bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten‐free diet
Authors: HALLERT C. , SVENSSON M. , THOLSTRUP J. , HULTBERG B.
Published: January 2009

Background  Patients with coeliac disease living on a gluten‐free diet show vitamin deficiency and reduced subjective health status.

Aim  To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease.

Methods  In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45–64 years on a strict gluten‐free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well‐being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status.

Results  Fifty‐seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 μmol/L (7.4–23.0), significantly higher than in matched population controls [10.2 μmol/L (6.7–22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well‐being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well‐being.

Conclusions  Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well‐being, suggesting that B vitamins should be considered in people advised to follow a gluten‐free diet.
Porcine skeletal muscle differentially expressed gene CMYA1: isolation, characterization, mapping, expression and association analysis with carcass traits
Authors: Xu X. L. , Xu X. W. , Pan P. W. , Li K. , Jiang Z. H. , Yu M. , Rothschild M. F. , Liu B.
Published: January 2009

To investigate the differences in gene expression between some obese and lean pig breeds, differential display of mRNA was employed in our previous research. One differentially expressed EST (BI596262) was further identified as the porcine cardiomyopathy associated 1 (CMYA1) gene because of its homology to the human CMYA1 gene. The full‐length DNA of the porcine CMYA1 gene encompasses 9379 bp, including a complete open reading frame encoding 1839 amino acid residues, a 158‐bp 5′‐untranslated region and a 630‐bp 3′‐untranslated region. The porcine CMYA1 gene was assigned to chromosome 13 by the radiation hybrid panel (IMpRH). The porcine CMYA1 gene was expressed only in the striated muscle. Single nucleotide polymorphism (SNP) scanning in the coding region identified one synonymous mutation (c.1053C>T) and three missense mutations, c.1394A>G (p.His465Arg), c.1751A>G (p.Asp582Gly) and c.3290C>A (p.Thr1097Asp). The allele frequencies were tested among about 200 unrelated pigs from several pig breeds. Linkage mapping was further conducted with the SNP c.1751A>G (p.Asp582Gly) in a Berkshire × Yorkshire resource family and this confirmed that porcine CMYA1 is closely linked with Sw344 (distance = 2 cM, LOD score is 129.47), an interesting region harbouring a QTL for back fat thickness. Association analysis in our experimental pig population showed that different genotypes of CMYA1 gene were associated with different back fat thicknesses (P < 0.05). Our results suggest that the porcine CMYA1 gene has effects on porcine back fat deposition and further investigation will be necessary to illustrate the underlying mechanisms.
Relationship between HLA‐DP supertype and survival in childhood acute lymphoblastic leukaemia: evidence for selective loss of immunological control of residual disease?
Authors: Taylor G. Malcolm , Richards Sue , Wade Rachel , Hussain Adiba , Simpson Jill , Hill Frank , Mitchell Chris , Eden Tim ,   on behalf of UKCCS and CCLG Investigators
Published: January 2009

We recently reported that two of six HLA‐DP supertypes (DP1–4, 6, 8) were associated with susceptibility (DP2) and resistance (DP1) to childhood acute lymphoblastic leukaemia (ALL). To determine whether DP supertypes are associated with childhood ALL prognosis, we compared treatment outcomes in a cohort (n = 798) of DPB1‐typed ALL cases in the UK Medical Research Council UKALL XI trial. No differences in clinical characteristics and outcome between DPB1‐typed and untyped (n = 1292) cases suggest no selection bias. Event‐free survival (EFS) rates in patients with DP1 and DP3 supertypes were significantly worse than in patients with DP2, DP4, DP6 and DP8 [10‐year EFS: 55%; 95% confidence interval (CI) = 49–61%; compared with 64% (61–68%), P = 0·006]. Ten‐year EFS in DP1/DP3 heterozygous patients [30% (2–58%)] was significantly worse than in patients with DP1, DP3 or neither allele [56% (50–62%); P = 0·02]. Lack of evidence that DP1 or DP3 are associated with known prognostic factors leads us to suggest that these two supertypes exert an independent effect on prognosis. This may involve abrogation of DP1/3‐restricted T‐cell control of residual disease due to selective effects of chemotherapy. Further studies of HLA supertypes in relation to outcome in recent childhood ALL trials may resolve this question.
Blue sucker stock characteristics in the Wabash River, Indiana–Illinois, USA
Authors: BACULA T. D. , DAUGHERTY D. J. , SUTTON T. M. , KENNEDY A. J.
Published: January 2009

Abstract  Blue sucker, Cycleptus elongatus (Lesueur), populations have declined because of habitat degradation and overharvest, and little information exists on the population characteristics and stock dynamics of this species. We examined size and age structure, mortality, growth and condition of blue sucker in the Wabash River, Indiana–Illinois, USA. A total of 356 fish collected by electric fishing from June 2003 to April 2006 ranged from 238 to 775 mm total length and 85 to 5288 g wet weight. Age ranged from 3 to 16 years and annual mortality ranged from 22 to 25%. Annual growth was greatest among younger age classes (range 48–141 mm yr−1) and declined after age 6, likely at the onset of reproductive maturity. Variation in the relative condition factor (range 66–141) was heteroscedastic over the size range of fish sampled, perhaps attributable to seasonal differences in reproductive condition among mature fish.
Linking above‐ and belowground responses to global change at community and ecosystem scales
Authors: ANTONINKA ANITA , WOLF JULIE E. , BOWKER MATTHEW , CLASSEN AIMÉE T. , JOHNSON NANCY COLLINS
Published: January 2009

Cryptic belowground organisms are difficult to observe and their responses to global changes are not well understood. Nevertheless, there is reason to believe that interactions among above‐ and belowground communities may mediate ecosystem responses to global change. We used grassland mesocosms to manipulate the abundance of one important group of soil organisms, arbuscular mycorrhizal (AM) fungi, and to study community and ecosystem responses to CO2 and N enrichment. Responses of plants, AM fungi, phospholipid fatty acids and community‐level physiological profiles were measured after two growing seasons. Ecosystem responses were examined by measuring net primary production (NPP), evapotranspiration, total soil organic matter (SOM), and extractable mineral N. Structural equation modeling was used to examine the causal relationships among treatments and response variables. We found that while CO2 and N tended to directly impact ecosystem functions (evapotranspiration and NPP, respectively), AM fungi indirectly impacted ecosystem functions by influencing the community composition of plants and other root fungi, soil fungi and soil bacteria. We found that the mycotrophic status of the dominant plant species in the mesocosms determined whether the presence of AM fungi increased or decreased NPP. Mycotrophic grasses dominated the mesocosm communities during the first growing season, and the mycorrhizal treatments had the highest NPP. In contrast, nonmycotrophic forbs were dominant during the second growing season and the mycorrhizal treatments had the lowest NPP. The composition of the plant community strongly influenced soil N, and the community composition of soil organisms strongly influenced SOM accumulation in the mesocosms. These results show how linkages between above‐ and belowground communities can determine ecosystem responses to global change.
On carbon sequestration in desert ecosystems
Authors: SCHLESINGER WILLIAM H. , BELNAP JAYNE , MARION GILES
Published: January 2009

Recent reports of net ecosysytem production >100 gCm−2 yr−1 in deserts are incompatible with existing measurements of net primary production and carbon pools in deserts. The comparisions suggest that gas exchange measurements should be used with caution and better validation if they are expected to indicate the magnitude of carbon sink in these ecosysytems.
Effect of Sub‐Polar Gyre, North Atlantic Oscillation and ambient temperature on size and abundance in the Icelandic Arctic fox
Authors: HERSTEINSSON PALL , YOM‐TOV YORAM , GEFFEN ELI
Published: January 2009

Animals are exposed to environmental factors that influence their life history and body size. Here we used the Arctic fox (Vulpes lagopus) as an indicator of the complex links between largescale environmental variables that influence both marine and tundra trophic dynamics to demonstrate how they affect the fox's body size and abundance. The Arctic fox inhabits throughout Iceland, where it preys mainly on birds. We studied the effects of the Sub‐Polar Gyre (SPG), winter and summer North Atlantic Oscillation (NAO), mean annual winter and summer temperature, and geographic sector (eastern and western Iceland, which differ in their ecology) on variations in mandible size (6345 specimens) and body mass (2732 specimens) as well as abundance on the Arctic fox in Iceland. We found that (a) SPG index negatively affected male mandible length as well as body mass of both sexes. SPG was also negatively related to fox abundance. (b) Summer NAO had a negative effect on Arctic foxes, that is, cold summers were correlated with shorter mandibles and lower body mass. (c) Winter NAO had a significant negative effect (although weaker than that of summer NAO) on female mandible length, but not on body mass. (d) Summer temperature had a positive effect on female mandible length, but no effect on body mass. However, winter temperature had no effect on either the mandible or body mass. (e) Foxes in the eastern sector had shorter mandibles and were of lighter mass than those in the western sector. We suggest that climate conditions during the growth period of the young affected their final size both directly, by influencing energy metabolism for maintenance, but mainly through their effects on food availability. As far as we are aware, this is the first report that the SPG has an effect on vertebrates, let alone terrestrial ones.
Localization of Hsp60 and Grp78 in the human testis, epididymis and mature spermatozoa
Authors: Lachance Catherine , Fortier Marlène , Thimon Véronique , Sullivan Robert , Bailey Janice L. , Leclerc Pierre
Published: January 2009

Molecular chaperones of the heat shock proteins (HSP) family are important in numerous cellular processes. In this study, the expression of Hsp60 and Grp78 proteins was investigated in the male reproductive tract. The cellular distribution of Hsp60 and Grp78 proteins was analysed in the human testis and epididymis by immunohistochemical approaches. DNA microarray technology was used to analyse HSP60 and GRP78 gene expression along human epididymis. The cellular localization of these chaperone proteins in ejaculated spermatozoa was investigated by indirect immunofluorescence and by Western blot following sperm sub‐cellular fractionation. In the human testis, Hsp60 was detected in spermatogonia, whereas a strong Grp78 staining was observed in spermatocytes and round spermatids. Grp78 protein was also observed in the epididymal epithelium, whereas no Hsp60 staining was observed in this organ by immunohistochemistry. The presence of both Hsp60 and Grp78 RNA in human epididymis was confirmed by microarrays. In ejaculated spermatozoa, Hsp60 was localized in the mid‐piece, whereas Grp78 was detected in the neck region. These results indicate that in addition to being expressed in human testis spermatogenic cells, both Hsp60 and Grp78 proteins persist in ejaculated spermatozoa. These findings are in agreement with the involvement of Hsp60 and Grp78 during spermatogenesis and in sperm functions such as fertilization.
Out of the Palaeotropics? Historical biogeography and diversification of the cosmopolitan ectomycorrhizal mushroom family Inocybaceae
Authors: Matheny P. Brandon , Aime M. Catherine , Bougher Neale L. , Buyck Bart , Desjardin Dennis E. , Horak Egon , Kropp Bradley R. , Lodge D. Jean , Soytong Kasem , Trappe James M. , Hibbett David S.
Published: January 2009

Aim  The ectomycorrhizal (ECM) mushroom family Inocybaceae is widespread in north temperate regions, but more than 150 species are encountered in the tropics and the Southern Hemisphere. The relative roles of recent and ancient biogeographical processes, relationships with plant hosts, and the timing of divergences that have shaped the current geographic distribution of the family are investigated.

Location  Africa, Australia, Neotropics, New Zealand, north temperate zone, Palaeotropics, Southeast Asia, South America, south temperate zone.

Methods  We reconstruct a phylogeny of the Inocybaceae with a geological timeline using a relaxed molecular clock. Divergence dates of lineages are estimated statistically to test vicariance‐based hypotheses concerning relatedness of disjunct ECM taxa. A series of internal maximum time constraints is used to evaluate two different calibrations. Ancestral state reconstruction is used to infer ancestral areas and ancestral plant partners of the family.

Results  The Palaeotropics are unique in containing representatives of all major clades of Inocybaceae. Six of the seven major clades diversified initially during the Cretaceous, with subsequent radiations probably during the early Palaeogene. Vicariance patterns cannot be rejected that involve area relationships for Africa–Australia, Africa–India and southern South America–Australia. Northern and southern South America, Australia and New Zealand are primarily the recipients of immigrant taxa during the Palaeogene or later. Angiosperms were the earliest hosts of Inocybaceae. Transitions to conifers probably occurred no earlier than 65 Ma.

Main conclusions  The Inocybaceae initially diversified no later than the Cretaceous in Palaeotropical settings, in association with angiosperms. Diversification within major clades of the family accelerated during the Palaeogene in north and south temperate regions, whereas several relictual lineages persisted in the tropics. Both vicariance and dispersal patterns are detected. Species from Neotropical and south temperate regions are largely derived from immigrant ancestors from north temperate or Palaeotropical regions. Transitions to conifer hosts occurred later, probably during the Palaeogene.
Psychometric evaluation of Chinese version of Violence Scale for objective rating among inpatients with schizophrenia
Authors: Chen Shing‐Chia , Hwu Hai‐Gwo
Published: January 2009

Aim.  The psychometric properties of the Chinese version of Violence Scale in clinical service setting were examined.

Background.  Psychiatric inpatient’s aggressive act is a significant clinical issue in psychiatric service. A useful objective rating scale for prospective study and clinical application was mandatory.

Design.  A prospective panel study.

Methods.  The Chinese version of Violence Scale developed from Morrison’s Violence Scale. Sampled patients (n = 107) with schizophrenia spectrum, fulfilling the DSM‐IV criteria, were recruited consecutively in a psychiatric acute ward of a university hospital over a period of one‐year. The patients’ counts of the aggressive acts measured by the Chinese version of Violence Scale occurred in the past one‐month prior to admission and in the prospective initial‐week after admission were collected during their hospitalisation. The prospective occurrence was observed daily and summed at a fixed weekly point. The internal consistency, content validity and predictive validity of the Chinese version of Violence Scale were examined. Also, a confirmatory factors analysis by LISREL was conducted to examine its measurement structure.

Results.  The Chinese version of Violence Scale follows a Poisson distribution of a fair quality (Cronbach’s α = 0·67). The Chinese version of Violence Scale with panel’s content validity has good predictive validity (r = 0·51, p < 0·001). Those correlated to one latent variable with six items, which constructs a core meaning of ‘threatening aggression toward others’.

Conclusions.  This panel study provides evidence for fair reliability and satisfactory validity of the Chinese version of Violence Scale. Internal consistency of the Chinese version of Violence Scale is limited and it may be because of the time‐varying characteristic and hierarchical pattern of the behaviour items. To further investigate the count scale of the Chinese version of Violence Scale follows a Poisson distribution, the over‐dispersion and weighting issues of aggressive acts were suggested to approach.

Relevance to clinical practice.  This study highlights the measurement issues and implications of the Chinese version of Violence Scale for objectively rating psychiatric patients’ aggressive acts to further develop fitted nursing care and prevention program.
An AFLP clock for the absolute dating of shallow‐time evolutionary history based on the intraspecific divergence of southwestern European alpine plant species
Authors: KROPF MATTHIAS , COMES HANS PETER , KADEREIT JOACHIM W.
Published: January 2009

The dating of recent events in the history of organisms needs divergence rates based on molecular fingerprint markers. Here, we used amplified fragment length polymorphisms (AFLPs) of three distantly related alpine plant species co‐occurring in the Spanish Sierra Nevada, the Pyrenees and the southwestern Alps/Massif Central to establish divergence rates. Within each of these species (Gentiana alpina, Kernera saxatilis and Silene rupestris), we found that the degree of AFLP divergence (DN72) between mountain phylogroups was significantly correlated with their time of divergence (as inferred from palaeoclimatic/palynological data), indicating constant AFLP divergence rates. As these rates did not differ significantly among species, a regression analysis based on the pooled data was utilized to generate a general AFLP rate. The application of this latter rate to AFLP data from other herbaceous plant species (Minuartia biflora: Schönswetter et al. 2006; Nigella degenii: Comes et al. 2008) resulted in a plausible timing of the recolonization of the Svalbard Islands and the separation of populations from the Alps and Scandinavia (Minuartia), and of island population separation in the Aegean Archipelago (Nigella). Furthermore, the AFLP mutation rate obtained in our study is of the same magnitude as AFLP mutation rates published previously. The temporal limits of our AFLP rate, which is based on intraspecific vicariance events at shallow (i.e. late glacial/Early Holocene) time scales, remains to be tested.
Global‐scale analyses of chemical ecology and population genetics in the invasive Argentine ant
Authors: BRANDT M. , VAN WILGENBURG E. , TSUTSUI N. D.
Published: January 2009

Ants are some of the most abundant and ecologically successful terrestrial organisms, and invasive ants rank among the most damaging invasive species. The Argentine ant is a particularly well‐studied invader, in part because of the extreme social structure of introduced populations, known as unicoloniality. Unicolonial ants form geographically vast supercolonies, within which territorial behaviour and intraspecific aggression are absent. Because the extreme social structure of introduced populations arises from the widespread acceptance of conspecifics, understanding how this colonymate recognition occurs is key to explaining their success as invaders. Here, we present analyses of Argentine ant recognition cues (cuticular hydrocarbons) and population genetic characteristics from 25 sites across four continents and the Hawaiian Islands. By examining both hydrocarbon profiles and microsatellite genotypes in the same individual ants, we show that native and introduced populations differ in several respects. Both individual workers and groups of nestmates in the introduced range possess less diverse chemical profiles than ants in the native range. As previous studies have reported, we also find that introduced populations possess much lower levels of genetic diversity than populations in the native range. Interestingly, the largest supercolonies on several continents are strikingly similar to each other, suggesting that they arose from a shared introduction pathway. This high similarity suggests that these geographically far‐flung ants may still recognize and accept each other as colonymates, thus representing distant nodes of a single, widely distributed supercolony. These findings shed light on the behaviour and sociality of these unicolonial invaders, and pose new questions about the history and origins of introduced populations.
Pathogenetical significance of porencephalic lesions associated with intracerebral inoculation of sheep with the bovine spongiform encephalopathy (BSE) agent
Authors: Sisó S. , Jeffrey M. , Martin S. , Houston F. , Hunter N. , González L.
Published: January 2009

Decreased rates of transmission of transmissible spongiform encephalopathies (TSEs) to sheep have been attributed to some polymorphisms of the prion protein (PrP) and to a ‘species barrier’ on interspecies experiments. In addition, the blood–brain barrier may be a further impediment to TSE neuroinvasion. The intracerebral (I/C) route is generally considered the most efficient for TSE transmission, as it may help to bypass those factors. Therefore, susceptibility of particular species to specific TSE agents is conducted by this route. Aims: This study characterizes the traumatic brain lesions associated with the I/C injection of the bovine spongiform encephalopathy agent in sheep, assesses the relevance of such lesions in the outcome of clinical disease and provides insight into the mechanisms of PrPd conversion and amplification following I/C challenge. Methods: A total of 27 hemibrains have been macroscopically and immunohistochemically examined to investigate the presence of lesions compatible with the needle track and the PrPd distribution, respectively. Results: No residual inoculum was found and the extension and severity of the traumatic brain lesions were unrelated to the clinical outcome. Sheep with PrPd accumulation in the brain also showed conspicuous focal aggregates in the porencephalic lesions and in the circumventricular organs. In contrast, sheep without PrPd deposits in the brain were also negative in the traumatic lesions. Conclusion: Overall, these findings suggest that the efficiency of the I/C route is due to effective absorption and blood recirculation of infection, rather than to primary amplification at the site of injection.
Satellite cell dysfunction contributes to the progressive muscle atrophy in myotonic dystrophy type 1
Authors: Thornell L.‐E. , Lindstöm M. , Renault V. , Klein A. , Mouly V. , Ansved T. , Butler‐Browne G. , Furling D.
Published: January 2009

Aims: Myotonic dystrophy type 1 (DM1), one of the most common forms of inherited neuromuscular disorders in the adult, is characterized by progressive muscle weakness and wasting leading to distal muscle atrophy whereas proximal muscles of the same patients are spared during the early phase of the disease. In this report, the role of satellite cell dysfunction in the progressive muscular atrophy has been investigated. Methods: Biopsies were obtained from distal and proximal muscles of the same DM1 patients. Histological and immunohistological analyses were carried out and the past regenerative history of the muscle was evaluated. Satellite cell number was quantified in vivo and proliferative capacity was determined in vitro.Results: The size of the CTG expansion was positively correlated with the severity of the symptoms and the degree of muscle histopathology. Marked atrophy associated with typical DM1 features was observed in distal muscles of severely affected patients whereas proximal muscles were relatively spared. The number of satellite cells was significantly increased (twofold) in the distal muscles whereas very little regeneration was observed as confirmed by telomere analyses and developmental MyHC staining (0.3–3%). The satellite cells isolated from the DM1 distal muscles had a reduced proliferative capacity (36%) and stopped growing prematurely with telomeres longer than control cells (8.4 vs. 7.1 kb), indicating that the behaviour of these precursor cells was modified. Conclusions: Our results indicate that alterations in the basic functions of the satellite cells progressively impair the muscle mass maintenance and/or regeneration resulting in gradual muscular atrophy.
Noncoding RNAs in mental retardation
Authors: Szulwach KE , Jin P , Alisch RS
Published: January 2009

Recent genome‐wide interrogations of transcribed RNA have yielded compelling evidence for pervasive and complex transcription throughout a large majority of the human genome. Tens of thousands of noncoding RNA transcripts have been identified, most of which have yet to be functionally characterized. Along with the revelation that noncoding RNAs in the human genome are surprisingly abundant, there has been a surge in molecular and genetic data showing important and diverse regulatory roles for noncoding RNA. In this report, we summarize the potential roles that noncoding RNAs may play in the molecular pathogenesis of different mental retardation disorders. We suspect that these findings are just the tip of the iceberg, with noncoding RNAs possibly being involved in disease pathogenesis at different levels and through multiple distinct mechanisms.
NMR Techniques Coupled with Multivariate Statistical Analysis: Tools to Analyse Oryza sativa Metabolic Content under Stress Conditions
Authors: Fumagalli E. , Baldoni E. , Abbruscato P. , Piffanelli P. , Genga A. , Lamanna R. , Consonni R.
Published: January 2009

Rice (Oryza sativa L.) is one of the most important crops in the world and its growth is influenced by several environmental stresses, such as drought and high salinity. In our study, we first investigated the metabolic profile in shoots and roots of two rice cultivars (Arborio and Nipponbare) through 1H‐high‐resolution magic angle spinning (HR MAS) and liquid‐state nuclear magnetic resonance (NMR) experiments. Drought and salt stress experiments on shoot and root growth showed Arborio seedlings to be more sensitive than those of Nipponbare to these abiotic stresses. Moreover, the metabolic content of the same samples was analysed by liquid‐state NMR coupled with multivariate statistical analysis. Principal component analysis highlighted a significant accumulation of amino acids and sugars in shoots and roots under stress conditions and the existence of clear differences between the two analysed rice cultivars. In particular, Arborio seedlings accumulated a higher concentration of amino acids and sugars than Nipponbare seedlings. Furthermore, we also obtained preliminary data about metabolic changes in rice following infection with the fungus Magnaporthe grisea. This study proves that NMR technique coupled with multivariate statistical analysis is a powerful tool to assess a possible correlation between differences in metabolic profile and in tolerance/sensitivity phenotype in rice cultivars.
Innovative rural and remote primary health care models: What do we know and what are the research priorities?
Authors: Wakerman John
Published: January 2009

This paper examines the literature pertaining to ‘innovative’ primary health care models in rural and remote areas in order to identify areas where knowledge is lacking and describes future research priorities. Although a number of reviews have identified successful primary health care models and synthesised principles that help to understand why they are successful, there is generally a dearth of rigorously collected information regarding rural and remote health service delivery. The evidence base that supports the superiority of any one model or models in a given context is thin because of the lack of systematic, policy‐informing evaluation of primary care innovations. The paper identifies the need for more rigorous health services evaluation information, including examination of optimal financing systems, the optimal range and mix of providers, and supports for team practice, appropriate community participation mechanisms, improved health information systems and relevant performance indicators.
Multidisciplinary management of complex care
Authors: Schofield Deborah , Fuller Jeffrey , Wagner Scott , Friis Leanne , Tyrell Bill
Published: January 2009

Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.
Rural–urban disparities in health: How does Canada fare and how does Canada compare with Australia?
Authors: Pong Raymond W. , DesMeules Marie , Lagacé Claudia
Published: January 2009

Objective:  To analyse rural–urban and intra‐rural disparities in health status in Canada and to compare Canada with Australia with respect to such disparities.

Design:  Four indicators were used to show rural–urban and intra‐rural differences in health status: (i) mortality due to circulatory diseases, (ii) mortality due to cancer, (iii) injury‐related mortality; and (iv) all‐cause mortality. Rural was disaggregated into finer categories based on degree of remoteness, using the Metropolitan Influence Zone classification in Canada and the Accessibility/Remoteness Index of Australia. Comparisons were made using age‐standardised mortality rates and standardised mortality ratios.

Participants:  Rural and urban populations of Canada and Australia.

Results:  The study confirmed previous findings that rural Canadians tended to have poorer health status than their urban counterparts. However, when rural was disaggregated into finer categories, different health status patterns emerged. Although the most rural areas tended to have the worst health status, the least rural areas generally enjoyed good health. The Canada–Australia comparisons revealed convergence and divergence.

Conclusions:  The similarities between Canada and Australia show that rural–urban disparities in health status are not limited to a particular country. For several causes of death, whereas the mortality risks in Rural 1 areas in Canada are significantly lower than in urban areas, the opposite is true in Australia, suggesting that although there are some common patterns across the two countries in relation to rural–urban health status disparities, nation‐specific uniqueness is to be expected.
High prevalence of vitamin D deficiency in north Indian adults is exacerbated in those with chronic kidney disease
Authors: JABBAR ZULFIKAR , AGGARWAL PARDEEP K , CHANDEL NIRUPAMA , KOHLI HARBIR S , GUPTA KRISHAN L , SAKHUJA VINAY , JHA VIVEKANAND
Published: January 2009

Aim:  Vitamin D is being increasingly recognized as an important player in disease. Hypovitaminosis D is widespread in chronic kidney disease (CKD) populations around the world. The vitamin D status of Indian CKD patients is not known.

Methods:  Levels of 25(OH) vitamin D and parathyroid hormone (PTH) were measured in adult north Indian male patients with newly diagnosed stage IV–V CKD and matched control subjects drawn from the same population. A total of 100 (34 stage IV and 66 stage V) patients with CKD and 72 controls were studied.

Results:  Only 4% control and 1% of CKD subjects had normal (>30 ng/mL) vitamin D levels. Approximately 68% of control and 77% of the CKD population had vitamin D deficiency (<15 ng/ml) whereas the remaining 38% control and 22% CKD patients had insufficient (15–30 ng/mL) vitamin D levels. Levels were lower in CKD subjects compared to their family members, and the CKD patients were significantly more likely to have severe vitamin D deficiency (<5 ng/mL). A strong negative correlation was noted between vitamin D and PTH. No significant correlation was found between vitamin D levels and body mass index, bodyfat percentage, serum albumin or calcium levels.

Conclusion:  Vitamin D deficiency is highly prevalent in north Indians, and this is more pronounced in CKD subjects. There is a significant inverse correlation between the vitamin D and PTH levels. The clinical significance of this deficiency and the potential benefits to be derived from vitamin D supplementation in this population merits further studies.
Clinical outcome of tumor recurrence for Ta, T1 non‐muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999–2001 report from the Japanese Urological Association
Authors: Kikuchi Eiji , Fujimoto Hiroyuki , Mizutani Yoichi , Okajima Eijiro , Koga Hiroshi , Hinotsu Shiro , Shinohara Nobuo , Oya Mototsugu , Miki Tsuneharu ,   the Cancer Registration Committee of the Japanese Urological Association
Published: January 2009

Objective:  To characterize the clinical outcome in a large contemporary series of Japanese patients with newly diagnosed Ta, T1 non‐muscle invasive bladder cancer who underwent transurethral bladder tumor resection with or without intravesical chemotherapy or Bacillus Calmette‐Guérin (BCG) therapy.

Methods:  We developed a database incorporating newly diagnosed non‐muscle invasive bladder cancer data and outcomes from a Japanese bladder cancer registry between 1999 and 2001 and identified a study population of 3237 consecutive patients who had complete data based on pathological features. Median patient age was 69.9 years.

Results:  The 1‐year, 3‐year, and 5‐year overall recurrence‐free survival rates were 77.0%, 61.3%, and 52.8%, respectively. In multivariate analyses, the multiplicity of bladder tumors, tumor size greater than 3 cm, pathological stage T1, tumor grade G3, and the absence of adjuvant intravesical instillation were independent risk factors for tumor recurrence. Overall, 1710 patients (52.8%) received intravesical instillation; chemotherapy in 1314 (76.8%) and BCG treatment in 396 (23.2%). In patients treated with intravesical chemotherapy in which an anthracycline chemo‐agent was used in 90.5% of the cases, multivariate analyses demonstrated that male gender, multiple bladder tumors, a tumor size greater than 3 cm, and pathological stage T1 were associated with tumor recurrence.

Conclusions:  The accumulation and analysis of data from the Japanese National Bladder Cancer Registry made it possible to determine the clinical characteristics, management trends, and survival rates for the period studied. Further study with a dataset created from longer follow‐up data would be warranted to analyze tumor progression and disease survival.
Psychometric validation of the Japanese version of the International Consultation on Incontinence Questionnaire‐Short Form
Authors: Gotoh Momokazu , Homma Yukio , Funahashi Yasuhito , Matsukawa Yoshihisa , Kato Masashi
Published: January 2009

Objective:  To evaluate the psychometric properties of the Japanese version of the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF).

Methods:  Two study samples of 180 patients with urinary incontinence were used for this psychometric evaluation. Analyses were carried out to examine the instrument's reliability and validity, as well as its responsiveness to change.

Results:  For the ICIQ‐SF items and total scores, there was no particular floor or ceiling effect. The internal consistency was sufficiently high, with a Cronbach's alpha coefficient of 0.78. In the analysis of test‐retest reliability, high correlations were observed, with Kappa coefficients of 0.61 for item 1 and 0.62 for item 2, and with intra‐class correlation coefficients of 0.90 for item 3 and 0.91 for the total score. For the concurrent validity, the ICIQ‐SF scores were moderately to highly correlated with most of the King's Health Questionnaire (KHQ) subscales. When the severity groups, divided in quartiles, were compared with respect to the 1‐h pad test and the number of daily incontinence episodes, there seemed to be linear trends in most of the ICIQ‐SF scores. For responsiveness, changes in the ICIQ‐SF after treatment demonstrated statistically significant correlations of more than 0.5 with changes in some of the KHQ subscale scores. All of the ICIQ‐SF items and total scores significantly decreased after treatment.

Conclusions:  The Japanese version of the ICIQ‐SF is a reliable, valid and responsive measure that performs well among patients with urinary incontinence.
Urates in uric acid renal calculi
Authors: Bellanato Juana , Cifuentes José‐Luis Rodríguez‐Miñón , Salvador Esperanza , Medina José‐Antonio
Published: January 2009

Objectives:  To investigate the presence of calcium urate, sodium, potassium and calcium in ‘pure’ uric acid calculi.

Methods:  Ten spontaneously passed uric acid urinary calculi have been examined by stereoscopic microscopy, infrared spectroscopy, scanning electron microscopy and energy dispersive X‐Ray analysis.

Results:  The analysis of selected uric acid calculi revealed the presence of a near‐pure calcium urate in two cases and of calcium enriched urate zones in all of the samples. Furthermore, in some cases complex urates containing sodium, potassium and calcium in different proportions appeared on the surface of the uric acid calculi studied, potassium being generally predominant. Ammonium urate was not detected.

Conclusions:  Most urinary uric acid calculi are not pure in composition. ‘Complex urates’, sodium, potassium and calcium were found together in various proportions in many areas of uric acid stones.
Clinical pathway for tension‐free vaginal mesh procedure: Evaluation in 300 patients with pelvic organ prolapse
Authors: Kato Kumiko , Suzuki Shoji , Yamamoto Shigeki , Furuhashi Kenichi , Suzuki Koichi , Murase Tatsuro , Gotoh Momokazu
Published: January 2009

Objectives:  To evaluate a clinical pathway of discharge on postoperative day 3 for the tension‐free vaginal mesh (TVM) procedure in patients with pelvic organ prolapse (POP).

Methods:  Between May 2006 and December 2007, 305 consecutive women with POP quantification stage 3 or 4 were planned to undergo the TVM procedure in a single general hospital. Excluding five patients with concomitant hysterectomy, a pathway (removal of the indwelling urethral catheter on the next morning, discharge on postoperative day 3) was applied to the remaining 300 patients. The perioperative complications and postoperative hospitalization were prospectively evaluated in this case series.

Results:  Perioperative complications were: bladder injury (11 cases, 3.7%), vaginal wall hematoma (two cases, 0.7%), rectal injury (one case, 0.3%) and temporary hydronephrosis (one case, 0.3%). None needed blood transfusion. The indwelling urethral catheters were removed on the next morning as in the pathway in 287 cases (95.6%), and none required clean intermittent catheterization at home. Postoperative hospitalization was within 3 days in 280 cases (93.3%). The six cases (2.0%) with longer hospitalization were due to complications (two cases of bladder injury, one of rectal injury, one of blood loss over 200 mL, one of temporary urinary retention, and one of hydronephrosis). Two patients were re‐hospitalized within one month due to vaginal bleeding or gluteal pain.

Conclusions:  Patients generally accepted the pathway of discharge on postoperative day 3 in spite of the Japanese culture preferring a longer hospital stay.
Pigment dispersion syndrome and pigmentary glaucoma – a major review
Authors: Niyadurupola Nuwan , Broadway David C
Published: January 2009

Abstract

Pigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans‐illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.
Graph models of habitat mosaics
Authors: Urban Dean L. , Minor Emily S. , Treml Eric A. , Schick Robert S.
Published: January 2009

Graph theory is a body of mathematics dealing with problems of connectivity, flow, and routing in networks ranging from social groups to computer networks. Recently, network applications have erupted in many fields, and graph models are now being applied in landscape ecology and conservation biology, particularly for applications couched in metapopulation theory. In these applications, graph nodes represent habitat patches or local populations and links indicate functional connections among populations (i.e. via dispersal). Graphs are models of more complicated real systems, and so it is appropriate to review these applications from the perspective of modelling in general. Here we review recent applications of network theory to habitat patches in landscape mosaics. We consider (1) the conceptual model underlying these applications; (2) formalization and implementation of the graph model; (3) model parameterization; (4) model testing, insights, and predictions available through graph analyses; and (5) potential implications for conservation biology and related applications. In general, and for a variety of ecological systems, we find the graph model a remarkably robust framework for applications concerned with habitat connectivity. We close with suggestions for further work on the parameterization and validation of graph models, and point to some promising analytic insights.
Visualization of Pseudomonas genomic structure by abundant 8–14mer oligonucleotides
Authors: Davenport Colin F. , Wiehlmann Lutz , Reva Oleg N. , Tümmler Burkhard
Published: January 2009

Under‐ and over‐represented mono‐ to hexanucleotides are signatures of bacterial genomes, but the compositional biases of octa‐ to tetradecanucleotides have not yet been explored. Thirteen completely sequenced genomes of the Pseudomonas genus were searched for highly overrepresented 8–14mers. Between 59–989 overrepresented 8–14mers were found to exceed the applied threshold value. All genomic data sets of the 13 strains showed a consistent pattern, with individual oligomers clustering in either non‐coding or coding regions. Non‐coding oligonucleotides were typically part of longer repeats. Coding oligonucleotides were evenly distributed in the core genome, preferred one reading frame and matched with the local tetranucleotide usage patterns. Genomic islands were recognized by the depletion of overrepresented oligonucleotides. Several mainly coding 8–14mers occurred in genomes on average every 10 000 bp or less. Such frequently occurring 8–14mers could become useful markers for species identification. In the future of next‐generation ultra‐high throughput DNA sequencing, the composition of bacterial metagenomes may be quantified by scanning the primary sequence reads for these 8–14mer markers.
Deciphering the products of evolution at the species level: the need for an integrative taxonomy
Authors: Padial José M. , Castroviejo‐Fisher Santiago , Köhler Jörn , Vilà Carles , Chaparro Juan C. , De la Riva Ignacio
Published: January 2009

Progress in molecular techniques together with the incorporation of phylogenetic analyses of DNA into taxonomy have caused an increase in the number of species’ discoveries in groups with morphological characters that are difficult to study or in those containing polytypic species. But some emerged criticisms plead for a taxonomic conservatism grounded either on the requirement of providing evidences of morphological distinctiveness or reproductive barriers to erect new species names. In a case study of taxonomic research on Neotropical frogs, we combine several lines of evidence (morphological characters, prezygotic reproductive isolation and phylogenetic analyses of mitochondrial DNA) to test the status of 15 nominal species and to assess the degree of agreement of the different lines of evidence. Our study reveals that morphology alone is not sufficient to uncover all species, as there is no other single line of evidence independently. Full congruence between lines of evidence is restricted to only four out of the 15 species. Five species show congruence of two lines of evidence, whereas the remaining six are supported by only one. The use of divergence in morphological characters seems to be the most conservative approach to delineate species boundaries because it does not allow the identification of some sibling reciprocally monophyletic species differing in their advertisement calls. The separate analysis of differences in advertisement calls (evidence of reproductive isolation) or of phylogenetic data alone also shows limitations, because they do not support some morphological species. Our study shows that only an integrative approach combining all sources of evidence provides the necessary feedback to evaluate the taxonomic status of existing species and to detect putative new ones. Furthermore, the application of integrative taxonomy enables the identification of hypotheses about the existence of species that will probably be rejected or changed, and those that can be expected to persist.
A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trial
Authors: Porpiglia Francesco , Fiori Cristian , Ghignone Gianpaolo , Vaccino Davide , Billia Michele , Morra Ivano , Ragni Francesca , Scarpa Roberto M.
Published: January 2009

OBJECTIVE

To evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET).

PATIENTS AND METHODS

We evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10‐day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety‐one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days. Group A (46 patients) received a further cycle of tamsulosin (0.4 mg daily), and group B (45) did not. Age, gender, stone size, time to expulsion, number of acute episodes of colic during treatment and analgesic consumption were recorded. Patients who were not stone‐free after the study period had ureteroscopy. The results were compared statistically using Student’s t‐, chi‐square test and Fisher’s exact test.

RESULTS

The groups were comparable inage, gender and stone size (5.93 mm for group A and 6.03 mm for group B). The expulsion rate was significantly higher in group A (80%) than in group B (49%) (P < 0.01), whilst there were no differences between the groups in the number of colic episodes and analgesic use. There were no reported side‐effects of medical therapy.

CONCLUSIONS

A second cycle of 10 days of MET with tamsulosin in nonresponders to a 10‐day first cycle of MET with tamsulosin and deflazacort is safe and effective, and therefore should be considered as an option in the management of uncomplicated distal ureteric stones.