bluuebunny/crossref_metadata_2025 huggingface dataset:
Profiling Planctomycetales diversity with reference to anammox‐related bacteria in a South China Sea, deep‐sea sediment
Authors: Shu Qinglong , Jiao Nianzhi
Published: September 2008

A systematic assessment of Planctomycetales diversity in a South China Sea, deep‐sea sediment (1657 m) was conducted using the 16S rRNA gene analysis approach. PCR amplification of the samples from seven sediment layers (0.1, 1, 3, 5, 7, 9 and 11 m below the surface sediment) using the primer set Pla‐46‐F/1392‐R showed that the Planctomycetales existed within a limited range of sediment depths (≤ 5 m), and had a decreasing trend in diversity with increasing depth. The majority of the retrieved Pla‐46‐F/1392‐R sequences belonged to Pirellula‐related Planctomycetales, and two sequences retrieved from the 0.1‐m layer (GenBank accession numbers: DQ996944 and DQ996945) shared the same anammox‐related signature oligonucleotides and were closely related to commonly recognized anammox organisms. To identify new anammox‐related biomarkers, three primer sets were designed for amplifying the fragments of hydroxylamine oxidoreductase and S‐adenosylmethionine radical enzyme genes, but no related sequences were found. Our multiple 16S rRNA gene primer sets (Journal of Rapid Methods and Automation in Microbiology, 2008, in press) revealed even an higher diversity of Planctomycetales in the 0.1‐m layer of the sediment, especially at genus level. Our data profiled the distribution pattern of Planctomycetales diversity along sediment depths, and provided molecular evidence for the existence of anammox‐related bacteria in a new location, which broadens our understanding of Planctomycetales diversity in deep sea sediments.
Improvement on parenchymal suturing technique in laparoscopic partial nephrectomy
Authors: Makiyama Kazuhide , Nakaigawa Noboru , Miyoshi Yasuhide , Murakami Takayuki , Yao Masahiro , Kubota Yoshinobu
Published: September 2008

Abstract:  This report aims to describe a new parenchymal continuous suturing technique for laparoscopic partial nephrectomy. In this new technique, the thread is not tightened or cinched until all stitches are completed. At the final step of the running suture, each thread is tightened and fixed by using Hem‐o‐lok clips. We performed laparoscopic partial nephrectomy with this procedure on eight patients between January and October 2007. The mean ischemic time was 35 min (range: 28–44 min). The mean time of parenchymal suturing was 9.9 min (range: 7–11 min). This procedure allowed us a clear vision during the suturing.
Favorable response to combination treatment of cimetidine, cyclooxygenase‐2 inhibitor and renin‐angiotensin system inhibitor in metastatic renal cell carcinoma: Report of three cases
Authors: Tatokoro Manabu , Fujii Yasuhisa , Kawakami Satoru , Fukui Naotaka , Komai Yoshinobu , Saito Kazutaka , Koga Fumitaka , Morimoto Shinji , Fukui Iwao , Kihara Kazunori
Published: September 2008

Abstract:  We report three cases of metastatic renal cell carcinoma (RCC) in which combination treatment of cimetidine, cyclooxygenase‐2 inhibitor and renin‐angiotensin system inhibitor (angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor antagonist) (CCA therapy) was effective. Case 1: A 47‐year‐old man who had a 12‐cm right renal tumor with multiple pulmonary and hepatic metastases refused cytokine therapy for economic reasons and received CCA therapy. All of the metastases showed partial remission, which continued for 12 months. Case 2: A 62‐year‐old man with multiple pulmonary and mediastinal lymph node metastases from clear cell RCC refractory to interferon‐α and interleukin‐2 started CCA therapy. Partial remission has been maintained for 16 months. Case 3: A 64‐year‐old man with pulmonary metastases from clear cell RCC discontinued interferon‐α treatment due to its side effects after six months and received CCA therapy. Pulmonary metastases showed partial remission for 31 months. The CCA therapy could be an alternative treatment for metastatic RCC patients unfit for cytokine therapy.
Profiling police presentations of mental health consumers to an emergency department
Authors: Lee Soung , Brunero Scott , Fairbrother Greg , Cowan Darrin
Published: September 2008

ABSTRACT:  Public mental health systems have been called on to better meet the needs of consumers presenting to health services with the police, yet few studies have examined police presentations among mental health consumers in large public mental health systems. This study was designed to determine the frequency profile and characteristics of consumers of mental health services brought in by police to an emergency department (ED) in Sydney, Australia. Using data from the emergency department information system and obtaining the psychiatric assessment from the medical record, we have examined trends and characteristics in mental health presentations brought in by the police to a general ED between 2003 and 2005. The sample consisted of 542 consumers with a mental health problem brought in by the police to the ED of a 350‐bed community hospital. The characteristics of this group were compared with those of all mental health related ED presentations for the same period using logistic regression. Results indicated that police presentations are likely to be young males who are unemployed, have past and present alcohol and other drugs use, present after hours, and are admitted to hospital as a result of their presentation. These consumers are likely to have a presenting problem of a psychotic disorder, less likely to have a presenting problem of depression and/or anxiety, and given a triage code of three or higher.

The study results highlight the importance of the availability of 24‐hour access to mental health care to ensure a quick care delivery response. Police presentations to EDs with mental health issues are an indicator of significant impact on health services, especially with the current overcrowding of EDs and the associated long waiting times. Systems need to be developed that facilitate collaboration between EDs, hospital security, police services, mental health, and ambulance services.
Crisis engagement in mental health: A New Zealand Māori contribution
Authors: Drury Nick , Munro Te Ata
Published: September 2008

ABSTRACT: The active engagement of clients in mental health services offers far greater chances of successful outcomes. When clients do not actively engage in treatment, their risk of becoming part of the population of ‘high users’ is greater. The ‘high users’ consume a disproportionate share of health resources, which may prevent other potential clients from accessing services. Engagement can be particularly challenging in crisis situations, which is how many clients attracting psychotic diagnoses first enter the service. New Zealand Māori bring a transcendent quality to the idea of ‘respect for Other’, which would make it sacrilegious to overpower Other in most situations. This paper reviews a growing body of literature indicating how we might integrate an enhanced respect or reverence of Other into clinical practice. This includes the idea of engaging more frequently with the social network when building rapport with an individual is particularly challenging. There is some evidence that services adopting this kind of approach are more economical.
The importance of clinical experience for mental health nursing – Part 1: Undergraduate nursing students’ attitudes, preparedness and satisfaction
Authors: Happell Brenda
Published: September 2008

ABSTRACT: Government inquiries and workforce data continue to draw attention to the current and impending crisis in mental health nursing. While undergraduate nursing education has been found at least partially responsible for the negative attitudes nursing students tend to hold towards mental health nursing, clinical experience has been identified as a potential strategy in enhancing more positive attitudes. However, research to date has not focused on the impact of clinical experience on specific factors such as attitudes to mental health nursing to people experiencing mental illness and perceived preparedness for the mental health field. This quasi‐experimental study measured changes in students’ attitudes to the three factors, including satisfaction with clinical experience following a placement in mental health nursing. A questionnaire was administered to undergraduate nursing students on the first and last day of a mental health clinical placement. This, the first of a two‐part paper, compares student responses over the two‐time periods and describes satisfaction with the clinical experience. The findings suggest that clinical experience in mental health nursing experience can positively influence attitudes, preparedness for practice, and the popularity of mental health nursing. Satisfaction with clinical experience was also high.
The importance of clinical experience for mental health nursing – Part 2: Relationships between undergraduate nursing students’ attitudes, preparedness, and satisfaction
Authors: Happell Brenda
Published: September 2008

ABSTRACT: Clinical experience is consistently emphasized in research findings as the primary influence in encouraging more positive attitudes to mental health nursing. The available research, however, presents two major limitations. First, it does not measure the specific factors that might contribute to a positive clinical experience. Second, it does not consider the relationship between clinical experience and attitudes towards people experiencing a mental illness or towards mental health nursing. This is the second of a two‐part paper presenting findings from a statewide survey of undergraduate nursing students in Victoria. A pre‐/post‐test design was used to measure the impact of clinical experience on the following subscales: (i) attitudes towards people experiencing a mental illness; (ii) attitudes toward mental health nursing; and (iii) preparedness for mental health practice. Subscale (iv) satisfaction with clinical experience was also measured in the post‐test phase. The findings demonstrated an improvement on all three subscales in the post‐test phase and a high level of satisfaction with clinical experience. Furthermore, a relationship between all four subscales was evident.
Let's get physical
Authors: Wand Timothy , Murray Linda
Published: September 2008

ABSTRACT:  There is growing recognition and understanding of the inextricable interrelationship between physical and mental health. In mental health care, the physical health of consumers is now acknowledged as a serious problem requiring urgent action. This issue is undoubtedly related to negative symptoms and the lifestyle of people with mental illness. Much of the burden is also clearly linked with the detrimental side effects of psychotropic medications and deficits in the knowledge, skill, and confidence of mental health clinicians in relation to physical health matters. This paper highlights the problem of physical health in mental health care and presents recommendations to address this issue. The benefits of exercise on mental health in particular are explored. The authors argue that mental health nurses must play an active role in health promotion, primary prevention, and the early detection and management of physical health problems in all areas of clinical practice.
Absconding: A review of the literature 1996–2008
Authors: Muir‐Cochrane Eimear , Mosel Krista A.
Published: September 2008

ABSTRACT:  Absconding is a significant problem with potential for harm to patients or the general public. The consequences of absconding include physical harm, prolonged treatment time, and substantial economic costs. The aim of this systematic literature review is to synthesize quality literature about absconding from psychiatric facilities, identify gaps in knowledge, and make recommendations for practice. An electronic search yielded 39 journal articles that met the review criteria. Findings demonstrate that a single definition of absconding remains elusive, making the prevalence of absconding difficult to establish. Absconding events are multifactorial, with environmental, psychosocial, and organic aspects. Negative consequences exist including violence, aggression, and self‐neglect and harm to self and others. Papers are clustered around the following themes: harm and risk, absconder profiles, absconding rates, and perceptions of nurses and patients. Nursing interventions designed to decrease absconding have been implemented with success, but only in a few studies and in Australia, none have been reported in the literature to date. Further research is required to identify appropriate nursing‐based interventions that may prove useful in reducing the risk of absconding.
Shifts in microbial and chemical patterns within the marine sponge Aplysina aerophoba during a disease outbreak
Authors: Webster Nicole S. , Xavier Joana R. , Freckelton Marnie , Motti Cherie A. , Cobb Rose
Published: September 2008

The microbial community composition in affected and unaffected portions of diseased sponges and healthy control sponges of Aplysina aerophoba was assessed to ascertain the role of microbes in the disease process. Sponge secondary metabolites were also examined to assess chemical shifts in response to infection. The microbial profile and aplysinimine levels in unaffected tissue near the lesions closely reflected those of healthy sponge tissue, indicating a highly localized disease process. DGGE detected multiple sequences that were exclusively present in diseased sponges. Most notably, a Deltaproteobacteria sequence with high homology to a coral black band disease strain was detected in all sponge lesions and was absent from all healthy and unaffected regions of diseased sponges. Other potential pathogens identified by DGGE include an environmental Cytophaga strain and a novel Epsilonproteobacteria strain with no known close relatives. The disease process also caused a major shift in prokaryote community structure at a very high taxonomic level. Using 16S rRNA gene sequence analysis, only the diseased sponges were found to contain sequences belonging to the Epsilonproteobacteria and Firmicutes, and there was a much greater number of Bacteroidetes sequences within the diseased sponges. In contrast, only the healthy sponges contained sequences corresponding to the cyanobacteria and ‘OP1’ candidate division, and the healthy sponges were dominated by Chloroflexi and Gammaproteobacteria sequences. Overall bacterial diversity was found to be considerably higher in diseased sponges than in healthy sponges. These results provide a platform for future cultivation‐based experiments to isolate the putative pathogens from A. aerophoba and perform re‐infection trials to define the disease aetiology.
Effect of sulfate on methanogenic communities that degrade unsaturated and saturated long‐chain fatty acids (LCFA)
Authors: Sousa Diana Z. , Alves Joana I. , Alves M. Madalena , Smidt Hauke , Stams Alfons J. M.
Published: September 2008

Anaerobic bacteria involved in the degradation of long‐chain fatty acids (LCFA), in the presence of sulfate as electron acceptor, were studied by combined cultivation‐dependent and molecular techniques. The bacterial diversity in four mesophilic sulfate‐reducing enrichment cultures, growing on oleate (C18:1, unsaturated LCFA) or palmitate (C16:0, saturated LCFA), was studied by denaturing gradient gel electrophoresis (DGGE) profiling of polymerase chain reaction (PCR)‐amplified 16S rRNA gene fragments. These enrichment cultures were started using methanogenic inocula in order to assess the competition between methanogenic communities and sulfate‐reducing bacteria. Phylogenetic affiliation of rRNA gene sequences corresponding to predominant DGGE bands demonstrated that members of the Syntrophomonadaceae, together with sulfate reducers mainly belonging to the Desulfovibrionales and Syntrophobacteraceae groups, were present in the sulfate‐reducing enrichment cultures. Subculturing of LCFA‐degrading methanogenic cultures in the presence of sulfate resulted in the inhibition of methanogenesis and, after several transfers, archaea could no longer be detected by real‐time PCR. Competition for hydrogen and acetate was therefore won by sulfate reducers, but acetogenic syntrophic bacteria were the only known LCFA‐degrading organisms present after subculturing with sulfate. Principal component analysis of the DGGE profiles from methanogenic and sulfate‐reducing oleate‐ and palmitate‐enrichment cultures showed a greater influence of the substrate than the presence or absence of sulfate, indicating that the bacterial communities degrading LCFA in the absence/presence of sulfate are rather stable.
Biodegradation of 2,4,6‐TCA by the white‐rot fungusPhlebia radiatais initiated by a phase I (O‐demethylation)–phase II (O‐conjugation) reactions system: implications for the chlorine cycle
Authors: Campoy Sonia , Álvarez‐Rodríguez María Luisa , Recio Eliseo , Rumbero Angel , Coque Juan‐José R.
Published: September 2008

Thirteen species of white‐rot fungi tested have been shown to efficiently biodegrade 1 mM 2,4,6‐trichloroanisole (2,4,6‐TCA) in liquid cultures. The maximum biodegradation rate (94.5% in 10‐day incubations) was exhibited by aPhlebia radiatastrain. The enzymes of the ligninolytic complex, laccase, lignin peroxidase (LiP), manganese peroxidase (MnP) and versatile peroxidase (VP) were not able to transform 2,4,6‐TCA inin vitroreactions, indicating that the ligninolytic complex was not involved in the initial attack to 2,4,6‐TCA. Instead, the first biodegradative steps were carried out by a phase I and phase II reactions system. Phase I reaction consisted on a O‐demethylation catalysed by a microsomal cytochrome P‐450 monooxygenase to produce 2,4,6‐trichlorophenol (2,4,6‐TCP). Later, in a phase II reaction catalysed by a microsomal UDP‐glucosyltransferase, 2,4,6‐TCP was detoxified by O‐conjugation withd‐glucose to produce 2,4,6‐TCP‐1‐O‐d‐glucoside (TCPG). This compound accumulated in culture supernatants, reaching its maximum concentration between 48 and 72 h of growth. TCPG levels decreased constantly by the end of fermentation, indicating that it was subsequently metabolized. A catalase activity was able to breakin vitrothe glycosidic link to produce 2,4,6‐TCP, whereas ligninolytic enzymes did not have a significant effect on the biotransformation of that compound. Once formed, 2,4,6‐TCP was further degraded as detected by a concomitant release of 2.6 mol of chloride ions by 1 mol of initial 2,4,6‐TCA, indicating that this compound underwent almost a complete dehalogenation and biodegradation. It was concluded thatP. radiatacombines two different degradative mechanisms in order to biodegrade 2,4,6‐TCA. The significance of the capability of white‐rot fungi to O‐demethylate chloroanisoles for the global chlorine cycle is discussed.
The ‘Stage, Size, Grade and Necrosis’ score is more accurate than the University of California Los Angeles Integrated Staging System for predicting cancer‐specific survival in patients with clear cell renal cell carcinoma
Authors: Ficarra Vincenzo , Novara Giacomo , Galfano Antonio , Brunelli Matteo , Cavalleri Stefano , Martignoni Guido , Artibani Walter
Published: September 2008

OBJECTIVE

To compare the prognostic accuracy of the two most used integrated staging systems to predict the outcome of patients with clear cell renal cell carcinoma (RCC).

PATIENTS AND METHODS

We retrospectively evaluated the clinical and pathological data of 388 patients surgically treated for clear cell RCC between 1986 and 2000. The pathological slides of all specimens were reviewed by a pathologist unaware of patient outcome. All patients were classified according to the ‘Stage, Size, Grade and Necrosis’ (SSIGN) score and University of California Los Angeles Integrated Staging System (UISS) model, and the predictive accuracy of the two models was evaluated using receiver operating characteristics (ROC) curves.

RESULTS

The median follow‐up was 56 months; the 10‐year cancer‐specific survival (CSS) probabilities according to the SSIGN score were 96% in the ‘0–2’ category, 78% in the ‘3–4’, 43% in the ‘5–6’, 25.8% in the ‘7–9’ and 0% in the ‘≥10’ group (P < 0.001). According to the UISS, in nonmetastatic patients the 10‐year CSS probabilities were 100% in low, 73% in intermediate and 62% in high‐risk groups; in metastatic patients the respective CSS probabilities were 37%, 33% and 12.5% (P < 0.001). The area under the ROC curve (AUC) was 0.870 for the SSIGN score and 0.832 for the UISS. Including only nonmetastatic patients in the analysis, the AUC was 0.830 for the SSIGN score and 0.760 for the UISS model.

CONCLUSION

Our study shows for the first time that the SSIGN score offers a better stratification of clear cell RCC than the UISS model. These data should be considered in the design of future randomized controlled trials.
Transitional cell carcinomas of the renal pelvis and the ureter: comparative demographic characteristics, pathological grade and stage and 5‐year survival in a Taiwanese population
Authors: Tan Lia‐Beng , Chang Lin‐Li , Cheng Kuang‐I. , Huang Chun‐Hsiung , Kwan Aij‐Lie
Published: September 2008

OBJECTIVE

To compare the predictive value for 5‐year survival of demographic characteristics, pathological grade and stage between upper tract urothelial carcinoma (UTUC) of the renal pelvis (RPUC) and ureter (UUC) in a Taiwanese population.

PATIENTS AND METHODS

In this study (1986–98) we analysed 141 patients with UTUC, including 71 with RPUC and 70 with UUC (median age 59 years; median follow‐up 54 months, sd 2.5). Prognostic indicators were examined by univariate and multivariate logistic regression analyses.

RESULTS

A significant percentage of patients had tumour on the right side and a high proportion of those with UUC were women. Gross haematuria and hypertension were the most common symptoms of RPUC. The sensitivity of intravenous pyelography in diagnosing RPUC and UUC was 49% (34/69) and 36% (25/70), respectively. However, in patients assessed by retrograde pyelography the diagnostic sensitivity was 85% (60/71) for RPUC and 89% (55/62) for UUC. The incidence of tumour recurrence after nephroureterectomy with bladder cuff excision was significantly higher in those with UUC (13%) than RPUC (3.6%). Distant metastasis was detected in 37 of 141 (26%) patients, the most common sites being bone (46%), lung (22%), liver (14%) and colon (8%). Univariate logistic regression analysis showed significant differences in the prognosis for high‐grade and high‐stage tumours. The prognosis was particularly poor in patients aged >60 years. According to the multivariate logistic regression analysis, tumour stage and grade were the best outcome predictors for RPUC, but stage and age were the best outcome predictors for UUC.

CONCLUSION

UUC is more common in women and has a more aggressive clinical outcome than RPUC after nephroureterectomy with bladder cuff incision. Tumour stage and grade are the best predictors of survival in patients with RPUC. Also, in patients with UUC the prognosis is poor in older patients and those with advanced stages of cancer.
Urolithiasis in the horseshoe kidney: a single‐centre experience
Authors: Symons Stephanie J. , Ramachandran Anil , Kurien Abraham , Baiysha Ramen , Desai Mahesh R.
Published: September 2008

OBJECTIVE

To report the operative management and subsequent stone‐free rates of patients with urolithiasis in a horseshoe kidney and treated at one centre.

PATIENTS AND METHODS

We retrospectively reviewed all patients presenting to our centre with a horseshoe kidney and urolithiasis over a 15‐year period. The stone burden, surgical management, complications and stone clearance rates were recorded.

RESULTS

In all, 55 patients with urolithiasis in horseshoe kidney were treated. Percutaneous nephrolithotomy (PCNL) was used in 60 renal units in 47 patients. Five patients had extracorporeal shock wave lithotripsy (ESWL), two had flexible ureteroscopy and one had a laparoscopic pyelolithotomy for a stone extending into the isthmus. PCNL was used for large stones (mean digitized surface area = 614.32 mm2) and required one to four stages to achieve an overall stone clearance rate of 88%. Stones were cleared at one sitting in 77% of PCNL procedures, completely cleared in two‐thirds of patients treated by ESWL, and in both who had flexible ureteroscopy and the one treated with laparoscopic pyelolithotomy. Complications were minimal, with 15% minor and 3% major complications in the PCNL group only.

CONCLUSION

Appropriate management of urolithiasis within the horseshoe kidney depends not only on stone burden, but also on stone location, calyceal configuration and malrotation. Stones can be cleared successfully in almost all patients providing that all techniques are available to the operating surgeon.
A canine model of irreversible urethral sphincter insufficiency
Authors: Eberli Daniel , Andersson Karl‐Erik , Yoo James J. , Atala Anthony
Published: September 2008

OBJECTIVE

To develop a canine model of external urinary sphincter insufficiency by creating irreversible damage to the sphincter, because there is a need for a reliable and reproducible large animal model for the study of stress urinary incontinence (SUI) caused by deficient sphincter function.

MATERIALS AND METHODS

About a quarter of the total external sphincter muscle was removed microsurgically from seven female dogs; three age‐matched dogs served as normal controls. The dogs had standard urodynamic and radiographic studies before and at 1, 2, 3, 4 and 7 months after surgery. Three dogs were killed at 4 months and four at 7 months after surgery for tissue analyses.

RESULTS

The interventions produced a consistent outcome. Urodynamic studies showed a significant and sustained decrease in sphincter function, which included a static urethral pressure profile, stress urethral profile and detrusor leak‐point pressure. Furthermore, in vivo pudendal nerve stimulation and organ‐bath studies of the retrieved tissue strips confirmed the loss of sphincter tissue function. Histologically, absence of functional sphincter muscle was evident in the damaged sphincter region.

CONCLUSIONS

These results show that a reliable and reproducible canine model of irreversible sphincter insufficiency can be created by microsurgical removal of sphincter muscle tissue. This model of external sphincter insufficiency could be used for evaluating methods (e.g. cell therapies) for treating SUI.
The single insult of hypoxic preconditioning induces an antiapoptotic response in human proximal tubular cells, in vitro, across cold storage
Authors: Daly Pádraig J. , Docherty Neil G. , Healy Declan A. , McGuire Barry B. , Fitzpatrick John M. , Watson R. William G.
Published: September 2008

OBJECTIVE

To examine whether hypoxia (one of the many components of ischaemic preconditioning) can induce a protective response in culture renal tubular cells, and thus determine if non‐lethal periods of hypoxia could confer protection against apoptotic injury to human proximal tubular cells during cold storage and subsequent cytotoxic insult, and establish the cellular mechanisms by which this protection is induced.

MATERIALS AND METHODS

Human proximal tubular cells (HK‐2) were pre‐incubated for 24 h in normoxic or hypoxic conditions and then incubated at 4 °C for 6 h to mimic cold storage, before being returned to normal conditions and exposed to varying concentrations of cyclosporine A (CSA). Cell viability and apoptosis were measured using propidium iodide staining and flow cytometry. The expression of heat‐shock protein (HSP)‐70 was determined by Western blotting.

RESULTS

Hypoxia had no effect on cell viability or apoptosis. Pre‐exposure of cells to hypoxia significantly protected against CSA‐induced damage even after a period of cold storage. Western blotting analysis showed that hypoxia up‐regulated the anti‐apoptotic protein HSP‐70. HK‐2 cells over‐expressing HSP‐70 mimicked hypoxia preconditioning, in that they were protected during cold storage and CSA‐induced apoptosis.

CONCLUSION

Exposure of renal tubular cells to a sequential model of cold storage, reperfusion and incubation with CSA resulted in apoptotic cell death. Preconditioning these cells with hypoxia induced a protective response and up‐regulation of the anti‐apoptotic protein HSP‐70. There was a similar response in non‐preconditioned cells over‐expressing HSP‐70. Further understanding of the cellular changes occurring during this period of preconditioning will allow the development of more targeted, clinically relevant methods of preconditioning in renal transplantation.
A phase II study of high‐dose calcitriol combined with mitoxantrone and prednisone for androgen‐independent prostate cancer
Authors: Chan Joseph S. , Beer Tomasz M. , Quinn David I. , Pinski Jacek K. , Garzotto Mark , Sokoloff Mitchell , Dehaze Daniel R. , Ryan Christopher W.
Published: September 2008

OBJECTIVE

To evaluate the preliminary efficacy, safety, and impact on quality of life (QoL) of high‐dose calcitriol (DN‐101) combined with mitoxantrone and glucocorticoids in androgen‐independent prostate cancer (AIPC).

PATIENTS AND METHODS

Nineteen patients with metastatic AIPC and no previous chemotherapy received DN‐101 180 µg orally on day 1 and mitoxantrone 12 mg/m2 intravenously on day 2 every 21 days with continuous daily prednisone 10 mg orally for a maximum of 12 cycles. A confirmed decline in prostate‐specific antigen (PSA) levels by half was the primary endpoint. QoL was evaluated using the European Organization for Research and Treatment of Cancer QLQ‐C30 questionnaire, and pain and analgesic use were evaluated.

RESULTS

Five of 19 patients (26%; 95% confidence interval, CI, 9–51) achieved a ≥50% decline in PSA level. The median (95% CI) time to PSA progression was 16 (6–26) weeks. The overall median (95% CI) survival was 16 (6–26) months; 47 (21–73)% of patients achieved an analgesic response. Toxicity was similar to that expected with mitoxantrone and prednisone alone. The QoL analysis suggested a decrease in physical functioning and increase in fatigue, insomnia, and diarrhoea.

CONCLUSIONS

DN‐101 given every 3 weeks does not add significant activity to mitoxantrone and prednisone in AIPC, as measured by the PSA decline. The high rate of analgesic response is encouraging. The addition of DN‐101 does not appear to increase the toxicity of mitoxantrone.
Stereological and biochemical analysis of muscular and connective tissue components in the penile corpus cavernosum adjacent to the fibrous plaque of Peyronie’s disease
Authors: Costa Waldemar S. , Rebello Sabrina B. , Cardoso Luiz E.M. , Cavalcanti Andre G. , Sampaio Francisco J.B.
Published: September 2008

OBJECTIVE

To investigate the structural organization of the connective tissue in the corpus cavernosum (CC) adjacent to the fibrous plaque in Peyronie’s disease (PD) using stereological and biochemical techniques, as most studies on PD have focused on the analysis of the fibrous plaque that forms in the tunica albuginea (TA). Because this fibrotic reaction is mediated by various inflammatory soluble factors, adjacent connective tissues might also be affected and this secondary effect might explain, for example, the erectile dysfunction that occurs in PD.

PATIENTS AND METHODS

During surgery biopsies were taken from the CC adjacent to the fibrous plaque and from the plaque itself in seven patients with PD (mean age 48.3 years). All the patients had normal erections. Control samples were similarly located samples from ‘normal’ penises obtained during autopsy of five men (mean age 52.3 years). Tissue samples were stained with Weigert’s stain (elastic fibres), Van Gieson’s stain (connective tissue), and Sirius red (collagen). Stereological analysis was done using a 42‐point grid to determine volumetric densities (Vv). Total collagen content was estimated as micrograms of hydroxyproline per milligram dry CC.

RESULTS

The Vv of elastic fibres was significantly reduced in PD by 17.3% compared with controls, at a mean (sd) of 19.49 (3.27)% vs 23.56 (1.87)% (P < 0.05). While in PD the Vv of smooth muscle at 34.46 (2.06)% and connective tissue at 35.39 (6.15)% were not significantly different from those of controls at 38.38 (3.17)% and 38.02 (5.03)%, respectively. The Vv of elastic fibres in the fibrous plaque was decreased by 38.3% compared with the normal TA, at 20.25 (5.49)% vs 32.81 (4.75)% (P < 0.02). The mean (sd) collagen concentration in the CC from controls was 77.94 (24.26) µg/mg and in the patients with PD was 66.57 (19.39) µg/mg, which did not differ significantly. Sirius red‐stained sections under polarized light showed that, in the normal CC, collagen‐associated colours were homogeneously distributed. However, in the PD samples, stained collagen had a disrupted orientation and had a more heterogeneous birefringence, implying looser collagen bundles.

CONCLUSIONS

The quantitative analyses indicated that collagen in the CC close to the fibrous plaque was not affected, although its organization was noticeably altered. The CC elastic fibres were reduced though, and there was a similar change in the fibrous plaque of the TA. These results suggest that, although occurring primarily in the TA, the PD fibrous plaque may induce changes in the adjacent CC.
Intermediate‐term results, up to 4 years, of a bone‐anchored male perineal sling for treating male stress urinary incontinence after prostate surgery
Authors: Guimarães Miguel , Oliveira Rui , Pinto Rui , Soares Alfredo , Maia Eurico , Botelho Francisco , Sousa Teixeira , Pina Francisco , Dinis Paulo , Cruz Francisco
Published: September 2008

OBJECTIVE

To examine the intermediate‐term outcome (up to 4 years) of a bone‐anchored perineal sling (InVanceTM, American Medical Systems, Minnetonka, MN, USA) in men with stress urinary incontinence (SUI) after prostate surgery.

PATIENTS AND METHODS

In all, 62 men with SUI were implanted with the InVance sling. SUI was diagnosed after radical prostatectomy in 58 patients and after benign prostatic hyperplasia (BPH) prostatectomy in four patients. Implantation of the InVance bone‐anchored bulbourethral sling was conducted primarily under spinal anaesthesia. Patients were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured.

RESULTS

In all, 40 patients (65%) were cured and 14 (23%) were improved after a mean follow‐up of 28 months. The UI cure rates at 3 and 4 years follow‐up were 70% and 66%, respectively. The most common side‐effect was transient scrotal or perineal pain or numbness, which affected 12 patients (19%). There was a prolonged postvoid residual urine volume of >100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization. Explantation of the sling was required in two cases (3%) because of infection. In one patient (2%), revision was required for bone‐anchor dislodgement.

CONCLUSION

The InVance sling offers good intermediate‐term cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms (≤5 pads per day) of SUI.
Short‐ and long‐term complications of open radical prostatectomy according to the Clavien classification system
Authors: Constantinides Constantinos A. , Tyritzis Stavros I. , Skolarikos Andreas , Liatsikos Evangelos , Zervas Anastasios , Deliveliotis Charalambos
Published: September 2008

OBJECTIVE

To assess the use of the Clavien classification system in documenting the complications related to open retropubic radical prostatectomy (RRP).

PATIENTS AND METHODS

The medical records of 995 patients, who had open RRP during a period of 7 years, were reviewed retrospectively. Short‐ and long‐term complications were classified according to the recently revised Clavien classification system. We also compared the results with a recently reported series of laparoscopic and robotic RRP.

RESULTS

The overall complication rate was 26.9%; Grade I, Id, II, IIIa, IIIb and V complications were recorded in 3.4%, 3.9%, 12.8%, 2.6%, 3.8% and 0.3% of cases, respectively. Rectal injuries (10) and postoperative wound infections (24) were included in the Grade I category. Anastomotic leakage was recorded in 39 patients and rated as Grade Id. Grade II included cases of deep vein thrombosis (11), urinary tract infections (42), lymphorrhoeas (22) and haemorrhage requiring transfusion (53). Anastomotic strictures (26) and incisional hernias (38) were included in Grade IIIa and IIIb, respectively. Pulmonary embolism was fatal for three patients (0.3%) of Grade IV and V.

CONCLUSIONS

To avoid incoherence in reporting morbidity data, a reproducible and practical classification system is necessary. The Clavien system could provide, after refinement and validation, a common language among urologists.
Matrix attachment region elements have small and variable effects on transgene expression and stability in field‐grown Populus
Authors: Li Jingyi , Brunner Amy M. , Meilan Richard , Strauss Steven H.
Published: September 2008

Matrix attachment regions (MARs) are thought to buffer transgenes from the influence of surrounding chromosomal sequences, and therefore to reduce transgene silencing and variation in expression. The statistical properties of more than 400 independent transgenic events produced in Populus, with and without flanking MAR elements from the tobacco root gene RB7, were analysed. The expression of two reporter genes in two poplar clones during three phases of vegetative growth, and the association of T‐DNA characteristics with expression, was examined. It was found that MARs did not show a consistent effect on transgene expression levels; they had no effect on the green fluorescent protein (GFP) reporter gene, but reduced expression in the Basta resistance (BAR) reporter gene by 23%. The presence of MARs reduced expression variability within transformant populations, apparently by reducing the number of silenced or weakly expressing events. Transgene expression was highly stable over vegetative growth cycles that spanned 3 years of growth in the glasshouse and field, but MARs showed no association with the strength of correlations in expression over the years. Nonetheless, MARs increased the correlation in expression between a p35S::GFP and prbcS::BAR transgene linked on the same vector, but the effect was small and varied between the years. The presence of MARs had no effect on the transgene copy number, but was positively associated with T‐DNA truncations, as well as with the formation of direct over inverted repeats at the same chromosomal locus.
JOINT BEHAVIOUR OF PRECEDENCES AND EXCEEDANCES IN RANDOM THRESHOLD MODELS
Authors: Bairamov Ismihan , Eryilmaz Serkan
Published: September 2008

This paper concerns the joint behaviour of precedence and exceedance statistics in random threshold models. Joint distributions of precedence and exceedance statistics, both exact and asymptotic, are obtained, and the results are illustrated for random thresholds based on order statistics and record values.
ASYMPTOTIC EFFICIENCY OF THE BLEST‐TYPE TESTS FOR INDEPENDENCE
Authors: Stepanova Natalia , Wang Shu
Published: September 2008

Blest(2000, Aust. N. Z. J. Stat.42, 101–111) proposed a new measure of rank correlation that is sensitive to discrepancies in the small ranks. This paper investigates the efficiency properties of non‐parametric tests for independence based on Blest's correlation coefficient and its modifications. Pitman efficiency comparisons are made with analogous tests existing in the literature. Conditions for Pitman optimality of the Blest‐type tests are established.
A GENERALIZED EMERSON RECURRENCE RELATION
Authors: Rayner J. C. W. , Thas O. , De Boeck B.
Published: September 2008

The Emerson (1968, Biometrics 24, 695–701) recurrence relation has many important applications in statistics. However, the original derivation applied only to discrete distributions. In the following, a simple derivation is given that generalizes the Emerson recurrence relation to any distribution for which the necessary expectations exist. A modern application is outlined.
Fear, Human Rights and New Labour Policy Post‐9/11
Authors: Denney David
Published: September 2008

New Labour's domestic and foreign policy have been driven by a complex and contradictory precautionary logic. Fear management appears to have replaced coherent principles in the development of some areas of policy. The preoccupation with fear and anxiety has provided a rationale for the suspension of liberty and the adoption of measures that Western democracies have only usually seen in times of war. Fear‐based policy has also created a more exclusivist, segmented society.
Does Difference Make a Difference in Financial Planning for Risk?
Authors: Quilgars Deborah , Jones Anwen , Abbott David
Published: September 2008

Current policy‐making assumes people perceive and respond to financial risk in a uniform and rational way. This research sought to investigate whether social and cultural differences along the dimensions of disability, sexuality, faith and ethnicity influence attitudes to money and approaches to planning for possible financial risk eventualities. Eighty in‐depth interviews with individuals committed to different faiths (Muslim and Christian), disabled people, gays, lesbians and bisexuals, and members of black and minority ethnic groups (black and Asian) were conducted in 2005/2006. Mainstream cultural reference points were dominant in respondents’ accounts; however, difference was also found to be more determining in some areas than has previously been documented. The article explores the impact of these relationships on financial planning and draws out the policy implications of the different elements of difference on financial planning. The study argues that socio‐cultural approaches to risk need to be better understood at the policy‐making level.
The Great Cut: The Support for Private Modes of Social Evasion by Public Policy
Authors: Atkinson Rowland
Published: September 2008

The counterpart city represents an attempt to conceptualize the hidden spaces inhabited by social problems and ‘problem’ people who are counter to the mainstream, or included, modes of contemporary urban social life. This ‘opposite’, or negative, space comprises the spatially withdrawn and socially excluded who are largely outside the purview of the comfortable classes of the same cities. Not only has residential segregation been sustained over recent decades, so too have mobile circuits of mutual exclusion been created, which enable higher‐income groups to avoid the associated negative externalities of poverty (visibility, disorder, aggression and so on). As responsibility for dealing with social risks has become devolved to the level of the household, the desire for social evasion, as politicians, media systems and welfare patterns mark out threatening territories, has become more evident. The counterpart city is shunned in ever more elaborate ways and with the support of public policies. As the ‘spatial’ social policies, housing and urban, have become increasingly criminalized in the focus of their agendas, such interventions expend energy to facilitate this separation between affluent and poor. Traditional imperatives for public intervention are diminished as poverty has become more concealed from affluence – its costs and impacts evaded by technologies, socio‐spatial circuits and policies that skirt those who are locked into places of poverty and abject marginality, a constellation of social forces and effects I term the great cut.
Fear of Others: Social Exclusion and the European Crisis of Solidarity
Authors: Delanty Gerard
Published: September 2008

In recent years a major challenge for the EU has emerged around social issues and collective identities. With the emergence of a European political community that has diminished national sovereignty at a time when global forces are also undermining nation states, both Europe and migration become linked as sources of instability. Anxieties about Europe and migration are linked with fears of a clash of civilizations and anxieties about social securities. Social discontent, fuelled by socio‐economic changes, has undermined the traditional sources of identity around class and the nation, releasing xenophobic and nationalistic currents. Fear of others and anxieties about the future have emerged as potent social forces in contemporary society. The result is a crisis of European solidarity, along with a wider crisis of collective purpose. To combat such developments it is essential that the European project gives greater attention to issues of social justice and inclusive forms of social solidarity.
A Different Burden: Race and the Social Thought of Emily Greene Balch
Authors: Plastas Melinda
Published: September 2008

Scientific racism bedeviled U.S. society during the nineteenth and early twentieth centuries. Challenges to scientific racism came from different corners of modern society. Emily Greene Balch, Wellesley economist and prominent leader of the Women's International League for Peace and Freedom, served as a persistent critic of early twentieth‐century racism. A study of her writing on immigration, U.S. democracy, and U.S. foreign policy on Haiti and Liberia complicates our understanding of the history of U.S. women's peace movements and of the challenges to U.S. racial discourse. Balch believed racism to be inimical to her efforts to move the world beyond nationalism and into an age of mutual humanity. Balch's three decades of work supports Peggy Pascoe's observation that the transition from scientific racism to modern ideas about race were not overnight occurrences or without contradictions. Balch's work also indicates that as historians continue to examine the dimensions of race that have so deeply defined the United States, the women's peace movement that developed in response to World War I deserves notice.
Attempts to Reduce and Eliminate Nuclear Weapons through the Nuclear Non‐Proliferation Treaty and the Creation of Nuclear‐Weapon‐Free Zones
Authors: Magnarella Paul J.
Published: September 2008

Nuclear weapons remain the most dangerous weapons of mass destruction threatening our lives and planet. To date, the Nuclear Non‐Proliferation Treaty (NPT) is the most comprehensive international agreement aimed at limiting these weapons. In response to some of NPT's shortcomings, a large number of nonnuclear weapon states have joined together to create nuclear‐weapon‐free zones (NWFZs). By doing so, they emphatically rejected nuclear weapons on their soil, in their territorial waters, and in their air space. In addition, they ask nuclear weapon states to solemnly promise not to use nuclear weapons against zone members and to do nothing to promote nuclear weapons in their zones. Currently, much of the Southern Hemisphere is covered by NWFZs. An NWFZ has been newly created in Central Asia, and the League of Arab States is considering one in the Middle East.
“What’s There to Fear?”—A Comparative Study of Responses to the Out‐Group in Mixed and Segregated Areas of Belfast
Authors: Hughes Joanne , Campbell Andrea , Hewstone Miles , Cairns Ed
Published: September 2008

Despite some significant political developments and the advent of paramilitary cease‐fires, Northern Ireland remains a deeply divided society characterized by high levels of residential segregation. Although a causal link between segregation and intercommunity conflict has not been established, a wealth of research data points to the benefits of intercommunity contact in divided societies. Drawing on theoretical literature from social psychology, this paper explores responses to the out‐group in ethnically mixed and segregated Belfast communities. It concludes that the opportunity presented for intergroup contact in the mixed community seems to have, at the very least, an ameliorating effect on the fear and sense of threat posed by the out‐group.