bluuebunny/crossref_metadata_2025 huggingface dataset:
Viscosupplementation in haemophilic arthropathy: a long‐term follow‐up study
Authors: CARULLI C. , CIVININI R. , MARTINI C. , LINARI S. , MORFINI M. , TANI M. , INNOCENTI M.
Published: September 2011

Summary.  Haemophilic arthropathy is the most common clinical manifestation of haemophilia, secondary to recurrent haemarthroses and chronic synovitis. Modern bleeding‐preventing drugs have limited significantly the incidence of severe arthropathy, and primary approach is usually conservative. Use of intra‐articular injections of hyaluronan acid is considered one of the most efficient treatments for early stages of articular degenerative diseases. Assessment of long‐term effectiveness of intra‐articular administration of hyaluronic acid (HA) in knees, ankles and elbows of patients affected by haemophilic arthropathy was done for 46 patients (10 elbows, 24 knees and 25 ankles) affected by haemophilic arthropathy. They received injections of HA and were evaluated with Visual Analogue Scale, Short Form‐36, World Federation of Haemophilia score and Petterson score with a 6‐year mean follow‐up. Most of the patients showed improvement in pain relief and functional recovery without any complications: only a limited number of patients (8.6%) found poor results, undergoing surgery or other further treatments in the follow‐up period for persistent pain or limitation. Viscosupplementation is an effective therapeutic strategy in early stages of haemophilic arthropathy, with no complications and long‐term good clinical results.
Success rates of a mixture of ciprofloxacin, metronidazole, and minocycline antibiotics used in the non‐instrumentation endodontic treatment of mandibular primary molars with carious pulpal involvement
Authors: TRAIRATVORAKUL CHUTIMA , DETSOMBOONRAT PALINEE
Published: September 2011

International Journal of Paediatric Dentistry 2012; 22: 217–227

Objective.  To evaluate the clinical and radiographic success rates of three mixed antibiotics in the non‐instrumentation endodontic treatment of primary mandibular molars at 24–27 months postoperatively.

Methods.  Eighty cariously involved lower primary molars from 58 children (ages 3–8 years) received a 3Mix medicament by non‐instrumentation endodontic treatment and were then sealed with glass‐ionomer cement and composite resin before permanent restoration with stainless steel crowns. The patients received a clinical and radiographic assessment every 6 months over a 2‐year follow‐up period with an intra‐examiner reliability of 0.83–1.00 (κ value).

Results.  In 60 cases at 24‐ to 27‐month follow‐up, the success rates as determined by clinical and radiographic evaluation were 75% and 36.7%, respectively; however, the overall success rate of 3Mix non‐instrumentation endodontic treatment was 36.7% with 15.8% of cases demonstrating a pulpal response of internal resorption.

Conclusions.  Non‐instrumentation endodontic treatment using 3Mix‐MP showed good clinical success but had a low success rate based on radiographic evaluation at 2‐year follow‐up. Hence, 3Mix antibiotic treatment cannot replace a conventional root canal treatment agent as a long‐term therapy.
Educational support for research utilization and capability beliefs regarding evidence‐based practice skills: a national survey of senior nursing students
Authors: Florin Jan , Ehrenberg Anna , Wallin Lars , Gustavsson Petter
Published: September 2011

florin j., ehrenberg a., wallin l. & gustavsson p. (2011) Educational support for research utilization and capability beliefs regarding evidence‐based practice skills: a national survey of senior nursing students. Journal of Advanced Nursing 68(4), 888–897.

Aim.  The aim of the study was to investigate Swedish university nursing students’ experience of educational support for research utilization and capability beliefs regarding evidence‐based practice skills.

Background.  Nursing programmes are offered at 26 universities in Sweden and even though there are common regulations for nursing education at the national level, substantial variations are found in local curricula. Little is known about students’ capability beliefs regarding evidence‐based practice skills, particularly in comparison across universities.

Methods.  A cross‐sectional survey design using self‐administered postal questionnaires was conducted in 2006. A total of 1440 students (from 26 different universities) participated, constituting 68% of the national population of nursing students in their 6th and final semester.

Results.  Campus education supported the students to a greater extent than clinical education in following the development of knowledge in an area of interest, using research findings, and acquiring knowledge on how to pursue changes in clinical practice. Perceived support during campus education varied between universities. Students reported high capability beliefs regarding evidence‐based practice skills, but large differences were found between universities for: stating a searchable question, seeking out relevant knowledge and critically appraising and compiling best knowledge.

Conclusion.  The identified differences between universities concerning the students’ perceived support for research utilization and their capability beliefs regarding evidence‐based practice skills have implications for curricula, pedagogical perspectives in nursing education and the potential to implement evidence‐based practice in healthcare settings. Further studies are warranted to investigate students’ individual characteristics and organizational characteristics as determinants of research utilization support and capability beliefs regarding evidence‐based practice skills.
KL‐6: a serological biomarker for interstitial lung disease in patients with polymyositis and dermatomyositis
Authors: Fathi M. , Barbasso Helmers S. , Lundberg I. E.
Published: September 2011

Abstract.  Fathi M, Barbasso Helmers S, Lundberg IE (Karolinska University Hospital, Stockholm; Karolinska Institutet, Karolinska University Hospital, Stockholm; and Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Sweden). KL‐6: a serological biomarker for interstitial lung disease in patients with polymyositis and dermatomyositis. J Intern Med 2012; 271: 589–597.

Objectives.  To investigate whether Caucasian patients with polymyositis (PM) or dermatomyositis (DM) and interstitial lung disease (ILD) have elevated serum levels of KL‐6 compared with patients without ILD and whether KL‐6 could be used as a marker for ILD activity and treatment efficacy of ILD in PM/DM.

Design and methods.  Thirty patients with PM/DM (seven with ILD) and 17 age‐ and sex‐matched healthy controls were included in a retrospective, cross‐sectional analysis. Twelve patients were followed for longitudinal evaluation. ILD was defined as restrictive lung function impairment with radiographic signs of ILD. Serum KL‐6 levels were measured using a sandwich enzyme immunoassay kit. Groups were compared by Mann–Whitney U‐test.

Results.  PM/DM patients with ILD had significantly higher median serum KL‐6 levels compared with those without ILD: 995 (range 533–2318) versus 322 (range 132–1225) U mL−1 (P = 0.0002). Median serum levels of healthy controls were 225 (range 136–519) U mL−1. Serum levels of KL‐6 were inversely correlated with percentages of forced expiratory volume in 1 s (FEV1), vital capacity (VC), total lung capacity (TLC), forced VC, diffusing capacity of carbon monoxide (DLco), maximal voluntary ventilation at 40 breaths min−1 and residual volume (RV). Changes in KL‐6 levels showed a significant inverse correlation with changes in percentage FEV1, TLC, DLco and RV. At a cut‐off level of 549 U mL−1 (mean ± 2.5 SD for controls), the sensitivity and specificity for diagnosis of ILD were 83% and 100%, respectively.

Conclusion.  The level of serum KL‐6 may serve as measure of ILD in patients with PM/DM and is a promising biomarker for use in clinical practice to assess clinical response to treatment.
Maternal Neglect: Oxytocin, Dopamine and the Neurobiology of Attachment
Authors: Strathearn L.
Published: September 2011

Maternal neglect, including physical and emotional neglect, is a pervasive public health challenge with serious long‐term effects on child health and development. I provide an overview of the neurobiological basis of maternal caregiving, aiming to better understand how to prevent and respond to maternal neglect. Drawing from both animal and human studies, key biological systems are identified that contribute to maternal caregiving behaviour, focusing on the oxytocinergic and dopaminergic systems. Mesocorticolimbic and nigrostriatal dopamine pathways contribute to the processing of infant‐related sensory cues leading to a behavioural response. Oxytocin may activate the dopaminergic reward pathways in response to social cues. Human neuroimaging studies are summarised that demonstrate parallels between animal and human maternal caregiving responses in the brain. By comparing different patterns of human adult attachment, we gain a clearer understanding of how differences in maternal brain and endocrine responses may contribute to maternal neglect. For example, in insecure/dismissing attachment, which may be associated with emotional neglect, we see reduced activation of the mesocorticolimbic dopamine reward system in response to infant face cues, as well as decreased peripheral oxytocin response to mother–infant contact. We are currently testing whether the administration of intranasal oxytocin, as part of a randomised placebo controlled trial, may reverse some of these neurological differences, and potentially augment psychosocial and behavioural interventions for maternal neglect.
Overcoming sequelae of childhood sexual abuse with stress management
Authors: WILSON D. R. , VIDAL B. , WILSON W. A. , SALYER S. L.
Published: September 2011

Accessible summary

The immense stress associated with experiencing and surviving childhood sexual abuse (CSA) directly influences coping, immune function, and overall health.

There are long‐term consequences from sexual abuse of children. Those who survive CSA tend to show evidence of damaging effects on physical, psychological, emotional, social, and spiritual well‐being. The early stress associated with experiencing and surviving CSA directly influences immune function and overall health. As a result, stress prevention and management play an increasingly important role in the holistic health of adult survivors of CSA.

The current study re‐examined stress management as part of the holistic care of adult survivors of CSA. The purpose of this research was to examine if a stress management education programme remains effective in improving coping skills as measured by the Ways of Coping.

Four weeks of stress management training classes were completed by 32 female adult survivors of CSA. After training, participants reported using fewer avoidance behaviours, more problem‐solving approaches, more direction on seeking social support, and more positive perception of stressors.

This study is relevant to the professions who serve adult survivors of CSA as it provides further evidence for including or continuing stress management education as part of clinical practice.

The immense stress associated with experiencing and surviving childhood sexual abuse directly influences coping, immune function and overall health. Lifelong overuse of maladaptive coping strategies results in impaired adjustment to stress. The purpose of this research was to re‐examine if stress management education would be effective in improving coping skills for this population. Two 4‐week series of stress management workshops were completed by 32 adult survivors who completed the Ways of Coping Questionnaire before and after the training. Four categories of coping showed significant change. Stress management education is an effective and cost‐efficient approach that gives adult survivors an empowering set of tools for their healing journey.
Role of ethylene in alleviation of cadmium‐induced photosynthetic capacity inhibition by sulphur in mustard
Authors: MASOOD ASIM , IQBAL NOUSHINA , KHAN NAFEES A.
Published: September 2011

Sulphur (S) assimilation leads to the formation of glutathione (GSH) and alleviation of cadmium (Cd) stress. GSH is synthesized from its immediate metabolite cysteine, which also serves as a metabolite for ethylene formation through S‐adenosyl methionine. To assess the role of ethylene in S‐induced alleviation of Cd stress on photosynthesis, the effects of S or ethephon (ethylene source) on GSH and ethylene were examined in mustard (Brassica juncea L. cv. Varuna). Sufficient‐S at 100 mg S kg−1 soil alleviated Cd‐induced photosynthetic inhibition more than excess‐S (200 mg S kg−1 soil) via ethylene by increased GSH. Under Cd stress, plants were less sensitive to ethylene, despite high ethylene evolution, and showed photosynthetic inhibition. Ethylene sensitivity of plants increased with ethephon or sufficient‐S, triggering the induction of an antioxidant system, and leading to increased photosynthesis even under Cd stress. The effects of ethephon and S under Cd stress were similar. The effects of S were reversed by ethylene biosynthesis inhibitor, aminoethoxyvinylglycine (AVG), suggesting that ethylene plays an important role in S‐induced alleviation of Cd stress on photosynthesis.
Arabidopsis lonely guy (LOG) multiple mutants reveal a central role of the LOG‐dependent pathway in cytokinin activation
Authors: Tokunaga Hiroki , Kojima Mikiko , Kuroha Takeshi , Ishida Takashi , Sugimoto Keiko , Kiba Takatoshi , Sakakibara Hitoshi
Published: September 2011

Cytokinins are phytohormones that play key roles in the maintenance of stem cell activity in plants. Although alternative single‐step and two‐step activation pathways for cytokinin have been proposed, the significance of the single‐step pathway which is catalyzed by LONELY GUY (LOG), is not fully understood. We analyzed the metabolic flow of cytokinin activation in Arabidopsis log multiple mutants using stable isotope‐labeled tracers and characterized the mutants’ morphological and developmental phenotypes. In tracer experiments, cytokinin activation was inhibited most pronouncedly by log7, while the other log mutations had cumulative effects. Although sextuple or lower‐order mutants did not show drastic phenotypes in vegetative growth, the log1log2log3log4log5log7log8 septuple T‐DNA insertion mutant in which the LOG‐dependent pathway is impaired, displayed severe retardation of shoot and root growth with defects in the maintenance of the apical meristems. Detailed observation of the mutants showed that LOG7 was required for the maintenance of shoot apical meristem size. LOG7 was also suggested to play a role for normal primary root growth together with LOG3 and LOG4. These results suggest a dominant role of the single‐step activation pathway mediated by LOGs for cytokinin production, and overlapping but differentiated functions of the members of the LOG gene family in growth and development.
‘Living stones’ reveal alternative petal identity programs within the core eudicots
Authors: Brockington Samuel F. , Rudall Paula J. , Frohlich Michael W. , Oppenheimer David G. , Soltis Pamela S. , Soltis Douglas E.
Published: September 2011

Petals, defined as the showy laminar floral organs in the second floral whorl, have been shown to be under similar genetic control in distantly related core eudicot model organisms. On the basis of these findings, it is commonly assumed that the petal identity program regulated by B‐class MADS‐box gene homologs is invariant across the core eudicot clade. However, the core eudicots, which comprise >70% of angiosperm species, exhibit numerous instances of petal and sepal loss, transference of petal function between floral whorls, and recurrent petal evolution. In the face of these complex patterns of perianth evolution, the concept of a core eudicot petal identity program has not been tested. We therefore examined the petal identity program in the Caryophyllales, a core eudicot clade in which perianth differentiation into sepals and petals has evolved multiple times. Specifically, we analyzed the expression patterns of B‐ and C‐class MADS‐box homologs for evidence of a conserved petal identity program between sepal‐derived and stamen‐derived petaloid organs in the ‘living stone’ family Aizoaceae. We found that neither sepal‐derived nor stamen‐derived petaloid organs exhibit gene expression patterns consistent with the core eudicot petal identity program. B‐class gene homologs are not expressed during the development of sepal‐derived petals and are not implicated in petal identity in stamen‐derived petals, as their transient expression coincides with early expression of the C‐class homolog. We therefore provide evidence for petal development that is independent of B‐class genes and suggest that different genetic control of petal identity has evolved within this lineage of core eudicots. These findings call for a more comprehensive understanding of perianth variation and its genetic causes within the core eudicots – an endeavor that will have broader implications for the interpretation of perianth evolution across angiosperms.
The H2S test versus standard indicator bacteria tests for faecal contamination of water: systematic review and meta‐analysis
Authors: Wright Jim A. , Yang Hong , Walker Kate , Pedley Steve , Elliott John , Gundry Stephen W.
Published: September 2011

Objectives  To assess the diagnostic accuracy of the H2S test for microbiological contamination of domestic water across different settings, as a basis for providing guidance on its use.

Methods  We searched a range of bibliographic and ‘grey’ literature databases to identify studies that had processed domestic water samples using both the H2S test and recognized tests for thermotolerant coliforms or Escherichia coli. We screened 661 study abstracts and identified 51 relevant studies based on 13 853 water samples. For each relevant study, we recorded the level of correspondence between the H2S and recognized tests, microbial testing procedures, details of the samples processed and study quality indicators. We conducted a meta‐analysis to investigate the impact of testing procedures, study quality and sample characteristics on the diagnostic accuracy of the H2S test.

Results  H2S test implementation varied between studies, and the test’s diagnostic accuracy varied significantly and substantially between studies. Little of this variation was explained by testing procedures, study quality or the nature of the samples processed.

Conclusions  Although in widespread use, our findings suggest that the diagnostic accuracy, particularly specificity, of the H2S test is variable. Optimal conditions for conducting the test remain unclear. As H2S test accuracy is low in a minority of these studies, we recommend that its performance be evaluated relative to standard methods, prior to its operational deployment in a new setting.
Clinical predictors and outcome of hypoxaemia among under‐five diarrhoeal children with or without pneumonia in an urban hospital, Dhaka, Bangladesh
Authors: Chisti Mohammod J. , Duke Trevor , Robertson Colin F. , Ahmed Tahmeed , Faruque Abu S. G. , Ashraf Hasan , La Vincente Sophie , Bardhan Pradip K. , Salam Mohammed A.
Published: September 2011

Objective  To explore the predictors and outcome of hypoxaemia in children under 5 years of age who were hospitalized for the management of diarrhoea in Dhaka, where comorbidities are common.

Methods  In a prospective cohort study, we enrolled all children <5 years of age admitted to the special care ward (SCW) of the Dhaka Hospital of ICDDR,B from September to December 2007. Those who presented with hypoxaemia (SpO2 < 90%) constituted the study group, and those without hypoxaemia formed the comparison group.

Results  A total of 258 children were enrolled, all had diarrhoea. Of the total, 198 (77%) had pneumonia and 106 (41%) had severe malnutrition (<−3 Z‐score of weight for age of the median of the National Centre for Health Statistics), 119 (46%) had hypoxaemia and 138 children did not have hypoxaemia at the time of admission. Children with hypoxaemia had a higher probability of a fatal outcome (21%vs. 4%; P < 0.001). Using logistic regression analysis, the independent predictors of hypoxaemia at the time of presentation were lower chest wall indrawing [OR 6.91, 95% confidence intervals (CI) 3.66–13.08, P < 0.001], nasal flaring (OR 3.22, 95% CI 1.45–7.17, P = 0.004) and severe sepsis (OR 4.48, 95% CI 1.62–12.42, P = 0.004).

Conclusion  In this seriously ill population of children with diarrhoea and comorbidities, hypoxaemia was associated with high case–fatality rates. Independent clinical predictors of hypoxaemia in this population, identifiable at the time of admission, were lower chest wall indrawing, nasal flaring and the clinical syndrome of severe sepsis.
Folliculitis keloidalis nuchae is associated with the risk for bleeding from haircuts
Authors: Khumalo Nonhlanhla P. , Gumedze Freedom , Lehloenya Rannakoe
Published: September 2011

Background  Folliculitis keloidalis nuchae (FKN), characterized by nucheal pimples and keloids, has a predilection for curly African hair. The disease is 10 times more common in males than females. The aim of this study was to investigate determinants of FKN in males.

Methods  Factors associated with the presence of FKN were investigated from two cross‐sectional studies involving 1042 children and 874 adults, respectively. All participants had given informed consent. A clinical diagnosis of FKN was made only if nucheal keloidal papules (or plaques) were present. Multiple logistic regression was used to assess the relationship between FKN and specific characteristics in male participants.

Results  The odds ratio (OR) for FKN in males was higher in the adult than the child study [OR = 7.26, 95% confidence interval (CI) 3.13–16.88; P < 0.0001]. The OR in the group aged <25 years was similar to that in the group aged >50 years (OR = 2.44, 95% CI 0.75–7.89; P = 0.14) but significantly higher in those aged >25–50 years (OR = 5.75, 95% CI 2.67–12.64; P < 0.0001), which is inconsistent with inherent degenerative disease (in which the OR would be expected to increase or remain constant) and may correspond to the current popularity of closely shaven hairstyles. Most hair (86%) was cut close to the scalp with clippers, a process often accompanied by the exhibition of symptoms. For example, 47% of respondents reported transient haircut‐related crusts or pimples (Yes vs. No, FKN OR = 3.44, 95% CI 1.43–8.301; P = 0.006), and 32% of adult males reported at least one episode of bleeding (Yes vs. Never, FKN OR = 3.45, 95% CI 1.23–9.68; P < 0.019).

Conclusions  Prospective studies are needed to clarify the extent to which mechanical haircut‐associated injuries cause or are the result of FKN. Haircut‐associated bleeding raises concern about the potential transmission of blood‐borne infections.
Ethical considerations in paediatric neurology: Neuromuscular disease and epilepsy
Authors: Bodensteiner John B , Ng Yu‐Tze
Published: September 2011

The pace of developing technology with respect to many diagnostic tests, as well as available treatments including artificial ventilation, may have progressed at a faster rate than our ethical, humane ability to decide on the optimal choices for our patients. In fact, who should make these choices; physicians or patients and families? Certain ethical aspects of neuromuscular disorders and epilepsy are reviewed. For neuromuscular disease, the example of Duchenne muscular dystrophy (DMD) with regards to genetic testing, relatively early wheelchair placement and individualised invasive ventilation is discussed. In epilepsy, performing neurosurgery in severely impaired children is probably appropriate in some cases if desired by the family. Financial and human costs restrict therapies and testing for epilepsy as well as other neurological and medical diseases. Whether it is ethical to consider costs in medical treatment or not, it is certainly a reality.
Ethical issues in bone marrow transplantation in children
Authors: Bendorf Aric , Kerridge Ian H
Published: September 2011

In the 50 years since the first successful human bone marrow transplant (BMT) was performed in 1959, BMT has become the optimal therapy for a wide variety of life‐threatening paediatric haematological, immunological and genetic disorders. Unfortunately, while BMT generally provides the only possibility of cure for such afflicted children, few (25%) have a matched sibling available, and suitably matched unrelated donors are often not identified for many children in need of BMT. And even where BMT is possible, treatment is complex and arduous and associated with significant mortality and morbidity. The issues raised when either or both the donor and recipient are children and lack the capacity to make informed and rational decisions relating to BMT pose great challenges for all involved. This paper examines some of the ethical dilemmas that confront patients, families and medical practitioners when considering bone marrow transplantation in a child.
Ethics, law and paediatric medicine
Authors: Waller Louis
Published: September 2011

Medicine is practised within an ethical and a legal framework. Doctors must obtain the broad consent of their patients before treatment begins, and tell them of their choices and the material risks inherent in treatment. Where children are the patients, it is their parents or guardians who must give their consent, unless the situation is an emergency or the children have been removed from parental custody and care. Today, mature teenagers may consent to their own medical treatment. Doctors must protect their patients' confidential information, however acquired. There are very limited exceptions where confidential information may be revealed, and a few where revelation is mandatory. Effective communication between doctors and their patients, or their parents, is of signal importance.
RPL36 as a prognostic marker in hepatocellular carcinoma
Authors: Song Myeong Jun , Jung Chan Kwon , Park Chung‐Hwa , Hur Wonhee , Choi Jung Eun , Bae Si Hyun , Choi Jong Young , Choi Sang Wook , Han Nam Ik , Yoon Seung Kew
Published: September 2011

Ribosomal proteins (RP) play key roles in the regulation of apoptosis, multidrug resistance and carcinogenesis. The aim of this study was to investigate the expression of ribosomal protein L36 (RPL36) in hepatocellular carcinoma (HCC) and to correlate it with clinicopathological parameters and clinical outcome. Liver specimens were obtained from 60 HCC patients who had undergone a partial hepatectomy. Expression of RPL36 in tumor tissue and surrounding non‐tumorous tissues was evaluated on a tissue microarray by immunohistochemistry. RPL36 was expressed in 45 of 60 (75%) HCC by immunohistochemistry, but was not detected in corresponding non‐tumors. RPL36 expression correlated significantly with serum levels of albumin (P= 0.044) and prothrombin time (P= 0.026), which reflect liver synthetic function. Moreover, expression of RPL36 was found to be higher in patients with early tumor stages (I/II) (P= 0.038) or without portal vein thrombosis (P= 0.005). In univariate analysis, patients with RPL36 expression revealed better overall survival (P= 0.037). By multivariate survival analysis, RPL36 expression was found to be an independent prognostic factor for overall survival (P= 0.026). Our data suggest that RPL36 may be involved in the early stage of hepatocarcinogenesis, and it can be used as an independent and potential prognostic marker for resected HCC.
Evaluation of clinical endobronchial ultrasound skills following clinical versus simulation training
Authors: STATHER DAVID R. , MAC EACHERN PAUL , CHEE ALEX , DUMOULIN ELAINE , TREMBLAY ALAIN
Published: September 2011

Background and objective:  Endobronchial ultrasound with transbronchial needle aspiration (EBUS‐TBNA) is a pulmonary procedure that can be challenging to learn. This study aims to compare trainee EBUS‐TBNA performance during clinical procedures, following training with a computer EBUS‐TBNA simulator versus conventional clinical EBUS‐TBNA training.

Methods:  A prospective study of pulmonary trainees performing EBUS‐TBNA procedures on patients with suspected lung cancer and mediastinal adenopathy. Two cohorts of trainees were each evaluated while performing EBUS‐TBNA on two patients. Group 1 received training by performing 15 cases on an EBUS‐TBNA simulator (n = 4) and had never performed a clinical EBUS‐TBNA procedure. Group 2 received training by doing 15–25 EBUS‐TBNA procedures on patients (n = 4).

Results:  There was no significant difference in the primary outcome measure of total EBUS‐TBNA procedure time/number of successful aspirates between Groups 1 and 2 (3.95 (±0.93) vs 3.64 (±0.89), P = 0.51). Total learner EBUS‐TBNA procedure time in minutes (23.67 (±5.58) vs 21.81 (±5.36), P = 0.17) and percentage of successful aspirates (93.3% (±5.8%) vs 86.3% (±6.7%), P = 0.12) were not significantly different between Group 1 and Group 2. The only significant difference found between Group 1 and Group 2 was time to intubation in minutes (0.99 (±0.46) vs 0.50 (±0.42), P = 0.04).

Conclusions:  EBUS‐TBNA simulator use leads to rapid acquisition of clinical EBUS‐TBNA skills comparable with that obtained with conventional training methods using practice on patients, suggesting that skills learned using an EBUS‐TBNA simulator are transferable to clinical EBUS‐TBNA performance. EBUS‐TBNA simulators show promise for training, potentially minimizing the burden of procedural learning on patients.
Core lower urinary tract symptom score (CLSS) for the assessment of female lower urinary tract symptoms: A comparative study
Authors: Fujimura Tetsuya , Kume Haruki , Tsurumaki Yuzuri , Yoshimura Yasukuni , Hosoda Chihiro , Suzuki Motofumi , Fukuhara Hiroshi , Enomoto Yutaka , Nishimatsu Hiroaki , Homma Yukio
Published: September 2011

Objective:  We have recently developed the core lower urinary tract symptom score (CLSS) questionnaire to readily address 10 important lower urinary tract symptoms (LUTS). The aim of the present study was to evaluate the performance of the CLSS in women compared with the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS).

Methods:  Three hundred and eighteen treatment‐naïve consecutive female patients, including 48 controls, completed the three questionnaires. Quality of life (QOL) was determined as per the IPSS QOL Index. The clinical diagnoses were overactive bladder (n = 69), mixed incontinence (n = 42), stress incontinence (n = 17), pelvic organ prolapse (n = 56), interstitial cystitis (n = 31), bacterial cystitis (n = 16), underactive bladder (n = 16), and “other” (n = 23). Simple statistics and the relationship between symptom scores and poor QOL (QOL Index ≥4) were examined.

Results:  All symptom scores were significantly increased in symptomatic women. The CLSS described the symptom profiles of patients with distinct conditions. The scores of corresponding symptoms on the three questionnaires were significantly correlated (r = 0.51–0.85; all P < 0.0001). Multivariate logistic regression modeling proved five CLSS symptoms (daytime frequency, nocturia, urgency incontinence, straining, and urethral pain) as independent predictors of poor QOL, with hazard ratios ranging from 2.0 to 4.2. The IPSS included only two (urgency and straining) significant symptoms.

Conclusions:  The IPSS alone does not fully evaluate female LUTS, with a possible negative impact on QOL. Using the CLSS questionnaire would enable a simple and comprehensive assessment of female LUTS.
Asian chestnut gall wasp in Tuscany: gall characteristics, egg distribution and chestnut cultivar susceptibility
Authors: Panzavolta Tiziana , Bracalini Matteo , Croci Francesco , Campani Carlo , Bartoletti Tamaro , Miniati Giuditta , Benedettelli Stefano , Tiberi Riziero
Published: September 2011

Preliminary investigations were carried out on Dryocosmus kuriphilus Yasumatsu on Castanea sativa Miller in Tuscany to assess variations in gall characteristics in coppice and high forest at two crown heights (height < 2 or 2–6 m), influence of bud size and bud position on oviposition rates and susceptibility of three cultivars.

Gall size may depend on various factors, including wasp population density. In the present study area, small galls (with one or two cells) were the most numerous in 2008, whereas larger galls (with more than three cells) prevailed in 2009.

Dryocosmus kuriphilus oviposition occurrence was influenced by both bud size and bud position. Buds with eggs tended to be larger in size compared with bud without eggs, suggesting that D. kuriphilus females prefer to lay eggs in larger buds (approximately 6 mm3) compared with smaller buds (approximately 3 mm3). The mean number of eggs per bud tended to decrease from the apical bud toward the basal bud.

Three C. sativa cultivars, Carpinese, Fusca and Cesurone, were examined. Fusca grafts had significantly more galls compared with Carpinese and Cesurone, whereas Cesurone grafts had more larvae per bud compared with Carpinese and Fusca. Overall, the Carpinese cultivar may be less susceptible to D. kuriphilus galling compared with the Fusca and Cesurone cultivars.
TAXING SWEETS: SWEETENER INPUT TAX OR FINAL CONSUMPTION TAX?
Authors: MIAO ZHEN , BEGHIN JOHN C. , JENSEN HELEN H.
Published: September 2011

Policymakers are considering various policies to reduce obesity and its associated costs, including consumption taxes on high‐calorie foods and specifically sweetened foods. We investigate two tax policies to reduce added sweetener consumption: a consumption tax on sweetened goods and a sweetener input tax. Both tax instruments can reach the same policy target of reducing added sweetener consumption and are found to be regressive. The tax on sweetener inputs targets sweeteners directly and leads to a loss in consumer surplus that is only one‐fifth of that caused by the final consumption tax. Previous analyses have overlooked this important point. (JEL I18, Q18)
VANISHING LEADERSHIP AND DECLINING RECIPROCITY IN A SEQUENTIAL CONTRIBUTION EXPERIMENT
Authors: FIGUIÈRES CHARLES , MASCLET DAVID , WILLINGER MARC
Published: September 2011

We examine experimentally how and why voluntary contributions are affected by sequentiality. Instead of deciding simultaneously in each round, subjects are randomly ordered in a sequence which differs from round to round. We compare sessions in which subjects observe the contributions from earlier decisions in each round (“sequential treatment with information”) to sessions in which subjects decide sequentially within rounds, but cannot observe earlier contributions (“sequential treatment without information”). We also investigate whether average contributions are affected by the length of the sequence by varying group size. Our results show that sequentiality alone has no effect on contributions, but that the level of contributions increases when subjects are informed about the contributions of lower‐ranked subjects. We provide evidence that the so‐called “leadership effect” vanishes within rounds, and that group size has no significant impact on the average level of contributions in our sequential contribution games. (JEL C92, H41, D63)
Fat burners: nutrition supplements that increase fat metabolism
Authors: Jeukendrup A. E. , Randell R.
Published: September 2011

The term ‘fat burner’ is used to describe nutrition supplements that are claimed to acutely increase fat metabolism or energy expenditure, impair fat absorption, increase weight loss, increase fat oxidation during exercise, or somehow cause long‐term adaptations that promote fat metabolism. Often, these supplements contain a number of ingredients, each with its own proposed mechanism of action and it is often claimed that the combination of these substances will have additive effects. The list of supplements that are claimed to increase or improve fat metabolism is long; the most popular supplements include caffeine, carnitine, green tea, conjugated linoleic acid, forskolin, chromium, kelp and fucoxanthin. In this review the evidence for some of these supplements is briefly summarized. Based on the available literature, caffeine and green tea have data to back up its fat metabolism‐enhancing properties. For many other supplements, although some show some promise, evidence is lacking. The list of supplements is industry‐driven and is likely to grow at a rate that is not matched by a similar increase in scientific underpinning.
Strange bedfellows: Appropriations of a tainted urban dialect1
Authors: Jaspers Jürgen
Published: September 2011

Teenagers often appropriate dialect features they find attractive. This paper argues that unattractive dialect features can also become a target for teenage constructions of linguistic style. Based on an ethnographic case study at a multi‐ethnic school in Antwerp, Belgium, it is shown that Antwerp dialect for non‐white students conjured up angry white and/or racist voices, and that it was frequently stylised as a way of speaking associated with others. At the same time, however, these students produced stylisations that were in synchrony with their own voice and self‐presentation when they recruited Antwerp dialect features to underline assertiveness and to distance themselves from recent, linguistically incompetent, arrivals. It is argued that Antwerp dialect's tainted connotations were outweighed by its value as a tool for shaping a working‐class, non‐immigrant identity.

Tieners eigenen zich vaak dialectkenmerken toe die ze aantrekkelijk vinden. Dit artikel toont aan hoe ook onaantrekkelijke dialectkenmerken het doelwit kunnen vormen voor tieners wanneer ze hun talige stijl construeren. Gebaseerd op etnografisch veldwerk op een multi‐etnische secundaire school in Antwerpen, België, zal aangetoond worden dat voor niet‐blanke studenten het Antwerps dialect de stem opriep van boze blanken en/of racisten, en dat het regelmatig gestileerd werd als een manier van spreken die met anderen werd geassocieerd. Tegelijkertijd produceerden deze studenten echter stileringen die veeleer in harmonie waren met hun eigen stem en zelfpresentatie wanneer ze Antwerpse dialectkenmerken rekruteerden om assertiviteit te onderstrepen en zich te distantiëren van talig incompetente nieuwkomers. Er zal worden betoogd dat de gekleurde connotaties van het Antwerps dialect werden tenietgedaan vanwege z’n grote bruikbaarheid in de constructie van een uit Antwerpen afkomstige arbeidersidentiteit. [Dutch]
Inverting the Lives of ‘Others’: Retelling the Nazi Past in Ehe im Schatten and Das Leben der Anderen
Authors: Wölfel Ute
Published: September 2011

The article compares Florian Henckel von Donnersmarck's film Das Leben der Anderen (2006) with Kurt Maetzig's early post‐war film Ehe im Schatten (1947). The comparison is based on significant narrative and thematic elements which the films share: They both have a ‘theatre couple’, representatives of the ‘Bildungsbürgertum’, at the centre of the story; in both cases the couple faces a crisis caused by the first and second German dictatorship respectively and then both try to solve the crisis by relying on the classical ‘bürgerliches Erbe’, particularly the ‘bürgerliches Trauerspiel’. The extensive use of the ‘bürgerliches Erbe’ in the films activates the function this heritage had for the definition of the German nation in the nineteenth century. However, while Maetzig's film shows how the ‘heritage’ and its representatives fail in the face of National Socialism, von Donnersmarck's film claims the effectiveness of this ‘heritage’ in the fight against the East German dictatorship. Von Donnersmarck thus inverts a critical film tradition of which Ehe im Schatten is an example; furthermore, as this tradition emerged from dealing with the Third Reich, von Donnersmarck's film, it will be argued, is more interested in the redemption of the Nazi past than the East German past.

Der Aufsatz vergleicht Florian Henckel von Donnersmarcks Film Das Leben der Anderen (2006) mit Kurt Maetzigs frühem Nachkriegsfilm Ehe im Schatten (1947). Der Vergleich basiert auf narrativen und thematischen Elementen, die beiden Filmen gemeinsam sind: Beide haben ein ‘Theater‐Paar’ im Mittelpunkt der Geschichte, das zudem als Repräsentant des Bildungsbürgertums fungiert; in beiden Filmen versucht das Paar eine schwere Krise, ausgelöst durch die erste bzw. zweite deutsche Diktatur, durch einen Rückbezug zum klassischen ‘bürgerlichen Erbe’ zu lösen. Der umfangreiche Bezug aufs ‘bürgerliche Erbe’ in beiden Filmen aktiviert jene Bedeutung, die dieses Erbe einst für die Definition der deutschen Nation im 19. Jahrhundert hatte. Während Maetzigs Film das Versagen des ‘Erbes’ und seiner Repräsentanten in der Konfrontation mit dem Nationalsozialismus zeigt, behauptet von Donnersmarcks Film dessen Wirksamkeit im Kampf gegen die ostdeutsche Diktatur. Von Donnersmarck kehrt so eine kritische Filmtradition um, für die Ehe im Schatten ein Beispiel war. Zudem kann argumentiert werden, dass von Donnersmarcks Film, gerade weil er eine Tradition bearbeitet, die im Zuge der Auseinandersetzung mit dem Dritten Reich entstand, mehr an der Versöhnung mit dem Nationalsozialismus als mit der ostdeutschen Vergangenheit interessiert ist.

Gleichgültig welcher Dreck in der Welt ist:

Die wahre Kunst, das wirklich Künstlerische

bleibt immer rein und wahr. Nein?

(Hendrik Höfgen in István Szabó's Mephisto)
‘Troubled Assets’: The Financial Emergency and Racialized Risk
Authors: ASHTON PHILIP
Published: September 2011

This article examines the repositioning of racialized credit risk produced by new regulatory practices that have emerged in the neoliberal era. As increasingly volatile financial markets have periodically threatened the ability of the banking sector to supply credit, US regulators have adopted more aggressive roles to isolate ‘troubled assets’ and restore the norms of risk management. Revisiting the emergence of the US subprime mortgage market in the early 1990s, I use this framework to assess a critical question for urban political economy: how could decades of racial exclusion from US credit markets have been transformed so quickly and decisively into the exploitation of minority borrowers within the subprime market? The article identifies a series of regulatory practices associated with the management of the late‐1980s banking crisis, arguing their distinctive orientation towards the circulation of risk created a new legal and market space for high‐risk loans. I then examine the migration of those emergency risk practices into the institutional venues that shaped the subprime market and that differentially exposed minority borrowers to heightened rent‐seeking. The results suggest new avenues for urban political economy emerging from a broader conceptualization of state relationships to financial risk.

Dans la mouvance néolibérale, de nouvelles pratiques réglementaires ont entraîné le repositionnement du risque de crédit ‘racialisé’. Aux États‐Unis, la volatilité accrue des marchés financiers a régulièrement menacé la capacité du secteur bancaire à fournir du crédit. Les auteurs des réglementations se sont donc montrés plus agressifs, afin d'isoler les ‘actifs toxiques’ et de rétablir les normes de gestion des risques. Revenant sur la création du marché américain des prêts hypothécaires à haut risque (subprimes) au début des années 1990, cet article étudie une question essentielle pour l'économie politique urbaine: comment des décennies d'exclusion raciale des marchés du crédit aux États‐Unis sont‐elles passées si vite et si radicalement à une exploitation des membres des minorités empruntant sur le marché des subprimes? Ce travail identifie un ensemble de pratiques régulatrices liées à la gestion de la crise bancaire de la fin des années 1980, et soutient que leur orientation spécifique vers la circulation du risque a crééà la fois un nouvel espace juridique et un nouvel espace de marché pour les prêts à haut risque. Il analyse ensuite la migration de ces pratiques à risque exceptionnelles vers les sites institutionnels qui ont configuré le marché des subprimes et ont exposé les emprunteurs issus des minorités à un parasitisme plus intense. On peut en déduire de nouvelles possibilités pour l'économie politique urbaine à partir d'une conceptualisation élargie des rapports entre l'État et le risque financier.
Cryptic hybridization and introgression between invasive Cyprinid species Cyprinus carpio and Carassius auratus in Australia: implications for invasive species management
Authors: Haynes G. D. , Gongora J. , Gilligan D. M. , Grewe P. , Moran C. , Nicholas F. W.
Published: September 2011

Interspecies hybridization is of concern for the management of invasive species, as it can allow the exchange of advantageous alleles between introduced species and undermine control efforts. In this study, hybridization between populations of introduced common carp and goldfish in Australia is investigated. Common carp and goldfish were sampled extensively from the Murray‐Darling Basin, the largest river basin in Australia. Fish identified in the field as hybrids, on the basis of having truncated or missing pairs of barbels around their mouths, were also sampled. All fish were genotyped for five microsatellite loci that could be amplified through polymerase chain reaction in both species, and the mitochondrial DNA control region was sequenced in the field‐identified hybrids and a subset of the goldfish and common carp. Bayesian clustering analyses, factorial correspondence analysis and direct inspection of the microsatellite profiles confirmed that all fish identified as hybrids in the field had ancestry from both species. A number of cryptic hybrids were also identified. While most hybrids were inferred to be F1‐generation, some F2‐generation and backcrossed individuals were detected, indicating that gene flow is ongoing between carp and goldfish in Australia. Gene flow was biased in favor of male carp mating with female goldfish, as 19 of the 20 F1‐generation hybrids had goldfish maternal ancestry. This ongoing gene flow could allow advantageous alleles (e.g. resistance to koi herpes virus) to move between species. This study illustrates that invasive species control programs should not only target the species considered most destructive, but should also consider the risks posed by introgression with related species.
Progress towards achieving Millennium Development Goal 5 in South‐East Asia
Authors: Islam M
Published: September 2011

Please cite this paper as: Islam M. Progress towards achieving Millennium Development Goal 5 in South‐East Asia. BJOG 2011; 118 (Suppl. 2): 6–11.
Achieving Millennium Development Goals 4 and 5 in India
Authors: Chatterjee A , Paily VP
Published: September 2011

Please cite this paper as: Chatterjee A, Paily VP. Achieving Millennium Development Goals 4 and 5 in India. BJOG 2011;118 (Suppl. 2):47–59.

This review relates to achieving the Millennium Development Goals (MDGs), especially MDGs 4 and 5, by India by the year 2015. India contributes the maximum number of maternal deaths (68 000) to the global estimate of 358 000 maternal deaths annually. Infant mortality rate (IMR) is also high at 50 per 1000 (2009). Low budgetary spending on health, poverty, lower literacy, poor nutritional status, rural–urban divide and lack of trained workers in the health sector are cited as reasons for a high maternal mortality ratio and IMR. Increased spending by the Government of India on the health sector has started to show encouraging results. Recent assessments by world bodies like the World Health Organisation have given hope that MDGs 4 and 5 are achievable.