bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser lipolysis with pulsed 1064 nm Nd:YAG laser for the treatment of gynecomastia
Authors: Rho Yong Kwan , Kim Beom Joon , Kim Myeung Nam , Kang Kweon Soo , Han Hee Jin
Published: November 2009

Background  Lipolysis using laser is currently widely used for reducing localized fat. A 1064 nm neodynium‐doped yttrium aluminum garnet (Nd:YAG) laser lipolysis was investigated in this study to evaluate its efficacy and safety in the treatment of gynecomastia.

Methods  Five male patients diagnosed with gynecomastia were enrolled in this study, which was designed as a controlled split‐breast trial. One breast of each patient was subjected to laser lipolysis and was then compared with a contralateral breast. Photographs and clinical assessments were obtained before the lipolysis, and at the fourth and eighth weeks thereafter. Computed tomography (CT) scan and ultrasound (US) imaging were used to evaluate the changes in the breasts’ thicknesses.

Results  The mean chest circumference was found to have been significantly reduced 8 weeks after the laser lipolysis. The clinical outcomes of the laser lipolysis were considered favorable by both the patients and clinicians. The CT and US scans showed that the thicknesses of the treated right breasts reduced more than those of the left breasts were 8 weeks after the laser lipolysis. The side effects (pain, edema, and ecchymosis) were minimal and disappeared shortly after they first manifested.

Limitations  The limitations of this study are that it employed small treatment groups and short‐term follow‐up.

Conclusion  This study demonstrated that gynecomastia can be treated effectively and safely through 1064 nm Nd:YAG laser lipolysis.
Diversity of bathyal macrofauna on the northeastern Pacific margin: the influence of methane seeps and oxygen minimum zones
Authors: Levin Lisa A. , Mendoza Guillermo F. , Gonzalez Jennifer P. , Thurber Andrew R. , Cordes Erik E.
Published: November 2009

The upper continental slope in the northeastern Pacific Ocean is intercepted by a deep oxygen minimum zone (OMZ; 650–1100 m) and punctuated by conduits of methane seepage. We examined the effects of these two dominant sources of heterogeneity on the density, composition and diversity of heterotrophic macrofauna off Hydrate Ridge, Oregon (OR; 800 m water depth), where the seeps co‐occur within an OMZ, and off the Eel River, Northern California (CA; 500 m), where seeps are overlain by better oxygenated waters. We hypothesized that seeps (containing clam beds and microbial mats) should contribute a suite of distinct species to the regional margin species pool but that OMZ‐associated hypoxia would dampen seep‐related heterogeneity. Macrofaunal densities were highest (23,000–33,510 ind·m−2) in the CA seep sediments and in the OR near‐seep samples, intermediate in the OR seep, CA near seep and CA and OR 500‐m margin sediments (10,054–19,777 ind·m−2), and lowest in the CA and OR OMZ habitats at 800 m (4269–7847 ind·m−2). Annelids constituted over 50% of the taxa in all but the CA clam bed and OR microbial mat sediments, where mollusks were abundant. Approximately 50% of seep species appeared to be habitat endemic; species present in microbial mats largely formed a subset of those present in the clam beds. Dorvilleid and ampharetid polychaetes were dominant in the seep sediments; non‐seep margin sediments at 500 and 800 m were populated heavily by branchiate polychaetes including cossurids and paraonids. Alpha diversity (Es[20] calculated per core) was lowest and rank 1 dominance was highest in the CA and OR microbial mat habitats. Pooled analyses of Es[100] revealed highest species richness in the CA clam bed and near‐seep habitats (30.3 and 29.6, respectively), and lowest species richness in the OR microbial mat and near‐seep habitats (16.5 and 17.9, respectively). Non‐seep sediments (500 and 800 m) off both CA and OR were more homogeneous (55–57% within‐habitat similarity) than clam bed and microbial mat sediments (only 32–37% within‐habitat similarity). CA sediment macrofauna generally exhibit higher alpha diversity, and as habitats are combined, a higher rate of increase in the slope of the species accumulation curves than do OR margin macrofauna. Methane seeps in the NE Pacific introduce significant heterogeneity that increases margin biodiversity at multiple spatial scales. However, our hypothesis that the OMZ would lessen the seep contributions to diversity was not supported. The better oxygenated CA seeps at 500 m shared more of the background margin fauna (at 500 m) than did the OR seeps at 800 m (with OMZ fauna at 800 m). Geographical differences in the fluxes of methane‐rich fluids and the increased reliance on chemosynthetic food sources with increased depth could explain these results.
The Australian species of the subfamily Pergulinae, with descriptions of two new Pergula Morice species (Hymenoptera: Symphyta: Pergidae)
Authors: Schmidt Stefan , Smith David R
Published: November 2009

The Pergulinae occur in South America and Australia with a single genus on each continent. The Australian genus Pergula Morice was known only from a single male of Pergula turneri Morice, 1919, from the south‐western part of Western Australia. Two additional species are described, Pergula exilis sp. nov. from Western Australia and Pergula xantha sp. nov. from Queensland and New South Wales. The female of P. xantha is the first female described for the genus, and the species is the first record of the genus for eastern Australia. A key is provided for separation of species.
Saga of the short‐range endemic
Authors: Majer Jonathan
Published: November 2009

Short‐range endemic invertebrates (SREs), by their very nature, can be threatened if an impending development overlaps their range. Since their extinction would be unacceptable under State and Federal legislation, surveys for their presence are often required before approval for a project can be granted. Annually, millions of dollars are being spent in Western Australia alone on surveys for SREs. In contrast, funds for research on non‐SRE terrestrial invertebrates, which probably represent around 98% of animal species, are extremely sparse. This overview outlines the current attention that is being paid to SRE surveys, and contrasts it to the situation with the rest of the invertebrate fauna. The perils of not including terrestrial invertebrates in survey and research agendas are discussed, and more inclusive solutions which consider all terrestrial invertebrates are outlined.
Salinity tolerance of Aedes camptorhynchus (Diptera: Culicidae) from two regions in southwestern Australia
Authors: Van Schie Clarissa , Spafford Helen , Carver Scott , Weinstein Philip
Published: November 2009

Aedes camptorhynchus (Thomson) (Diptera: Culicidae) is widely distributed throughout southwestern Australia in both coastal and inland sites, and is a vector of Ross River virus (Togoviridae: Alphavirus). Larvae of this species are most commonly found in brackish to saline and hypersaline waters. In inland southwestern Australia secondary (anthropogenic) salinisation of agricultural land has led to widespread increases in the amount and saline standing water and available breeding habitat for Ae. camptorhynchus. Given the epidemiological significance of this mosquito species it is particularly important to understand the fundamental biology in order to inform vector management and environmental remediation strategies. We therefore sought to determine the salinity tolerance of Ae. camptorhynchus larvae collected from the coastal saltmarshes (coastal) and the southern wheatbelt (inland) of Western Australia. Ae. camptorhynchus neonate larvae were collected from the two sites and then reared in seawater or water from the source locations which were manipulated to saline concentrations ranging from 2.96 to 88.8 parts per thousand (p.p.t.) by dilution or addition of NaCl. Overall, Ae. camptorhynchus tolerated a wide range of salinities. The majority of Ae. camptorhynchus from the inland site that survived to adulthood did so at salinities between 8 and 30 p.p.t., whereas the majority of coastal mosquitoes that survived to adulthood did so in salinities between 22 and 52 p.p.t. Larvae were able to complete development in salinities up to 62 p.p.t., but none survived to adulthood at higher salinities. An increase in the number and distribution of Ae. camptorhynchus, associated with rising salinity, in previously freshwater habitats of inland southwestern Australia could have health consequences by increasing the potential for Ross River virus activity.
Procontarinia pustulata, a new gall midge species (Diptera: Cecidomyiidae) feeding on mango, Mangifera indica (Anarcadiaceae), in northern Australia and Papua New Guinea
Authors: Kolesik Peter , Rice Anthony D , Bellis Glenn A , Wirthensohn Michelle G
Published: November 2009

Procontarinia pustulata sp. n. is described from northern Australia and Papua New Guinea. Larvae feed on mango Mangifera indica causing blister‐like galls on leaves. The new species pupates in the soil. The genus Procontarinia Kieffer & Cecconi contains 15 named and several unnamed species, all of which feed on mango, with several being pests of cultivated mango worldwide. Procontarinia pustulata sp. n. differs from its congeners in morphology and gall anatomy as well as DNA sequence of COI. A simple technique is presented for rearing soil‐pupating gall midges in tropical region.
Seroepidemiological survey of cytomegalovirus infection among pregnant women in Nagasaki, Japan
Authors: Tagawa Masato , Minematsu Toshio , Masuzaki Hideaki , Ishimaru Tadayuki , Moriuchi Hiroyuki
Published: November 2009

Background:  Epidemiology of cytomegalovirus (CMV) infection varies widely, depending on ethnicity and socioeconomic status. A seroepidemiological survey was conducted to determine CMV infection among pregnant women in Nagasaki Prefecture, Japan.

Methods:  We measured serum CMV‐specific immunoglobulin (Ig) M and IgG at the first and third trimesters. IgG avidity was determined when both CMV‐IgG and CMV‐IgM were positive.

Results:  Of 339 pregnant women, 296 (87.3%) were CMV‐IgG‐positive at the first trimester. Of 267 paired sera, one (0.37%) had CMV‐IgG seroconversion, another one (0.37%) had CMV‐IgM seroconversion, and 12 had both CMV‐IgG and CMV‐IgM, two (0.75%) of whom had low IgG avidity, suggesting recent infection. Thus, the incidence of primary CMV infection during pregnancy was 0.74–1.5%. Assuming the rate of in utero transmission following maternal primary infection to be approximately 40%, the incidence of congenital infection is estimated to be 0.3–0.6%.

Conclusion:  Although CMV seroprevalence among pregnant women has been decreasing in industrialized regions including other parts of Japan, CMV‐seroprevalence remains high in Nagasaki. Thus, epidemiology of CMV infection seems variable within Japan, a country generally considered to be ethnically and socioeconomically homogeneous. However, 40–80 infants may be congenitally infected and 15–27% (or 6–22) of them may ultimately suffer from certain neurological sequelae annually in Nagasaki Prefecture, so where annual live births are approximately 13,300, congenital CMV infection seems to be a significant public health problem in such an apparently low‐risk region as Nagasaki.
Surfactant lavage decreases systemic interleukin‐1β production in meconium aspiration syndrome
Authors: Wang Pei‐Wei , Jeng Mei‐Jy , Wang Liang‐Shun , Fang Li‐Jung , Soong Wen‐Jue
Published: November 2009

Background:  Surfactant lavage has been used to remove meconium debris in meconium aspiration syndrome (MAS), but the influence of surfactant lavage on pro‐inflammatory cytokines and cellular apoptosis is unclear. The aim of this study was to investigate the response of pro‐inflammatory cytokine and the influence on alveolar cellular apoptosis using therapeutic bronchoalveolar lavage with diluted surfactant to treat MAS.

Methods:  Twelve newborn piglets were anesthetized, intubated via tracheostomy, and artificially ventilated. MAS was induced by intratracheal instillation of 3–5 mL/kg of 20% human meconium. The piglets were then randomly assigned to a surfactant lavage group (n= 6) or a control group (n= 6). Piglets in the lavage group received bronchoalveolar lavage with 30 mL/kg diluted surfactant (5 mg/mL) in two aliquots. Cardiopulmonary parameters were monitored continuously. Serum was obtained hourly to measure concentrations of pro‐inflammatory cytokines, including interleukin (IL)‐Iβ, IL‐6, and tumor necrosis factor α. Lung tissue was histologically examined after experiments, and terminal deoxynucleotidyl transferase‐mediated nick‐end labeling assay for apoptotic cell death was also performed.

Results:  The animals in the lavage group displayed significantly better gas exchange and lower serum concentrations of IL‐1β than the animals in the control group (P < 0.05). The number of apoptotic cells in lung tissues was significantly lower in the lavage group than the control group, and also in the nondependent than the dependent site.

Conclusion:  Therapeutic surfactant lavage improves oxygenation, decreases production of systemic pro‐inflammatory cytokine IL‐1β, and alleviates the severity of lung cell apoptosis in newborn piglets with experimentally‐induced MAS.
Intravesical prostatic protrusion predicts clinical progression of benign prostatic enlargement in patients receiving medical treatment
Authors: Lee Lui Shiong , Sim Hong Gee , Lim Kok Bin , Wang Delin , Foo Keong Tatt
Published: November 2009

Objectives:  To assess intravesical prostatic protrusion (IPP) as a novel predictor of clinical progression in patients with benign prostatic enlargement (BPE).

Methods:  All patients attending the outpatient clinic at our institution who were being treated for lower urinary tract symptoms (LUTS) secondary to BPE between January 1997 and December 2003 were recruited into the study. International Prostate Symptom Score (IPSS) scores, uroflowmetry parameters, post‐void residual urine volume (PVR), IPP and serum prostate‐specific antigen (PSA) were collected. IPP was classified into Grade 1, 2 or 3. Patients were stratified to different treatment options including watchful waiting, alpha blockers or 5‐alpha reductase inhibitors. Those who developed high post‐void residual urine volume (>100 mL), acute urinary retention or a deterioration of at least 4 points in IPSS score were considered to have disease progression. Using the Grade 1 IPP group as a reference, the odds ratio for clinical progression of Grade 2 and Grade 3 IPP were calculated by using multivariate analysis.

Results:  A total of 259 patients with a mean age of 63 years (range 50–90 years) and mean follow‐up time of 32 months were available for analysis. Fifty‐two patients were found to have clinical progression. Odds ratio for progression of a Grade 2 IPP was 5.1 (95% confidence interval [CI] 1.6–16.2) and that of a Grade 3 IPP was 10.4 (95% CI 3.3–33.4).

Conclusion:  A higher IPP grade is associated with a higher risk of clinical progression in BPE. IPP is a useful non‐invasive predictor for clinical progression in BPE.
Renal tubular epithelial cell injury and oxidative stress induce calcium oxalate crystal formation in mouse kidney
Authors: Hirose Masahito , Yasui Takahiro , Okada Atsushi , Hamamoto Shuzo , Shimizu Hideo , Itoh Yasunori , Tozawa Keiichi , Kohri Kenjiro
Published: November 2009

Objectives:  To clarify the role of renal tubular cell (RTC) injury and oxidative stress in the early stage of renal calcium oxalate crystal formation in a mouse model.

Methods:  Daily intra‐abdominal injections of glyoxylate (1.35 mmol/kg/day) into 8‐week‐old mice were carried out over 6 days. Kidneys were extracted before and at 6, 12 and 24 h and 3 and 6 days after glyoxylate injection. Crystal formation was detected using Pizzolato staining and polarized light optical microscopy. Immunohistochemical staining and western blotting of superoxide dismutase, and 4‐hydroxynonenal and malondialdehyde were carried out in order to observe oxidative stress and lipid peroxidation, respectively. RTC microstructural damage and crystal nuclei formation were observed using transmission electron microscopy. To ameliorate RTC injury, mice were treated with green tea 1 week before and 1 week after glyoxylate administration. The number of crystals and RTC damage were observed and comparisons were made between glyoxylate‐treated mice with and without green tea administration.

Results:  Oxidative stress and lipid peroxidation were observed after 6 h. Crystal nuclei containing collapsed mitochondria and fallen microvilli appeared in the renal distal tubular lumen after 24 h. Crystals occupying the tubular lumen were detected on day 3. The number of crystals in mice receiving green tea was significantly lower than in those receiving glyoxylate alone.

Conclusions:  RTC injury, especially mitochondrial damage, and oxidative stress induce the early stage of calcium oxalate crystal formation in mice.
Potential allelopathic rice lines for weed management in Cambodian rice production
Authors: PHENG SOPHEA , OLOFSDOTTER MARIA , JAHN GARY , ADKINS STEVE W.
Published: November 2009

In Cambodia, the planting of rice lines with a competitive and/or allelopathic ability would be a very useful way to supplement weed management in the rain‐fed, low‐input production systems. The present study examines a wide range of rice germplasm, mainly from Cambodia, and uses a series of bioassay techniques to identify those that might have a weed growth‐suppressing, allelopathic trait. A laboratory bioassay study that involved 359 rice lines showed that there were 15 that could significantly reduce the growth of awnless barnyard grass seedlings. In a second laboratory bioassay, involving the best 96 rice lines that were identified in the first study, 14 were shown to suppress the shoot growth of awnless barnyard grass, 11 could suppress the shoot growth of barnyard grass, six could suppress the shoot growth of small umbrella sedge, four could suppress the shoot growth of two‐leaf fimbristylis, four could suppress the shoot growth of water primrose, and three could suppress the shoot growth of gooseweed. Of the 13 rice lines that were able to suppress the growth of at least two weed species, there were three lines that could suppress the growth of three weed species, one line that could suppress the growth of four weed species, and one line that could suppress the growth of five weed species. In a third soil‐based, pot bioassay that studied the 18 best lines coming from the second laboratory bioassay, all showed a significant weed growth‐suppressive ability. A linear regression analysis showed that there was no correlation between their weed growth‐suppressive ability and their physical seedling size, supporting the idea that the growth suppression was allelopathic in nature and not a physical competition effect. In summary, the results indicate that an allelopathic trait does exist in some Cambodian rice lines and that this trait is effective in the growth suppression of a number of major rice weeds.
Utilization of Parthenium hysterophorus for the remediation of lead‐contaminated soil
Authors: HADI FAZAL , BANO ASGHARI
Published: November 2009

A greenhouse experiment was conducted to study the role of plant growth regulators, a chelating agent, and plant growth‐promoting bacteria in lead (Pb) phytoextraction and their subsequent effect on the weed plant, Parthenium hysterophorus. Gibberellic acid (GA3) and indole‐3‐acetic acid (IAA) were used as the foliar spray. Ethylenediamine tetra acetic acid (EDTA) was applied in split doses. Bacillus and Rhizobium strains were used as a single culture and as co‐cultures. The accumulation of Pb in different parts of the plant was analyzed by using an atomic absorption spectrophotometer. The amount of lead translocation and accumulation in the stems and leaves was significantly higher in the hormonal and EDTA treatments, while the microbial treatments showed no significant difference in the amount of Pb translocation into the stems and leaves, when compared to the control. The EDTA increased the amount of translocation into the shoots, but the dry biomass declined and subsequently reduced the total Pb phytoextraction. The GA3 treatment showed the maximum total Pb accumulation, along with a higher dry biomass. The microbial co‐inoculated plants showed a significant increase in their dry biomass but the Pb accumulation did not increase like with the GA3 and IAA treatments. These findings encourage the use of the GA3 application for Pb phytoextraction by P. hysterophorus. One important feature of this weed plant is its unpalatable nature to herbivores, which could help in reducing the entrance of Pb into the food chain. Gibberellic acid is environmentally friendly compared to EDTA; therefore, more investigation of GA3 and P. hysterophorus is required.
Comparing peripheral venous access between obese and normal weight children
Authors: NAFIU OLUBUKOLA O. , BURKE CONSTANCE , COWAN ANDY , TUTUO NARKO , MACLEAN SARAH , TREMPER KEVIN K.
Published: November 2009

Introduction:  Intravenous (i.v.) access is sometimes a difficult, time‐consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures.

Methods:  We prospectively collected data on children aged 2–18 years undergoing elective noncardiac surgery at our institution. A trained research assistant (RA) was present for PIV placement in all patients and noted the following: age, gender, ethnicity, weight, height, and BMI. We also collected data on i.v. insertion site, number of attempts, number of operators, and the number of i.v. cannula used. The main outcome variable was success or failure of i.v. placement on first attempt. Sample size calculation indicated a need for 40 obese and 40 control patients.

Results:  A total of 103 (56 lean and 47 obese) patients comprised the study population. PIV cannulation was achieved on the first attempt in 55.2% while 39.6% of patients had 2–3 attempts before successful cannulation. Obese children were more likely to have failed attempt at first cannulation than lean controls (P < 0.001). Similarly, obese children were more likely to require two or more attempts at cannulation than lean children (P < 0.001).

Conclusion:  These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.
A pretreatment nomogram predicting biochemical failure after salvage cryotherapy for locally recurrent prostate cancer
Authors: Spiess Philippe E. , Katz Aaron E. , Chin Joseph L. , Bahn Duke , Cohen Jeffrey K. , Shinohara Katsuto , Hernandez Mike , Bossier Julie , Kassouf Wassim , Pisters Louis L.
Published: November 2009

Study Type – Prognosis (retrospective cohort) Level of Evidence 2b

OBJECTIVE

To gather a pooled database from six tertiary‐care referral centres using salvage cryotherapy (SC) for locally recurrent prostate cancer, and develop a pretreatment nomogram allowing a prediction of the probability of biochemical failure after SC, based on pretreatment clinical variables.

PATIENTS AND METHODS

We retrospectively analysed 797 men treated at six tertiary‐care referral centres with SC for locally recurrent disease after primary radiotherapy with curative intent. The median duration of follow‐up from the time of SC to the date of last contact was 3.4 years. The primary study endpoint was biochemical failure, defined as a serum prostate‐specific antigen (PSA) level after SC of >0.5 ng/mL.

RESULTS

Overall, the rate of biochemical failure was 66% with a median of 3.4 years of follow‐up. A logistic regression model was used to predict biochemical failure. Covariates included serum PSA level at diagnosis, initial clinical T stage, and initial biopsy Gleason score. On the basis of these results, a pretreatment nomogram was developed which can be used to help select patients best suited for SC. Our pretreatment nomogram was internally validated using 500 bootstrap samples, with the concordance index of the model being 0.70.

CONCLUSION

A pretreatment nomogram based on several diagnostic variables (serum PSA level at diagnosis, biopsy Gleason grade, and initial clinical T stage) was developed and might allow the selection of ideal candidates for SC.
Use of systemic therapy and factors affecting survival for patients undergoing cytoreductive nephrectomy
Authors: Kutikov Alexander , Uzzo Robert G. , Caraway Aaron , Reese Carl T. , Egleston Brian L. , Chen David Y.T. , Viterbo Rosalia , Greenberg Richard E. , Wong Yu‐Ning , Raman Jay D. , Boorjian Stephen A.
Published: November 2009

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

To present a multi‐institutional experience evaluating the use of systemic therapy in patients undergoing cytoreductive nephrectomy (CN), as prospective randomized trials showed a survival benefit for CN in patients with metastatic renal cell carcinoma treated with immunotherapy, and these data have been extrapolated to support CN in the era of targeted therapy, but the likelihood that patients with metastatic kidney cancer who undergo CN will receive systemic treatment afterward remains poorly defined.

PATIENTS AND METHODS

In all, 141 patients who underwent CN between 1990 and 2008 were identified from our Institutional Kidney Cancer Registries. Kaplan‐Meier analyses and Cox regression models were used to assess the effect of clinicopathological and perioperative variables on patients’ subsequent receipt of systemic therapy, and survival after CN.

RESULTS

Overall, 98 of the 141 patients (69.5%) received postoperative systemic treatment, at a median (range) of 2.5 (0.1–61.5) months after CN. In this group, 52 (53%) patients received immunotherapy, 34 (35%) targeted agents, and 12 (12%) other regimens. By contrast, 43 patients (31%) did not receive systemic therapy, because of rapid disease progression (13, 30%), decision for surveillance by medical oncology (nine, 21%), patient refusal (10, 23%), perioperative death (eight, 19%), and unknown reasons in three (7%). The median (range) survival after CN was 16.7 (0–120) months. The risk of death after surgery correlated with the number of metastatic sites (P = 0.012) and symptoms (P = 0.001) at presentation, poor performance status (P = 0.001), high tumour grade (P = 0.006), and presence of sarcomatoid features (P < 0.024).

CONCLUSION

Nearly a third of patients undergoing CN did not receive systemic treatment. While some were electively observed or declined therapy, others did not receive treatment due to rapidly progressive disease. Further investigation is warranted to identify those patients at highest risk of rapid postoperative disease progression who might benefit instead from an initial approach to treatment with systemic therapy.
Are patients with non‐muscle‐invasive bladder cancer a suitable population for a lung cancer screening trial?
Authors: Del Rey Javier , Placer José , Vallmanya Felip , Pujol Núria , Prat Esther , Miró Rosa , Gelabert Antoni
Published: November 2009

Study Type – Prognosis (case series) Level of Evidence 4

OBJECTIVE

To estimate the relative risk of developing a second primary neoplasm, in particular lung cancer, after having non‐muscle‐invasive bladder cancer (NMIBC).

PATIENTS AND METHODS

Patients were included in the study if they had developed NMIBC between 1995 and 2003. All clinical data were extracted from the medical records of our institution’s database. The interval between neoplasms, smoking habits, histological subtypes and survival were also analysed. Patient follow‐up was ≥5 years.

RESULTS

We found 231 patients with NMIBC, 39 of which had a second primary neoplasm: 10 lung cancer, one pancreas, one gastric, one pharynx, one liver, one parathyroid, one oesophageal, five basal cell carcinoma, three larynx, two colon, three rectal and 10 prostate. In patients with lung cancer, NMIBC was the first primary tumour. Overall, the median (range) interval between occurrence of NMIBC and lung cancer was 54.2 (8–168) months. For the relationship between the observed and expected cases of lung cancer, after normalizing our frequencies to the sex ratio and age of our group of patients, the risk of lung cancer was 10.27‐fold higher in patients with NMIBC as compared with the general population of Catalonia (95% confidence interval 4.92–18.88).

CONCLUSION

We consider that an annual examination for the detection and prevention of lung cancer must be included in clinical guides for patients with NMIBC. This proposal is reinforced by the finding that death in our group of patients with both tumours was always derived from lung cancer and not from bladder cancer.
The EU Childhood Obesity Project
Authors: De La Hunty A.
Published: November 2009

The European Union Childhood Obesity Project was set up in 2001 to test the hypothesis that the higher risk of obesity seen in formula‐fed infants – as compared with breastfed babies – is a result of the higher protein content in infant formulas than in breastmilk. The infants participating in the study were recruited between 2002 and 2004 and followed up for 2 years. The first results of the study were published earlier this year. After 2 years, the weight‐for‐length and body mass index of the infants fed the lower‐protein formula were significantly lower than those fed the higher‐protein formulas. Extrapolating from previous studies suggests that the children in the higher‐protein group have a 13% increased risk of being obese in adolescence compared with those in the lower‐protein group. An analysis of the timing of weaning has also been published: this showed that formula‐fed infants were given solid foods on average 2 weeks earlier than breastfed infants (19 weeks compared with 21 weeks) and were twice as likely to be introduced to solid foods before the age of 4 months as breastfed infants.
Efficacy and safety of anti‐obesity drugs in children and adolescents: systematic review and meta‐analysis
Authors: Viner R. M. , Hsia Y. , Tomsic T. , Wong I. C. K.
Published: November 2009

We undertook a meta‐analysis of randomized controlled trials to summarize the efficacy of anti‐obesity drugs in reducing BMI and improving health in children and adolescents. Data sources included Medline, Embase, the Cochrane controlled trials register and other registers of controlled trials, together with reference lists of identified articles. All data sources were searched from January 1996 to July 2008. We searched for double blind randomized placebo controlled trials of approved anti‐obesity drugs used in children and adolescents (age <20) with primary obesity for ≥6 months. Six trials, 4 of sibutramine (total patients = 686) and 2 of orlistat (n = 573) met inclusion criteria. No trials of rimonabant were identified. Compared with placebo, sibutramine together with behavioural support reduced BMI by 2.20 kg/m2 (95% CI: 1.57 to 2.83) and orlistat together with behavioural support reduced BMI by 0.83 kg/m2 (95% CI 0.47 to 1.19). Sibutramine improved waist circumference, triglycerides and high density lipoprotein (HDL)‐cholesterol, but raised systolic and diastolic blood pressure and pulse. Orlistat increased rates of gastrointestinal side‐effects. We conclude that sibutramine in adolescents produces clinically meaningful reductions in BMI and waist circumference of approximately 0.63 SD, with improvements in cardiometabolic risk. Orlistat modestly reduces BMI (effect size approximately 0.24 SD) with a high prevalence of gastrointestinal adverse effects.
Obesity, intentional weight loss and physical disability in older adults
Authors: Rejeski W. J. , Marsh A. P. , Chmelo E. , Rejeski J. J.
Published: November 2009

We examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short‐term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat‐free mass during caloric restriction. Multi‐year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long‐term feasibility and effects of combining resistance exercise with weight loss in older adults.
Obesity is a sign – over‐eating is a symptom: an aetiological framework for the assessment and management of obesity
Authors: Sharma A. M. , Padwal R.
Published: November 2009

Obesity is characterized by the accumulation of excess body fat and can be conceptualized as the physical manifestation of chronic energy excess. Using the analogy of oedema, the consequence of positive fluid balance or fluid retention, obesity can be seen as the consequence of positive energy balance or calorie ‘retention’. Just as the assessment of oedema requires a comprehensive assessment of factors related to fluid balance, the assessment of obesity requires a systematic assessment of factors potentially affecting energy intake, metabolism and expenditure. Rather than just identifying and describing a behaviour (‘this patient eats too much’), clinicians should seek to identify the determinants of this behaviour (‘why, does this patient eat too much?’). This paper provides an aetiological framework for the systematic assessment of the socio‐cultural, biomedical, psychological and iatrogenic factors that influence energy input, metabolism and expenditure. The paper discusses factors that affect metabolism (age, sex, genetics, neuroendocrine factors, sarcopenia, metabolically active fat, medications, prior weight loss), energy intake (socio‐cultural factors, mindless eating, physical hunger, emotional eating, mental health, medications) and activity (socio‐cultural factors, physical and emotional barriers, medications). It is expected that the clinical application of this framework can help clinicians systematically assess, identify and thereby address the aetiological determinants of positive energy balance resulting in more effective obesity prevention and management.
The Importance of Compensating Strategic Network Board Members for Network Performance: A Contingency Approach
Authors: Thorgren Sara , Wincent Joakim , Anokhin Sergey
Published: November 2009

Firms in government‐supported strategic networks tend to rely on professional network board members for support and assistance. As such, two significant issues arise: should board members be compensated and under which circumstances is compensation more – or less – effective for network performance. Based on yearly panel data from 53 government‐supported strategic networks of small‐ and medium‐sized enterprises over a five‐year period, this study examines the effects of compensating network board members. Advocating for a contingency approach, we combine the agency and stewardship literatures to posit that the effects of compensation are moderated by contingency factors that stimulate either an agency or stewardship relationship between the network board and the networking firms. Our findings indicate that significant funding, network firms represented on the network board, and top‐down network formation stimulate board members to become agents rather than stewards. This therefore explains the higher effect of board member compensation under such conditions.
RESEARCH SECTION: Inclusive special education: the role of special education teachers in Finland
Authors: Takala Marjatta , Pirttimaa Raija , Törmänen Minna
Published: November 2009

This study concentrates on the work of special education teachers in mainstream education in Finland, where these professionals work with children from various classes, usually in a separate room. The research reported in this article by Marjatta Takala of the University of Helsinki, Raija Pirttimaa of the University of Oulu and Minna Törmänen, who is studying for her PhD at the University of Helsinki, involved sending a questionnaire to 133 special education teachers and undertaking observations. The work of the special education teachers was revealed to consist of three elements: teaching, consulting and background work. Teaching, often focusing on giving support to children who had challenges in the main academic subjects, was realised in small groups, in co‐operative or individual settings. Consultation mainly concerned co‐operation and discussion. Behavioural challenges needed a targeted approach. The main problems experienced by the teachers were the lack of time for consultation and co‐operation, an unclear work profile and too much work. The work of special education teachers was partly inclusive, but also entailed segregative elements. The authors discuss the potential for promoting further steps towards inclusion as well as possible changes in organising special educational provision at school level.
ALTERNATIVE CURRICULUM: The integration of an alternative curriculum: Skill Force
Authors: Rogers Lynne , Hallam Susan , Shaw Jacquelene , Rhamie Jasmine
Published: November 2009

The introduction of alternative curricula in the UK for students in the secondary phase is one of a number of strategies designed to improve attendance at school, reduce exclusion and improve attainment. Skill Force is a charitable youth initiative that offers 14‐ to 16‐year‐old students a key skills based vocational alternative to the traditional curriculum. In this article, Lynne Rogers, Susan Hallam and Jacquelene Shaw of the Institute of Education, University of London, and Jasmine Rhamie of the University of Southampton set out to explore the views of Skill Force instructors and team leaders, school staff and Skill Force Regional Directors. These participants perceived the critical factors in the successful integration of Skill Force to be: effective introduction of the programme to pupils and parents; careful selection of students; clear introduction of the programme to staff; integrated discipline policies; strong support from senior management; good communication; and a willingness to resolve practical difficulties.
FOCUS ON PRACTICE: Inclusion and museums: developing inclusive practice
Authors: Shepherd Hannah
Published: November 2009

Recent policy on inclusion has had an impact on the development of museum galleries and related educational provision. Museums are used as learning organisations and, as such, need to consider how to create an inclusive environment. However, inclusive provision for people with learning difficulties in museums tends to be isolated and small scale, lacking the formal structure found within schools. While much can be learnt from the development and evaluation of practice in schools, there is little research or published literature that explores the inclusion of people with learning difficulties in museums. This article, by Hannah Shepherd, Exhibition Co‐ordinator at Freeman College in Sheffield, analyses an example of a specific exhibit within a gallery development. This example reflects an approach that uses guidance from the literature to create a more inclusive experience for visitors, particularly those with learning difficulties. A case is made for the use of consultation and partnership to develop inclusive museum provision.
Bäcklund Transformations and Superposition Principles in Nonlinear Elastodynamics
Authors: Rogers C. , Schief W. K.
Published: November 2009

A Bäcklund transformation is presented which allows the construction of model nonlinear elastic laws associated with a reduction of the uniaxial Lagrangian elastodynamic system to the canonical form adopted for the classical Hooke's law. A nonlinear superposition principle for the iterative generation of such elastic laws is recorded.
Using art with vulnerable children
Authors: CUMMING STEVI , VISSER JOHN
Published: November 2009

Refugee children are often admitted into schools having experienced traumatic events. The impact of trauma on children has been well documented and these children frequently have complex needs. The Devon Behaviour Support Team (BST) has offered Art Workshops to schools to support children with social, emotional and behavioural difficulties and refugees in their transition into schools in England. Self‐esteem and social interaction were measured by observations and qualitative assessment techniques over a period of six months for six refugee children from four Art Workshops. The results of the study show overall positive development in the children's confidence and reflect their increasing skills in social interaction within the classroom. The study also highlights the refugee children's attitudes to the art process and their responses to materials and requests.
The inclusion of pupils perceived as having social and emotional behavioural difficulties in mainstream schools: a focus upon learning
Authors: MOWAT JOAN
Published: November 2009

This article focuses upon the relationship between social and emotional behavioural difficulties (SEBD) and learning. It argues that, while inclusion is desirable in principle, it can be highly problematic in practice. Further, it explores the contested nature of the concept of SEBD and the nature of support for pupils categorised as such. The article draws upon a case study which evaluates a group work approach devised by the author to support pupils experiencing SEBD within a mainstream secondary school, within a deprived area. The study (N = 69) established benchmark measures relating to pupil attendance, discipline sanctions, attainment and pupil attitudes and followed the progress of the pupils until one to two years after completion of the intervention. The findings indicate that the intervention did not reduce the differential in performance in National Tests between the Support Group pupils and comparator groups but it did impact positively upon dispositions towards learning.
The effect of light intensity and noise on the classroom behaviour of pupils with Asperger syndrome
Authors: MENZINGER BERNHARD , JACKSON ROBIN
Published: November 2009

The focus of the study reported in this article is the behavioural response of pupils with Asperger syndrome to light and sound intensity and the development of ways to help them to cope with such sensory stimuli. A number of practical ways of minimising the negative effects of various sensory stimuli are noted: (1) the establishment of ‘a place of safety’ for every pupil who needs it; (2) the necessity for pupils to have a clear understanding of the programme that has been designed for them; (3) the critical importance for staff of reflecting on the day that has passed in order to prepare effectively for the day that lies ahead; (4) the use of pictorial communication given the pupils' poor comprehension of the spoken word; and (5) the importance of a consistent and predictable approach to the pupil.
Darren: a case study in school–college liaison
Authors: SMITH ANDREW
Published: November 2009

Some recent attention has been directed towards the role that post‐16 colleges can play in providing young people at risk of exclusion from school with opportunities to experience ‘alternative’ curricula and ways of learning. In this article the case of ‘Darren’ is considered, a boy for whom education in a mainstream secondary school setting appeared to have grown increasingly disjointed and irrelevant. This ‘case’ is used to highlight some of the challenges involved in school–college liaison in supporting young people who experience social, emotional and behavioural difficulties (SEBD).
The nature of teacher authority and teacher expertise
Authors: ELLIOTT JULIAN G.
Published: November 2009

The so‐called ‘soft skills’ utilised by teachers – including relationship building, awareness of the pupil's context and background and the demonstration of authority – to develop an appropriate learning culture in their classrooms have long been recognised as being a major contribution to effective promotion of positive behaviour. This article considers some of the dimensions of these, focusing on how these help in contributing towards ‘teacher authority’. The article draws on the parallel experiences of teachers and researchers in England, Russia and the United States to illustrate some of the international dimensions of this theme.
Path Analysis for Discrete Variables: The Role of Education in Social Mobility
Authors: Kuha Jouni , Goldthorpe John H.
Published: November 2009

An important open question in sociology with obvious policy implications is how to assess the magnitude of the effect of educational attainment on intergenerational social mobility. To examine this, we propose a general method of path analysis, which can be used to estimate direct and indirect effects even in systems where some of the variables are categorical. It provides an additive decomposition of total effects which is exact when the effects are expressed as mean differences, and approximate but typically quite accurate for other measures of association such as log-odds-ratios. Estimates of the effects and their standard errors can be calculated by using standard output for fitted models. The method is illustrated by an analysis of British survey data on social mobility.
Using Proxy Measures and Other Correlates of Survey Outcomes to Adjust for Non-Response: Examples from Multiple Surveys
Authors: Kreuter F. , Olson K. , Wagner J. , Yan T. , Ezzati-Rice T. M. , Casas-Cordero C. , Lemay M. , Peytchev A. , Groves R. M. , Raghunathan T. E.
Published: November 2009

Non-response weighting is a commonly used method to adjust for bias due to unit non-response in surveys. Theory and simulations show that, to reduce bias effectively without increasing variance, a covariate that is used for non-response weighting adjustment needs to be highly associated with both the response indicator and the survey outcome variable. In practice, these requirements pose a challenge that is often overlooked, because those covariates are often not observed or may not exist. Surveys have recently begun to collect supplementary data, such as interviewer observations and other proxy measures of key survey outcome variables. To the extent that these auxiliary variables are highly correlated with the actual outcomes, these variables are promising candidates for non-response adjustment. In the present study, we examine traditional covariates and new auxiliary variables for the National Survey of Family Growth, the Medical Expenditure Panel Survey, the American National Election Survey, the European Social Surveys and the University of Michigan Transportation Research Institute survey. We provide empirical estimates of the association between proxy measures and response to the survey request as well as the actual survey outcome variables. We also compare unweighted and weighted estimates under various non-response models. Our results from multiple surveys with multiple recruitment protocols from multiple organizations on multiple topics show the difficulty of finding suitable covariates for non-response adjustment and the need to improve the quality of auxiliary data.