bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic development, business strategy, and corporate restructuring in India
Authors: Aggarwal Raj
Published: May 2009

Purpose

The purpose of this paper is to review the reasons for the increased pace of restructuring of Indian industry in response to increasing market efficiencies and declining transactions costs in India.

Design/methodology/approach

This paper uses theory of transactions cost economics as the theoretical framework for analyzing the changing structure of Indian industry.

Findings

As in many developing countries, the Indian business environment has reflected high‐transactions costs so that Indian companies found it more efficient to diversify and internalize many unrelated activities. Consequently, most large Indian businesses have traditionally been widely diversified with vertically integrated group structures. As economic deregulation and adoption of internet technology reinforce each other, Indian transactions costs are declining and vertical integrated and diversified group structure is likely to become inefficient and a disadvantage.

Practical implications

Declining transactions costs will continue to force significant and sudden restructuring and specialization among the large and major Indian conglomerates with rising volumes of mergers and acquisitions activity in India. This will require managers with new skill sets that include strategic analysis and undertaking successful corporate re‐structuring.

Originality/value

The paper presents an assessment of the impact on Indian business of new technologies and economic deregulation in India.
India's economic growth and market potential: benchmarked against China
Authors: Kalyanaram G.K.
Published: May 2009

Purpose

In the context of India's growth and development benchmarked against China, this paper aims to address two important research questions: How do the growth models and market potential of China and India compare? What are some policy lessons to be learned?

Design/methodology/approach

This paper presents a critical analysis and review of the empirical results.

Findings

While India has adopted policies that have stimulated consumer demand and fostered entrepreneurship, China has adopted policies that have encouraged resource‐mobilization. China's physical infrastructure, while impressive, may have come at the cost of social investments (e.g. primary and secondary education). Empirical result shows that social investments are important for an economy's sustained growth, more than incentives to attract foreign direct investments. While the structure of the economy appears to be more promising for India, there is one enigmatic issue yet to be understood: China's path of economic development (agriculture to industry to services) has been demonstrated to be viable but India's path of development (almost directly agrarian to services‐based) may or may not be viable (the jury is still out). Finally, data from China and India are not yet discriminating enough to answer the question: is growth driven by greater export‐import trade recommended for long‐term and stable growth?

Originality/value

This study shows that while China and India have adopted two different models of growth, India's model is likely to be more sustainable.
Diverse alcohol drinking patterns in 20 African countries
Authors: Clausen Thomas , Rossow Ingeborg , Naidoo Nirmala , Kowal Paul
Published: May 2009

Aims This paper describes drinking patterns in 20 African countries, exploring the extent of abstention, heavy occasional drinking and daily light drinking and how these aspects of drinking are inter‐related.

Design and participants Data were collected as part of the World Health Survey in 2002–04 and comprise national representative data sets from 20 African countries. A cross‐sectional survey of 77 165 adults aged 18 years and older were undertaken by face‐to‐face interviews in respondent households.

Measures Drinking behaviour was assessed in terms of life‐time abstention and the following measures over the 7 days immediately preceding interview: high consumption (15 or more drinks); heavy drinking occasions (five or more standard units at at least one session) and daily light drinking (one or two drinks daily).

Findings In four countries (Comoros, Mali, Mauritania and Senegal), virtually all respondents were life‐time abstainers. The prevalence of current drinkers (previous week) did not exceed one‐third in any country. Among current drinkers the prevalence of heavy drinking varied between 7% and 77% and the prevalence of daily light drinkers varied between 0% and 21%. Overall drinking patterns varied significantly between and within the examined African countries.

Conclusions African drinking patterns are diverse, and although life‐time abstinence dominates in African countries, a single typical pattern of drinking for the African continent, such as the alleged ‘all‐or‐none’ pattern, was not observed.
Mortality among opiate users: opioid maintenance therapy, age and causes of death
Authors: Clausen Thomas , Waal Helge , Thoresen Magne , Gossop Michael
Published: May 2009

Aims  This study investigates how age of opioid users is related to causes of death prior to, during and after opioid maintenance treatment (OMT), and estimates risks of death from various causes in relation to age.

Design, setting and participants  Data on all opiate dependents in Norway (1997–2003) who applied for and were accepted for OMT (n = 3789) were cross‐linked with the Norwegian death register. The total observation time was 10 934 person‐years.

Findings  A total of 213 deaths was recorded. Of these, 73% were subject to autopsy, and causes of death were known for 208 cases: the overall death rate was 1.9%. Deaths were due to drug overdose (54%), somatic (32%) and traumatic causes (14%). Overdose deaths among all age groups were reduced during OMT but age had a differential effect upon risk when out of treatment. Younger opioid users were at greater risk of overdose before entering treatment; older users were at greater risk after leaving treatment. Older OMT patients were at higher risk of both somatic and traumatic deaths, and deaths during OMT were most likely to be due to somatic causes.

Conclusions  The high rates of overdose prior to and after treatment emphasize the need to provide rapid access to OMT, to retain patients in treatment and to re‐enrol patients. The high prevalence among older patients of deaths due to somatic causes has implications for screening, treatment and referral, and may also lead to increased treatment costs.
Progressive stage transition does mean getting better: a further test of the Transtheoretical Model in recovery from alcohol problems
Authors: Heather Nick , Hönekopp Johannes , Smailes David
Published: May 2009

Aims  To test two central assumptions of the Transtheoretical Model (TTM) regarding recovery from alcohol problems: (i) individuals making a forward transition from pre‐action to action stages will show greater drinking improvements than those remaining in pre‐action stages; and (ii) individuals remaining in pre‐action stages will not demonstrate improvements in drinking outcomes.

Design and setting  Large, multi‐centre, randomized controlled trial of treatment for alcohol problems [United Kingdom Alcohol Treatment Trial (UKATT)].

Measurements  Stage of change, drinks per drinking day and percentage days abstinent at baseline, 3‐ and 12‐month follow‐ups.

Findings  In support of TTM assumption 1, improvements in drinking outcomes were consistently greater among clients who showed a forward stage transition (Cohen's d = 0.68) than among those who did not (d = 0.10). Two tests of assumption 2 showed a significant improvement in drinking outcomes in non‐transition groups, inconsistent with the TTM; one test showed a significant deterioration and the other showed equivalent drinking outcomes across time. An explanation is offered as to why, under the relevant assumption of the TTM, clients in non‐transition groups showed small changes in drinking outcomes.

Conclusions  In contrast to a previous study by Callaghan and colleagues, our findings largely support the TTM account of recovery from alcohol problems in treatment. The discrepancy can be explained by the use in our study of a more reliable and valid method for assigning stage of change.
Variation in the CYP2D6 gene is associated with a lower serum sodium concentration in patients on antidepressants
Authors: Kwadijk‐de Gijsel Sonja , Bijl Monique J. , Visser Loes E. , Van Schaik Ron H. N. , Hofman Albert , Vulto Arnold G. , Van Gelder Teun , Ch. Stricker Bruno H.
Published: May 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Several antidepressants are metabolized by the polymorphic enzyme cytochrome P450 2D6 (CYP2D6).

• The variant allele CYP2D6*4 is the main polymorphism resulting in decreased enzyme activity in Caucasians.

• Decreased CYP2D6 enzyme activity potentially leads to higher plasma concentrations of antidepressants.

• Consequently, patients carrying the *4 allele are more likely to suffer from adverse drug reactions such as hyponatraemia.

WHAT THIS STUDY ADDS

• The association between CYP2D6 genotype and serum sodium concentration in users of antidepressants has not been examined thoroughly, and most studies suffer from small numbers of poor metabolizers (PMs) of CYP2D6.

• This study shows that serum sodium concentrations in users of tricyclic antidepressive drugs are lower in CYP2D6 PMs than in extensive metabolizers.

AIM

To study the effect of the CYP2D6*4 polymorphism on serum sodium concentration in users of antidepressants [selective serotonin reuptake inhibitors and tricyclic antidepressants (TCAs)].

METHODS

In this population‐based cohort study, all subjects in the Rotterdam Study were included who used an antidepressant at baseline and from whom a blood sample was available in which CYP2D6 genotype and serum sodium concentration could be determined (n= 76). Multivariate linear regression was used to study the association between CYP2D6*4 and serum sodium concentration.

RESULTS

CYP2D6 poor metabolizers (PMs) (*4/*4) had a significantly lower mean serum sodium concentration in comparison with CYP2D6 extensive metabolizers (EMs) (*1/*1) [difference −3.9 mmol l−1; 95% confidence interval (CI) −0.86, −7.03; P= 0.013]. In CYP2D6*4 heterozygotes (*1/*4) serum sodium concentration was 1.7 mmol l−1 (95% CI −3.48, 0.18) lower compared with CYP2D6 EMs, but this difference was not statistically significant (P= 0.077).

CONCLUSIONS

The serum sodium concentration in PMs was lower in users of an antidepressant, especially in TCA users. Therefore CYP2D6 PMs might be at increased risk of developing symptoms of hyponatraemia.
Medication consumption in the Spanish paediatric population: related factors and time trend, 1993–2003
Authors: Carrasco‐Garrido Pilar , Jiménez‐García Rodrigo , Barrera Valentín Hernández , De Andrés Ana López , De Miguel Ángel Gil
Published: May 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT?

• Health authorities undertake specific campaigns targeted at making the population more keenly aware of the need to use medications rationally.

• Parents are increasingly turning to medications prescribed for the ‘over‐the‐counter’ (OTC) specialties as substitutes, using them – not always correctly – to treat symptoms such as acute cough, fever or pain.

WHAT THIS STUDY ADDS?

• Our study constitutes an approach to self‐reported drug consumption in the Spanish paediatric population, based on a representative nationwide sample.

• There was a significant decline in overall drug consumption in the Spanish paediatric population from 1993 to 2003.

• Nevertheless, the prevalence of consumption of analgesics, antipyretics and antibiotics has risen.

AIMS

To ascertain the prevalence of consumption of medications in the Spanish paediatric population and to identify the factors associated with such consumption.

METHODS

This was a descriptive, cross‐sectional study covering the Spanish adult population, using data drawn from the 1993 and 2003 Spanish National Health Surveys (SNHS). The 1993 and 2003 SNHS include data on 5280 and 6463 children, respectively, age range 0–15 years. The independent variables were sociodemographic and health‐related, and the dependent variable was medications use. Using logistic multivariate regression models, we analysed the temporal evolution of medication consumption between 1993 and 2003.

RESULTS

The 1993 SNHS data revealed that 36.81% of the paediatric population had consumed some type of medication, whereas in 2003 this figure had dropped to 34%. Over the decade of study, there was a significant decrease in use of medications for catarrh, influenza, throat (P < 0.05), and an increase in consumption of pain‐relieving drugs and/or fever‐lowering, antibiotics and anti‐allergy remedies. Multivariate analysis highlighted the association between medication consumption, negative perception of the child's health [odds ratio (OR) 2.84, 95% confidence interval (CI) 2.16, 3.72 in 1993, and OR 3.54, 95% CI 2.74, 4.56 in 2003] and medical visits to the physician across the 2 years (OR 12.09, 95% CI 10.13, 14.42 in 1993, and OR 7.17, 95% CI 6.06, 8.47 in 2003).

CONCLUSIONS

Although there was a significant decline in overall drug consumption in the Spanish paediatric population from 1993 to 2003, the prevalence of consumption of certain groups, such as analgesics, antipyretics and antibiotics, has risen.
The protective role of antibody responses duringMycobacterium tuberculosisinfection
Authors: Abebe F , Bjune G
Published: May 2009

Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) is one of the most important infectious diseases globally. Immune effector mechanisms that lead to protection or development of clinical disease are not fully known. It is generally accepted that cell-mediated immunity (CMI) plays a pivotal role in controlling Mtb infection, whereas antibody responses are believed to have no protective role. This generalization is based mainly on early classical experiments that lacked standard protocols, and the T helper type 1 (Th1)/Th2 paradigm. According to the Th1/Th2 paradigm Th1 cells protect the host from intracellular pathogens, whereas Th2 cells protect form extracellular pathogens. During the last two decades, the Th1/Th2 paradigm has dominated not only our understanding of immunity to infectious pathogens but also our approach to vaccine design. However, the last few years have seen major discrepancies in this model. Convincing evidence for the protective role of antibodies against several intracellular pathogens has been established. Studies of B cell-deficient mice, severe combined immunodeficiency (SCID) mice, passive immunization using monoclonal (mAb) and polyclonal antibodies and immune responses against specific mycobacterial antigens in experimental animals reveal that, in addition to a significant immunomodulatory effect on CMI, antibodies play an essential protective role against mycobacterial infections. In this review, our current understanding of the essential role of antibodies during Mtb infections, limitations of the Th1/Th2 model and the unfolding interdependence and mutual regulatory relationships between the humoral and CMI will be presented and discussed.
Dexamethasone suppresses interleukin-22 associated with bacterial infection in vitro and in vivo
Authors: Ziesché E , Scheiermann P , Bachmann M , Sadik C D , Hofstetter C , Zwissler B , Pfeilschifter J , Mühl H
Published: May 2009

Interleukin (IL)-22 production triggered by innate immune mechanisms has been identified as key to efficient intestinal anti-bacterial host defence and preservation of homeostasis. We hypothesized that glucocorticoid therapy may impair IL-22 expression, which should promote intestinal epithelial damage with the potential of subsequent bacterial translocation. High-dose corticosteroid therapy in Crohn’s disease has been associated with an increased rate of abscess formation and ultimately with a higher risk of developing postoperative infectious complications, including abdominal sepsis. Thus, we sought to investigate effects of the prototypic glucocorticoid dexamethasone on IL-22 production in the context of bacterial infection. Enhanced IL-22 plasma levels were detectable in rat sepsis. Moreover, heat-inactivated Staphylococcus epidermidis, used as a prototypic activator of innate immunity, induced robust production of IL-22 by human peripheral blood mononuclear cells (PBMC). Here, we report for the first time that dexamethasone mediates remarkable suppression of IL-22 as detected in S. epidermidis-activated PBMC and rat sepsis, respectively. The data presented herein suggest that insufficient IL-22 function may contribute to impaired intestinal host defence in the context of corticosteroid therapy.
A randomized, controlled, multicentre trial comparing pegvisomant alone with combination therapy of pegvisomant and long‐acting octreotide in patients with acromegaly
Authors: Trainer Peter J. , Ezzat Shereen , D’Souza Gwyn A. , Layton Gary , Strasburger Christian J.
Published: May 2009

Objective  For patients with acromegaly who are suboptimally controlled on long‐acting octreotide (LAR), treatment options are to switch to pegvisomant monotherapy (PM) or add pegvisomant to LAR (P‐LAR). Our objective was to evaluate if the safety and efficacy of these regimens differ.

Design  This was an open‐label, multicentre, randomized, 40‐week outpatient study. The control arm consisted of patients controlled on LAR (n = 28).

Patients  A total of 27 patients with suboptimally controlled acromegaly [as indicated by a serum IGF‐I level ≥ 1·3 × upper limit of normal (ULN) of the age‐related reference range] were randomized to PM (10 mg once daily initially, then adjusted in 5‐mg increments every 8 weeks based on IGF‐I levels) and 29 to P‐LAR (LAR dosing remained fixed).

Measurements  The primary end‐point was adverse events (AEs). The secondary end‐point was biochemical IGF‐I‐based efficacy. The RIA for IGF‐I was discontinued by the manufacturer during the study and a chemiluminescent assay was subsequently used. Previously obtained IGF‐I levels were re‐analysed.

Results  PM and P‐LAR were well tolerated and there were no differences in the number of AEs. Patients receiving P‐LAR tended to be more likely to have clinically significant increases in hepatic transaminase levels, especially those receiving high‐dose LAR. Normalization of IGF‐I was similar with both regimens (56% and 62% of patients for PM and P‐LAR respectively). The change in IGF‐I assay resulted in lower rates of IGF‐I normalization than expected. Reductions in fasting glucose levels were greater with PM than with P‐LAR (−0·8 mmol/l; 95% confidence interval −1·16, −0·53 mmol/l).

Conclusions  In patients suboptimally controlled on LAR, PM and P‐LAR were equally well tolerated and effective in normalizing IGF‐I, and overall clinical improvement was observed with both regimens. Thus, pegvisomant monotherapy and adjunctive therapy are equally viable options for the treatment of LAR‐resistant acromegaly.
Molecular analysis of congenital goitres with hypothyroidism caused by defective thyroglobulin synthesis. Identification of a novel c.7006C>T [p.R2317X] mutation and expression of minigenes containing nonsense mutations in exon 7
Authors: Machiavelli Gloria A. , Caputo Mariela , Rivolta Carina M. , Olcese María C. , Gruñeiro‐Papendieck Laura , Chiesa Ana , González‐Sarmiento Rogelio , Targovnik Héctor M.
Published: May 2009

Background  Thyroglobulin (TG) deficiency is an autosomal‐recessive disorder that results in thyroid dyshormonogenesis. A number of distinct mutations have been identified as causing human hypothyroid goitre.

Objectives  The purpose of this study was to identify and characterize new mutations in the TG gene in an attempt to increase the understanding of the genetic mechanism responsible for this disorder. A total of six patients from four nonconsanguineous families with marked impairment of TG synthesis were studied.

Methods  Single‐strand conformation polymorphism (SSCP) analysis, sequencing of DNA, genotyping, expression of chimeric minigenes and bioinformatic analysis were performed.

Results  Four different inactivating TG mutations were identified: one novel mutation (c.7006C>T [p.R2317X]) and three previously reported (c.886C>T [p.R277X], c.6701C>A [p.A2215D] and c.6725G>A [p.R2223H]). Consequently, one patient carried a compound heterozygous for p.R2223H/p.R2317X mutations; two brothers showed a homozygous p.A2215D substitution and the remaining three patients, from two families with typical phenotype, had a single p.R277X mutated allele. We also showed functional evidences that premature stop codons inserted at different positions in exon 7, which disrupt exonic splicing enhancer (ESE) sequences, do not interfere with exon definition and processing.

Conclusions  In this study, we have identified a novel nonsense mutation p.R2317X in the acetylcholinesterase homology domain of TG. We have also observed that nonsense mutations do not interfere with the pre‐mRNA splicing of exon 7. The results are in accordance with previous observations confirming the genetic heterogeneity of TG defects.
Minimal diagnostic criteria for myelodysplastic syndromes and separation from ICUS and IDUS: update and open questions
Authors: Valent P. , Horny H.‐P.
Published: May 2009

Although a classification for myelodysplastic syndromes (MDS) has been proposed by several working groups and by the World Health Organization (WHO), with criteria useful to discriminate between disease variants, the important issue of minimal diagnostic criteria of MDS has only recently been addressed. In the current article, proposed minimal diagnostic criteria for MDS are discussed together with two conditions that do not meet these criteria, although cytopenia or dysplasia is present. These two conditions, idiopathic cytopenia of unknown significance and idiopathic dysplasia of unknown significance should be kept in mind as a provisional (potential) diagnosis in patients with suspected MDS. Both conditions can progress to frank MDS over time. Therefore, once diagnosed, these patients should have a haematological follow‐up. The diagnosis MDS, on the other hand, needs to be based on robust criteria and exclusion of all other causes of cytopenia and dysplasia, which requires detailed and sometimes extensive investigations, including a bone marrow biopsy, cytogenetic analyses, molecular studies and flow cytometry.
The effect of trehalose, sucrose and maltodextrin addition on physicochemical and sensory aspects of freeze ‐ dried strawberry puree
Authors: Galmarini Mara V. , Schebor Carolina , Zamora María C. , Chirife Jorge
Published: May 2009

Use of trehalose as a novel drying aid to produce freeze‐dried strawberry puree was studied and compared with conventional drying aids for fruit purees, namely sucrose and maltodextrin (MD). Glass transition temperature (Tg), colour, sensory profile and consumer preference were determined. Purees dried with MD and/or trehalose presented higher Tg values as compared to sucrose. Sensory evaluation indicated that samples dried with trehalose retained fresh strawberry aroma and flavour, keeping a good sweetness/sourness balance, while puree dried with sucrose was mostly sweet. Addition of MD caused an increase in products visual viscosity and sourness, attributes which were negatively correlated to preference. Trehalose presented several advantages for increasing the quality of freeze dried fruit purees. It raised Tg, gave an adequate sweetness/sourness balance, and allowed a better perception of fresh strawberry flavour.
Multiple colonizations of a remote oceanic archipelago by one species: how common is long‐distance dispersal?
Authors: Shepherd Lara D. , De Lange Peter J. , Perrie Leon R.
Published: May 2009

Aim  It is well established that many groups of plants and animals have undergone long‐distance dispersal, but the extent to which this continues beyond initial colonization is largely unknown. To provide further insight into the frequency of gene flow mediated by long‐distance dispersal, we investigated the origins of the fern Asplenium hookerianum on the Chatham Islands, and present a review of the contribution of molecular data to elucidating the origins of this archipelago’s biota.

Location  Chatham Islands and New Zealand. A. hookerianum is scarce on the Chatham Islands but common in New Zealand, some 800 km to the west.

Methods  We compared chloroplast trnL–trnF DNA sequence data from Chatham Islands’A. hookerianum with extensive phylogeographic data for this genetically variable species in mainland New Zealand.

Results  Our sequencing revealed the presence of two haplotypes in Chatham Islands’A. hookerianum. These haplotypes differed by four mutational events and were each more closely related to haplotypes found in New Zealand than to each other.

Main conclusions  Despite the rarity of A. hookerianum on the Chatham Islands, its populations there appear to derive from at least two long‐distance dispersal events from New Zealand, these possibly originating from different areas. We suggest that long‐distance transoceanic dispersal, and the gene flow it can mediate, may be more common than is generally appreciated.
Evidence for oesophageal visceral hypersensitivity and aberrant symptom referral in patients with globus
Authors: Chen C. L. , Szczesniak M. M. , Cook I. J.
Published: May 2009

Abstract  We tested the hypotheses that globus patients demonstrate oesophageal visceral hypersensitivity and aberrant viscerosomatic referral of oesophageal stimuli. Oesophageal visceral perception was assessed by oesophageal balloon distension and electrical stimulation in nine patients with globus and compared with 11 healthy controls. Oesophageal perception and pain thresholds were determined. Subjects recorded the area of thoracic viscerosomatic referral on a body map in response to each stimulus. All the patients reported their first sensation at balloon volumes between 2 and 6 mL whereas controls reported their first sensation at volumes between 3 and 14 mL (P = 0.03). All the patients reported pain at balloon volumes between 5 and 12 mL whereas controls experienced pain at volumes between 8 and 20 mL (P = 0.001). In response to electrical stimulation to the oesophagus patients and controls demonstrated comparable sensory thresholds. In response to oesophageal balloon distension seven of nine patients, but no controls, referred the sensation to the region at or above the suprasternal notch (P = 0.001). Similarly, significant differences in viscerosomatic referral pattern were observed in response to oesophageal electrical stimulation (P = 0.03). Patients with globus demonstrate oesophageal visceral hypersensitivity to mechanical distension. The differential responses to stretch and electrical stimuli may indicate that the hypersensitivity is a peripheral, rather than central, phenomenon. The aberrant referral of oesophageal sensations in response to both mechanical and electrical stimulation supports the hypothesis that referral of symptoms to the neck might be a central phenomenon.
Galβ1‐6Gal, antigenic epitope which accounts for serological cross‐reaction in diagnosis ofEchinococcus multilocularisinfection
Authors: YAMANO K. , GOTO A. , NAKAMURA‐UCHIYAMA F. , NAWA Y. , HADA N. , TAKEDA T.
Published: May 2009

Parasitic helminths express various antigenic carbohydrates, which often account for serological cross‐reactions. In serodiagnosis, it is essential to inspect cross‐reactivity between the target parasite and other parasites in order to assess diagnostic performance. Our previous study showed that the Galβ1‐6Gal sequence was a common epitope betweenEchinococcus multilocularis(Em) andE. granulosus(Eg). Furthermore, compounds with this sequence fromFasciola hepatica(Fh) reportedly were recognized by sera with Eg infection. Our aim is to investigate whether this sequence is one of the widely common epitopes in many kinds of parasites. For various parasites, sera with Fh infection cross‐reacted at the highest frequency (71·4%) against Em antigen. In patients with other parasitic infections, sera showed cross‐reactions against Fh antigen bound to Em antigen with a high frequency (23·7%). Binding inhibition tests with commercial Galβ1‐6Gal disaccharide showed that Galβ1‐6Gal was the common epitope between not only Em, Eg and Fh, but also between various other parasites. Furthermore, the presence of the Galβ1‐6Gal epitope in Em antigen was confirmed by immunoblot testing with the specific antibody for this sequence. This study showed that the Galβ1‐6Gal sequence is one of the antigenic epitopes that accounts for serological cross‐reactivity between Em and various other parasites.
Mutator transposon activity reprograms the transcriptomes and proteomes of developing maize anthers
Authors: Skibbe David S. , Fernandes John F. , Medzihradszky Katalin F. , Burlingame Alma L. , Walbot Virginia
Published: May 2009

Despite the high conservation of anther gene expression patterns across maize lines, Mu transposition programmed by transcriptionally active MuDR results in a 25% change in the transcriptome, monitored over 90 h of immature anther development, without altering the morphology, anatomy or pace of development. Most transcriptome changes are stage specific: cases of suppression of normal transcripts and ectopic activation are equally represented. Protein abundance changes were validated for numerous metabolic enzymes, and highlight the increased carbon and reactive oxygen management in Mutator anthers. Active Mutator lines appear to experience chronic stress, on a par with abiotic treatments that stimulate early flowering. Despite the diversity of acclimation responses, anther development progresses normally, in contrast to male‐sterile mutants that disrupt anther cell fate or function completely, and cause fewer transcriptome changes. The early flowering phenotype ultimately confers an advantage in Mu element transmission.
Use of reverse‐phase liquid chromatography, linked to tandem mass spectrometry, to profile the Calvin cycle and other metabolic intermediates in Arabidopsis rosettes at different carbon dioxide concentrations
Authors: Arrivault Stéphanie , Guenther Manuela , Ivakov Alexander , Feil Regina , Vosloh Daniel , Van Dongen Joost T. , Sulpice Ronan , Stitt Mark
Published: May 2009

A platform using reverse‐phase liquid chromatography coupled to tandem mass spectrometry was developed to measure 28 metabolites from photosynthetic metabolism. It was validated by comparison with authentic standards, with a requirement for distinct and clearly separated peaks, high sensitivity and repeatability in Arabidopsis rosette extracts. The recovery of authentic standards added to the plant material before extraction was 80–120%, demonstrating the reliability of the extraction and analytic procedures. Some metabolites could not be reliably measured, and were extracted and determined by other methods. Measurements of 37 metabolites in Arabidopsis rosettes after 15 min of illumination at different CO2 concentrations showed that most Calvin cycle intermediates remain unaltered, or decrease only slightly (<30%), at compensation point CO2, whereas dedicated metabolites in end‐product synthesis pathways decrease strongly. The inhibition of end‐product synthesis allows high levels of metabolites to be retained in the Calvin cycle to support a rapid cycle with photorespiration.
The analysis of entire gene promoters by surface plasmon resonance
Authors: Moyroud Edwige , Reymond Mathieu C. A. , Hamès Cécile , Parcy François , Scutt Charles P.
Published: May 2009

We demonstrate that the biophysical technique of surface plasmon resonance (SPR) analysis, which has previously been used to measure transcription factor binding to short DNA molecules, can also be used to characterize interactions involving entire gene promoters. This discovery has two main implications that relate, respectively, to novel qualitative and quantitative uses of the SPR technique. Firstly, SPR analysis can be used qualitatively to test the capacity of any transcription factor to interact physically with its putative target genes. This application should prove particularly useful for the confirmation of predicted transcriptional interactions in model species, and for comparative studies of non‐model species in which transcriptional interactions are not amenable to study by other methods. Secondly, SPR may be used quantitatively to characterize interactions between transcription factors and gene promoters containing multiple cis‐acting sites. This application should prove useful for the detailed dissection of promoter function in known target genes. The qualitative and quantitative applications of the SPR analysis of whole promoters combine to make this a uniquely powerful technique, which should prove particularly useful in systems biology, evolutionary developmental biology and various branches of applied biology.
The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenation
Authors: PARK E. Y. , KOO B.‐N. , MIN K. T. , NAM S. H.
Published: May 2009

Background: daVinci® robot‐assisted laparoscopic radical prostatectomy (RALP) requires pneumoperitoneum in the steep Trendelenburg position, which results in increased intracranial pressure and cerebral blood flow. The aim of this study was to evaluate the effect of pneumoperitoneum in a 30° Trendelenburg position on cerebral oxygenation using regional cerebral oxygen saturation (rSO2).

Methods: Thirty‐two male patients of ASA I and II physical status without previous episodes of cerebral ischemia or hemorrhage undergoing daVinci® RALP were enrolled. The rSO2 was continuously monitored with near‐infrared spectroscopy (INVOS® 5100™) during the study period. Measurements were obtained immediately after anesthesia induction (T0; baseline), 5 min after a 30° Trendelenburg position (T1), 5 min after 15 mmHg pneumoperitoneum in a supine position (T2), 30, 60 and 120 min after the pneumoperitoneum in a Trendelenburg position (T3, T4 and T5, respectively) and after desufflation in a supine position (T6).

Results: The change in the left and right rSO2 was statistically significant (Left P=0.004 and Right P=0.023). Both the right and the left rSO2 increased significantly during pneumoperitoneum in a Trendelenburg position (from T3 to T5) and at T6 compared with the baseline value at T0. The partial pressure of carbon dioxide (PaCO2) was increased significantly at T2, T3, T5 and T6 compared with the baseline value at T0.

Conclusions: During daVinci® RALP, cerebral oxygenation, as assessed by rSO2, increased slightly, which suggests that the procedure did not induce cerebral ischemia. The PaCO2 should be maintained within the normal limit during pneumoperitoneum in a Trendelenburg position in patients undergoing daVinci® RALP because the rSO2 increased in conjunctions with the increase in PaCO2.
Chronic kidney disease care program improves quality of pre‐end‐stage renal disease care and reduces medical costs
Authors: WEI SHU‐YI , CHANG YONG‐YUAN , MAU LIH‐WEN , LIN MING‐YEN , CHIU HERNG‐CHIA , TSAI JER‐CHIA , HUANG CHIH‐JEN , CHEN HUNG‐CHUN , HWANG SHANG‐JYH
Published: May 2009

Aim:  Multidisciplinary care of patients with chronic kidney disease (CKD) provides better care outcomes. This study is to evaluate the effectiveness of a CKD care program on pre‐end‐stage renal disease (ESRD) care.

Methods:  One hundred and forty incident haemodialysis patients were classified into the CKD Care Group (n = 71) and the Nephrologist Care Group (n = 69) according to participation in the CKD care program before dialysis initiation. The ‘total observation period’ was divided into ‘6 months before dialysis’ and ‘at dialysis initiation’. Quality of pre‐ESRD care, service utilization and medical costs were evaluated and compared between groups.

Results:  The mean estimated glomerular filtration rates at dialysis initiation were low in both groups; but the levels of haematocrit and serum albumin of the CKD Care Group were significantly higher. The percentages of patients initiating dialysis with created vascular access, without insertion of double‐lumen catheter and without hospitalization were 57.7%, 50.7% and 40.8%, respectively, in the CKD Care Group, and 37.7%, 29.0% and 18.8% in the Nephrologist Care Group (P < 0.001). Participation in the CKD care program, though with higher costs during the 6 months before dialysis ($US1428 ± 2049 vs US$675 ± 962/patient, P < 0.001), was significantly associated with lower medical costs at dialysis initiation ($US942 ± 1941 vs $US2410 ± 2481/patient, P < 0.001) and for the total period of observation ($US2674 ± 2780 vs $US3872 ± 3270/patient, P = 0.009). The cost‐saving effect came through the early preparation of vascular access and the lack of hospitalization at dialysis initiation.

Conclusion:  CKD care programs significantly improve quality of pre‐ESRD care, decrease service utilization and save medical costs.
Review article: Managing bone complications after kidney transplantation
Authors: MAINRA RAHUL , ELDER GRAHAME
Published: May 2009

Chronic kidney disease mineral and bone disorder (CKD‐MBD) describes the laboratory, bone and vascular abnormalities that exist in patients with CKD stages 3–5D and that may persist after transplantation. Persisting abnormalities of bone turnover and abnormal mineralization, together with bone mineral density (BMD) loss from glucocorticoids, may all predispose to a loss of structural integrity and increased fracture risk in kidney and kidney pancreas recipients. Vitamin D, calcitriol, calcitonin and bisphosphonates have all been used to preserve BMD following transplantation, despite a lack of safety data and the potential for some of these drugs to cause harm. A limited number of post‐transplant studies utilizing these drugs have not yet documented improved fracture prevention or fracture‐related mortality and have not considered allocation based on risk factors for fracture or markers of bone turnover. Targeted allocation of the available therapies based on a stratification of risk appears warranted. This might be achieved using an algorithm incorporating BMD, X‐ray evaluation, laboratory investigations including bone turnover markers and the assessment of standard fracture risk factors at the time of and soon after transplantation. This approach, which is similar to protocols used in the general population, may result in more effective management of patients and fewer adverse effects such as adynamic bone disease. Although BMD is a surrogate for fracture risk in the general population it is not validated in this transplant population. Consequently, such an approach should be confirmed by studies that include bone biopsy data and an evaluation of patient level outcomes.
Prevalence of known diabetes in German adults aged 25–69 years: results from national health surveys over 15 years
Authors: Heidemann C. , Kroll L. , Icks A. , Lampert T. , Scheidt‐Nave C.
Published: May 2009

Aims  The few studies examining the secular trend in diabetes prevalence in Germany have yielded conflicting results. Therefore, using nationally representative samples of adults, we investigated whether the prevalence of known diabetes has changed over 15 years.

Methods  Study participants were 25‐ to 69‐year‐old residents participating in nationally representative health surveys performed in the following time periods: 1990–1992, 1997–1999, 2002–2003, 2003–2004 and 2004–2005. Prevalences of diabetes, standardized to the population structure of 2004, and trends over time were assessed for the total study population as well as by gender and other diabetes‐associated factors.

Results  Between 1990–1992 and 2002–2005, no statistically significant trend in the total (5.16 and 5.34%, P trend = 0.68) or sex‐specific diabetes prevalence (men: 5.43 and 5.73, P trend = 0.62; women: 4.88 and 4.95%, P trend = 0.94) was observed. For each time period, prevalence rose substantially with increasing age, increasing body mass index, lower sporting activity and lower education.

Conclusions  Our findings reflect no temporal increase in the total prevalence of known diabetes in German adult men and women. However, prevalence estimates were relatively high when compared with other European studies and call for continued efforts for the prevention and management of diabetes.
Impact of diabetes and gender on survival after acute myocardial infarction in the Province of Quebec, Canada—a population‐based study
Authors: Ouhoummane N. , Abdous B. , Émond V. , Poirier P.
Published: May 2009

Aims  To examine the impact of diabetes, gender and their interaction on 30‐day, 1‐year and 5‐year post‐acute myocardial infarction (AMI) mortality in three age groups (20–64, 65–74 and ≥ 75 years).

Methods  Retrospective analysis including 23 700 patients aged ≥ 20 years (22% with diabetes) admitted to hospital for a first AMI in any hospital in the Province of Quebec, Canada, between April 1995 and March 1997. Administrative databases were used to identify patients and assess outcomes.

Results  Regarding 30‐day mortality, there was non‐significant interaction between diabetes and gender. Women aged < 75 years had, independently of diabetes status, at least a 38% (P < 0.05) higher mortality than their male counterparts after adjustment for socio‐economic status and co‐morbid conditions. Gender difference disappeared, however, after controlling for in‐hospital complications. Regarding 1‐year mortality (31–365 days), there was no significant gender disparity for all age groups. During the 5‐year follow‐up, no gender differences were seen in any age group, except for younger (< 65 years) women with diabetes, who had a 52% (P = 0.004) higher mortality than men after controlling for co‐variables. This female disadvantage was demonstrated by a significant interaction between diabetes and gender in patients aged < 65 years (P = 0.009).

Conclusions  The higher 30‐day mortality post‐AMI in younger (20–64 years) and middle‐aged (65–74 years) women compared with men was not influenced by diabetes status. However, during the 5‐year follow‐up, the similar gender mortality observed in patients without diabetes seemed to disappear in younger patients with diabetes, which may be explained by the deleterious, long‐term, post‐AMI impact of diabetes in younger women.
The relationship between depression and diabetes mellitus: findings from the Hertfordshire Cohort Study
Authors: Holt R. I. G. , Phillips D. I. W. , Jameson K. A. , Cooper C. , Dennison E. M. , Peveler R. C. ,   The Hertfordshire Cohort Study Group
Published: May 2009

Aims  To assess the relationship between depression scores and diabetes, glucose and insulin in a cross‐sectional population‐based study.

Methods  One thousand, five hundred and seventy‐nine men and 1418 women from the Hertfordshire Cohort Study were assessed for diabetes. Plasma glucose and insulin concentrations were measured at 0, 30 and 120 min during a standard 75‐g oral glucose tolerance test. Depressive and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale (HADS).

Results  Overall, 431 (14.6%) were diagnosed with diabetes [232 men (14.9%) and 199 women (14.3%)]. One hundred and eight (47%) men and 74 (37%) women had known diabetes. The remainder were previously undiagnosed. Fifty‐nine (3.7%) men and 65 (4.6%) women had possible depression (HAD‐D scores 8–10) and 17 (1.1%) men and 20 (1.4%) women had probable depression (HAD‐D scores ≥ 11). Probable depression was associated with an adjusted odds ratio for diabetes of 3.89 [95% confidence interval (CI) 1.28–11.88] in men and 1.51 (95% CI 0.47–4.84) in women. In men without previously diagnosed diabetes, fasting insulin (P = 0.035), 2‐h glucose concentrations (P = 0.028) and insulin resistance (P = 0.032) were significantly associated with HAD‐D scores. With the exception of 2‐h glucose concentrations (P = 0.034), the associations were not significant in women.

Conclusions  These data support the hypothesis that depression may increase the risk for diabetes. The relationship between depression score and metabolic variables extends across the whole population and is not confined to those with either diagnosed depression or diabetes. This relationship should lead clinicians to consider screening for diabetes in those with depression and vice versa.
The effect of anti‐inflammatory (aspirin and/or statin) therapy on body weight in Type 2 diabetic individuals: EAT, a retrospective study
Authors: Boaz M. , Lisy L. , Zandman‐Goddard G. , Wainstein J.
Published: May 2009

Aims  Obesity is associated with inflammation. Anti‐inflammatory interventions such as aspirin and statins (anti‐IFRx) might be a novel approach to the treatment of obesity and Type 2 diabetes mellitus (T2DM). The present study was designed to determine whether exposure to anti‐IFRx is associated with weight loss in T2DM patients.

Methods  Exposure to anti‐IFRx was compared between T2DM patients with a history of weight loss (n = 100) and those with no weight loss or with weight gain (n = 102) during a 1‐year follow‐up period. Logistic regression was used to develop odds ratios for weight loss status.

Results  Subjects who lost weight were more frequently exposed to anti‐IFRx (85.0 vs. 71.5%, P = 0.018) than subjects who maintained or gained weight during follow‐up. The 158 subjects exposed to anti‐IFRx were older (64.2 ± 9.4 vs. 60.6 ± 11.2 years, P = 0.04), had longer duration T2DM (14.5 ± 9.5 vs. 9.0 ± 9.4 years, P = 0.001), had greater prevalence of dyslipidaemia (72 vs. 19%, P < 0.0001) hypertension (57.3 vs. 38.1%, P = 0.03) and cardiovascular disease (37.7 vs. 9.5%, P < 0.0001) than subjects not exposed to anti‐IFRx. In a logistic regression model for weight change status, anti‐IFRx exposure was significantly associated with weight status (odds ratio = 2.3, 95% confidence interval 1.1–4.8, P = 0.02, an association that persisted), even after controlling for age, sex, baseline body mass index, years since diagnosis, OHA therapy and co‐morbidities.

Conclusions  Exposure to anti‐IFRx more than doubled the odds of weight loss in T2DM patients. Results of this study justify a randomized clinical trial to determine definitively the role of anti‐IFRx in weight loss in subjects with T2DM.
Investigation of the effect of oral metformin on dipeptidylpeptidase‐4 (DPP‐4) activity in Type 2 diabetes1
Authors: Cuthbertson J. , Patterson S. , O’Harte F. P. M. , Bell P. M.
Published: May 2009

Aims  Glucagon‐like peptide‐1 (GLP‐1) is an insulinotropic hormone and major component of the enteroinsular axis. Its therapeutic potential in human diabetes is limited by rapid degradation and inactivation by the enzyme dipeptidylpeptidase‐4 (DPP‐4). We investigated the acute effects of metformin with and without food on DPP‐4 activity in Type 2 diabetes.

Methods  Ten subjects with Type 2 diabetes (6 male/4 female, age 65.8 ± 2.6 years, body mass index 30.0 ± 1.2 kg/m2, glycated haemoglobin (HbA1c) 6.3 ± 0.2%, mean ± sem) received metformin 1 g orally or placebo together with a standard mixed meal (SMM) in a random crossover design. Six subjects re‐attended fasting and received metformin 1 g without a SMM.

Results  Following SMM (n = 10), DPP‐4 activity was not suppressed by metformin compared with placebo [area under curve (AUC)0–4 h 1574 ± 4 vs. 1581 ± 8 μmol/ml/min, respectively]. Plasma glucose, insulin and active GLP‐1 were not different. However, DPP‐4 activity was suppressed with metformin following fasting compared with a SMM (n = 6) (AUC0–4 h 1578 ± 4 vs. 1494 ± 9 μmol/min, P < 0.02). Metformin serum levels were significantly lower (P < 0.001) after SMM than fasting (AUC0–4 h 350 ± 66 vs. 457 ± 55 mg/ml/min).

Conclusion  Metformin inhibits DPP‐4 activity in Type 2 diabetic patients in the fasting state but not when taken with a standard mixed meal. Metformin serum concentrations are lower if the drug is taken with food. These findings should be taken into account in establishing how to maximize efficacy of the drug.
Forging the new talent compact
Authors: Ready Douglas
Published: May 2009

It is difficult to attract and keep top talent, acknowledges Douglas Ready, but he believes that your company's culture and climate are key to creating a system that works.