bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of M43B Lumbar puncture simulator‐II as a training tool for identification of the epidural space and lumbar puncture*
Authors: Uppal V. , Kearns R. J. , McGrady E. M.
Published: May 2011

The identification of the epidural space, insertion of an epidural catheter and lumbar puncture are advanced technical skills that can be challenging to teach to novice anaesthetists. The M43B Lumbar puncture simulator‐II (Limbs & Things Ltd., Sussex Street, Bristol, UK) is a teaching aid designed for epidural and spinal insertion. The aim of this study was to determine if experienced anaesthetists thought this simulator may be a useful tool for training novice anaesthetists in these procedures. Experienced anaesthetists performed an epidural insertion followed by a lumbar puncture procedure on the simulator model. Various aspects of both epidural and lumbar puncture insertions were scored by the anaesthetists for likeness to a real patient using a Likert scale (0 ‐ strongly disagree; 1 ‐ disagree; 2 ‐ neither agree nor disagree; 3 ‐ agree; 4 ‐ strongly agree). The simulator was found to be life‐like for most aspects of epidural insertion. Median (IQR [range]) scores were: iliac crests 3.0 (3.0–3.2 [3–4]); spinous processes 3.0 (3.0–3.2 [2–4]); skin puncture 3.0 (3.0–3.0 [1–4]); subcutaneous tissues 3.0 (2.7–3.0 [1–4]); and loss of resistance 3.0 (3.0–4.0 [3–4]). The scores for supraspinous ligament 2.0 (1.0–3.0 [0–3]), interspinous ligament 2.5 (1.7–3.0 [0–3]) and ligamentum flavum 2.0 (1.0–3.0 [0–4]) were borderline for life‐likeness. The volunteers found threading of the epidural catheter difficult and rated it unlike a real patient (score 1.0 (0.2–2.0 [0–3])). During lumbar puncture, dural puncture scored 3.0 (3.0–4.0 [2–4]) and intrathecal injection scored 2.5 (1.0–3.0 [1–4]). However, the overall impression was that the simulator could be a useful tool for training of both epidurals (score 3.0 (3.0–4.0 [3–4])) and spinals (score 3.0 (3.0–3.5 [2–4])).
Parents report better health‐related quality of life for their food‐allergic children than children themselves
Authors: van der Velde J. L. , Flokstra‐de Blok B. M. J. , DunnGalvin A. , Hourihane J. O'B. , Duiverman E. J. , Dubois A. E. J.
Published: May 2011

Background Food allergy affects 5–6% of children and impairs health‐related quality of life (HRQL). Children and parents may differ in their views concerning the child's HRQL. In food allergy, child‐ and parent‐proxy‐reported HRQL have never been compared using valid disease‐specific instruments.

Objective The aim of this study was to compare child‐ and parent‐proxy reports on HRQL in food‐allergic children (8–12 years).

Methods The Food Allergy Quality of Life Questionnaire‐Child Form (FAQLQ‐CF), and ‐Parent Form (FAQLQ‐PF) and the Food Allergy Independent Measure‐Child Form and ‐Parent Form (FAIM‐CF and ‐PF) were completed by Dutch food‐allergic child–parent pairs. Child‐ and parent‐proxy reports were correlated and tested for significant differences. Construct validity (Spearman's correlation coefficient between the FAQLQs and FAIMs) and internal consistency (Cronbach's α) were assessed and compared.

Results Seventy‐four child–parent pairs were included. The FAQLQ‐CF score was significantly higher than the FAQLQ‐PF score (3.74 vs. 2.68, P<0.001, where 1 indicates no impairment and 7 indicates extreme impairment). FAIM‐CF and ‐PF scores were almost identical (3.29 vs. 3.33, P=0.594). There was moderate agreement between the FAQLQ‐CF and ‐PF scores (ICC=0.57 [P<0.001]) and good agreement between the FAIM‐CF and ‐PF scores (ICC=0.80 [P<0.001]). Construct validity was confirmed for the FAQLQ‐CF (ρ=0.60, P<0.001) and ‐PF (ρ=0.58, P<0.001). Internal consistency was excellent for the FAQLQ‐CF (α=0.95) and ‐PF (α=0.95).

Conclusions and Clinical Relevance Parents reported significantly less impact of food allergy on the child's HRQL than children themselves, while reported perceptions of disease severity were nearly identical. This may reflect real differences in perspectives between children and parents and may indicate that parents tend to underestimate their child's HRQL impairment.

It is important for clinicians to include both the child's and their parent's perceptions in order to perform a complete assessment of the impact of food allergy on the child's HRQL and to identify areas of disagreement that need special attention in clinical practice.

Cite this as: J. L. van der Velde, B. M. J. Flokstra‐de Blok, A. DunnGalvin, J. O'B. Hourihane, E. J. Duiverman and A. E. J. Dubois, Clinical & Experimental Allergy, 2011 (41) 1431–1439.
Harnessing engineered antibodies of the IgE class to combat malignancy: initial assessment of FcɛRI‐mediated basophil activation by a tumour‐specific IgE antibody to evaluate the risk of type I hypersensitivity
Authors: Rudman S. M. , Josephs D. H. , Cambrook H. , Karagiannis P. , Gilbert A. E. , Dodev T. , Hunt J. , Koers A. , Montes A. , Taams L. , Canevari S. , Figini M. , Blower P. J. , Beavil A. J. , Nicodemus C. F. , Corrigan C. , Kaye S. B. , Nestle F. O. , Gould H. J. , Spicer J. F. , Karagiannis S. N.
Published: May 2011

Background IgE antibodies, sequestered into tissues and retained locally by the high‐affinity IgE receptor, FcɛRI, on powerful effector cells such as mast cells, macrophages and eosinophils, may offer improvements in the therapy of solid tumours. The chimeric antibody, MOv18 IgE, against the human ovarian carcinoma antigen, folate receptor α (FRα), is more effective than its IgG1 counterpart in xenograft models of ovarian cancer. Although MOv18 IgE binds to a single epitope on FRα and cannot cross‐link IgE receptors on basophils, there remains a risk that components in the circulation of ovarian cancer patients might cross‐link FRα‐MOv18‐IgE‐receptor‐FcɛRI complexes on basophils to cause type I hypersensitivity.

Objective To assess the propensity for MOv18 used in a therapeutic setting to cause FcɛRI‐mediated type I hypersensitivity.

Methods As validated readouts of the potential for MOv18 to cause FcɛRI‐mediated type I hypersensitivity we measured release of a granule‐stored mediator from a rat basophilic leukaemia cell line RBL SX‐38 stably transfected with human tetrameric (αβγ2) FcɛRI, and induction of CD63 on blood basophils from patients with ovarian carcinoma and healthy controls ex vivo.

Results Serum FRα levels were increased in ovarian cancer patients compared with healthy controls. MOv18 IgE alone, or in the presence of its antigen recombinant human FRα, or of healthy volunteer (n=14) or ovarian carcinoma patient (n=32) sera, did not induce RBL SX‐38 cell degranulation. Exposure to FRα‐expressing ovarian tumour cells at target‐to‐effector ratios expected within tumours induced degranulation. MOv18 IgE did not induce expression of CD63 in blood basophils from either healthy volunteers (n=6), or cancer patients, despite detectable levels of circulating FRα (n=5).

Conclusion and Clinical Relevance These encouraging data are compatible with the hypothesis that, when ovarian carcinoma patients are treated with MOv18, FcɛRI‐mediated activation of effector cells occurs within the tumour mass but not in the circulation mandating, with due caution, further pre‐clinical studies.

Cite this as: S. M. Rudman, D. H. Josephs, H. Cambrook, P. Karagiannis, A. E. Gilbert, T. Dodev, J. Hunt, A. Koers, A. Montes, L. Taams, S. Canevari, M. Figini, P. J. Blower, A. J. Beavil, C. F. Nicodemus, C. Corrigan, S. B. Kaye, F. O. Nestle, H. J. Gould, J. F. Spicer and S. N. Karagiannis, Clinical & Experimental Allergy, 2011 (41) 1400–1413.
Fertility preservation in girls and young women
Authors: Anderson Richard A. , Wallace W. Hamish B.
Published: May 2011

There is increasing interest and experience in the options available to preserve fertility in those about to undergo potentially gonadotoxic chemotherapy or radiation therapy, usually related to treatment for cancer. Recent years have seen the development of methods for prepubertal girls, female adolescents and adult women, although these remain less established than sperm cryopreservation for men. At present, the options for prepubertal boys remain experimental. Embryo cryopreservation following ovarian stimulation and IVF is a routine procedure technically and its success in the management of infertility is established. However, there are no data on uptake or success rates in the context of fertility preservation in women with cancer. Oocyte cryopreservation is technically challenging and requires ovarian stimulation, thus potentially resulting in a delay in cancer treatment. Oocyte vitrification offers increased success rates in comparison with slow freezing; however, this approach is also limited by the number of oocytes that can be obtained. The third possibility, ovarian tissue cryopreservation, can be performed without significant delay and is the only option for prepubertal girls. Worldwide, a small number of children have been born following reimplantation of frozen/thawed ovarian tissue. It is clear that fertility preservation is important for some girls and young women facing treatments that will compromise their fertility, but the availability of all approaches varies widely. Effective approaches for prepubertal boys are also required.
Visfatin in juvenile obesity – the effect of obesity intervention and sex
Authors: Krzystek‐Korpacka Malgorzata , Patryn Eliza , Bednarz‐Misa Iwona , Hotowy Katarzyna , Noczynska Anna
Published: May 2011

Eur J Clin Invest 2011; 41 (12): 1284–1291

Background  The association of visfatin, an adipocytokine relevant to the development of inflammation and metabolic disorders, with juvenile obesity needs to be re‐established as previously used tests occurred to be nonspecific.

Objective  To evaluate visfatin association with a metabolic profile of 88 overweight/obese and 26 lean children/adolescents as well as changes in its levels following weight reduction programme (diet + enhanced physical activity ± metformin).

Design  A case–control and cohort study.

Results  Visfatin was higher in obese than lean and overweight individuals (2·07 vs. 1·53 and 1·47 ng mL−1, P = 0·034). Of metabolic syndrome components, central obesity combined with either insulin resistance (IR) or hyperinsulinemia (HI) was associated with increases in circulating visfatin. In girls, visfatin correlated with leptin (r = 0·40, P = 0·009) and thiols (r = −0·36, P = 0·009), which explained 24% in visfatin variability. In boys, visfatin correlated with waist circumference (r = 0·36, P = 0·036), BMI% (r = 0·38, P = 0·025), whole body insulin sensitivity index (r = −0·36, P = 0·036), IL‐6 (r = 0·38, P = 0·024) and thiobarbituric acid reactive substances (TBARS) (r = 0·52, P = 0·001), of which IL‐6 and TBARS were independent predictors of visfatin elevation, explaining 42% in data variability. Visfatin was significantly lower following weight reduction programme than at baseline (1·43 vs. 1·83 ng mL−1, P = 0·033). Visfatin reduction correlated neither with changes in metabolic parameters nor was it affected by metformin. ΔVisfatin correlated exclusively with baseline visfatin (r = 0·612, P < 0·0001), which explained 38% in data variability.

Conclusions  Central obesity combined with HI/IR contributes to visfatin elevation. Visfatin association with metabolic/biochemical variables is gender dependent. Diet + enhanced physical activity are effective in visfatin reduction, the degree of which depends on baseline visfatin.
Plasma concentrations of chloramphenicol after subcutaneous administration to koalas (Phascolarctos cinereus) with chlamydiosis
Authors: GOVENDIR M. , HANGER J. , LOADER J. J. , KIMBLE B. , GRIFFITH J. E. , BLACK L. A. , KROCKENBERGER M. B. , HIGGINS D. P.
Published: May 2011

Govendir, M., Hanger, J., Loader, J. J., Kimble, B., Griffith, J. E., Black, L. A., Krockenberger, M. B., Higgins, D. P. Plasma concentrations of chloramphenicol after subcutaneous administration to koalas (Phascolarctos cinereus) with chlamydiosis. J. vet. Pharmacol. Therap. 35, 147–154.

Nine mature koalas with chlamydiosis, typically keratoconjunctivitis and/or urogenital tract infection, were treated with daily subcutaneous injections of chloramphenicol at 60 mg/kg for 45 days (five koalas), or for a shorter duration (four koalas). All koalas were initially positive for Chlamydia pecorum as determined by real‐time polymerase chain reaction (qPCR). Plasma chloramphenicol concentrations were determined at t = 0, 1, 2, 4, 8, and 24 h after the day 1 injection (nine koalas) and after the day 15 injection (seven koalas). Chloramphenicol reached a median (and range) maximum plasma concentration of 3.03 (1.32–5.03 μg/mL) at 4 (1–8 h) after the day 1 injection and 4.82 (1.97–27.55 μg/mL) at 1 (1–2 h) after day 15. The median (and range) of AUC0–24 on day 1 and day 15 were 48.14 (22.37–81.14 μg·h/mL) and 50.83 (28.43–123.99 μg·h/mL), respectively. The area under the moment curve (AUMC)0–24 median (and range) for day 1 and day 15 were 530.03 (233.05–798.97 h) and 458.15 (291.72–1093.58 h), respectively. Swabs were positive for chlamydial DNA pretreatment, and all koalas except one, produced swabs negative for chlamydial DNA during treatment and which remained so, for 2–63 days after treatment, however whether chloramphenicol treatment prevented long‐term recrudescence of infection was not established. At this dose and dosing frequency, chloramphenicol appeared to control mild chlamydial infection and prevent shedding, but severe urogenital disease did not appear to respond to chloramphenicol at this dosage regime. For koalas affected by severe chlamydiosis, antibiotics alone are not sufficient to effect a cure, possibly because of structural or metabolic changes associated with chronic disease and inflammation.
An atypical heterotrimeric G‐protein γ‐subunit is involved in guard cell K+‐channel regulation and morphological development in Arabidopsis thaliana
Authors: Chakravorty David , Trusov Yuri , Zhang Wei , Acharya Biswa R. , Sheahan Michael B. , McCurdy David W. , Assmann Sarah M. , Botella José Ramón
Published: May 2011

Currently, there are strong inconsistencies in our knowledge of plant heterotrimeric G‐proteins that suggest the existence of additional members of the family. We have identified a new Arabidopsis G‐protein γ‐subunit (AGG3) that modulates morphological development and ABA‐regulation of stomatal aperture. AGG3 strongly interacts with the Arabidopsis G‐protein β‐subunit in vivo and in vitro. Most importantly, AGG3‐deficient mutants account for all but one of the ‘orphan’ phenotypes previously unexplained by the two known γ‐subunits in Arabidopsis. AGG3 has unique characteristics never before observed in plant or animal systems, such as its size (more than twice that of canonical γ‐subunits) and the presence of a C‐terminal Cys‐rich domain. AGG3 thus represent a novel class of G‐protein γ‐subunits, widely spread throughout the plant kingdom but not present in animals. Homologues of AGG3 in rice have been identified as important quantitative trait loci for grain size and yield, but due to the atypical nature of the proteins their identity as G‐protein subunits was thus far unknown. Our work demonstrates a similar trend in seeds of Arabidopsis agg3 mutants, and implicates G‐proteins in such a crucial agronomic trait. The discovery of this highly atypical subunit reinforces the emerging notion that plant and animal G‐proteins have distinct as well as shared evolutionary pathways.
Metabolomic approaches reveal that cell wall modifications play a major role in ethylene‐mediated resistance against Botrytis cinerea
Authors: Lloyd Amanda J. , William Allwood J. , Winder Catherine L. , Dunn Warwick B. , Heald James K. , Cristescu Simona M. , Sivakumaran Anushen , Harren Frans J. M. , Mulema Joseph , Denby Katherine , Goodacre Royston , Smith Aileen R. , Mur Luis A. J.
Published: May 2011

In Arabidopsis, resistance to the necrotrophic fungus Botrytis cinerea is conferred by ethylene via poorly understood mechanisms. Metabolomic approaches compared the responses of the wild‐type, the ethylene‐insensitive mutant etr1‐1, which showed increased susceptibility, and the constitutively active ethylene mutants ctr1‐1 and eto2 both exhibited decreased susceptibility to B. cinerea. Fourier transform–infrared (FT‐IR) spectroscopy demonstrated reproducible biochemical differences between treatments and genotypes. To identify discriminatory mass‐to‐charge ratios (m/z) associated with resistance, discriminant function analysis was employed on spectra derived from direct injection electrospray ionisation‐mass spectrometry on the derived principal components of these data. Ethylene‐modulated m/z were mapped onto Arabidopsis biochemical pathways and many were associated with hydroxycinnamate and monolignol biosynthesis, both linked to cell wall modification. A high‐resolution linear triple quadrupole‐Orbitrap hybrid system confirmed the identity of key metabolites in these pathways. The contribution of these pathways to defence against B. cinerea was validated through the use of multiple Arabidopsis mutants. The FT‐IR microspectroscopy indicated that spatial accumulation of hydroxycinnamates and monolignols at the cell wall to confine disease was linked ot ethylene. These data demonstrate the power of metabolomic approaches in elucidating novel biological phenomena, especially when coupled to validation steps exploiting relevant mutant genotypes.
High‐density kinetic analysis of the metabolomic and transcriptomic response of Arabidopsis to eight environmental conditions
Authors: Caldana Camila , Degenkolbe Thomas , Cuadros‐Inostroza Alvaro , Klie Sebastian , Sulpice Ronan , Leisse Andrea , Steinhauser Dirk , Fernie Alisdair R. , Willmitzer Lothar , Hannah Matthew A.
Published: May 2011

The time‐resolved response of Arabidopsis thaliana towards changing light and/or temperature at the transcriptome and metabolome level is presented. Plants grown at 21°C with a light intensity of 150 μE m−2 sec−1 were either kept at this condition or transferred into seven different environments (4°C, darkness; 21°C, darkness; 32°C, darkness; 4°C, 85 μE m−2 sec−1; 21°C, 75 μE m−2 sec−1; 21°C, 300 μE m−2 sec−1; 32°C, 150 μE m−2 sec−1). Samples were taken before (0 min) and at 22 time points after transfer resulting in (8×) 22 time points covering both a linear and a logarithmic time series totaling 177 states. Hierarchical cluster analysis shows that individual conditions (defined by temperature and light) diverge into distinct trajectories at condition‐dependent times and that the metabolome follows different kinetics from the transcriptome. The metabolic responses are initially relatively faster when compared with the transcriptional responses. Gene Ontology over‐representation analysis identifies a common response for all changed conditions at the transcriptome level during the early response phase (5–60 min). Metabolic networks reconstructed via metabolite–metabolite correlations reveal extensive environment‐specific rewiring. Detailed analysis identifies conditional connections between amino acids and intermediates of the tricarboxylic acid cycle. Parallel analysis of transcriptional changes strongly support a model where in the absence of photosynthesis at normal/high temperatures protein degradation occurs rapidly and subsequent amino acid catabolism serves as the main cellular energy supply. These results thus demonstrate the engagement of the electron transfer flavoprotein system under short‐term environmental perturbations.
AtMPK4 is required for male‐specific meiotic cytokinesis in Arabidopsis
Authors: Zeng Qingning , Chen Jin‐Gui , Ellis Brian E.
Published: May 2011

Mitogen‐activated protein kinase (MAPK) cascades have been implicated in regulating various aspects of plant development, including somatic cytokinesis. The evolution of expanded plant MAPK gene families has enabled the diversification of potential MAPK cascades, but functionally overlapping components are also well documented. Here we report that Arabidopsis MPK4, an MAPK that was previously described as a regulator of disease resistance, can interact with and be phosphorylated by the cytokinesis‐related MAP kinase kinase, AtMKK6. In mpk4 mutant plants, anthers can develop normal microspore mother cells (MMCs) and peripheral supporting tissues, but the MMCs fail to form a normal intersporal callose wall after male meiosis, and thus cannot complete meiotic cytokinesis. Nevertheless, the multinucleate mpk4 microspores subsequently proceed through mitotic cytokinesis, resulting in enlarged mature pollen grains that possess increased sets of the tricellular structure. This pollen development phenotype is reminiscent of those observed in both atnack2/tes/stud and anq1/mkk6 mutants, and protein–protein interaction analysis defines a putative signalling module linking AtNACK2/TES/STUD, AtANP3, AtMKK6 and AtMPK4 together as a cascade that facilitates male‐specific meiotic cytokinesis in Arabidopsis.
Identification of a new HLA‐B*08 allele in a family of Iraqi origin
Authors: Buffi O. , Nesci S. , Iliescu A. , Amadei M. , Valentini M.
Published: May 2011

The novel allele HLA‐B*08:62 differs from HLA‐B* 08:01:01 by a nonsynonymous nucleotide substitution at position 24 of exon 2 (codon 9 changes from GAC to CAC).
Ninety‐six novel HLA class I and II alleles identified in volunteers for the National Marrow Donor Program Registry in 2009
Authors: Lazaro A. M. , Xiao Y. , Henry J. , Ng J. , Hurley C. K. , Posch P. E.
Published: May 2011

Ninety‐six novel human leukocyte antigen (HLA) class I and class II alleles are described from volunteers for the ‘Be The Match Registry®’: 15 HLA‐A alleles, 11 HLA‐C alleles, 36 HLA‐B alleles and 34 HLA‐DRB1 alleles. Sixty‐eight (∼71%) of the 96 novel alleles are single nucleotide substitution variants when compared with their most homologous allele. Twenty‐three of these single nucleotide variants are silent substitutions and one creates a non‐expressed allele (B*27:59N). The remaining novel alleles differ from their most similar allele by two to five nucleotide substitutions. One of the novel HLA‐A alleles (A*11:52Q) is of questionable expression because of a deletion of codon 11. Three of the novel alleles encode amino acid changes at codons 63 (HLA‐C), 88 (HLA‐B) and 79 (HLA‐DRB1) which have not previously been reported to be polymorphic in these loci. Some of the new alleles encode novel codons and unique amino acid changes at polymorphic positions in the HLA‐A (codons 115, 149 and 168), HLA‐C (codon 90), HLA‐B (codons 23, 44, 70, 120 and 153) and HLA‐DRB1 (codon 88) loci.
Neuraxial techniques in patients with pre‐existing back impairment or prior spine interventions: a topical review with special reference to obstetrics
Authors: VERCAUTEREN M. , WAETS P. , PITKÄNEN M. , FÖRSTER J.
Published: May 2011

Many anaesthetists consider neurological disorders of all kinds as a contraindication for regional anaesthesia particularly for neuraxial techniques. This hesitation is partly rooted in fears of medicolegal problems but also in the heterogeneous literature. Therefore, the present topical review is an attempt to describe the feasibility and the risks of neuraxial techniques in patients with spinal injury, anatomical compromise, chronic back pain or previous spinal interventions, ranging from ‘minor’ types like epidural blood patches to major surgery such as Harrington fusions. Most reviews and case reports were describing experiences in obstetrics as these patients are more likely to insist on neuraxial blocks. In the acute phase of new neurologic injury, general anaesthesia may be the technique of choice to prevent further haemodynamic and respiratory deterioration. After the acute phase, current evidence is mostly reassuring with respect to the risks of neuraxial blocks as they may even be recommendable in some conditions. Ultrasound technology may be of additional help to increase the success rate. A careful pre‐operative examination remains mandatory, while patients should be sufficiently informed about technical aspects and possible relapses or progression of their disease. When necessary, patients should have additional technical and clinical examinations as close as possible to surgery to establish the actual pre‐operative status. Most patients may benefit more from spinal techniques rather than from less reliable epidural ones. High concentrations and volumes of local anaesthetics should be avoided at all times, especially in patients with nerve compression, large disc herniation or spinal stenosis.
Blood transfusion after cardiac surgery: is it the patient or the transfusion that carries the risk?
Authors: DARDASHTI A. , EDEROTH P. , ALGOTSSON L. , BRONDÉN B. , LÜHRS C. , BJURSTEN H.
Published: May 2011

Background: The transfusion of red blood cells (RBCs) after cardiac surgery has been associated with increased long‐term mortality. This study reexamines this hypothesis by including pre‐operative hemoglobin (Hb) levels and renal function in the analysis.

Methods: A retrospective single‐center study was performed including 5261 coronary artery bypass grafting (CABG) patients in a Cox proportional hazard survival analysis. Patients with more than eight RBC transfusions, early death (7 days), and emergent cases were excluded. Patients were followed for 7.5 years. Previously known risk factors were entered into the analysis together with pre‐operative Hb and estimated glomerular filtration rate (eGFR). In addition, subgroups were formed based on the patients' pre‐operative renal function and Hb levels.

Results: When classical risk factors were entered into the analysis, transfusion of RBCs was associated with reduced long‐term survival. When pre‐operative eGFR and Hb was entered into the analysis, however, transfusion of RBCs did not affect survival significantly. In the subgroups, transfusion of RBCs did not have any effect on long‐term survival.

Conclusions: When pre‐operative Hb levels and renal function are taken into account, moderate transfusions of RBC after CABG surgery do not seem to be associated with reduced long‐term survival.
Severe traumatic brain injury: consequences of early adverse events
Authors: BRORSSON C. , RODLING‐WAHLSTRÖM M. , OLIVECRONA M. , KOSKINEN L.‐O. D. , NAREDI S.
Published: May 2011

Background: Several factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre‐hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end‐tidal carbon dioxide (ETCO2). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre.

Methods: Prospective, observational study design. Patients with severe TBI (n=48), admitted to Umeå University Hospital between January 2002 to December 2005 were included. All medical records from the site of the accident to arrival at the level 1 trauma centre were collected and evaluated.

Results: A pre‐hospital time of >60 min, secondary referral to a level 1 trauma centre, documented hypoxia (oxygen saturation <95%), hypotension (systolic blood pressure <90 mmHg), hyperventilation (ETCO2<4.5 kPa) or tachycardia (heart rate >100 beats/min) at any time before arrival at a level 1 trauma centre were not significantly related to an unfavourable outcome (Glasgow Outcome Scale 1–3).

Conclusion: Early adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.
Reactive oxygen species are involved in pollen tube initiation in kiwifruit
Authors: Speranza A. , Crinelli R. , Scoccianti V. , Geitmann A.
Published: May 2011

The role of reactive oxygen species (ROS) during pollen tube growth has been well established, but its involvement in the early germination stage is poorly understood. ROS production has been reported in germinating tobacco pollen, but evidence for a clear correlation between ROS and germination success remains elusive. Here, we show that ROS are involved in germination and pollen tube formation in kiwifruit. Using labelling with dihydrofluorescein diacetate (H2FDA) and nitroblue tetrazolium (NBT), endogenous ROS were detected immediately following pollen rehydration and during the lag phase preceding pollen tube emergence. Furthermore, extracellular H2O2 was found to accumulate, beginning a few minutes after pollen suspension in liquid medium. ROS production was essential for kiwifruit pollen performance, since in the presence of compounds acting as superoxide dismutase/catalase mimic (Mn‐5,10,15,20‐tetrakis(1‐methyl‐4‐pyridyl)21H,23H‐porphin, Mn‐TMPP) or as NADPH oxidase inhibitor (diphenyleneiodonium chloride, DPI), ROS levels were reduced and pollen tube emergence was severely or completely inhibited. Moreover, ROS production was substantially decreased in the absence of calcium, and by chromium and bisphenol A, which inhibit germination in kiwifruit. Peroxidase activity was cytochemically revealed after rehydration and during germination. In parallel, superoxide dismutase enzymes, particularly the Cu/Zn‐dependent subtype – which function as superoxide radical scavengers – were detected by immunoblotting and by an in‐gel activity assay in kiwifruit pollen, suggesting that ROS levels may be tightly regulated. Timing of ROS appearance, early localisation at the germination aperture and strict requirement for germination clearly suggest an important role for ROS in pollen grain activation and pollen tube initiation.
Effects of high and moderate non‐structural carbohydrate hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings
Authors: Shepherd M. L. , Pleasant R. S. , Crisman M. V. , Werre S. R. , Milton S. C. , Swecker Jr W. S.
Published: May 2011

The objective of this study was to determine the effects of high and moderate non‐structural carbohydrates (NSC) hay on insulin, glucose, triglyceride, and leptin concentrations in overweight Arabian geldings. Eight adult overweight (average BCS 7 [9‐point scale]) Arabian geldings were fed each of two orchardgrass hays, high NSC (18% DM) and moderate NSC (12% DM), in a cross over design during two 28‐day periods. Body weight and body condition score assessment along with blood sampling to measure insulin, glucose, leptin, and triglyceride concentrations were performed on days 0, 7, 14, 21 and 28 of each period. Effects of hay, period, day, and day*hay on plasma glucose and serum leptin were not detected. Serum insulin was influenced by hay (p = 0.001), day (p = 0.03), and day*hay (p = 0.04). Insulin concentrations were higher on day 7 in the high NSC group (15.6 μIU/ml) than the moderate NSC group (9.5 μIU/ml), but not by day 14 (p = 0.0007). Plasma triglyceride was influenced by period (p = 0.0003), day*period (p < 0.0001), and day*hay (p = 0.02). Hyperinsulinaemia was not observed in the overweight Arabian geldings fed either a moderate or high NSC hay.
Blonanserin in the treatment of delirium
Authors: Kato Koji , Yamada Keigo , Maehara Mizuki , Akama Fumiaki , Kimoto Keitaro , Saito Mai , Yano Hiroshi , Ichimura Atsushi , Matsumoto Hideo
Published: May 2011

The purpose of the present study was to provide preliminary data on the usefulness and safety of blonanserin for patients with delirium in the intensive care unit (ICU). The charts of 32 consecutive patients with delirium in the ICU were retrospectively reviewed. These patients were treated with blonanserin. A total of 96.6% had reduction in Memorial Delirium Assessment Scale score. The proportion of patients with side‐effects was 24.1%. Blonanserin may be effective and safe in the treatment of delirium in the ICU.
Distress due to lithium‐induced polyuria: Exploratory study
Authors: Pradhan Basant K. , Chakrabarti Subho , Irpati Anand S. , Bhardwaj Rahul
Published: May 2011

Lithium‐induced polyuria, although common, often goes unrecognized. The purpose of the present study was therefore to investigate the complaints of polyuria, and distress and functional impairment associated with polyuria, in 56 patients with bipolar disorder on long‐term lithium treatment. All participants underwent 24‐h urine collection, and renal function tests. Polyuria (24‐h urine volume > 3 L) was found in 70% of subjects. Unless directly enquired about, polyuria was underreported. Impairment in work and daily routine due to increased urine output/frequency was associated with 24‐h urine volumes. Polyuria is a highly prevalent, distressing and impairing side‐effect of long‐term lithium treatment, requiring due attention.
Abnormal sensitivity to negative feedback in late‐life depression
Authors: von Gunten Armin , Herrmann François R. , Elliott Rebecca , Duc René
Published: May 2011

Aims:  The purpose of the present study was to probe sensitivity to potentially misleading negative feedback on cognitive tasks as a possible mechanism of cognitive impairment in elderly patients with mild depression.

Methods:  A total of 22 mildly depressed elderly subjects were compared to 22 healthy controls, using a computerized Tower‐of‐London task.

Results:  Failure and magnitude of failure were significantly worse after negative but not positive feedback. Depression predicted failure after negative feedback but not the magnitude of failure. Neither failure nor magnitude of failure increased as a consequence of repeated negative feedback.

Conclusions:  Altered sensitivity to negative feedback occurs in mild late‐life unipolar depression and may represent a subtle context‐specific phenomenon.
Does the volume of Internet searches using suicide‐related search terms influence the suicide death rate: Data from 2004 to 2009 in Japan
Authors: Sueki Hajime
Published: May 2011

Cross‐correlation was examined for the volume of suicide‐related Internet searches and suicide death rate. Analysis of Google data and figures released by the Ministry of Health, Labour, and Welfare indicated that the volume of searches using the search terms jisatsu (suicide) and jisatsu houhou (suicide method) are not correlated with the suicide death rate. In addition, a rising suicide death rate might be related to the increase in suicide‐related search activity (particularly utsu[depression]), but an increase in suicide‐related search activity itself is not directly linked to the rise of suicide death rate.
Primary kaposiform hemangioendothelioma of a long bone: Two cases in unusual locations with long‐term follow up
Authors: Ma Jie , Shi Qun‐li , Jiang Shao‐jun , Zhou Hang‐bo , Zhou Xiao‐jun
Published: May 2011

Kaposiform hemangioendothelioma (KHE) is a rare vascular neoplasm of low malignant potential that mainly affects infants and adolescents. The tumor almost exclusively occurs in somatic soft tissue or the retroperitoneum. We report herein two cases of primary KHE occurring in a long bone without cutaneous changes with long‐term follow up in young patients. The patients were a 9‐year‐old girl and 5‐year‐old boy presenting with lytic lesions of the femur and humerus, respectively, without cutaneous lesions. Histologically, the neoplasms were comprised of nodules of spindle‐ to oval‐shaped cells growing in an infiltrative fashion. The neoplastic cells formed poorly canalized or slit‐like blood vessels alternating with solid spindle areas. Immunohistochemical studies showed that the tumor cells expressed CD31, CD34 and Fli1, but not HHV8, LNA‐1 or GLUT1. D2‐40 stained the neoplastic spindle cells and lymphatic channels adjacent to vascular lobules. The girl remains well with 15 years and 6 months follow up after a second complete excision. The boy has no signs of recurrence or metastasis nearly 5 years after local complete excision. To our best knowledge, this is the first report in the English literature of primary long bone occurrences of KHE without cutaneous changes with long‐term follow up.
Guideline for the prevention of health care‐associated infection in urological practice in Japan
Authors: Hamasuna Ryoichi , Takahashi Satoshi , Yamamoto Shingo , Arakawa Soichi , Yanaihara Hitoshi , Ishikawa Satoru , Matsumoto Tetsuro
Published: May 2011

For developing the Japanese guideline for the prevention of health care‐associated infection in urological practice, we surveyed the literature including standard precautions, environmental considerations in both the inpatient and outpatient settings, the management of urinary catheters, endoscopy techniques, and the disinfection and sterilization of instruments used in endoscopies and related procedures. The concept of this guideline is to show the minimum precautions that urologists and other medical professionals should observe when they work in the urological field. Standard precautions based on hand hygiene and the use of personal protective equipment should be observed in both the inpatient and outpatient settings. In the inpatient setting, the management of the toilet is important. Collecting urine should be restricted only when it is necessary to determine a patient's urinary output. The management for urinary catheter and infection are created based on the “European and Asian guidelines on management and prevention of catheter‐associated urinary tract infections”. In addition, we propose that nephrostomy should be carried out after maximum barrier precautions have been taken. Urinary catheters are replaced in the event of an occlusion or if there are signs that an occlusion might occur, but the same catheter cannot be left in place for more than 2 months. Regarding the handling of urine containing Mycobacterium tuberculosis, airborne infection countermeasures are unnecessary, except for the laboratory personnel. For the procedures using urological endoscopes, aseptic techniques are recommended. Endoscopes and related devices should be used by sterilization or high‐level disinfection, but formaldehyde gas cannot be used.
Elective sigmoid colectomy for diverticular disease. Laparoscopic vs open surgery: a systematic review
Authors: Cirocchi R. , Farinella E. , Trastulli S. , Sciannameo F. , Audisio R. A.
Published: May 2011

Aim  A meta‐analysis of nonrandomized studies and one randomized trial was conducted to compare laparoscopic surgery with open surgery in the elective treatment of patients with diverticular disease.

Method  Published randomized and controlled clinical trials that directly compared elective open (OSR) with laparoscopic surgical resection (LSR) in patients with diverticular disease were identified using the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. End‐points included 30‐day mortality and morbidity and were compared by determining the relative risk ratio, odds ratio, and the absolute effects.

Results  Eleven nonrandomized studies of 1430 patients were identified and included in the meta‐analysis. There was only one randomized study, which included 104 patients. The meta‐analysis suggested that elective LSR was a safe and appropriate option for patients with diverticular disease and was associated with lower overall morbidity (P = 0.01) and minor complication rate (P = 0.008).

Conclusion  The results of the nonrandomized study generally agreed with those of the randomized study, except for the incidence of minor complications, which was higher in both the LSR and OSR groups of the randomized study. In this study, the high overall morbidity of 42.3% reported in the LSR group is a cause for concern.
The prevalence of dysplasia in the ileoanal pouch following restorative proctocolectomy for ulcerative colitis with associated dysplasia
Authors: Kuiper T. , Vlug M. S. , van den Broek F. J. C. , Tytgat K. M. A. J. , van Eeden S. , Fockens P. , Bemelman W. A. , Dekker E.
Published: May 2011

Aim  A recent systematic review indicated that dysplasia present before restorative proctocolectomy is a predictor of subsequent dysplasia in the pouch. This prospective study was carried out to assess the prevalence of dysplasia in the ileal pouch in patients having RPC for ulcerative colitis with co‐existing dysplasia in the operation specimen.

Method  Eligible patients were invited for a surveillance endoscopy. The afferent and blind efferent ileal loop, ileoanal pouch and rectal cuff were examined by standard endoscopy using a dye‐spray technique with methylene blue. Mucosal abnormalities were biopsied and random biopsies were taken from the afferent and blind ileal loop, pouch and rectal cuff.

Results  Fourty‐four patients (25 male, mean 49 years) underwent pouch endoscopy at a mean interval from RPC of 8.6 years. Dysplasia was detected in two (4.5%) patients. In one, low‐grade dysplasia was found in the rectal cuff and in the other low‐grade dysplasia was detected in random biopsies from the pouch and the efferent ileal loop.

Conclusion  This prospective pouch‐endoscopy study detected dysplasia in < 5% of patients over nearly 10 years. The benefit of routine surveillance for dysplasia in the pouch is uncertain, as the significance of low‐grade dysplasia in the pouch is not clear.
Anal encirclement with sphincter repair (AESR procedure) using a biological graft for anal sphincter damage involving the entire circumference
Authors: Zutshi M. , Hull T. , Gurland B.
Published: May 2011

Aim  The effect of a biological material to support an overlapping sphincter repair was investigated in patients with damage to the entire circumference of the external sphincter due to radiation or trauma.

Method  A tunnel is created under the damaged external anal sphincter muscle to encircle the anal canal. A biological graft (Surgisis™; 6 ply, 2 × 20 cm) is then inserted through the tunnel and sutured to the muscle after being pulled firmly to close the patulous anus. An overlapping repair is then carried out. Between January 2009 and June 2010, 13 patients underwent this procedure.

Results  The average age at surgery was 68.6 years. The mean follow up was 16.3 (range 6–24) months. The average length of stay was 1 day. No complications were reported. Postoperatively, incontinence severity scores and quality of life scales [39.22 (± 16.1) to 9.66 (± 11.9)] showed improvement. Incontinence episodes were markedly decreased to one per week.

Conclusion  Anal encirclement using a biological graft with sphincter augmentation may achieve continence in patients with circumferential anal sphincter damage.
THE ROLE OF LAW IN ECONOMIC GROWTH: A LITERATURE REVIEW
Authors: Xu Guangdong
Published: May 2011

Abstract Compared with other explanatory variables, such as capital accumulation, technological innovations, geographical endowments, economic openness, and cultural factors, institutions, especially legal institutions have been regarded as a crucial condition for economic growth in recent years. The importance of legal rules is systematically revealed by a series of cross‐country econometric studies conducted by La Porta et al., who claim that legal origins are central to understanding the divergence in living standards across the regions and countries of the world and, compared with civil law countries, especially those countries with French civil law tradition, common law countries have enjoyed superior economic outcomes. The controversies set off by La Porta et al.'s proposition indicate that there are a number of questions that are difficult to explain by La Porta et al.'s theory, and hence call for more work on comparative analysis of different legal families before a consensus can be reached.
HOW DO CONSUMERS MAKE CHOICES? A SURVEY OF EVIDENCE
Authors: Babutsidze Zakaria
Published: May 2011

Abstract In this paper, we review the evidence about the purchase behaviour of consumers. We concentrate on the characteristics of the choice process, choice of the external information source and nature of the information obtained from these sources. The impact of important systematic differences among consumers and products on choice behaviour is also discussed.
Multilateral Efforts to Reduce Black Carbon Emissions: A Lifeline for the Warming Arctic?
Authors: Rosenthal Erika , Watson Robert
Published: May 2011

Rapid reductions in emissions of the short‐lived climate forcers black carbon, tropospheric ozone and methane have been identified as an effective strategy to slow rapid warming and melting in the Arctic and other glaciated areas in the near‐term, and avert abrupt, irreversible changes while strategies to reduce emissions of CO2 are implemented to limit long‐term consequences. Black carbon is a component of fine particulate matter, a traditional air pollutant with significant health impacts; it has a short atmospheric residence time of about a week, thus emissions reductions provide rapid climate benefit. This article analyses the mitigation approaches that are being discussed in multilateral fora including the Arctic Council, the Convention on Long Range Transboundary Air Pollution and the International Maritime Organization. Arctic climate dynamics will affect climate globally, which calls for leadership from Arctic nations to spur faster action to abate emissions.
Optimizing Language Instruction: Matters of Explicitness, Practice, and Cue Learning
Authors: Stafford Catherine A. , Bowden Harriet Wood , Sanz Cristina
Published: May 2011

Input exposure is essential for nonprimary language learning, but the importance of explicit instruction and corrective feedback continues to be debated. If instruction is required, how might it be optimized in terms of its nature and timing? In this study, 65 Spanish‐English bilinguals were introduced to Latin through an interactive computer program designed to promote initial learning of thematic role assignment by drawing learners’ attention to efficient input processing strategies when new, informative morphosyntactic cues to thematic role assignment were set up in competition with more familiar but potentially misleading cues. Participants in 4 experimental groups completed input‐based, task‐essential practice with interpreting agent/patient roles in Latin sentences and received feedback throughout the practice session. Two of the groups additionally received prepractice explanation of how thematic roles are assigned in Latin via morphosyntactic cues. Groups also varied systematically in whether they received less or more explicit feedback during practice. Results suggest that practice and less explicit feedback were sufficient to trigger improvement in the ability to interpret Latin case morphology; however, more explicit, metalinguistic feedback was necessary to promote improvement in production. Prepractice explanation without metalinguistic feedback during practice did not significantly influence development of either interpretive or productive abilities.
Older Learners in SLA Research: A First Look at Working Memory, Feedback, and L2 Development
Authors: Mackey Alison , Sachs Rebecca
Published: May 2011

A great deal of research into second‐language (L2) development focuses on the role of cognitive factors and other individual differences. Studies of children and prime‐of‐life adult L2 learners suggest that differences exist in the learning processes of these groups. However, to date, little empirical work has been conducted with older adult learners. In this article we argue that older adults’ L2 learning aptitudes, processes, and outcomes merit investigation. We present interaction and working memory (WM) research as a case in point and then, as a preliminary illustration, report on a small‐scale study of nine older adults, age 65–89, who were native speakers of Spanish learning English as a second language. These learners carried out communicative tasks with native speakers of English, who provided interactional feedback in response to nontargetlike question forms. Interestingly, the only older learners who showed L2 development were those with the highest scores on a first‐language listening‐span test of WM. We conclude by proposing that larger scale longitudinal research into the often overlooked population of older L2 learners is likely to shed interesting light on important questions concerning WM and learning processes in the field of second language acquisition.