bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistent Cloaca, Fused Kidneys, Female Pseudohermaphroditism and Skeletal Anomalies in a Simmental Calf
Authors: Gulbahar M. Y. , Kabak M. , Yarim M. , Guvenc T. , Kabak Y. B.
Published: May 2009

A 5‐day‐old Simmental calf was referred to our department for atresia ani and postural abnormalities caused by skeletal deformities. The calf had a short and deviated tail and a bowed hind limb. The calf appeared like a male because of the prepuce and penis located just near the teats and the absence of female external genitalia. During the necropsy, a horseshoe kidney, single ureter that originated from the kidney, and bilateral uterine horns with one ovary each were detected. The ureter, blind‐ended large intestine, and bilateral uterine horns were connected to a dilated cloaca having two sacs, which were filled with a yellowish brown viscous fluid admixed with meconium and urine. Skeletal deformities found included scoliosis, partial synostosis of vertebrae, deviation of rudimentary sacrum and coccygeal vertebrae, and narrowed pelvic cavity. This is the first report of an anomalous combination including urogenital, large intestinal, and skeletal deformities in cattle.
Factors affecting recurrence in node‐negative advanced gastric cancer
Authors: Huang Kuo‐Hung , Chen Jen‐Hao , Wu Chew‐Wun , Lo Su‐Shun , Hsieh Mao‐Chih , Li Anna F‐Y , Lui Win‐Yiu
Published: May 2009

Background and Aim: Prognostic factors of lymph node‐negative gastric adenocarcinoma after curative resection have been discussed. Recurrent pattern of advanced lymph node‐negative gastric cancer after curative resection has rarely been described.

Methods: Recurrent sites and correlated clinicopathological factors of 372 patients with lymph node‐negative advanced gastric adenocarcinoma that underwent R0 resection from 1988 to 2005 were analyzed.

Results: Recurrence was noted in 51 (13.7%) patients. Recurrent rates according to site of recurrence were 26 peritoneal seeding (51.0%), 26 locoregional (51.0%), 17 hematogenous (33.3%), and 4 lymph node metastasis (7.8%). Clinicopathological factors to predict peritoneal seeding were serosal exposure, lymphovascular invasion, Lauren's diffuse type differentiation and scirrhous stromal reaction. Serosal exposure, tumor size, microscopic infiltrating growth type predicts locoregional recurrence. Tumor had only lymphovascular invasion predict hematogenous spreading.

Conclusion: Node‐negative advanced gastric cancer has more peritoneal seeding and locoregional recurrence. Aggressive cell behavior predicted the route of tumor cell spreading.
Feasibility of self‐expandable metallic stent plus chemotherapy for metastatic gastric cancer with pyloric stenosis
Authors: Shimura Takaya , Kataoka Hiromi , Sasaki Makoto , Yamada Tomonori , Hayashi Kazuki , Togawa Shozo , Okumura Fumihiro , Kubota Eiji , Ohara Hirotaka , Joh Takashi
Published: May 2009

Background and Aim:  Self‐expandable metallic stent placement is accepted as palliative therapy for advanced gastric cancer with gastric outlet obstruction, but data are lacking for chemotherapy after self‐expandable metallic stent insertion. This study retrospectively compared results between surgery plus chemotherapy and stenting plus chemotherapy for metastatic gastric cancer with pyloric stenosis.

Methods:  Subjects comprised 26 patients who received chemotherapy after surgery or endoscopic stenting for metastatic gastric cancer with pyloric stenosis between April 2000 and December 2007 in four Japanese hospitals. Patients were categorized into two groups: 15 patients who received chemotherapy after surgery for pyloric stenosis (Surgery group); and 11 patients who received chemotherapy after self‐expandable metallic stent placement for pyloric stenosis (Stent group).

Results:  Median survival time and median time to treatment failure were 284 days and 226 days in the Surgery group and 337 days and 247 days in the Stent group, respectively. No significant differences were noted between survival and time to treatment failure. No significant differences were found in median oral intake rate (Surgery, 93.1%; Stent, 93.2%) or median hospital stay rate (Surgery, 24.6%; Stent, 23.7%) during survival. Response rate was 45.5% in the Surgery group and 50% in the Stent group, with no significant difference. Likewise, no significant differences were noted between groups for frequencies of toxicity or complications.

Conclusions:  The present results suggest that chemotherapy after stenting is as effective and safe as chemotherapy after surgery. Stents may replace surgery in combination therapy with chemotherapy for metastatic gastric cancer with gastric outlet obstruction.
Metabolic risk factors associated with erosive esophagitis
Authors: Chua Chian‐Sem , Lin Yu‐Min , Yu Fu‐Chun , Hsu Yi‐Hsin , Chen Jui‐Hao , Yang Kuo‐Ching , Shih Chia‐Hui
Published: May 2009

Background and Aim:  Our aim was to determine associations between metabolic risk factors and erosive esophagitis.

Methods:  In this retrospective case‐control study, diagnosis of erosive esophagitis was based on the Los Angeles classification. Endoscopic findings in subjects with erosive esophagitis were reviewed by two experienced endoscopists and those with agreement of diagnosis were enrolled for study. Body mass index (BMI), abdominal girdle, blood pressure, and serum triglyceride, glucose, and β‐lipoprotein levels were compared between individuals with and without erosive esophagitis. Multivariate binary logistic regression analysis was used to identify independent metabolic risk factors associated with erosive esophagitis.

Results:  Between October 2004 and April 2006, 518 of 4206 subjects who underwent endoscopic examination were diagnosed as having erosive esophagitis. After expert review, 427 (male : female = 365:62) individuals met the study criteria of having erosive esophagitis (10.5%). Compared with age‐ and gender‐matched controls, patients with erosive esophagitis had significantly higher BMI, abdominal girdle, blood pressure, and triglyceride levels, and lower levels of high density lipoprotein (HDL) cholesterol (P < 0.05). More subjects with metabolic syndrome had erosive esophagitis than without metabolic syndrome (OR: 1.76, 95% CI: 1.27–2.44, P = 0.001). Multivariate logistic regression analysis revealed that central obesity (OR: 1.41, 95% CI: 05‐1.89, P = 0.023) and hypertriglyceridemia (OR: 1.57, 95% CI: 1.19–2.13, P = 0.004) were significantly associated with erosive esophagitis.

Conclusions:  Obesity and hypertriglyceridemia, which are key components of metabolic syndrome, are moderate independent risk factors for erosive esophagitis.
ORIGINAL ARTICLE: The reliability of long and short cases undertaken as practice for a summative examination
Authors: Wilkinson T. J. , D'Orsogna L. J. , Nair B. R. , Judd S. J. , Frampton C. M.
Published: May 2009

Background: This study explores whether long and short cases performed in the workplace during training could be integrated into an overall summative assessment. Less examiner training and a less formalized structure might compromise reliability, but increased testing time might improve it.

Methods: Results of practice long and short cases, undertaken in preparation for the Royal Australasian College of Physicians clinical examination, were compared with actual examination results. The effects on reliability of the examination were compared by modelling varying combinations of practice and examination long and short cases.

Results: Fifty‐nine candidates in two centres undertook 256 practice long cases and 154 practice short cases. Two practice long cases correlated with two examination long cases (r= 0.46). The reliability of a single long case was 0.22 under practice conditions and 0.36 under examination conditions. The reliability of a single short case was similar under either condition (0.18 vs 0.21). Reliability of over 0.80 could be achieved by assimilating two examination long cases and four examination short cases with varying combinations of seven practice cases.

Conclusions: Long cases undertaken in the workplace are not as reliable those undertaken under examination conditions, but short cases have similar reliability under either condition.
Examination of opioid prescribing in Australia from 1992 to 2007
Authors: Leong M. , Murnion B. , Haber P. S.
Published: May 2009

Background: Opioid prescribing is controversial with evidence of both significant under‐utilization and over‐utilization. There is some evidence to support efficacy for chronic non‐malignant pain, but community and individual harms are increasingly reported.

Aims: To review availability of opioid preparations and prescription patterns of opioids through the subsidized Pharmaceutical Benefits Scheme in Australia from 1992 to 2007.

Methods: Interrogation of the Health Insurance Commission database from 1992 to 2007. Item numbers for all available opioid preparations were identified, and frequency of dispensing was collected and collated.

Results: The number of opioids on the Pharmaceutical Benefits Scheme (PBS) increased from 11 preparations of four medications to 70 preparations of eight medications during this period. The total number of PBS opioid prescriptions increased from 2 397 006 in 1992 to 6 998 556 in 2007. We identified a dramatic and continuing increase in prescription of oxycodone in all dose ranges. Fentanyl prescribing is increasing to a lesser degree. Morphine and tramadol prescribing appears to have plateaued.

Conclusion: Opioid use is increasing. There is a pressing need for co‐ordinated assessment of efficacy and harms to facilitate quality usage of opioids.
The dorsal premotor cortex orchestrates concurrent speech and fingertapping movements
Authors: Meister Ingo G. , Buelte Dorothee , Staedtgen Mario , Boroojerdi Babak , Sparing Roland
Published: May 2009

Human speech and hand use both involve highly specialized complex movement patterns. Whereas previous studies in detail characterized the cortical motor systems mediating speech and finger movements, the network that provides coordination of concurrent speech and hand movements so far is unknown. Using functional magnetic resonance imaging (fMRI), the present study investigated differential cortical networks devoted to speech or fingertapping, and regions mediating integration of these complex movement patterns involving different effectors. The conjunction contrasts revealing regions activated both during sole fingertapping and sole repetitive articulation or reading aloud showed contralateral regions at the border of ventral and dorsal motor cortex. In contrast, the analyses revealing regions showing a higher level of fMRI activation for concurrent movements of both effectors compared with sole hand movements or repetitive articulation or reading aloud showed distinct premotor activations, which were situated dorsal and caudal to the areas activated across speech and fingertapping tasks. These results indicate that the premotor cortex (PMC) subserves coordination of concurrent speech with hand movements. This integrative motor region is not identical with the area that shows overlapping activations for speech and fingertapping. Thus, concurrent performance of these complex movement patterns involving different effectors requires, in addition to somatotopic motor cortex activation, orchestration subserved by a distinct PMC area.
Epilepsy‐induced abnormal striatal plasticity in Bassoon mutant mice
Authors: Ghiglieri Veronica , Picconi Barbara , Sgobio Carmelo , Bagetta Vincenza , Barone Ilaria , Paillè Vincent , Di Filippo Massimiliano , Polli Federica , Gardoni Fabrizio , Altrock Wilko , Gundelfinger Eckart D. , De Sarro Giovambattista , Bernardi Giorgio , Ammassari‐Teule Martine , Di Luca Monica , Calabresi Paolo
Published: May 2009

Recently, the striatum has been implicated in the spread of epileptic seizures. As the absence of functional scaffolding protein Bassoon in mutant mice is associated with the development of pronounced spontaneous seizures, we utilized this new genetic model of epilepsy to investigate seizure‐induced changes in striatal synaptic plasticity. Mutant mice showed reduced long‐term potentiation in striatal spiny neurons, associated with an altered N‐methyl‐d‐aspartate (NMDA) receptor subunit distribution, whereas GABAergic fast‐spiking (FS) interneurons showed NMDA‐dependent short‐term potentiation that was absent in wild‐type animals. Alterations in the dendritic morphology of spiny neurons and in the number of FS interneurons were also observed. Early antiepileptic treatment with valproic acid reduced epileptic attacks and mortality, rescuing physiological striatal synaptic plasticity and NMDA receptor subunit composition. However, morphological alterations were not affected by antiepileptic treatment. Our results indicate that, in Bsn mutant mice, initial morphological alterations seem to reflect a more direct effect of the abnormal genotype, whereas plasticity changes are likely to be caused by the occurrence of repeated cortical seizures.
Earnings and Occupational Attainment among Immigrants1
Authors: CHISWICK BARRY R. , MILLER PAUL W.
Published: May 2009

This paper examines the determinants of occupational attainment and the impact of occupation on earning among foreign‐born men using the U.S. 2000 Census. Years of schooling and proficiency in English are the key factors determining access to high‐paying occupations among immigrants. Foreign labor market experience, however, has a negative impact on current occupational status, especially among those in high‐status jobs, due to the limited international transferability of skills acquired on the job.
Validation Studies on a Measure of Overall Managerial Readiness for the Chinese
Authors: Hui C. Harry , Pak S. Tess , Cheng Kevin H. C.
Published: May 2009

The Overall Managerial Readiness (OMR) scale was first developed as a simple measure of managerial potential for the Chinese workforce. OMR purports to predict managerial performance by assessing a person's attitudes and intention to engage in managerial practices. It consists of 28 forced‐choice statements most of which refer to attitudes and behaviors in a work setting. Three studies together showed that OMR was correlated negatively with neuroticism, and positively with conscientiousness, agreeableness, openness to experience, and extraversion. Notwithstanding, OMR was distinct from the Big Five, and had incremental predictive power on work performance (Study 3). Besides, OMR alone predicted bank managers' productivity (Study 4). Finally, internal consistency and concurrent validity of a Likert version of OMR was ascertained (Study 5).
Agreement in Self–Other Ratings of Leader Effectiveness: The role of demographics and personality
Authors: Vecchio Robert P. , Anderson Robert J.
Published: May 2009

Personality and demographic attributes for a set of 1221 focal managers were examined as correlates of leadership effectiveness evaluations that were obtained via a 360° feedback program. Polynomial regression was used to study the congruence of self‐ratings provided by focal managers relative to the different evaluative perspectives (i.e., immediate superior, peer, and subordinate). Analyses supported the prediction that focal manager's sex and age would be associated with the ratings provided by themselves and others. Plus, the tendency to overestimate one's own leader effectiveness relative to evaluations provided by others was found to be greater for males and older managers. Focal managers who expressed greater social sensitivity were evaluated more favorably by subordinates and peers, although not by superiors. Ratings of leader effectiveness from immediate superiors were, instead, more readily predicted by judgments of the performance of the focal manager's organizational unit relative to comparable units. Results of polynomial regression analysis, however, indicated that self–other agreement was related to the focal's sex, social sensitivity, and social dominance. Implications for understanding obstacles to openness to change are discussed.
How Widespread is Graphology in Personnel Selection Practice? A case study of a job market myth
Authors: Bangerter Adrian , König Cornelius J. , Blatti Sandrine , Salvisberg Alexander
Published: May 2009

Graphology is allegedly widely used in personnel selection in Europe. This is amyth: a widespread but false belief. We explored this myth in five studies. Study 1 established that job ads rarely require handwritten letters. Study 2 showed that handwritten letters serve multiple purposes but are seldom used for handwriting analysis. In Study 3, job market actors overestimated the frequency with which handwritten letters are subjected to graphological analysis. In Study 4, we showed experimentally that people expect graphology to be used when job ads require submission of a handwritten letter. Study 5 showed that advice books may transmit the myth. The myth may foster tolerant attitudes toward graphology, thereby facilitating its persistence in selection practice.
Opiate-Induced Persistent Pronociceptive Trigeminal Neural Adaptations: Potential Relevance to Opiate-Induced Medication Overuse Headache
Authors: Felice M De , Porreca F
Published: May 2009

Medication overuse headache (MOH) is a challenging, debilitating disorder that develops from the frequent use of medications taken for the treatment of migraine headache pain. MOH affects an estimated 3-5% of the general population. The mechanisms underlying the development of MOH remain unknown. Opiates are one of the major classes of medications used for the treatment of migraine at least in some countries, including the USA. Although the effects of repeated opiate use for headache are unknown, it is possible that opiate use may contribute to increased frequency and occurrence of such headaches. Recent preclinical studies exploring the neuroadaptive changes following sustained exposure to morphine may give some insights into possible causes of MOH. Peripherally, these changes include increased expression of calcitonin gene-related peptide (CGRP) in trigeminal primary afferent neurons. Centrally, they include increased excitatory neurotransmission at the level of the dorsal horn and nucleus caudalis. Critically, these neuroadaptive changes persist for long periods of time and the evoked release of CGRP is enhanced following morphine pretreatment. Stimuli known to elicit migraine, such as nitric oxide donors or stress, produce hyperalgesia in morphine- but not in saline-pretreated rats even long after the discontinuation of the opiate. CGRP plays a prominent role in initiating vasodilation of the intracranial blood vessels and subsequent headache. Furthermore, studies have demonstrated increased excitability of the nociceptive pathway in migraine sufferers, and CGRP receptor antagonists have been shown to be efficacious in migraine pain. Thus, such persistent neuroadaptive changes may be relevant to the processes that promote MOH.
Underdiagnosis and Undertreatment of Migraine in Italy: A Survey of Patients Attending for The First Time 10 Headache Centres
Authors: Cevoli S , D'Amico D , Martelletti P , Valguarnera F , Bene E Del , Simone R De , Sarchielli P , Narbone MC , Testa L , Genco S , Bussone G , Cortelli P
Published: May 2009

The aim of this study was to asses the clinical features, pattern of healthcare and drug utilization of migraine patients attending 10 Italian headache centres (HC). Migraine is underdiagnosed and undertreated everywhere throughout the world, despite its considerable burden. Migraine sufferers often deal with their problem alone using self-prescribing drugs, whereas triptans are used by a small proportion of patients. All patients attending for the first time 10 Italian HCs over a 3-month period were screened for migraine. Migraine patients underwent a structured direct interview about previous migraine diagnosis, comorbidity, headache treatments and their side-effects and healthcare utilization for migraine. Patient satisfaction with their usual therapy for the migraine attack was evaluated with the Migraine-Assessment of Current Therapy (ACT) questionnaire. The quality of life of migraine patients was assessed by mean of Short Form (SF)-12 and Migraine-Specific Quality of life (MSQ) version 2.1 questionnaires. Of the 2675 patients who attended HCs for the first time during the study period, 71% received a diagnosis of migraine and the first 953 subjects completed the study out of 1025 patients enrolled. Only 26.8% of migraine patients had a previous diagnosis of migraine; 62.4% of them visited their general practitioner (GP) in the last year, 38.2% saw a specialist for headache, 23% attended an Emergency Department and 4.5% were admitted to hospital for migraine; 82.8% of patients used non-specific drugs for migraine attacks, whereas 17.2% used triptans and only 4.8% used a preventive migraine medication. Triptans were used by 46.4% of patients with a previous diagnosis of migraine. About 80% of migraine patients took over-the-counter medications. The Migraine-ACT revealed that 60% of patients needed a change in their treatment of migraine attacks, 85% of whom took non-specific drugs. Both the MSQ version 2.1 and the SF-12 questionnaires indicated a poor quality of life of most patients. Migraine represents the prevalent headache diagnosis in Italian HCs. Migraine is still underdiagnosed in Italy and migraine patients receive a suboptimal medical approach in our country, despite the healthcare utilization of migraine subjects being noteworthy. A cooperative network involving GPs, neurologists and headache specialists is strongly desirable in order to improve long-term migraine management in Italy.
Therapy-resistant cluster headache in childhood: Case report and literature review
Authors: Antonaci F , Alfei E , Piazza F , De Cillis I , Balottin U
Published: May 2009

The mean age of onset of cluster headache (CH) is in the late third decade. Only few cases of childhood-onset (< 14 years) CH have been reported in the literature. We report the case of an 11-year-old boy who suffered from sudden attacks of shock-like, intense pain, localized in the right orbital region, with associated photophobia, phonophobia, conjunctival injection, lacrimation, nasal congestion, rhinorrhoea and psychomotor agitation. The episodes lasted 60–180 min, and the headache frequency was one to three per day. Physical and neurological examinations, magnetic resonance imaging and blood examinations were normal. The first bout lasted 8 months. Attacks were resistant to every symptomatic and partially to prophylactic treatment that has been tried. The second bout lasted approximately 2 months.
Delayed Migraine-Like Headache in Healthy Volunteers After a Combination of Acetazolamide and Glyceryl Trinitrate
Authors: Daugaard D , Thomsen LL , Iversen HK , Olesen J
Published: May 2009

Glyceryl trinitrate (GTN) is a pro-drug dissociating nitric oxide throughout the body. It dilates cephalic arteries without increasing cerebral blood flow (CBF). GTN induces headache in healthy volunteers and migraine attacks in migraineurs. Acetazolamide (Az) increases CBF but does not dilate cerebral arteries. The hypothesis tested here was that Az, by dilating cerebral arterioles but not arteries and thereby decreasing pulsatile stretching of the wall of the large arteries and their perivascular sensory nerves, would reduce or prevent the GTN-induced headache We tested this hypothesis in 14 healthy volunteers. In a randomized, double-blind, cross-over study, they were pretreated with Az or placebo followed on both study days by a GTN infusion of 0.5 μg kg-1 min-1 for 20 min. Headache was scored on a verbal rating scale and a headache diary was kept for 12 h. Mean blood velocity of the middle cerebral artery was measured (transcranial Doppler). Our hypothesis was disproved, as Az did not decrease GTN-induced headache. Unexpectedly but interestingly, GTN combined with Az induced more delayed headache than GTN alone. Furthermore, a migraine-like headache was observed in three volunteers, who did not develop migraine after GTN alone. The fact that a suitable pharmacological intervention may trigger migraine in individuals with no prior migraine may suggest that the ability to develop migraine without aura is a quantitative genetic trait.
Clinical outcomes from a randomised comparison of Microwave Endometrial Ablation with Thermal Balloon endometrial ablation for the treatment of heavy menstrual bleeding
Authors: Sambrook AM , Cooper KG , Campbell MK , Cook JA
Published: May 2009

Objective  To compare the clinical outcomes of microwave endometrial ablation and thermal balloon ablation for the treatment of heavy menstrual bleeding.

Design  A double blind randomised controlled trial.

Setting  A UK teaching hospital.

Population  Three hundred and twenty women requesting endometrial ablation.

Methods  Operative data collection and patient completed postal questionnaires were used to ascertain women’s satisfaction with outcome, acceptability of each procedure, changes in menstrual symptoms and health related quality of life and additional treatments received.

Main outcome measures  Primary outcomes were satisfaction and menstrual scores 1 year. Secondary outcomes were operative differences, acceptability of treatment and changes in health related quality of life.

Results  Both technologies achieved high levels of satisfaction (−1%, 95% CI (−11, 9)). Menstrual scores were also similar (4%, 95% CI (−7, 19)) Microwave had a significantly shorter operating time, reduced usage of antiemetics and opiate analgesia, increased discharge by 6 hours and fewer device failures.

Conclusions  Both treatments are acceptable to women, with high levels of satisfaction. Microwave is quicker to perform with faster hospital discharge.
Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review
Authors: Berghella V , Airoldi J , O’Neill AM , Einhorn K , Hoffman M
Published: May 2009

Background  Second trimester pregnancy induction with misoprostol in women with prior caesarean delivery is not well studied.

Objective  To estimate the risk of uterine rupture using misoprostol as an induction agent for pregnancy termination in the second trimester of pregnancy in women with prior caesarean delivery.

Search strategy  Cases of women with a history of prior caesarean delivery and subsequent misoprostol induction for pregnancy termination in the second trimester (16–28 weeks) were obtained from two main data sources. First, a retrospective chart analysis was performed at Thomas Jefferson University Hospital and Christiana Hospital between 1998 and 2004. Second, multiple Medline, Scopus and POPLINE literature searches were performed.

Selection criteria  Case series and cohort studies of women with one or more prior caesarean delivery (of any type), and with a subsequent pregnancy with induction of labour for pregnancy termination at 16–28 weeks using misoprostol as the initial primary agent were included. Case reports were analysed separately.

Data collection and analysis  Total cases were analysed by type and number of prior caesarean delivery, for the primary outcome of uterine rupture.

Main results  The incidence of uterine rupture associated with second trimester misoprostol termination was 0.4% (2/461) in women with one prior low transverse, 0% (0/46) in those with two prior low transverse and 50% (1/2) in those with a prior classical caesarean delivery. One of the cases of uterine rupture in a woman with a prior low transverse caesarean required transfusion. None of the total eight cases (including case reports) of uterine rupture was associated with hysterectomy.

Conclusions  Second trimester misoprostol termination appears safe among women with one prior low transverse caesarean birth, as it is associated with incidences of uterine rupture of 0.4% (95% confidence interval 0.08–1.67%), of hysterectomy of 0% and of transfusion of 0.2%. There are insufficient data on risk with more than one prior caesarean birth or with prior classical caesarean birth.
Antenatal ultrasound to predict postnatal renal function in congenital lower urinary tract obstruction: systematic review of test accuracy
Authors: Morris RK , Malin GL , Khan KS , Kilby MD
Published: May 2009

Background  Congenital urinary tract obstruction can lead to perinatal mortality and morbidity. Assessing antenatal ultrasound features may help identify fetuses likely to suffer complications.

Objective  To evaluate the accuracy of antenatal ultrasound in the prediction of postnatal renal function in cases of congenital lower urinary tract obstruction (LUTO).

Search strategy  We conducted electronic searches in MEDLINE, EMBASE, the Cochrane Library, MEDION, SIGLE, SCISEARCH Index of scientific and technical proceedings, National Research Register (database inception – 2008) and Medical Conferences register and searched reference lists.

Selection criteria  Two reviewers independently selected articles in which the accuracy of fetal ultrasound features were evaluated to predict postnatal renal function with no language restrictions.

Data collection and analysis  Data were extracted on study characteristics, quality and results to construct 2 × 2 tables. Likelihood ratios for positive (LR+) and negative (LR−) test results, sensitivity and specificity were generated for the different ultrasound parameters and reference standards.

Main results  Thirteen articles that met the selection criteria, including 215 women and 33 2 × 2 tables. Meta‐analysis was performed using clinically similar subgroups to minimise clinical heterogeneity. The ultrasound parameter that showed the best predictive value for postnatal renal function in survivors was renal cortical appearance, sensitivity 0.57 (95% CI 0.37–0.76) and specificity 0.84 (95% CI 0.71–0.94), area under the curve 0.78.

Conclusion  Measurement of amniotic fluid volume and the appearance of the renal cortex at diagnosis of LUTO show promising predictive accuracy for poor postnatal renal function.
Bifocals and Down’s syndrome: correction or treatment?
Authors: Al‐Bagdady Mohammad , Stewart Ruth E. , Watts Patrick , Murphy Paul J. , Woodhouse J. Margaret
Published: May 2009

Purpose:  Accommodation is reduced in approximately 75% of children with Down’s syndrome (DS). Bifocals have been shown to be beneficial and they are currently prescribed regularly. Clinical observations suggest the likelihood of improving accommodative ability after bifocal wear. The aim of the study is to evaluate the potential use of bifocals as a treatment for the reduced accommodation.

Methods:  Clinical records of 40 children from the Cardiff Down’s Syndrome Vision Research Unit, who were prescribed bifocals, were reviewed. Accommodation was noted before wearing the bifocals and during either their latest visit or when the children stopped using bifocals. Accommodation was reassessed during a follow up visit for the children who stopped wearing bifocals. Development of accommodation before bifocal commencement, age at bifocal prescription, gender, type of refractive error, visual acuity and the presence of strabismus were examined to evaluate their contribution to accommodation improvement.

Results:  The accommodative ability of 65% (n = 26) of the children improved (through the distance part of the lens) after using the bifocals. More than half of those developed accurate accommodation without the use of bifocals (n = 14). Accommodative responses did not show any improvement with age before the children began wearing bifocals. Accurate accommodation was sustained after returning to single vision lenses in all examined children. The age distribution of the children on bifocal commencement was diverse. Presence of strabismus, refractive error type, visual acuity and gender did not have any effect on gaining improvement.

Conclusions:  Bifocals are an effective correction for the reduced accommodation in children with DS and also act to improve accommodation with a success rate of 65%. Bifocal wear can therefore be temporary, i.e. a ‘treatment’ for the deficit, in at least one third of children.
Statins inhibit the growth of variant human embryonic stem cells and cancer cells in vitro but not normal human embryonic stem cells
Authors: Gauthaman K , Manasi N , Bongso A
Published: May 2009

Background and purpose:  Statins inhibit proliferation of various human cancer cell lines in vitro. As human embryonic stem cells (hESCs) possess neoplastic‐like properties we have evaluated the role of various statins on karyotypically normal hESCs (HES3 and BG01), abnormal hESCs (BG01V) and breast adenocarcinoma cells (MCF‐7) to evaluate whether the mode of action of the statins was via a stemness pathway.

Experimental approach:  All cell lines were treated with simvastatin, pravastatin, lovastatin and mevastatin (1 µmol·L−1 to 20 µmol·L−1) up to 7 days and their effects on cell proliferation, cell cycle, apoptosis and pluripotency studied.

Key results:  All four statins did not inhibit HES3 and BG01 proliferation, but BG01V and MCF‐7 were inhibited by simvastatin, lovastatin and mevastatin. These inhibitory effects were reversed by the endogenous isoprenoids, farnesylpyrophosphate and geranylgeranylpyrophosphate. Terminal deoxynucleotidyl transferase biotin‐dUTP nick end labelling and cell cycle assay confirmed apoptosis in BG01V and MCF‐7. Stem cell surface markers [stage‐specific embryonic antigen‐4, tumour rejection antigen‐1‐81, octamer‐4 (OCT‐4)] were expressed in HES3 and BG01, but not in BG01V cells, even after prolonged treatment with simvastatin. In BG01V and MCF‐7, the pro‐apoptotic Bcl‐2‐associated X protein genes were up‐regulated, while the antiapoptotic BCL2 and SURVIVIN genes were down‐regulated. Expression of the stemness‐related genes namely, the growth differentiation factor‐3, NANOG and OCT‐4 was decreased in BG01V compared with BG01 and HES3.

Conclusions and implications:  Normal hESCs were resistant to prolonged exposure to statins over a range of doses, compared with BG01V and MCF‐7, probably because of genetic and behavioural differences. The statins not only have anti‐cancer properties but can suppress abnormal hESCs thus promoting growth of normal hESCs in vitro.
Reactive oxygen species up‐regulate p53 and Puma; a possible mechanism for apoptosis during combined treatment with TRAIL and wogonin
Authors: Lee Dae‐Hee , Rhee Juong G , Lee Yong J
Published: May 2009

Background and purpose: Tumour necrosis factor‐related apoptosis‐inducing ligand (TRAIL) triggers apoptotic death in a variety of cancer cells without marked toxicity to most normal cells. We previously reported that wogonin, a potent anticancer agent from a Chinese herb, up‐regulates p53 in prostate cancer cells. In this study, the effects of combinations of TRAIL and wogonin on a human prostate cancer cell line LNCaP, resistant to TRAIL, was evaluated for evidence of synergy in triggering apoptosis.

Experimental approach: Western blot assay and the ‘comet’ assay were used to study the underlying mechanisms of cell death and search for any mechanisms of enhancement of TRAIL‐induced apoptosis in the presence of wogonin.

Key results: During combined treatment with wogonin and TRAIL, cytotoxicity, poly(ADP‐ribose) polymerase cleavage and caspase activation were associated with up‐regulation of p53 through DNA damage and reactive oxygen species (ROS) generation. N‐acetylcysteine (NAC), an antioxidant, inhibited ROS generation and synergistic interaction between TRAIL and wogonin. Experimental results in human colon cancer HCT116 cells demonstrated that p53‐dependent Puma up‐regulation played an important role; deficiency in either p53 or Puma prevented wogonin‐enhanced TRAIL‐induced apoptosis.

Conclusions and implications: The present studies suggest that wogonin enhances TRAIL‐induced cytotoxicity through up‐regulation of p53 and Puma, mediated by ROS.
30 000 years of productivity and salinity variations in the late Quaternary Cariaco Basin revealed by dinoflagellate cysts
Authors: MERTENS KENNETH NEIL , GONZÁLEZ CATALINA , DELUSINA IRINA , LOUWYE STEPHEN
Published: May 2009

Dinoflagellate cysts and other palynomorphs were studied from ODP Hole 1002C in the Cariaco Basin over the past 30 000 years. The assemblage shifts between a dominance of heterotrophic dinoflagellate cysts (mainly Brigantedinium spp., Lejeunecysta spp., Selenopemphix nephroides and Stelladinium reidii) and autotrophic dinoflagellate cysts (mainly Spiniferites ramosus, Lingulodinium machaerophorum and Operculodinium centrocarpum). These assemblage shifts are associated with stronger upwelling during stadials and stronger river influx during interstadials. Increases in productivity caused by enhanced upwelling are coupled to improved preservation and vice versa. More stratified water is indicated by higher abundances of L. machaerophorum and succeeds Heinrich events. The average process length of L. machaerophorum can be used to track changes in salinity, since this shows a similar pattern as the δ18OSW (paired Mg/Ca −δ18O) reconstruction. During the last glacial, conditions were more saline than during the current interglacial. On a millennial scale, changes in salinity are opposite to open ocean salinities and the hydrological proxies, which can be explained by a modulation of the signal by stratification, isolation of the Basin or advection of freshwater masses. These results highlight both generalities and particularities of the palaeoecological record of this tropical semi‐enclosed basin.
Red blood cell alloimmunization among sickle cell Kuwaiti Arab patients who received red blood cell transfusion
Authors: Ameen Reem , Al Shemmari Salem , Al‐Bashir Abdulaziz
Published: May 2009

BACKGROUND: Sickle cell disease (SCD) is common in the Arabian Gulf region. Most cases require a red blood cell (RBC) transfusion, increasing the potential for RBC alloantibody development. The incidence of RBC alloimmunization among Kuwaiti Arab SCD patients is not yet known. This study retrospectively assessed the effect of using two different matching protocols on the incidence of alloimmunization among multiply transfused Kuwaiti Arab SCD patients.

STUDY DESIGN AND METHODS: A total of 233 Kuwaiti Arab SCD patients were divided into two groups: Group 1 (n = 110) received RBC transfusion through standard ABO‐ and D‐matched nonleukoreduced blood; Group 2 (n = 123) received RBCs matched for ABO, Rh, and K1 poststorage‐leukoreduced blood. Multivariate analysis was performed on the factors associated with RBC alloimmunization and antibody specificity.

RESULTS: Sixty‐five percent of patients in Group 1 developed clinically significant RBC alloantibody with an increased prevalence in females; in patients in Group 2, 23.6% developed RBC alloantibodies (p = 0.01). In Group 1, 72 patients (65.5%) had alloantibodies directed against Rh and Kell systems (p = 0.01). Multivariate analysis further confirmed the results, showing that blood transfusion type and sex have significant effects on the rate of alloimmunizations.

CONCLUSION: This study confirms the importance of selecting RBCs matched for Rh and Kell to reduce the risk of alloimmunizations among Kuwaiti Arab SCD patients.
Higher infused CD34+ hematopoietic stem cell dose correlates with earlier lymphocyte recovery and better clinical outcome after autologous stem cell transplantation in non‐Hodgkin's lymphoma
Authors: Yoon Dok Hyun , Sohn Byeong Seok , Jang Geundoo , Kim Eun Kyoung , Kang Byung Woog , Kim Chul , Kim Jeong‐Eun , Kim Shin , Lee Dae Ho , Lee Jung‐Shin , Park Seo‐Jin , Park Chan‐Jeoung , Huh Jooryung , Suh Cheolwon
Published: May 2009

BACKGROUND: Lymphocyte recovery after autologous stem cell transplantation (ASCT) has been shown to be associated with positive clinical outcome in non‐Hodgkin's lymphoma (NHL). This study sought to identify variables that affect lymphocyte recovery and survival after ASCT.

STUDY DESIGN AND METHODS: A retrospective analysis of outcomes in 97 consecutive patients with NHL who underwent ASCT in a single center from August 1999 to January 2008 was conducted.

RESULTS: A significant relationship was not observed between infused lymphocyte count and days to recovery of absolute lymphocyte count 500 × 106/L or greater after ASCT (ALC500; r = 0.139, p = 0.176), but there was a significant inverse correlation between infused CD34+ cell count and days to ALC500 (r = −0.333, p = 0.001). Univariately, infused CD34+ cell count and recovery of ALC500 by 20th day after ASCT were significant predictors of survival. The median overall survival (OS) and event‐free survival (EFS) were significantly longer in patients who received 8.2 × 106 CD34+ cells/kg or more than in those who received fewer than 8.2 × 106 CD34+ cells/kg (OS, not reached vs. 11.6 months, p = 0.001; EFS, not reached vs. 4.8 months, p = 0.003). Multivariate analysis confirmed that infused CD34+ cell count was an independent prognostic factor for OS (p = 0.017) and EFS (p = 0.002).

CONCLUSION: These data suggest that infused CD34+ cell count is predictive of kinetics of lymphocyte recovery after ASCT and is an independent prognostic factor for OS and EFS after ASCT in patients with NHL.
Evaluation of low red blood cell mean corpuscular volume in an apheresis donor population
Authors: Bryant Barbara J. , Hopkins Julie A. , Arceo Sarah M. , Leitman Susan F.
Published: May 2009

BACKGROUND: Apheresis donors are routinely evaluated with a complete blood count (CBC). Low red blood cell mean corpuscular volume (MCV) values (<80 fL) in the presence of an acceptable hemoglobin (Hb; ≥12.5 g/dL) could be due to iron deficiency or hemoglobinopathy. The etiology of a low MCV in a healthy apheresis donor population was assessed.

METHODS: Predonation samples for CBC were obtained from 1162 consecutive apheresis donors. Donors with a MCV of less than 80 fL were evaluated by CBC, iron studies (ferritin, serum iron, transferrin, percentage of transferrin saturation), and hemoglobin (Hb) electrophoresis. Iron deficiency was defined as a ferritin value below the reference range. Beta chain Hb variants were determined by Hb electrophoresis. Alpha thalassemia trait was presumed if the red blood cell (RBC) count was elevated, no variant Hbs were detected, and the iron studies were within normal ranges.

RESULTS: In a 19‐month period, 33 of 1162 apheresis donors had low MCV values. Iron deficiency was present in 64%; 49% had isolated iron deficiency and 15% had iron deficiency plus hemoglobinopathy. Hemoglobinopathy without concomitant iron deficiency was found in the remaining 36%.

CONCLUSION: Iron deficiency is present in the majority of apheresis donors with repeatedly low MCV values and Hb levels of 12.5 g/dL or more. Hemoglobinopathy is also commonly present but may not be easily recognized in the setting of iron deficiency. The MCV is a useful screening tool to detect iron deficiency and hemoglobinopathy. Low MCV values should be investigated to determine if iron replacement therapy is indicated.
Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality?
Authors: Lelubre Christophe , Piagnerelli Michael , Vincent Jean‐Louis
Published: May 2009

BACKGROUND: The duration of red blood cell (RBC) storage before transfusion may alter RBC function and, therefore, influence the incidence of complications.

STUDY DESIGN AND METHODS: With a computerized literature search from 1983 to 2008, 27 studies reporting the relationship between age of transfused RBCs and physiologic variables or incidence of complications in adult patients were identified.

RESULTS: Three studies (one abstract only, two foreign language) were excluded. The 24 remaining studies were grouped according to the patient population: cardiac surgery (eight studies), colorectal surgery (three), intensive care unit (ICU; seven), and trauma (six). The studies were too heterogeneous to allow a formal meta‐analysis. Twenty‐one of the 24 studies were single‐center, and 12 were retrospective. The number of patients was highly variable, ranging from 15 to 6002. In cardiac surgery, two studies reported an increased risk of mortality but had statistical limitations. In colorectal surgery, two studies that addressed the effect on postoperative infections in the same database but with different designs yielded conflicting results. In general ICU patients, two retrospective studies reported a significant correlation between length of RBC storage and microcirculatory alterations or mortality, but the results were not confirmed in subsequent prospective, double‐blinded studies. In trauma, five studies reported a correlation between RBC age and development of infection, multiple organ dysfunction, or mortality.

CONCLUSIONS: From the currently available published data, it is difficult to determine whether there is a relationship between the age of transfused RBCs and outcome in adult patients, except possibly in trauma patients receiving massive transfusion.
Negotiating Community Engagement and Science in the Federal Environmental Public Health Sector
Authors: Little Peter C.
Published: May 2009

In this case study, I use ethnographic data to explore how community engagement and science are deployed at the U.S. Agency for Toxic Substances and Disease Registry, with the goal of formulating an understanding of the personalized meanings of science–community relations for key environmental public health experts. In focus is the cultural discourse circulating in the agency that exposes the real concerns, beliefs, and attitudes of these scientists and experts vis‐à‐vis their community engagement experiences. Finally, I propose that critical attention to the place of power relations, knowledge politics, and environmental justice are fundamental to studies of toxic contamination where commitments to community engagement and quality science are joined to form a positive research goal and where attempts are made to improve the conditions of quality environmental public health service.
On Becoming a Male Sex Worker in Mysore: Sexual Subjectivity, “Empowerment,” and Community‐Based HIV Prevention Research
Authors: Lorway Robert , Reza‐Paul Sushena , Pasha Akram
Published: May 2009

Growing public health attention has been placed on the HIV vulnerability of males who sell sex to males in India. However, there is little research that outlines the trajectories through which males come to be involved in practicing sex work in India. Locating “male sex work” within a vibrant social, political, and erotic landscape, this article explores the intertwining of “sexual subjectivity” and “sex work.” The authors refer to 70 sexual life histories generated from research conducted in Mysore to unsettle dominant public health notions that regard male sex work as rooted solely in poverty or as a decontexualized “behavioral risk factor.” Such perspectives are countered by demonstrating how male sex work in Mysore encompasses a complex interplay between self‐realization, sexual desire, social interaction, and public health discourse. Local conceptualizations of selfhood are discussed to suggest the limitations of prevailing empowerment discourses that advance Western notions of individuality.