bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistolocalization and Gene Expression of the Carbonic Anhydrase Isoenzymes (CA‐II and CA‐VI) in Glands Associated with the Canine Lacrimal Apparatus
Authors: Sugiura Y. , Soeta S. , Ichihara N. , Nishita T. , Murakami M. , Amasaki H. , Amasaki T. , Asari M.
Published: October 2009

Cytosolic and secretory carbonic anhydrase isoenzymes (CA‐II and CA‐VI, respectively) were detected by immunohistolocalization using specific canine CA‐II and CA‐VI antisera. CA‐II and CA‐VI were identified in glands associated with the canine lacrimal apparatus, such as lacrimal gland, superficial gland of the third eyelid (third eyelid gland) and tarsal gland. CA‐II and CA‐VI mRNA signals were also detected by reverse‐transcriptase polymerase chain reaction in the same tissues. Some serous acinar cells and duct segments in the lacrimal gland and serous acinar cells in the third eyelid gland were immunopositive for anti‐CA‐II and CA‐VI antisera. In particular, some immunopositive acini to CA‐II and CA‐VI on the edge of the third eyelid gland are histologically similar to sebaceous gland cells. Sebaceous gland cells in the tarsal and ciliary glands also showed immunopositivity to both CA antisera. CA‐II and CA‐VI gene transcripts were detected in the same regions. These results suggest that secreted CA‐VI may form together with cytosolic CA‐II, a high‐activity isozyme mostly considered as a bicarbonate producer, in a mutually complementary system for the maintenance of bicarbonate levels to regulate pH in tear fluid and protect the corneal epithelia against injuries. In sebaceous gland cells in the lacrimal apparatus, CA‐VI may be related to lipogenesis in an unknown function.
Development and validation of a simple and sensitive liquid chromatography–tandem mass spectrometry method for quantifying trimetazidine in human plasma
Authors: Zhou Gan , Tan Zhi‐Rong , Ouyang Dong‐Sheng , Chen Yao , Guo Dong , Xie Hai‐Tang , Liu Ying‐Zi , Fan Lan , Deng Han‐Wu
Published: October 2009

1. A simple and sensitive liquid chromatography–tandem mass spectrometry (LC‐MS‐MS) method for quantifying trimetazidine in human plasma was developed and validated. Sample preparation was based on deproteinating with acetonitrile.

2. Chromatography was performed on a C18 analytical column (5 μm; 150 × 2.1 mm i.d.) and the retention times for trimetazidine and cetirizine (used as the internal standard) were 1.8 and 3.0 min, respectively. The ionization was optimized using an electrospray ionization source and enhanced selectivity was achieved using tandem mass spectrometry. The calibration curve ranged from 0.1 to 200 ng/mL. The inter‐day precision, accuracy and the relative standard deviation (RSD) were all < 15%. The analyte was shown to be stable over the time‐scale of the entire procedure.

3. The robustness of the method was demonstrated by the good reproducibility of the results obtained during the analysis of clinical samples.
4‐Phenyl butyric acid does not generally reduce glucose levels in rodent models of diabetes
Authors: Xu Tian‐Ying , Chen Ruo‐Hua , Wang Pei , Zhang Ruo‐Yu , Ke Sen‐Fang , Miao Chao‐Yu
Published: October 2009

1. Endoplasmic reticulum (ER) stress plays a role in the pathogenesis of diabetes. The aim of the present study was to investigate the effect of 4‐phenyl butyric acid (PBA), a novel chemical chaperone reducing ER stress, on serum glucose level in different strains of normal and diabetic rodents.

2. 4‐Phenyl butyric acid (1 g/kg per day, i.g.) was administered to ob/ob Type 2 diabetic mice, alloxan‐induced Type 1 diabetic mice and hydrocortisone (HC)‐induced Type 2 diabetic mice as well as normal C57BL/6J mice and Kumming mice for 14 days to evaluate its effect on serum glucose levels. In addition, mice were treated simultaneously with PBA (1 g/kg per day) and HC for 9 days to determine its preventive effect against the development of insulin resistance. PBA (0.7 and 1.4 g/kg per day) was administered to non‐obese Type 2 diabetic Goto‐Kakizaki (GK) and normal Wistar‐Kyoto (WKY) rats for 14 and 7 days, respectively, to determine its effects on serum glucose levels.

3. 4‐Phenyl butyric acid significantly reduced serum glucose levels in obese Type 2 diabetic ob/ob mice. Normoglycaemia was obtained in ob/ob mice after 4 days of PBA treatment and was maintained for up to 14 days treatment.

4. 4‐Phenyl butyric acid had no glucose‐lowering effect in alloxan‐induced Type 1 diabetic mice, HC‐induced Type 2 diabetic mice and non‐obese Type 2 diabetic GK rats. In addition, it had no beneficial effects on insulin resistance in HC‐treated mice.

5. 4‐Phenyl butyric acid did not affect normal serum glucose levels in C57BL/6 J mice, Kunming mice or WKY rats.

6. In conclusion, PBA does not generally reduce glucose levels in rodent models of diabetes, although it can normalize glucose levels in ob/ob diabetic mice, indicating that restoration of ER function as diabetes therapy is limited to conditions under which ER stress is involved in the high glucose levels.
Hepatitis B immunoglobulins and/or lamivudine for preventing hepatitis B recurrence after liver transplantation: A systematic review
Authors: Chen Jie , Yi Liping , Jia Ji Dong , Ma Hong , You Hong
Published: October 2009

Background: Currently, hepatitis B immunoglobulins (HBIg) and/or lamivudine have become the main options for prevention of hepatitis B recurrence after liver transplantation.

Aim: To assess the benefits of HBIg and/or lamivudine for prevention of hepatitis B recurrence after liver transplantation.

Methods: We conducted a search of electronic databases and a manual search of bibliographical lists of relevant articles. All randomized clinical trials and non‐randomized studies that meet the pre‐specified criteria were included. However, results of non‐randomized studies were reported under ‘exploratory analyses’ in the result section. The outcome measure was hepatitis B recurrence.

Results: Two randomized and 44 non‐randomized studies were included. Meta‐analysis of two randomized studies shows one week HBIg combined with lamivudine regimen had equivalent effect compared with long‐term high‐dose HBIg regimen for preventing hepatitis B recurrence (RR 1.23; 95% CI 0.38–4.03;P = 0.73). For 44 non‐randomized studies, only qualitative systematic review was performed. With long‐term HBIg prophylaxis, hepatitis B recurrence rate ranged from 3.7% to 65%; with lamivudine prophylaxis, hepatitis B recurrence rate varied from 3.8% to 40.4%; Long‐term high‐dose HBIg plus lamivudine prophylaxis can reduce the risk of HBV recurrence to less than 10%.

Conclusions: Long‐term HBIg prophylaxis or lamivudine prophylaxis can reduce the risk for hepatitis B virus recurrence. Long‐term high‐dose HBIg combined with lamivudine can further reduce HBV recurrence to less than 10%.
Gastrointestinal and biliary stents
Authors: Chun Hoon Jai , Kim Eun Sun , Hyun Jong Jin , Kwon Yong Dae , Keum Bora , Kim Chang Duck
Published: October 2009

Advances in stent design have led to a substantial increase in the use of stents for a variety of malignant and benign strictures in the gastrointestinal tract and biliary system. Whereas early stents were mostly composed of plastic, the majority of contemporary stents are self‐expanding metal stents that are composed of either nitinol or stainless steel. These stents are able to exert an adequate expansile force and, at the same time, are highly flexible and biocompatible. Covered stents have been introduced to minimize tumor ingrowth through the metal mesh but are associated with higher rates for spontaneous migration. This has led to the development of covered stents with uncovered ends and stents with both covered and uncovered layers. Drug‐eluting and biodegradable stents are also likely to become available in the near future. Although stents appear to be the preferred form of palliation for some patients with advanced cancer, many patients will benefit from a multidisciplinary approach that usually includes surgeons and oncologists.
Comparison of tissue microarray and full section in immunohistochemistry of gastrointestinal stromal tumors
Authors: Kwon Mi Jung , Nam Eun Sook , Cho Seong Jin , Park Hye Rim , Shin Hyung Sik , Park Jun Ho , Park Chan Heun , Lee Won Jae
Published: October 2009

The aim of the present study was to compare the efficiency of tissue microarray (TMA) results using immunohistochemistry markers applied to a variety of core sizes and full sections of gastrointestinal stromal tumors (GIST) using performance measures such as core loss rate and concordance rate. Six primary antibody markers (c‐Kit, CD34, smooth muscle actin (SMA), S‐100, p53, and Ki‐67) were used with the TMA technique to analyze 0.6 mm, 2 mm, and 3 mm punch cores of GIST samples from 67 patients. No statistical association was found between core size and loss rate (P= 0.512). TMA results for the 0.6 mm, 2 mm, and 3 mm core showed that all core sizes could statistically significantly reflect full sections with regard to c‐Kit, SMA, and S‐100 antibodies, but that the 3 mm core section was the most representative except for CD34. With regard to p53 and Ki‐67 staining, the 0.6 mm core section was not representative, but the 2 mm and 3 mm core sections could statistically significantly represent full section results. Among them, the 3 mm core section was more accurate than the 2 mm core section. Use of a single 3 mm core size in TMA is suitable for evaluating large numbers of protein and nuclear stains with regard to immunohistochemistry for GIST.
Support for infertility treatment in Japan: Differences in perceptions between female clients and staff
Authors: Takabayashi Chikako , Shimada Keiko
Published: October 2009

The aim of this study was to clarify the perceptions of both infertile women accessing support services from local governments related to infertility treatment and the public servants providing that assistance. This cross‐sectional descriptive study surveyed 62 local government staff members who managed medical expense subsidy programs for infertility treatment in the Hokuriku region of Japan and 84 infertile women attending the clinics. We measured the levels of satisfaction regarding the support services from local governments and the perceptions of the importance of each type of support. The data were analyzed descriptively and included factor analysis and multiple regression analysis. Local governments' support services were analyzed by using four factors: providing information, education and consultation, improving existing services, and improving access. Both the women and the staff endorsed the importance of information provision, the easing of restrictions on subsidies for infertility treatment, reconsideration of the application procedures, and improvement of the publicizing of the available subsidies.
A qualitative evaluation of the Care of the Critically Ill Surgical Patient course
Authors: Zotti Mario Giuseppe , Waxman Bruce Philip
Published: October 2009

Background:  The Care of the Critically Ill Surgical Patient (CCrISP) course was adapted by the Royal Australasian College of Surgeons, being made compulsory for all Basic Surgical Trainees in 2001. The aim of this study was to evaluate whether the course objectives were achieved and identify strengths and weaknesses.

Methods:  A retrospective cohort study was completed, after CCrISP Committee support of the proposed conduct, by distribution of questionnaires to instructors and trainees who had completed CCrISP in 2006 or earlier. The questionnaires were qualitative and designed to evaluate the success of CCrISP objectives.

Results:  Fourteen instructors and 40 Victorian trainees completed the questionnaires. The major weaknesses identified by the instructors were the trainees' management of complications, nutrition, multiple injuries and sedation, procedural skills and mentoring. Trainees identified weaknesses in procedural skills and mentoring. Both groups identified the strongest areas being the emphasis on communication skills, utilization of clinical knowledge and acumen, management of shock and haemorrhage and management of the acute abdomen. The trainees further identified the systematic approach to the critically ill surgical patient as a major strength.

Conclusion:  The primary objectives of the CCrISP course have been met. This study has identified teaching of communication skills, shock and haemorrhage and the systematic approach being the strengths of the course, whereas further refining of the mentoring process and reconsidering the importance of procedural skills is needed, both of which are secondary objectives.
Is sentinel lymph node biopsy after neoadjuvant chemotherapy feasible in Chinese patients with invasive breast cancers?
Authors: Cheung Tanfo T. , Suen Dacita T. K. , Kwong Ava
Published: October 2009

Background:  A wide variation in the accuracy of performance of sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy in breast cancer has been reported despite its increased use. This study aimed to be the first to evaluate the feasibility and accuracy of SLNB after neoadjuvant chemotherapy in Chinese patients with breast cancer.

Methods:  A review of prospectively collected data from breast cancer patients who had SLNB after prior neoadjuvant chemotherapy was performed. A combination of radiopharmaceutical 99mTc‐albumin colloid (Pharmalucence, MA, USA) and Patent Blue V dye (Guerbet, France) was used to identify the SLN. SLNB was followed by standard axillary dissection in all patients.

Results:  A total of 365 patients received SLNB from May 1999 to April 2006. A total of 78 patients with neoadjuvant chemotherapy followed by SLNB were recruited. The SLN identification rate, false‐negative rate and accuracy rate were 83.3, 10.3 and 73.1%, respectively. Analysis was stratified into clinical and pathological response group.

Location of the tumour was also found to be an important factor in affecting the false‐negative rate (P= 0.019). For upper, outer quadrant tumour, five (32.3%, out of 16) patients presented with false‐negative. Patients with more sentinel lymph node harvest had higher accuracy. A total of 22 patients had three or more lymph nodes harvested, and the false‐negative rate was 21.7% (5 out of 23 patients) (P= 0.00).

Conclusions:  The results of our study show that SLNB is feasible and applicable in Chinese patients with breast cancer with operable disease who have received neoadjuvant chemotherapy.
Use of inferior vena cava filters in a tertiary referral centre in Australia
Authors: Tiwari Alok , Saw Chong , Li Michelle , Mohan Irwin , Daly Tom , Swinnen John , Richardson Arthur , So Simon , Young Noel , Vicaretti Mauro , Fletcher John
Published: October 2009

Introduction:  To investigate the use of inferior vena cava (IVC) filters in a tertiary referral centre, looking at indication, types of filters and, with temporary/optional filters, removal rates.

Methods:  Data was collected from a prospective database of all IVC filters inserted from January 2003 to January 2007. Patients' records and radiological imaging were all reviewed.

Results:  66 patients (40 males) had IVC filters inserted during the study period. The median age of the male patients was 57.5 (21–79) years, and females 56 (24–81). There were 49 (74.2%) temporary/optional filters and 17 (25.8%) permanent filters. The most common indication for filter was a contraindication to anticoagulation for both permanent (64.7%) and temporary/optional filters (77.6%). In the temporary/optional filter group, 38 of 49 (77.6%) patients had documented venous thromboembolism, while in the permanent filter group, this was 14 of 17 (82.4%). Of the optional filters, 22 of 49 (45.8%) have been removed.

Conclusion:  More than half (54.2%) of temporary/optional filters were not removed and with potential for long‐term complications. A protocol has now being instituted for vascular surgeons to authorize the insertion of filters and to then be responsible for ensuring their removal.
Protective role of Coenzyme Q10 in two models of rat lung injury
Authors: Lim Hou‐Kiat , Jayaweera Suren , Calderone Alicia , Pepe Salvatore , Rosenfeldt Franklin L. , Marasco Silvana F.
Published: October 2009

Background:  Ischaemia‐reperfusion injury is a life‐threatening complication of lung transplantation. Attempts to ameliorate this injury have included optimization of donor management and improving techniques of lung preservation. However, few investigators have sought to pretreat potential recipients. Coenzyme Q10 (CoQ10) is a potent antioxidant and cellular energizer that has been shown to protect the heart against injury. However, its protective effect in the lung is unknown. We therefore set out to study the impact of Coenzyme Q10 pretreatment in a model of mild and severe lung injury.

Methods:  We evaluated the impact of CoQ10 in a two‐stage laboratory study. In the first stage, in order to measure the magnitude of increase in tissue and plasma CoQ10 following oral therapy we administered high‐dose oral CoQ10 to rats (n = 6). In the second stage we evaluated the impact of CoQ10 in the rat lung (n = 10) that was subjected to 230 min of normoxic lung injury or 90 min of warm ischaemia and 120 min of reperfusion in a model of lung transplantation.

Results:  High‐dose oral CoQ10 for 7 days produced a 15‐fold increase in plasma and a 3‐fold increase in lung CoQ10. In the normoxic lung, the injury‐induced rise in peak airway pressure was reduced by CoQ10 treatment at 90 min (P = 0.037) and at 120 min (P = 0.005) without any change in arterial oxygen. In the lung subjected to severe ischaemia‐reperfusion injury, CoQ10 did not reduce the injury‐induced increase in peak airway pressure (P = 0.599) nor the decrease in arterial oxygen (P = 0.844). However, CoQ10 markedly reduced the increase in tumour necrosis factor‐alpha in ischaemic compared with normoxic lung (P = 0.027).

Conclusions:  The effect of CoQ10 pretreatment is insufficient to protect the lung against severe ischaemia‐reperfusion as may occur in lung transplantation. However, in the setting of less severe pulmonary injury as in anaesthesia and non‐transplant surgery, CoQ10 may have a protective role.
Enterocutaneous fistula: a single‐centre experience
Authors: Gyorki D. E. , Brooks C. E. , Gett R. , Woods R. J. , Johnston M. , Keck J. O. , Mackay J. R. , Heriot A. G.
Published: October 2009

Background:  Enterocutaneous fistulae (ECFs) present a difficult management problem and can cause significant morbidity. The aim of the study was to assess the outcome of these patients.

Methods:  A retrospective chart review of all patients with ECF managed at a tertiary centre between 1996 and 2006 was performed. Demographic, management and outcome data including ECF closure, morbidity and mortality were recorded.

Results:  A total of 33 patients (17 male) were identified with ECF (median age: 63 years, range: 27–84). The primary aetiology was Crohn's (30%), anastomotic leak (24%), iatrogenic (18%), mesh (6%), neoplasia (6%) and other (16%). Definitive surgery was undertaken in 21 (64%) at a median of 6.4 months (0.4–72 range) following presentation. Twenty percent of patients required emergency surgical intervention and 5 patients required preoperative total parenteral nutrition (TPN). Surgical management was formal resection and reanastomosis in all patients, with a mean operative time of 4.75 h (standard deviation = 1.8). The median hospital stay for the operative group was 19 days (7–85). Four patients required post‐operative TPN with one patient requiring home TPN. Fistula closure rate was 97% (operative group: 21 out of 21; non‐operative group: 11 out of 12). Mean follow‐up was 37.3 months (0.5–217). Six (19%) operative patients developed fistula recurrence. There were two deaths at 2 and 5 months (fistula aetiology malignant colonic fistula and radiation enteritis, respectively).

Conclusion:  Patients with ECF can be treated with low morbidity and low recurrence rate in a multidisciplinary setting. We believe that patients with ECF should be referred to specialist units for management.
Transjugular intrahepatic portosystemic shunt: an analysis of outcomes
Authors: Kurmis Timothy P.
Published: October 2009

Background:  Transjugular intrahepatic portosystemic shunts (TIPS) are utilized for the management of complications of portal hypertension, particularly diuretic‐resistant ascites and recurrent variceal bleeding. It has also been applied in Budd–Chiari syndrome and hepatorenal syndrome. We report the results in a small series, over 9 years, from a single centre, and compare these to those published in the literature.

Methods:  A retrospective case note review of 20 consecutive TIPS procedures performed at Flinders Medical Centre from January 1997 to December 2005 was completed. All indications were included in the analysis. Underlying liver disease, peri‐procedure complications, relief of symptoms and patient survival were recorded. Data on type of TIPS, shunt patency and method of follow‐up were recorded.

Results:  Thirty‐six TIPS were performed in 20 subjects. All initial TIPS attempts were successful. Indications were: refractory ascites (18), acute variceal bleeding (12) and hepatorenal syndrome (2). There were no peri‐procedure deaths, however. Ninety‐day mortality was 20%. Outcomes in model of end‐stage liver disease score and biochemical characteristics post‐TIPS were comparable to those reported. Overall, TIPS dysfunction rate was 35% at 1 year. TIPS follow‐up and patency surveillance was an ad hoc combination of Doppler ultrasound and venography.

Conclusion:  TIPS procedure outcomes in our centre are similar to those reported in the literature from large centres. TIPS patency rates may be improved with regular monitoring and early intervention when stenosis occurs.
Feeding signals and brain circuitry
Authors: Dietrich Marcelo O. , Horvath Tamas L.
Published: October 2009

Food intake is a major physiological function in animals and must be entrained to the circadian oscillations in food availability. In the last two decades a growing number of reports have shed light on the hormonal, cellular and molecular mechanisms involved in the regulation of food intake. Brain areas located in the hypothalamus have been shown to play a pivotal role in the regulation of energy metabolism, controlling energy balance. In these areas, neuronal plasticity has been reported that is dependent upon key hormones, such as leptin and ghrelin, that are produced by peripheral organs. This review will provide an overview of recent discoveries relevant to understanding these issues.
Bidirectional interactions between the circadian and reward systems: is restricted food access a unique zeitgeber?
Authors: Webb Ian C. , Baltazar Ricardo M. , Lehman Michael N. , Coolen Lique M.
Published: October 2009

Reward is mediated by a distributed series of midbrain and basal forebrain structures collectively referred to as the brain reward system. Recent evidence indicates that an additional regulatory system, the circadian system, can modulate reward‐related learning. Diurnal or circadian changes in drug self‐administration, responsiveness to drugs of abuse and reward to natural stimuli have been reported. These variations are associated with daily rhythms in mesolimbic electrical activity, dopamine synthesis and metabolism, and local clock gene oscillations. Conversely, the presentation of rewards appears capable of influencing circadian timing. Rodents can anticipate a daily mealtime by the entrainment of a series of oscillators that are anatomically distinct from the suprachiasmatic nucleus. Other work has indicated that restricted access to non‐nutritive reinforcers (e.g. drugs of abuse, sex) or to palatable food in the absence of an energy deficit is capable of inducing relatively weak anticipatory activity, suggesting that reward alone is sufficient to induce anticipation. Recent attempts to elucidate the neural correlates of anticipation have revealed that both restricted feeding and restricted palatable food access can entrain clock gene expression in many reward‐related corticolimbic structures. By contrast, restricted feeding alone can induce or entrain clock gene expression in hypothalamic nuclei involved in energy homeostasis. Thus, under ad libitum feeding conditions, the weak anticipatory activity induced by restricted reward presentation may result from the entrainment of reward‐associated corticolimbic structures. The additional induction or entrainment of oscillators in hypothalamic regulatory areas may contribute to the more robust anticipatory activity associated with restricted feeding schedules.
Thalamo‐cortical processing of near‐threshold somatosensory stimuli in humans
Authors: Klostermann Fabian , Wahl Michael , Schomann Jesko , Kupsch Andreas , Curio Gabriel , Marzinzik Frank
Published: October 2009

Somatosensory stimuli elicit complex cortical responses that are discernible as somatosensory evoked potentials (SEPs) in scalp electroencephalographic recordings. Whereas earlier SEP components, occurring up to 100 ms after stimulus delivery, have been labeled ‘preconscious’, later responses have been associated with stimulus awareness. To date, how far these processes are primarily cortical or comprise additional subcortical operations remains open. Therefore, we recorded thalamic and scalp SEPs evoked by perceived as well as unperceived median nerve stimulation in neurosurgical patients with electrodes implanted into the ventral intermediate nucleus of the thalamus for deep brain stimulation. At stimulation intensities below perceptual threshold, only thalamic SEP components appeared consistently during the first 75 ms after stimulus delivery. Stimulation that was perceived by the patients elicited cortical as well as thalamic SEPs that lasted longer than 75 ms. These results indicate that the thalamus remains active after the primary propagation of a sensory signal to the cortex, and suggest that the transition from elementary to higher‐order somatosensory processing is based on thalamo‐cortical interactions.
Resources drive trade‐off between viral lifestyles in the plankton: evidence from freshwater microbial microcosms
Authors: Pradeep Ram A. S. , Sime‐Ngando T.
Published: October 2009

Viruses have evolved different life strategies for coping with environmental challenges and this is a key explanation for their omnipresence in aquatic systems. However, factors that determine the balance between lytic versus lysogenic decision within natural virioplankton are poorly documented, primarily in freshwaters. This study was designed to investigate the experimental short‐term (24 h incubation) effects of added organic and inorganic nutrients on the two viral lifestyles in nutrient‐depleted freshwater microbial (i.e. < 0.8 μm fraction) microcosms, using mitomycin C as prophage inductor agent. In the absence of mitomycin, viral lytic production increased as a functional response to the strong stimulation of bacterial growth rates (0.7–0.8 day−1) by the added nutrients, primarily the organic nutrients which appeared scarcer than inorganic nutrients and was related to the sampling period and the geomorphological peculiarities of Lake Pavin. In the presence of mitomycin, temperate phage production (frequency of lysogenically infected bacterial cells, FLC = 17–19% of total cells) significantly exceeded lytic production (frequency of lytically infected bacterial cells, FIC = 9–11%) in natural samples (i.e. without nutrient additions) as a result of enhanced prophage induction, which relatively increased with the decreasing contact probability between viruses and their potential hosts. In contrast, addition of nutrients drastically reduced FLC (< 4%) and increased FIC (> 22%). Both variables were antagonistically correlated as was the correlation between FLC and bacterial growth rates, supporting the idea that lysogeny may represent a maintenance strategy for viruses in harsh nutrient/host conditions which appeared as major instigators of the trade‐off between the two viral lifestyles. Overall, at the community level, we reject the hypothesis that nutrients but mitomicyn C stimulate temperate phage induction, and retained the hypotheses that nutrients rather (i) stimulate lytic viruses via enhanced host growth and (ii) when limiting, promote lysogenic conversion in natural waters.
Impact of glucagon‐like peptide‐1 on endothelial function
Authors: Sjöholm Å
Published: October 2009

Cardiovascular (CV) disease is the major cause of mortality and morbidity in individuals with diabetes. Individuals with diabetes often have a variety of factors such as hyperglycaemia, dyslipidaemia, hypertension, insulin resistance and obesity, which increase their risks of endothelial dysfunction and CV disease. The incretin hormones, such as glucagon‐like peptide‐1 (GLP‐1), induce the glucose‐dependent secretion of insulin, improve beta‐cell function and induce slowing of gastric emptying and feelings of satiety – which result in reduced food intake and weight loss. Therapeutic treatments targeting the incretin system, such as GLP‐1 receptor agonists, offer the potential to address beta‐cell dysfunction (one the underlying pathogenic mechanisms of type 2 diabetes), as well as the resulting hyperglycaemia. Initial evidence now suggests that incretins could have beneficial effects on endothelial function and the CV system through both indirect effects on the reduction of hyperglycaemia and direct effects mediated through GLP‐1 receptor–dependent and –independent mechanisms. If these initial findings are confirmed in larger clinical trials, GLP‐1 receptor antagonists could help to address the major CV risks faced by patients with diabetes.
Flood proneness and coping strategies: the experiences of two villages in Bangladesh
Authors: Paul Shitangsu Kumar , Routray Jayant K.
Published: October 2009

This paper explores peoples' indigenous survival strategies and assesses variations in people's ability to cope with floods in two flood‐prone villages in Bangladesh. It reveals that people continuously battle against flood vulnerability in accordance with their level of exposure and abilities, with varied strategies employed at different geophysical locations. The paper reports that people in an area with low flooding and with better socioeconomic circumstances are more likely to cope with impacts compared to people in areas with high and sudden flooding. Similarly, households' ability to cope varies depending on people's socioeconomic conditions, such as education, income and occupation. Although floods in Bangladesh generate socioeconomic misery and cause damage to the environment, health and infrastructure, people's indigenous coping strategies have helped them to reduce significantly their vulnerability. Such flood‐mitigating strategies should be well recognised and emphasised further via proper dissemination of information through an early‐warning system and subsequently external assistance.
Weight loss interventions in young people (18 to 25 year olds): a systematic review
Authors: Poobalan A. S. , Aucott L. S. , Precious E. , Crombie I. K. , Smith W. C. S.
Published: October 2009

This systematic review assesses weight loss interventions in young adults (18–25 years), who are vulnerable to weight gain. This age group experience critical life course points (leaving home for higher studies or job, pregnancy, cohabitation) and develop/establish lifestyle and behavioural patterns making this an opportune intervention period. Medline, Embase, Cinahl, PsychINFO and Cochrane Library were searched (1980 to March 2008). All trials and cohort studies with control groups that assessed weight loss interventions in this specific age group were included finally identifying 14 studies. Before and after comparison of behavioural/motivational interventions (−2.40 kg; 95% CI −5.4 to 0.6) and combination interventions (−2.96; 95% CI −4.4 to −1.5) consistently showed weight loss. Behavioural/motivational interventions increased self‐efficacy, the desire to control weight, boosted self‐esteem, and increased satisfaction with body areas and appearance. Interventions also showed improvements in HDL cholesterol, insulin, glucose and maximum oxygen uptake. However, recruitment to participation in interventions was a barrier for this age group with small sample sizes and short‐term interventions. There may be gender differences in preference to participation in certain type of interventions. Further research to understand attitudes towards healthy lifestyle and preferences of interventions is needed to develop suitable interventions for this vulnerable age group.
ESTIMATING A PARAMETER WHEN IT IS KNOWN THAT THE PARAMETER EXCEEDS A GIVEN VALUE
Authors: Gordon Ian R. , Hall Peter
Published: October 2009

In some statistical problems a degree of explicit, prior information is available about the value taken by the parameter of interest, θ say, although the information is much less than would be needed to place a prior density on the parameter's distribution. Often the prior information takes the form of a simple bound, ‘θ > θ1’ or ‘θ < θ1’, where θ1 is determined by physical considerations or mathematical theory, such as positivity of a variance. A conventional approach to accommodating the requirement that θ > θ1 is to replace an estimator, , of θ by the maximum of  and θ1. However, this technique is generally inadequate. For one thing, it does not respect the strictness of the inequality θ > θ1, which can be critical in interpreting results. For another, it produces an estimator that does not respond in a natural way to perturbations of the data. In this paper we suggest an alternative approach, in which bootstrap aggregation, or bagging, is used to overcome these difficulties. Bagging gives estimators that, when subjected to the constraint θ > θ1, strictly exceed θ1 except in extreme settings in which the empirical evidence strongly contradicts the constraint. Bagging also reduces estimator variability in the important case for which  is close to θ1, and more generally produces estimators that respect the constraint in a smooth, realistic fashion.
THE USE OF AGGREGATE DATA TO ESTIMATE GOMPERTZ‐TYPE OLD‐AGE MORTALITY IN HETEROGENEOUS POPULATIONS
Authors: Heathcote Christopher R. , Puza Borek D. , Roberts Steven P.
Published: October 2009

We consider two related aspects of the study of old‐age mortality. One is the estimation of a parameterized hazard function from grouped data, and the other is its possible deceleration at extreme old age owing to heterogeneity described by a mixture of distinct sub‐populations. The first is treated by half of a logistic transform, which is known to be free of discretization bias at older ages, and also preserves the increasing slope of the log hazard in the Gompertz case. It is assumed that data are available in the form published by official statistical agencies, that is, as aggregated frequencies in discrete time. Local polynomial modelling and weighted least squares are applied to cause‐of‐death mortality counts. The second, related, problem is to discover what conditions are necessary for population mortality to exhibit deceleration for a mixture of Gompertz sub‐populations. The general problem remains open but, in the case of three groups, we demonstrate that heterogeneity may be such that it is possible for a population to show decelerating mortality and then return to a Gompertz‐like increase at a later age. This implies that there are situations, depending on the extent of heterogeneity, in which there is at least one age interval in which the hazard function decreases before increasing again.
CLONING DATA: GENERATING DATASETS WITH EXACTLY THE SAME MULTIPLE LINEAR REGRESSION FIT
Authors: Haslett S. J. , Govindaraju K.
Published: October 2009

This paper presents a simple computational procedure for generating ‘matching’ or ‘cloning’ datasets so that they have exactly the same fitted multiple linear regression equation. The method is simple to implement and provides an alternative to generating datasets under an assumed model. The advantage is that, unlike the case for the straight model‐based alternative, parameter estimates from the original data and the generated data do not include any model error. This distinction suggests that ‘same fit’ procedures may provide a general and useful alternative to model‐based procedures, and have a wide range of applications. For example, as well as being useful for teaching, cloned datasets can provide a model‐free way of confidentializing data.
Frontal‐lobe mediated behavioral dysfunction in amyotrophic lateral sclerosis
Authors: Witgert M. , Salamone A. R. , Strutt A. M. , Jawaid A. , Massman P. J. , Bradshaw M. , Mosnik D. , Appel S. H. , Schulz P. E.
Published: October 2009

Background:  Cognitive impairment secondary to frontal lobe atrophy exists in 40–60% of Amyotrophic Lateral Sclerosis (ALS) cases. We aimed to determine the prevalence of frontal‐lobe mediated behavioral impairment in (ALS) and to ascertain its relationship to cognitive impairment.

Methods:  Two‐hundred and twenty five patients diagnosed with sporadic ALS were evaluated for behavioral dysfunction using the Frontal Systems Behavior Scale (FrSBe), a validated measure used to examine frontal‐lobe mediated behaviors, specifically apathy, executive dysfunction and disinhibition; a total behavior score is also provided. Additionally, a subset of patients also underwent a comprehensive neuropsychological evaluation.

Results:  Changes in the total FrSBe scores were observed in 24.4% of the patients and 39.6% of the patients had impairment in at least one behavioral domain with symptoms of Apathy being the most common (31.1%). Cognitively impaired ALS patients had worse total (P = 0.05) and apathy scores (P < 0.01); however, behavioral dysfunction was also present in 16% of the cognitively intact patients. Half of the behaviorally intact patients exhibited cognitive impairment. Significant correlations were observed for performance on certain neuropsychological tests (Animal fluency, Block Design, Logical Memory I and Verbal Series Attention Test) and severity of behavioral dysfunction on certain FrSBe sub scores.

Conclusions:  Frontal‐lobe mediated behavioral dysfunction appears to be common in ALS. Cognitively impaired ALS patients had greater behavioral dysfunction. Recognition of behavioral and cognitive dysfunction may assist health‐care providers and care‐givers recognize changes in decision‐making capacity and treatment compliance of patients with ALS.
High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador
Authors: Vaca M , Guadalupe I , Erazo S , Tinizaray K , Chico ME , Cooper PJ , Hay P
Published: October 2009

Please cite this paper as: Vaca M, Guadalupe I, Erazo S, Tinizaray K, Chico M, Cooper P, Hay P. High prevalence of bacterial vaginosis in adolescent girls in a tropical area of Ecuador. BJOG 2010;117:225–228.

Bacterial vaginosis (BV) is a common clinical syndrome, but data are scarce on the BV prevalence in tropical regions among sexually active and virgin adolescents. To estimate the prevalence of BV among adolescent girls in an Ecuadorian coastal town, girls were asked to complete a questionnaire on risk factors for BV and vaginal samples were examined. Bacterial vaginosis was present in 31.5% of 213 girls, and the prevalence was similar in self‐reported virgin and sexually active girls (OR 1.06, 95% CI, 0.51–2.21, P = 0.88), although the power of this analysis was limited. The prevalence of BV was high among Ecuadorian adolescent girls, and did not appear to be associated with sexual activity.
Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer
Authors: Hazewinkel MH , Sprangers MAG , Taminiau‐Bloem EF , van der Velden J , Burger MPM , Roovers J‐PWR
Published: October 2009

Objective  (1) To explore the reasons for not seeking help for severe pelvic floor symptoms after gynaecological cancer treatment. (2) To determine the willingness to undergo treatment for these symptoms. (3) To invite suggestions to improve outpatient care.

Design  Qualitative study using semistructured interviews.

Setting  Vulvar, endometrial or cervical cancer survivors treated in the Academic Medical Centre, Amsterdam, the Netherlands between1997 and 2007.

Population  Purposively selected sample from 138 eligible respondents to pelvic floor‐related questionnaires, who were severely bothered by their symptoms (>75th percentile of domain sum score of questionnaires) and had not sought medical help.

Methods  After each semistructured interview, a checklist with reasons for not seeking help was complemented with newly mentioned reasons. The interviews were stopped when data saturation was accomplished, i.e. three consecutive interviewees had not revealed new reasons. The interviews were analysed by two researchers independently.

Main outcome measure  Help‐seeking behaviour for bothersome pelvic floor symptoms.

Results  Fifteen interviews were conducted. Most reported reasons for not seeking help were that women found their symptoms bearable in the light of their cancer diagnosis and lacked knowledge about possible treatments. Seven women were willing to undergo treatment. Eleven women stated that care should be improved, specifically by timely referral to pelvic floor specialists and additional care by oncology nurses.

Conclusions  There is a need for standardised attention to adverse effects on pelvic floor function after cancer treatment. This could be realised by quantifying symptoms using questionnaires, standardised attention for such symptoms by gynaecological oncologists or oncology nurses, and timely referral to pelvic floor specialists of women with bothersome pelvic floor symptoms.
Myelin protein composition is altered in mice lacking either sulfated or both sulfated and non‐sulfated galactolipids
Authors: Fewou Simon Ngamli , Fernandes Alda , Stockdale Katie , Francone Victor P. , Dupree Jeffrey L. , Rosenbluth Jack , Pfeiffer Steven E. , Bansal Rashmi
Published: October 2009

J. Neurochem. (2010) 112, 599–610.

Myelin is highly enriched in galactocerebroside (GalCer) and its sulfated form sulfatide. Mice, unable to synthesize GalCer and sulfatide (CGTnull) or sulfatide alone (CSTnull), exhibit disorganized paranodal structures and progressive dysmyelination. To obtain insights into the molecular mechanisms underlying these defects, we examined myelin composition of these mutants by two‐dimensional differential fluorescence intensity gel electrophoresis proteomic approach and immunoblotting. We identified several proteins whose expressions were significantly altered in these mutants. These proteins are known to regulate cytoskeletal dynamics, energy metabolism, vesicular trafficking or adhesion, suggesting a disruption in these physiological processes in the absence of myelin galactolipids. Further analysis of one of these proteins, nucleotide diphosphate kinase (NDK)/Nm23, showed that it was reduced in myelin of CGTnull and increased in CSTnull, but not in whole brain homogenate. Immunostaining showed an increase in its expression in the cell bodies of CGTnull‐ and a decrease in CSTnull‐oligodenrocytes, together leading to the hypothesis that transport of NDK/Nm23 from oligodenrocyte cell bodies into myelin may be differentially dysregulated in the absence of these galactolipids. This study provides new insights into the changes that occur in the composition/distribution of myelin proteins in mice lacking either unsulfated and/or sulfated galactolipids and reinforces the role of these lipids in intracellular trafficking.
The Value of Specialty Oncology Drugs
Authors: Goldman Dana P. , Jena Anupam B. , Lakdawalla Darius N. , Malin Jennifer L. , Malkin Jesse D. , Sun Eric
Published: October 2009

Objective. To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high‐cost specialty medications treating metastatic disease or hematologic malignancies.

Data Source/Study Setting. Claims data from 71 private health plans from 1997 to 2005.

Study Design. This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out‐of‐pocket costs.

Data Collection/Extraction Methods. We extracted key variables from administrative health insurance claims records.

Principal Findings. A 25 percent reduction in out‐of‐pocket costs leads to a 5 percent increase in the probability that a patient initiates specialty cancer drug therapy. Among patients who initiate, a 25 percent reduction in out‐of‐pocket costs reduces the number of treatments (claims) by 1–3 percent, depending on the drug. On average, the value of these drugs to patients who use them is about four times the total cost paid by the patient and his or her insurer, although this ratio may be lower for oral specialty therapies.

Conclusions. The decision to initiate therapy with specialty oncology drugs is responsive to price, but not highly so. Among patients who initiate therapy, the amount of treatment is equally responsive. The drugs we examine are highly valued by patients in excess of their total costs, although oral agents warrant further scrutiny as copayments increase.
Cytoprotective effects of adenosine and inosine in anin vitromodel of acute tubular necrosis
Authors: Módis Katalin , Gerő Domokos , Nagy Nóra , Szoleczky Petra , Tóth Zoltán Dóri , Szabó Csaba
Published: October 2009

Background and purpose: We have established anin vitromodel of acute tubular necrosis in rat kidney tubular cells, using combined oxygen‐glucose deprivation (COGD) and screened a library of 1280 pharmacologically active compounds for cytoprotective effects.

Experimental approach: We usedin vitrocell‐based, high throughput, screening, with cells subjected to COGD using hypoxia chambers, followed by re‐oxygenation. The 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) and the Alamar Blue assay measured mitochondrial respiration and the lactate dehydrogenase assay was used to indicate cell death. ATP levels were measured using a luminometric assay.

Key results: Adenosine markedly reduced cellular injury, with maximal cytoprotective effect at 100 µM and an EC50value of 14 µM. Inosine was also found to be cytoprotective. The selective A3adenosine receptor antagonist MRS 1523 attenuated the protective effects of adenosine and inosine, while an A3adenosine receptor agonist provided a partial protective effect. Adenosine deaminase inhibition attenuated the cytoprotective effect of adenosine but not of inosine during COGD. Inhibition of adenosine kinase reduced the protective effects of both adenosine and inosine during COGD. Pretreatment of the cells with adenosine or inosine markedly protected against the fall in cellular ATP content in the cells subjected to COGD.

Conclusions and implications: The cytoprotection elicited by adenosine and inosine in a model of renal ischaemia involved both interactions with cell surface adenosine receptors on renal tubular epithelial cells and intracellular metabolism and conversion of adenosine to ATP.
Mothering Mexico: The Historiography of Mothers and Motherhood in 20th‐Century Mexico
Authors: Sanders Nichole
Published: October 2009

This essay explores how both scholars have understood the category of motherhood in 20th‐century Mexican history. From the self‐sacrificing, long‐suffering icon of ‘traditional’ motherhood to the ‘modern’ mother who used up‐to‐date child‐rearing techniques, mothers and mothering has had a tremendous symbolic value to various parts of Mexican society. The discourse of motherhood was deployed in multiple ways, by multiple actors since Porfirian times and throughout the postrevolutionary era. A robust scholarship has developed around the concept of mothers, motherhood and maternity.