bluuebunny/crossref_metadata_2025 huggingface dataset:
USEFULNESS AND SAFETY OF SB KNIFE JR IN ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL TUMORS
Authors: OKA SHIRO , TANAKA SHINJI , TAKATA SAYAKA , KANAO HIROYUKI , CHAYAMA KAZUAKI
Published: April 2012

Use of a Dual knife has become commonplace for endoscopic submucosal dissection (ESD) of colorectal tumors at Hiroshima University Hosipital. A Hook knife has been also used in combination with the Dual knife, depending on the location of the lesion. We have had recent opportunities to use a scissors‐type SB knife Jr. We retrospectively compared outcomes of colorectal ESD performed with the Dual knife in combination with the SB knife Jr versus the Hook knife. In conclusion, although the Hook knife was shown to be a very useful auxiliary device for colorectal ESD, the SB knife Jr. yielded better results than the Hook knife in terms of complete en block resection and avoidance of perforation. Use of the Dual knife with the SB Knife Jr shows good potential for improving complete en bloc resection rate and safety of technically difficult colorectal ESD.
TERMINOLOGY FOR TRAINING OF ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: KAKUSHIMA NAOMI , HIRASAWA KINGO , MORITA YOSHINORI , TAKEUCHI MANABU , YAMAMOTO YORIMASA , ODA ICHIRO , GODA KENICHI , UEDO NORIYA , FUJISHIRO MITSUHIRO
Published: April 2012

Like many other advanced endoscopic skills, to master the skill of endoscopic submucosal dissection (ESD) requires training for a novice. The general medical terminology should be used similarly even in case of ESD training. However, it is not common for everyone to recall the same meaning from one medical term. Therefore, it is necessary to unify the meaning of medical terms and review their usage in a meeting to achieve a consensus. For this purpose, terms used in the upper gastrointestinal session, Endoscopic Forum Japan 2011, entitled ‘Towards further penetration of ESD techniques – what is the role of Japanese ESD experts?’, were determined beforehand as shown. Additionally, the present educational approach of ESD in Japan is simply outlined in this article.
COVERED METALLIC STENT FOR ISCHEMIC HILAR BILIARY STRICTURE
Authors: KAWAKAMI HIROSHI , KUWATANI MASAKI , ETO KAZUNORI , KUDO TAIKI , ASAKA MASAHIRO
Published: April 2012

Compared with surgery, endoscopic treatment is safe and highly effective for a postoperative hilar benign bile duct stricture (BDS). However, the long‐term outcome of conventional placement of a single biliary stent for hilar benign BDS is generally poor. Although the placement of multiple biliary stents is preferred, multiple stenting in a BDS is difficult. Alternatively, single or multiple stent placement above the papilla (‘inside stent’) or fully‐covered self‐expandable metallic stents (SEMS) are feasible approaches for benign BDS. Nevertheless, controversy remains regarding whether and how to perform endoscopic biliary drainage for a hilar benign BDS. In patients with hilar benign BDS, endoscopic biliary drainage can be performed by placing conventional plastic stents across the papilla, plastic stents above the papilla or fully‐covered SEMS. Individualized treatment should be considered. We report the placement of a fully‐covered SEMS for a hilar benign biliary stricture after extended left hepatectomy.
USE OF A PARTIALLY COVERED SELF‐EXPANDABLE METALLIC STENT TO TREAT A BILIARY STRICTURE SECONDARY TO CHRONIC PANCREATITIS COMPLICATED BY RECURRENT CHOLANGITIS: A CASE REPORT
Authors: OKABE YOSHINOBU , ISHIDA YUSUKE , SASAKI YU , USHIJIMA TOMOYUKI , SUGIYAMA GEN , TSURUTA OSAMU
Published: April 2012

The patient was a 69 year old man who had been diagnosed with alcoholic chronic pancreatitis and lower common bile duct (CBD) stricture. He subsequently developed cholangitis 2–3 times a year, and we replaced the endoscopic biliary stent (EBS) each time. In April 2010, he was admitted because of complication by a liver abscess and acute cholangitis. We performed percutaneous transhepatic liver abscess drainage. The inflammatory findings then rapidly improved, but the patient developed acute cholangitis due to the sludge and the stones. Then, we placed a partially covered self‐expandable metallic stent (C‐SEMS) in the lower CBD and performed endoscopic lithotripsy through the C‐SEMS, and the cholangitis subsequently improved. Two weeks after, we removed the C‐SEMS endoscopically and replaced it with a 10 Fr plastic stent; since then there have been no recurrences of cholangitis. Our experience in this case suggested that when a plastic stent is placed long‐term to treat a biliary stricture associated with chronic pancreatitis, it might be useful to also control biliary sludge and stones using a C‐SEMS.
SUCCESSFUL TREATMENT OF BENIGN BILIARY STRICTURE BY A COVERED SELF‐EXPANDABLE METALLIC STENT IN A PATIENT WITH CHRONIC PANCREATITIS
Authors: KANNO ATSUSHI , MASAMUNE ATSUSHI , HIROTA MORIHISA , KIKUTA KAZUHIRO , SHIMOSEGAWA TOORU
Published: April 2012

The patient was a 73 year old man for whom surgery under general anesthesia was difficult to perform because of pulmonary emphysema. In April 2003, he visited our hospital complaining of epigastralgia and dorsal pain, and was admitted under a diagnosis of acute exacerbation of chronic pancreatitis. In 2005, acute cholangitis concomitantly developed with acute exacerbation of chronic pancreatitis, for which a plastic stent was placed in the common bile duct. Cholangitis repeatedly developed every 2–3 months thereafter, and admission was required each time to exchange the stent. Surgery was considered but not applicable because of his poor respiratory function, and a partially covered self‐expandable metallic stent was inevitably placed in the bile duct. Ten months later, an aberration of the metallic stent in the bile duct occurred, but it was dealt with by placing an additional metallic stent, and no cholangitis or pancreatitis developed until the patient died of respiratory insufficiency 3 years later. Placement of a covered self‐expandable metallic stent might be an option for the treatment of benign biliary stricture, especially in patients at high risk from surgery.
ENDOSCOPIC SUBMUCOSAL DISSECTION FOR LARGE COLORECTAL TUMORS USING A CROSS‐COUNTER TECHNIQUE AND A NOVEL LARGE‐DIAMETER BALLOON OVERTUBE
Authors: OKAMOTO KOICHI , MUGURUMA NAOKI , KITAMURA SHINJI , KIMURA TETSUO , TAKAYAMA TETSUJI
Published: April 2012

Background and Aim:  Endoscopic submucosal dissection (ESD) in early gastric cancer (EGC), which provides a higher complete resection rate than conventional endoscopic mucosal resection (EMR), has rapidly come into widespread use. However, colorectal ESD is not widely used because of its technical difficulty and complications such as perforation, and the procedure time is longer than that of conventional EMR. Development of safer and more reliable devices as well as technique modifications are therefore required. The aim of our study is to compare safety and efficacy of a new traction method, the cross‐counter technique, for large colorectal tumors combined with a balloon overtube.

Methods:  A total of 30 patients with large colorectal tumors were analyzed retrospectively; 15 patients for the cross‐counter technique group (CC group) and 15 patients for the no‐traction group (NT group). Procedure time, complete resection rate, perforation rate and bleeding rate were assessed.

Results:  The procedure time was 126 ± 42.2 min and 165 ± 61.3 min in the CC and NT groups, respectively, and there was a significant difference between the two groups (P < 0.05). There were no significant differences in complete resection rate, perforation rate and bleeding rate between the two groups.

Conclusion:  The cross‐counter technique shortened the treatment time in colorectal ESD without any complication.
LEARNING CURVE FOR ENDOSCOPIC SUBMUCOSAL DISSECTION OF EARLY GASTRIC CANCER BASED ON TRAINEE EXPERIENCE
Authors: ODA ICHIRO , ODAGAKI TOMOYUKI , SUZUKI HARUHISA , NONAKA SATORU , YOSHINAGA SHIGETAKA
Published: April 2012

Background and Aim:  There have been few previous reports on endoscopic submucosal dissection (ESD) learning curve for early gastric cancer (EGC) so we retrospectively assessed this subject based on experience of our trainees.

Methods:  Trainees in our center start performing ESDs for lesions in lower third of stomach with hands‐on support by experts during first 10 cases and then perform ESDs by themselves primarily with verbal guidance from experts. They are gradually assigned to perform ESDs in middle and upper thirds of stomach. From January 1999 to December 2008, 464 EGC patients, who underwent ESD performed by 13 trainees, were assessed by dividing ESD cases into five training periods (A, 1‐10; B, 11‐20; C, 21‐30; D, 31‐40; and E, 41‐50). We compared data from B to C, D and E.

Results:  Lesions in lower third were A/59%, B/57%, C/55%, D/36% and E/40% with B significantly higher than D (p<0.01) and E (p<0.05). Mean tumor sizes were A/13.9±7.5mm, B/18.3±11.4mm, C/19.0±12.5mm, D/19.3±11.7mm and E/16.8±10.3mm. En‐bloc resection rate was 100% in every period. Delayed bleeding / perforation rates were A/0%/1.8%, B/2.8%/1.9%, C/1.9%/2.9%, D/1.1%/0% and E/2.1%/2.1%, respectively. Lower third procedure times were A/76±39, B/90±61, C/70±48, D/60±50 and E/55±26 minutes with B significantly longer than D and E (p<0.05). Middle and upper third procedure times were A/104±80, B/115±68, C/106±67, D/134±86 and E/96±55 minutes.

Conclusion:  Step‐by‐step training was highly effective with 100% en‐bloc resection rate and few complications. Learning curve point for our trainees to acquire performing ESD in lower third of stomach was 30 cases.
EFFICACY OF NOVEL SB KNIFE JR EXAMINED IN A MULTICENTER STUDY ON COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: HOMMA KIYOAKI , OTAKI YUZO , SUGAWARA MASAKI , KOBAYASHI MAKOTO
Published: April 2012

Background and Aim:  Secure manipulation of forceps in endoscopic submucosal dissection (ESD) for colorectal tumors is sometimes hindered by the characteristics of that organ. SB knife Jr, which are scissor forceps using a mono‐pole high frequency, were developed to avoid the difficulty of ESD operation in the colorectum. The aim of the present study was to examine the effectiveness of the SB knife Jr in colorectal ESD in 11 hospitals, mostly in northeastern Japan.

Materials:  One hundred and two colorectal tumors (49 non‐granular laterally spreading tumor [LST] lesions, 39 granular LST lesions and 14 other lesions) that were resected by ESD operations using SB knife Jr between October 2009 and March 2010.

Results:  All tumors (102/102) were resected en bloc and could be observed in detail. The mean size of the resected pieces was 40.3 mm. The mean operation time was 54.2 min. Of the complications, one case of micro‐perforation occurred during the manipulation of submucosal dissection, and this case was treated with clips in that operation. The rates of resection carried out only with SB knife Jr were 74.5% (76/102).

Conclusion:  The novel ESD using SB knife Jr in the colorectum offers a breakthrough in resection techniques for not only expert endoscopists but also general endoscopists.
MAKING ENDOSCOPY MOBILE: THE JOURNEY
Authors: TALUKDAR RUPJYOTI , REDDY D NAGESHWAR
Published: April 2012

In spite of the economic development through the past six decades post‐independence, nearly 70% of the Indian population still live in villages, and these people very often have limited access to the advanced health‐care technology. In an attempt to render cost‐effective gastrointestinal care to the rural dwellers, we have initiated a Rural Health Care Project. We have tailor‐made and converted a bus into a mobile hospital equipped with basic diagnostic facilities including a custom‐made endoscopy unit. This bus travels to rural areas and renders basic diagnostic and therapeutic services including endoscopy. A telemedicine van accompanies the mobile hospital and endoscopy unit and transmits all procedures and data to the main telemedicine center at our parent institute. We have so far performed over 30 000 endoscopic procedures in 4837 villages with a population of over 10 million people. Both the rural dwellers and the staff involved in this project have reported a high level of satisfaction. This project runs on philanthropic donations.
EFFECTIVE TRAINING SYSTEM IN COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: OHATA KEN , ITO TAKAFUMI , CHIBA HIDEYUKI , TSUJI YOSUKE , MATSUHASHI NOBUYUKI
Published: April 2012

Although colorectal endoscopic submucosal dissection (ESD) is superior to endoscopic mucosal resection (EMR) in en bloc resection rate, it is technically quite difficult because of the anatomical and histological characteristics of the colorectal wall. This difficulty prevents wide spread of the technique. Establishment of the training system for colorectal ESD is necessary to standardize training and to achieve wider acceptance of this technique. Herein, we describe our training system for colorectal ESD, and assess the validity of the training system for colorectal ESD, based on the clinical outcomes and learning curve of trainees. Our training system for colorectal ESD would help the spread of this procedure.
INDICATION, STRATEGY AND OUTCOMES OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL NEOPLASM
Authors: TAKEUCHI YOJI , OHTA TAKASHI , MATSUI FUMI , NAGAI KENGO , UEDO NORIYA
Published: April 2012

Although endoscopic submucosal dissection (ESD) for colorectal neoplasm is a promising endoscopic therapy with a high rate of successful en bloc resection, ESD for colorectal neoplasm is not a health‐care service provided by Japanese public heath insurance, yet. Now, ESD for colorectal neoplasm has been approved as an ‘advanced medical treatment’ system, which is a partial‐care service provided by Japanese public health insurance with individual payment of medical expenses, and the indication for ESD for colorectal neoplasm has been under debate. In our hospital, a total of 348 colorectal neoplasms underwent ESD using the FlexKnife and the FlushKnife, and 317 lesions (91%) were resected en bloc. Perforation occurred in eight cases (2%) and they were not critical and did not require emergent surgery. Delayed bleeding occurred in 16 cases (4%) and they were able to be controlled without transfusion and were not critical. The major impact of the advanced medical treatment system on clinical practice in our hospital was the increased incidence of adenocarcinoma and increased tumor size in the lesions that underwent ESD. It is thought that the application of the advanced medical treatment system resulted in careful selection of lesions for ESD while maintaining the principle of en bloc resection. We expect that a new, revised indication that covers recurrent carcinoma after endoscopic therapy will be indicated when ESD for colorectal neoplasm becomes a health‐care service provided by Japanese public health insurance.
CURRENT STATUS OF TRAINING FOR ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC EPITHELIAL NEOPLASM AT CANCER INSTITUTE HOSPITAL, JAPANESE FOUNDATION FOR CANCER RESEARCH, A FAMOUS JAPANESE HOSPITAL
Authors: YAMAMOTO YORIMASA , FUJISAKI JUNKO , ISHIYAMA AKIYOSHI , HIRASAWA TOSHIAKI , IGARASHI MASAHIRO
Published: April 2012

Aim:  Endoscopic submucosal dissection (ESD) is relatively difficult compared with endoscopic mucosal resection (EMR), thus, proper training is essential for the safe performance of the procedure. The aim of this study is to clarify the current status of training for ESD for gastric epithelial neoplasm by following the performance of 13 preceptees.

Methods:  We performed ESD for 1520 lesions between March 2005 and April 2011 and conducted ESD training of 13 preceptees who were supervised by experts. We classified the samples into four groups according to the number of ESD performed by the preceptees to chart their progress by comparing the procedural outcomes. Group A included cases 1–40 performed by all 13 preceptees, group B consisted of cases 41–80 performed by 10 of the preceptees and group C included cases 81 onwards executed by five of the preceptees. Group D comprised the cases that were performed by experts during the same period as group C.

Results:  The procedural outcomes of group A were similar to those of group B with regard to operation time, complete en bloc resection and complications. However, the results of group B included significantly more lesions of the middle or upper third of the stomach, resected specimen and lesions were larger in diameter, lesions with positive ulcer finding were more frequent and a higher frequency of lesions were of expanded, non‐indication type. Group B outcomes were similar to those of group C but differed in location of lesions and specimen size. Group C outcomes were similar to group D's in all parameters.

Conclusion:  Preceptees were able to safely perform ESD for gastric epithelium neoplasms under appropriate supervision by expert endoscopists. The number of cases in which preceptees successfully extracted guideline‐indication lesions and expanded‐indication lesions by ESD were approximately 40 and 80 cases, respectively. The procedural outcomes of ESD performed by preceptees who had experience in over 80 cases were similar to those by expert endoscopists. Thus, these findings show that the minimal amount of training for achieving preceptorship of ESD is performance of at least 80 of the procedures.
Surgical management of cystic lesions in the liver
Authors: Garcea Giuseppe , Rajesh Arumugam , Dennison Ashley R.
Published: April 2012

Background:  Liver cysts are common, occurring in up to 5% of the population. For many types of cysts, a variety of different treatment options exist and the preferred management is unclear.

Methods:  A Pubmed and Medline literature review using key words non‐parasitic hepatic cysts, polycystic liver disease, echinococcus, hydatid cysts parasitic cysts, Caroli's disease, cystadenoma; liver abscess, surgery, aspiration and treatment was undertaken and papers pertaining to the diagnosis and management of cystic lesions within the liver were retrieved.

Results:  Asymptomatic simple cysts in the liver require no treatment. Therapy for symptomatic cysts may incorporate aspiration with sclerotherapy or de‐roofing. At present, insufficient evidence exists to recommend one over the other. Polycystic liver disease presents a unique management problem because of high morbidity and mortality rates from intervention and high rates of recurrence. Careful patient counselling and assessment of symptom index is essential before embarking on any treatment. New medical treatments may ameliorate symptoms. Acquired cystic lesions in the liver require a thorough work‐up to fully characterize the abnormality and direct appropriate treatment. Hydatid cysts are best treated by chemotherapy followed by some form of surgical intervention (either aspiration and sclerotherapy or surgery). Liver abscesses can effectively be treated by aspiration or drainage. With improved antimicrobial efficacy, prolonged treatment with antibiotics may also be considered.

Conclusion:  All patients with cystic lesions in the liver require discussion at multi‐disciplinary meetings to confirm and the diagnosis and determine the most appropriate method of treatment.
Role of the mental health nurse towards physical health care in serious mental illness: An integrative review of 10 years of UK Literature
Authors: Blythe Jeanette , White Jacquie
Published: April 2012

People with serious mental illness have significantly poorer physical health compared to the general population. Mental health nurses are in a prime position to help reduce unacceptable death in this population. A literature search was undertaken to identify the role of the mental health nurse in regards to physical health care, intervention, and attaining the necessary knowledge to address the physical health needs of people in the UK with serious mental illness. Of 254 papers identified, nine met the inclusion criteria. An integrative literature review found that mental health nurses are not routinely supported by physical health‐care education and training, with many expressing role ambiguity. Inpatient setting correlated to a less positive role attitude; poor primary–secondary care interface communication compounded the problem of this vulnerable population having their physical health needs identified and met.
Physical health and wellbeing of emerging and young adults with mental illness: An integrative review of international literature
Authors: McCloughen Andrea , Foster Kim , Huws‐Thomas Michelle , Delgado Cynthia
Published: April 2012

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental–physical comorbidities in middle to older‐aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16–24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental–physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid–late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health‐care behaviours.
Evolving role of mental health nurses in the physical health care of people with serious mental health illness
Authors: Bradshaw Tim , Pedley Rebecca
Published: April 2012

Life expectancy in members of the general population has steadily improved in most countries since 1960. However, during the same period, the life expectancy of people with serious mental illness (SMI) has actually reduced. The majority of premature deaths result from natural causes, such as coronary heart disease. Obesity, a key risk factor for heart disease in this client group, might be caused both by unhealthy lifestyle behaviours and the side‐effects of antipsychotic medication. Mental health nurses (MHN) nurses have an important role to play in improving the physical health of people with SMI. Evidence, however, suggests that they are often ambivalent about this role, and might perceive themselves as being inadequately trained and lacking in confidence. In this paper, we will argue that MHN need to re‐evaluate their practice and recognize that the provision of physical health care is as important as other roles they occupy in relation to the care of people with SMI. We will also consider examples of best practice in physical health care, and discuss how these might be adopted by MHN and other professionals, in order to begin to improve services and to reduce health inequalities in this client group.
Insulinemia and the risk of breast cancer and its relapse
Authors: Formica V. , Tesauro M. , Cardillo C. , Roselli M.
Published: April 2012

A fairly large body of evidence has shown that insulin is a tumour‐promoting agent, especially for breast cancer. High circulating and microenvironmental levels of insulin may directly increase the risk of breast cancer via the activation of cognate receptors expressed on normal and cancer cells and indirectly be associated with other known metabolic risk factors of cancer that usually are present in conjunction with the hyperinsulinic state.

The focus of this review is to analyse and discuss available data in the literature on the possible causative/prognostic role of insulin resistance/hyperinsulinemia in breast cancer development and progression.
12‐Month‐Olds’ Phonotactic Knowledge Guides Their Word–Object Mappings
Authors: MacKenzie Heather , Curtin Suzanne , Graham Susan A.
Published: April 2012

This study examined whether 12‐month‐olds will accept words that differ phonologically and phonetically from their native language as object labels in an associative learning task. Sixty infants were presented with sets of English word–object (N = 30), Japanese word–object (N = 15), or Czech word–object (N = 15) pairings until they habituated. Infants associated CVCV English, CCVC English, and CVCV Japanese words, but not CCVC Czech words, with novel objects. These results demonstrate that by 12 months of age, infants are beginning to apply their language‐specific knowledge to their acceptance of word forms. That is, they will not map words that violate the phonotactics of their native language to objects.
The Role of Emotional Reactivity, Self‐regulation, and Puberty in Adolescents' Prosocial Behaviors
Authors: Carlo Gustavo , Crockett Lisa J. , Wolff Jennifer M. , Beal Sarah J.
Published: April 2012

This study was designed to examine the roles of emotional reactivity, self‐regulation, and pubertal timing in prosocial behaviors during adolescence. Participants were 850 sixth graders (50 percent female, mean age = 11.03, standard deviation = .17) who were followed up at the age of 15. In hierarchical regression models, measures of emotional reactivity, self‐regulation, pubertal timing, and their interactions were used to predict (concurrently and over time) adolescents' prosocial behaviors in the home and with peers. Overall, the findings provide evidence for pubertal and temperament‐based predictors of prosocial behaviors expressed in different contexts. Self‐regulation was positively related to both forms of prosocial behavior, concurrently and longitudinally. Emotional reactivity showed moderately consistent effects, showing negative concurrent relations to prosocial behavior with peers and negative longitudinal relations (4 years later) to prosocial behavior at home. Some curvilinear effects of temperament on prosocial behaviors were also found. Effects of pubertal timing were found to interact with gender, such that boys who were early maturers showed the highest levels of prosocial behavior at home concurrently. Discussion focuses on the role of temperament‐based mechanisms in the expression of prosocial behaviors in different contexts in adolescence.
The social side of human–wildlife interaction: wildlife can learn harmful behaviours from each other
Authors: Donaldson R. , Finn H. , Bejder L. , Lusseau D. , Calver M.
Published: April 2012

Read the Commentaries on this Feature Paper: Individual dolphins as tools for conservation ; Wildlife social learning should inform sustainable tourism management; Conservation issues arising from maladaptive behaviours spreading socially

Response from the authors: Social learning of risky behaviour: importance for impact assessments, conservation and management of human‐wildlife interactions
On how nucleus‐endplate integration is achieved at the fibrillar level in the ovine lumbar disc
Authors: Wade Kelly R. , Robertson Peter A. , Broom Neil D.
Published: April 2012

The intervertebral disc nucleus has traditionally been viewed as a largely unstructured amorphous gel having little obvious integration with the cartilaginous endplates (CEPs). However, recent work by the present authors has provided clear evidence of structural cohesion across the nucleus‐endplate junction via a distinctive microanatomical feature termed insertion nodes. The aim of this study was to explore the nature of these insertion nodes at the fibrillar level. Specially prepared vertebra‐nucleus‐vertebra composite samples from ovine lumbar motion segments were extended axially and chemically fixed in this stretched state, and then decalcified. Sections taken from the samples were prepared for examination by scanning electron microscopy. A close morphological correlation was obtained between previously published optical microscopic images of the nodes and those seen using low magnification SEM. Progressively high magnifications provided insight into the fibrillar‐level modes of structural integration across the nucleus‐endplate junction. The closely packed fibrils of the CEP were largely parallel to the vertebral endplate and formed a dense, multi‐layer substrate within which the nodal fibrils appeared to be anchored. Our idealised structural model proposes a mechanism by which this integration is achieved. The nodal fibrils, in curving into the CEP, are locked in place within its close‐packed layers of transversely aligned fibrils, and probably at multiple levels. Secondly, there appears to be a subtle interweaving of the strongly aligned nodal fibrils with the multi‐directional endplate fibrils. It is suggested that this structural integration provides the nucleus with a form of tethered mobility that supports physiological functions quite distinct from the primary strength requirements of the disc.
Efficacy of a reading and language intervention for children with Down syndrome: a randomized controlled trial
Authors: Burgoyne Kelly , Duff Fiona J. , Clarke Paula J. , Buckley Sue , Snowling Margaret J. , Hulme Charles
Published: April 2012

Background:  This study evaluates the effects of a language and literacy intervention for children with Down syndrome.

Methods:  Teaching assistants (TAs) were trained to deliver a reading and language intervention to children in individual daily 40‐min sessions. We used a waiting list control design, in which half the sample received the intervention immediately, whereas the remaining children received the treatment after a 20‐week delay. Fifty‐seven children with Down syndrome in mainstream primary schools in two UK locations (Yorkshire and Hampshire) were randomly allocated to intervention (40 weeks of intervention) and waiting control (20 weeks of intervention) groups. Assessments were conducted at three time points: pre‐intervention, after 20 weeks of intervention, and after 40 weeks of intervention.

Results:  After 20 weeks of intervention, the intervention group showed significantly greater progress than the waiting control group on measures of single word reading, letter‐sound knowledge, phoneme blending and taught expressive vocabulary. Effects did not transfer to other skills (nonword reading, spelling, standardised expressive and receptive vocabulary, expressive information and grammar). After 40 weeks of intervention, the intervention group remained numerically ahead of the control group on most key outcome measures; but these differences were not significant. Children who were younger, attended more intervention sessions, and had better initial receptive language skills made greater progress during the course of the intervention.

Conclusions:  A TA‐delivered intervention produced improvements in the reading and language skills of children with Down syndrome. Gains were largest in skills directly taught with little evidence of generalization to skills not directly taught in the intervention.
Alternative oxidase modulates leaf mitochondrial concentrations of superoxide and nitric oxide
Authors: Cvetkovska Marina , Vanlerberghe Greg C.
Published: April 2012

The nonenergy‐conserving alternative oxidase (AOX) has been hypothesized to modulate the amount of reactive oxygen species (ROS) and reactive nitrogen species (RNS) in plant mitochondria but there is sparse direct in planta evidence to support this.

Laser scanning fluorescent confocal microscopy and biochemical methods were used to directly estimate in planta leaf concentrations of superoxide (), nitric oxide (NO), peroxynitrite (ONOO−) and hydrogen peroxide (H2O2) in wildtype (Wt) tobacco (Nicotiana tabacum) and transgenic tobacco with altered amounts of AOX.

We found that plants lacking AOX have increased concentrations of leaf mitochondrial‐localized and leaf NO in comparison to the Wt, while leaf concentrations of H2O2 were similar or lower in the AOX‐suppressed plants.

Based on our results, we suggest that AOX respiration acts to reduce the generation of ROS and RNS in plant mitochondria by dampening the leak of single electrons from the electron transport chain to O2 or nitrite. This may represent a universal role for AOX in plants. More work is now needed to establish the functional implications of this role, such as during abiotic and biotic stress.
Alpha‐synuclein impairs normal dynamics of mitochondria in cell and animal models of Parkinson’s disease
Authors: Xie Weilin , Chung Kenny K. K.
Published: April 2012

J. Neurochem. (2012) 122, 404–414.

Alpha‐synuclein (α‐syn) is a synaptic protein that mutations have been linked to Parkinson’s disease (PD), a common neurodegenerative disorder that is caused by the degeneration of the dopaminergic neurons in the substantia nigra pars compacta (SNc). How α‐syn can contribute to neurodegeneration in PD is not conclusive but it is agreed that mutations or excessive accumulation of α‐syn can lead to the formation of α‐syn oligomers or aggregates that interfere with normal cellular function and contribute to the degeneration of dopaminergic neurons. In this study, we found that α‐syn can impair the normal dynamics of mitochondria and this effect is particular prominent in A53T α‐syn mutant. In mice expressing A53T α‐syn, age‐dependent changes in both mitochondrial morphology and proteins that regulate mitochondrial fission and fusion were observed. In the cellular model of PD, we found that α‐syn reduces the movement of mitochondria in both SH‐SY5Y neuroblastoma and hippocampal neurons. Taken together, our study provides a new mechanism of how α‐syn can contribute to PD through the impairment of normal dynamics of mitochondria.
Temperature‐related increases in grass growth and greater competition for food drive earlier migrational departure of wintering Whooper Swans
Authors: STIRNEMANN REBECCA L. , O’HALLORAN JOHN , RIDGWAY MARGARET , DONNELLY ALISON
Published: April 2012

Understanding the departure decisions of migratory birds is critical for determining how changing climatic conditions will influence subsequent arrival times on the breeding grounds. A long‐term dataset (1972–2008) of Whooper Swan Cygnus cygnus departure dates from a wintering site in Ireland was used to assess the factors determining the timing of migration. Early and late migrating swans showed different departure patterns. Earlier wintering ground departure was more pronounced for the first 50% of the population than the last 10% of departing individuals. Earlier departure was associated with an increase in February temperatures at the wintering site for all departure phases except the date when the last individual departed. The date by which the first 50% of Swans had departed was earlier with increasing numbers of wintering Swans, suggesting that competition on the wintering grounds may further influence the timing of departure. The results also suggested that departure is mediated by the influence of spring temperature on food resources, with increased February grass growth in warmer years enabling earlier departure of migrating Swans. To determine why arrival dates in the breeding ground have altered, environmental conditions in the wintering grounds must be taken into account.
The effect of changes in habitat conditions on the movement of juvenile Snail KitesRostrhamus sociabilis
Authors: BOWLING ANDREA C. , MARTIN JULIEN , KITCHENS WILEY M.
Published: April 2012

The degradation of habitats due to human activities is a major topic of interest for the conservation and management of wild populations. There is growing evidence that the Florida Everglades ecosystem continues to suffer from habitat degradation. After a period of recovery in the 1990s, the Snail KiteRostrhamus sociabilispopulation suffered a substantial decline in 2001 and has not recovered since. Habitat degradation has been suggested as one of the primary reasons for this lack of recovery. As a consequence of the continued degradation of the Everglades, we hypothesized that this would have led to increased movement of juvenile Kites over time, as a consequence of the need to find more favourable habitat. We used multistate mark‐recapture models to compare between‐site movement probabilities of juvenile Snail Kites in the 1990s (1992–95; which corresponds to the period before the decline) and 2000s (2003–06; after the decline). Our analyses were based on an extensive radiotelemetry study (266 birds tracked monthly over the entire state of Florida for a total period of 6 years) and considered factors such as sex and age of marked individuals. There was evidence of increased movement of juvenile Snail Kites during the post‐decline period from most of the wetland regions used historically by Kites. Higher movement rates may contribute to an increase in the probability of mortality of young individuals and could contribute to the observed declines.
Genome‐wide miRNA signatures of human longevity
Authors: ElSharawy Abdou , Keller Andreas , Flachsbart Friederike , Wendschlag Anke , Jacobs Gunnar , Kefer Nathalie , Brefort Thomas , Leidinger Petra , Backes Christina , Meese Eckart , Schreiber Stefan , Rosenstiel Philip , Franke Andre , Nebel Almut
Published: April 2012

Little is known about the functions of miRNAs in human longevity. Here, we present the first genome‐wide miRNA study in long‐lived individuals (LLI) who are considered a model for healthy aging. Using a microarray with 863 miRNAs, we compared the expression profiles obtained from blood samples of 15 centenarians and nonagenarians (mean age 96.4 years) with those of 55 younger individuals (mean age 45.9 years). Eighty miRNAs showed aging‐associated expression changes, with 16 miRNAs being up‐regulated and 64 down‐regulated in the LLI relative to the younger probands. Seven of the eight selected aging‐related biomarkers were technically validated using quantitative RT‐PCR, confirming the microarray data. Three of the eight miRNAs were further investigated in independent samples of 15 LLI and 17 younger participants (mean age 101.5 and 36.9 years, respectively). Our screening confirmed previously published miRNAs of human aging, thus reflecting the utility of the applied approach. The hierarchical clustering analysis of the miRNA microarray expression data revealed a distinct separation between the LLI and the younger controls (P‐value < 10−5). The down‐regulated miRNAs appeared as a cluster and were more often reported in the context of diseases than the up‐regulated miRNAs. Moreover, many of the differentially regulated miRNAs are known to exhibit contrasting expression patterns in major age‐related diseases. Further in silico analyses showed enrichment of potential targets of the down‐regulated miRNAs in p53 and other cancer pathways. Altogether, synchronized miRNA–p53 activities could be involved in the prevention of tumorigenesis and the maintenance of genomic integrity during aging.
Relationship between peak cardiac pumping capability and indices of cardio‐respiratory fitness in healthy individuals
Authors: Jakovljevic Djordje G , Popadic‐Gacesa Jelena Z , Barak Otto F , Nunan David , Donovan Gay , Trenell Michael I , Grujic Nikola G , Brodie David A
Published: April 2012

Cardiac power output (CPO) is a unique and direct measure of overall cardiac function (i.e. cardiac pumping capability) that integrates both flow‐ and pressure‐generating capacities of the heart. The present study assessed the relationship between peak exercise CPO and selected indices of cardio‐respiratory fitness. Thirty‐seven healthy adults (23 men and 14 women) performed an incremental exercise test to volitional fatigue using the Bruce protocol with gas exchange and ventilatory measurements. Following a 40‐min recovery, the subjects performed a constant maximum workload exercise test at or above 95% of maximal oxygen consumption. Cardiac output was measured using the exponential CO2 rebreathing method. The CPO, expressed in W, was calculated as the product of the mean arterial blood pressure and cardiac output. At peak exercise, CPO was well correlated with cardiac output (r = 0·92, P<0·01), stroke volume (r = 0·90, P<0·01) and peak oxygen consumption (r = 0·77, P<0·01). The coefficient of correlation was moderate between CPO and anaerobic threshold (r = 0·47, P<0·01), oxygen pulse (r = 0·57, P<0·01), minute ventilation (r = 0·53, P<0·01) and carbon dioxide production (r = 0·56, P<0·01). Small but significant relationship was found between peak CPO and peak heart rate (r = 0·23, P<0·05). These findings suggest that only peak cardiac output and stroke volume truly reflect CPO. Other indices of cardio‐respiratory fitness such as oxygen consumption, anaerobic threshold, oxygen pulse, minute ventilation, carbon dioxide production and heart rate should not be used as surrogates for overall cardiac function and pumping capability of the heart.
EVALUATING THE DISTRIBUTIONAL EFFECTS OF FISCAL POLICIES USING QUANTILE REGRESSIONS
Authors: CASALONE GIORGIA , SONEDDA DANIELA
Published: April 2012

The objective of this paper is to propose and apply a new method to evaluate the distributional impact of fiscal policies and potential marginal reforms. The econometric tool adopted is structural quantile treatment effects regression, which allows a complete picture of the effects of the fiscal policy of interest on households with different incomes, abilities, and needs. We apply this method to personal income taxation and non‐cash transfers in Italy for the year 2004. Our estimates suggest that, although heterogeneous, the redistributive effects of the potential fiscal reforms are almost zero.
Prognostic value of tumour‐associated macrophages in canine mammary tumours
Authors: Raposo T. , Gregório H. , Pires I. , Prada J. , Queiroga F. L.
Published: April 2012

Tumour‐associated macrophages (TAMs) have already been associated in human breast cancer to a poor prognosis. As a part of a tumoural microenvironment, TAMs have an important contribution influencing neoplastic progression. Hitherto, in canine mammary tumours (CMT) the prognostic value of TAMs has not been reported. In this study, MAC387 immunohistochemical expression was evaluated in 59 CMTs (20 benign and 39 malignant). The TAM value was significantly higher in malignant than benign CMT (P = 0.011). In malignant CMT, TAMs were associated with skin ulceration (P = 0.022), histological type (P = 0.044), nuclear grade (P = 0.031) and tubular differentiation (P = 0.042). The survival analysis revealed a significant association between tumours with higher levels of TAMs and the decrease in overall survival (P = 0.030). TAMs have proven to have a prognostic value. These findings suggest the future possibility of using TAMs as a novel therapeutic target in CMT.
The use of Jatobá bark for removal of cationic dyes
Authors: Demarchi Carla A , Debrassi Aline , Rodrigues Clóvis A
Published: April 2012

In this work, the application of Jatobá bark (the waste product of medicinal plant processing) in removal of the cationic dyes Methylene Blue, Crystal Violet and Rhodamine B from aqueous solution was studied in a batch system. The effect of contact time, pH and temperature on dye removal was investigated. An increase in pH from 2 to 10 was accompanied by an increase in the amount of dye adsorbed. The equilibrium sorption data fitted to the Langmuir, Freundlich and Langmuir–Freundlich equations were investigated. The Langmuir–Freundlich isotherm exhibited the best fit with the experimental data and the maximum adsorption capacities at room temperature being 211.5, 89.5 and 69.4 for Rhodamine B, Methylene Blue and Crystal Violet, respectively. The kinetic sorption was evaluated by the pseudo‐first‐order, pseudo‐second‐order and intraparticle diffusion models. It was observed that sorption follows the pseudo‐second‐order kinetic model. The thermodynamic parameters for the sorption process were also determined. The spontaneous and endothermic nature of adsorption was obtained based on the negative value of free energy (ΔG) and the positive value of enthalpy (ΔH). The results indicate that Jatobá bark could be used as a low‐cost material for the removal of cationic dyes from wastewater.
Novel water‐soluble metallophthalocyanines supported on cotton fabric
Authors: Yıldırım Özgür , Sevim Altuğ M , Gül Ahmet
Published: April 2012

In this study, two novel phthalonitrile derivatives were firstly prepared starting from 4‐nitrophthalonitrile: substitution of the nitro group with 3‐mercaptopropionic acid and 4‐mercaptobenzoic acid gave two precursors, namely, 4‐(carboxyethylsulphanyl) phthalonitrile and 4‐(carboxyphenylsulphanyl)phthalonitrile. Zinc(ii), copper(ii) and cobalt(ii) metallophthalocyanines bearing four carboxylic acid groups on the periphery were prepared by cyclotetramerisation of the new precursors in the presence of the corresponding divalent metal salts. The new compounds were characterised by elemental analyses, infrared, ultraviolet–visible, mass and proton nuclear magnetic resonance techniques. All these newly synthesised water‐soluble metallophthalocyanine derivatives were supported on cationic cotton fabrics in the presence of ammonia solution and sodium hydroxide and the dyeing effectiveness, levelness and fastness of these novel dyed fabrics were investigated. These novel dyed fabrics are considered to be useful in the textile industry and also in optical and catalytic applications, especially for air‐purifying materials in air conditioners.
Association of Malaysian Helicobacter pylori Virulence Polymorphisms with Severity of Gastritis and Patients’ Ethnicity
Authors: Alfizah Hanafiah , Ramelah Mohamed , Rizal Abdul M. , Anwar Abdullah S. , Isa Mohamed R.
Published: April 2012

Background and aim:  Polymorphisms of Helicobacter pylori cagA and vacA genes do exist and may contribute to differences in H. pylori infection and gastroduodenal diseases among races in the Malaysian population. This study was conducted to characterize the polymorphisms in H. pylori cagA and vacA in Malaysian population.

Methods:  A total of 110 H. pylori isolates were genotyped by PCR and sequenced for cagA and PCR‐RFLP for vacA.

Results:  East Asian cagA was predominantly detected (64.5%), whereas vacA s1m1 and s1m2 alleles were detected in 60.9 and 37.3% of strains, respectively. A statistical association between cagA type with patients’ ethnicity (p < .0001) and age group >50 years old (p = .027) was identified. vacA alleles showed significant association with age group >50 years old (p = .017) and increased neutrophil activity in gastric mucosa (p = .028 and p = .016 for moderate and marked activity, respectively). Further identification of vacA polymorphism revealed that 84% of strains from Malays and Indians showed one RFLP pattern (RFLP‐1), whereas more than one RFLP patterns (RFLP‐2, 3, 4, 5, 6, and 8) were predominantly observed in strains from Chinese (82%) (p < .0001). Increasing severity of gastric inflammation was observed in gastric mucosa infected with strains carrying RFLP‐2, 3, 4, 5, and 6 (p = .037). About 86.6% of H. pylori strains with East Asian cagA were vacA RFLP‐2, 3, 4, 5, 6, and 8, and 88% of Western cagA strains were vacA RFLP‐1 (p < .0001). Chinese and Indians are susceptible to different virulence genotypes of H. pylori, whereas Malays showed a mixed virulence genotypes.

Conclusion:  Marked differences in the polymorphisms of cagA and vacA were observed among strains in Malaysian population. This provides a new insight into the pathogenicity of H. pylori in multiracial population.
Will People Act to Mitigate Climate Change?
Authors: Clayton Susan
Published: April 2012

The articles by Markowitz and Bowerman (2011) and by Liu and Sibley (2011) highlight the importance of individual behavior and attitudes in addressing climate change, and suggest reasons for optimism about the possibility of individual change. In this comment, I reflect on the role of identity in both studies. Appeals based on personal and group identities have an important role in behavior change.