bluuebunny/crossref_metadata_2025_split huggingface dataset:
LMA SupremeTM insertion by novices in manikins and patients
Authors: Howes B. W. , Wharton N. M. , Gibbison B. , Cook T. M. 
Published: February 2010

SummaryThe LMA Supreme™ has been suggested for use in emergency situations by medical personnel with no experience in endotracheal intubation. We evaluated the LMA Supreme when inserted by non‐anaesthetists, firstly in a manikin and then in patients. Fifty airway novices inserted a LMA Supreme in a manikin without any complications so we proceeded to the patient phase. Fifty airway novices inserted the LMA Supreme in anaesthetised patients undergoing elective surgery. First time insertion success rate was 86% and overall insertion success rate was 100%. Mechanical ventilation was successful in all cases. Median (IQR [range]) time to establish an airway was 34 s (26‐40 [18–145] s). Median (IQR [range]) pharyngeal seal pressure was 23 cmH2O (19‐28 [13–40] cmH2O). There were no important complications. Results are consistent with previous studies of use of the LMA Supreme by airway experts. We conclude that the LMA supreme is suitable for use by airway novices. Further research is needed before it may be recommended for cardiopulmonary resuscitation and emergency airway use.
Effect of a new synbiotic mixture on atopic dermatitis in infants: a randomized‐controlled trial
Authors: Van Der Aa L. B. , Heymans H. S. , Van Aalderen W. M. , Sillevis Smitt J. H. , Knol J. , Ben Amor K. , Goossens D. A. , Sprikkelman A. B. ,   the Synbad Study Group
Published: February 2010

SummaryBackground
Clinical trials investigating the therapeutic effect of probiotics on atopic dermatitis (AD) show inconsistent results. Better results can possibly be achieved by combining probiotics with prebiotics, i.e. synbiotics.Objective
To investigate the therapeutic effect of a synbiotic mixture on the severity of AD in infants.Methods
In a double‐blind, placebo‐controlled multi‐centre trial, 90 infants with AD [SCORing Atopic Dermatitis (SCORAD) score 15], aged <7 months and exclusively formula fed, were randomly assigned to receive either an extensively hydrolysed formula with Bifidobacterium breve M‐16V and a galacto‐/fructooligosaccharide mixture (Immunofortis®), or the same formula without synbiotics for 12 weeks. The primary outcome was severity of AD, assessed using the SCORAD index. A secondary outcome measure was intestinal microbiota composition.Results
There was no difference in SCORAD score improvement between the synbiotic and the placebo group. The synbiotic group did have a significantly higher percentage of bifidobacteria (54.7% vs. 30.1%, P<0.001) and significantly lower percentages of Clostridium lituseburense/Clostridium histolyticum (0.5 vs. 1.8, P=0.02) and Eubacterium rectale/Clostridium coccoides (7.5 vs. 38.1, P<0.001) after intervention than the placebo group. In the subgroup of infants with IgE‐associated AD (n=48), SCORAD score improvement was significantly greater in the synbiotic than in the placebo group at week 12 (−18.1 vs. −13.5 points, P=0.04).Conclusions
This synbiotic mixture does not have a beneficial effect on AD severity in infants, although it does successfully modulate their intestinal microbiota. Further randomized‐controlled trials should explore a possible beneficial effect in IgE‐associated AD. Cite this as: L. B. van der Aa, H. S. Heymans, W. M. van Aalderen, J. H. Sillevis Smitt, J. Knol, K. Ben Amor, D. A. Goossens, A. B. Sprikkelman and the Synbad Study Group, Clinical & Experimental Allergy, 2010 (40) 795–804.
The simultaneous inference of zooplanktivorous fish and macrophyte density from sub‐fossil cladoceran assemblages: a multivariate regression tree approach
Authors: DAVIDSON THOMAS A. , SAYER CARL D. , PERROW MARTIN , BRAMM METTE , JEPPESEN ERIK 
Published: February 2010

Summary1. Quantitative palaeolimnology has traditionally sought to quantify species‐environment relationships to use alterations in biological assemblages to reflect past environmental change. Transfer functions have used regression techniques, such as weighted averaging, to define taxon optima and tolerance for a single chemical or biological variable.2. Cladoceran assemblages and their sub‐fossil remains in shallow lakes are shaped by a combination of interacting factors. Partial constrained ordination of sub‐fossil cladoceran assemblages from 39 shallow lakes (29 in Norfolk, U.K. and 10 in Denmark) indicated that both zooplanktivorous fish (ZF) density and submerged macrophyte abundance significantly influenced community composition. These dual structuring forces precluded the use of a transfer function as one of the key assumptions of this approach was not met, namely that environmental variables apart from the variable being modelled have negligible influence on species distribution or that there is a linear relationship between the two. Separate transfer functions for ZF and macrophyte abundance were developed but had poor performance diagnostics with low bootstrapped r2, high root mean square error of prediction (RMSEP) and large bias.3. To obviate the problem of multiple structuring forces a multivariate regression tree (MRT) was employed, which allows for more than one explanatory variable within a model. The MRT analysis defined six groups with discrete ranges of ZF and macrophyte densities. The technique identified critical values or ‘break points’ in ZF and macrophyte abundances which result in significant alterations in the sub‐fossil cladoceran assemblage. In addition, the MRT groups had different summer mean values for chlorophyll‐a, Secchi depth, total phosphorus and nitrate‐nitrogen.4. The predictive abilities of the model were assessed by comparing the observed versus predicted MRT group membership. In general group membership was reliably predicted, suggesting sub‐fossil cladoceran assemblages reliably reflect ZF and macrophyte density in shallow lakes. For a relatively small number of sites there were differences between the observed and predicted MRT group membership. These failures of prediction may result, at least in part, from the disparity of the time period represented by the environmental data and the surface sediment cladoceran assemblage.
Back to the future: using palaeolimnology to infer long‐term changes in shallow lake food webs
Authors: RAWCLIFFE RUTH , SAYER CARL D. , WOODWARD GUY , GREY JONATHAN , DAVIDSON THOMAS A. , IWAN JONES J. 
Published: February 2010

Summary1. Shallow lakes are often cited as classic examples of systems that exhibit trophic cascades but, whilst they provide good model systems with which to test general ecological theory and to assess long‐term community change, their food web linkages have rarely been resolved, so changes associated with the structure and dynamics of the ecological network as a whole are still poorly understood.2. We sought to redress this, and to demonstrate the potential benefits of integrating palaeolimnological and contemporary data, by constructing highly resolved food webs and stable isotope derived measures of trophic interactions and niche space, for the extant communities of two shallow U.K. lakes from different positions along a gradient of eutrophication. The contemporary surface sediment cladoceran and submerged macrophyte assemblages in the less enriched site, Selbrigg Pond, matched the palaeolimnological assemblages of the more enriched site, Felbrigg Hall Lake, in its more pristine state during the 1920s. Thus, Selbrigg was a temporal analogue for Felbrigg, from which the consequences of long‐term eutrophication on food web structure could be inferred. These data represent the first steps towards reconstructing not only past assemblages (i.e. nodes within a food web), but also past interactions (i.e. links within a food web): a significant departure from much of the previous research in palaeolimnology.3. The more eutrophic food web had far fewer nodes and links, and thus a less reticulate network, than was the case for the more pristine system. In isotopic terms, there was vertical compression in δ15N range (NR) and subsequent increased overlap in isotopic niche space, indicating increased trophic redundancy within Felbrigg. This structural change, which was associated with a greater channelling of energy through a smaller number of nodes as alternative feeding pathways disappear, could lead to reduced dynamic stability, pushing the network towards further simplification. These changes reflected a general shift from a benthic‐dominated towards a more pelagic system, as the plant‐associated subweb eroded.4. Although these data are among the first of their kind, the palaeo‐analogue approach used here demonstrates the huge potential for applying food web theory to understand how and why these ecological networks change during eutrophication. Furthermore, because of the rich biological record preserved in their sediments, shallow lakes represent potentially important models for examining long‐term intergenerational dynamics, thereby providing a means by which models and data can be integrated on meaningful timescales – a goal that has long proved elusive in food web ecology.
Ecological influences on larval chironomid communities in shallow lakes: implications for palaeolimnological interpretations
Authors: LANGDON PETER G. , RUIZ ZOE , WYNNE SHIRLEY , SAYER CARL D. , DAVIDSON THOMAS A. 
Published: February 2010

Summary1. To correctly interpret chironomid faunas for palaeoenvironmental reconstruction, it is essential that we improve our understanding of the relative influence of ecosystem variables, biotic as well as physicochemical, on chironomid larvae. To address this, we analysed the surface sediments from 39 shallow lakes (29 Norfolk, U.K., 10 Denmark) for chironomid head capsules, and 70 chironomid taxa (including Chaoborus) were identified.2. The shallow lakes were selected over large environmental gradients of aquatic macrophytes, total phosphorus (TP) and fish communities. Redundancy analysis (RDA) identified two significant variables that explained chironomid distribution: macrophyte species richness (P < 0.001) and TP (P < 0.005). Generalised linear models (GLM) identified specific taxa that had significant relationships with both these variables. Macrophyte percentage volume infested (PVI) and species richness were significant in classifying the lake types based on chironomid communities under twinspan analysis, although other factors, notably nutrient concentrations and fish communities, were also important, illustrating the complexities of classifying shallow lake ecosystems. Lakes with plant species richness >10 all had relatively diverse (Hill’s N2) chironomid assemblages, and lakes with Hill’s N2 >10 all had TP <250 μg L−1 and total fish densities <2 fish per m2.3. Plant density (PVI), and perhaps more importantly species richness, were primary controls on the distribution of chironomid communities within these lakes. This clearly has implications for palaeoenvironmental reconstructions using zoobenthos remains (i.e. chironomids) and suggests that they could be used to track changes in benthic/pelagic production and could be used as indicators of changing macrophyte habitat.4. Measuring key biological gradients, in addition to physicochemical gradients, allowed the major controls on chironomid distribution to be assessed more directly, in terms of plant substrate, food availability, competition and predation pressure, rather than implying indirect mechanisms through relationships with nutrients. Many of these variables, notably macrophyte abundance and species richness, are not routinely measured in such studies, despite their importance in determining zoobenthos in temperate shallow lakes.5. When physical, chemical and ecological gradients are considered, as is often the case with palaeo‐reconstructions rather than training sets chosen to maximise one gradient, complex relationships exist, and attempting to reconstruct a single trophic variable quantitatively may not be appropriate or reliable.
Seasonal dynamics of macrophytes and phytoplankton in shallow lakes: a eutrophication‐driven pathway from plants to plankton?
Authors: SAYER CARL D. , DAVIDSON THOMAS A. , JONES JOHN IWAN 
Published: February 2010

Summary1. Seasonal relationships between macrophyte and phytoplankton populations may alter considerably as lakes undergo eutrophication. Understanding of these changes may be key to the interpretation of ecological processes operating over longer (decadal‐centennial) timescales.2. We explore the seasonal dynamics of macrophytes (measured twice in June and August) and phytoplankton (measured monthly May–September) populations in 39 shallow lakes (29 in the U.K. and 10 in Denmark) covering broad gradients for nutrients and plant abundance.3. Three site groups were identified based on macrophyte seasonality; 16 lakes where macrophyte abundance was perennially low and the water generally turbid (‘turbid lakes’); 7 where macrophyte abundance was high in June but low in August (‘crashing’ lakes); and 12 where macrophyte abundance was high in both June and August (‘stable’ lakes). The seasonal behaviour of the crashing and turbid lakes was extremely similar with a consistent increase in nutrient concentrations and chlorophyll‐a over May–September. By contrast in the stable lakes, seasonal changes were dampened with chlorophyll‐a consistently low (<10–15 μg L−1) over the entire summer. The crashing lakes were dominated by one or a combination of Potamogeton pusillus, Potamogeton pectinatus and Zannichellia palustris, whereas Ceratophyllum demersum and Chara spp. were more abundant in the stable lakes.4. A long‐term loss of macrophyte species diversity has occurred in many shallow lakes affected by eutrophication. One common pathway is from a species‐rich plant community with charophytes to a species‐poor community dominated by P. pusillus, P. pectinatus and Z. palustris. Such compositional changes may often be accompanied by a substantial reduction in the seasonal duration of plant dominance and a greater tendency for incursions by phytoplankton. We hypothesise a slow‐enacting (10–100 s years) feedback loop in nutrient‐enriched shallow lakes whereby increases in algal abundance are associated with losses of macrophyte species and hence different plant seasonal strategies. In turn such changes may favour increased phytoplankton production thus placing further pressure on remaining macrophytes. This study blurs the distinction between so‐called turbid phytoplankton‐dominated and clear plant‐dominated shallow lakes and suggests that plant loss from them may be a gradual process.
Combining contemporary ecology and palaeolimnology to understand shallow lake ecosystem change
Authors: SAYER CARL D. , DAVIDSON THOMAS A. , JONES JOHN IWAN , LANGDON PETER G. 
Published: February 2010

Summary1. Palaeolimnology and contemporary ecology are complementary disciplines but are rarely combined. By reviewing the literature and using a case study, we show how linking the timescales of these approaches affords a powerful means of understanding ecological change in shallow lakes.2. Recently, palaeolimnology has largely been pre‐occupied with developing transfer functions which use surface sediment‐lake environment datasets to reconstruct a single environmental variable. Such models ignore complex controls over biological structure and can be prone to considerable error in prediction. Furthermore, by reducing species assemblage data to a series of numbers, transfer functions neglect valuable ecological information on species’ seasonality, habitat structure and food web interactions. These elements can be readily extracted from palaeolimnological data with the interpretive assistance of contemporary experiments and surveys. For example, for one shallow lake, we show how it is possible to infer long‐term seasonality change from plant macrofossil and fossil diatom data with the assistance of seasonal datasets on macrophyte and algal dynamics.3. On the other hand, theories on shallow lake functioning have generally been developed from short‐term (<1–15 years) studies as opposed to palaeo‐data that cover the actual timescales (decades–centuries) of shallow lake response to stressors such as eutrophication and climate change. Palaeolimnological techniques can track long‐term dynamics in lakes whilst smoothing out short‐term variability and thus provide a unique and important means of not only developing ecological theories, but of testing them.4. By combining contemporary ecology and palaeolimnology, it should be possible to gain a fuller understanding of changing ecological patterns and processes in shallow lakes on multiple timescales.
Synchronous tumours of the female genital tract
Authors: Singh Naveena 
Published: February 2010

Singh N (2010) Histopathology56, 277–285 Synchronous tumours of the female genital tract About 1–2% of women with gynaecological cancers are found to have two or more simultaneous independent primary malignancies. Low stage multiple primaries must be distinguished from metastasis from one to other site for correct management. Synchronous tumours in the ovary and endometrium are the commonest combination. Most of these can be accurately categorised by standard histological criteria. Molecular testing has been advocated for valuable adjunctive information in ambiguous cases but must be interpreted with clinicopathological correlation: loss of heterozygosity, pTEN or beta‐catenin gene mutational analysis, microsatellite instability and most recently gene expression profiling have all been used. The pattern of beta‐catenin immunohistochemical expression has been reported to be of value. A very low percentage of women with synchronous primaries in the uterus and ovary are HNPCC patients and testing for mismatch repair gene mutations is unnecessary in all cases, even if young; the diagnosis of HNPCC should be based on standard criteria. Women with endometrial cancer under 50 are more likely than older patients to have a synchronous ovarian cancer. Rarer combinations of synchronous tumours are less well studied but may also represent a mixture of unusual patterns of metastasis and multifocal origin; these are discussed briefly.
Clinicopathological correlates and prognostic significance of maspin expression in 450 patients after potentially curative resection of node‐positive colonic cancer
Authors: Fung Caroline L‐S , Chan Charles , Jankova Lucy , Dent Owen F , Robertson Graham , Molloy Mark , Bokey Les , Chapuis Pierre H , Lin Betty P C , Clarke Stephen J 
Published: February 2010

Fung C L‐S, Chan C, Jankova L, Dent O F, Robertson G, Molloy M, Bokey L, Chapuis P H, Lin B P C & Clarke S J (2010) Histopathology56, 319–330 Clinicopathological correlates and prognostic significance of maspin expression in 450 patients after potentially curative resection of node‐positive colonic cancer Aims:  The tumour suppressor maspin has been investigated for its association with conventional histopathological features in colorectal cancer and for its potential as an independent predictor of survival and response to adjuvant chemotherapy. The aim of this study was to examine associations between maspin expression, other histopathology and survival in a large consecutive series of patients after potentially curative resection of node‐positive colonic adenocarcinoma.Methods and results:  Nuclear and cytoplasmic maspin expression in both superficial and deep parts of the tumour were assessed retrospectively by tissue microarray and immunohistochemistry in specimens from 450 patients whose other histopathology had been recorded in a prospective hospital registry of large bowel cancer resections from 1971 to 2001 with a minimum follow‐up of 5 years. Among 13 clinicopathological features examined, the only associations that persisted across all four maspin assessments were stronger expression in right‐ than in left‐sided tumours (P = 0.001–0.011) and stronger expression in high‐grade tumours (P < 0.001–0.007). There was no significant association between intensity of maspin expression and overall survival.Conclusions:  In this large and thoroughly documented series of patients with clinicopathological stage C colonic tumour, maspin expression was correlated with few other conventional histopathology variables and was not a significant prognostic factor.
Clinicopathological features and CD57 expression in renal cell carcinoma in acquired cystic disease of the kidneys: with special emphasis on a relation to the duration of haemodialysis, the degree of calcium oxalate deposition, histological type, and possible tumorigenesis
Authors: Enoki Yasuyuki , Katoh Genichi , Okabe Hidetoshi , Yanagisawa Akio 
Published: February 2010

Enoki Y, Katoh G, Okabe H & Yanagisawa A (2010) Histopathology56, 384–394 Clinicopathological features and CD57 expression in renal cell carcinoma in acquired cystic disease of the kidneys: with special emphasis on a relation to the duration of haemodialysis, the degree of calcium oxalate deposition, histological type, and possible tumorigenesis Aims:  Acquired cystic disease of the kidney (ACDK) in patients undergoing haemodialysis is known to develop into renal cell carcinoma (RCC), but its pathogenesis remains unclear. The aims were to analyse the histological findings of ACDK‐RCC and to determine its histogenesis.Methods and results:  Twenty‐nine RCCs in 23 patients with ACDK were classified into three groups according to the duration of haemodialysis and were analysed for histological type, calcium oxalate (Oxa) deposition, and cyst and atypical cyst (AC) formation. Histologically, 21 tumours were ACDK‐RCC and eight were clear cell carcinoma (CCC). The ratio of ACDK‐RCC and the numbers of cysts and ACs increased as the duration of haemodialysis was prolonged. The degrees of intratumoral Oxa deposition and cyst and AC formation of ACDK‐RCCs were higher than those of CCCs (Oxa, P = 0.028; cyst, P < 0.0001; AC, P = 0.0002). Many ACDK‐RCCs (85.7%) and some CCCs (50%) had characteristics of the thin ascending loop of Henle as assessed by CD57 (HNK‐1) expression, which was rarely expressed in the 29 control cases.Conclusions:  ACDK‐RCCs reveal characteristics of Henle’s loop, which may be related to their peculiar pathological features, including intratumoral oxalate deposition and cyst and AC formation.