bluuebunny/crossref_metadata_2025 huggingface dataset:
Matrix correlations for high-dimensional data: the modified RV-coefficient
Authors: Smilde A. K. , Kiers H. A. L. , Bijlsma S. , Rubingh C. M. , van Erk M. J.
Published: December 2008

Motivation: Modern functional genomics generates high-dimensional datasets. It is often convenient to have a single simple number characterizing the relationship between pairs of such high-dimensional datasets in a comprehensive way. Matrix correlations are such numbers and are appealing since they can be interpreted in the same way as Pearson's correlations familiar to biologists. The high-dimensionality of functional genomics data is, however, problematic for existing matrix correlations. The motivation of this article is 2-fold: (i) we introduce the idea of matrix correlations to the bioinformatics community and (ii) we give an improvement of the most promising matrix correlation coefficient (the RV-coefficient) circumventing the problems of high-dimensional data.

Results: The modified RV-coefficient can be used in high-dimensional data analysis studies as an easy measure of common information of two datasets. This is shown by theoretical arguments, simulations and applications to two real-life examples from functional genomics, i.e. a transcriptomics and metabolomics example.

Availability: The Matlab m-files of the methods presented can be downloaded from http://www.bdagroup.nl.

Contact:  a.k.smilde@uva.nl
A Standardized Transcutaneous Electric Acupoint Stimulation for Relieving Tobacco Urges in Dependent Smokers
Authors: Lambert Caroline , Berlin Ivan , Lee Tat-Leang , Hee Siew Wan , Tan Audrey S. L. , Picard David , Han Ji Sheng
Published: December 2008

The efficacy of acupuncture in smoking cessation, and its effect on the urge to smoke are unclear. We evaluated the effect of a standardized protocol of transcutaneous electric acupoint stimulations (TEAS) on alleviating the urge to smoke. Ninety‐eight smokers were recruited in two double‐blind studies. Participants abstained from smoking for 26 h, and were randomized to receive TEAS alternating between 2 and 100 Hz at four acupoints (LI4 and PC8, PC6 and TE5) at four different intensities (10, 5, Intermittent 5 or 0 mA). The urge to smoke was assessed by the Questionnaire of Smoking Urges (QSU‐Brief). In Experiment 1, the 10 mA group (n = 20) was compared with the 5 mA group (n = 20); the increase in smoking urges did not differ significantly. Considering the possibility that 5 mA may be an active intervention, in Experiment 2, a true placebo (0 mA), and a proxy of placebo [Intermittent 5 mA (i5 mA)] were compared with 10 mA TEAS. In this experiment, 10 mA (n = 20) TEAS showed a tendency to alleviate smoking urges compared with 0 mA (n = 16), and i5 mA (n = 19) TEAS. Only when the data of smokers with Fagerstöm Test for Nicotine Dependence score ≥5 were analyzed that the difference between the 10 mA group and the control group (0 and i5 mA) became significant. Based on these preliminary findings, we conclude that TEAS applied on the skin may antagonize the increase in urge to smoke in abstinent‐dependent smokers. It seems warranted to assess the efficacy of TEAS in smoking cessation clinical trials involving a larger population of dependent smokers.
Decision Making in Children and Young People: Gillick Competent?
Authors: Hayhoe Benedict
Published: December 2008

Valid consent to treatment is vitally important in medical practice both in the protection of patients and, for those providing treatment, as a defence against criminal charges of assault or battery or civil claims of trespass against the person.
Adolescence and Associated Behavioural Problems
Authors: Manoharan Brenda
Published: December 2008

Adolescence is a time of physical, emotional and social change, marking the transition from child to adult. This usually begins at the age of 11 in girls and 13 years in boys and typically concludes by the age of 17.
Chlamydia Screening
Authors: Simon Chantal
Published: December 2008

Chlamydia is the most common sexually transmitted infection (STI) in the UK. It is asymptomatic in 70% of infected women and 50% of infected men and so often goes undiagnosed. Between 2000 and 2004, the rate of new diagnoses of chlamydia among people who attended Genito-urinary medicine clinics greatly increased from 116 to 175/100 000 ( Fig. 1 ), with the largest increases in chlamydia rates occurring in the under 16 age group. However, the highest rates of chlamydia infection are seen in females aged between 16 and 19 years (1339/100 000) and males aged 20–24 years (1034/100 000). The National Chlamydia Screening Programme (NCSP) in England was established in 2003 with the objective of controlling chlamydia through the early detection and treatment of asymptomatic infection, thus preventing the development of sequelae and reducing onward disease transmission. Similar programmes are underway in the rest of the UK.
Cost of exposure to trematode cercariae and learned recognition and avoidance of parasitism risk by fathead minnowsPimephales promelas
Authors: James C. T. , Noyes K. J. , Stumbo A. D. , Wisenden B. D. , Goater C. P.
Published: December 2008

Fathead minnowsPimephales promelasexposed to cercariae of the trematodeOrnithodiplostomumsp. incurred a significant mass loss 17 days after exposure to 20 or 120 cercariae. Parasite‐naïveP. promelasshowed no evidence of innate recognition or avoidance of cercariae. After a single exposure to cercariae, however, fish responded to chemical and visual cues of dead (thawed) cercariae with a reduction in activity. Encounter rate with cercariae, and hence infection rate, increased with fish activity. The data indicated that experiencedP. promelasassociated parasitism risk with novel chemical and visual cues that later triggered avoidance behaviour. Parallels and interactions between antiparasite behaviour and antipredator behaviour open new avenues for behavioural ecological research in risk‐sensitive decision‐making.
Role of altitude and water temperature as regulating factors for the geographical distribution of Tetracapsuloides bryosalmonae infected fishes in Switzerland
Authors: Wahli T. , Bernet D. , Segner H. , Schmidt‐Posthaus H.
Published: December 2008

The role of water temperature and altitude of the river sites on distribution, prevalence and infection intensity of Tetracapsuloides bryosalmonae infected salmonids was investigated. The study is based on a 6 year survey of salmonids, mainly brown trout, Salmo trutta from 2000 to 2006 at 287 sampling sites across Switzerland. Almost 7000 fishes were tested for the presence of T. bryosalmonae by histological and immunohistochemical techniques. A good correlation between altitude and water temperature in Swiss rivers could be demonstrated. Therefore, the relation between altitude and sites tested for T. bryosalmonae infected fishes was investigated since water temperature values from these sites were not available. Percentage of sites with positive (infected) fishes was identical for altitudes between 200 and 800 m above sea level (m a.s.l.), while above 800 m a.s.l. only three sites with infected fishes were recorded. Site‐specific prevalence values ranging from 0 to 100% and infection intensities from 0 to 6 were found over the whole altitude range from 200 to 800 m a.s.l., and no correlation with altitude was found. Conditions at altitudes >800 m may not be favourable for the establishment of the infection in fishes. With rising temperatures due to climatic changes, however, the prevalence of T. bryosalmonae infected fishes in altitudes >800 m a.s.l. could increase.
Host–parasite interactions in polluted environments
Authors: Sures B.
Published: December 2008

In recent years, there has been an increasing number of papers showing how parasitism and pollution can interact with each other in aquatic organisms. In addition to synergistic negative effects of both stressors, there are also indications of antagonistic interactions. The latter are related to the reduction of pollutant levels in infected hosts compared with uninfected conspecifics. As reduced pollutant concentrations are usually correlated with less adverse effects, it might be advantageous to be infected if hosts are confronted with environmental pollution. On the other hand, possible pathological effects might reduce a potentially beneficial effect of parasites. There are also examples, however, which show that parasites may enhance toxic effects of pollutants by interfering with host‐protection mechanisms. In these cases, a parasitosis would have exclusively negative effects on the physiological homeostasis of their hosts. This presentation summarizes the current knowledge on interactions between parasites and pollutants with respect to their effects on the host’s health.
First record of Philometra ovata (Nematoda) infection in Gobio lozanoi in Portugal
Authors: Saraiva A. , Hermida M. , Costa M. J. , Maia C. , Reis A. R. , Cruz C. , Valente A.
Published: December 2008

Gobio lozanoi, from the River Febros northern Portugal, contained female Philometra ovata in the body cavity causing abdominal swelling. A mild chronic inflammation and some tissue necrosis were observed in infected fish. Significant correlations were found between occurrence of infection and host length, and gonado‐somatic index; and between intensity of infection and condition factor.
Co‐evolutionary patterns in congeneric monogeneans: a review ofDactylogyrusspecies and their cyprinid hosts
Authors: ŠImková A. , Morand S.
Published: December 2008

Patterns associated with the evolution of parasite diversity, speciation and diversification were analysed usingDactylogyrusspecies (gill monogeneans) and their cyprinid hosts as a model. The aim of this study was to use this highly specific host–parasite systems to review: (1) the diversity and distribution ofDactylogyrusspecies, (2) the patterns of organization and structure ofDactylogyruscommunities, (3) the evolution and determinants of host specificity and (4) the mode ofDactylogyrusspeciation and co‐evolutionary patterns in thisDactylogyrus–cyprinid systems.Dactylogyrusare a highly diverse group of parasites, with their biogeography and distribution clearly linked to the evolutionary history of their cyprinid hosts. The coexistence of severalDactylogyrusspecies on one host is facilitated by increasing niche distances and the differing morphology of their reproductive organs. The positive interspecific and intraspecific interactions seem to be the most important factors determining the structure ofDactylogyruscommunities. Host specificity is partially constrained by parasite phylogeny. Being a strict specialist is an ancestral character forDactylogyrus, being the intermediate specialists or generalists are the derived characters. The evolution of attachment organ morphology is associated with both parasite phylogeny and host specificity. Considering larger and long‐lived hosts or hosts with several ecological characters as the measures of resource predictability, specialists with larger anchors occurred on larger or longer‐living fish species. Intra‐host speciation, a mode of speciation not often recorded in parasites, was observed inDactylogyrusinfecting sympatric cyprinids. Sister parasite species coexisting on the same host occupied niches that differed in at least one niche variable. Intra‐host speciation, however, was not observed inDactylogyrusspecies of congeneric hosts from geographically isolated areas, which suggested association by descent and host‐switching events.
Loss of heterozygosity on 10q23 is involved in metastatic recurrence of hepatocellular carcinoma
Authors: Okuno Tomoko , Ueda Mikiko , Tsuruyama Tatsuaki , Haga Hironori , Takada Yasutsugu , Maetani Yoji , Tamaki Keiji , Manabe Toshiaki , Tanaka Koichi , Uemoto Shinji
Published: December 2008

We performed loss of heterozygosity (LOH) analysis on five chromosomal arms (1p, 3p, 9p, 10q, 17p) in hepatocellular carcinoma (HCC). Univariate analyses of 80 patients who underwent liver transplantation demonstrated significant correlations between cancer recurrence and the following variables: LOH on 3p26, LOH on 10q23, LOH on 17p13, tumor diameter ≥ 5 cm, number of tumors ≥ 4, histologic Grade 3, alpha‐fetoprotein (AFP) ≥ 400 ng/mL, American Joint Committee on Cancer (AJCC) pT classification, and portal invasion. Patients with LOH on 10q23 exhibited a significantly higher 3‐year recurrence rate (38.9%vs 11.9%, P = 0.0009). Multivariate analysis identified LOH on 10q23, histologic Grade 3, tumor nodules ≥ 4, and AFP ≥ 400 ng/mL as the risk factors of advanced HCC recurrence. These results suggest that LOH on 10q23 is associated with metastatic recurrence of HCC. (Cancer Sci 2009; 100: 520–528)
Oral or intravenous proton pump inhibitor in patients with peptic ulcer bleeding after successful endoscopic epinephrine injection
Authors: Tsai Jai‐Jen , Hsu Yao‐Chun , Perng Chin‐lin , Lin Hwai‐Jeng
Published: December 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT?

• Endoscopic therapy significantly reduces recurrent bleeding, surgery and mortality in patients with bleeding peptic ulcers.

• Intravenous (i.v.) proton pump inhibitors (PPIs) have been found to be effective as adjuvant pharmacotherapy in preventing rebleeding in these patients.

• It remains undetermined whether oral and i.v. regular‐dose PPIs are equally effective.

WHAT THIS STUDY ADDS?

• Oral rabeprazole and i.v. regular‐dose omeprazole are comparable in preventing rebleeding in patients with high‐risk bleeding peptic ulcers after successful endoscopic injection with epinephrine.

AIMS We aimed to assess the clinical effectiveness of oral vs. intravenous (i.v.) regular‐dose proton pump inhibitor (PPI) after endoscopic injection of epinephrine in patients with peptic ulcer bleeding.

METHODS Peptic ulcer patients with active bleeding, nonbleeding visible vessels, or adherent clots were enrolled after successful endoscopic haemostasis achieved by epinephrine injection. They were randomized to receive either oral rabeprazole (RAB group, 20 mg twice daily for 3 days) or i.v. omeprazole (OME group, 40 mg i.v. infusion every 12 h for 3 days). Subsequently, the enrolled patients receive oral PPI for 2 months (rabeprazole 20 mg or esomeprazole 40 mg once daily). The primary end‐point was recurrent bleeding up to 14 days. The hospital stay, blood transfusion, surgery and mortality within 14 days were compared as well.

RESULTS A total of 156 patients were enrolled, with 78 patients randomly allocated in each group. The two groups were well matched for factors affecting the clinical outcomes. Primary end‐points (recurrent bleeding up to 14 days) were reached in 12 patients (15.4%) in the OME group and 13 patients (16.7%) in the RAB group [95% confidence interval (CI) of difference −12.82, 10.22]. All the rebleeding events occurred within 3 days of enrolment. The two groups were not different in hospital stay, volume of blood transfusion, surgery or mortality rate (1.3% of the OME group and 2.6% of the RAB group died, 95% CI of difference −5.6, 3.0).

CONCLUSIONS Oral rabeprazole and i.v. regular‐dose omeprazole are equally effective in preventing rebleeding in patients with high‐risk bleeding peptic ulcers after successful endoscopic injection with epinephrine.
Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome
Authors: Keogan M T
Published: December 2008

Patients presenting with recurrent orogenital ulcers may have complex aphthosis, Behçet's disease, secondary complex aphthosis (e.g. Reiter's syndrome, Crohn's disease, cyclical neutropenia) or non-aphthous disease (including bullous disorders, erythema multiforme, erosive lichen planus). Behçet's syndrome is a multi-system vasculitis of unknown aetiology for which there is no diagnostic test. Diagnosis is based on agreed clinical criteria that require recurrent oral ulcers and two of the following: recurrent genital ulcers, ocular inflammation, defined skin lesions and pathergy. The condition can present with a variety of symptoms, hence a high index of suspicion is necessary. The most common presentation is with recurrent mouth ulcers, often with genital ulcers; however, it may take some years before diagnostic criteria are met. All patients with idiopathic orogenital ulcers should be kept under review, with periodic focused assessment to detect evolution into Behçet's disease. There is often a delay of several years between patients fulfilling diagnostic criteria and a diagnosis being made, which may contribute to the morbidity of this condition. Despite considerable research effort, the aetiology and pathogenesis of this condition remains enigmatic.
Analysis of islet inflammation in human type 1 diabetes
Authors: Willcox A , Richardson S J , Bone A J , Foulis A K , Morgan N G
Published: December 2008

The immunopathology of type 1 diabetes (T1D) has proved difficult to study in man because of the limited availability of appropriate samples, but we now report a detailed study charting the evolution of insulitis in human T1D. Pancreas samples removed post-mortem from 29 patients (mean age 11·7 years) with recent-onset T1D were analysed by immunohistochemistry. The cell types constituting the inflammatory infiltrate within islets (insulitis) were determined in parallel with islet insulin content. CD8+ cytotoxic T cells were the most abundant population during insulitis. Macrophages (CD68+) were also present during both early and later insulitis, although in fewer numbers. CD20+ cells were present in only small numbers in early insulitis but were recruited to islets as beta cell death progressed. CD138+ plasma cells were infrequent at all stages of insulitis. CD4+ cells were present in the islet infiltrate in all patients but were less abundant than CD8+ or CD68+ cells. Forkhead box protein P3+ regulatory T cells were detected in the islets of only a single patient. Natural killer cells were detected rarely, even in heavily inflamed islets. The results suggest a defined sequence of immune cell recruitment in human T1D. They imply that both CD8+ cytotoxic cells and macrophages may contribute to beta cell death during early insulitis. CD20+ cells are recruited in greatest numbers during late insulitis, suggesting an increasing role for these cells as insulitis develops. Natural killer cells and forkhead box protein P3+ T cells do not appear to be required for beta cell death.
Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection
Authors: Calum H , Moser C , Jensen P Ø , Christophersen L , Maling D S , Van Gennip M , Bjarnsholt T , Hougen H P , Givskov M , Jacobsen G K , Høiby N
Published: December 2008

Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6% third-degree burn injury was induced in mice with a hot-air blower. The third-degree burn was confirmed histologically. The mice were allocated into five groups: control, shave, burn, infection and burn infection group. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization of the skin showed a more polymorphonuclear neutrophil granulocytes (PMNs)-dominated inflammation in the group of mice with infected burn wound compared with the with burn wound group. In contrast, a higher degree of inflammation was observed in the burn wound group compared with the group of mice with infected burn wound. Furthermore, the oxidative burst and the phagocytic capacity of the PMNs were reduced in the group of mice with burn wound. Using this novel mouse model of thermal injury a decline of peripheral leucocytes was observed, whereas the increased local inflammatory response at the site of infection showed reduced capacity to contain and eliminate the infection.
Serum concentrations and tissue expression of a novel endocrine regulator fibroblast growth factor‐21 in patients with type 2 diabetes and obesity
Authors: Mraz M. , Bartlova M. , Lacinova Z. , Michalsky D. , Kasalicky M. , Haluzikova D. , Matoulek M. , Dostalova I. , Humenanska V. , Haluzik M.
Published: December 2008

Objective  Fibroblast growth factor‐21 (FGF21) is a novel endocrine and paracrine regulator of metabolic homeostasis. The aim of our study was to measure its serum concentrations in patients with obesity, obesity and type 2 diabetes mellitus (T2DM) and healthy subjects (C), and to assess the changes of its circulating levels and mRNA expression after dietary and pharmacological interventions.

Design  We measured biochemical parameters, serum FGF21, adiponectin, leptin and insulin levels by commercial ELISA and RIA kits, and mRNA expression in the liver, subcutaneous and visceral fat by RT PCR in 26 obese patients, 11 T2DM patients and 32 control subjects. The interventions were acute hyperinsulinaemia during isoglycaemic–hyperinsulinaemic clamp, very low calorie diet (VLCD) and 3 months treatment with PPAR‐α agonist fenofibrate.

Results  Baseline serum FGF21 levels were significantly higher in both obese and T2DM patients relative to healthy controls. FGF21 levels in obesity did not significantly differ from T2DM group. Both 3 weeks of VLCD and 3 months of fenofibrate treatment significantly increased FGF21 levels. FGF21 mRNA expression in visceral fat was twofold higher in obesity relative to C group, while it did not differ in subcutaneous fat. VLCD significantly increased FGF21 mRNA expression in subcutaneous fat of obesity. 3‐h hyperinsulinaemia during the clamp increased FGF21 levels in T2DM but not in C group.

Conclusion  An increase in FGF21 levels after VLCD and fenofibrate treatment may contribute to positive metabolic effect of these interventions and suggests the possibility of direct positive metabolic effects of FGF21 in humans.
Echo Doppler parameters predict response to cardiac resynchronization therapy
Authors: Wiesbauer F. , Baytaroglu C. , Azar D. , Blessberger H. , Goliasch G. , Graf S. , Mundigler G. , Pacher R. , Maurer G. , Binder T.
Published: December 2008

Background  Cardiac resynchronization therapy (CRT) has been shown to reduce heart failure related morbidity and mortality. However, approximately 30% of patients do not respond to CRT. We investigated the usefulness of Echo Doppler parameters to predict reverse remodelling, functional improvement and mortality following CRT.

Materials and methods  Our population consists of 200 consecutive heart failure patients evaluated for ventricular dyssynchrony by echocardiography between February 1999 and May 2007 who subsequently received CRT. Patients were reassessed for signs of reverse remodelling after a mean follow‐up of 10 months. Information on vital status was obtained from local registration authorities.

Results  Three parameters significantly predicted reverse remodelling in the logistic regression analysis: the Q‐to‐E‐wave‐delay (QED) at a cutoff of 550 ms (odds ratio 4·5, P‐value 0·001), the interventricular mechanical delay (IVMD) at a cutoff of 60 ms (odds ratio 2·4, P‐value 0·02), and the aortic electromechanical delay (A‐EMD) at a cutoff of 140 ms (odds ratio 2·9, P‐value 0·004). Furthermore, the QED and the IVMD also predicted all‐cause mortality (hazard ratio 0·36, P‐value 0·02 and 0·21, P‐value 0·004, respectively). Adjustment for confounders did not alter the results.

Conclusions  The QED and IVMD predict reverse remodelling and survival following CRT. These parameters are easy to obtain, provide valuable prognostic information, and should thus be measured in CRT candidates evaluated by echocardiography.
A study for maternal thyroid hormone deficiency during the first half of pregnancy in China
Authors: Shan Z. Y. , Chen Y. Y. , Teng W. P. , Yu X. H. , Li C. Y. , Zhou W. W. , Gao B. , Zhou J. R. , Ding B. , Ma Y. , Wu Y. , Liu Q. , Xu H. , Liu W. , Li J. , Wang W. W. , Li Y. B. , Fan C. L. , Wang H. , Guo R. , Zhang H. M.
Published: December 2008

Background  Maternal thyroid hormone deficiency is the most common disorder of thyroid function during pregnancy and can influence the outcome for mother and foetus. The purpose of this study was to investigate the prevalence of thyroid hormone deficiency during the first half of pregnancy in iodine sufficient areas of China.

Materials and methods  Four thousand eight hundred pregnant women from 10 hospitals during the first 20  weeks of gestation were enrolled in this study. All sera obtained from pregnant women were measured for thyrotropin, free thyroxine and thyroid peroxidase antibody. Screening for thyroid hormone deficiency was performed on pregnant women using gestational age‐specific reference intervals or non‐pregnant population reference intervals.

Results  With gestational age‐specific reference intervals as the criterion, the prevalence of subclinical hypothyroidism at 4, 8, 12,16 and 20 weeks of gestation was 4·59%, 6·15%, 4·68%, 4·53% and 5·96%, respectively, and the prevalence of hypothyroxinaemia was 3·69%, 1·11%, 2·92%, 1·29% and 2·29%, respectively. Different prevalence was obtained when non‐pregnant population reference intervals was used as the criterion.

If non‐pregnant population reference intervals were used, the percentage of potentially misclassified cases of subclinical hypothyroidism were 0·18%, 2·85%, 4·1%, 3·24%, and 3·21%, respectively, and 3·45%, 0·66%, 2·34%, 1·29%, and 1·83%, respectively, in potentially misclassified cases of hypothyroxinaemia.

Conclusions  The percentage of potentially misclassified cases of subclinical hypothyroidism and hypothyroxinaemia in pregnant women decreased by using the gestational age‐specific reference intervals as a diagnostic criteria during the first half of pregnancy.
Foetal ‘flat’ bile acids reappear during human liver regeneration after surgery
Authors: Stärkel P. , Shindano T. , Horsmans Y. , Gigot J. F. , Fernandez‐Tagarro M. , Marin J. J. G. , Monte M. J.
Published: December 2008

Background  Changes in bile acid (BA) pool, such as the reappearance of typically foetal‐type molecular species with a ‘flat’ structure at the steroid ring, occur during hepatocarcinogenesis, both in humans and rodents. Moreover flat‐BAs also appear during rat liver regeneration. These changes can be detected in urine. The aim of the present study was to investigate whether flat‐BAs also reappear during human liver regeneration, and whether this change correlates with the magnitude of liver resection.

Materials and methods  Patients undergoing partial hepatectomy were divided in two groups: major hepatectomy group (> 50% of hepatic tissue resection, n = 17) and minor hepatectomy group (< 50%, n = 13). BAs were extracted from serum and urine (collected over 24 h) and analysed by gas chromatography‐mass spectrometry. Samples were obtained before surgery (day 0) and on the third and seventh days after hepatectomy.

Results  In serum, total BAs significantly increased on day seven after hepatectomy, but only a moderate increase in flat‐BA concentrations was observed. By contrast, urinary excretion of total as well as flat‐BAs significantly increased at day three and day seven after hepatectomy. Moreover, the amount of flat‐BAs excreted in urine during the first week after partial hepatectomy correlated with the magnitude of the resection.

Conclusions  Urinary BA output increases and flat‐BAs reappear in urine during human liver regeneration. These results suggest that determination of BAs in urine may be an interesting parameter obtained by non‐invasive techniques whose actual clinical value during human liver regeneration warrants further evaluation.
Different strategies to overcome the effect of carbimazole on high‐ and low‐dose radioiodine therapy: results from continuous dose–effect models
Authors: Walter M. A. , Schindler C. , Christ‐Crain M. , Müller‐Brand J. , Müller B.
Published: December 2008

Background  Until now, it remains elusive which strategy – antithyroid drug withdrawal or increased radioiodine target doses – should be preferred to avoid the detrimental effect of antithyroid drugs in high‐ and low‐dose radioiodine therapy, respectively.

Methods  We explored the effects of carbimazole on the 1‐year post‐radioiodine success and hypothyroidism rates by continuous dose–effect models, whereas success was defined as elimination of hyperthyroidism. Euthyroidism rates with and without carbimazole were calculated by numerical integration of the area between success and hypothyroidism curves. Target dose amplification factors for equal chance of success with and without carbimazole were calculated using logistic regression.

Results  Two hundred and twenty‐eight patients were included in this study. Radioiodine target doses between 33 and 839 Gy were applied. Overall, the euthyroidism rates were 16·5% and 64·8%, while the hypothyroidism rates were 37·6% and 14·8% in Graves’ disease and toxic nodular goitre, respectively. The success rate with simultaneous carbimazole (median dose 15 mg day−1; range 2·5–60 mg day−1) was reduced over the entire target dose range in Graves’ disease and toxic nodular goitre. The areas between curves for euthyroidism without and with simultaneous carbimazole were 127 and 43 Gy in Graves’ disease and 178 and 128 Gy in toxic nodular goitre. The estimated radioiodine target dose amplification factor was 5·5 for Graves’ disease and 3·0 for toxic nodular goitre.

Conclusions  Simultaneous carbimazole reduces the euthyroidism rate, the aim of low‐dose radioiodine therapy, over the entire target dose range in both Graves’ disease and toxic nodular goitre. Therefore, antithyroid drug discontinuation should be preferred in low‐dose radioiodine therapy. Conversely, escalation of the target dose should be preferred in high‐dose radioiodine therapy.
Disturbance, rainfall and contrasting species responses mediated aboveground biomass response to 11 years of CO2 enrichment in a Florida scrub‐oak ecosystem
Authors: SEILER TROY J. , RASSE DANIEL P. , LI JIAHONG , DIJKSTRA PAUL , ANDERSON HANS P. , JOHNSON DAVID P. , POWELL THOMAS L. , HUNGATE BRUCE A. , HINKLE C. ROSS , DRAKE BERT G.
Published: December 2008

This study reports the aboveground biomass response of a fire‐regenerated Florida scrub‐oak ecosystem exposed to elevated CO2 (1996–2007), from emergence after fire through canopy closure. Eleven years exposure to elevated CO2 caused a 67% increase in aboveground shoot biomass. Growth stimulation was sustained throughout the experiment; although there was significant variability between years. The absolute stimulation of aboveground biomass generally declined over time, reflecting increasing environmental limitations to long‐term growth response. Extensive defoliation caused by hurricanes in September 2004 was followed by a strong increase in shoot density in 2005 that may have resulted from reopening the canopy and relocating nitrogen from leaves to the nutrient‐poor soil. Biomass response to elevated CO2 was driven primarily by stimulation of growth of the dominant species, Quercus myrtifolia, while Quercus geminata, the other co‐dominant oak, displayed no significant CO2 response. Aboveground growth also displayed interannual variation, which was correlated with total annual rainfall. The rainfall × CO2 interaction was partially masked at the community level by species‐specific responses: elevated CO2 had an ameliorating effect on Q. myrtifolia growth under water stress. The results of this long‐term study not only show that atmospheric CO2 concentration had a consistent stimulating effect on aboveground biomass production, but also showed that available water is the primary driver of interannual variation in shoot growth and that the long‐term response to elevated CO2 may have been caused by other factors such as nutrient limitation and disturbance.
Impacts of climate change on the vegetation of Africa: an adaptive dynamic vegetation modelling approach
Authors: SCHEITER SIMON , HIGGINS STEVEN I.
Published: December 2008

Recent IPCC projections suggest that Africa will be subject to particularly severe changes in atmospheric conditions. How the vegetation of Africa and particularly the grassland–savanna–forest complex will respond to these changes has rarely been investigated. Most studies on global carbon cycles use vegetation models that do not adequately account for the complexity of the interactions that shape the distribution of tropical grasslands, savannas and forests. This casts doubt on their ability to reliably simulate the future vegetation of Africa. We present a new vegetation model, the adaptive dynamic global vegetation model (aDGVM) that was specifically developed for tropical vegetation. The aDGVM combines established components from existing DGVMs with novel process‐based and adaptive modules for phenology, carbon allocation and fire within an individual‐based framework. Thus, the model allows vegetation to adapt phenology, allocation and physiology to changing environmental conditions and disturbances in a way not possible in models based on fixed functional types. We used the model to simulate the current vegetation patterns of Africa and found good agreement between model projections and vegetation maps. We simulated vegetation in absence of fire and found that fire suppression strongly influences tree dominance at the regional scale while at a continental scale fire suppression increases biomass in vegetation by a more modest 13%. Simulations under elevated temperature and atmospheric CO2 concentrations predicted longer growing periods, higher allocation to roots, higher fecundity, more biomass and a dramatic shift toward tree dominated biomes. Our analyses suggest that the CO2 fertilization effect is not saturated at ambient CO2 levels and will strongly increase in response to further increases in CO2 levels. The model provides a general and flexible framework for describing vegetation response to the interactive effects of climate and disturbances.
The role of species traits in the establishment success of exotic birds
Authors: BLACKBURN TIM M. , CASSEY PHILLIP , LOCKWOOD JULIE L.
Published: December 2008

There is now abundant evidence that propagule pressure, a composite measure of the number of individuals released into the nonnative location that varies between introduction events, is the most consistent predictor of success in the establishment of exotic species. However, the reasons why we expect propagule pressure to be important – because larger propagules ameliorate the effects of demographic, environmental or genetic stochasticity, or of Allee effects – also predict an influence of species traits on success. Here, we use a quantitative meta‐analytical approach to assess the effect of three categories of species‐level traits in the successful establishment of nonnative bird species: traits relating to population growth rates, traits that predispose species to Allee effects, and traits that enable a species to cope with novel environments. Traits that predispose species to Allee effects tend to decrease introduction success, whereas traits that enable a species to cope with novel environments tend to increase success. The breadth of habitats a species uses has the strongest mean effect of all variables analysed here. Mean effects for traits relating to population growth rates conflict in sign: in general, success is greater for species with large body mass whereas clutch size is not consistently related to establishment success. These results suggest a likely influence of some species‐level traits on exotic bird establishment success, especially traits that enable a species to cope with novel environments. We suggest that considering such traits in terms of the small‐population paradigm from conservation biology may be a productive avenue for future research.
Factors related to incidence of eye disorders in Korean patients at intensive care units
Authors: Oh Eui Geum , Lee Won Hee , Yoo Ji Soo , Kim So Sun , Ko Il Sun , Chu Sang Hui , Song Eun Kyeung , Kang Se Won
Published: December 2008

Aims.  The purpose of this study was to identify the incidence rate of eye disorders and further to identify factors related to incidence of eye disorders in intensive care unit patients.

Background.  Although the incidence of eye disorders in intensive care unit patients is very high, it is difficult to come to an accurate estimate of number of eye disorders in intensive care unit patients because eye disorders are often perceived to be minor problems.

Design.  A retrospective, descriptive survey design was used.

Method.  The medical records of a total 235 patients with eye disorders were identified through a review of the medical records of 2500 patients hospitalised in the intensive care units of Yonsei University Hospital, Seoul, Korea from January to December, 2004. To examine factors related to eye disorders, 522 patients without eye disorders from the cohort of 2265 patients were randomly selected. Factors related to incidence of eye disorder were included in a multiple logistic regression model, after screening by the chi‐squared test.

Results.  The incidence rate for eye disorders in the intensive care unit patients was 8·6%. From the multiple regression model, the following odds ratios (95% confidence intervals) of eye disorder were estimated; length of stay in intensive care unit of at least seven days: 2·8 (1·70–4·70); death: 2·5 (1·47–4·29); drowsy mental state: 2·2 (1·10–4·37); stupor mental state: 7·0 (3·20–15·45); coma mental state: 10·8 (3·47–33·74); no self‐respiration: 1·9 (1·00–3·52); positive end expiratory pressure: 2·9 (1·66–4·92); sedatives: 4·2 (2·26–7·74); muscle relaxants: 2·3 (1·11–4·95).

Conclusions.  Factors related to incidence of eye disorders in intensive care unit patients identified in this study support the need to pay attention to eye problems and eye care in intensive care unit patients.

Relevance to clinical practice.  An evidence‐based eye care protocol should be provided as routine care to prevent eye complication, especially in critically ill patients with mechanical ventilators, positive end expiratory pressure, sedatives or muscle relaxants and for patients whose mental status is decreased.
Predicting pressure ulcer risk: a multifactorial approach to assess risk factors in a large university hospital population
Authors: Nonnemacher Michael , Stausberg Jürgen , Bartoszek Gabriele , Lottko Birgit , Neuhaeuser Markus , Maier Irene
Published: December 2008

Aims.  The purpose of this study was: (1) to determine the combination of risk factors which best predicts the risk of developing pressure ulcers among inpatients in an acute care university hospital; (2) to determine the appropriate weight for each risk factor; and (3) to derive a concise and easy‐to‐use risk assessment tool for daily use by nursing staff.

Background.  Efficient application of preventive measures against pressure ulcers requires the identification of patients at risk. Adequate risk assessment tools are still needed because the predictive value of existing tools is sometimes unsatisfactory.

Design.  Survey.

Methods.  A sample of 34,238 cases admitted to Essen University Clinics from April 2003 and discharged up to and including March 2004, was enrolled into the study. Nursing staff recorded data on pressure ulcer status and potential risk factors on admission. Predictors were identified and weighted by multivariate logistic regression. We derived a risk assessment scale from the final logistic regression model by assigning point values to each predictor according to its individual weight.

Results.  The period prevalence rate of pressure ulcers was 1·8% (625 cases). The analysis identified 12 predictors for developing pressure ulcers. With the optimum cut‐off point sensitivity and specificity were 83·4 and 83·1%, respectively, with a positive predictive value of 8·4% and a negative predictive value of 99·6%. The diagnostic probabilities of the derived scale were similar to those of the original regression model.

Conclusions.  The predictors mostly correspond to those used in established scales, although the use of weighted factors is a partly novel approach. Both the final regression model and the derived scale show good prognostic validity.

Relevance to clinical practice.  The derived risk assessment scale is an easy‐to‐understand, easy‐to‐use tool with good prognostic validity and can assist in effective application of preventive measures against pressure ulcer.
Reflection in night nursing: a phenomenographic study of municipal night duty registered nurses’ conceptions of reflection
Authors: Gustafsson Christine , Asp Margareta , Fagerberg Ingegerd
Published: December 2008

Aim.  The aim of the study was to describe nurses’ conception of reflection in their working situation.

Background.  To be a municipal night duty registered nurse in Sweden means to shoulder nursing care responsibility for numerous units with older people in need of care. Two night nurses share nursing care responsibility for up to 1300 people. In nursing research, reflection is an often‐mentioned phenomenon discussed with advantages and benefits within the ‘traditional fields’ of nursing (hospital context). A question to ask is, how do night nurses having an untraditional amount of nursing care responsibility conceptualise and experience reflection in their working situation?

Design.  A phenomenographic methodology was used.

Methods.  Data were collected by interviewing all nurses (n = 7) in a medium‐sized municipality bordering a metropolitan area of Sweden.

Results.  The nurses’ conceptions of reflection are categorised as ‘Field of applications’ (an instrument for interpreting, a strategy for handling the working situation and an approach to learning) and ‘Field of prerequisites’ (presence facilitates reflection; flexibility implies reflection; courage in thought and activity increases reflection).

Conclusion.  The findings reveal that reflection in the nurses’ working situation is more than an instrument for learning, understanding and encouragement for change and improvement. Reflection is conceptualised as an instrument for interpreting nursing care situations, which requires courage and is facilitated by presence and flexibility. Reflection is also conceptualised as an approach to handling, managing and coping with a sometimes impossible working situation that includes nursing responsibility for hundreds of older people and can sometimes entail difficulties and stress.

Relevance to clinical practice.  The findings showed that reflection has a broader use than had earlier been described. Deliberate use of reflection could mean improved nursing practice. This guides nursing managers to pay attention to the phenomenon as an instrument for nursing care improvement.
Incidence of ambulatory care visits among female nursing staff in Taiwan: a claim data‐based retrospective cohort analysis
Authors: Huang I‐Chin , Yang Chiang‐Hsing , Sung Fung‐Chang , Chen Hua‐Fen , Li Chung‐Yi
Published: December 2008

Aims.  To investigate the incidence of ambulatory care visits among female nursing staff in Taiwan.

Background.  Literature frequently indicates increased risks of needlestick injury and musculoskeletal disorders among practicing nurses. With increased workload in the healthcare system, nursing staff could also be vulnerable to other diseases.

Design.  A retrospective cohort study design including 27,624 female nursing staff with a contract with Taiwan’s National Health Insurance (NHI) programme between 2001–2004.

Methods.  Information on ambulatory care visits was retrieved from the NHI claim data. Comparison groups included other female medical personnel and active non‐medical working women. Incidence rates of ambulatory care visits were calculated using person‐year approach. Rate ratio adjusted for potential confounders was estimated from the Poisson regression model.

Results.  The nurse cohort developed a total of 781,352 ambulatory care visits, representing an incidence rate of 85,285/104 person‐years. Compared with the other female medical personnel, female nurses had significantly elevated incidence of genitourinary [adjusted rate ratio (ARR) = 1·20], circulatory (ARR = 1·14), mental (ARR = 1·12), infectious/parasitic diseases (ARR = 1·11) and pregnancy/birth complications (ARR = 1·07). Significantly increased incidence sustained for both infectious/parasitic diseases and pregnancy/birth complications as the nurse cohort was compared with the active non‐medical working women. The nurses, on the contrary, had significantly lower ARRs than the comparison groups of neoplasm, injury, metabolic, respiratory, digestive and musculoskeletal diseases.

Conclusions.  Female nurses had increased incidences of certain types of systemic illness when compared with other medical personnel and with women working outside of the health industry. Whether the findings found in this study were region specific or could be applicable to other nations, requires further investigations.

Relevance to clinical practice.  Policy makers and hospital administrators must not overlook nurses’ potentially unseen health problems. A mandatory periodical physical examination for nursing staff must be considered.
Post‐SARS knowledge sharing and professional commitment in the nursing profession
Authors: Chen Shu‐Lan , Chang Shao‐Min , Lin Huey‐Shyan , Chen Chung‐Hey
Published: December 2008

Aim.  The aim of the present study was to examine the 2003 severe acute respiratory syndrome (SARS) crisis in relation to the degree of knowledge sharing and professional commitment, as perceived by the current nursing staff in Taiwan.

Background.  The mortality rate for medical personnel during the SARS outbreak in Taiwan, which began in April 2003, was the highest among Asian countries. The SARS crisis severely challenged not only the medical skills of nurses, but also their professional commitment.

Design.  Survey.

Methods.  This study was conducted between August–December 2005, in Taiwan. Data were collected by structured questionnaire. The questionnaire was distributed by post to 8056 nurses nationwide; 2833 nurses completed and returned the questionnaire for a valid response rate of 39%.

Results.  The results showed that knowledge sharing correlated positively with professional commitment but negatively with the impact of SARS. Professional commitment negatively correlated with SARS impact (r = −0·074, p < 0·001); however, as knowledge sharing was a controlled variable, the partial correlation between SARS impact and professional commitment was −0·039 with a p‐value of 0·045, indicating virtual insignificance. That is, knowledge sharing was an antecedent variable for both SARS impact and professional commitment.

Conclusion.  This cross‐sectional study provides preliminary evidence that knowledge sharing is significantly correlated with impact of SARS and professional commitment of nursing personnel.

Relevance to clinical practice.  Hospitals and healthcare services can enhance retention of medical personnel by encouraging knowledge sharing, which enhances professional commitment and alleviates the impact of newly introduced contagious diseases.