bluuebunny/crossref_metadata_2025 huggingface dataset:
Unexpected loss of contact allergy to aluminium induced by vaccine
Authors: Gente Lidholm Anette , Bergfors Elisabet , Inerot Annica , Blomgren Ulla , Gillstedt Martin , Trollfors Birger
Published: April 2013

Background. In studies in Gothenburg, Sweden, in the 1990s of an aluminium hydroxide‐adsorbed pertussis toxoid vaccine, 745 of ∼76 000 vaccinated children developed long‐lasting itchy subcutaneous nodules at the vaccination site. Of 495 children with itchy nodules patch tested for aluminium allergy, 376 (76%) were positive.

Objectives. To study the prognosis of the vaccine‐induced aluminium allergy.

Patients and methods. Two hundred and forty‐one children with demonstrated aluminium allergy in the previous study were patch tested again 5–9 years after the initial test, with the same procedure as used previously.

Results. Contact allergy to aluminium was no longer demonstrable in 186 of the retested 241 children (77%). A negative test result was more common in children who no longer had itching at the vaccination site; it was also related to the age of the child, the time after the first aluminium‐adsorbed vaccine dose, and the strength of the reaction in the first test.

Conclusions. Patch test reactivity to aluminium seems to disappear or weaken with time.
Results of patch testing with fragrance mix 1, fragrance mix 2, and their ingredients, and Myroxylon pereirae and colophonium, over a 21‐year period
Authors: Nardelli Andrea , Carbonez An , Drieghe Jacques , Goossens An
Published: April 2013

Background.

The frequency of fragrance contact allergy has shown a fluctuating trend over the years.

Objectives.

To describe the frequency of positive reactions to the baseline screening agents and fragrance mix (FM) 1 and 2 components, to determine trends of the latter over the years, and to evaluate simultaneous reactions.

Patients and methods

This was a cross‐sectional study on patch test results of 13 332 patients from January 1990 to December 2011.

Results.

Of the total population, 9.6% reacted positively to FM 1, and 6% of 3416 tested with FM 2 reacted positively. Of those tested with both, 30.4% of 349 FM 1‐positive patients reacted to FM 2, and 51.7% of 205 FM 2‐positive patients reacted to FM 1. Hydroxyisohexyl 3‐cyclohexene carboxaldehyde (HICC) and FM 2 were tested simultaneously in 3401 patients: 6 reacted to HICC alone. Nine hundred and forty patients were tested with FM 1 ingredients and 205 with FM 2 ingredients; Evernia prunastri was the most frequent FM 1 allergen, and HICC was the most frequent FM 2 allergen. Simultaneous reactions were frequently observed.

Conclusions.

Fragrance‐allergic subjects often show multiple positive reactions, some of which are highly significantly associated. Recently, there has been a decreasing trend in positivity for both Evernia prunastri and HICC, whereas a slight increase for cinnamyl alcohol has been observed.
The ‘not so short‐bowel syndrome’: potential health problems in patients with an ileostomy
Authors: Ng D. H. L. , Pither C. A. R. , Wootton S. A. , Stroud M. A.
Published: April 2013

Aim

The study aimed to determine whether an ileostomy compromises nutritional, hydration and electrolyte status and bone mineral density.

Method

Body weight, body mass index (BMI) and fat and lean body mass (LBM) were measured in 60 patients with an ileostomy [14 small‐bowel resection (SBR); 46 non‐small‐bowel resection (NSBR)] and in 60 age‐ and sex‐matched normal controls. Measurement of plasma sodium, potassium, calcium, magnesium, urea and creatinine and 24‐h urinary output of water, Na, K, Ca and Mg was made in 45 NSBR and 14 SBR ileostomists and in all the controls. Forty‐six NSBR and 13 SBR ileostomists had bone mineral density (BMD) measurements of lumbar spine (LS) and femoral neck (FN).

Results

The body weight of ileostomists was less than controls [median 67.8 (36.4–115.1) vs 77.7 (48.0–103.3) kg; P < 0.05]. BMI was also less [25.0 (14.3–43.0) vs 27.3 (20.2–32.2) kg/m2; P < 0.05] with a lower LBM [47.8 (19.3–73.0) vs 52.9 (34.0–73.8) kg; P < 0.05]. The 24‐h urinary output of the ileostomists was lower than for controls [1380 (430–4690) vs 2000 (840–4440) ml/24 h; P < 0.05] suggesting some degree of dehydration. In 62.7% of ileostomists 24‐h urinary Na excretion was < 100 mmol/day vs 16.7% of controls, and ileostomists with lower urinary Na were more likely than ileostomists with normal Na excretion to have a low BMI [23.9 (14.3–33.0) vs 28.4 (16.6–43.0) kg/m2; P < 0.001] and LBM [44.1 (19.3–73.0) vs 59.5 (36.6–67.9) kg; P < 0.001]. The respective 24‐h output of Ca was [2.2 (0–6.1) vs 4.7 (0–13) mmol; P < 0.001] and Mg was [2.0 (0–13.7) vs 3.9 (1.2–5.4) mmol; P < 0.001], and BMD Z‐score LS was −0.15 (−2.0 to 5.2) vs 0.3 (−2.5 to 2.1), Z‐score FN −0.5 (−1.9 to 3.1) vs 0.2 (−1.2 to 1.4), both P < 0.05.

Conclusion

Patients with an ileostomy tend to have low body weight, BMI, LBM and BMD. They also tend to have low urine volumes, and some are depleted of Na, Ca and Mg. Abnormalities are greater in those with a lower urinary Na and measuring this will identify ileostomists at risk of Na depletion who will be benefitted by Na supplements.
Forearm–finger skin temperature gradient as an index of cutaneous perfusion during steady‐state exercise
Authors: Keramidas Michail E. , Geladas Nickos D. , Mekjavic Igor B. , Kounalakis Stylianos N.
Published: April 2013

The purpose of this study was to examine whether the forearm–finger skin temperature gradient (Tforearm–finger), an index of vasomotor tone during resting conditions, can also be used during steady‐state exercise. Twelve healthy men performed three cycling trials at an intensity of ~60% of their maximal oxygen uptake for 75 min separated by at least 48 h. During exercise, forearm skin blood flow (BFF) was measured with a laser‐Doppler flowmeter, and finger skin blood flow (PPG) was recorded from the left index fingertip using a pulse plethysmogram. Tforearm–finger of the left arm was calculated from the values derived by two thermistors placed on the radial side of the forearm and on the tip of the middle finger. During exercise, PPG and BFF increased (P<0·001), and Tforearm–finger decreased (P<0·001) from their resting values, indicating a peripheral vasodilatation. There was a significant correlation between Tforearm–finger and both PPG (r = −0·68; P<0·001) and BFF (r = −0·50; P<0·001). It is concluded that Tforearm–finger is a valid qualitative index of cutaneous vasomotor tone during steady‐state exercise.
Identifying potential kidney donors using social networking web sites
Authors: Chang Alexander , Anderson Emily E. , Turner Hang T. , Shoham David , Hou Susan H. , Grams Morgan
Published: April 2013

Social networking sites like Facebook may be a powerful tool for increasing rates of live kidney donation. They allow for wide dissemination of information and discussion and could lessen anxiety associated with a face‐to‐face request for donation. However, sparse data exist on the use of social media for this purpose. We searched Facebook, the most popular social networking site, for publicly available English‐language pages seeking kidney donors for a specific individual, abstracting information on the potential recipient, characteristics of the page itself, and whether potential donors were tested. In the 91 pages meeting inclusion criteria, the mean age of potential recipients was 37 (range: 2–69); 88% were US residents. Other posted information included the individual's photograph (76%), blood type (64%), cause of kidney disease (43%), and location (71%). Thirty‐two percent of pages reported having potential donors tested, and 10% reported receiving a live‐donor kidney transplant. Those reporting donor testing shared more potential recipient characteristics, provided more information about transplantation, and had higher page traffic. Facebook is already being used to identify potential kidney donors. Future studies should focus on how to safely, ethically, and effectively use social networking sites to inform potential donors and potentially expand live kidney donation.
Detection and genetic variability of European mountain ash ringspot‐associated virus (EMARaV) in Sweden
Authors: von Bargen S. , Arndt N. , Robel J. , Jalkanen R. , Büttner C.
Published: April 2013

European mountain ash ringspot‐associated virus (EMARaV) is a plant virus inducing characteristic ringspots and mottling in Sorbus aucuparia L. For the first time, EMARaV was detected in mountain ash in Sweden. All four genomic segments of the virus were detectable by RT‐PCR after total RNA extraction from leaves showing chlorotic ringspots, mottling or necrotic lesions. The samples originated from southern and northern Sweden. Sequence analyses of amplified fragments revealed low genetic variability of the virus at nucleotide as well as protein level. All investigated coding regions of EMARaV were under strong purifying selection pressure.
The influence of a clinical rural placement programme on the work location of new dental graduates from the University of Sydney, NSW, Australia
Authors: Johnson G. , Blinkhorn A.
Published: April 2013

Introduction

In Australia, as in many other countries there is a disparity in the number of dentists working in rural locations compared with metropolitan areas, and this is a growing problem. The aim of the research was to monitor the location of recent graduates who undertook a rural clinical placement whilst in the final year of Sydney Dental School, to determine whether it influenced their choice of job location.

Materials and Methods

Students who graduated in 2008 and 2009 were followed up to ascertain their working location. Forty per cent of the 2009 graduates participated in a rural placement during their undergraduate degree and 60% did not. In 2008, none of the students went on a rural placement as the scheme had not been implemented. The Australian Health Practitioner Regulation Agency (AHPRA) internet website was used to find the working location of the graduates. The rural, remote and metropolitan areas (RRMA) classification system was used to classify which areas of Australia were metropolitan, regional, rural and remote zones.

Results

The graduates of 2008 and 2009 were followed up in 2011 and 2012 to ascertain their working location. In 2011, 12.7% of the 2008 graduates were employed in a rural location compared to 27.6% of the entire 2009 graduating class. In 2011, of those 2009 graduates who participated in the rural placement programme, 44.8% were working in a rural or remote region compared to 17% of the graduates who did not participate. In 2012, the second follow‐up found that 18.6% of the 2008 graduates were working in a rural location compared to 25.9% of all the 2009 graduates. In 2012, 43.3% of the 2009 rural placement participants were found to be working in a rural location compared to 14.9% of the non‐participants.

Conclusions

The study followed up recent dental graduates' working locations to provide longitudinal evidence of the influence of an undergraduate rural placement programme on their work choices. It was found that a higher proportion of graduates who participated in the rural placement programme were working in a rural location when compared with those who had not been offered a placement.
The Roles of Knowledge Ascriptions in Epistemic Assessment
Authors: Gerken Mikkel
Published: April 2013

Knowledge norms of action are sometimes said to be motivated by the fact that they align with natural assessments of action in ordinary language. Competent and rational speakers normally use ‘knowledge’ and its cognates when they assess action. In contrast, competing accounts in terms of evidence, warrant or reliability do not straightforwardly align with ordinary language assessments of action. In response to this line of reasoning, I argue that a warrant account of action may explain the prominence of ‘knowledge’ in epistemic assessments better than the knowledge account. If this explanation is successful, it undermines a central rationale for the ‘knowledge first’ program in epistemology. Moreover, the explanation provides an insight into the social functions of knowledge ascriptions as well as a methodological lesson about the relationship between folk epistemology and epistemological theorizing.
Wing dimorphism in the migratory locust,Locusta migratoria: differentiation of wing morph and phase polyphenism
Authors: Nishide Yudai , Tanaka Seiji
Published: April 2013

A short‐winged morph was recently discovered in the migratory locust,Locusta migratoria. It is different from the normal, long‐winged morph not only in forewing length but also in hind femur length, displaying a dimorphism. To understand the significance of this dimorphism, other morphological characters were compared between the two morphs, and the time of differentiation of wing‐pad length was investigated. Wing weights were heavier in the long‐winged morph than in the short‐winged morph. This result showed that the short‐winged morph is not formed by a failure of wing expansion. No obvious morph‐specific differences were observed in wing venation, but wing allometry studies indicated that the distal areas of the fore‐ and hindwings were disproportionally reduced in the short‐winged morph compared to the long‐winged morph. The morphological differentiation of the wing pad between the two morphs was observed at the penultimate nymphal stage. The flight muscle was well developed in the two morphs, and no sign of flight muscle histolysis was detected in either morph after adult emergence. An analysis of adult body dimensions suggested that the density‐dependent phase shifts known for the long‐winged morph of this locust were also exhibited by the short‐winged morph, demonstrating that these shifts are not specific to the migratory long‐winged morph.
Multimodal therapy including electroacupuncture for the treatment of facial nerve paralysis in a horse
Authors: de Fourmestraux C. , Tessier C. , Touzot‐Jourde G.
Published: April 2013

This Case Report describes a 5‐year‐old Standardbred gelding that was referred to the Equine Hospital of ONIRIS Veterinary School of Nantes, France for a surgical procedure under general anaesthesia. Anaesthesia was induced and maintained intravenously and the horse was placed in left lateral recumbency with a padded halter. On post operative Day 1, a post anaesthetic distal facial nerve branch paresis was diagnosed based on clinical signs. The horse was discharged on post operative Day 2 with medical treatment based on anti‐inflammatory drug administration locally and systemically. The horse was re‐examined 2 weeks after the surgery; the left partial facial paralysis was still present and associated with amyotrophy of the muscles supplied by the buccal branches of the facial nerve. In accordance with the owner, the horse was hospitalised to start an electrostimulation treatment. The horse was treated every day for the first 4 days, then every 2 or 3 days during the following 3 weeks, for a total of 11 sessions. At the end of the second week of treatment, the horse was able to normally prehend the food and atrophy seemed reduced. The horse was discharged from hospitalisation at the end of the third week of treatment with specific recommendations. One month after discharge from the hospital just a slight asymmetry could be noticed at rest. Six months later, the training season began and the horse was able to perform. Facial paralysis due to nerve compression is a well‐known complication of anaesthesia. Gradual recovery of function over the weeks of treatment suggests that electroacupuncture may promote recovery and may hasten time of recovery.
PARP inhibitors: polypharmacology versus selective inhibition
Authors: Ekblad Torun , Camaioni Emidio , Schüler Herwig , Macchiarulo Antonio
Published: April 2013

Inhibition of ADP‐ribosyltransferases with diphtheria toxin homology (ARTD), widely known as the poly(ADP‐ribose) polymerase (PARP) family, is a strategy under development for treatment of various conditions, including cancers and ischemia. Here, we give a brief summary of ARTD enzyme functions and the implications for their potential as therapeutic targets. We present an overview of the PARP inhibitors that have been used in clinical trials. Finally, we summarize recent insights from structural biology, and discuss the molecular aspects of PARP inhibitors in terms of broad‐range versus selective inhibition of ARTD family enzymes.
Sp1 and c‐Myc regulate transcription of BMI1 in nasopharyngeal carcinoma
Authors: Wang Hong‐Bo , Liu Gui‐Hong , Zhang Hua , Xing Shan , Hu Li‐Juan , Zhao Wei‐Feng , Xie Bo , Li Man‐Zhi , Zeng Bo‐Hang , Li Yingqiu , Zeng Mu‐Sheng
Published: April 2013

B‐lymphoma mouse Moloney leukemia virus insertion region 1 (Bmi1), a member of the polycomb group, has elevated expression and is involved in the pathogenesis of various aggressive cancers, including nasopharyngeal carcinoma (NPC). To date, the mechanisms underlying the high expression of Bmi1 in NPC remain obscure. To gain new insights into the transcriptional regulation of BMI1, we cloned and characterized the promoter region of BMI1. Luciferase reporter assays demonstrated that the region from −783 to +375 showed significant promoter activity. With the use of a series of 5′‐deletion and 3′‐deletion promoter constructs in luciferase reporter assays, the +167/+232 and −536/−134 regions were found to be sufficient for full promoter activity. Transcriptional activity of the BMI1 promoter was dependent on the Sp1 binding site cluster (+181/+214) as well as the E‐box elements (−181), and was abolished after mutation of the two cis‐elements. Electrophoretic mobility shift assays and chromatin immunoprecipitation assays demonstrated that Sp1 bound to the region from +181 to +214 within the BMI1 promoter. In addition, gain‐of‐function and loss‐of‐function analyses revealed that Sp1 augmented Bmi1 expression. Further investigations using immunohistochemistry and quantitative RT‐PCR disclosed a significant positive correlation between the expression of Sp1 and Bmi1 in normal nasopharyngeal epithelial cells, NPC cells, and NPC tissue specimens. In addition, Myc, the known transcription factor for BMI1 in neuroblastomas, also activated the transcription of BMI1 through binding to the E‐box element (−181) within its promoter, and showed a positive correlation with the mRNA level of BMI1 in NPC. In conclusion, these findings provide valuable mechanistic insights into the role of Sp1 and c‐Myc in BMI1 transcription in NPC, and suggest that targeting of Sp1 or c‐Myc may be a potential therapeutic strategy for NPC.
Why Bureaucratic Stability Matters for the Implementation of Democratic Governance Programs
Authors: Cornell Agnes
Published: April 2013

The theoretical framework developed in this article suggests that high turnover rates in the public administrations of aid‐recipient countries present a challenge to the implementation of democratic governance (DG) aid. If high turnover rates are due to individuals' search for better opportunities, it will affect the implementation primarily through lack of experience and shorter time horizons among civil servants. However, if high turnover rates are due to political appointment of personnel, there is an additional negative factor that will affect the implementation: the reluctance to engage in old projects. Hence, high turnover rates affect the implementation of DG programs negatively, especially if caused by political appointment. These mechanisms are shown to be at work in interviews with donors and recipients of a broad range of DG programs in Peru and Bolivia.
Comparison of fermentation quality and ruminal degradability between two different harvest timings of forage soybean (Glycine max (L.) Merr.) ensiled with the corn‐silage system
Authors: Kawamoto Hidenori , Touno Eiko , Uchino Hiroshi , Uozumi Sunao
Published: April 2013

We evaluated soybean (Glycine max (L.) Merr. cv. Ryuho) silage that was harvested at two growth stages by the direct cutting system used for corn‐silage production. R6 (full‐size green beans) and R7 (pods and 50% of leaves yellowed) growth stages of grain‐type soybean were compared after being harvested with a corn harvester and ensiled with a round baler for chopped material. Dry matter (DM), crude protein (CP) and acid detergent fiber contents were higher for R7 silage than for R6 silage. The silage of both stages exhibited lactic‐acid dominant fermentation, with no significant difference in ruminal effective DM degradability. R6 silage had higher volatile basic nitrogen in total nitrogen (P < 0.01) and a higher ruminal soluble CP fraction (P < 0.01) than R7 silage. In conclusion, although well‐preserved silage was obtained from harvesting soybean at both R6 and R7 stages using the direct cutting system, R7 stage harvesting appeared to result in better conservation of protein quality.
The Role of ExbD in Periplasmic pH Homeostasis in Helicobacter pylori
Authors: Marcus Elizabeth A. , Sachs George , Scott David R.
Published: April 2013

Background

Helicobacter pylori, a neutralophile, colonizes the acidic environment of the human stomach by employing acid acclimation mechanisms that regulate periplasmic and cytoplasmic pH. The regulation of urease activity is central to acid acclimation. Inactive urease apoenzyme, UreA/B, requires nickel for activation. Accessory proteins UreE, F, G, and H are required for nickel insertion into apoenzyme. The ExbB/ExbD/TonB complex transfers energy from the inner to outer membrane, providing the driving force for nickel uptake. Therefore, the aim of this study was to determine the contribution of ExbD to pH homeostasis.

Materials and Methods

A nonpolar exbD knockout was constructed and survival, growth, urease activity, and membrane potential were determined in comparison with wildtype.

Results

Survival of the ΔexbD strain was significantly reduced at pH 3.0. Urease activity as a function of pH and UreI activation was similar to the wildtype strain, showing normal function of the proton‐gated urea channel, UreI. The increase in total urease activity over time in acid seen in the wildtype strain was abolished in the ΔexbD strain, but recovered in the presence of supraphysiologic nickel concentrations, demonstrating that the effect of the ΔexbD mutant is due to loss of a necessary constant supply of nickel. In acid, ΔexbD also decreased its ability to maintain membrane potential and periplasmic buffering in the presence of urea.

Conclusions

ExbD is essential for maintenance of periplasmic buffering and membrane potential by transferring energy required for nickel uptake, making it a potential nonantibiotic target for H. pylori eradication.
Serum transferrin as a predictor of prognosis for hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma
Authors: Zaitsu Junichi , Yamasaki Takahiro , Saeki Issei , Harima Yohei , Iwamoto Takuya , Harima Yumiko , Matsumoto Toshihiko , Urata Yohei , Hidaka Isao , Marumoto Yoshio , Ishikawa Tsuyoshi , Takami Taro , Yamamoto Naoki , Kaino Seiji , Uchida Koichi , Terai Shuji , Sakaida Isao
Published: April 2013

Aim

We recently reported that the iron chelator deferoxamine (DFO) is efficacious in advanced hepatocellular carcinoma (HCC) patients. Iron regulation may thus have an important impact in HCC therapy. Because transferrin is a native chelator that regulates iron homeostasis, it may act as an anticancer agent in a similar manner as DFO. The objective of this study was to evaluate serum transferrin as a prognostic predictor in advanced HCC patients undergoing hepatic arterial infusion chemotherapy (HAIC).

Methods

We retrospectively studied 44 patients receiving HAIC and analyzed various parameters for their possible use as prognostic predictors.

Results

The 1‐, 2‐ and 3‐year cumulative survival rates were 36.4%, 18.2% and 8.5%, respectively, and the median survival time (MST) was 7.0 months. The survival rates of patients who had serum transferrin of 190 mg/dL or more (MST, 12.0 months) were significantly better than those of patients who had serum transferrin of less than 190 mg/dL (MST, 4.9 months). Multivariate analysis identified serum transferrin of 190 mg/dL or more (hazard ratio [HR], 0.282; 95% confidence interval [CI], 0.132–0.603; P = 0.001) and Child–Pugh score B (HR, 1.956; 95% CI, 1.034–3.700; P = 0.039) as independent prognostic predictors. There was a significant correlation between serum transferrin level and therapeutic effect (P < 0.001).

Conclusion

Serum transferrin could be useful as a prognostic predictor in advanced HCC patients before HAIC treatment.
Carvedilol improves ethanol‐induced liver injury via modifying the interaction between oxidative stress and sympathetic hyperactivity in rats
Authors: Hakucho Ayako , Liu Jinyao , Liu Xu , Fujimiya Tatsuya
Published: April 2013

Aim

Oxidative stress is a major pathway mediating ethanol hepatotoxicity and liver injury. We previously found that carvedilol, which can block the sympathetic nervous system via β1‐, β2‐ and α1‐adrenoreceptors, modifies ethanol‐induced production of lipogenesis‐ and fibrogenesis‐related mediators from hepatic stellate cells (HSC). In the present study, we assessed the effects of carvedilol on ethanol‐induced liver injury, hepatic insulin resistance, and the interaction between oxidative stress and sympathetic hyperactivity in rats with alcoholic fatty liver disease (AFLD).

Methods

Male Wistar rats were pair‐fed for 49 days and divided into four groups: control and ethanol liquid‐diet‐fed rats with and without 7‐day carvedilol treatment. Rats' sympathetic activity, hepatic oxidative stress, hepatic insulin resistance and liver injury were evaluated based on biochemical analysis, enzyme‐linked immunosorbent assay, fluorescence immunohistochemistry, western blot and reverse transcriptase polymerase chain reaction.

Results

Forty‐nine days of ethanol consumption induced the increases in circulating noradrenaline metabolite (3‐methoxy‐4‐hydroxyphenylglycol), hepatic noradrenaline and 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) levels, the downregulation of hepatic insulin receptor substrate‐1 gene expression, and the accumulation of fatty droplets within hepatocytes with the increased hepatic triglyceride and blood alanine aminotransferase levels. All of these changes were modified by carvedilol treatment. 8‐OHdG was detected in activated HSC and suppressed by carvedilol treatment based on fluorescence immunohistochemical double‐staining analysis.

Conclusion

Carvedilol may modify the interaction between the oxidative stress and the sympathetic hyperactivity, and then contribute to attenuating the development of AFLD in rats. Additionally, oxidative stress may be responsible for the activation of HSC during the early stage of alcoholic liver disease.
Improving the standard of lymph node retrieval after gastric cancer surgery
Authors: Hanna George B , Amygdalos Iakovos , Ni Melody , Boshier Piers R , Mikhail Sameh , Lloyd Josephine , Goldin Robert
Published: April 2013

Aims

To examine factors that influence lymph node count and to study the relationship between nodal size and metastatic involvement in gastric cancer.

Methods and results

Observational study comparing lymph node retrieval by manual nodal dissection (MND) and systematic fat blocking (SFB) from 114 gastrectomy specimens. The influence of lymph node retrieval method, patient characteristics, oncological factors and surgical approach on lymph node count were examined using regression models. The risk‐adjusted cumulative sum chart method was also used to analyse lymph node count. The lymph node count increased during the course of this study (P < 0.005). Both pathologist and lymph node retrieval method were independent predictors for lymph node count. MND yielded lower lymph node counts than SFB (58 versus 66, P < 0.05). The pathologist influenced lymph node retrieval by MND (R2: 0.297–0.518, P < 0.0001), but not SFB (R2: 0.340–0.344, P > 0.05). The percentage of positive lymph nodes below 5 mm was 24.2% and 44.1% for MND and SFB, respectively, resulting in cancer upstaging (P = 0.037).

Conclusions

Systematic fat blocking is associated with a higher total and positive lymph node yield compared to MND and is independent of the pathologist. Ignoring small lymph nodes can be a major cause for missing positive nodes, leading in turn to cancer down‐staging.
Farmland versus forest: comparing changes in Odonata species composition in western and eastern Sweden
Authors: Koch Kamilla , Wagner Christine , Sahlén Göran
Published: April 2013

Despite the loss of natural ecosystems in the developed world during the past millennia, anthropogenic landscapes still sustain much biodiversity. Our question was, whether ten year changes in regional Odonata faunas are comparable between farmland and forested areas, or if the species pool of farmland areas respond in other ways than that of forest.

We used data of dragonfly larvae collected from 16 lakes in a farmland area in south‐western Sweden in the years 2002 and 2011/12, and compared these to data from 34 lakes in a forest area in south‐eastern Sweden in the years 1996 and 2006.

The species‐richness in the agricultural region increased by 17% but decreased by 13% in the forested region. The changes in occurrence and regional distribution were similar in both areas, affecting 71% and 69% of the species pool. Average extinction rates were comparable between the agricultural and the forested region (38% and 43%) while colonisation rates differed greatly (64% and 114%).

The species composition differed between the regions; the forest lakes harboured a 29% larger species pool. It is possible that in the forested region, the regional species pool in areas surrounding the study sites could stabilise the extinction and have a positive effect on changes in species composition. We assume that the different habitat structures of the waters in the agricultural and the forest regions and changes in temperature are the main driving forces behind the shifts. The mean seasonal air temperature has increased by circa 0.5 °C in both regions, when comparing ten‐year periods before each sampling year.
Glass Crystallization Research – A 36‐Year Retrospective. Part II, Methods of Study and Glass‐Ceramics
Authors: Zanotto Edgar D.
Published: April 2013

Most of our original studies on the fundamental scientific aspects of glass crystallization were reviewed in Part I of this article. In this part, we describe some relevant methods we developed to study glass crystallization and review a number of systematic studies that we conducted to develop, improve, or characterize some types of glass‐ceramics, such as bioactive glass‐ceramics; photo‐thermo‐refractive glasses (or glass‐ceramics because the “active” components are sodium fluoride nanocrystals embedded in a glass matrix); new glass‐ceramics derived from blast furnace and steel‐making slags (hard materials for architecture and construction); sintered glass‐ceramics that emulate expensive stones such as marble and granite; and the first large‐grain, highly crystalline optically transparent glass‐ceramic.
Audit Fees and Auditor Independence: The Case of ISO 14001 Certification
Authors: Dogui Kouakou , Boiral Olivier , Heras‐Saizarbitoria Iñaki
Published: April 2013

This study analyses the effects of audit fees and the clients' financial power on the independence of ISO 14001 auditors on the basis of a qualitative analysis of interviews with 36 professionals involved in the certification process. The results of the study demonstrate that most respondents support the legitimacy of the current remuneration system based on the user‐pays principle, despite its business and financial ramifications, claiming that the independence of auditors is in fact ensured by the imposition of contractual duty, the observance of ethical codes, distancing the auditor from negotiations with the client, and dissociating the fee charged for the audit from the granting of the ISO 14001 certificate. However, the study demonstrates that auditors often adapt their behaviour to the client's economic context and the company size, which may call into question the prevailing opinion on the independence and impartiality of the certification process. This paper, on the one hand, discusses the manner in which auditors legitimize the current remuneration system and, on the other, describes the potential threat that it represents for their independence. The paper also highlights the similarities in this regard between the conflicts of interest in the field of environmental audits and in that of financial audits. Finally, the paper analyses a number of possible solutions to reduce the financial dependence of auditors on the audited companies.
Evaluation of ICSH schistocyte measurement guidelines in France
Authors: Lesesve J.‐F. , El Adssi H. , Watine J. , Oosterhuis W. , Régnier F.
Published: April 2013

Introduction

The schistocytes are fragmented red blood cells mainly observed in the setting of hemolytic anemias where they remain an important criterion for the diagnosis. As the identification of these cells is still problematic, the International Council for Standardization in Hematology (ICSH) set up a consensus report in November, 2011. The French Group of Cellular Hematology (GFHC) aimed to collect the opinion of French biologists directly confronted to schistocytes measurements, about these guidelines.

Methods

Among the 578 professionals, 169 (29%) answered to the 10 questions dealing with the identification and measurements of schistocytes as proposed by the ICSH.

Results

A consensus was reached for the urgent need of such guidelines documents, especially in the current background of the European accreditation EN ISO 15189 rules. A traduction in native (French) language was warmly wished in order to facilitate the diffusion of the information. The pathologic threshold for the diagnosis of thrombotic microangiopathic anemia (TMA) (>1%) remained questionable. For half of the biologists, the new fragmented red blood cell (FRC) parameter recently provided by two manufacturers of automated blood cell counters was still doubtfull for routine use.

Conclusion

This survey assessed the impact of international ‘guidelines’ on the French biological community. The will to implement validated recommendations was strong, reflecting the awareness of the biologists to standardize the laboratory investigations.
Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence
Authors: Thubert Thibault , Deffieux Xavier , Jousse Marylène , Guinet‐Lacoste Amandine , Ismael Samer Sheikh , Amarenco Gerard
Published: April 2013

Objectives

To assess the predictive value of a simple clinical test (posterior vaginal wall pull down maneuver) in the diagnosis of intrinsic sphincter deficiency.

Methods

The present prospective study included 62 women suffering from stress urinary incontinence. Every patient underwent a urogynecological examination including multichannel urodynamic testing (cystometry, urethral pressure profile, Valsalva Leak Point Pressure measurement) and a clinical examination including posterior vaginal wall pull down maneuver. Posterior vaginal wall pull down maneuver was carried out with the bladder filled with 400 mL of saline in a supine position, and was obtained by means of a split speculum allowing gentle pull down traction of the posterior vaginal wall. Posterior vaginal wall pull down maneuver was considered as positive when a urine leak was observed during the manoeuvre. Intrinsic sphincter deficiency was urodynamically defined by maximum urethral closure pressure ≤20 cmH2O. Correlations between positive/negative posterior vaginal wall pull down maneuver and urodynamic intrinsic sphincter deficiency were calculated.

Results

There was a statistical correlation between age and low maximum urethral closure pressure (P < 0.0001), and between low maximum urethral closure pressure and positive posterior vaginal wall pull down maneuver (P < 0.0001). Regarding the intrinsic sphincter deficiency diagnosis, the posterior vaginal wall pull down maneuver positive predictive value was 94.67% and the negative predictive value was 95.4%, with a specificity of 97.6% and sensitivity of 90%.

Conclusion

Posterior vaginal wall pull down maneuver is a reliable clinical test, easy to carry out, inexpensive and without significant risk. This test allows the diagnosis of intrinsic sphincter deficiency in women suffering from stress urinary incontinence, thus avoiding further invasive urodynamic testing (urethral pressure profile, Valsalva Leak Point Pressure measurement) in women with genuine stress urinary incontinence. Furthermore, it is helpful when choosing the type of sling procedure (retropubic vs transobturator) when a surgery is planned.
Transcriptional network of androgen receptor in prostate cancer progression
Authors: Takayama Ken‐ichi , Inoue Satoshi
Published: April 2013

The androgen receptor belongs to the nuclear receptor superfamily and functions as a ligand‐dependent transcription factor. It binds to the androgen responsive element and recruits coregulatory factors to modulate gene transcription. In addition, the androgen receptor interacts with other transcription factors, such as forkhead box A1, and other oncogenic signaling pathway molecules that bind deoxyribonucleic acid and regulate transcription. Androgen receptor signaling plays an important role in the development of prostate cancer. Prostate cancer cells proliferate in an androgen‐dependent manner, and androgen receptor blockade is effective in prostate cancer therapy. However, patients often progress to castration‐resistant prostate cancer with elevated androgen receptor expression and hypersensitivity to androgen. Recently, comprehensive analysis tools, such as complementary DNA microarray, chromatin immunoprecipitation‐on‐chip and chromatin immunoprecipitation‐sequence, have described the androgen‐mediated diverse transcriptional program and gene networks in prostate cancer. Furthermore, functional and clinical studies have shown that some of the androgen receptor‐regulated genes could be prognostic markers and potential therapeutic targets for the treatment of prostate cancer, particularly castration‐resistant prostate cancer. Thus, identifying androgen receptor downstream signaling events and investigating the regulation of androgen receptor activity is critical for understanding the mechanism of carcinogenesis and progression to castration‐resistant prostate cancer.
Longer operative time is associated with higher risk of severe complications after percutaneous nephrolithotomy: Analysis of 1511 cases from a Japanese nationwide database
Authors: Sugihara Toru , Yasunaga Hideo , Horiguchi Hiromasa , Fujimura Tetsuya , Nishimatsu Hiroaki , Kume Haruki , Ohe Kazuhiko , Matsuda Shinya , Fushimi Kiyohide , Homma Yukio
Published: April 2013

Objectives

To evaluate risk factors of severe adverse events after percutaneous nephrolithotomy with an emphasis on operation time, and to develop a nomogram for predicting them.

Methods

This was an observational retrospective study including 1511 patients who underwent percutaneous nephrolithotomy in 332 hospitals identified from the Japanese Diagnosis Procedure Combination database between 2007 and 2010. Severe adverse events were defined as follows: (i) in‐hospital mortality; (ii) postoperative medications including catecholamine, gamma‐globulin products, protease inhibitors and medications for disseminated intravascular coagulation; and (iii) postoperative interventions including central vein catheterization, dialysis and mechanical cardiopulmonary support. Univariate and multivariate logistic regression analyses were carried out for the occurrence of severe adverse events, and a nomogram was generated from this model.

Results

Overall, 126 severe adverse events (8.34%) were identified. In the multivariate model, a linear trend between severe adverse events and operation time was observed (OR 4.72 for 120–179 min to 17.95 for ≥300 min compared with ≤119 min; each P < 0.05) after adjustment for sex, age, Charlson Comorbidity Index and type of admission. Female sex and emergency admission were also significant risk factors (OR 1.92 and 2.04, respectively), and hospital volume did not reach statistical significance. The nomogram based on these results was well fitted to predict a probability between 0.05 and 0.40 (concordance index 0.696).

Conclusions

Longer operation time is a significant and independent risk factor for severe adverse events after percutaneous nephrolithotomy. Our nomogram can be an effective tool for predicting postoperative complications.
Differential diagnosis between bacterial infection and neoplastic fever in patients with advanced urological cancer: The role of procalcitonin
Authors: Yaegashi Hiroshi , Izumi Kouji , Kitagawa Yasuhide , Kadono Yoshifumi , Konaka Hiroyuki , Mizokami Atsushi , Namiki Mikio
Published: April 2013

It is difficult to determine the cause of high fever in patients with advanced cancer, because they tend to have both neoplastic fever and concomitant bacterial infections with elevated white blood cells and C‐reactive protein levels. Procalcitonin has been reported to be a valuable marker for bacterial infections in a wide range of clinical scenarios. However, there have been no studies regarding the usefulness of procalcitonin to differentiate between febrile episodes caused by bacterial infections and neoplastic fever in patients with advanced urological cancer. In the present study, 37 febrile episodes were retrospectively analyzed. Although there were no differences in white blood cell number, C‐reactive protein level or body temperature between bacterial infections and non‐bacterial infections, procalcitonin levels were significantly higher in the former than the latter. Our findings suggest that measurement of procalcitonin might be valuable to determine the cause of febrile episodes in patients with advanced urological cancer, and can help clinicians to make appropriate decisions for treatment.
Newborn care in Nepal: the effects of an educational intervention on nurses' knowledge and practice
Authors: Shrestha S. , Petrini M. , Turale S.
Published: April 2013

Aim

To determine the effectiveness of an educational intervention for improving nurses' knowledge and practice regarding newborn care in Kathmandu, Nepal.

Background

Four million neonatal deaths occur annually, especially in developing countries. In 2010 in Nepal, the neonatal mortality rate was 28/1000 births. Modern nursing and research education is still developing in Nepal, but the country's nurses are in a unique position to help combat avoidable morbidity and mortality. This study was designed to assist nurses working in maternity units to obtain and/or sustain knowledge and competence in practice to ensure the health and safety of vulnerable newborns, and thereby to help reduce mortality and morbidity.

Theoretical Framework

Concepts from the Transtheoretical Model of behaviour change developed in the USA informed this study in the belief that an educational intervention would assist in behaviour changes in nurses caring for newborns.

Design

Quasi‐experimental, time‐series pre‐test/post‐test.

Setting

Maternity and women's hospitals in Kathmandu, Nepal.

Participants

Convenience sample of 30 nurses working in emergency room, delivery room and birthing centre.

Methods

Nurses were measured on study outcomes at multiple time points: before a self‐directed educational intervention and discussion, immediately, 1 and 3 months after intervention. Data were collected using three instruments: a demographics questionnaire, the Knowledge Survey Questionnaire and the Skills Learning Checklist (SLC). The SLC was completed during nursing practice in observations by the researcher.

Results

Significant findings suggested that this educational intervention was effective for improving nurses' knowledge and practice regarding newborn care, and there was a positive correlation between knowledge and practice.

Conclusion

This was the first study of its kind in Nepal, a small step in enhancing nurses' abilities to improve their knowledge and competence regarding care of newborns. However, continued education and guidance are required to sustain knowledge and competence in practice, and our educational intervention needs further testing with other populations of nurses. There are various policy implications required to enable this to happen. This includes health ministry funding and support for in‐service education; hospitals and universities working together to offer in‐service education, competency testing and revised curricula; and nurse registering authorities requiring ongoing nurse education programmes and competency testing.
An implementation framework for seru production
Authors: Liu ChenGuang , Stecke Kathryn E. , Lian Jie , Yin Yong
Published: April 2013

Seru production, which merges the flexibility of job shops, efficiency of mass production, and environment friendly characteristics of sustainable manufacturing, largely for electronics assembly, is the latest manufacturing mode developed in Japan. It is receiving attention from Japanese practitioners and researchers. However, some attempts to implement seru production are unsuccessful, especially outside Japan. This is because of lack of knowledge of the specific means to implement seru production. The purpose of this paper is to provide a general framework and some basic principles that should be followed while implementing seru production for practitioners from a practical perspective. This work is based on a systematic analysis of many implementation experiences of seru production in Japanese manufacturing factories as well as a broad investigation of the popular literature information. The proposed framework can serve as a concise guide to help implement seru production in the manufacturing industry. In addition, constructive information is provided for researchers who would like to know and study the advanced manufacturing mode of seru production but do not understand the Japanese language.
Integrated value function construction with application to impact assessments
Authors: Stewart Theodor J. , Janssen Ron
Published: April 2013

In this article, an integrated structure is provided for processing various forms of imprecise preference information in the context of multicriteria impact assessments. Linear programing formulations generate best‐fit value function models and associated ranking of alternatives, both when preferences are overdetermined (leading to potential inconsistencies) or when preference information is incomplete. In the latter context, the algorithm identifies a range of possible rank orders for the decision alternatives under consideration, consistent with the information provided. The approach is primarily aimed at structuring opinions of experts concerning the desirability of different actions in terms of technical aspects, intended as input into the final political decision‐making process. It is demonstrated that the approach described here can be implemented with modest levels of effort by the experts. Experience is reported with the approach in the context of soil sanitation problem in the Netherlands, in which experts expressed satisfaction with the resulting rank ordering of alternatives.