , Giles Melanie , McLaughlin Marian
Published: July 2013

Objectives

A substantial number of children are involved in informal caregiving and make a significant contribution to health care delivery. While this places high levels of demand on their coping resources, there is some evidence that these children find benefit in their caring role.

Design

A survey design using questionnaire data collection was used with a sample of 442 children (174 boys and 268 girls) between the ages of 12 and 16.

Methods

The role of benefit finding and resilience was explored within a stress and coping model of the impact of caregiving.

Results

Hierarchical multiple regression analysis (HMRA) identified resilience and benefit finding as accounting for significant amounts of variance in positive health and mediating the impact of caregiving. In regard to negative health, only benefit finding played a significant role.

Conclusions

Young caregivers do experience benefit finding and exhibit resilience although the relationship with caregiving burden was inverse. Benefit finding seems to be related to social recognition of the caregiving role and to family support.

Statement of contribution

What is already known on this subject? There is some emerging evidence that child caregivers experience some positive effects or benefits from their caring in spite of the demands of the role. However, the main focus has been on reducing negative outcomes rather than on building resilience.

What this study adds? This study provides evidence that young caregivers do experience benefit finding in situations where the role demand is not overly excessive and where the role is socially recognized.
Reflecting on non‐reflective action: An exploratory think‐aloud study of self‐report habit measures
Authors: Gardner Benjamin , Tang Vinca
Published: July 2013

Objectives

Within health psychology, habit – the tendency to enact action automatically as a learned response to contextual cues – is most commonly quantified using the ‘Self‐Report Habit Index’, which assesses behavioural automaticity, or measures combining self‐reported behaviour frequency and context stability. Yet, the use of self‐report to capture habit has proven controversial. This study used ‘think‐aloud’ methods to investigate problems experienced when completing these two measures.

Design

Cross‐sectional survey with think‐aloud study.

Methods

Twenty student participants narrated their thoughts while completing habit measures applied to four health‐related behaviours (active commuting, unhealthy snacking, and one context‐free and one context‐specific variant of alcohol consumption). Data were coded using thematic analysis procedures.

Results

Problems were found in 10% of responses. Notable findings included participants lacking confidence in reporting automaticity, struggling to recall behaviour or cues, differing in interpretations of ‘commuting’, and misinterpreting items.

Conclusions

While most responses were unproblematic, and further work is needed to investigate habit self‐reports among larger and more diverse samples, findings nonetheless question the sensitivity of the measures, and the conceptualization of habit underpinning common applications of them. We offer suggestions to minimize these problems.

Statement of contribution

What is already known on this subject?

Habit is most commonly measured within health psychology via the Self‐Report Habit Index, or a combination of self‐reported behaviour frequency and contextual stability.

The suitability of self‐report for capturing automatic processes has been questioned.

What does this study add?

This is the first study of how people interpret and respond to self‐report habit measures.

Results show the potential for errors in recalling automaticity, cues, and behaviours.

We discuss practical and theoretical challenges to assessing habit in health behaviours.
Percutaneous nephrolithotomy in England: practice and outcomes described in the Hospital Episode Statistics database
Authors: Armitage James N. , Withington John , van der Meulen Jan , Cromwell David A. , Glass Jonathan , Finch William G. , Irving Stuart O. , Burgess Neil A.
Published: July 2013

Objective

To investigate the postoperative outcomes of percutaneous nephrolithotomy (PCNL) in English National Health Service (NHS) hospitals.

Patients and Methods

We extracted records from the Hospital Episode Statistics (HES) database for all patients undergoing PCNL between March 2006 and January 2011 in English NHS hospitals.

Outcome measures were haemorrhage, infection within the index admission, and rates of emergency readmission and in‐hospital mortality within 30 days of surgery.

Results

A total of 5750 index PCNL procedures were performed in 165 hospitals.

During the index admission, haemorrhage was recorded in 81 patients (1.4%), 192 patients (3.8%) had a urinary tract infection (UTI), 95 patients (1.7%) had fever, and 41 patients (0.7%) had sepsis.

There were 595 emergency readmissions in 518 patients (9.0%). Reasons for readmission were varied: 70 (1.2%) with UTI, 15 (0.3%) sepsis, 73 (1.3%) haematuria, 25 (0.4%) haemorrhage, and 25 (0.4%) acute urinary retention.

There were 13 (0.2%) in‐hospital deaths within 30 days of surgery.

Conclusions

Haemorrhage and infection represent relatively common and potentially severe complications of PCNL.

Mortality is extremely rare after PCNL (about one in 400 procedures overall) but almost one in 10 patients have an unplanned hospital readmission within 30 days of surgery.

Complications of PCNL may be under‐reported in the HES database and need to be corroborated using other data sources.
Analysis of oncological outcomes and renal function after laparoendoscopic single‐site (LESS) partial nephrectomy: a multi‐institutional outcome analysis
Authors: Springer Christopher , Greco Francesco , Autorino Riccardo , Rha Koon H. , Derweesh Ithaar , Cindolo Luca , Richstone Lee , Herrmann Thomas R.W. , Liatsikos Evangelos , Sun Yinghao , Fanizza Caterina , Nagele Udo , Stolzenburg Jens‐Uwe , Rais‐Bahrami Soroush , Liss Michael A. , Schips Luigi , Kassab Ahmad , Wang Linhui , Kallidonis Panagiotis , Wu Zhenjie , Young Shin Tae , Altieri Vincenzo M. , Haber Georges‐Pascal , Fornara Paolo , Kaouk Jihad H.
Published: July 2013

Objective

To report on a large multi‐institutional series of laparoendoscopic single‐site (LESS) partial nephrectomy (PN) and analyse renal function and short‐term oncological outcomes.

Material and Methods

We conducted a retrospective analysis of consecutive cases of LESS‐PN performed between November 2007 and March 2012 at 11 participating institutions.

Demographic data and data on the main peri‐operative outcomes and complications were gathered and analysed.

Kidney function was evaluated by measuring serum creatinine concentration and estimated glomerular filtration rate (eGFR).

Chronic kidney disease was defined in stages for each patient according to the National Kidney Foundation, Kidney Disease Outcomes Quality Initiative.

Results

A total of 190 cases were included in this analysis. The mean renal tumour size was 2.6 cm, and the mean PADUA score was 7.2.

The median operating time was 170 min with a median estimated blood loss of 150 mL. A clampless technique was used in 70 cases (36.8%) and the median warm ischaemia time (WIT) was 16.5 min.

PADUA score independently predicted the length of WIT (low vs high score: odds ratio 5.11, CI 1.50–17.41, P = 0.009; intermediate vs high score: odds ratio 5.13, CI 1.56–16.88, P = 0.007).

The overall postoperative complication rate was 14.7%. Where a clamping technique was used, a significant increase in serum creatinine concentration and a significant decrease in eGFR were observed postoperatively and at 6 months. On multivariate analysis PADUA score was the only predicting factor.

Overall survival rates were 99, 97 and 88% at 12‐, 24‐ and 36‐month follow‐up, respectively, while disease‐free survival rates were 98% at 12‐month and 97% at 24‐ and 36‐month follow‐up.

Conclusion

The study showed that LESS‐PN is effective in terms of renal function preservation and oncological control at short‐ and intermediate‐term follow‐up.
Changes in Ground‐dwelling Ant Functional Diversity are Correlated with Water‐Table Level in an Amazonian Terra Firme Forest
Authors: Baccaro Fabricio B. , Rocha Ivaneide F. , del Aguila Barbara E. G. , Schietti Juliana , Emilio Thaise , Pinto José Luiz Purri da Veiga , Lima Albertina P. , Magnusson William E.
Published: July 2013

Areas with shallow water tables comprise a significant portion of tropical forests and have distinct forest structure and plant‐assemblage composition. It is not clear, however, how the water table regime shapes the distributions of other organisms. Here, we evaluated the influence of water‐table level on ant‐assemblage richness, abundance, and composition in a terra firme forest, in Central Amazonia. We sampled ants in ten 250 m‐long transects, regularly distributed over 5 km2 by extracting ants from 100 1‐m2 litter samples, 100 pitfall traps, and 100 sardine baits. During 1 year, the water‐table level in each transect was monitored every 15 d with a 6‐m deep dipwell. Overall the abundance of individuals and occurrence of species were lower in areas where the water table was closer to the surface (< 1 m depth) for longer periods (~ 5.5 mo). The number of ant species, however, was higher in transects where the water table was close to the surface more frequently. Changes in number of species were mainly a result of an increase in generalist species associated with a decrease in the number of specialist predators and small hypogeic generalist foragers. Although disturbance by the water table may increase local alpha diversity, only one third of generalist species seems to prefer areas with shallow water table.
MicroRNA‐26a Promotes Tumor Growth and Angiogenesis in Glioma by Directly Targeting Prohibitin
Authors: Qian Xu , Zhao Peng , Li Wei , Shi Zhu‐Mei , Wang Lin , Xu Qing , Wang Min , Liu Ning , Liu Ling‐Zhi , Jiang Bing‐Hua
Published: July 2013

Backgrounds and Aims

Glioma accounts for the majority of primary malignant brain tumors in adults. Upregulation of microRNA‐26a (miR‐26a) has been observed in glioma. However, the biological function and molecular mechanism of miR‐26a in glioma remain to be elucidated.

Methods

Glioma cells stably overexpressing or down‐expressing miR‐26a were analyzed for both in vitro and in vivo biological functions. Novel target of miR‐26a was identified by bioinformatics searching and molecular biological assays. Glioma specimens and normal brain tissues were analyzed for both expression levels of miR‐26a and its target.

Results

Forced expression of miR‐26a in glioma cells significantly increased both growth rate and colony formation in vitro and tumor growth and angiogenesis in vivo, while reduced expression of miR‐26a played opposite roles. MiR‐26a directly targeted prohibitin (PHB) whose expression levels were downregulated in glioma specimens. The levels of miR‐26a were inversely correlated with PHB expression levels in glioma samples and strongly correlated with clinical WHO grades of glioma.

Conclusion

These results reveal that miR‐26a regulates PHB and promotes glioma progression both in vitro and in vivo and that miR‐26a and its target PHB are associated with glioma development, which can be helpful in developing microRNA‐based treatment for glioma in the future.
Heme Oxygenase‐1 Mediated Memorial and Revivable Protective Effect of Ischemic Preconditioning on Brain Injury
Authors: Le Li‐Li , Li Xue‐Yi , Meng Dan , Liang Qiu‐Jun , Wang Xin‐Hong , Li Ning , Quan Jing , Xiang Meng , Jiang Mei , Sun Jian , Chen Si‐Feng
Published: July 2013

Aims

Ischemic preconditioning (IPC) has short‐term benefits for stroke patients. However, if IPC protective effect is memorial and the role of the intracellular protective protein heme oxygenase‐1 (HO‐1) is not known.

Methods

Ischemic preconditioning and the corresponding sham control were achieved by blocking the blood flow of the left internal carotid artery for 20 min and 2 second, respectively, in rats. Both IPC and sham‐operated animals were divided into three groups and treated with PBS, the HO‐1 inducer hemin, and the HO‐1 inhibitor Znpp. Three weeks after IPC, brain ischemia–reperfusion injury was achieved by left middle cerebral artery obstruction for 45 min followed by 24‐h reperfusion.

Results

2,3,5‐triphenyltetrazolium chloride staining and neurological dysfunction scoring showed IPC significantly reduced brain infarct area and improved neurological function occurred 3 weeks after IPC. Hemin treatment promoted whereas ZnPP blocked the benefits of IPC. Immunohistochemical analysis and Western blotting showed that the expression of HO‐1 was higher in the border zone than in the necrotic core zone. The memorial IPC protection is independent of adenosine receptor A1R and A2aR expressions.

Conclusions

We found for the first time that the protective effect of IPC can be remembered to protect brain injury occurred after acute response disappear. The results indicate that interventional treatment can achieve protective effect for future cerebral injury not only through interventional treatment itself but also through the memorial and revivable IPC, eliminating the concern that temporary ischemia caused by interventional treatment may leave harmful effect in the brain.
Contact dermatitis caused by iodopropynyl butylcarbamate in Denmark
Authors: Martin‐Gorgojo Alejandro , Johansen Jeanne‐Duus
Published: July 2013

Background

Iodopropynyl butylcarbamate (IPBC) is a preservative that may cause contact allergy. The first cases were reported in 1997, and IPBC is currently included in our extended European baseline series in Denmark.

Objectives

To assess trends during the period 2000–2011 concerning IPBC allergy in Denmark, and to address the question of the significance of concomitant reactions to the thiuram mix.

Patients/materials/methods

Nine thousand seven hundred and fifty‐five (6449 female; 3306 male) patients were patch tested with IPBC and the European baseline series at Gentofte Hospital during 2000–2011. The results were registered in an anonymized database, and analyzed with spss™.

Results

Fifty‐four cases of IPBC contact allergy were detected. A significant rising trend during 2000–2011 was observed, with no significant changes during 2006–2011. MOAHLFA index analysis showed that IPBC contact allergy was, in our cohort, significantly more prevalent among male patients, occupational, related to hand eczema, and more frequent among patients over 40 years old. A significant relationship between IPBC and thiuram mix allergy was found.

Conclusions

IPBC continues to be among the less frequent allergens. A 0.2% concentration in patch testing has contributed to the diagnosis of more sensitizations to this substance. Further studies are needed to clarify the reason for the over‐representation of thiuram allergy in patients sensitized to IPBC.
Enrichment of ovarian cancer stem‐like cells is associated with epithelial to mesenchymal transition through an miRNA‐activated AKT pathway
Authors: Luo X. , Dong Z. , Chen Y. , Yang L. , Lai D.
Published: July 2013

Objectives

Evidence has indicated that ovarian epithelial cancer‐type cells under serum‐free culture conditions can form spheroid cells and exhibit characteristics expected of cancer stem‐like cells (CSCs). However, the mechanism by which differentiated ovarian cancer cells acquire stem‐cell properties during CSC enrichment has needed to be elucidated. Recent studies have demonstrated that induction of epithelial to mesenchymal transition (EMT) can generate CSCs and be associated with tumour aggressiveness and metastasis.

Materials and methods

Ovarian epithelial cancer cell lines, SKOV3 and HO8920, were cultured for spheroid cells and adherent cells. CSC enrichment was investigated using MTT assay, flow cytometery and qRT‐PCR and expression level of PI3K/AKT pathway components was analysed by western blotting.

Results

Compared to adherent cells, the spheroid cells expressed mesenchymal markers highly and exhibited significantly more motility; we also observed increases in phosphate AKT1 levels in the spheroid cells. Moreover, transfection of miR‐20a or miR‐200c led to corresponding reduction in endogenous PTEN protein, while AKT1 and phosphate AKT1 levels were upregulated in miRNAs‐transfected cells. Finally, PI3K/AKT pathway inhibitor LY294002 reduced expressions of mesenchymal markers and stem‐cell gene activity in spheroid cells, enhancing sensitivity of spheroid cells to paclitaxel treatment.

Conclusions

Our findings demonstrate that EMT contributed to enrichment of ovarian CSCs in vitro, making EMT targeting in epithelial ovarian cancer a novel therapeutic option.
Risk factors for extensively drug‐resistant tuberculosis: a review
Authors: Flor de Lima Bárbara , Tavares Margarida
Published: July 2013

Introduction

Extensively drug‐resistant tuberculosis (XDR‐TB) is emerging as a global public health problem. Its treatment is more expensive and difficult, and the outcomes much severe. The identification of risk factors for XDR‐TB is of paramount importance to design effective TB control strategies.

Objective

To review published articles on risk factors for XDR‐TB.

Methods

We identified 249 English articles on PubMed, and 182 were excluded by the abstract. The remaining articles were retrieved for full‐text detailed evaluation by authors, and 27 relevant articles were selected for final review.

Results

Some risk factors were consistently present, mainly previous TB treatment and its length. Other conditions often associated were immigration, alcoholism and HIV coinfection. Pre‐XDR‐TB points to an increased risk of XDR‐TB.

Conclusion

The information regarding determinants of XDR‐TB is relatively weak. However, special emphasis should be given to minimize the risks of TB retreatment to prevent the emergence of highly resistant TB.
International humanitarian actors and governments in areas of conflict: challenges, obligations, and opportunities
Authors: Harvey Paul
Published: July 2013

For too long international humanitarian aid has neglected the primary responsibility of the state to assist and protect its citizens in times of disaster. A focus on the role of the state in contexts where governments are active parties to a conflict and are failing to live up to these responsibilities is difficult and underpins many of the recurring dilemmas of humanitarian action. The fundamental principles of humanitarian action should offer a framework for principled engagement with governments in situations of conflict but too often they are still interpreted as shorthand for ignoring governments. Using principles to inform engagement with both states and other international actors engaged in crises could provide a way forward. However, this would need to be a humanitarian agenda that engages with developing country governments, with non‐OECD (Organisation for Economic Co‐operation and Development) donors, and with the stabilisation and security agendas of Western governments, and not one that attempts to ring‐fence an ever‐shrinking isolationist humanitarian space.
Humanitarian agencies and authoritarian states: A symbiotic relationship?
Authors: del Valle Hernan , Healy Sean
Published: July 2013

The relationship between humanitarian agencies and authoritarian states is of growing concern to Médecins Sans Frontières (MSF), given the recurring difficulties experienced in negotiating access and implementing operations in such contexts. The effort to negotiate and gain approval from states to operate on their territory prompts reflection on the sources of legitimacy for action. Drawing on direct field examples in two countries only very rarely examined—Turkmenistan and Uzbekistan—this paper explores MSF's attempts to offer live‐saving medical care there. It shows that successful access negotiations hinged heavily on demonstrating added value (medical relevance) while simultaneously building relationships with authorities, identifying possible allies within health ministries, and hoping that such measures could promote a level of acceptance or trust needed to operate. It is clear that the operational space achieved is bound to remain limited and fragile, and that many compromises have to be considered and judged against ethical principles and the overall impact of the intervention.
Three legacies of humanitarianism in China
Authors: Hirono Miwa
Published: July 2013

The rise of China has altered the context of the international humanitarian community of donors and aid agencies. China is becoming one of the key actors in this grouping, undertaking infrastructure projects in areas in which paramount humanitarian challenges exist. The literature discusses how the Chinese approach differs from that of Western donors, but it does not pay much attention to why China concentrates on its state‐centric and infrastructure‐based approach. This paper seeks to shed some light on this subject by examining the historical evolution of the concept of humanitarianism in China. This evolution has produced three legacies: (i) the ideal of a well‐ordered state; (ii) anti‐Western sentiment; and (iii) the notion of comprehensive development based on a human‐oriented approach. China's policies and discourses on assistance in humanitarian crises today rest on these three legacies. Traditional donors would be well advised to consider carefully the implications of the Chinese understanding of humanitarianism when engaging with the country.
Stand up and be counted
Authors: Novak Iona
Published: July 2013

This commentary is on the original article by Rodby‐Bousquet et al. on pages 1009–12015 of this issue.
Developing a hierarchy of needs for Type 1 diabetes
Authors: Beran D.
Published: July 2013

Aims

The aim of this study was to use the concept of Maslow's hierarchy of needs and apply this to Type 1 diabetes.

Methods

Qualitative methods were employed using semi‐structured interviews with 101 people from 13 countries. Grounded theory was used for data collection and analysis, with thematic analysis employed to identify the interviewees' needs.

Results

Sixteen needs were identified and links between these were mapped. Aligning these with Maslow's hierarchy allowed for a hierarchy to be developed for Type 1 diabetes with ‘Policies’, ‘Organization of health system’, ‘Insulin’, ‘Delivery of insulin’, ‘Control’, ‘Healthcare workers’ and ‘Information and education’ at the base, as they were needed for survival. Next came ‘Community, family and peers’ and changing roles for ‘Healthcare workers’ in their approach to care and delivering ‘Information and education’. This enabled people to learn how to use ‘Insulin’, ‘Delivery of insulin’ and ‘Control’ flexibly. People's ‘Experience’ and ‘Personality’ then helped them ‘Adapt’ and ‘Be open’ about their diabetes, allowing for ‘Acceptance’ and viewing ‘Diabetes as something positive’.

Conclusions

Despite limitations, this work highlights that some needs are required for survival and others for well‐being. Some are tangible as they can be directly provided, whereas others are intangible and cannot be provided directly by the health system. These results might be used for policy and practice in identifying needs that are met within a health system or what needs are lacking for the individual to then implement targeted interventions.