bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of resistant starches types II and IV with minimal amounts of oat bran yields good quality, low glycaemic index pasta
Authors: Bustos Mariela Cecilia , Perez Gabriela T. , León Alberto Edel
Published: September 2012

The objective of this work was to study the effects of the combination of resistant starch type II (RSII), resistant starch type IV (RSIV) and oat bran (OB) on technological and nutritional properties of pasta, applying response surface analysis. Cooking properties were improved by combining RSII and RSIV in pasta formulation, while OB addition negatively affected all technological attributes, and a negative synergistic effect was observed between this fibre and resistant starches in cooking losses. Considering nutritional properties, substitution of bread wheat flour with resistant starch type II and IV increased starch resistant to digestion and OB addition increased pasta starch hydrolysis. A positive synergistic effect was observed on glycaemic index by combining both types of resistant starches. Finally, we optimised the formulation considering three aspects separately: technological properties, nutritional attributes and these two features together. The combination of RSII 12.6, RSIV 3.1 and OB 0.6 g per 100 g of wheat flour will allow to obtain a pasta with low glycaemic index (GI = 69) and good technological characteristics.
Investigation of TiO2 nanoparticle efficiency on decolourisation of industrial date syrup
Authors: Nasabi Mahshad , Labbafi Mohsen , HadiNezhad Mehri , Khanmohammadi Mohammadreza , Bagheri Garmarudi Amir
Published: September 2012

The TiO2 nanoparticle photocatalyst was used to decolourise industrial date syrup. The effect of TiO2 concentration (1 and 4% w/v), UV power (15 and 30 w) and processing time (12 and 48 h) on date syrup characteristics was investigated using a factorial design. The colour, turbidity, sugar content, total phenolic compounds, ash content and mineral (K, Na, Ca, Mg and Fe) of date syrup were analysed. The results demonstrated that using TiO2 nanoparticle as a photocatalyst for the decolourisation of date syrup is an effective and promising method. Colour in all treatments was significantly (P < 0.05) reduced between 30 and 53% in comparison with the initial date syrup (491 000 IU), and the reduction was even higher for date syrup turbidity (between 47 and 75%). The result showed that the process condition significantly affected the colour and turbidity reduction. On the basis of the result, the best treatment was TiO2 4%, 15 w and 48 h. Under this condition, date syrup colour, turbidity, ash content, sugar content reduced by 52%, 61%, 13% and 9%, respectively.
New insights into the biogeography of south‐western Europe: spatial patterns from vascular plants using cluster analysis and parsimony
Authors: Moreno Saiz Juan Carlos , Donato Mariano , Katinas Liliana , Crisci Jorge V. , Posadas Paula
Published: September 2012

Aim

We analysed the distributional pattern of the vascular flora of the Iberian Peninsula and Balearic archipelago using cluster and parsimony methods to delineate a biogeographical scheme for south‐western Europe and to compare the results with previous regionalizations. Additionally, we aim to identify areas of endemism.

Location

South‐western Europe (Iberian Peninsula and the Balearic Islands).

Methods

Pattern analysis of a chorological dataset, consisting of the occurrences of 3041 vascular plant species in each of the 50 km × 50 km UTM cells of a grid covering Iberia and the Balearic Islands, was based on cluster analysis (unweighted pair‐group method using arithmetic averages; UPGMA) and parsimony analysis of endemicity (PAE). The Jaccard similarity index was used in the UPGMA, and the set of most parsimonious trees from the PAE were summarized in a 75% majority consensus tree.

Results

The UPGMA dendrogram delineated two main branches in the study region: (1) an eastern area of six sectors including the Balearic Islands plus those regions of Iberia with basic substrates, and (2) a western area with three sectors comprising the regions with acidic soils. The majority rule consensus tree of 53 most parsimonious trees from PAE showed eight main clades similarly separating eastern Iberia plus the Balearic Islands with their basic substrates, from western Iberia with its acidic and basic substrates; in addition the PAE tree showed some previously undetected chorological patterns.

Main conclusions

The use of large and inclusive datasets allows for the recognition of different spatial patterns from those obtained using a limited number of endemic or indicator species. The analyses support some floristic regions previously recognized for Iberia, but not the classic Eurosiberian–Mediterranean division, and some transition territories. Our recognition of 19 areas of endemism consisting of two or more cells and 60 consisting of one cell in south‐western Europe is new.
Snails on oceanic islands: testing the general dynamic model of oceanic island biogeography using linear mixed effect models
Authors: Cameron Robert A. D. , Triantis Kostas A. , Parent Christine E. , Guilhaumon François , Alonso María R. , Ibáñez Miguel , de Frias Martins António M. , Ladle Richard J. , Whittaker Robert J.
Published: September 2012

Aim

We collate and analyse data for land snail diversity and endemism, as a means of testing the explanatory power of the general dynamic model of oceanic island biogeography (GDM): a theoretical model linking trends in species immigration, speciation and extinction to a generalized island ontogeny.

Location

Eight oceanic archipelagos: Azores, Canaries, Hawaii, Galápagos, Madeira, Samoa, Society, Tristan da Cunha.

Methods

Using data obtained from literature sources we examined the power of the GDM through its derivative ATT2 model (i.e. diversity metric = b1 + b2Area + b3Time + b4Time2), in comparison with all the possible simpler models, e.g. including only area or time. The diversity metrics considered were the number of (1) native species, (2) archipelagic endemic species, and (3) single‐island endemic species. Models were evaluated using both log‐transformed and untransformed diversity data by means of linear mixed effect models. For Hawaii and the Canaries, responses of different major taxonomic groups were also analysed separately.

Results

The ATT2 model was always included within the group of best models and, in many cases, was the single‐best model and was particularly successful in fitting the log‐transformed diversity metrics. In four archipelagos, a hump‐shaped relationship with time (island age) is apparent, while the other four archipelagos show a general increase of species richness with island age. In Hawaii and the Canaries outcomes vary between different taxonomic groups.

Main conclusions

The GDM is an intentionally simplified representation of environmental and diversity dynamics on oceanic islands, which predicts a simple positive relationship between diversity and island area combined with a humped response to time. We find broad support for the applicability of this model, especially when a full range of island developmental stages is present. However, our results also show that the varied mechanisms of island origins and the differing responses of major taxa should be taken into consideration when interpreting diversity metrics in terms of the GDM. This heterogeneity is reflected in the fact that no single model outperforms all the other models for all datasets analysed.
An integrated model of clinical reasoning: dual‐process theory of cognition and metacognition
Authors: Marcum James A.
Published: September 2012

Rationale and aim

Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non‐analytic and analytic processes of cognition, along with metacognition.

Method

The dual‐process theory of cognition (system 1 non‐analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning.

Results

In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations.

Conclusions

The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills.
Principles of reasoning in historical epidemiology
Authors: Tulodziecki Dana
Published: September 2012

The case ofJohnSnow has long been important to epidemiologists and public health officials. However, despite the fact that there have been many discussions about the various aspects ofSnow's case, there has been virtually no discussion about what guidedSnow's reasoning in his coming to believe his various conclusions about cholera. Here, I want to take up this question in some detail and show that there are a number of specific principles of reasoning that played a crucial role forSnow. Moreover, these principles were epistemologically important toSnow, a fact about whichSnow is explicit in many places. An analysis ofSnow's case suggests that, because of the epistemic role such principles of reasoning can play, health care practitioners ought to understand their practices to be theoretically informed in these ways, and not just data driven.
Challenging the epistemological foundations of EBM: what kind of knowledge does clinical practice require?
Authors: Hutchison Katrina J. , Rogers Wendy A.
Published: September 2012

This paper raises questions about the epistemological foundations of evidence‐based medicine (EBM). We argue that EBM is based upon reliabilist epistemological assumptions, and that this is appropriate – we should focus on identifying the most reliable processes for generating and collecting medical knowledge. However, we note that this should not be reduced to narrow questions about which research methodologies are the best for gathering evidence. Reliable processes for generating medical evidence might lie outside of formal research methods. We also question the notion of the knower that is assumed by EBM. We argue that EBM assumes an enlightenment conception of knowers as autonomous, substitutable individuals. This conception is troubled by the way that clinicians learn the role of anecdote in health care and the role of patient choice, all of which bring into play features of clinicians and patients as situated individuals with particular backgrounds and experiences. EBM's enlightenment conception of the knower is also troubled by aspects of the way evidence is produced. Given these limitations, we argue that EBM should retain its reliabilist bent, but should look beyond formal research methodologies in identifying processes that yield reliable evidence for clinical practice. We suggest looking to feminist epistemology, with its focus on the standpoints of individual situated knowers, and the role of social context in determining what counts as knowledge.
Mechanisms: what are they evidence for in evidence‐based medicine?
Authors: Andersen Holly
Published: September 2012

Even though the evidence‐based medicine (EBM) movement labels mechanisms a low quality form of evidence, consideration of the mechanisms on which medicine relies, and the distinct roles that mechanisms might play in clinical practice, offers a number of insights into EBM itself. In this paper, I examine the connections between EBM and mechanisms from several angles. I diagnose what went wrong in two examples where mechanistic reasoning failed to generate accurate predictions for how a dysfunctional mechanism would respond to intervention. I then use these examples to explain why we should expect this kind of mechanistic reasoning to fail in systematic ways, by situating these failures in terms of evolved complexity of the causal system(s) in question. I argue that there is still a different role in which mechanisms continue to figure as evidence in EBM: namely, in guiding the application of population‐level recommendations to individual patients. Thus, even though the evidence‐based movement rejects one role in which mechanistic reasoning serves as evidence, there are other evidentiary roles for mechanistic reasoning. This renders plausible the claims of some critics of EBM who point to the ineliminable role of clinical experience. Clearly specifying the ways in which mechanisms and mechanistic reasoning can be involved in clinical practice frames the discussion about EBM and clinical experience in more fruitful terms.
The application of Cartwright's concept of capacities to complex interventions in psychiatry
Authors: Hubbeling Dieneke
Published: September 2012

Cartwright and Munro argued that extrapolation of findings from randomized controlled trials to other settings can be difficult because information about the underlying causal structure and subgroups is often not available. They advocated the use of ‘capacities’ – that is fixed causal contributions – in predicting effects of interventions. In psychiatry, it is often not possible to determine what the fixed causal contributions are and one can only establish ‘approximate capacities’. However, using ‘approximate capacities’ does imply a different way of evaluating health services, especially combined interventions. In health service research, if different studies, randomized controlled trials or other designs, have given different outcomes, the best way to investigate the effectiveness of a particular way of service organization is not to conduct more randomized controlled trials. It is preferable to study the effects of certain elements of the complex intervention, which have been tested before in other settings, that is investigating ‘approximate capacities’. One should check whether the separate elements do form a part of the complex intervention in practice and whether they have the same effect as in other studies and if not, why not. This enhances knowledge about the underlying causal structure and increases the possibility of extrapolation of the findings.
Autonomy and reason: treatment choice in breast cancer
Authors: Twomey Mary
Published: September 2012

The practice of offering choice to those women with breast cancer for whom either breast conserving surgery or mastectomy would be equally beneficial has come to be seen as an important aspect of medical care. As well as improving satisfaction with treatment, this is seen as satisfying the ethical principle of respect for autonomy. A number of studies, however, show that women are not always comfortable with such choice, preferring to leave treatment decisions to their surgeons. A question then arises as to the extent that these women can be seen as autonomous or as exercising autonomy. This paper argues, however, that the understanding of autonomy which is applied in current approaches to breast cancer care does not adequately support the exercise of autonomy, and that the clinical context of care means that women are not able to engage in the kind of reasoning that might promote the exercise of autonomy. Where respect for autonomy is limited to informed consent and choice, there is a danger that women's interests are overlooked in those aspects of their care where choice is not appropriate, with very real, long‐term consequences for some women. Promoting the exercise of autonomy, it is argued, needs to go beyond the conception of autonomy as rational individuals making their own decisions, and clinicians need to work with an understanding of autonomy as relational in order to better involve women in their care.
Can there be a good death?
Authors: Scarre Geoffrey
Published: September 2012

While some deaths are worse than others, there is no such thing as a ‘good death’ since the plausible desiderata of a ‘good death’ form an inconsistent set. Because death is of the greatest existential consequence to us, a ‘good’ death must be a self‐aware death in which we grasp the import of what is happening to us; however, such realization is incompatible with our achieving the tranquillity of mind which is another requirement for the ‘good’ death. Nevertheless, the welcome recognition in recent years by medical personnel, palliative care workers and hospice staff that dying is an existential predicament as well as a physiological condition has enabled more people to avoid a ‘soulless death in intensive care’, even if it pays insufficient regard to the personal virtues that we need if we are to mitigate the worst evils of dying.
Medicine and the individual: is phenomenology the answer?
Authors: Gergel Tania L.
Published: September 2012

The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces and suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions.
Pleistocene survival on central Alpine nunataks: genetic evidence from the jumping bristletail Machilis pallida
Authors: Wachter Gregor A. , Arthofer Wolfgang , Dejaco Thomas , Rinnhofer Lukas J. , Steiner Florian M. , Schlick‐Steiner Birgit C.
Published: September 2012

Mechanisms of survival during the Pleistocene glaciation periods have been studied for more than a century. Until now, molecular studies that confirmed animal survival on Alpine nunataks, that is, ice‐free summits surrounded by glaciers, were restricted to peripheral areas. Here, we search for molecular signatures of inner‐Alpine survival of the narrow endemic and putatively parthenogenetic Alpine jumping bristletail Machilis pallida combining mitochondrial and AFLP data from its three known populations. The mitochondrial data indicate survival on both peripheral and central nunataks, the latter suggesting that refugia in the centre of the Alpine main ridge were more widespread than previously recognized. Incongruences between mitochondrial and AFLP patterns suggest a complex evolutionary history of the species and may be explained via parallel fixation of parthenogenesis of different origins during the last glacial maximum. We suggest that the inferred parthenogenesis may have been essential for central nunatak survival, but may pose a serious threat for M. pallida in consideration of the present climatic changes.
Associations of CD6, TNFRSF1A and IRF8 polymorphisms with risk of inflammatory demyelinating diseases
Authors: Park T.‐J. , Kim H. J. , Kim J.‐H. , Bae J. S. , Cheong H. S. , Park B.‐L. , Shin H. D.
Published: September 2012

Aims

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are inflammatory autoimmune diseases that affect the central nervous system. Several genome‐wide and candidate gene studies have identified genetic polymorphisms associated with the risk of MS or NMO. In particular, two recently published studies of meta‐analysis in European‐origin populations have suggested associations of single‐nucleotide polymorphisms (SNPs) in CD6, TNFRSF1A and IRF8 with MS. The aim of our study was to assess the associations between SNPs in these three genes and the risk of inflammatory demyelinating disease (IDD) including MS and NMO. To the best of our knowledge, this is the first time such a study has been performed in an Asian population.

Methods

A total of 21 SNPs of CD6, TNFRSF1A and IRF8 were genotyped in 178 IDD cases (79 MS and 99 NMO patients) and 237 normal controls in a Korean population.

Results

Logistic analyses revealed that one SNP in CD6 (rs12288280, P = 0.04) and three SNPs in TNFRSF1A (rs767455, rs4149577 and rs1800693, P = 0.01–0.03) were associated with NMO. However, there was no association of IRF8 polymorphisms with IDD, including MS and NMO. Using further information from the SNP Function Prediction website, two exonic splicing enhancers (ESEs), including the polymorphic site of rs767455, were predicted to be binding sites for splicing factors (SRp55, SF2/ASF2 and SF2/ASF1).

Conclusion

Although additional studies are needed, our findings could provide information regarding the genetic aetiology of IDD in the Korean population.
Cryoprecipitate: an outmoded treatment?
Authors: Yang L. , Stanworth S. , Baglin T.
Published: September 2012

Cryoprecipitate is an allogeneic blood product prepared from human plasma. It contains factors VIII, von Willebrand factor (vWF), fibrinogen, fibronectin and factor XIII. Its use was first described in the 1960s for treatment of patients with factor VIII deficiency. It has also been used to treat patients with congenital hypofibrinogenaemia. Now, the most common use of cryoprecipitate is fibrinogen replacement in patients with acquired hypofibrinogenaemia and bleeding. Despite almost 50 years of use, evidence of efficacy is limited. This review provides an overview of the history of cryoprecipitate use, the current debates on the use of this product and future developments.
Progressive cutaneous lesions in an elderly woman with systemic failure
Authors: Fleta‐Asin Beatriz , Truchuelo‐Díez Mayte , Carrillo‐Gijón Rosario , Jaen‐Olasolo Pedro
Published: September 2012

What is your diagnosis?
Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers
Authors: Heller Misha M. , Fullerton‐Stone Honor , Murase Jenny E.
Published: September 2012

Breastfeeding is thought to be the most optimal form of infant nutrition. Nursing mothers are generally advised to continue breastfeeding until the infant is two years of age or beyond. Unfortunately, however, a majority of nursing mothers will discontinue breastfeeding much earlier than recommended. The most common reason for early discontinuation of breastfeeding is nipple pain. It is, therefore, essential that dermatologists know how to appropriately diagnose and effectively treat nipple pain associated with nipple dermatitis among nursing mothers. This review article provides a detailed discussion on the clinical features and management of various causes of nipple dermatitis during lactation, including problems with infant latch‐on, congenital oral anomalies, plugged lactiferous ducts, atopic dermatitis, irritant contact dermatitis, allergic contact dermatitis, yeast infections, bacterial infections, herpes simplex virus, and Raynaud’s phenomenon of the nipple.
Adverse effects of intralesional meglumine antimoniate and its influence on clinical laboratory parameters in the treatment of cutaneous leishmaniasis
Authors: Esfandiarpour Iraj , Farajzadeh Saeedeh , Rahnama Zahra , Fathabadi Elahe Arabpoor , Heshmatkhah Amireh
Published: September 2012

Objectives  Intralesional injection of pentavalent antimoniate is recommended by the World Health Organization for the treatment of cutaneous leishmaniasis (CL). This study aimed to evaluate the adverse effects of intralesional injection of meglumine antimoniate (Glucantime®) and its influence on clinical laboratory parameters.

Methods  A total of 105 patients with suspected lesions and therapeutic features of CL diagnosed by direct smear or skin biopsy were included in this study. Intralesional injection of Glucantime® was administered to treat CL. Fifty‐five of the 105 patients were checked for hematological features, liver and kidney function, and fasting blood sugar levels before and after treatment.

Results  The observed side effects included pain (89.5%), burning sensation (81.9%), erythema (45.7%), pruritus (28.6%), secondary infection (17.1%), nausea (11.4%), vomiting (7.6%), urticaria (5.7%), necrosis (2.9%), sporotrichoid lesions (2.9%), dizziness (1.9%), dyspnea (1.9%), and anaphylactic shock (0.9%). No statistically significant differences were found in occurrences of adverse effects according to the part of the body affected, patient sex or age group, except for pruritus, which appeared more frequently in extremities than in other parts of the body (P < 0.001), and secondary infection, which was observed more frequently in people aged >45 years (P < 0.042). All clinical parameters remained normal after treatment.

Conclusions  The occurrence of severe adverse reactions, particularly of anaphylactic shock, should be considered before treatment with Glucantime® is initiated. Thus, it is important that intralesional Glucantime® injections are administered in centers that are well equipped with appropriate resuscitation and support apparatus.
Corticosteroid‐induced hyperglycemia is increased 10‐fold in patients with pemphigus
Authors: Alavi Afsaneh , Lowe Julia , Walsh Scott , Juurlink David , Mortaz‐Hedjri Soroush , Shear Neil H.
Published: September 2012

This study aimed to highlight the importance of routine screening for hyperglycemia and to develop a standardized, evidence‐based approach for the management of pemphigus patients on prolonged systemic corticosteroid (CS) therapy. A cross‐sectional study was conducted in two university‐affiliated teaching hospitals using a referred sample of 200 patients with a confirmed diagnosis of pemphigus vulgaris, pemphigus foliaceus, or mucous membrane pemphigoid. All patients were receiving systemic CS therapy. A total of 150 patients responded to the survey. Six participants were excluded and 144 were included. The main outcome measure was blood glucose level to detect hyperglycemia. New‐onset hyperglycemia was identified in 40% of patients who received CS therapy. None of the expected variables, including age, body mass index, family history of diabetes, corticosteroid dose, and duration of corticosteroid therapy, were independently associated with new‐onset hyperglycemia. These findings indicate that the prevalence of CS‐induced hyperglycemia in pemphigus patients is 40% and that in patients with pemphigus or MMP, CS therapy is associated with a markedly increased risk for hyperglycemia (odds ratio = 10.7, 95% confidence interval 1.38–83.50) compared with that of patients with the same diseases who do not receive CS therapy.
Acne in the adult female patient: a practical approach
Authors: Kamangar Faranak , Shinkai Kanade
Published: September 2012

Acne vulgaris is a common reason why adult women present to dermatologists and can be a clinical challenge to treat. It may also be an important sign of an underlying endocrine disease such as Polycystic Ovary Syndrome (PCOS). Although standard acne therapies can be successfully used to treat acne in adult female patients, hormonal treatment is a safe and effective therapeutic option that may provide an opportunity to better target acne in this population, even when other systemic therapies have failed. In this article, a practical approach to the adult female patient with acne will be reviewed to enhance the dermatologist’s ability to use hormonal acne therapies and to better identify and evaluate patients with acne in the setting of a possible endocrine disorder.
Strong specificity in the interaction between parasitoids and symbiont‐protected hosts
Authors: Rouchet R. , Vorburger C.
Published: September 2012

Coevolution between hosts and parasites may promote the maintenance of genetic variation in both antagonists by negative frequency‐dependence if the host–parasite interaction is genotype‐specific. Here we tested for specificity in the interaction between parasitoids (Lysiphlebus fabarum) and aphid hosts (Aphis fabae) that are protected by a heritable defensive endosymbiont, the γ‐proteobacterium Hamiltonella defensa. Previous studies reported a lack of genotype specificity between unprotected aphids and parasitoids, but suggested that symbiont‐conferred resistance might exhibit a higher degree of specificity. Indeed, in addition to ample variation in host resistance as well as parasitoid infectivity, we found a strong aphid clone‐by‐parasitoid line interaction on the rates of successful parasitism. This genotype specificity appears to be mediated by H. defensa, highlighting the important role that endosymbionts can play in host–parasite coevolution.
Why join a neighbour: fitness consequences of colony fusions in termites
Authors: Korb J. , Roux E. A.
Published: September 2012

The evolution of life is characterized by major evolutionary transitions during which independent units cooperated and formed a new level of selection. Relatedness is a common mechanism that reduces conflict in such cooperative associations. One of the latest transitions is the evolution of social insect colonies. As expected, they are composed of kin and mechanisms have evolved that prevent the intrusion of nonrelatives. Yet, there are exceptions an extreme case is the fusion of unrelated colonies. What are the advantages of fusions that have colonies with a high potential for conflict as a consequence? Here, we investigated fitness costs and benefits of colony fusions in a lower termite species, Cryptotermes secundus, in which more than 25% of all colonies in the field are fused. We found two benefits of colony fusion depending on colony size: very small colonies had an increased probability of survival when they fused, yet for most colony sizes mainly a few workers profit from colony fusions as their chance to become reproductives increased. This individual benefit was often costly for other colony members: colony growth was reduced and the current reproductives had an increased chance of dying when fusions were aggressive. Our study suggests that fusion of colonies often is the result of ‘selfish’ worker interests to become reproductives, and this might have been important for the termites' social evolution. Our results uniquely shows that selfish interests among related colony members can lead to the formation of groups with increased potential for conflict among less related members.
Long‐term radical prostatectomy outcomes among participants from the European Randomized Study of Screening for Prostate Cancer (ERSPC) Rotterdam
Authors: Loeb Stacy , Zhu Xiaoye , Schroder Fritz H. , Roobol Monique J.
Published: September 2012

Study Type – Therapy (cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?

Radical prostatectomy was previously shown to improve long‐term outcomes among men with clinically‐detected prostate cancer. Our data suggests that radical prostatectomy is also associated with improved outcomes in men with screen‐detected prostate cancer.

OBJECTIVE

To examine the long‐term outcomes of radical prostatectomy (RP) among men diagnosed with prostate cancer from the screening and control arms of the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer (ERSPC).

PATIENTS AND METHODS

Among 42 376 men randomised during the period of the first round of the trial (1993–1999), 1151 and 210 in the screening and control arms were diagnosed with prostate cancer, respectively.

Of these men, 420 (36.5%) screen‐detected and 54 (25.7%) controls underwent RP with long‐term follow‐up data (median follow‐up 9.9 years).

Progression‐free (PFS), metastasis‐free (MFS) and cancer‐specific survival (CSS) rates were examined, and multivariable Cox proportional hazards models were used to determine whether screen‐detected (vs control) was associated with RP outcomes after adjusting for standard predictors.

RESULTS

RP cases from the screening and control arms had statistically similar clinical stage and biopsy Gleason score, although screen‐detected cases had significantly lower prostate‐specific antigen (PSA) levels at diagnosis.

Men from the screening arm had a significantly higher PFS (P= 0.003), MFS (P < 0.001) and CSS (P= 0.048).

In multivariable models adjusting for age, PSA level, clinical stage, and biopsy Gleason score, the screening group had a significantly lower risk of biochemical recurrence (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.23–0.83, P= 0.011) and metastasis (HR 0.18, 95% CI 0.06–0.59, P= 0.005).

Additionally adjusting for tumour volume and other RP pathology features, there was no longer a significant difference in biochemical recurrence between the screening and control arms.

Limitations of the present study include lead‐time bias and non‐randomised treatment selection.

CONCLUSIONS

After RP, screen‐detected cases had significantly improved PFS, MFS and CSS compared with controls within the available follow‐up time.

The screening arm remained significantly associated with lower rates of biochemical recurrence and metastasis after adjusting for other preoperative variables.

However, considering also RP pathology, the improved outcomes in the screening group appeared to be mediated by a significantly lower tumour volume.
FROM BUDGETARY FORECASTS TO EX POST FISCAL DATA: EXPLORING THE EVOLUTION OF FISCAL FORECAST ERRORS IN THE EUROPEAN UNION
Authors: BEETSMA ROEL , BLUHM BENJAMIN , GIULIODORI MASSIMO , WIERTS PETER
Published: September 2012

This paper splits the ex post error in the budget balance, defined as the final budget figure minus the planned figure, into implementation and revision errors, and investigates the determinants of these errors. The implementation error is the difference between the nowcast, published toward the end of the year of budget implementation, and the planned budget, while the revision error is the difference between the final figure and the nowcast. The split takes account of differences in reporting incentives at the different budgeting stages. The predictive content of fiscal plans is important, because it determines the reliability of the budget, while that of the nowcasts is important also because these figures are an input for the next budget and may contain important signals about the fiscal stance. Implementation and revision errors may arise for political and strategic reasons. Our results suggest that an improvement in the quality of institutions, whether measured by the tightness of national fiscal rules, the medium‐term budgetary framework or budgetary transparency, increases the quality of budgetary reporting at both the planning and the nowcast stage. This supports the recently adopted requirements on national fiscal frameworks. It also strengthens the case for a close monitoring by the European Commission of national budgeting. (JEL E6, H6)
Longitudinal analysis of integrase N155H variants in heavily treated patients failing raltegravir‐based regimens
Authors: Nguyen HL , Charpentier C , Nguyen N , de Truchis P , Molina J‐M , Ruxrungtham K , Delaugerre C
Published: September 2012

Objectives

The mechanism of raltegravir (RAL)‐resistant evolutions has not already been elucidated. Because the emergence of RAL resistance is usually initiated by the N155H mutant, we assessed the role of minor N155H‐mutated variants in circulating RNA and archived DNA in five heavily treated patients experiencing long‐term RAL therapy failure and harbouring three different resistance profiles determined by standard genotyping.

Methods

Allele‐specific polymerase chain reaction (AS‐PCR) was used to detect N155H mutants in longitudinal stored plasma and whole‐blood samples before, during and after RAL‐based regimens in five patients infected with the HIV‐1 B subtype.

Results

No minor N155H‐mutated variant was found by AS‐PCR in either plasma or whole‐blood samples collected at baseline and after RAL withdrawal in any of the five patients. During RAL failure, the mutation N155H was detected at different levels in three patients displaying the N155H pathway and gradually declined when the double mutant Q148H+G140S was selected in one patient. In two patients with the Q148H resistance pathway, no N155H variant was identified by AS‐PCR in either viral RNA or DNA.

Conclusions

The N155H mutation present at various levels from minority to majority showed no relationship with the three RAL‐associated resistance profiles, suggesting that this mutant may not play a role in determining different resistance profiles. Moreover, pre‐existing N155H is very infrequent and, if selected during RAL failure, the N155H mutant disappears quickly after RAL withdrawal.
Predictors of symptomatic HIV‐associated neurocognitive disorders in universal health care
Authors: McCombe JA , Vivithanaporn P , Gill MJ , Power C
Published: September 2012

Objectives

The aim of the study was to determine the risk factors predictive of symptomatic HIV‐associated neurocognitive disorders (sHAND) among HIV‐infected patients receiving active medical care.

Methods

Baseline demographic and clinical characteristics were analysed in patients with sHAND (HIV‐associated dementia and minor neurocognitive disorder) in a population‐based longitudinal cohort of HIV‐infected patients with access to universal health care, including combination antiretroviral therapy (cART) from 1999 to 2008. Variables evaluated for their association with sHAND included age and ethnicity, survival duration with HIV‐1 infection, vascular disease risk factors, and laboratory indices such as blood CD4 T‐cell count at its nadir and at cART initiation, using both univariable and multivariable logistic regression models.

Results

A total of 1320 patients were investigated, including the patients diagnosed with sHAND (n = 90) during the study period. In univariable analyses, increased age, increased length of survival with HIV, low nadir CD4 and CD8 T‐cell counts, high baseline viral load (> 1 000 000 HIV‐1 RNA copies/mL), and African origin were predictive of a diagnosis of sHAND (P < 0.05). In multivariable analysis, increased age, increased length of survival, low nadir CD4 T‐cell counts, and high baseline viral load remained predictive of sHAND (P < 0.05). Remarkably, CD4 T‐cell counts at cART initiation, hepatitis C virus coinfection, and vascular disease risk factors failed to predict sHAND in both analyses.

Conclusions

Increased age and survival duration, lower nadir CD4 T‐cell counts, and higher baseline viral load were consistent predictors of the development of sHAND among persons with HIV/AIDS in universal health care, underscoring the importance of attention to these variables in clinical care.
Number of daily pills, dosing schedule, self‐reported adherence and health status in 2010: a large cross‐sectional study of HIV‐infected patients on antiretroviral therapy
Authors: Gianotti N , Galli L , Bocchiola B , Cahua T , Panzini P , Zandonà D , Salpietro S , Maillard M , Danise A , Pazzi A , Lazzarin A , Castagna A
Published: September 2012

Objectives

The aim of the study was to assess whether pill burden is associated with self‐reported adherence to current combination antiretroviral regimens and health status in a large sample of unselected and chronically treated HIV‐infected patients.

Methods

An adherence and health status questionnaire was offered to all patients collecting their drugs between March and May 2010 at our clinic; both parameters were primarily evaluated using a visual analogue scale. Linear correlations were evaluated using Spearman's correlation coefficient. Wilcoxon's rank‐sum test and the χ2 test were used to compare quantitative and qualitative variables. The generalized linear model was used in multivariable analyses.

Results

Among 2763 subjects on treatment during the study period, 2114 (78.8% male; mean age 46.9 ± 8.84 years) were tested for adherence; 1803 (85.3%) had viral loads < 50 HIV‐1 RNA copies/mL.

After adjusting for age, gender, HIV risk factor, current CD4 count, pill burden and dosing interval, adherence was higher in patients with undetectable HIV RNA (P < 0.0001) and directly associated with current CD4 count (P = 0.029). After adjusting for the same variables, health status was better in patients with undetectable viraemia (P = 0.004) and in men who have sex with men (MSM) and heterosexuals compared with injecting drug users and those with other risk factors (P < 0.0001 for MSM and P = 0.008 for heterosexuals); it was also directly associated with current CD4 count (P < 0.0001) and inversely associated with age (P < 0.0001) and pill burden (P = 0.019).

Conclusions

In this highly adherent population, the number of daily pills was related to self‐reported health status but not to self‐reported adherence, whereas the dosing interval did not influence self‐reported adherence or health status.
Pancreatic insufficiency in patients with HIV infection: role of didanosine questioned
Authors: Martin TCS , Scourfield A , Rockwood N , Martin NK , Patel N , Nelson M , Gazzard BG
Published: September 2012

Objectives

The aim of the study was to identify possible causes of pancreatic insufficiency in patients with HIV infection.

Methods

A retrospective analysis of 233 HIV‐positive patients for whom faecal elastase measurement was available was performed to investigate potential associations with core demographic data, HIV infection characteristics, degree of immunosuppresion, exposure to antiretroviral therapy (ART), alcohol misuse, diabetes, hepatitis C virus (HCV) infection, triglyceride and cholesterol levels and symptomatology. The response to pancreatic enzyme replacement for patients with evidence of insufficiency was also evaluated.

Results

Of 233 patients, 104 (45%) had evidence of pancreatic exocrine insufficiency (faecal elastase < 200 mcg/g). A positive association with exocrine pancreatic insufficiency was found for HCV infection (P = 0.007), previous or current HCV treatment (P = 0.003), alcohol misuse history (P = 0.006) and the presence of steatorrhoea (P = 0.03). There was no demonstrated association between exocrine pancreatic insufficiency and didanosine (ddI) exposure (P = 0.43) or stavudine (d4T) exposure (P = 0.62). Seventy‐seven per cent of patients who were treated with pancreatic enzymatic supplementation reported a subjective improvement in symptoms.

Conclusions

Faecal elastase sampling should form part of the routine work‐up for HIV‐positive patients with chronic diarrhoea even in the absence of ‘traditional’ risk factors such as ddI exposure. In particular, if the patient has steatorrhoea, a history of alcohol exposure or their HCV serology is positive, they should be considered for investigation. Treatment with pancreatic enzyme supplementation appears to be effective in the treatment of chronic diarrhoea caused by pancreatic insufficiency in the majority of patients.
Rewarding Excellent Teaching: The Translation of a Policy Initiative in the United Kingdom
Authors: Turner Rebecca , Gosling David
Published: September 2012

The need to provide more significant rewards for ‘teaching excellence’ in order to provide parity of status with research in higher education has often been asserted. This paper examines ways in which the idea of rewarding excellent teaching has been understood and translated within a large teaching and learning initiative that was overtly based on rewarding and recognising excellent teaching. The initiative studied here, was the formation of 74 Centres for Excellence in Teaching and Learning, established by the Higher Education Funding Council for England in 2004. The findings are based on research that traced the ‘translation’ of this policy aim in 15 institutions. The research found that the process of translation resulted in multiple interpretations of this agenda, including some that rejected the notion completely, raising some pertinent questions about policy formation in relation in teaching and learning.
Wage and hour violations in urban labour markets: a comparison ofLosAngeles,NewYork andChicago
Authors: Milkman Ruth , González Ana Luz , Ikeler Peter
Published: September 2012

This article compares violations of minimum wage laws and other labour standards inNewYorkCity,LosAngeles andChicago.LosAngeles has the highest violation rates, due to such factors as its industrial composition and disproportionately large number of small establishments, as well as its vast unauthorised immigrant population. In addition,LosAngeles’ higher rates reflect the stricter legal standards inCalifornia. We conclude that, although stronger workplace laws and regulations are crucial, in the absence of effective enforcement, they may fail to prevent workplace violations.
Genomic tillage and the harvest of fungal phytopathogens
Authors: Oliver Richard
Published: September 2012

Genome sequencing has been carried out on a small selection of major fungal ascomycete pathogens. These studies show that simple models whereby pathogens evolved from phylogenetically related saprobes by the acquisition or modification of a small number of key genes cannot be sustained.The genomes show that pathogens cannot be divided into three clearly delineated classes (biotrophs, hemibiotrophs and necrotrophs) but rather into a complex matrix of categories each with subtly different properties. It is clear that the evolution of pathogenicity is ancient, rapid and ongoing. Fungal pathogens have undergone substantial genomic rearrangements that can be appropriately described as ‘genomic tillage’. Genomic tillage underpins the evolution and expression of large families of genes – known as effectors – that manipulate and exploit metabolic and defence processes of plants so as to allow the proliferation of pathogens.

Contents

Summary
1015

I.
Introduction
1015

II.
Magnaporthe oryzae
1016

III.
Stagonospora nodorum
1017

IV.
Fusarium graminearum
1018

V.
Fusarium solani, Fusarium oxysporum and Fusarium verticilioides
1018

VI.
Mycosphaerella graminicola
1019

VII.
Leptosphaeria maculans
1019

VIII.
Blumeria graminis
1019

IX.
Genomic tillage and the crop of effectors
1020

X.
Research priorities
1020

Acknowledgements
1021

References
1021