bluuebunny/crossref_metadata_2025 huggingface dataset:
Tracking of climatic niche boundaries under recent climate change
Authors: La Sorte Frank A. , Jetz Walter
Published: February 2012

1. Global climate has changed significantly during the past 30 years and especially in northern temperate regions which have experienced poleward shifts in temperature regimes. While there is evidence that some species have responded by moving their distributions to higher latitudes, the efficiency of this response in tracking species’ climatic niche boundaries over time has yet to be addressed.

2. Here, we provide a continental assessment of the temporal structure of species responses to recent spatial shifts in climatic conditions. We examined geographic associations with minimum winter temperature for 59 species of winter avifauna at 476 Christmas Bird Count circles in North America from 1975 to 2009 under three sampling schemes that account for spatial and temporal sampling effects.

3. Minimum winter temperature associated with species occurrences showed an overall increase with a weakening trend after 1998. Species displayed highly variable responses that, on average and across sampling schemes, contained a strong lag effect that weakened in strength over time. In general, the conservation of minimum winter temperature was relevant when all species were considered together but only after an initial lag period (c. 35 years) was overcome. The delayed niche tracking observed at the combined species level was likely supported by the post1998 lull in the warming trend.

4. There are limited geographic and ecological explanations for the observed variability, suggesting that the efficiency of species’ responses under climate change is likely to be highly idiosyncratic and difficult to predict. This outcome is likely to be even more pronounced and time lags more persistent for less vagile taxa, particularly during the periods of consistent or accelerating warming. Current modelling efforts and conservation strategies need to better appreciate the variation, strength and duration of lag effects and their association with climatic variability. Conservation strategies in particular will benefit through identifying and maintaining dispersal corridors that accommodate diverging dispersal strategies and timetables.
Factors associated with hospitalisations for ambulatory care‐sensitive conditions among persons with an intellectual disability – a publicly insured population perspective
Authors: Balogh R. S. , Ouellette‐Kuntz H. , Brownell M. , Colantonio A.
Published: February 2012

Background  Hospitalisations for ambulatory care‐sensitive (ACS) conditions are used as an indicator of access to, and the quality of, primary care. The objective was to identify factors associated with hospitalisations for ACS conditions among adults with an intellectual disability (ID) in the context of a publicly insured healthcare system.

Methods  This study examined adults with an ID living in a Canadian province between 1999 and 2003 identified from administrative databases. Using 5 years of data for the study population, characteristics of persons hospitalised or not hospitalised for ACS conditions were compared. Using a conceptual model, independent variables were selected and an analysis performed to identify which were associated with hospitalisations for ACS conditions. The correlated nature of the observations was accounted for statistically.

Results  Living in a rural area [odds ratio (OR) 1.3; 95% confidence intervals (CI) = 1.0, 1.8], living in an area with a high proportion of First Nations people (OR 2.3; 95% CI = 1.3, 4.1), and experiencing higher levels of comorbidity (OR 25.2; 95% CI = 11.9, 53.0) were all associated with a higher likelihood of being hospitalised for an ACS condition. Residing in higher income areas had a protective effect (OR 0.56; 95% CI = 0.37, 0.85). None of the health service resource variables showed statistically significant associations.

Conclusions  Persons with an ID experience inequity in hospitalisations for ACS conditions according to rurality, income and proportion who are First Nations in a geographic area. This suggests that addressing the socio‐economic problems of poorer areas and specifically areas densely populated by First Nations people may have an impact on the number of hospitalisations for ACS conditions. Study strengths and limitations and areas for potential future research are discussed.
Determinants of adult functional outcome in adolescents receiving special educational assistance
Authors: McGeown H. R. , Johnstone E. C. , McKirdy J. , Owens D. C. , Stanfield A. C.
Published: February 2012

Background  This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance.

Methods  A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood Behaviour Checklist – CBCL) and autistic traits (using the Social Communication Questionnaire – SCQ) during adolescence and were followed up 6 years later (at a mean age of 22 years) using the World Health Organization Disability Assessment Schedule II (WHO‐DAS II) to assess functional outcome.

Results  A significant positive relationship was found between CBCL score and WHO‐DAS II score (β = 0.511, P = 0.001). IQ score showed a negative relationship with total WHO‐DAS II score (β = −0.247, P = 0.04). SCQ score was not found to significantly influence total WHO‐DAS II score (β = −0.028, P = 0.84).

Conclusions  Although the role of global intellectual ability is important, these results stress the highly predictive value of adolescent behaviours on functional outcomes in adult life among young adults receiving special educational assistance.
Clopidogrel and the risk of osteoporotic fractures: a nationwide cohort study
Authors: Jørgensen N. R. , Grove E. L. , Schwarz P. , Vestergaard P.
Published: February 2012

Jørgensen NR, Grove EL, Schwarz P, Vestergaard P (Research Center for Aging and Osteoporosis, Copenhagen University Hospital Glostrup; Aarhus University Hospital, Skejby; University of Copenhagen, Copenhagen; The Osteoporosis Clinic, Aarhus University Hospital, Denmark). Clopidogrel and the risk of osteoporotic fractures: a nationwide cohort study. J Intern Med 2012; 272: 385–393.

Objectives:  The P2Y12 inhibitor clopidogrel inhibits platelet aggregation and is used in the treatment and prevention of coronary artery disease. It is widely used and, in combination with acetylsalicylic acid, is the standard of care for acute coronary syndrome and percutaneous coronary intervention. The mode of action of clopidogrel involves pathways that are important to the metabolic activity in bone cells, although to our knowledge whether P2Y12 receptors are involved in the regulation of bone metabolism has not yet been investigated. Therefore, the objective of the present study was to investigate the association between clopidogrel use and risk of fractures.

Methods:  We investigated the association between clopidogrel use and fracture incidence in a nationwide cohort study within the Danish population of approximately 5.3 million individuals. All patients who were prescribed clopidogrel during the years 1996–2008 were included in the study (n = 77 503), and three nonusers were randomly selected, matched for age and gender (n = 232 510), for each clopidogrel‐treated subject.

Results:  Treatment with clopidogrel was associated with both increased overall fracture risk and increased risk of osteoporotic fractures, especially in subjects with a treatment duration of more than 1 year. However, individuals with low exposure to clopidogrel (<0.01 defined daily dose) had a lower risk of fracture than never users.

Conclusions:  Use of the P2Y12 inhibitor clopidogrel is associated with risk of fractures. There seems to be a biphasic relation so that lower doses are associated with decreased fracture risk, whereas higher doses (recommended dose range) are associated with increased risk. More studies are warranted to determine the potential in vivo effect of platelet aggregation inhibitors on bone metabolism.
Central Administration of Aminoprocalcitonin Inhibits Food Intake and Stimulates the Hypothalamic‐Pituitary‐Adrenal Axis in Rats via the Corticotrophin‐Releasing Factor System
Authors: Tavares E. , Maldonado R. , Garcia‐Martinez A. , Miñano F. J.
Published: February 2012

Aminoprocalcitonin (N‐PCT), a neuroendocrine peptide derived from procalcitonin, reduces food intake and body weight when administered centrally in rats. We have recently shown that N‐PCT is expressed in brain areas known to be involved in energy homeostasis, including the paraventricular nucleus (PVN) of the hypothalamus, which contains a prominent population of corticotrophin‐releasing factor (CRF)‐synthesising neurones. CRF plays a pivotal role in the regulation of the hypothalamic‐pituitary adrenal (HPA) axis and food intake. However, little is known about functional interactions of N‐PCT and CRF. In the present study, we found endogenous N‐PCT protein in the rat PVN. We also showed N‐PCT immunoreactivity in PVN co‐localised with NeuN, a neuronal marker, or glial fibrillary acidic protein, an astrocyte marker. Double staining immunohistochemistry revealed that N‐PCT co‐localised with CRF in parvocellular neurones of the PVN. Intracerebroventricular N‐PCT administration increased CRF mRNA and content in the hypothalamus, suggesting that N‐PCT stimulates the HPA axis and suppresses food intake and body weight via CRF‐dependent pathways. In keeping with this, i.c.v. co‐injection of D‐Phe‐CRF12‐41, a CRF receptor antagonist, significantly attenuated N‐PCT‐induced reduction in food intake and body weight in a dose‐dependent manner. Furthermore, i.c.v. administration of N‐PCT increased plasma adrenocorticotrophic hormone and corticosterone concentrations and induced the expression of Fos protein, a marker of neuronal activity, in parvocellular CRF neurones. These data collectively support the hypothesis that N‐PCT inhibits food intake and body weight and stimulates the HPA axis via CRF‐mediated pathways.
Concepts of social inclusion, exclusion and mental health: a review of the international literature
Authors: WRIGHT N. , STICKLEY T.
Published: February 2012

Accessible summary

This is a review of 36 papers published in the peer reviewed literature on the subject of social inclusion, exclusion and mental health.

Many of the reviewed papers offered only simplistic definitions of the concept.

We identify the relationship between exclusion, inequality and injustice and question the application of the findings to current and future mental health policy.

Social inclusion and exclusion are concepts which have been widely associated with politics and policy in the first decade of the 2000s. People with mental health problems have become the focus of a range of social inclusion initiatives. A literature review was conducted to explore the peer‐reviewed evidence relating social inclusion/exclusion and mental health. In total 36 papers were included in the review from the UK, Canada, Australia and Scandinavia. The papers had used a range of different approaches to research and evaluation. The included papers associated being socially included to: social roles and responsibilities such as employment, participation in social activities, environmental work and voting. Although some papers engaged in a critical discussion of the concept, many offered only simplistic accounts or definitions. Social inclusion is such a widely used term within political and policy discourses that it is surprising so little research is available within the mental health realm. There was a lack of clarity related to the concept of social exclusion and the qualitative studies focused entirely on the experiences of being excluded within an institutional or semi‐institutional setting. The relationship between exclusion, inequality and injustice is identified and the relevance of the concept to current and future mental health policy is questioned.
The effect of once daily omeprazole and succinic acid (VECAM) vs once daily omeprazole on 24‐h intragastric pH
Authors: Chowers Y. , Atarot T. , Pratha V. S. , Fass R.
Published: February 2012

Background  Parietal cell H+/K+ATPase activation is essential for optimal proton pump inhibitor (PPI) activity. Succinic acid (SA) was shown to induce gastric acid secretion. VECAM is a combination of omeprazole (OMP) and SA. To compare the effect of once daily bedtime dosing of VECAM 40 and VECAM 20 without food vs OMP 20 mg administered before breakfast on gastric acidity.

Methods  Open label, randomized, crossover study enrolling 36 healthy subjects comparing the study treatments at steady state for 24 h intragastric pH monitoring.

Key Results  The median percent time intragastric pH > 4 demonstrated that VECAM 40 was superior to VECAM 20 (65.7%vs 49.1%P < 0.0001) and OMP 20 mg (65.7%vs 47.6%P = 0.005) during 24 h. VECAM 40 was superior to VECAM 20 (52.8%vs 38.8%P = 0.0079) and OMP 20 mg (52.8%vs 27.2%P < 0.0001), and VECAM 20 was superior to OMP 20 mg (38.8 vs 27.2 P = 0.0069) during the nighttime. VECAM 20 and OMP 20 mg were comparable during 24 h.

Conclusions & Inferences  VECAM 40 and VECAM 20 were significantly better in maintaining intragastric pH > 4 during the nighttime than OMP 20 mg. Succinic acid eliminates the need for a subsequent meal for intragastric pH control by VECAM.
Organ‐specific responses of tomato growth and phenolic metabolism to nitrate limitation
Authors: Larbat R. , Le Bot J. , Bourgaud F. , Robin C. , Adamowicz S.
Published: February 2012

Phenolic compounds are secondary metabolites involved in plant innate chemical defence against pests and diseases. Their concentration varies depending on plant tissue and also on genetic and environmental factors, e.g. availability of nutrient resources. This study examines specific effects of low (LN) and high (HN) nitrogen supply on organ (root, stem and leaf) growth and accumulation of major phenolics [chlorogenic acid (CGA); rutin; kaempferol rutinoside (KR)] in nine hydroponically grown tomato cultivars. LN limited shoot growth but did not affect root growth, and increased concentrations of each individual phenolic in all organs. The strength of the response was organ‐dependent, roots being more responsive than leaves and stems. Significant differences were observed between genotypes. Nitrogen limitation did not change the phenolic content in shoots, whereas it stimulated accumulation in roots. The results show that this trade‐off between growth and defence in a LN environment can be discussed within the framework of the growth–differentiation balance hypothesis (i.e. GDBH), but highlight the need to integrate all plant organs in future modelling approaches regarding the impact of nitrogen limitation on primary and secondary metabolism.
Cell‐free antigens of Sporothrix brasiliensis: antigenic diversity and application in an immunoblot assay
Authors: Almeida‐Paes Rodrigo , Bailão Alexandre Melo , Pizzini Cláudia Vera , Reis Rosani Santos , de Almeida Soares Célia Maria , Peralta José Mauro , Gutierrez‐Galhardo Maria Clara , Zancopé‐Oliveira Rosely Maria
Published: February 2012

Sporotrichosis is a subcutaneous mycosis diagnosed by isolation of the fungus in culture. Serological tests for help in diagnosis in general do not use purified or recombinant antigens, because there is a paucity of described immunoreactive proteins, especially for the new described Sporothrix species, such as Sporothrix brasiliensis. This study aims to characterise antigens from S. brasiliensis and verify their application in serodiagnosis of sporotrichosis. An immunoblot assay allied with computer‐based analysis was used to identify putative antigenic molecules in a cell‐free extracts of both morphological phases of this fungus, and to delineate antigenic polymorphism among seven S. brasiliensis isolates and one S. schenckii Brazilian strain. The mycelial and yeast phase of the fungus originated 14 and 23 reactive bands, respectively, which were variable in intensity. An 85 kDa antigen, verified in the yeast phase of the fungus, was observed in all strains used and the immunodominant protein was identified. This protein, however, cross‐react with serum samples from patients infected with other pathogens. The results show that the S. brasiliensis cell‐free antigen extract is a single and inexpensive source of antigens, and can be applied on the sporotrichosis serodiagnosis.
Bone marrow stem cells‐derived microvesicles protect against renal injury in the mouse remnant kidney model
Authors: HE JUAN , WANG YAN , SUN SHU , YU MEINING , WANG CUIYU , PEI XIAOHUA , ZHU BEI , WU JIANQING , ZHAO WEIHONG
Published: February 2012

Aims:  Several studies have demonstrated administration of mesenchymal stem cells (MSC) could reverse kidney injury by paracrine mechanisms rather than by MSC transdifferentiation. Recently, a few researchers found microvesicles (MV) derived from MSC might be a paracrine mechanism for cell‐to‐cell communication. The aim of this study was to investigate the repair effects of MV in a 5/6 subtotal nephrectomy (Nx) mice model.

Methods:  The animals were randomly divided into four groups: Control, Nx, Nx + MSC and Nx + MV group. MSC were injected (1 × 106/mouse) through caudal vein in Nx + MSC group at the second day after the surgery and MV were injected (30 µg/mouse) through caudal vein in Nx + MV group on alternate days. Mice were killed on day 7 after the first time of administration. Blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA) and proteinuria were evaluated. Histopathology of kidney was analysed.

Results:  In Nx mice, the levels of Scr, UA and proteinuria were significantly decreased with administration of MV and MSC (P < 0.05). The remnant kidneys of MV and MSC‐treated Nx mice showed less fibrosis, interstitial lymphocyte infiltrates and less or absent tubular atrophy compared with the untreated Nx group. The Histological Score of Kidney in untreated mice was 3.13 ± 0.74, while in the MSC‐treated group it was 1.67 ± 0.47 and in the MV‐treated group it was 1.80 ± 0.44, nearly preserving normal morphology of the kidney (P < 0.01).

Conclusion:  This study showed MV protects against renal injury induced by 5/6 Nx, which could mimic the role of MSC in kidney repair. The research showed a newly potential therapeutic approach to kidney diseases.
Relationships between exploratory eye movement dysfunction and clinical symptoms in schizophrenia
Authors: Suzuki Masahiro , Takahashi Sakae , Matsushima Eisuke , Tsunoda Masahiko , Kurachi Masayoshi , Okada Takashi , Hayashi Takuji , Ishii Yohei , Morita Kiichiro , Maeda Hisao , Katayama Seiji , Otsuka Tatsui , Hirayasu Yoshio , Sekine Mizuho , Okubo Yoshiro , Motoshita Mai , Ohta Katsuya , Uchiyama Makoto , Kojima Takuya
Published: February 2012

Aim:  Many psychophysiological tests have been widely researched in the search for a biological marker of schizophrenia. The exploratory eye movement (EEM) test involves the monitoring of eye movements while subjects freely view geometric figures. Suzuki et al. (2009) performed discriminant analysis between schizophrenia and non‐schizophrenia subjects using EEM test data; consequently, clinically diagnosed schizophrenia patients were identified as having schizophrenia with high probability (73.3%). The aim of the present study was to investigate the characteristics of schizophrenia patients who were identified as having schizophrenia on EEM discriminant analysis (SPDSE) or schizophrenia patients who were identified as not having schizophrenia on EEM discriminant analysis (SPDNSE).

Methods:  The data for the 251 schizophrenia subjects used in the previous discriminant‐analytic study were analyzed, and the demographic or symptomatic characteristics of SPDSE and SPDNSE were investigated. As for the symptomatic features, a factor analysis of the Brief Psychiatric Rating Scale (BPRS) rating from the schizophrenia subjects was carried out.

Results:  Five factors were found for schizophrenia symptoms: excitement/hostility; negative symptoms; depression/anxiety; positive symptoms; and disorganization. SPDSE had significantly higher factor scores for excitement/hostility, negative symptoms and disorganization than SPDNSE. Furthermore, the BPRS total score for the SPDSE was significantly higher than that for the SPDNSE.

Conclusion:  SPDSE may be a disease subtype of schizophrenia with severe symptoms related to excitement/hostility, negative symptoms and disorganization, and EEM parameters may detect this subtype. Therefore, the EEM test may be one of the contributors to the simplification of the heterogeneity of schizophrenia.
Malignant transformation of ovarian mature cystic teratoma with a predominant pulmonary type small cell carcinoma component
Authors: Ikota Hayato , Kaneko Kou , Takahashi Sachio , Kawarai Mitsue , Tanaka Yuko , Yokoo Hideaki , Nakazato Yoichi
Published: February 2012

A 68‐year‐old woman was diagnosed with mature cystic teratoma of the left ovary when she was 44 years old. The tumor recently enlarged rapidly, and abdominal magnetic resonance imaging revealed an intrapelvic cystic lesion, which measured 123 × 120 × 107 mm and contained a mural nodule. Under a clinical diagnosis of malignant transformation of mature cystic teratoma, bilateral salpingo‐oophorectomy with total hysterectomy and omentectomy were performed. The resected specimen showed a unilocular cystic lesion containing a well‐demarcated mural nodule measuring 35 × 30 × 25 mm in the left ovary. A microscopic examination revealed various types of carcinoma in the mural nodule: pulmonary type small cell carcinoma (65%), adenocarcinoma (25%), squamous cell carcinoma (5%), and transitional cell carcinoma (5%). Small cell carcinoma was positive for CD56, synaptophysin, and chromogranin A. The adenocarcinoma component showed intestinal phenotypes; i.e. cytokeratin (CK) 7(−), CK20(+), CDX2(+), estrogen receptor(−), and progesterone receptor (−). Interestingly, CDX2 positivity was retained in all of the carcinomas. It was assumed that the adenocarcinoma had arisen from an intestinal epithelium in the mature cystic teratoma and then differentiated into the diverse histological types mentioned above.
First report of idiopathic segmental ureteritis successfully treated by steroid therapy
Authors: Atsuta Takeshi , Shimizu Yosuke , Masuda Norihiko , Watanabe Jun , Sumiyoshi Shinji , Yoshimura Koji , Kanematsu Akihiro , Ogawa Osamu
Published: February 2012

We report a case of bilateral idiopathic segmental ureteritis in a 52‐year‐old woman. The diagnosis was established by imaging studies (magnetic resonance imaging/computed tomography scan), ureteroscopy and biopsies. The left side improved spontaneously, but the right ureteral stricture persisted after 3 months of ureteral stenting. Administration of prednisolone effectively relieved obstruction on the right side after 4 months. This is the first report of idiopathic segmental ureteritis successfully treated by steroid therapy, without invasive open procedures.
Diagnosis of tuberculous lymphadenitis using fine needle aspiration biopsy
Authors: Knox J. , Lane G. , Wong J. S. J. , Trevan P. G. , Karunajeewa H.
Published: February 2012

Background:  Tuberculous lymphadenitis is the commonest form of extrapulmonary tuberculosis. However, the optimal approach to diagnosis, employing biopsy by either fine needle aspiration (FNA) or surgical excision, remains uncertain.

Aims:  To evaluate the diagnostic value of biopsy using each of the component diagnostic modalities of FNA (microscopy, cytology and culture), and compare these with excision biopsy in the diagnosis of tuberculous lymphadenitis in a predominantly migrant population in Melbourne.

Methods:  A retrospective examination of tuberculous lymphadenitis cases presenting to Western Health over 12 years was conducted. Using a reference method of positive culture of Mycobacterium tuberculosis, the diagnostic sensitivities of each modality employed in FNA were determined.

Results:  Forty‐two subjects having FNA and 30 having excision biopsy as the initial investigation were compared. Among specimens obtained by FNA, sensitivity of microscopy was 18% (95% confidence interval (CI): 5–40%) and sensitivity of cytology was 38% (95% CI: 20–59%). For specimens obtained by excision biopsies, sensitivities for microscopy and histology were 17% (95% CI: 2–32%) and 96% (95% CI: 88–100%) respectively. Sensitivity of culture performed on FNA specimens was 86% (95% CI: 65–97%).

Conclusions:  Given the relatively high sensitivity of mycobacterial cultures from FNA, this study supports its routine use as the initial investigation in most patients with suspected tuberculous lymphadenitis. Microscopy and cytology add relatively little to the clinical utility of FNA.
Hospitalisation of high‐care residents of aged care facilities: are goals of care discussed?
Authors: Lane H. , Zordan R. D. , Weiland T. J. , Philip J.
Published: February 2012

Background

Residents of residential aged care facilities (RACF) are commonly hospitalised towards the end of life. Determining the hospitalisation experiences, including the discussion of goals of treatment, is essential to best plan care including planning for end‐of‐life care for this population.

Aim

To document hospital presentation characteristics, course, outcomes and care planning for high‐care residents of RACF.

Methods

A retrospective review of medical records was conducted for all high‐care residents aged >64 years presenting to a metropolitan hospital over a 6‐month period.

Results

One hundred and eighty‐six high‐care residents of RACF presented to hospital 228 times. Transfer paperwork documented resuscitation status for 49 (21%) presentations, and a medical enduring power of attorney or advanced care plan for 85 (37%). Patients had high rates of comorbidities (average Charlson comorbidity index score = 3), polypharmacy (93%), impaired mobility (89%), impaired cognition (81%) and incontinence (76%). Resuscitation status was documented in 50 (55%) and family discussion in 38 (42%) of 91 admissions exceeding 48 h. Documented family discussion was significantly associated with complications or new events occurring during admission (odds ratio 1.56, 95% confidence interval 1.07–2.26).

Conclusion

There were low rates of documentation of resuscitation status or family discussion for this highly vulnerable population. Neither hospitals nor community providers appear to take responsibility for future care planning. Acute hospitals could play a greater role in care planning because discussion around course of illness and goals of treatment may enhance patient management, satisfaction and reduce hospitalisations.
Treatment with unfunded drugs in oncology: the impact of access programmes and clinical trials
Authors: Tie J. , Gibbs P.
Published: February 2012

Background

Where proven cancer therapies remain unfunded, patients are faced with difficult decisions regarding personally covering some or all of the treatment cost. Clinical trials provide an alternative form of access to unfunded drugs.

Aims

To examine the patient population and utilisation of the colorectal cancer cetuximab Interim Access Programme (IAP) in Australia.

Methods

We retrospectively analysed de‐identified data collected as part of the costsharing colorectal cancer cetuximab IAP in Australia, which extended from June 2005 until November 2009. The impact of the CO20 clinical trial that opened in early 2008 and provided free access to cetuximab was also examined.

Results

Eight hundred and fifty‐eight patients received ≥1 treatment on the IAP. The median age of participants was lower than the general colorectal cancer population (61 vs 71 years). A greater uptake by males was limited to patients over 65 years old. Socioeconomic status correlated with programme enrolment, and there appeared to be lower uptake among regional patients. The majority (93%) of patients received combination treatment with irinotecan, with a trend towards increasing use of single‐agent cetuximab over time. The median time‐on‐treatment was longer in patients treated with combination therapy than with monotherapy (12 vs 8 weeks). The CO20 trial had minimal impact on IAP enrolment and approximately doubled the number of Australian patients receiving cetuximab.

Conclusions

Patients' age and gender in older patients impacted on participation in the IAP. Both the IAP and the CO20 trial contributed to a substantial proportion of Australian patients accessing an unfunded treatment, with an estimated 50% of the eligible patient population receiving cetuximab.
Gastroenterology training in Australia: a perspective from the coal face
Authors: De Cruz P. , Leung C. , Raftopoulos S. , Allen P. B. , Burgell R. , Rode A. , Rosenbaum J. , Bell S. J , Hebbard G. S.
Published: February 2012

Background

The Royal Australasian College of Physicians is developing curricula for training.

Aims

We surveyed gastroenterology trainees on their training experience to establish whether training needs were being met.

Methods

An online anonymous survey of all gastroenterology trainees in 2009.

Results

Ninety‐one per cent of trainees responded (105/115). Of these, 92% were adult, and 8% were paediatric trainees. Seventy four were core, and 31 were noncore trainees. Of those who had completed core training, the majority (86%) felt that their training had prepared them adequately for independent practice as a gastroenterologist. However, most respondents felt that core advanced training should be 3 years instead of 2 years. The majority (86%) saw a benefit in moving between hospitals during core training. Of the trainees managing inpatients, 57% were managing 10 or more per day, and 63% had three or more consultant ward rounds per week. The top three noncore fellowships were advanced endoscopy (44%), hepatology (28%) and inflammatory bowel disease (17%). Sixty‐one per cent and 39% were undertaking a clinical and research fellowship respectively. Seventy‐two per cent of core trainees attended up to three endoscopy lists per week, and 76% were on the on‐call urgent endoscopy roster. For on‐call endoscopy, 27% of third‐year noncore trainees and 5% of core trainees were unsupervised.

Conclusions

The majority of trainees felt that their core training would prepare them adequately for independent practice as gastroenterologists. Overall, trainees valued movement between hospitals during training and felt that core training should be 3 years. Some trainees had inadequate consultant support for out‐of‐hours emergency endoscopy.
Diabetes as a risk factor for dementia and mild cognitive impairment: a meta‐analysis of longitudinal studies
Authors: Cheng G. , Huang C. , Deng H. , Wang H.
Published: February 2012

This study examined the association of diabetes with the onset of dementia (including Alzheimer's disease (AD), vascular dementia (VD) and any dementia) and mild cognitive impairment (MCI) by using a quantitative meta‐analysis of longitudinal studies. EMBASE and MEDLINE were searched for articles published up to December 2010. All studies that examined the relationship between diabetes and the onset of dementia or MCI were included. Pooled relative risks were calculated using fixed and random effects models. Nineteen studies met our inclusion criteria for this meta‐analysis, and 6184 subjects with diabetes and 38 530 subjects without diabetes were included respectively. All subjects were without dementia or MCI at baseline. The quantitative meta‐analysis showed that subjects with diabetes had higher risk for AD (relative risk (RR):1.46, 95% confidence interval (CI): 1.20–1.77), VD (RR: 2.48, 95% CI: 2.08–2.96), any dementia (RR: 1.51, 95% CI: 1.31–1.74) and MCI (RR: 1.21, 95% CI: 1.02–1.45) than those without. The quantitative meta‐analysis showed that diabetes was a risk factor for incident dementia (including AD, VD and any dementia) and MCI.
NPY modulates PYY function in the regulation of energy balance and glucose homeostasis
Authors: Zhang L. , Nguyen A. D. , Lee I.‐C. J. , Yulyaningsih E. , Riepler S. J. , Stehrer B. , Enriquez R. F. , Lin S. , Shi Y.‐C. , Baldock P. A. , Sainsbury A. , Herzog H.
Published: February 2012

Aims: Both the neuronal‐derived neuropeptide Y (NPY) and the gut hormone peptide YY (PYY) have been implicated in the regulation of energy balance and glucose homeostasis. However, despite similar affinities for the same Y receptors, the co‐ordinated actions of these two peptides in energy and glucose homeostasis remain largely unknown.

Methods: To investigate the mechanisms and possible interactions between PYY with NPY in the regulation of these processes, we utilized NPY/PYY single and double mutant mouse models and examined parameters of energy balance and glucose homeostasis.

Results: PYY−/− mice exhibited increased fasting‐induced food intake, enhanced fasting and oral glucose‐induced serum insulin levels, and an impaired insulin tolerance, − changes not observed in NPY−/− mice. Interestingly, whereas PYY deficiency‐induced impairment in insulin tolerance remained in NPY−/−PYY−/− mice, effects of PYY deficiency on fasting‐induced food intake and serum insulin concentrations at baseline and after the oral glucose bolus were absent in NPY−/−PYY−/− mice, suggesting that NPY signalling may be required for PYY's action on insulin secretion and fasting‐induced hyperphagia. Moreover, NPY−/−PYY−/−, but not NPY−/− or PYY−/− mice had significantly decreased daily food intake, indicating interactive control by NPY and PYY on spontaneous food intake. Furthermore, both NPY−/− and PYY−/− mice showed significantly reduced respiratory exchange ratio during the light phase, with no additive effects observed in NPY−/−PYY−/− mice, indicating that NPY and PYY may regulate oxidative fuel selection via partly shared mechanisms. Overall, physical activity and energy expenditure, however, are not significantly altered by NPY and PYY single or double deficiencies.

Conclusions: These findings show significant and diverse interactions between NPY and PYY signalling in the regulation of different aspects of energy balance and glucose homeostasis.
Equine keratomycosis in Japan
Authors: Wada Shinya , Hobo Seiji , Ode Hirotaka , Niwa Hidekazu , Moriyama Hidekazu
Published: February 2012

Objective To describe the incidence, clinical progress, visual outcome, and laboratory findings of equine keratomycosis in Japan.

Procedure Retrospective study of the medical records of horses clinically and mycologically diagnosed with keratomycosis at the Equine Hospitals of the Japan Racing Association from 2005 to 2011.

Results The diagnosis of keratomycosis was confirmed in eight horses (40.0% of the 20 horses with infectious keratitis from which fungi and/or bacteria were isolated). Fungi recovered from corneal swabs were identified asAspergillus flavus(4),Aspergillus niger(1),Fusarium solani(1), andMortierella wolfii(2). All horses were treated medically with topical antifungals, and one horse was also treated surgically. The median of treatment period was 40 days. Two horses were rendered blind in the affected eye and the others retained vision.

Conclusions Equine keratomycosis comprises a considerable portion of infectious keratitis in Japan, and the causative fungi that we isolated had been isolated previously from horses with keratomycosis in other regions with the exception ofM. wolfii. Culture and cytological examination of corneal lesions should be immediately performed on eyes with signs of keratitis, particularly on those not improving with antibacterial medication, as early initiation of aggressive antifungal treatment tended to result in better outcome and shorter treatment period.
Measurement of peri‐prostatic fat thickness using transrectal ultrasonography (TRUS): a new risk factor for prostate cancer
Authors: Bhindi Bimal , Trottier Greg , Elharram Malik , Fernandes Kimberly A. , Lockwood Gina , Toi Ants , Hersey Karen M. , Finelli Antonio , Evans Andrew , van der Kwast Theodorus H. , Fleshner Neil E.
Published: February 2012

Study Type – Prognosis (cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?

ADIPOSE tissue secretes various endocrine and paracrine mediators. Some authors have begun to consider whether peri‐prostatic fat (PPF) may interact with the prostate and play a role in carcinogenesis. It has recently been shown that the PPF quantity measured by CT is associated with more aggressive disease in patients undergoing radiation therapy.

Our group studied a population not yet diagnosed with prostate cancer. By doing so we were able to identify PPF thickness on transrectal ultrasonography as a risk factor for prostate cancer detection upon biopsy, and as a risk factor for high‐grade disease. Our study also raises interesting questions about the underlying mechanisms of the association between PPF quantity and prostate cancer.

OBJECTIVE

To determine if the amount of peri‐prostatic fat (PPF) on transrectal ultrasonography (TRUS) is a risk factor for incident prostate cancer overall and high‐grade prostate cancer (Gleason ≥4).

PATIENTS AND METHODS

A prospectively maintained database of patients undergoing prostate biopsy at Princess Margaret Hospital for cancer suspicion was used.

All TRUS examinations were retrospectively reviewed upon ‘blinding’ to outcome.

PPF thickness, measured as the distance between the prostate and the pubic bone, was used as an index of the quantity of PPF.

PPF measurements, together with other prostate cancer risk factors, were evaluated against prostate cancer and high‐grade prostate cancer detection upon biopsy with univariable and multivariable logistic regression and area under the receiver operating characteristic curve (AUC) analysis.

RESULTS

Of the 931 patients, 434 (47%) were diagnosed with prostate cancer and 218 (23%) were diagnosed with high‐grade prostate cancer.

The mean (range) PPF thickness was 5.3 (0–15) mm.

Increasing PPF thickness was associated with prostate cancer and high‐grade prostate cancer diagnosis, with graded effect. When adjusting for other variables, the odds of detecting any prostate cancer and high‐grade prostate cancer increased 12% (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.02–1.23) and 20% (OR 1.20, 95% CI 1.07–1.34), respectively, for each millimetre increase in PPF thickness.

The AUCs for the association of PPF with prostate cancer and high‐grade prostate cancer were 0.58 (95% CI 0.54–0.62) and 0.59 (95% CI 0.55–0.64), respectively.

CONCLUSION

The amount of PPF can be estimated with TRUS and is a predictor of prostate cancer and high‐grade prostate cancer at biopsy. To our knowledge, this study is the first to investigate PPF quantity in patients without prior prostate cancer diagnosis.
Pharmacological preconditioning of ATP‐sensitive potassium channel openers on acute urinary retention‐induced bladder dysfunction in the rat
Authors: Ohmasa Fumiya , Saito Motoaki , Oiwa Harunori , Tsounapi Panagiota , Shomori Kohei , Kitatani Kazuyuki , Dimitriadis Fotios , Kinoshita Yukako , Satoh Keisuke
Published: February 2012

What's known on the subject? and What does the study add?

Acute urinary retention (AUR) and catheterization for AUR (AURC) or drainage of the urine is a well established cause of bladder dysfunction. Previously, we reported that the induction of AURC significantly reduced contractile responses to both carbachol and KCl compared with a control group, and that this reduction was prevented by nicorandil and cromakalim in a dose‐dependent manner; however, although we reported a possible beneficial effect of nicorandil and cromakalim on bladder dysfunction caused by AURC, its molecular mechanism is still unknown.

Our study establishes that nicorandil and cromakalim, but not glibenclamide, prevent AURC‐induced bladder dysfunction via up‐regulation of both KIR6.1 and KIR6.2 with a subsequent decrease in oxidative stress and decreased induction of apoptosis in the bladder.

OBJECTIVE

To investigate whether ATP‐sensitive potassium (KATP) channel openers prevent bladder injury after acute urinary retention (AUR) and subsequent catheterization for AUR (AURC) in the rat.

MATERIALS AND METHODS

Eight‐week‐old male Sprague–Dawley rats were divided into five groups: a sham‐operated control group, an AUR group, and three AUR groups treated with: nicorandil (10 mg/kg); cromakalim (300 µg/kg); or glibenclamide (5 mg/kg).

AUR was induced by intravesical infusion of 3.0 mL of saline via cystostomy with simultaneous clamping of the penile urethra and, after 30 min of AUR, the bladder was allowed to drain for 60 min.

After the experimental period, bladder function was assessed using organ bath techniques (carbachol and KCl), and by measuring tissue levels of 8‐isoprostane, a marker of oxidative stress. The participation levels of KATP channel pores were investigated using ELISA and real‐time PCR methods, respectively.

The degree of apoptosis was estimated using the TUNEL method in the bladder smooth muscle and epithelium.

RESULTS

The AURC group showed significantly decreased contractile responses to carbachol and KCl, and significant increases in tissue 8‐isoprostane levels and apoptosis index in the epithelium compared with the control group.

Nicorandil and cromakalim, but not glibenclamide, significantly prevented these AURC‐induced alterations.

The expressions of KIR6.1 and KIR6.2 mRNAs were significantly up‐regulated by the induction of AURC.

Nicorandil and cromakalim, but not glibenclamide, significantly up‐regulated expressions of KIR6.1 and KIR6.2 mRNAs in the bladder compared with the AUR group.

CONCLUSION

Our data indicate that nicorandil and cromakalim, but not glibenclamide, prevent AURC‐induced bladder dysfunction via activation of KATP channels, with a subsequent decrease in oxidative stress and decreased induction of apoptosis.
Lazy Visibility Evaluation for Exact Soft Shadows
Authors: Mora F. , Aveneau L. , Apostu O. , Ghazanfarpour D.
Published: February 2012

This paper presents a novel approach to compute high quality and noise‐free soft shadows using exact visibility computations. This work relies on a theoretical framework allowing to group lines according to the geometry they intersect. From this study, we derive a new algorithm encoding lazily the visibility from a polygon. Contrary to previous works on from‐polygon visibility, our approach is very robust and straightforward to implement. We apply this algorithm to solve exactly and efficiently the visibility of an area light source from any point in a scene. As a consequence, results are not sensitive to noise, contrary to soft shadows methods based on area light source sampling. We demonstrate the reliability of our approach on different scenes and configurations.
Generalized Model‐Based Human Motion Recognition with Body Partition Index Maps
Authors: Deng Liqun , Leung Howard , Gu Naijie , Yang Yang
Published: February 2012

Content‐based human motion analysis has captured extensive concerns of researchers from the domains of computer animation, human‐machine interaction, entertainment, etc. However, it is a non‐trivial task due to the spatial and temporal variations in the motion data. In this paper, we propose a generalized model (GM)‐based approach to model the variations and accurately recognize motion patterns. We partition the human character model into five parts, and extract the features of the submotions of each specific body part using clustering techniques. These features from the training trials in each class are combined to build the GM. We propose a new penalty based similarity measure for DTW to be used with the GMs for isolated motion recognition. On the other hand, from the GMs five body partition index maps are constructed and used for matching together with a flexible end point detection scheme during continuous motion recognition. In the experiments, we examine the effectiveness and efficiency of the approach in both isolated motion and continuous motion recognition. The results show that our proposed method has good performance compared with other state‐of‐the‐art methods in recognition accuracy and processing speed.
Exploring Different Parameters to Assess Left Ventricle Global and Regional Functional Analysis from Coronary CT Angiography
Authors: Silva Samuel , Santos Beatriz Sousa , Madeira Joaquim
Published: February 2012

Coronary CT angiography is widely used in clinical practice for the assessment of coronary artery disease. Several studies have shown that the same exam can also be used to assess left ventricle (LV) function. Even though coronary CT angiography provides data concerning multiple cardiac phases, along the cardiac cycle, LV function is usually evaluated using just the end‐systolic and end‐diastolic phases. This unused wealth of data, mostly due to its complexity and the lack of proper tools, has still to be explored to assess if further insight is possible regarding regional LV functional analysis. Furthermore, different parameters can be computed to characterize LV function and though some are well known by clinicians others still need to be tested concerning their value in clinical scenarios. Based on these premises, we present several parameters characterizing global and regional LV function, computed for several cardiac phases over one cardiac cycle. The data provided by the computed parameters is shown using a set of visualizations allowing synchronized visual exploration of the different data. The main purpose is to provide means for clinicians to explore the data and gather insight over their meaning and their correlation with each other and with diagnosis outcomes.
Spatio‐Temporal Filtering of Indirect Lighting for Interactive Global Illumination
Authors: Chen Ying‐Chieh , Lei Su Ian Eugene , Chang Chun‐Fa
Published: February 2012

We introduce a screen‐space statistical filtering method for real‐time rendering with global illumination. It is inspired by statistical filtering proposed by Meyer et al. to reduce the noise in global illumination over a period of time by estimating the principal components from all rendered frames. Our work extends their method to achieve nearly real‐time performance on modern GPUs. More specifically, our method employs the candid covariance‐free incremental PCA to overcome several limitations of the original algorithm by Meyer et al., such as its high computational cost and memory usage that hinders its implementation on GPUs. By combining the reprojection and per‐pixel weighting techniques, our method handles the view changes and object movement in dynamic scenes as well.
Liberal Neutrality and Charitable Purposes
Authors: Martin Nick
Published: February 2012

Under UK charity law, organisations seeking charitable status must demonstrate, inter alia, that they will pursue a purpose the state deems ‘charitable’. Such purposes inevitably reflect conceptions of the good, thus it is argued here that the state, in granting charitable status, affirms the value of ideas about the good; it indicates that a set of conceptions of the good are worthy of special advantages that are not provided for the pursuit of other conceptions. The designation of charitable status appears to be at odds with liberal neutrality, which argues that the state should not pursue, promote or pass judgement on particular conceptions of the good. In short, there is a prima facie tension between the general liberal neutrality doctrine and charity law. Yet liberal neutralists have not addressed this policy area. This article surveys the grounds for reconciliation between some conceptions of liberal neutrality and the present charity law. ‘Neutrality of effect’ addresses some concerns but its implications for charity law are not in accord with the general practice and principles regarding charities. Barry's process of abstraction is argued to be untenable as a policy option for charities. The article concludes that in so far as one is neutralist, ‘neutrality of justification’ in the form of neutral goods provides the most plausible account of charity law. However, such an account entails alterations to the existing legislation that one may view as a failure to account for well-established, legitimate principles and traditions in charity law.