bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial
Authors: GAUDERNACK LISE CHRISTINE , FORBORD SOLFRID , HOLE ELI
Published: December 2009

Background. The objective was to investigate whether acupuncture could be a reasonable option for augmentation in labor after spontaneous rupture of membranes at term and to look for possible effects on the progress of labor. Methods. In a randomized controlled trial 100 healthy parturients, with spontaneous rupture of membranes at term, were assigned to receive either acupuncture or no acupuncture. The main response variables were the duration of active labor, the amount of oxytocin given, and number of inductions. Results. Duration of labor was significantly reduced (mean difference 1.7 h, p = 0.03) and there was significant reduction in the need for oxytocin infusion to augment labor in the study group compared to the control group (odds ratio 2.0, p = 0.018). We also discovered that the participants in the acupuncture group who needed labor induction had a significantly shorter duration of active phase than the ones induced in the control group (mean difference 3.6 h, p = 0.002). These findings remained significant also when multiple regression was performed, controlling for potentially confounding factors like parity, epidural analgesia, and birth weight. Conclusion. Acupuncture may be a good alternative or complement to pharmacological methods in the effort to facilitate birth and provide normal delivery for women with prelabor rupture of membranes.
Maternal mortality in the Greater Accra region in Ghana: assessing completeness of registration and data quality
Authors: YAKUBU ZAKARIAH AFISAH , ALEXANDER SOPHIE , VAN ROOSMALEN JOS , YAO KWAWUKUME ENYONAM
Published: December 2009

Objective. To assess the completeness of registration of maternal mortality by comparing various data sources and to review the quality of information pertaining to individual cases. Data source and methods. Female deaths aged 10–50 years in the Greater Accra region in Ghana from January 1, 2000 to December 31, 2000 were recorded. Identified maternal deaths (International Classification of Diseases, 9th revision) in four major hospitals in the region were compared with those registered in the civil registers. Results. During the study period, 148 maternal deaths were identified and a total of 21,183 live births were recorded in the study hospitals, yielding a maternal mortality ratio of 699/105 live births. This ratio is more than six times the officially reported maternal mortality ratio for the whole region in the same period. Ninety‐two percent of the deaths were due to direct obstetric causes and 8% to indirect causes. One hundred and twenty‐one of the cases were correctly classified and registered. By using the multiple source approach, 27 new cases were identified, an under‐registration of 18%. The sources of error were misclassification (n = 25) and error in registration (n = 2). Conclusion. The process of registration of deaths in this region is incomplete. Enhanced registration systems (including routine linkage of death and birth certificates) on a regular basis could be used in Ghana.
Validation of an Italian Translation of the 30-Item General Health Questionnaire for Use in Australia
Authors: Febbo Salvatore , Burvill Peter W.
Published: December 2009

A validity study of an Italian translation of the GHQ-30 was conducted on a sample of 96 Italian-born subjects in the community in Perth, Western Australia, using the shortened version of the Present State Examination as the gold standard for a “case” of non-psychotic psychiatric morbidity. The 96 subjects were a subsample of a study of 1109 subjects seen in a community survey, in which 45.8% had a score above 4 on the GHQ-30. It was found that 5/6 was the most appropriate cut-off point. At this level the sensitivity was 81.2% the specificity 79.7% the positive predictive value 66.7% the negative predictive value 89.5% and the overall misclassification rate 19.8%. Adjusting the results to truly reflect the lower case-prevalence rate in the community, using a method suggested by Goldberg, the corresponding values were 57.7% 92.6% 66.7% 89.5% and 14.6%. It was concluded that this version of the GHQ-30 is suitable for use in the Italian-born, in the community and in general practice in Australia, using a cut-off point of 5/6.
Effect of Recommended Dosage Range on the Prescribing of Antidepressants
Authors: Little J. D.
Published: December 2009

The aim of the study was to explore the role that suggested dosage range may play in suboptimal prescribing practice of tricyclic antidepressants. Clinicians practising in adult psychiatry were shown a clinical vignette of melancholia (as per DSM-III-R). One of two questionnaires on treatment practices, specifying either 75–200 mg or 75–425 mg of an unnamed tricyclic antidepressant, were randomly distributed to subjects. A highly significant (p=0.001) difference was found: those who were given a narrow dosage range prescribed an average of 82.5 mg/day less antidepressant than those for whom the dosage range had been widened, indicating that the range within which dosages are recommended affects prescribing practices. When erroneously constrained, the range may contribute toward sub-optimal prescribing practices and as a consequence toward treatment-resistant depression.
Psychiatry in the Land of the Sphinx: Is an Overseas Elective Justified?
Authors: Rege Sanil
Published: December 2009

Objective: The aim of this paper is to provide a descriptive account of a 6-month sabbatical in Egypt to highlight the diversity of benefits in incorporating such activities within psychiatric training programs.

Conclusions: An overseas elective offers an exciting practical opportunity to broaden one's experience of transcultural psychiatry and obtain a perspective on mental illness and its cultural variations. It also promotes an understanding of health service management in low and middle income countries and offers the opportunity to contribute to their healthcare at minimal cost. However, the elective needs to be undertaken at an optimal period of a psychiatrist's career and with minimal disruption to local services. Training schemes and employers could provide more opportunities for interested trainees, with specified projects and aims in mind, to undertake such electives so that they can begin to develop expertise in treating a particular cultural group. In turn, this would go a long way to producing culturally capable psychiatrists for the wide range of ethnic minorities in Australia.
Shared Mental Health Care for a Marginalized Community in Inner-City Canada
Authors: Kisely Stephen , Chisholm Pamela
Published: December 2009

Objectives: This paper describes the experience and evaluation of a shared care project targeted at marginalized individuals living in the North End of Halifax, Nova Scotia. This population has high rates of psychiatric disorder, often comorbid with chronic medical conditions, and people have difficulty in obtaining the help they need. This primary care liaison service covers all ages and includes outreach to emergency shelters, transitional housing and drop-in centres. Collaborative care improved access, satisfaction and outcomes for marginalized individuals in urban settings. Primary care providers with access to the service reported greater comfort in dealing with mental health problems, and satisfaction with collaborative care, as well as mental health services in general. Results were significantly better than those of control practices when such data were available. The median wait time was 6 days in comparison with 39.5 days for the comparison site.

Conclusions: This model can complement other initiatives to improve the health of marginalized populations, and may be relevant to Australia.
China–Australia Training on Psychosocial Crisis Intervention: Response to the Earthquake Disaster in Sichuan
Authors: Ng Chee , Ma Hong , Raphael Beverley , Yu Xin , Fraser Julia , Tang Denghua
Published: December 2009

Objective: This paper describes the AusAID-funded psychosocial training program conducted jointly by Chinese and Australian mental health facilitators in the wake of the devastating earthquake disaster in Sichuan.

Conclusions: A total of 280 professional and volunteer leaders in disaster mental health response from across China took part in the national disaster mental health training program. A comprehensive, evidence-based and practical program was collaboratively developed and delivered to meet the needs of the medical professionals and volunteer mental health workers working in the field. Results of the training evaluation indicated high levels of uptake and usefulness for the participants. Further outcome assessments will be utilized at the service delivery and community levels. The training program has contributed significantly to the building of national and local capacity to deliver psychological first-aid and psychosocial response management to assist the populations who have been affected by disaster.
Psychiatrically Impaired Medical Practitioners: An Overview with Special Reference to Impaired Psychiatrists
Authors: Wilson Andrew , Rosen Alan , Randal Patte , Pethebridge Andrew , Codyre David , Barton David , Norrie Peter , McGeorge Peter , Rose Lynette
Published: December 2009

Objective: This paper will define and describe impairment in medical practitioners due to mental illness, with special reference to the specialty of psychiatry, and then review the prevalence and identification of impaired practitioners.

Methods: The quantitative and qualitative evidence regarding the incidence and impact of medical practitioner impairment due to mental illness (and, to some extent, substance use), with special reference to impaired psychiatrists, is reviewed.

Results: Medical practitioner impairment due to mental illness has a severe impact on their lives and their families due to both the effects of the disorder and the experience of communal, professional and self stigma.

Conclusions: The consequences of impairment among medical practitioners and specialist psychiatrists as well as the under-reporting of impaired practitioners is a significant problem.
Service User and Significant other Versions of the Health of the Nation Outcome Scales
Authors: Stewart Malcolm
Published: December 2009

Objectives: The aim of this paper was to test the measurement properties of self-report (SR) and significant other (SO) versions of the Health of the Nation Outcome Scales (HoNOS).

Method: SR and SO HoNOSs, with content closely paralleling the clinician HoNOS but with item 8 expanded into scales rating each difficulty separately, were developed and trialed with Early Intervention for Psychosis service users and their significant others.

Results: Satisfactory agreement was found between SR, SO and clinician HoNOSs, and between the SR and SO on most additional items.

Conclusions: Results suggest adequate validity of the measures. The additional items proved useful for identifying comorbidities that may have been under-recognized. Results suggest that SR and SO versions of the HoNOS can be valid and valuable for triangulating and recording the perspectives of different stakeholders in promoting recovery.
Delivering Youth-Specific Mental Health Services: The Advantages of a Collaborative, Multi-Disciplinary System
Authors: Scott Elizabeth , Naismith Sharon , Whitwell Bradley , Hamilton Blake , Chudleigh Catherine , Hickie Ian
Published: December 2009

Objective: Evidence suggests that quality mental health care is based on well-integrated multi-disciplinary care provided by a range of mental health, substance use, and general healthcare clinicians. There is a growing focus in Australia on providing this type of mental health care to young people, particularly those in the early stages of a major disorder. The development of such services has proceeded on the basis of limited service-based data and has also been impeded by current healthcare funding structures.

Methods: This report outlines the service characteristics of three models: a traditional ‘fee for service’ model, a specialized youth mental health clinic, and a new headspace multi-disciplinary site in South Western Sydney.

Results: Naturalistic data from these three services collected during their developmental phase indicate that each model is associated with differential demographic, illness and service organization characteristics.

Conclusions: Compared with ‘fee-for-service’ type care, specialized youth models provide greater access to a broad range of multi-disciplinary clinicians.
Surveying Perceptions of the Progress of National Mental Health Reform
Authors: Hickie Ian , Groom Grace
Published: December 2009

Objective: To provide comment on the latest Australian government commitment to a 5 year plan under the National Mental Health Strategy.

Conclusions: In the absence of a credible system of accountability for the implementation of mental health reform, the Mental Health Council of Australia, in association with the Brain and Mind Research Institute, has taken up the task of auditing. A national, government-supported system needs to be developed in order to monitor progress of genuine mental health reform in Australia.
A Preliminary Survey of Undergraduate Education on Depression in Medical Schools in the Asia Pacific Region
Authors: Lee Min-Soo
Published: December 2009

Objective: To describe the undergraduate medical curricula pertaining to depression across the Asia Pacific region.

Methods: Questions were sent to the members of the SEBoD International Advisory Board asking for details on the specifics of medical curricula regarding depression.

Results: Representatives of 13 medical universities from eight Asia Pacific countries provided information. All curricula include psychiatry lectures, and most countries also conduct seminars and tutorials. Provision of clinical experience is common, but not all curricula include specific presentation of cases of depression. Within the psychiatry courses reviewed, only a small component of teaching is related specifically to depression.

Conclusions: As there is growing recognition of the burden of depression, development and implementation of national curricula standards are recommended to address inadequacies in teaching of depression in undergraduate medical universities throughout the Asia Pacific region.
Australia Needs a Mental Health Commission
Authors: Rosen Alan , McGorry Patrick , Groom Grace , Hickie Ian , Gurr Roger , Hocking Barbara , Leggatt Margaret , Deveson Anne , Wilson Keith , Holmes Douglas , Miller Vivienne , Dunbar Lynne , Stanley Fiona
Published: December 2009

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the ∗ substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.

Conclusions: It is recommended that the Australian National Mental Health Plan 2003–2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention.
‘Every Me and Every You’: Responding to the Hidden Challenge of Mental Illness in Australia
Authors: Mcgorry Patrick
Published: December 2009

Objective: To show that mental illness affects everyone in society, describe some of the main obstacles to better outcomes, and build confidence that they can be overcome.

Methods: A review and analysis of relevant evidence and experience combined with personal advocacy.

Results: Mental illnesses are common and seriously under-treated, reform of the system of care has completely stalled, and insidious reinstitutionalization of the modernized system is occurring. A number of contributing factors and possible solutions are identified, including mental health literacy and advocacy campaigns, a focus on young people and early intervention, and functional reintegration of the treatment of mental and substance use disorders.

Conclusions: A new wave of reform and major financial investment in the treatment of mental and substance use disorders is overdue. This can be best achieved by combining the evidence-based health care (EBHC) paradigm with a direct appeal to the self-interest of members of the general community. A National Institute of Mental Health and Addiction should be a key element of such reform, which must be a continuing process with substantially increased federal and State funding.
Therapy With Women With Metastatic Breast Cancer
Authors: Beacham Bronwen , Hill Christine , Mcdermott Fiona , O'Brien Mary , Turner Jane
Published: December 2009

Objective: To describe some clinical issues encountered in individual and group therapy with women with metastatic breast cancer.

Conclusions: The pressure to ‘keep positive’ poses dilemmas for patients and therapists alike, whether in individual or group therapy. The basis of skilled supportive care rests on the ability of therapists to assist patients and their families to face death rather than avoid it. Paradoxically, facing issues of death and dying leads to a greater sense of control, and empowers patients to reorder life's priorities, thus improving quality of life and relationships. In addition to the obvious need to detect and treat illness such as depression, working with women with metastatic breast cancer requires flexibility on the part of the therapist to adapt to her physical state of health, to include partners and family members where possible, and to liaise with colleagues in the treating team to facilitate communication and understanding of specific difficulties that may be encountered.
Diagnosis of Dementia With Lewy Bodies in Clinical Practice: A Literature Review
Authors: Singh Dhiren
Published: December 2009

Objective: To review the research data about dementia with Lewy bodies (DLB) and describe those clinical features and investigations that will enhance more accurate diagnosis in day-to-day practice.

Methods: A literature search using MEDLINE, Psychlit, Psychinfo and Cochrane databases was performed.

Conclusions: The diagnosis of DLB is important now that treatment is available using cognitive enhancers and because of the risk to patients with DLB who are prescribed neuroleptics. The use of consensus criteria, despite their limitations, and judicious use of ancillary investigations, especially neuroimaging and neuropsychological tests, will enhance diagnostic accuracy.
Postnatal Depression: A Korean Perspective
Authors: Kim Jihyeon , Buist Anne
Published: December 2009

Objective: To provide insight into the cultural influences on postnatal depression (PND) in women from Korean backgrounds.

Conclusions: Lack of support has been seen to be a key risk factor in postnatal depression. In Korean society, little research has been done on this disorder, but it is likely that traditional support might have a protective role. Erosion of this with westernization of Korea, or isolation in Korean immigrants to Australia, is likely to be significant for new mothers from this cultural background.
Using Continuous Quality Improvement to Implement a Clinical Governance Framework in Amental Health Service
Authors: Arya Dinesh , Callaly Tom
Published: December 2009

Objectives: To outline the principles of continuous quality improvement that can be utilized to develop a clinical governance framework in a mental health service.

Conclusions: The term clinical governance is used to describe the framework through which health organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care. Implementing a clinical governance framework requires clear leadership, particularly clinical leadership, the development of structures and processes to facilitate communication and the development of systems for monitoring and evaluating services. Effective implementation can be supported by the development of an open culture that promotes organizational learning from experience and supporting innovation.
Transcranial Magnetic Stimulation and Chronic Pain: Current Status
Authors: Pridmore Saxby , Oberoi Gajinder , Marcolin Marco , George Mark
Published: December 2009

Objective: To examine evidence suggesting a potential role for transcranial magnetic stimulation (TMS) in the treatment of chronic pain.

Conclusion: Chronic pain is characterized by brain changes that can reasonably be presumed to be associated with hyperalgesia, as occurs with neuropathic changes in the periphery. TMS has the ability to induce plastic changes in the cortex at the site of stimulation and at connected sites, including the spinal cord. It also has the ability to influence the experience of experimental/acute pain. In studies of TMS in chronic pain, there is some evidence that temporary relief can be achieved in a proportion of sufferers. Chronic pain is common. Current treatments are often ineffective and complicated by side-effects. Work to this point is encouraging, but systematic assessment of stimulation parameters is necessary if TMS is to achieve a role in the treatment of chronic pain. Maintenance TMS is currently provided in relapsing major depression and may be a useful model in chronic pain management.
Trainingmodels for Psychiatry in Primary Care: A New Frontier
Authors: Murrihy Rachael , Byrne Mitchell K.
Published: December 2009

Objective: Under policies implemented by the Australian Government, the success of community mental health care has increasingly relied upon general practitioners (GPs) assuming an enhanced role in the delivery of evidence-based psychological treatment. In undertaking this role, it is crucial that GPs significantly build upon limited training in evidence-based psychological therapies such as cognitive behaviour therapy (CBT). This pilot study investigates the potential role of CBT group supervision as a training model.

Method: Two groups of GPs (n = 9) and one comparison group of psychiatric registrars (n = 4) completed eight 1.5 h sessions of CBT group supervision over an 8month period. Pre- to post-training measures were taken of GP performance (skills, knowledge and confidence) and the mental health outcomes of their patients. On the completion of group supervision, focus groups were conducted for in-depth feedback.

Results: Randomization tests indicated that GPs' confidence and knowledge in using CBT had improved over the course of group supervision. Results from focus groups confirmed that GPs' CBT skills had improved.

Conclusions: Findings suggest that group supervision is a promising training model for psychiatry in primary care. Cognitive behaviour therapy should be replaced, however, with a briefer therapy model, such as brief CBT, better suited to a general practice environment. Future research needs to replicate these findings on a larger scale.
Patterns of Current Comorbidity in Young Help-Seekers: Implications for Service Planning and Delivery
Authors: Godfrey Katherine , Yung Alison , Killackey Eóin , Cosgrave Elizabeth , Yuen Hok Pan , Stanford Carrie , Buckby Joe , Mcgorry Patrick
Published: December 2009

Objective: To identify the pattern of current comorbidity in young help-seekers referred to a specialist mental health service.

Method: One hundred and forty-nine participants were assessed for current psychiatric diagnoses following their referral to ORYGEN Youth Health.

Results: Seventy-eight per cent of the sample rated for at least one diagnosis with almost half the sample presenting with two or more disorders. Next to comorbid depression and anxiety, comorbidity between substance use disorders and mood and anxiety disorders was the most prominent pattern of comorbidity in the sample.

Conclusions: The present findings suggest that integration between mental health and substance abuse services is well overdue and must be addressed at policy, service system and clinical levels.
Challenges of Mental Health Interpreting when Working with Deaf Patients
Authors: Cornes Andy , Napier Jemina
Published: December 2009

Objective: The aim of this present paper is to highlight some of the issues faced by therapists and sign language interpreters when working with deaf patients.

Conclusions: Key issues include linguistic, interpreting and role challenges, and potential threats to the therapeutic alliance. Recommendations are made in relation to preparation strategies and training for sign language interpreters and therapists.
Is Psychiatry an Art or a Science? The Views of Psychiatrists and Trainees
Authors: Chur-Hansen Anna , Parker Damon
Published: December 2009

Objective: It is generally considered by many practitioners that psychiatry is an art, that is, one of the humanities, as well as being a science. We systematically collected the views of practitioners and trainee psychiatrists regarding the question ‘Is psychiatry an art or a science?’

Method: Eleven supervisors and nine trainees were interviewed and their responses analysed, using a qualitative method, the modified framework approach.

Results: Several themes emerged from the data: that ‘art’ and ‘science’ are different; psychiatry as a discipline is difficult to define; psychiatry demands a broader range of skills than other medical specialties; the relationship of psychology to psychiatry; supervisor cynicism to the ‘science’ of psychiatry; and the ‘art’ and ‘science’ of the assessment process.

Conclusions: The tension that exists within the profession's identity as a discipline has important implications for teaching, learning, and clinical and research practices.
Current Delivery of Infantmental Health Services: Are Infant Mental Health Needs Being Met?
Authors: Macdonald Elspeth , Mohay Heather , Sorensen Debra , Alcorn Neil , Mcdermott Brett , Lee Erica ,   Members of the Mater CYMHS Infant Mental Health Steering Committee
Published: December 2009

Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available.

Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement.

Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty ofproviding services for some at-risk populations.

Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expandingjoint mother–infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.
The Response of Doctors to a Formal Complaint
Authors: Nash Louise , Curtis Bradley , Walton Merrilyn , Willcock Simon , Tennant Christopher
Published: December 2009

Objectives: This pilot study investigates the psychological impact on doctors of a complaint to the New South Wales Health Care Complaints Commission and the doctor's perception of legal risk.

Method: Doctors who received a complaint were sent a set of questionnaires embracing psychological variables and their perceptions of legal risk.

Results: The response rate was 60%. Thirty-eight per cent of respondents met screening criteria for psychiatric disorder. There was, however, minimal functional impairment of work, social or family life. Respondents scored highly on altruism, but at the same time were ‘tough minded’. The questionnaire to assess the doctor's perception of legal risk appeared to have acceptable construct validity but showed that doctors still misunderstand medico-legal risk.

Conclusions: Psychiatric morbidity rates of our sample were comparable with other Australian medical samples. This small sample appeared to cope with the stress of a complaint better than those reported in other studies.
c-Rel is required for the development of thymic Foxp3+ CD4 regulatory T cells
Authors: Isomura Iwao , Palmer Stephanie , Grumont Raelene J. , Bunting Karen , Hoyne Gerard , Wilkinson Nancy , Banerjee Ashish , Proietto Anna , Gugasyan Raffi , Wu Li , McNally Alice , Steptoe Raymond J. , Thomas Ranjeny , Shannon M. Frances , Gerondakis Steve
Published: December 2009

During thymopoiesis, a unique program of gene expression promotes the development of CD4 regulatory T (T reg) cells. Although Foxp3 maintains a pattern of gene expression necessary for T reg cell function, other transcription factors are emerging as important determinants of T reg cell development. We show that the NF-κB transcription factor c-Rel is highly expressed in thymic T reg cells and that in c-rel−/− mice, thymic T reg cell numbers are markedly reduced as a result of a T cell–intrinsic defect that is manifest during thymocyte development. Although c-Rel is not essential for TGF-β conversion of peripheral CD4+CD25− T cells into CD4+Foxp3+ cells, it is required for optimal homeostatic expansion of peripheral T reg cells. Despite a lower number of peripheral T reg cells in c-rel−/− mice, the residual peripheral c-rel−/− T reg cells express normal levels of Foxp3, display a pattern of cell surface markers and gene expression similar to those of wild-type T reg cells, and effectively suppress effector T cell function in culture and in vivo. Collectively, our results indicate that c-Rel is important for both the thymic development and peripheral homeostatic proliferation of T reg cells.
Immunological evaluation of personalized peptide vaccination monotherapy in patients with castration‐resistant prostate cancer
Authors: Uemura Hirotsugu , Fujimoto Kiyohide , Mine Takashi , Uejima Shigeya , De Velasco Marco A. , Hirao Yoshihiko , Komatsu Nobukazu , Yamada Akira , Itoh Kyogo
Published: December 2009

(Cancer Sci 2010; 101: 601–608)

We previously reported that personalized peptide vaccine (PPV) therapy in combination with leutenizing hormone‐releasing hormone (LH‐RH) analog and estramustine phosphate in certain cases is safe and capable of inducing both immune responses and clinical responses for metastatic castration‐resistant prostate cancer (CRPC) patients. In the present study, PPV monotherapy was given to CRPC patients. Twenty‐three patients with metastatic CRPC were treated with PPV without any additional treatment modalities, including LH‐RH analogs. Samples were analyzed for peptide‐specific cytotoxic T‐lymphocyte (CTL) precursor analysis and peptide‐reactive IgG. Toxicity and immunological and clinical responses were assessed on a three‐monthly basis. Seventeen patients were available for immunological and clinical evaluation. The vaccines were well tolerated, with grade 3 erythema at injection sites in only one patient. Augmentation of CTL or IgG responses to at least one of the peptides was observed in six of 17 (35%) and 15 of 17 (88%) patients tested, respectively. Among 57 peptides used, 9 and 36 peptides induced CTL and IgG responses, respectively. Delayed‐type hypersensitivity reaction was observed in eight of 17 patients. More than 30% prostate‐specific antigen (PSA) decline was observed in four of 17 patients. Of these, one patient achieved a complete PSA response and another patient showed a partial PSA response with profound shrinking of lymph node metastases and prostate. The overall median survival time was 24 months (range, 5–37 months). These results suggest that PPV monotherapy appears to be safe and capable of inducing peptide‐specific immune responses and clinical responses in CRPC patients. This trial was registered with University Hospital Medical Information Network (UMIN) number R000003339.
Platelets release novel thiol isomerase enzymes which are recruited to the cell surface following activation
Authors: Holbrook Lisa‐Marie , Watkins Nicholas A. , Simmonds Alan D. , Jones Chris I. , Ouwehand Willem H. , Gibbins Jonathan M.
Published: December 2009

The thiol isomerase enzymes protein disulphide isomerase (PDI) and endoplasmic reticulum protein 5 (ERp5) are released by resting and activated platelets. These re‐associate with the cell surface where they modulate a range of platelet responses including adhesion, secretion and aggregation. Recent studies suggest the existence of yet uncharacterised platelet thiol isomerase proteins. This study aimed to identify which other thiol isomerase enzymes are present in human platelets. Through the use of immunoblotting, flow cytometry, cell‐surface biotinylation and gene array analysis, we report the presence of five additional thiol isomerases in human and mouse platelets and megakaryocytes, namely; ERp57, ERp72, ERp44, ERp29 and TMX3. ERp72, ERp57, ERp44 and ERp29 are released by platelets and relocate to the cell surface following platelet activation. The transmembrane thiol isomerase TMX3 was also detected on the platelet surface but does not increase following activation. Extracellular PDI is also implicated in the regulation of coagulation by the modulation of tissue factor activity. ERp57 was identified within platelet‐derived microparticle fractions, suggesting that ERp57 may also be involved in the regulation of coagulation as well as platelet function. These data collectively implicate the expanding family of platelet‐surface thiol isomerases in the regulation of haemostasis.
A numerical study of inferred rockfish (Sebastes spp.) larval dispersal along the central California coast
Authors: PETERSEN CHRISTINE H. , DRAKE PATRICK T. , EDWARDS CHRISTOPHER A. , RALSTON STEPHEN
Published: December 2009

Successful recruitment of marine fishes depends on survival during early life‐history stages, which is influenced by oceanic advection due to its impact on coastal trophodynamics and transport processes. Here we evaluate the influence of ocean circulation on the dispersal of rockfish (Sebastes spp.) larvae along the central California coast using an implementation of the Regional Ocean Modeling System, driven at the surface by output from the Coupled Ocean Atmosphere Mesoscale Prediction System. Thousands of floats simulating rockfish larval propagules, constrained to follow fixed depths, were released over a broad coastal area at 2‐day intervals, and transported by simulated ocean currents at depths of 1, 7, 20, 40, and 70 m. Trajectory statistics are averaged across the 4‐yr period from January 2000 through December 2003 to reveal mean trajectory direction, net displacement, fractional cross‐shore loss, and duration of retention for different seasons. On average, near‐surface propagules originating nearshore are transported offshore during the upwelling season, whereas deeper propagules move alongshore to the north. This vertical shear vanishes during winter, with most floats moving alongshore to the north, regardless of depth. After 35 days in the water column, typical transport distances were ∼50 km for floats remaining nearshore and ∼150 km for floats over the midshelf and slope. Implications for performance of marine reserves for rockfish conservation are discussed. Our results also provide evidence for a strong semiannual pattern of coastal retention rates, with high export of near‐surface drifters during the upwelling season. In contrast, high rates of shelf retention occurred for releases at 20 m and deeper during summer, and at all depths during winter.
Silkmoth chorion gene regulation revisited: promoter architecture as a key player
Authors: Lecanidou R. , Papantonis A.
Published: December 2009

Regulation of silkmoth chorion genes has long been used as a model system for studying differential gene expression. The large numbers of genes, their overlapping expression patterns and the overall complexity of the system hinted towards an elaborate mechanism for transcriptional control. Recent studies, however, offer evidence of a molecular pathway governed by the interplay between two general transcription factors, CCAAT enhancer binding proteins (C/EBP) and GATA, an architectural protein, high mobility group A and a chromatin remodeller, chromo‐helicase/ATPase‐DNA binding protein 1. In this review we present a parsimonious model that adequately describes regulation of transcription across all temporally regulated chorion genes, and propose a role for promoter architecture.
Comparison of working length determination with radiographs and two electronic apex locators
Authors: Vieyra J. P. , Acosta J. , Mondaca J. M.
Published: December 2009

Aim  To evaluate the accuracy of the Root ZX and Elements‐Diagnostic electronic apex locators when compared with radiographs for locating the canal terminus or minor foramen.

Methodology  The canal terminus of 482 canals in 160 maxillary and mandibular teeth was located in vivo with both locators and radiographically. After extraction, the actual location of the minor foramen was determined visually and with magnification. A paired samples t‐test, chi‐square test and a repeated measure anova at the 0.05 level of significance were used to determine differences between the groups.

Results  The Root ZX located the minor foramen correctly 68% of the time in anterior and premolar teeth, and 58% of the time in molar teeth. The Elements‐Diagnostic located the minor foramen correctly 58% of the time in anterior and premolar teeth and 49% of the time in molar teeth. Radiographs located the minor foramen correctly 20% of the time in anterior and premolar teeth and 11% of the time in molar teeth. There was no statistically significant difference between the two locators, but there was a significant difference between them and radiographs. For all teeth, the measurements made by the apex locators were within ±0.5 mm of the minor foramen 100% of the time, whereas for the radiographs, the measurements were within this range only 15% of the time. This difference was significant (P = 0.05).

Conclusion  Measuring the location of the minor foramen using the two apex locators was more accurate than radiographs and would reduce the risk of instrumenting and filling beyond the apical foramen.
The effect of sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, individually and in alternation, on tooth surface strain
Authors: Rajasingham R. , Ng Y.‐L. , Knowles J. C. , Gulabivala K.
Published: December 2009

Aim  To evaluate the effect of irrigation regimens on tooth surface strain using saline, sodium hypochlorite (3% and 5% NaOCl) and ethylenediaminetetraacetic acid (17% EDTA), individually and in alternating combinations.

Methodology  Single‐rooted premolar teeth with single canals prepared to standardized dimensions were grouped by anatomical features and randomly distributed amongst six experimental groups (n = 12 each). The six groups were: (1) saline; (2) 5% NaOCl; (3) 3% NaOCl; (4) 17% EDTA; (5) 3% NaOCl and 17% EDTA; (6) 5% NaOCl and 17% EDTA. All groups underwent four (group 1) or five (groups 2, 3, 4, 5, 6) sequential 30‐min irrigation periods following each of which the tooth was subjected to a standard regime of cyclic, nondestructive, occlusal loading. Tooth surface strain was measured during each loading cycle using electrical strain gauges mounted cervico‐proximally. The data were analysed by Hierarchical anova and post hoc multiple comparisons.

Results  Irrigation with 5% NaOCl alone or alternating with 17% EDTA significantly (P < 0.001) increased the peak strain values for each of the irrigation periods compared with that of saline (group 1). The data for the other groups revealed no significant differences compared with those of saline. The strain increase after the fourth irrigation cycle was significantly higher for group 6 than for group 2. The measured canal morphology and dentine thickness parameters did not prove to have a significant effect on tooth surface strain.

Conclusions  Irrigation with 5% NaOCl acting alone or alternated with 17% EDTA (used in 30 min cycles), significantly increased tooth surface strain. The alternated regimen showed significantly greater changes in tooth surface strain than NaOCl alone. Irrigation with 3% NaOCl and 17% EDTA individually or in combination did not significantly alter the tooth surface strain.
Masticatory jaw movement optimization after introduction of occlusal interference
Authors: YASHIRO K. , FUKUDA T. , TAKADA K.
Published: December 2009

Summary  How ‘control’ characteristics of masticatory jaw movement, such as skilfulness of the movement, change after alteration in occlusion remains uncertain. For each of 10 healthy adults with good occlusion, an occlusal interference with artificial ‘tooth‐cusp’ was introduced to the crown of the upper molar tooth on the non‐working side of unilateral chewing. Mandibular incisor‐point movements were then recorded by a 3D tracking device. The introduction of the occlusal interference induced a remarkable increase in the normalized jerk‐cost (NJC), prolonged duration of the decelerative phase and lowered peak velocity for jaw closing movement during chewing. Overall, the NJC and velocity profile showed significant recoveries during the course of about 90 repetitive chewing cycles performed under the altered occlusal condition. These findings suggest that acute adaptive changes of jaw motion after introduction of occlusal interference might be characterized as the recovery process of movement skilfulness in terms of movement smoothness and velocity profile.
New Zealand strains of plant pathogenic bacteria classified by multi‐locus sequence analysis; proposal of Xanthomonas dyei sp. nov.
Authors: Young J. M. , Wilkie J. P. , Park D.‐C. , Watson D. R. W.
Published: December 2009

Strains of Xanthomonas isolated in New Zealand from diseased endemic and introduced plants, investigated in a multi‐locus sequence analysis (MLSA), were distributed primarily in two species. Strains from Dysoxylum, Hardenbergia, Liquidambar, Magnolia and Mahonia were members of Xanthomonas arboricola. Strains of Xanthomonas campestris pv. laureliae, X. campestris pv. eucalypti and strains from Aralia, Diospyros, Dysoxylum, Eriostemon, Eucalyptus, Metrosideros and Olea formed a population distinct from all known Xanthomonas spp. These latter strains have a unique fatty acid methyl ester profile and are considered to be members of a new Xanthomonas species, for which the name Xanthomonas dyei is proposed. Xanthomonas campestris pv. eucalypti and X. campestris pv. laureliae are considered to be pathovars of the new species and their reclassification as X. dyei pv. eucalypti and X. dyei pv. laureliae, respectively, is proposed. Strains previously identified as Pseudomonas syringae pv. dysoxyli from Dysoxylum spectabile, including the pathotype strain, were examined and found not to represent the pathogen originally described as P. dysoxyli. Other strains (proved to be pathogenic) from diseased D. spectabile, corresponding to the original description of P. dysoxyli, are members of X. dyei and the new combination X. dyei pv. dysoxyli is proposed. The geographic and evolutionary origins of X. dyei, apparently endemic to Australasia, and the adaptation of strains to the introduced host plants Aralia, Diospyros, Eriostemon, Metrosideros and Olea, are discussed. The origins of the X. arboricola strains isolated from Dysoxylum, Hardenbergia, Liquidambar, Magnolia and Mahonia pose a conundrum.
Parasitic plant infection is partially controlled through symbiotic pathways
Authors: FERNÁNDEZ‐APARICIO M , RISPAIL N , PRATS E , MORANDI D , GARCÍA‐GARRIDO J M , DUMAS‐GAUDOT E , DUC G , RUBIALES D
Published: December 2009

Fernández‐Aparicio M, Rispail N, Prats E, Morandi D, García‐Garrido JM, Dumas‐Gaudot E, Duc G & Rubiales D (2009). Parasitic plant infection is partially controlled through symbiotic pathways. Weed Research.50, 76–82.

Legumes are unique in interacting with Rhizobium, arbuscular mycorrhizal (AM) fungi, and parasitic plants. To dissect common parts of these three plant–organism interactions, infection by Orobanche crenata was studied in mutants with altered symbiotic phenotypes of Medicago truncatula and Pisum sativum. Orobanche crenata inoculation of mutant lines carrying defective mutation in the genes dmi2/sym19 and dmi3 resulted in an increase in O. crenata establishment. Similarly, inoculation of mutants carrying mutation in the gene sunn/sym29 that controls the autoregulation mechanism of the symbiosis, also lead to a significant increase in haustoria formation. Altogether, our results suggest that parasitic plant infection is partly controlled by both the conserved symbiotic pathway that mediates symbiont recognition and establishment and the autoregulation mechanism that regulates the extent of colonisation by Rhizobium and AM fungi.
Rapid assessment and safe management of severe pulmonary hypertension with milrinone during orthotopic liver transplantation
Authors: Fukazawa Kyota , Poliac Liviu C. , Pretto Ernesto A.
Published: December 2009

Fukazawa K, Poliac LC, Pretto EA. Rapid assessment and safe management of severe pulmonary hypertension with milrinone during orthotopic liver transplantation. Clin Transplant 2010: 24: 515–519. © 2009 John Wiley & Sons A/S.

Abstract:  The incidence of porto‐pulmonary hypertension (PPHN) in patients with end stage liver disease is 8.5%. Evidence indicates that proceeding with orthotopic liver transplantation (OLT) in patients diagnosed with severe PPHN (mean pulmonary artery pressure [mPAP] > 45 mmHg) at the time of OLT surgery is associated with high perioperative mortality. We describe a case of severe PPHN that was diagnosed by right heart catheterization at the time of surgery. We quickly determined the reversibility of PPHN with a bolus of milrinone and proceeded with OLT. Further episodes of pulmonary hypertension were successfully managed with continuous milrinone infusion and transesophageal echocardiography monitoring. Reversibility via vasodilator trial after identification of high pulmonary artery pressures (PAP) may be an important indication of the feasibility of OLT. Milrinone may be useful for the rapid identification of the reversibility of high PAP and may be an effective agent to control abrupt increases in PAP during OLT.