bluuebunny/crossref_metadata_2025 huggingface dataset:
Salivary parameters in Brazilian individuals with cerebral palsy who drool
Authors: Santos M. T. B. R. , Ferreira M. C. D. , Leite M. F. , Guaré R. O.
Published: November 2010

Background  Although drooling of saliva is considered abnormal in a child over 4 years of age, it has been estimated to occur in approximately in 10–37% of children with cerebral palsy.

Aim  The aim of this study was to evaluate the flow rate, pH and buffering capacity in saliva of Brazilian individuals with cerebral palsy who drool.

Methods  Cross‐sectional assessment of saliva from 139 individuals with cerebral palsy (3–16 years old) enrolled in a specialized rehabilitation centre in Sao Paulo, Brazil, divided into two groups, according to the presence (G1) or absence (G2) of drooling and controls (G3): G1 consisted of 63 individuals who drool; G2 consisted of 76 who do not drool; and G3 consisted of 47 individuals with no neurological damage of similar age and sex. Unstimulated whole saliva was collected and salivary flow rate (mL/min), initial pH and buffering capacity, by titration of saliva with a constant amount of 0.01 N HCl, were evaluated. The results from G1, G2 and G3 were compared by one‐way anova and the χ2‐test.

Results  A higher percentage of severe drooling (60.3%) was observed compared with moderate (27.0%) and mild (12.7%) in the cerebral palsy individuals who drool and the prevalence of drooling was highest among children and adolescents with spastic quadriplegia. Significant reductions in salivary flow rate, initial pH, buffering capacity of whole saliva in pH range 6.0–6.9 and total buffering capacity occurred in G1 and G2 compared with G3.

Conclusion  All individuals with cerebral palsy present lower flow rate, pH and buffering capacity of saliva, which increases the risk of oral diseases.
Can the abundance of tigers be assessed from their signs?
Authors: Jhala Yadvendradev , Qureshi Qamar , Gopal Rajesh
Published: November 2010

1. Indices of abundance offer cost effective and rapid methods for estimating abundance of endangered species across large landscapes, yet their wide usage is controversial due to their potential of being biased. Here, we assess the utility of indices for the daunting task of estimating the abundance of the endangered tiger at landscape scales.

2. We use double sampling to estimate two indices of tiger abundance (encounters of pugmarks and scats per km searched) and calibrate those indices against contemporaneous estimates of tiger densities obtained using camera‐trap mark–recapture (CTMR) at 21 sites (5185 km2) in Central and North India. We use simple and multiple weighted regressions to evaluate relationships between tiger density and indices. A model for estimating tiger density from indices was validated by Jackknife analysis and precision was assessed by correlating predicted tiger density with CTMR density. We conduct power analysis to estimate the ability of CTMR and of indices to detect changes in tiger density.

3. Tiger densities ranged between 0·25 and 19 tigers 100 km−2 were estimated with an average coefficient of variation of 13·2(SE 2·5)%. Tiger pugmark encounter rates explained 84% of the observed variability in tiger densities. After removal of an outlier (Corbett), square root transformed scat encounter rates explained 82% of the variation in tiger densities.

4. A model including pugmark and scat encounters explained 95% of the variation in tiger densities with good predictive ability (PRESS R2 = 0·99). Overall, CTMR could detect tiger density changes of >12% with 80% power at α = 0·3, while the index based model had 50% to 85% power to detect >30% declines. The power of indices to detect declines increased at high tiger densities.

5. Synthesis and applications. Indices of tiger abundance obtained from across varied habitats and a range of tiger densities could reliably estimate tiger abundance. Financial and temporal costs of estimating indices were 7% and 34% respectively, of those for CTMR. The models and methods presented herein have application in evaluation of the abundance of cryptic carnivores at landscape scales and form part of the protocol used by the Indian Government for evaluating the status of tigers.
An historical perspective on the treatment of vocation in the Briggs Report (1972)
Authors: Bradshaw Ann
Published: November 2010

Aims and objectives.  To examine the vocational ideal in the Briggs Report (Briggs 1972), its evidence, context and interpretation.

Background.  As recently argued in Journal of Clinical Nursing, twentieth century reports have misrepresented nursing. This paper considers this argument in relation to the Briggs Report and its understanding of vocation.

Design.  Sources consulted: nursing periodicals 1960–1975, nursing textbooks 1937–1971, the Briggs Report, research studies on nursing 1961–1971, secondary works on nursing history. Included are three newly discovered major primary sources.

Methods.  An historiographical analysis of archival sources which interrogates primary and secondary evidence to make transparent interconnection, coherence, consistency and reliability.

Results.  Despite evidence from its own commissioned data that vocation was an important motivating factor, the Briggs Report recommended a new nursing model.

Conclusion.  The concept of vocation in nursing has been commonly interpreted as a cultural tool hindering the subsequent development of nursing. This approach has been a driver for policy decisions in nursing. Despite its own evidence, the Briggs Committee recommended far reaching changes, accepted by government and implemented over the following decade as Project 2000. The concept of vocation warrants further scholarship.

Relevance to clinical practice.  Whether the historical ideal of vocation remains important, negatively or positively, to the attitudes, values and motivations of the clinical nurse and the quality of patient care, is a relevant and significant issue for contemporary UK and international nursing practice and policy.
The National Expert Standard Pressure Ulcer Prevention in Nursing and pressure ulcer prevalence in German health care facilities: a multilevel analysis
Authors: Wilborn Doris , Grittner Ulrike , Dassen Theo , Kottner Jan
Published: November 2010

Aims and objectives.  The objective of this study was to describe the relationship between the German National Expert Standard Pressure Ulcer Prevention and the pressure ulcer prevalence in German nursing homes and hospitals.

Background.  The patient outcome pressure ulcer does not only depend on individual characteristics of patients, but also on institutional factors. In Germany, National Expert Standards are evidence‐based instruments that build the basis of continuing improvement in health care quality. It is expected that after having implemented the National Expert Standard Pressure Ulcer Prevention, the number of pressure ulcers should decrease in health care institutions.

Design.  The analysed data were obtained from two cross‐sectional studies from 2004–2005.

Methods.  A multilevel analysis was performed to show the impact of the National Expert Standard Pressure Ulcer Prevention on pressure ulcer prevalence.

Results.  A total of 41·5% of hospitals and 38·8% of the nursing homes claimed to use the National Expert Standard in the process of developing their local protocols. The overall pressure ulcer prevalence grade 2–4 was 4·7%. Adjusted for hospital departments, survey year and individual characteristics, there was no significant difference in the prevalence of pressure ulcers between institutions that refer to the National Expert Standard or those referring to other sources in developing their local protocols (OR = 1·14, 95% CI = 0·90–1·44).

Conclusions.  There was no empirical evidence demonstrating that local protocols of pressure ulcer prevention based on the National Expert Standard were superior to local protocols which refer other sources of knowledge with regard to the pressure ulcer prevalence.

Relevance to clinical practice.  The use of the National Expert Standard Pressure Ulcer Prevention can neither be recommended nor be refused. The recent definition of implementation of Expert Standards should be mandatory for all health care institutions which introduce Expert Standards.
Lower extremity ulcer management: best practice algorithm
Authors: Simms Kimberly W , Ennen Kathleen
Published: November 2010

Aims and objectives. This literature review aims to define best nursing practice for lower limb ulcer care promoting stabilisation of this physiological consequence of diabetes mellitus and to help provide improved integration of health‐within‐illness for the patients.

Background. According to the Centers of Disease Control, the number of people with diabetes has risen from 20·8 million in 2005 to over 23·6 million in 2007. Research has identified best practice algorithms for care of the diabetic foot, yet none for the ulcerations on the limb from the knee to the ankle.

Design. The design of this literature review is to compile research from both nursing and medical communities to develop a best practice for the stabilisation of a lower limb ulcer. A literature search was conducted based on the theoretical framework of stabilisation of a chronic condition.

Methods. Twenty‐nine articles were identified for use in the evaluation of best practice of lower limb ulcerations. Each article was synthesised using a protocol tool.

Results. Control of hyperglycaemia, infection control, ulcer debridement, use of dressings and compression therapy to relieve venous congestion were all identified as important factors in the treatment of lower limb ulcerations.

Conclusions. This systematic literature review has resulted in a ‘best nursing practice algorithm’ for the stabilisation and care of lower limb ulcerations regardless of underlying cause. This care algorithm could be used in collaboration with other health care providers to promote stabilisation of lower limb ulcers and improve the overall quality of life of patient cohort.

Relevance to clinical practice. The results of this study yield a suggested ‘best practice’ algorithm for the stabilisation of a lower limb ulcer – treat and control hyperglycaemia; prevent and/or control infection of the ulcer; routine debridement of the ulcer; using the most appropriate type of dressings for each patient; and the application of compression therapy. This algorithm can also be used for to frame patient teaching regarding appropriate treatments and therapies to promote the patient’s self‐care and stabilisation of the ulcer.
Continuous control of flagellar gene expression by the σ28–FlgM regulatory circuit in Salmonella enterica
Authors: Saini Supreet , Floess Emily , Aldridge Christine , Brown Jonathon , Aldridge Phillip D. , Rao Christopher V.
Published: November 2010

The flagellar genes in Salmonella enterica are expressed in a temporal hierarchy that mirrors the assembly process itself. The σ28–FlgM regulatory circuit plays a key role in controlling this temporal hierarchy. This circuit ensures that the class 3 genes are expressed only when the hook‐basal body (HBB), a key intermediate in flagellar assembly, is complete. In this work, we investigated the role of the σ28–FlgM regulatory circuit in controlling the timing and magnitude of class 3 gene expression using a combination of mathematical modelling and experimental analysis. Analysis of the model predicted that this circuit continuously controls class 3 gene expression in response to HBB abundance. We experimentally validated these predictions by eliminating different components of the σ28–FlgM regulatory system and also by rewiring the transcriptional hierarchy. Based on these results, we conclude that the σ28–FlgM regulatory circuit continuously senses the HBB assembly process and regulates class 3 gene expression and possibly flagellar numbers in response.
A role for the essential YycG sensor histidine kinase in sensing cell division
Authors: Fukushima Tatsuya , Furihata Isako , Emmins Robyn , Daniel Richard A. , Hoch James A. , Szurmant Hendrik
Published: November 2010

The YycG sensor histidine kinase co‐ordinates cell wall remodelling with cell division in Gram‐positive bacteria by controlling the transcription of genes for autolysins and their inhibitors. Bacillus subtilis YycG senses cell division and is enzymatically activated by associating with the divisome at the division septum. Here it is shown that the cytoplasmic PAS domain of this multi‐domain transmembrane kinase is a determining factor translocating the kinase to the division septum. Furthermore, translocation to the division septum, per se, is insufficient to activate YycG, indicating that specific interactions and/or ligands produced there are required to stimulate kinase activity. N‐terminal truncations of YycG lose negative regulation of their activity inferring that this regulation is accomplished through its transmembrane and extramembrane domains interacting with the membrane associated YycH and YycI proteins that do not localize to the divisome. The data indicate that YycG activity in non‐dividing cells is suppressed by its interaction with YycH and YycI and its activation is co‐ordinated to cell division in dividing cells by specific interactions that occur within the divisome.
Xylan degradation, a metabolic property shared by rumen and human colonic Bacteroidetes
Authors: Dodd Dylan , Mackie Roderick I. , Cann Isaac K. O.
Published: November 2010

Microbial inhabitants of the bovine rumen fulfil the majority of the normal caloric requirements of the animal by fermenting lignocellulosic plant polysaccharides and releasing short chain fatty acids that are then metabolized by the host. This process also occurs within the human colon, although the fermentation products contribute less to the overall energy requirements of the host. Mounting evidence, however, indicates that the community structure of the distal gut microbiota is a critical factor that influences the inflammatory potential of the immune system thereby impacting the progression of inflammatory bowel diseases. Non‐digestible dietary fibre derived from plant material is highly enriched in the lignocellulosic polysaccharides, cellulose and xylan. Members of the Bacteroidetes constitute a dominant phylum in both the human colonic microbiome and the rumen microbial ecosystem. In the current article, we review recent insights into the molecular mechanisms for xylan degradation by rumen and human commensal members of the Bacteroidetes phylum, and place this information in the context of the physiological and metabolic processes that occur within these complex microbial environments.
Staphylococci and staphylococcal superantigens in asthma and rhinitis: a systematic review and meta‐analysis
Authors: Pastacaldi C. , Lewis P. , Howarth P.
Published: November 2010

To cite this article: Pastacaldi C, Lewis P, Howarth P. Staphylococci and staphylococcal superantigens in asthma and rhinitis: a systematic review and meta‐analysis. Allergy 2011; 66: 549–555.

Background:  There is a need for new treatment options of allergic respiratory diseases based on a better knowledge of their pathogenesis. An association between bacterial products and allergic airway diseases has been suggested by the results of human and animal studies that describe a link between Staphylococcus aureus enterotoxins and atopic diseases. The aim of the systematic review is to assess the evidence for a role of Staphylococcus aureus enterotoxins, as an environmental risk factor, for the development and/or the severity of asthma and allergic rhinitis.

Methods:  We performed a systematic review of controlled clinical studies in adults and/or children affected by asthma/early wheeze and/or allergic rhinitis. To be eligible, studies had to use reproducible methods to provide evidence of exposure to S. aureus, clinical outcome and disease severity.

Results:  Ten studies, published between 2000 and 2007, fulfilled all eligibility criteria. Patients with asthma or allergic rhinitis showed an increased prevalence of positivity for measures of exposure to S. aureus in nine studies: differences were statistically significant (P < 0.05) in seven studies. In a meta‐analysis of study results, patients with asthma were more likely than controls to have serum‐specific IgE to Staphylococcus aureus enterotoxins (OR = 3.3, 95% CI: 1.6–7.1, P = 0.002); similarly, patients with allergic rhinitis were more likely than controls to test positive for local or systemic exposure to Staphylococcus aureus and/or or its enterotoxins (OR = 2.4, 95% CI: 1.3–4.7, P = 0.008).

Conclusions:  A potential role of S. aureus superantigens in allergic respiratory diseases is supported by results of this meta‐analysis of clinical studies.
Addition of anti‐CD25 to thymoglobulin for induction therapy: delayed return of peripheral blood CD25‐positive population
Authors: Sageshima Junichiro , Ciancio Gaetano , Gaynor Jeffrey J. , Chen Linda , Guerra Giselle , Kupin Warren , Roth David , Ruiz Phillip , Burke George W.
Published: November 2010

Sageshima J, Ciancio G, Gaynor JJ, Chen L, Guerra G, Kupin W, Roth D, Ruiz P, Burke GW. Addition of anti‐CD25 to thymoglobulin for induction therapy: delayed return of peripheral blood CD25‐positive population.  Clin Transplant 2011: 25: E132–E135. © 2010 John Wiley & Sons A/S.

Abstract:  An anti‐CD25 monoclonal antibody was added to thymoglobulin for induction therapy in simultaneous pancreas/kidney (SPK) recipients. T‐cell subsets including CD3 and CD25 were assessed by flow cytometry analysis in the peripheral blood of SPK (n = 88), and for comparison kidney transplant (KT) recipients were assessed. KT recipients were treated with daclizumab (anti‐CD25) alone (five doses; 1 mg/kg) (n = 27) or thymoglobulin alone (4–7 doses; 1 mg/kg) (n = 23). SPK recipients received daclizumab (two doses; 1 mg/kg) in addition to thymoglobulin (five doses; 1 mg/kg). The return of peripheral blood CD25+ cells was delayed for 45 d post‐transplantation in the SPK recipients where anti‐CD25 was added to thymoglobulin, compared to those KT recipients with thymoglobulin alone. This strategy may result in reduced allogeneic (donor‐specific) T effector cells at the time of solid organ transplantation.
Two Atypical Cases of Granulosa Cell Tumours in Belgian Blue Heifers
Authors: Meganck V , Govaere J , Vanholder T , Vercauteren G , Chiers K , de Kruif A , Opsomer G
Published: November 2010

Contents

This paper describes two atypical cases of granulosa cell tumours (GCTs) in Belgian Blue heifers. In the first case, an 18‐month‐old heifer died after ovariectomy, and a granulosa‐theca cell tumour was diagnosed post‐mortem. The second heifer (31 months of age) was near term and was successfully treated surgically for a malignant granulosa cell tumour. Unfortunately, no further reproductive data are available, as the heifer was sold for slaughter. This is the first report describing GCTs in Belgian Blue beef cattle.
HIV‐infected patients' adherence to highly active antiretroviral therapy: A phenomenological study
Authors: Mohammadpour Ali , Yekta Zohre Parsa , Nikbakht Nasrabadi Ali R.
Published: November 2010

Adherence to the treatment regimen is essential to the success of highly active antiretroviral therapy for patients who are infected with HIV. The evidence suggests that poor adherence to antiretroviral drug therapy is a major problem that has the potential to diminish effective viral suppression, promote viral resistance, and place patients at risk for hospitalization, opportunistic infections, and an increased risk of HIV transmission. The primary aim of this study was to understand patients' experiences regarding their adherence to antiretroviral drug therapy. Thus, 19 participants were recruited for in‐depth interviews regarding their adherence to drug regimens. All the interviews were transcribed verbatim and analyzed by using Benner's phenomenological analysis approach. Four main themes emerged from the data: (i) choosing to live and the decision to start taking medications; (ii) strategies for adhering to the regimen and managing the side‐effects; (iii) relationships with healthcare providers; and (iv) advantages of the medications as a motivator to continue one's adherence to the regimen. Studying and understanding the experiences of patients can provide new insights and strategies in order to enhance patients' adherence to highly active antiretroviral therapy.
Relationship between prostate‐specific antigen and obesity in prostate cancer screening: Analysis of a large cohort in Japan
Authors: Kubota Yasuaki , Seike Kensaku , Maeda Shinichi , Shinohara Yuka , Iwata Masamitsu , Sugimoto Norio
Published: November 2010

Previous studies have shown that lower prostate‐specific antigen (PSA) levels in obese men might decrease the sensitivity of prostate cancer screening, leading to delayed diagnosis and unfavorable prognosis. We examined whether the effect of obesity is important in prostate cancer screening of Japanese men, who have a low prevalence of obesity. We analyzed 19 294 male subjects from a large cohort of Toyota Motor Corporation (TMC) employees (aged >50 years, serum PSA level ≤4.0 ng/mL) who underwent physical examinations from August 2006 to December 2009. The relationship between PSA level and obesity‐related factors was analyzed by simple and multiple regression analysis. The relationships between six body mass index (BMI) categories, and PSA level and PSA mass (PSA concentration × plasma volume) were analyzed. PSA level decreased significantly with increasing BMI, but the coefficient of determination was very low. Mean PSA values decreased from 1.02 to 0.85 ng/mL as BMI increased from underweight (BMI <18.5) to morbidly obese (BMI >35). However, PSA mass peaked in the overweight category and was slightly reduced with increasing BMI. On multiple regression analysis, PSA level was influenced by age, diastolic blood pressure and high‐density lipoprotein as well as BMI. We found an inverse but weak relationship between PSA level and BMI. Obesity seems to have very limited influence on prostate cancer screening in this population. Nonetheless, when considering indications for prostatic biopsy in obese men, we should be aware that the hemodilution effect might reduce PSA levels.
Laparoscopic donor nephrectomy
Authors: He Bulang , Mitchell Andrew , Delriviere Luc , Shannon Tom , Pemberton Richard , Tan Andrew , Bremner Alexandra , Vivian Justin
Published: November 2010

Background:  Kidney transplantation is a definitive treatment of end‐stage renal disease. Laparoscopic donor nephrectomy (LDN) has been widely accepted around the world since its introduction in 1995 as a minimum invasive procedure. We report our clinical experience of 141 consecutive LDNs performed in two tertiary hospitals in Western Australia.

Methods:  From December 2000 (Royal Perth Hospital) and January 2005 (Sir Charles Gairdner Hospital) to January 2009, 141 LDNs were performed in two tertiary hospitals by four urologists. All donors underwent rigorous work‐up prior to surgery. Donor age ranged from 23 years to 81 years (49.85 ± 11.30 years). The male to female ratio was 1 to 1.3. Donor body mass index (BMI) was 26.77 ± 4.31, and glomerular filtration rate was 96.25 ± 12.33 mL/min/1.73 sqm. The laparoscopic technique was transperitoneal approach exclusively.

Results:  All LDNs were performed successfully without hand assistance. The warm ischaemic time ranged from 3 to 11 min. The hospital stay was 4.16 ± 1.30 days. The overall complication rate was 17.0%, with three major complications (2.1%): a splenetic infarction, a chylous ascites and a pulmonary embolism occurred. Donors' demographic data (age, sex, BMI, side of surgery) did not show a statistically significant association with surgical complications.

Conclusions:  Transperitoneal laparoscopic live donor nephrectomy is a safe and effective procedure. Combined use of vascular stapler and Hem‐o‐Lok is very important for management of the renal artery stump. It is our current practice to administer anticoagulants during and post‐surgery for at least 2 weeks.
Correlation of MAPT scores with clinical and radiographic assessment of patients awaiting THR/TKR
Authors: David Vikram Mohan , Bousounis George , Kapakoulakis Theo , Champion Robert , Masman Kevin , McCullough Keith
Published: November 2010

Background:  The Multi‐attribute Arthritis Prioritisation Tool (MAPT) score is used as a tool to prioritize referrals to specialist clinics and care given to patients with hip and knee problems. Our pilot study aimed to determine the extent of any relationship between the MAPT scores and the clinician's assessment of severity of disease in terms of surgical waiting list (SWL) categories and radiological assessment.

Methods:  This is a retrospective study of patients with symptomatic hip or knee osteoarthritis (OA) that were referred via the orthopaedic waiting list project between January and July 2009 to the Bendigo Health's orthopaedic outpatients clinic and were waitlisted for a total hip replacement (THR)/total knee replacement (TKR). The MAPT score was calculated and the Surgical waitlist Category was obtained from the surgical booking office. The radiographs of all these patients were reviewed and graded independently according to the Kellgren and Lawrence radiographic grading for severity of arthritis. The relationships between MAPT score, SWL category and the Kellgren and Lawrence radiographic grades were examined using graphical methods and Kendall's tau correlation coefficients.

Results:  There were 62 patients in the study. The Kendall‐tau sample correlation coefficient between MAPT score and the radiographic grade is τb=−0.091 (P= 0.330) and between MAPT score and SWL category is τb= 0.007 (P= 0.951).

Conclusions:  The sample data suggests that there is no significant relationship between the MAPT score and radiographic severity of OA, or between MAPT score and surgical waitlist category of patients with OA waitlisted for a THR/TKR.
Case of uterine leiomyoma showing fludeoxyglucose uptake on F‐18 fludeoxyglucose positron emission tomography/computed tomography
Authors: Park Jee Hyun , Han Jee Young , Hyun In Young , Lee Byoung Ick , Moon Yeon Sook
Published: November 2010

In order not to over treat uterine leiomyoma and to avoid overlooking uterine leiomyosarcoma, a highly reliable diagnostic method has been thought. Occasionally, it is difficult to discriminate uterine leiomyoma from uterine leiomyosarcoma. Recently positron emission tomography/computed tomography (PET/CT) has been proved useful in assessing pelvic malignancies. We experienced a case of uterine leiomyoma showing increased F‐18 fludeoxyglucose uptake on PET/CT in a postmenopausal woman. However, histological analysis demonstrated benign leiomyoma by the hysterectomy. Immunohistochemical analysis of glucose transporter‐1 showed negative in leiomyoma. Our case indicates that uterine leiomyoma in a postmenopausal woman may show false positive result of PET/CT.
The effect of marital status on pregnancy outcome in Israel: A retrospective case‐control study
Authors: Lurie Samuel , Zalmanovitch Anath , Golan Abraham , Sadan Oscar
Published: November 2010

Aims:  Previous studies have observed an association between unmarried status of the mother and adverse perinatal outcome such as increased rate of preterm deliveries, low birthweight and small‐for‐gestational‐age infants. In Israel, attendance of prenatal care is imposed by the state and is not related to socioeconomic status; therefore, unmarried women are expected to have a similar prenatal care as married women. The objective of this study is to test the hypothesis that unmarried and married pregnant women have a similar perinatal outcome.

Material & Methods:  In a retrospective case‐control study, analysis of the records of women who gave birth at the delivery ward of Edith Wolfson Medical Center (a tertiary health care center) over a one‐year period (2005) with respect to marital status was performed. The cases group included 304 unmarried women who were matched with 1:1 ratio for maternal age, parity, and number of fetuses in the current pregnancy.

Results:  Unmarried women (n = 304) were more likely to smoke during pregnancy (35.2% vs 15.2%, P < 0.001), had a longer second stage (44.4 ± 9.8 min vs 54.4 ± 4.4 min, P < 0.05) and a shorter first stage (484.0 ± 34.8 min vs 421.0 ± 25.3 min P < 0.05) of labor. The unmarried women had similar length of gestation, preterm delivery rate, mode of delivery, low birthweight rates, low Apgar scores or meconium passage during labor as married women.

Conclusion:  In Israel, unmarried and married pregnant women may have almost similar pregnancy outcomes on length of gestation, mode of delivery and Apgar score.
Predicting creep crack initiation in austenitic and ferritic steels using the creep toughness parameter and time‐dependent failure assessment diagram
Authors: Davies C. M.
Published: November 2010

Methods for evaluating the creep toughness parameter, are reviewed and data are determined for a ferritic P22 steel from creep crack growth tests on compact tension, C(T), specimens of homogenous parent material (PM) and heterogeneous specimen weldments at 565 °C and compared to similar tests on austenitic type 316H stainless steel at 550 °C. Appropriate relations describing the time dependency of are determined accounting for data scatter. Considerable differences are observed in the form of the data and the time‐dependent failure assessment diagrams (TDFADs) for both the 316H and P22 steel. The TDFAD for P22 shows a strong time dependency, but is insensitive to time for 316H. Creep crack initiation (CCI) time predictions are obtained using the TDFAD approach and compared to experimental results from C(T) specimens and feature components. The TDFAD based on parent material properties can be used to obtain conservative predictions of CCI on weldments. Conservative predictions are almost always obtained when lower bound values are employed. Long‐term test are generally more relevant to industrial component lifetimes. The different trends between long‐ and short‐term CCI time and growth data indicate that additional long‐term test are required to further validate the procedure to predict the lifetimes of high temperature components.
Mucosectomy and stapled pouch‐anal anastomosis in familial adenomatous polyposis
Authors: Bülow S.
Published: November 2010

Aim  In familial adenomatous polyposis, a restorative proctocolectomy with an ileo‐anal pouch may be performed either with a mucosectomy and a hand‐sewn anastomosis or as a stapled anastomosis without a mucosectomy. The disadvantage of the former is suboptimal bowel function and the disadvantage of the latter is a high risk of recurrent adenomas in the rectal mucosal remnant.

Method  A procedure is presented that combines the advantages of mucosectomy and stapled ileo‐anal anastomosis.

Results  No severe complications were seen in 14 patients. After a median follow up of 29 (range 7–144) months, 13 (93%) patients were fully continent day and night with a median frequency of defecation of 5 (range 2–8)/24 h. No adenomas were found at the annual endoscopic follow up.

Conclusion  Mucosectomy with a stapled ileo‐anal pouch has few complications. Short‐term results show good function and a very low risk of recurrent adenoma development.
Renal cell carcinoma: stage, grade and histology migration over the last 15 years in a large Australian surgical series
Authors: Doeuk Norbert , Guo Ding Y. , Haddad Richard , Lau Howard , Woo Henry H. , Bariol Simon , Drummond Malcolm , Vladica Philip , Brooks Andrew , Patel Manish I.
Published: November 2010

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

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

Recent studies suggest that the incidence of RCC is increasing among early‐stage, incidentally discovered tumours, presumably detected because of the increased use of soft tissue imaging for evaluating a wide variety of abdominal and pelvic symptoms. This study did not show migration towards earlier stage and smaller RCCs.

OBJECTIVE

• To verify whether migration towards earlier‐stage renal cell carcinoma (RCC), which has been observed in the USA over the last decade, also applies to Australia.

PATIENTS AND METHODS

• Between January 1993 and December 2007, 547 nephrectomies performed in public and private hospitals in western Sydney were analysed from a retrospectively collected database.

• Data were divided into three consecutive time groups.

• Tumour‐node‐metastasis (TNM) stage as well as patient demographics, size, grade and histology of tumours and proportion of benign tumours were also assessed.

RESULTS

• In all, 499 nephrectomies were performed for RCC. The median age was 62 years, with a male:female ratio of 1.9 : 1. Similarly sized tumours were identified in each time group [group 1 (1993–1997), 54.8 mm; group 2 (1998–2002), 52.0 mm; group 3 (2003–2007), 52.2 mm, P= 0.6].

• Pathological stage II disease decreased from 18.1 to 11.1%, but stage III disease showed an increase from 13.9 to 21.5% over that time period (P= 0.02).

• The proportion of stage I and stage IV disease has remained relatively the same. There has been a statistically significant upward histological migration for the papillary subtype from 1.3 to 10.2% (P= 0.01).

• There has also been an increasing representation of Fuhrman grade III tumours over time, from 17.6 to 30.8%, and a decreasing proportion of Fuhrman grade I tumours from 16.2 to 7.1% (P= 0.03).

• There was a decrease in the incidence of benign tumours originally thought to be malignant on preoperative investigations, from 10% in group 1 to 4% in group 3 (P= 0.03).

CONCLUSION

• The recent US phenomenon of migration towards earlier‐stage, smaller RCCs as well as increased representation of benign tumours was not observed in the present study. The results of the present study, however, show an upward histological migration for papillary RCCs and an increasing representation of more aggressive Fuhrman grade III tumours.
Trends in the care of radical prostatectomy in the United States from 2003 to 2006
Authors: Williams Stephen B. , Prasad Sandip M. , Weinberg Aaron C. , Shelton Jeremy B. , Hevelone Nathanael D. , Lipsitz Stuart R. , Hu Jim C.
Published: November 2010

Study Type – Therapy (outcomes research)  Level of Evidence 2b

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

There is an increasing trend of minimally invasive treatments for prostate cancer with increased utilization of robotic technology contributing largely to this trend. Our study found that increased utilization of MIRP corresponded with a decreasing trend for complications, blood transfusions, lengths of stay and need for reoperation. Additionally, MIRP was found to have fewer associated complications compared with men undergoing open procedures.

OBJECTIVE

• To determine differences in surgical outcomes by surgical approach during a period of rapid adoption of minimally invasive surgical approaches in radical prostatectomy.

PATIENTS AND METHODS

• We identified 19 542 men undergoing minimally invasive (MIRP), perineal (PRP), and retropubic (RRP) radical prostatectomy from 2003 to 2006 from the MarketScan® Medstat database, a national employer‐based administrative database.

• We assessed for temporal trends in perioperative complications, use of postoperative cystography and anastomotic strictures by surgical approach.

RESULTS

• Between 2003 and 2006, MIRP use increased 33.6% vs 31.8% and 1.7% decreases in RRP and PRP, respectively. During the 4‐year study, median length of stay for MIRP decreased from 2.0 to 1.0 day (P= 0.004) and overall perioperative complications decreased from 13.8 to 10.7%, (P= 0.023).

• These findings were driven by reductions in genitourinary complications (3.3 to 2.5%, P= 0.049), miscellaneous surgical complications (3.6 to 2.3%, P= 0.006) and intestinal injury (1.5 to 0.1%, P= 0.009).

• Median length of stay for RRP decreased from 3.2 to 2.9 days, (P < 0.001), overall perioperative complications decreased from 18.1 to 14.6%, (P= 0.007), because of reductions in both wound/bleeding complications (2.0 to 1.1%, P= 0.002) and heterologous blood transfusions.

• Men undergoing MIRP vs RRP were less likely to have perioperative complications (12.5 vs 17.1%, P < 0.001), blood transfusions (1.5 vs 8.9%, P < 0.001) and anastomotic strictures (6.3 vs 12.8%, P < 0.001), and they had shorter mean lengths of stay (1.8 vs 3.1 days, P < 0.001) during the study period.

CONCLUSION

• The increased use of MIRP corresponds with a decreasing trend for complications, blood transfusions, lengths of stay and need for reoperation. Additionally, MIRP was found to have fewer associated complications compared with men undergoing open procedures. Further study is needed to assess the impact of tumour characteristics and surgeon volume on these perioperative outcomes as well as effects on long‐term cancer control.
Renal nephrometry score is associated with urine leak after partial nephrectomy
Authors: Bruner Bryan , Breau Rodney H. , Lohse Christine M. , Leibovich Bradley C. , Blute Michael L.
Published: November 2010

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

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

There have been no studies to date that look at the relationship between kidney tumour location and the risk of developing a urine leak. This study is the first to add to the literature showing that tumour complexity does increase the risk of developing a urine leak.

OBJECTIVE

• To determine if the RENAL nephrometry score is associated with urine leak after partial nephrectomy for tumours ≤7 cm.

PATIENTS AND METHODS

• Thirty‐one patients who developed urine leak after partial nephrectomy between 1998 and 2006 were identified. Each patient was individually matched (1 : 4 by age, gender and surgery date) to 124 patients who had undergone partial nephrectomy but without urine leak.

• Associations of RENAL nephrometry scores and each component of the score (Radius; Endophytic; Nearness to collecting system; and Location) with urine leak were evaluated using conditional logistic regression.

RESULTS

• Mean tumour size for the 31 patients who developed urine leak was 3.4 cm (median 3.5; range 1.5–5.9). Mean RENAL score was 8 (median 8; range 5–11).

• Each unit increase in RENAL score was associated with a 35% increased odds of urine leak (OR 1.35; 95% CI 1.08–1.69; P= 0.009).

• On multivariable analysis, tumours that were <50% exophytic (OR 16.65; 95% CI 2.75–100.71; P= 0.002), completely endophytic (OR 17.02; 95% CI 2.88–100.55; P= 0.002), or located at the renal pole (OR 4.34; 95% CI 1.30–14.53; P= 0.017) were associated with urine leak.

• If the score attributed to tumour location was reversed (polar location given a higher score), each unit increase in RENAL score was associated with an 89% increased odds of urine leak (OR 1.89; 95% CI 1.40–2.55; P < 0.001).

CONCLUSION

• The RENAL nephrometry score is associated with risk of urine leak after partial nephrectomy. When assessing risk of urine leak, reversal of the score attributed to tumour location may improve risk prediction.
Risk group stratification to predict recurrence after transurethral resection in Japanese patients with stage Ta and T1 bladder tumours: validation study on the European Association of Urology guidelines
Authors: Sakano Shigeru , Matsuyama Hideyasu , Takai Kimio , Yoshihiro Satoru , Kamiryo Yoriaki , Shirataki Satoshi , Kaneda Yoshitaka , Hashimoto Osamu , Joko Keiji , Suga Akinobu , Yamamoto Mitsutaka , Hayashida Shigeaki , Baba Yoshikazu , Aoki Akihiko ,   The Yamaguchi Uro‐Oncology Group
Published: November 2010

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

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

EAU guidelines on non‐muscle‐invasive bladder tumours have been widely used for the prediction of recurrence after TUR. However, there are substantial differences in bladder cancer incidence and mortality rates between European countries and Japan.

This study provides useful factors for predicting recurrence and validation of EAU guidelines on the risk group stratification to predict recurrence in Japanese patients with stage Ta and T1 bladder tumours.

OBJECTIVE

To validate the European Association of Urology (EAU) guidelines on risk group stratification to predict recurrence in Japanese patients with stage Ta and T1 bladder tumours.

PATIENTS AND METHODS

A cohort of 592 Japanese patients who were treated with transurethral resection (TUR) and histopathologically diagnosed with Ta and T1 urothelial carcinoma of the bladder were enrolled in this retrospective study.

The primary endpoint of the present study was recurrence‐free survival, and the median follow‐up duration was 37 months in recurrence‐free survivors.

RESULTS

Multivariate Cox proportional hazards regression analysis showed that the Eastern Cooperative Oncology Group performance status (ECOG PS), prior recurrence rate, number of tumours and T category were independent predictors of time to recurrence (P < 0.05). According to the EAU guidelines for predicting recurrence, the vast majority of Japanese patients were classified into intermediate risk.

The intermediate‐risk patients were further divided into intermediate‐low‐risk and intermediate‐high‐risk subgroups based on the European Organization for Research and Treatment of Cancer risk table, and a significant difference in the recurrence‐free survival rates was found between these subgroups (P < 0.001).

It was also found that patients with high risk combined with intermediate‐high risk had significantly poorer recurrence‐free survival rates than those with low risk combined with intermediate‐low risk (P < 0.001).

CONCLUSIONS

This is the first report on the ECOG PS as a potentially useful predictor for bladder tumour recurrence.

The risk group stratification of the EAU guidelines for recurrence might not be applicable to Japanese patients with Ta and T1 bladder tumours, but the subgroup classification of intermediate risk could be appropriate.
Attenuation of bladder overactivity in KIT mutant rats
Authors: Okada Shinsuke , Kojima Yoshiyuki , Kubota Yasue , Mizuno Kentaro , Sasaki Shoichi , Kohri Kenjiro
Published: November 2010

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

Attenuation of KIT activity in ICCs of KIT gene‐deficient rat bladder may demonstrate the possibility of negatively regulating the sensory pathway of bladder hyperactivity mediated by C‐fibers, suggesting that KIT could be a candidate target of medical therapy in the future.

Although recent reports have suggested that KIT is a detection marker of interstitial cells (ICC)s in the urinary bladder, there are few reports that ICCs themselves play a crucial role in the control of bladder function. We identify the role of KIT in the sensory mechanisms of urinary bladder in this paper.

OBJECTIVES

• To investigate morphological and physiological findings in the bladder of KIT mutant (WsRCWs/Ws) rats to clarify whether the disturbance of KIT pathways affects bladder activity.

• To discuss the potential role of KIT‐positive interstitial cells of Cajal (ICC)‐like cells in the urinary bladder.

MATERIALS AND METHODS

• Reverse transcriptase‐polymerase chain reaction and western blotting was used to confirm the absence of c‐kit mRNA and protein in the bladders of 12‐week‐old WsRCWs/Ws rats.

• Light and transmission electron microscopy was used to identify the differences in morphological and ultrastructural characteristics of the bladder between WsRCWs/Ws and wild‐type (WsRC+/+) rats.

• The voiding pattern of WsRCWs/Ws rats and the effects of cyclophosphamide (CYP) and protamine sulphate on bladder function were examined using cystometry.

RESULTS

• In WsRC+/+ rats, c‐kit mRNA and KIT protein expression were observed in the urinary bladder, while they were not detectable in WsRCWs/Ws rats.

• Deformation of ICC‐like cells with the collapse of the organelle was not observed in the bladders of WsRCWs/Ws rats.

• Each cystometry variable in WsRCWs/Ws rats was similar to that in WsRC+/+ rats.

• The reduction in the intercontraction intervals in WsRCWs/Ws rats with chemically (CYP and protamine sulphate) induced cystitis was significantly lower than in WsRC+/+ rats (P < 0.05).

CONCLUSION

• Certain voiding disturbances might be associated with impaired KIT signalling in ICC‐like cells, therefore, KIT could be a candidate target for medical therapy in the future.
Do dividend changes predict the future profitability of firms?
Authors: Choi Young M. , Joo Hyo K. , Park Young K.
Published: November 2010

Many previous studies have been conducted to test whether corporate dividend changes predict the future profitability of firms. While the debate continues, we assess the information content of dividends (ICD) hypothesis in the Korean market as it provides an interesting experimental setting for testing the hypothesis in the context of corporate governance. We find that it is difficult to support the ICD hypothesis if one accepts nonlinear patterns in earnings. However, when we divide the sample in terms of Chaebol vs. non‐Chaebol and high‐growth vs. low‐growth firms, we find that the ICD hypothesis becomes valid, especially for non‐Chaebol firms and for low‐growth firms. Therefore, we suggest that the validity of the ICD hypothesis may be dependent on firm characteristics such as the corporate governance structure and growth stage.
Why Care about Scientific Controversies?
Authors: DE FREITAS RENAN SPRINGER , PIETROBON RICARDO
Published: November 2010

Since Kuhn claimed that scientific controversies are not always settled by means of rational evaluations of the intrinsic merits of competing theories, the view that the history of science should be recounted by examining the background of scientific controversies and how these controversies came to be settled has become a real heuristic maxim for the historian of science. We take issue with this view by arguing that controversies are not relevant by themselves but only insofar as one can make something out of them. Two important questions then arise: what did one come to learn from a given controversy and what came out of this apprenticeships. We compare Pauline Mazumdar's and Alfred Tauber's approaches to the history of immunology and argue that only the latter addressed these questions. In so doing, he was able to show the extension in which modern immunology is an outcome of Metchnikoff's success in correcting Haeckel's “fundamental biogenetic law”.
Accounting for the Contribution of Vitamin B to Canada's WWII Effort
Authors: BRAUN ROBYN
Published: November 2010

Canada began to fortify its flour and bread with vitamin B when it entered the Second World War. The decision was informed by the biology of vitamin B and therefore I suggest that the complexity of this political maneuver can best be understood by considering the specificity of the biochemistry of vitamin B. In this paper I will show that the specific biology of vitamin B allowed the Canadian government the possibility of a healthier population under wartime conditions but also allowed the government a variety of means by which to develop and organize food processing practices to this end.
The Civilizing and Sportization of Gaelic Football in Ireland: 1884–2009
Authors: CONNOLLY JOHN , DOLAN PADDY
Published: November 2010

Over the course of the last 125 years the sport of Gaelic football in Ireland has undergone a sportization and civilizing process as the rules governing the sport became stricter and players developed greater levels of self‐control. However, the civilizing of Gaelic football was a particularly fragile and uneven process. The growing social desire to diminish displays of violence was moderated by ambivalence towards violence. Gradually the external social controls on players increased and, greater and more stable levels of internalization occurred reflected by more advanced levels of player self‐restraint in the control of violence. At the same time the threshold of shame toward displays of violence advanced. This transformation was shaped by lengthening chains of social interdependencies in Ireland.