bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrasting effects of glucose, living roots and maize straw on microbial growth kinetics and substrate availability in soil
Authors: Blagodatskaya E. V. , Blagodatsky S. A. , Anderson T.‐H. , Kuzyakov Y.
Published: February 2009

The most modern molecular approaches fail to link structure of soil microbial community with its functions. We used classical physiological approaches based on (i) microbial growth kinetics and (ii) microbial affinity to the substrate to show the shift in functional properties of the soil microbial community after amendments with substrates of contrasting availability. Kinetic parameters of substrate‐induced respiration and substrate availability in soil were monitored during the growth of maize, and decomposition of glucose or maize straw. Input of small amounts of easily available substrates (i.e. glucose or root exudates) significantly increased the specific growth rates of soil microorganisms by up to 13 and 20%, respectively. This increase, showing the shift from K to r strategies, was confirmed by a 50% decrease in the affinity of microorganisms to the easily available substrates. In contrast, maize straw lowered specific growth rates by 16–30% and increased the affinity of microorganisms to the substrate by 23–131% compared with untreated soil. After maize straw addition, the shift of the microbial community to K strategy was accompanied by an increase in the fraction of microbial biomass responding to glucose addition by immediate growth. The generation time of this fraction was 1.8 to 2.8 hours, which was 100 to 1000 times faster than that of the whole microbial community. Easily available carbon (C) in soil amended with maize straw comprised only half of that extracted by 0.05 m K2SO4. Therefore, we conclude that C extracted by 0.05 m K2SO4 from the soil with maize straw residues had a lower availability for microorganisms as compared with glucose. Adding N to the soil prolonged the intensive mineralization period of plant residues, decreased specific microbial growth rates and increased the amount of easily available C in the soil. This indicates a more efficient use of maize residues by K‐selected microorganisms after the removal of N limitation. Combination of two complementary physiological approaches based on microbial growth kinetics and substrate affinity showed contrasting effects of easily and less available substrates on the shift of growth strategies (r vs. K) of the whole microbial community. These approaches are also suitable for estimation of microbial availability of indigenous C in the soil.
Critical reflection in planning information systems: a contribution from critical systems thinking
Authors: Córdoba José‐Rodrigo
Published: February 2009

This paper presents a methodological framework to support the process of information systems (IS) planning in organizations. It draws on the ideas of critical systems thinking (CST), a research perspective that encourages the analysis of stakeholders’ understandings prior to the selection and implementation of planning methods. The framework emphasizes continuous identification of concerns from stakeholders, and facilitates critical reflection in the exploration of possibilities for improvement. Some of these possibilities might require the support of IS and communication technologies. To define the framework, two systems theories are used: boundary critique and autopoiesis. The first one enables critical reflection on values and assumptions about potential situations or marginalization. The second one fosters continuous dialogue, listening and mutual collaboration between participants. With these theories, the framework enables people to reflect on issues of inclusion, exclusion and marginalization, and to participate in the design of plans for improvement. Ultimately, the definition of this framework suggests the importance of critical reflection about ethics to improve the practice of IS planning.
Struggling with an unfamiliar and unreliable body: the experience of irritable bowel syndrome
Authors: Håkanson Cecilia , Sahlberg‐Blom Eva , Nyhlin Henry , Ternestedt Britt‐Marie
Published: February 2009

Aim.  To describe the phenomenon living with irritable bowel syndrome from a life‐world perspective.

Background.  Ten to twenty per cent of the adult population in the world is known to live with irritable bowel syndrome. The life‐world experience of people with irritable bowel syndrome has been paid little attention. A deeper understanding about the phenomenon living with irritable bowel syndrome is of interest for the future development of care.

Design and methods.  The study was performed using a phenomenological method. Data was collected by in‐depth, open interviews performed in 2006, with nine persons between 25–55 years, diagnosed with irritable bowel syndrome. The interviews were analysed according to the method of Giorgi.

Results.  Six interrelated key constituents have been identified: Having an altered self‐image, feeling ashamed, distrusting the body, feeling tired, blaming oneself, and finding solutions. A structure has been formulated, describing that living with irritable bowel syndrome means struggling with an unfamiliar and unreliable body. Tiredness, distrust, and feelings of shame towards the body bring about limitations in everyday life. At the same time, living with irritable bowel syndrome means having a strong will to exceed the limitations and become familiar with one self.

Conclusion.  This study suggests that living with irritable bowel syndrome means to struggle with an unfamiliar and unreliable body that brings about changes of self‐image and limitations in every day life. Feelings of distrust, shame and embarrassment towards troublesome symptoms, are important contributions to the limitations experienced.

Relevance to clinical practice.  Nurses have a major role to play in the care for people with irritable bowel syndrome. A caring perspective, in which the life‐world is central, is an important approach to care for these persons. Using the dialogue as a forum where patients can share their unique life‐world experiences lets nurses gather knowledge that is essential in helping patients identify and acknowledge new and positive understandings of the lived body.
Determining patient activity levels in chronic kidney disease
Authors: Bonner Ann , Wellard Sally , Caltabiano Marie
Published: February 2009

Aim. This study used the human activity profile to investigate the levels of activity in people with chronic kidney disease in far North Queensland, Australia.

Background. People with chronic kidney disease experience reduced levels of fitness and a reduced capacity to engage in regular activity because of a number of illness related factors. Consequently there is an impact on the ability to perform routine activities of daily life. Increasingly the promotion of activity is viewed as an integral component of rehabilitation programs in renal units.

Design and methods. A descriptive cross sectional design was used to assess differences in current levels of activity for groups of persons with chronic kidney disease who differed in their renal history and type of renal therapy. Both descriptive data (such as activity levels and breathlessness) as measured by a researcher‐administered questionnaire and biochemistry data were collected on 112 people with chronic kidney disease. The study was conducted in 2006.

Results. Participants in this study were less active than the general population with women, older or indigenous patients significantly less active. Participants with diabetic nephropathy were significantly the least active. A significant difference between mean activity scores was found for type of renal replacement therapy, with participants receiving haemodialysis being the least active. Additionally, lower levels of albumin were significantly correlated with fewer activities.

Conclusion. The human activity profile is a useful indicator of the broad range of physical activities undertaken by people with chronic kidney disease, and that there is a reduced ability to undertake ordinary everyday activities. The broad scope of the human activity profile may make it a valuable assessment tool.

Relevance to clinical practice. It is particularly important for nurses to understand the impact of chronic illness on the ability to undertake basic activities of daily life, and the necessity to introduce routine assessment of everyday activities for all renal patients is warranted.
The meaning of living with chronic obstructive pulmonary disease
Authors: Clancy Karen , Hallet Christine , Caress Ann
Published: February 2009

Aim.  To explore the existential experiences of 10 patients with chronic obstructive pulmonary disease (COPD) who had been prescribed long‐term oxygen therapy (LTOT) and their carers.

Background.  Chronic obstructive pulmonary disease is a progressive and debilitating condition, with an insidious onset often diagnosed in the middle to later years of life, after a history of worsening breathlessness (Herbert & Gregor 1997). It is a life limiting condition that is on the increase worldwide. Evidence suggests that for some people with COPD oxygen therapy can improve longevity and quality of life (MRC 1981, NOTT 1980). Understanding of the existential meaning of COPD for people is required.

Method.  This longitudinal Heideggerian study was carried out between 2005–2006. Participants were interviewed separately, in their own homes, at the start of LTOT, second 3 months later and finally at 9 months.

Results.  Themes of living with COPD emerged from the data; struggling, fear, experience of ill health, blame, fatalism and hidden disability.

Conclusion.  The participants all shared very negative experiences regarding the changes that living with COPD had placed on their lifestyle and quality of life. The introduction of oxygen appeared, for all but one couple, to increase the negative impact of living with poor health.

Relevance to clinical practice.  The participants’ experiences in this study highlight the need for health professionals to explore with people what it is like living with a long‐term condition. This sharing of experiences may help individuals to make informed choices about treatment and readdress their perception of ‘just existing’ with ‘no quality to their lives’ thereby enabling people and carers to adjust to living with a life‐limiting condition like COPD and the introduction of life long‐term therapeutic interventions.
The triumph of hope over experience: using peoples’ experiences to inform leg ulcer care through participatory action research
Authors: Petersson Pia , Springett Jane , Blomqvist Kerstin
Published: February 2009

Aim.  To explore how people experienced leg ulcer care so as to inform practitioners about the patients’ view as a vehicle for a changed leg ulcer care practice.

Background.  Great numbers of people suffer from chronic leg ulcers and many have to live with their illness for a long time. Even when the illness is controlled by medical treatment, the person with leg ulcers has to deal with physical, emotional, cognitive and social problems and long‐term encounters with practitioners.

Method.  A Participatory Action Research approach was used. Nine older persons with chronic leg ulcers, treated in primary care, were asked about their experiences of the care. Content analysis and reflective dialogues with practitioners and persons with chronic leg ulcers was performed. The study was undertaken from autumn 2004 to spring 2005.

Result.  Although the persons with chronic leg ulcers experienced their encounters with practitioners as satisfying, findings illuminated low participation in their own care and low practitioner involvement in issues about their daily living with chronic illness. In addition, the participatory action research project did not proceed from problem identification towards development and change.

Conclusion.  Participation is about negotiation and transferring power and authority from practitioners towards patients and from researchers towards practitioners and patients. Undertaking a participatory action research project that brings sustainable change requires substantial work to involve practitioners in initiating and planning the research.

Relevance to clinical practice.  Participation requires true partnership. To reach participation between researchers, practitioners and patients would need a significant change in attitude of all parties as well as a change in the care culture. Changing attitudes is not enough as long as practitioners and patients are stuck in a hierarchical structure with predetermined and taken for granted roles and relations in the medical culture.
Evaluation of a multidisciplinary patient education program for people with systemic lupus erythematosus
Authors: Miljeteig Kari , Graue Marit
Published: February 2009

Aim.  To evaluate an educational program for people with systemic lupus erythematosus using an action research approach.

Background.  People with systemic lupus erythematosus can benefit from attending patient education programs that address their psychosocial needs. Although patient education has always been a feature of practice, educational programs have not always included patients’ input into the design. Involving patients in all stages of a project is a challenge for both professionals and patients.

Methods.  One participatory action research cycle was used to explore peoples’ learning needs and views on form and content of the program and to explore teaching and learning competence in the multidisciplinary team. The decision on how to develop the educational program was based on focus group interviews and field notes. The educational program was implemented in 2001 with two groups of patients (n = 13) and outcomes of action evaluated at an individual level using quality of life, pain, fatigue and physical well‐being instruments pre and post implementation.

Results.  The adoption of new roles was a challenge for both patients and members of the multidisciplinary team. Training to combine counselling with interactive teaching and learning methods was wanted by professionals. Patients said safe environments which facilitate learning experiences and communication with professionals are essential.

Conclusion.  Clinical competence combined with patient knowledge and experiences were used to develop a patient centred educational program and to plan further action. Collaboration in the multidisciplinary team and with patients should be considered in both the planning and implementation of patient education programs.

Relevance to clinical practice.  The potential for patients to collaborate in designing programs for improved self‐care management is tremendous. The information gained from this study can be used to inform educational program planning for systemic lupus erythematosus patients and future collaboration in the multidisciplinary team.
A 750 bp sensory integration region directs global control of the Escherichia coli GadE acid resistance regulator
Authors: Sayed Atef K. , Foster John W.
Published: February 2009

Escherichia coli survives pH 2 environments through an acid resistance (AR) system regulated by the transcriptional activator GadE. Numerous proteins control gadE at an upstream, conserved, 798 bp intergenic region. We show this region produces three transcripts starting at −124 (T1), −324/−317 (T2) and −566 (T3) bp from the gadE start codon. Transcriptional lacZ fusions to gadE promoter regions revealed P1 and P3 were active while P2 alone was not. However, pairing P3 with P2 activated P2 and increased expression 20‐fold above P3 alone. The fusions were transferred to Salmonella, which lacks this AR system, and plasmid‐borne E. coli‐specific regulators EvgA, YdeO, GadE and GadX were introduced. Data revealed that YdeO and GadX activate P3, P2 and P3P2, while GadE autoactivates P1 and represses P3 and P3P2. The developing model indicates that different signals activate YdeO, GadX, or an MnmE‐dependent regulator, which stimulate gadE transcription from the P3 and P2 promoters. Once made, GadE activates P1 and represses P3 and P2. The P1 region also enables efficient downstream transcription and translation of the P3 or P2 transcripts. Evidence indicates the entire 750 bp sensory integration locus is necessary for a versatile response.
Cross‐talk between two global regulators in Streptomyces: PhoP and AfsR interact in the control of afsS, pstS and phoRP transcription
Authors: Santos‐Beneit Fernando , Rodríguez‐García Antonio , Sola‐Landa Alberto , Martín Juan F.
Published: February 2009

The regulatory proteins AfsR and PhoP control expression of the biosynthesis of actinorhodin and undecylprodigiosin in Streptomyces coelicolor. Electrophoretic mobility shift assays showed that PhoPDBD does not bind directly to the actII‐ORF4, redD and atrA promoters, but it binds to the afsS promoter, in a region overlapping with the AfsR operator. DNase I footprinting studies revealed a PhoP protected region of 26 nt (PHO box; two direct repeats of 11 nt) that overlaps with the AfsR binding sequence. Binding experiments indicated a competition between AfsR and PhoP; increasing concentrations of PhoPDBD resulted in the disappearance of the AfsR–DNA complex. Expression studies using the reporter luxAB gene coupled to afsS promoter showed that PhoP downregulates afsS expression probably by a competition with the AfsR activator. Interestingly, AfsR binds to other PhoP‐regulated promoters including those of pstS (a component of the phosphate transport system) and phoRP (encoding the two component system itself). Analysis of the AfsR‐protected sequences in each of these promoters allowed us to distinguish the AfsR binding sequence from the overlapping PHO box. The reciprocal regulation of the phoRP promoter by AfsR and of afsS by PhoP suggests a fine interplay of these regulators on the control of secondary metabolism.
Micro‐arrayed wheat seed and grass pollen allergens for component‐resolved diagnosis
Authors: Constantin C. , Quirce S. , Poorafshar M. , Touraev A. , Niggemann B. , Mari A. , Ebner C. , Akerström H. , Heberle‐Bors E. , Nystrand M. , Valenta R.
Published: February 2009

Background:  Wheat is a potent allergen source and can cause baker’s asthma, food and pollen allergy. The aim of the study was to develop an allergen micro‐array for differential diagnosis of baker’s asthma, wheat‐induced food allergy and grass pollen allergy.

Methods:  We analysed the immunoglobulin‐E reactivity profiles of patients suffering from baker’s asthma, wheat‐induced food allergy and grass pollen allergy to micro‐arrayed recombinant wheat flour allergens and grass pollen allergens and compared these results with clinical results and diagnostic tests based on crude wheat flour, wheat pollen and grass pollen allergen extracts.

Results:  We identified recombinant wheat flour allergens, which are specifically recognized by patients suffering from baker’s asthma, but not from patients with food allergy to wheat or pollen allergy. rPhl p 1 and rPhl p 5 were identified as marker allergens specific for grass pollen allergy. They can be used to replace grass pollen extracts for allergy diagnosis and to identify grass pollen allergic patients among patients suffering from baker’s asthma and wheat‐induced food allergy. Profilin was identified as a cross‐reactive allergen recognized by patients suffering from baker’s asthma, food and pollen allergy.

Conclusions:  Our results indicate that it will be possible to design serological tests based on micro‐arrayed recombinant wheat seed and grass pollen allergens for the discrimination of baker’s asthma, wheat‐induced food allergy and grass pollen allergy.
T cell‐mediated immunoregulation in the gastrointestinal tract
Authors: Saurer L. , Mueller C.
Published: February 2009

In the intestinal tract, only a single layer of epithelial cells separates innate and adaptive immune effector cells from a vast amount of antigens. Here, the immune system faces a considerable challenge in tolerating commensal flora and dietary antigens while preventing the dissemination of potential pathogens. Failure to tightly control immune reactions may result in detrimental inflammation. In this respect, ‘conventional’ regulatory CD4+ T cells, including naturally occurring and adaptive CD4+ CD25+ Foxp3+ T cells, Th3 and Tr1 cells, have recently been the focus of considerable attention. However, regulatory mechanisms in the intestinal mucosa are highly complex, including adaptations of nonhaematopoietic cells and innate immune cells as well as the presence of unconventional T cells with regulatory properties such as resident TCRγδ or TCRαβ CD8+ intraepithelial lymphocytes. This review aims to summarize the currently available knowledge on conventional and unconventional regulatory T cell subsets (Tregs), with special emphasis on clinical data and the potential role or malfunctioning of Tregs in four major human gastrointestinal diseases, i.e. inflammatory bowel diseases, coeliac disease, food allergy and colorectal cancer. We conclude that the clinical data confirms some but not all of the findings derived from experimental animal models.
A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China
Authors: Li J. , Sun B. , Huang Y. , Lin X. , Zhao D. , Tan G. , Wu J. , Zhao H. , Cao L. , Zhong N. ,   China Alliance of Research on Respiratory Allergic Disease (CARRAD)
Published: February 2009

Background:  The prevalence of sensitization in patients with asthma and rhinitis in mainland China remains unclear.

Objective:  Our aim was to estimate the prevalence of allergy in patients with respiratory allergic diseases such as asthma and/or rhinitis attending respiratory clinics within mainland China. The study also investigated regional and annual differences in the prevalence and pattern of sensitization among the patients in China.

Method:  A cross‐sectional survey was performed in 6304 patients suffering from asthma and/or rhinitis in 17 cities from 4 regions of China. Patients completed a standardized questionnaire asking for the presence of respiratory and allergic symptoms. They also underwent skin prick tests with 13 common aeroallergens.

Results:  Among the 6304 patients, 4545 (72.1%) had at least one positive skin prick reaction. The overall prevalence of positive skin prick responses was 59.0% for Dermatophagoides farinae, 57.6% for Dermatophagoides pteronyssinus, 40.7% for Blomia tropicalis, 16.1% for American cockroach, 14.0% for dog, 11.5% for Blatella germanica, 11.3% for Artemisia vulgaris, 10.3% for cat, 6.5% for Ambrosia artemisifolia, 6.3% for mixed mould I, 4.4% for mixed mould IV, 3.5% for mixed grass pollen and 2.2% for mixed tree pollen. Sensitizations to common allergens varied widely between geographical areas and demonstrated unique pattern in patients by stratification with age groups, with asthma and/or rhinitis. Severity of rhinitis and asthma was significantly correlated with skin index of reactivity to Artemisia vulgaris, Ambrosia artemisifolia and to D. pteronyssinus, D. farinae and Blomia tropicalis respectively (P < 0.001). Positive reactivity to the tested allergens and concomitant reactivity to multiple allergens including to house dust mites and Blomia tropicalis was markedly increased in patients with both asthma and rhinitis.

Conclusion:  House dust mites were the most prevalent allergens in patients with asthma and/or rhinitis in China. There were significant differences in patterns of sensitizations in patients from different geographical areas, age groups as well as asthma and/or rhinitis.
Long‐term outcomes of dual kidney transplantation—a single center experience
Authors: Salifu Moro O. , Norin Allen J. , O'Mahony Christine , Sumrani Nabil , Apel Anatoly , Ikram Muhammad , Alam Anis , Hayat Amir , Jindal Rahul M. , Friedman Eli A. , Distant Dale A.
Published: February 2009

Abstract:  The shortage of kidney donors has led to broadening of the acceptance criteria for deceased donor organs beyond the traditional use of young donors. We determined long‐term post‐transplant outcomes in recipients of dual expanded criteria donor kidneys (dECD, n = 44) and compared them to recipients of standard criteria donor kidneys (SCD, n = 194) and single expanded criteria donor kidneys (sECD, n = 62). We retrospectively reviewed these 300 deceased donor kidney transplants without primary non‐function (PNF) or death in the first two wk, at our center from 1996 to 2003. The three groups were similar in baseline characteristics. Kidney allograft survival and patient survival (nine yr) were similar in the three respective donor groups, SCD, sECD and dECD (60% vs. 59% vs. 64% and 82% vs. 73% vs. 73%). Acute rejection in the first three months was 23.2%, 16.1%, and 22.7% in SCD, sECD and dECD, respectively (p = 0.49) and delayed graft function was 25.2%, 31.9% and 17.1% in the three groups, respectively (p = 0.28). When PNF and death within the first two wk was included, there was no significant difference in graft survival between the three groups. In our population, recipients of dECD transplants have acceptable patient and graft survival with kidneys that would have usually been discarded.
Adverse reactions to skin prick testing in children – Prevalence and possible risk factors
Authors: Norrman Gunilla , Fälth‐Magnusson Karin
Published: February 2009

Skin prick test (SPT) is usually considered to be a safe procedure, but recently there have been occasional case reports of generalized allergic reactions. This study was performed to delineate the prevalence of, and evaluate possible risk factors for, adverse reactions to SPT in a prospective study. Altogether 5,908 patients aged ≤18 yr from 11 different pediatric settings were included. The adverse reactions were classified into two groups: (1) Generalized allergic reactions (GAR), (2) Vasovagal reactions (VVR). Adverse reactions were observed in 14 out of 5,908 children examined with SPT. Seven of the adverse reactions were GARs and required medication, yielding a 0.12% risk for GAR. Seven of 14 were VVRs, giving the same risk, 0.12%. Identified risk factors for GAR were low age (<1 yr) (RR 6.28) and active eczema (RR 16.98). For VVR, the risk factors were female sex (RR 7.32) and multiple skin pricks performed on a single patient (p < 0.05). We conclude that GARs do occur, albeit rarely, so the need for proper emergency handling should always be acknowledged. The risk factors suggested may help to identify patients who need extra attention.
Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin
Authors: Palmeira Patricia , Costa‐Carvalho Beatriz T. , Arslanian Christina , Pontes Gerlândia N. , Nagao Aparecida T. , Carneiro‐Sampaio Magda M. S.
Published: February 2009

We studied the levels of immunoglobulins in colostrum, milk and sera from two common variable immunodeficiency (CVID) mothers (M1 and M2), and in sera from their newborn infants. During pregnancy they continued intravenous immunoglobulin therapy (IVIG). Antibody levels from maternal and cord blood collected at delivery and colostrum and milk, collected on the 3rd and 7th post‐partum days, respectively, were analyzed. Although cord/maternal blood ratios of total immunoglobulins and subclasses, as well as specific antibodies differed between M1 and M2, both showed good placental transfer of anti‐protein and anti‐polysaccharide antibodies, despite lower cord/maternal blood ratios in M2. Anti‐Streptococcus pneumoniae antibody avidity indexes were similar between paired maternal and cord serum. Both mothers’ colostrum and milk samples showed only traces of IgA, and IgM and IgG levels in colostrum were within normal range in M1, whereas M2 presented elevated IgG and low IgM levels, when compared with healthy mothers. The study of colostrum and milk activity showed that they strongly inhibited enteropathogenic Escherichia coli adhesion in vitro. CVID patients must be informed about the relevance of regular IVIG administration during pregnancy, not only for their own health but also for their immune immature offspring. Breast‐feeding should be encouraged as colostra from these CVID patients strongly inhibited E. coli adhesion to human epithelial cells thus providing immunological protection plus nutritional and psychological benefits for the infant.
Diversity in the bronchial epithelial cell response to infection with different rhinovirus strains
Authors: WARK Peter A.B. , GRISSELL Terry , DAVIES Bronwyn , SEE Hayley , GIBSON Peter G.
Published: February 2009

Background and objective:  Infection with rhinovirus (RV) is the most common trigger for acute asthma and COPD. The aim of this study was to characterize the variability in the response of primary bronchial epithelial cells to infection with several strains of RV.

Methods:  RV strains, RV‐43, RV‐48 (major group RV), RV‐47 (minor) and EV‐68 (enterovirus), were cultured from subjects with acute asthma and compared with the laboratory RV strains, RV‐16, RV‐14 (major) and RV‐1B (minor). Primary bronchial epithelial cells were obtained from healthy control and asthmatic subjects by endobronchial brushing. Response to infection was assessed by the release of IL‐6, interferon (IFN)‐γ induced protein (IP)‐10 and IFN‐β, as measured by ELISA. Viral replication was assessed by serial titration assays and cell viability by flow cytometry.

Results:  Major group RV strains and EV‐68 all efficiently infected and replicated in epithelial cells causing little cell death. The clinical major group RV strains caused greater release of IL‐6 and IP‐10 compared with laboratory major group RV strains. Infection with minor group RV resulted in greater release of IP‐10, IL‐6 and IFN‐β that was associated with induction of apoptosis and less efficient viral replication. Asthmatic bronchial epithelial cells were less able to respond by releasing IFN‐β following infection with RV‐1B.

Conclusions:  Considerable diversity exists in the response to RV strains, especially between minor and major group RV. The impaired IFN‐β response in asthmatic bronchial epithelial cells may make them particularly susceptible to minor group RV.
Using the posterior pelvic pain provocation test in pregnant Japanese women
Authors: Ando Fukiko , Ohashi Kazutomo
Published: February 2009

This study investigated the usefulness of the posterior pelvic pain provocation (PPPP) test for differentiating between pelvic pain and low back pain because of the different prognoses and treatment strategies. We recruited 263 Japanese women who were > 36 weeks' gestation and 213 were included. The PPPP test was applied to 154 women with self‐reported lumbopelvic pain. The participants were divided into three groups: the PPPP test positive (PPPP+, n = 60) subgroup, PPPP test negative (PPPP−, n = 94) subgroup, and no pain group (n = 59). The disability scores of the PPPP+ subgroup were significantly higher than the scores of the PPPP− subgroup and no pain group. In the PPPP+ subgroup, the intensity of pelvic pain was significantly correlated with the disability scores, but that of low back pain was not. The PPPP test could be carried out by a midwife without side‐effects and could detect pregnant women with impaired ability in daily life due to lumbopelvic pain.
Review of work‐related stress in mainland Chinese nurses
Authors: Zeng Yingchun
Published: February 2009

The aim of this review was to identify the specific work‐related stressors of mainland Chinese nurses and to present the current state of stress research in order to discuss directions for further research. A literature search from January 2000 to June 2007 was conducted among three electronic databases. The specific stressors among Chinese nurses were effort–reward imbalance, the poor image of nursing in the community, and managerial issues. The studies were limited to either descriptive or correlation designs, a variety of stress scales were used to investigate the nurses' work‐related stressors, and there were no published studies reporting stress management interventions for Chinese nurses. This review highlights that further stress research targeted to Chinese nurses needs more prospective and longitudinal studies and has to develop a consistent instrument to measure stressors. The priority issue is the initiation of stress management interventions to improve nurses' coping skills, while the long‐term goal is to reduce the level of stress or eliminate the stressors through individual, organizational, and societal interventions.
Wealth Index association with gender issues and the reproductive health of Egyptian women
Authors: Afifi Mustafa
Published: February 2009

This study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19 474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health‐care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy‐makers to reduce the poverty burden on health.
Retracted: Identifying patient readmission subtypes from unplanned readmissions to hospitals in Hong Kong: A cluster analysis
Authors: Chan Moon‐fai , Wong Frances K. Y. , Chang Katherine , Chow Susan , Chung Loretta , Lee Wai‐man , Lee Rance
Published: February 2009

It has been conjectured with regard to patient readmission patterns that there might be significant differences in patient characteristics, need factors, enabling resources, and health behavior. The aim of this study was to identify the profiles of readmitted patients in Hong Kong (n = 120) based on their predisposing characteristics, needs, health behavior, and enabling resources. All the readmitted patients were recruited to the study in three hospitals from 2003 to 2005. A cluster analysis yielded three clusters: Clusters 1, 2, and 3 constituted 27.5% (n = 33), 27.5% (n = 33), and 45.0% (n = 54) of the total sample, respectively. The study results show that community nurse services do affect the rate at which patients are admitted to hospital for a second time. The findings might help by providing important information that will enable health‐care policy‐makers to identify strategies to target a specific group of patients in the hope of reducing its readmission rate.
Clinical outcome of high‐grade non‐muscle‐invasive bladder cancer: A long‐term single center experience
Authors: Iida Shoichi , Kondo Tsunenori , Kobayashi Hirohito , Hashimoto Yasunobu , Goya Nobuyuki , Tanabe Kazunari
Published: February 2009

Objectives:  To report on the long‐term clinical outcome of high‐grade (G3) non‐muscle‐invasive bladder cancer (NMIBC) patients treated at a single institution.

Methods:  A retrospective analysis of 93 patients with NMIBC treated between January 1991 and September 2005 was performed. Patients were divided into three groups on the basis of treatment they received after transurethral resection (TUR) of the bladder. Forty‐seven patients received adjuvant intravesical epirubicine after TUR of the bladder (Group 1). Twenty‐four patients received intravesical bacillus Calmette–Guérin (BCG) (Group 2). A radical cystectomy (RC) was performed on twenty‐two patients (Group 3).

Results:  Median follow up was 68.7 months. Overall, thirty patients (33%) experienced tumor recurrence. The survival rates of Group 3 were significantly higher than the 71 patients undergoing conservative therapy (Group 1 and 2). There was no statistically significant difference between Group 1 and 2, but treatment failure in patients treated with epirubicine was significantly higher than in those with BCG. Cases without concomitant carcinoma in situ (CIS) showed statistically significantly higher survival rates than those with concomitant CIS.

Conclusions:  RC provides excellent survival rates in patients with high‐grade NMIBC. Adjuvant therapy with BCG after a complete TUR of the bladder may be an effective treatment for high‐grade NMIBC. If a conservative treatment is preferred to RC, co‐existence of a concomitant CIS should be considered with caution.
Lower urinary tract symptoms and their impact on quality of life after successful renal transplantation
Authors: Mitsui Takahiko , Shimoda Naohiko , Morita Ken , Tanaka Hiroshi , Moriya Kimihiko , Nonomura Katsuya
Published: February 2009

Objective:  To investigate lower urinary tract symptoms (LUTS) and their impact on quality of life (QOL) in patients having undergone renal transplantation (RTX).

Methods:  Forty‐three patients (25 males and 18 females; age 20–68 years) undergoing RTX at Hokkaido University Hospital were included in this study. Median follow‐up after RTX was 41 months (range 6–184). Pre‐transplant dialysis had been carried out in 38 patients (median: 4.3 years, range: 1 month–31 years). All patients were assessed by uroflowmetry (UFM), postvoid residual urine volume (PVR), 24 h bladder diary, and International Prostate Symptom Score (IPSS). QOL score and King's Health Questionnaire (KHQ) were used for the assessment of LUTS‐related QOL.

Results:  Mean fluid intake volume and urine output volume for 24 h were 2136 mL (1150–3430 mL) and 2446 mL (1336–4733 mL), respectively. Voiding dysfunction assessed by UFM and PVR was observed in 12 patients (28%) showing higher IPSS. QOL score and overall QOL in KHQ were not different between patients with and without voiding dysfunction. Although 19 (49%) had polyuria, 20 (51%) had nocturnal polyuria, which affected nocturia in IPSS as well as sleep/energy disturbances in KHQ compared with patients without nocturnal polyuria.

Conclusions:  Patients having RTX frequently present voiding dysfunction and nocturia basically caused by nocturnal polyuria. We should focus on LUTS in these patients to provide an appropriate management.
Near real‐time, autonomous detection of marine bacterioplankton on a coastal mooring in Monterey Bay, California, using rRNA‐targeted DNA probes
Authors: Preston Christina M. , Marin Roman , Jensen Scott D. , Feldman Jason , Birch James M. , Massion Eugene I. , DeLong Edward F. , Suzuki Marcelino , Wheeler Kevin , Scholin Christopher A.
Published: February 2009

A sandwich hybridization assay (SHA) was developed to detect 16S rRNAs indicative of phylogenetically distinct groups of marine bacterioplankton in a 96‐well plate format as well as low‐density arrays printed on a membrane support. The arrays were used in a field‐deployable instrument, the Environmental Sample Processor (ESP). The SHA employs a chaotropic buffer for both cell homogenization and hybridization, thus target sequences are captured directly from crude homogenates. Capture probes for seven of nine different bacterioplankton clades examined reacted specifically when challenged with target and non‐target 16S rRNAs derived from in vitro transcribed 16S rRNA genes cloned from natural samples. Detection limits were between 0.10–1.98 and 4.43– 12.54 fmole ml−1 homogenate for the 96‐well plate and array SHA respectively. Arrays printed with five of the bacterioplankton‐specific capture probes were deployed on the ESP in Monterey Bay, CA, twice in 2006 for a total of 25 days and also utilized in a laboratory time series study. Groups detected included marine alphaproteobacteria, SAR11, marine cyanobacteria, marine group I crenarchaea, and marine group II euryarchaea. To our knowledge this represents the first report of remote in situ DNA probe‐based detection of marine bacterioplankton.
Comparative analysis of magnetosome gene clusters in magnetotactic bacteria provides further evidence for horizontal gene transfer
Authors: Jogler Christian , Kube Michael , Schübbe Sabrina , Ullrich Susanne , Teeling Hanno , Bazylinski Dennis A. , Reinhardt Richard , Schüler Dirk
Published: February 2009

The organization of magnetosome genes was analysed in all available complete or partial genomic sequences of magnetotactic bacteria (MTB), including the magnetosome island (MAI) of the magnetotactic marine vibrio strain MV‐1 determined in this study. The MAI was found to differ in gene content and organization betweenMagnetospirillumspecies and strains MV‐1 or MC‐1. Although a similar organization of magnetosome genes was found in all MTB, distinct variations in gene order and sequence similarity were uncovered that may account for the observed diversity of biomineralization, cell biology and magnetotaxis found in various MTB. While several magnetosome genes were present in all MTB, others were confined toMagnetospirillumspecies, indicating that the minimal set of genes required for magnetosome biomineralization might be smaller than previously suggested. A number of novel candidate genes were implicated in magnetosome formation by gene cluster comparison. Based on phylogenetic and compositional evidence we present a model for the evolution of magnetotaxis within theAlphaproteobacteria, which suggests the independent horizontal transfer of magnetosome genes from an unknown ancestor of magnetospirilla into strains MC‐1 and MV‐1.
Update on therapeutic strategies to increase adiponectin function and secretion in metabolic syndrome
Authors: Montecucco F. , Mach F.
Published: February 2009

Changes in diagnostic criteria have impacted on the definition of the metabolic syndrome. The central aetiological importance of insulin resistance has lessened, while the role of other cardiovascular risk factors has progressively increased. Inflammatory mediators have also been identified as crucial targets for more selective therapies in metabolic syndrome. Among several pro‐inflammatory factors, adiponectin has been shown to be associated with reduced cardiovascular risk in metabolic syndrome patients. Here, we review new therapeutic approaches, which could potentially increase adiponectin levels in metabolic syndrome.
High‐intensity focused ultrasound for localized prostate cancer: initial experience with a 2‐year follow‐up
Authors: Challacombe Benjamin J. , Murphy Declan G. , Zakri Rhana , Cahill Declan J.
Published: February 2009

OBJECTIVE

To report on the short‐term functional and oncological results, from one institution, of high‐intensity focused ultrasound (HIFU) for treating localized prostate cancer.

PATIENTS AND METHODS

Over a 3‐year period, 43 patients with localized prostate cancer were scheduled for HIFU in the primary (31) and salvage (12) settings using a second‐generation AblathermTM device (EDAP, Lyon, France). Oncological failure was defined by several criteria, including biochemical failure (assessed using both the Phoenix definition of the nadir + 2 ng/mL) and the current Food and Drug Administration (FDA) trial endpoint of a prostate‐specific antigen (PSA) level of ≥0.5 ng/mL, or starting salvage therapy, or the presence of cancer on biopsy after treatment.

RESULTS

Three patients had their procedures abandoned due to technical limitations/rectal wall thickness. The mean PSA levels in the primary and salvage groups were 9.2 and 5.1 ng/mL, respectively. The mean HIFU treatment time in the primary and salvage groups was 71.1 and 63.3 min, respectively. Using the Phoenix definition of biochemical failure, HIFU treatment failed in 13 patients in the primary group (46%) and five in the salvage group. Using the FDA trial endpoint, HIFU failed in 21 patients in the primary group (75%) and eight in the salvage group. One man died from metastatic prostate cancer 18 months after salvage HIFU. There were two urethral strictures in the primary (7%) and one in the salvage treatment group. There were two prostato‐rectal fistulae in the salvage HIFU group.

CONCLUSIONS

HIFU is proposed to be a minimally invasive low‐morbidity ablative treatment for localized prostate cancer, and with good efficacy. The present limited series is unable to support these claims. There were significant rates of complications and oncological failure in both the primary and salvage setting. As a result we have suspended our programme pending further evidence of its safety and efficacy.
Have phosphodiesterase‐5 inhibitors changed the indications for penile implants?
Authors: Cortés‐González Jeff R. , Glina Sidney
Published: February 2009

OBJECTIVE

To evaluate the indications for penile prosthesis implantation in the treatment of erectile dysfunction (ED) before and after the introduction of sildenafil.

PATIENTS AND METHODS

Penile prosthesis implantation was indicated in 144 men with ED at our institution between 1992 and 2007; 83 (55.6%) accepted the procedure, 55 (38.2%) refused it and six (4.2%) accepted but eventually had no surgery. Sixty‐seven patients were operated primarily, and the remainder were referred cases with complications after or dissatisfaction with primary operations done elsewhere. Thirty‐two were operated before the introduction of sildenafil (BS) and 35 after (AS).

RESULTS

In the BS group the most frequent aetiology was vascular disease, with 11(34%) vs two (6%) in the AS group. The most frequent aetiology in the AS group was previous radical pelvic surgery (radical prostatectomy, sigmoidectomy, etc.) with 17 (49%) vs none in the BS group. There were no significant differences in complication rates in both groups. Satisfaction rates in patients with malleable and inflatable devices were 36 (86%) and 17 (85%), respectively.

CONCLUSIONS

After the introduction of oral therapy for ED there were some changes in the aetiology of refractory ED; ED after radical prostatectomy is gaining acceptance as the main reason for a penile implant.
Body mass index as a prognostic marker for biochemical recurrence in Dutch men treated with radical prostatectomy
Authors: Van Roermund Joep G.H. , Kok Dieuwertje E.G. , Wildhagen Mark F. , Kiemeney Lambertus A. , Struik Femke , Sloot Sarah , Van Oort Inge M. , Hulsbergen‐van de Kaa Christina A. , Van Leenders Geert J.L.H. , Bangma Chris H. , Witjes J. Alfred
Published: February 2009

OBJECTIVE

To investigate whether body mass index (BMI) is a prognostic factor for biochemical recurrence (BCR) in Dutch men after radical prostatectomy (RP), as although epidemiological studies of obesity in relation to prostate cancer have provided conflicting results, recent studies from the USA suggest that a higher BMI is a risk factor for progression of prostate cancer.

PATIENTS AND METHODS

Of the 1417 patients with prostate cancer who had RP at two University hospitals, 1302 were included in the present study. BMI (kg/m2) classes were defined as normal (<25), overweight (25–30) and obese (≥30). The median follow‐up was 59 months and clinical data were obtained retrospectively from charts. BCR was defined as two consecutive prostate‐specific antigen (PSA) levels of >0.1 ng/mL.

RESULTS

In all, 600 patients were classified as having normal weight (43.9%), 665 as overweight (48.6%) and 103 as obese (7.5%). Overall, 297 patients developed BCR after RP; the 10‐year risk (95% confidence interval) of BCR was 31.9 (26.6–37.2)%, 30.5  (25.8–35.2)% and 23.9 (14.9–32.9)% for patients in the three categories, respectively (P = 0.836). Multivariable proportional hazard regression analyses of BMI and established prognostic factors for BCR did not change these results.

CONCLUSION

BMI appeared to have no prognostic value for BCR in Dutch patients with clinically localized prostate cancer and treated with RP.