bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of effect of impaired renal function on lamivudine pharmacokinetics
Authors: Bouazza Naïm , Tréluyer Jean‐Marc , Ghosn Jade , Hirt Déborah , Benaboud Sihem , Foissac Frantz , Viard Jean‐Paul , Urien Saik
Published: April 2014

Aims

This study aimed to describe lamivudine pharmacokinetics in patients with impaired renal function and to evaluate the consistency of current dosing recommendations.

Methods

A total of 244 patients, ranging in age from 18 to 79 years (median 40 years) and in bodyweight from 38 to 117 kg (median 71 kg), with 344 lamivudine plasma concentrations, were analysed using a population pharmacokinetic analysis. Serum creatinine clearance (CLCR) was calculated using the Cockcroft–Gault formula; 177 patients had normal renal function (CLCR > 90 ml min−1), 50 patients had mild renal impairment (CLCR = 60–90 ml min−1), 20 patients had moderate renal impairment (CLCR = 30–60 ml min−1), and five patients had severe renal impairment (CLCR < 30 ml min−1).

Results

A two‐compartment model adequately described the data. Typical population estimates (percentage interindividual variability) of the apparent clearance (CL/F), central (Vc/F) and peripheral volumes of distribution (Vp/F), intercompartmental clearance (Q/F) and absorption rate constant (Ka) were 29.7 l h−1 (32%), 68.2 l, 114 l, 10.1 l h−1 (85%) and 1 h−1, respectively. Clearance increased significantly and gradually with CLCR. Our simulations showed that a dose of 300 mg day−1 in patients with mild renal impairment could overexpose them. A dose of 200 mg day−1 maintained an exposure close to that of adults with normal renal function. However, the current US Food and Drug Administration recommendations for lamivudine in other categories of patients (from severe to moderate renal impairment) provided optimal exposures.

Conclusions

Lamivudine elimination clearance is related to renal function. To provide optimal exposure, patients with mild renal impairment should receive 200 mg day−1 instead of 300 mg day−1.
Use of a Birth Plan within Woman‐held Maternity Records: A Qualitative Study with Women and Staff in Northeast Scotland
Authors: Whitford Heather M. , Entwistle Vikki A. , van Teijlingen Edwin , Aitchison Patricia E. , Davidson Tracey , Humphrey Tracy , Tucker Janet S.
Published: April 2014

Background

Birth plans are written preferences for labor and birth which women prepare in advance. Most studies have examined them as a novel intervention or “outside” formal care provision. This study considered use of a standard birth plan section within a national, woman‐held maternity record.

Methods

Exploratory qualitative interviews were conducted with women (42) and maternity service staff (24) in northeast Scotland. Data were analyzed thematically.

Results

Staff and women were generally positive about the provision of the birth plan section within the record. Perceived benefits included the opportunity to highlight preferences, enhance communication, stimulate discussions, and address anxieties. However, not all women experienced these benefits or understood the birth plan's purpose. Some were unaware of the opportunity to complete it or could not access the support they needed from staff to discuss or be confident about their options. Some were reluctant to plan too much. Staff recognized the need to support women with birth plan completion but noted practical challenges to this.

Conclusions

A supportive antenatal opportunity to allow discussion of options may be needed to realize the potential benefits of routine inclusion of birth plans in maternity notes.
Measuring Adequacy of Prenatal Care: Does Missing Visit Information Matter?
Authors: Kurtzman Jordan H. , Wasserman Erin B. , Suter Barbara J. , Glantz J. Christopher , Dozier Ann M.
Published: April 2014

Background

Kotelchuck's Adequacy of Prenatal Care Utilization (APNCU) Index is frequently used to classify levels of prenatal care. In the Finger Lakes Region (FLR) of upstate New York, prenatal care visit information late in pregnancy is often not documented on the birth certificate. We studied the extent of this missing information and its impact on the validity of regional APNCU scores.

Methods

We calculated the “weeks between” a mother's last prenatal care visit and her infant's date of birth. We adjusted the APNCU algorithm creating the Last Visit Adequacy of Prenatal Care (LV‐APNC) Index using the last recorded prenatal care visit date as the end point of care and the expected number of visits at that time. We compared maternal characteristics by care level with each index, examining rates of reclassification and number of “weeks between” by birth hospital. Stuart‐Maxwell, McNemar, chi‐square, and t‐tests were used to determine statistical significance.

Results

Based on 58,462 births, the mean “weeks between” was 2.8 weeks. Compared with their APNCU Index score, 42.4 percent of mothers were reclassified using the LV‐APNC Index. Major movement occurred from Intermediate (APNCU) to Adequate or Adequate Plus (LV‐APNC) leaving the Intermediate Care group a more at‐risk group of mothers. Those with Adequate or Adequate Plus Care (LV‐APNC) increased by 31.6 percent, surpassing the Healthy People 2020 objective.

Conclusions

In the FLR, missing visit information at the end of pregnancy results in an underestimation of mothers’ prenatal care. Future research is needed to determine the extent of this missing visit information on the national level.
Histopathological characteristics of microfocal prostate cancer detected during systematic prostate biopsy
Authors: Guttilla Andrea , Zazzara Michele , Zattoni Fabio , Novara Giacomo , Zanin Martina , Gardiman Marina , Ficarra Vincenzo , Zattoni Filiberto
Published: April 2014

Objective

To evaluate the prevalence of adverse pathological features and the percentage of multifocal and/or bilateral disease in a series of patients who underwent radical prostatectomy (RP) for unique, microfocal prostate cancer (miPCa) detected on prostate biopsy in the pre‐active surveillance (AS) era.

Patients and Methods

In this retrospective, multi‐institutional study, we analysed the clinical records of 131 consecutive patients who underwent either retropubic or robot‐assisted RP for miPCa at two referral centres from January 2000 to December 2011. miPCa was defined as a neoplastic lesion present in ≤10% of core with biopsy Gleason score not applicable or biopsy Gleason score 6.

Results

There were 17 (13%) pT3–4 prostate cancers and a single case (0.8%) of pN+ tumour. Moreover, 31 (24.1%) patients had a Gleason score of >6 in the RP specimen. Therefore, unfavourable pathological features (pT3–4/N+ and/or Gleason score >6) were present in 40 (30.5%) patients. The median (interquartile range) prostate‐specific antigen (PSA) density was 0.11 (0.09–0.17) and 0.16 (0.11–0.24) ng/mL/mL in patients with favourable and unfavourable pathological characteristics, respectively (P = 0.003). The receiver operating characteristic curve had an area under the curve value of 0.67 (95% confidence interval 0.56–0.77) for PSA density to predict the risk of unfavourable pathological features.

Conclusion

Patients with miPCa who are candidates for an AS protocol should be adequately informed that in ≈30% of cases the cancer might be locally advanced and/or with a Gleason score of >6. Those unfavourable pathological characteristics could be predicted by the PSA density value. Further studies should investigate the role of a more extensive biopsy sampling to reduce the risk of under‐staging and/or under‐grading in patients with an initial diagnosis of miPCa.
Vessel-associated myogenic precursors control macrophage activation and clearance of apoptotic cells
Authors: Bosurgi L , Brunelli S , Rigamonti E , Monno A , Manfredi A A , Rovere-Querini P
Published: April 2014

Swift and regulated clearance of apoptotic cells prevents the accumulation of cell remnants in injured tissues and contributes to the shift of macrophages towards alternatively activated reparatory cells that sustain wound healing. Environmental signals, most of which are unknown, in turn control the efficiency of the clearance of apoptotic cells and as such determine whether tissues eventually heal. In this study we show that vessel-associated stem cells (mesoangioblasts) specifically modulate the expression of genes involved in the clearance of apoptotic cells and in macrophage alternative activation, including those of scavenger receptors and of molecules that bridge dying cells and phagocytes. Mesoangioblasts, but not immortalized myoblasts or neural precursor cells, enhance CD163 membrane expression in vitro as assessed by flow cytometry, indicating that the effect is specific. Mesoangioblasts transplanted in acutely or chronically injured skeletal muscles determine the expansion of the population of CD163+ infiltrating macrophages and increase the extent of CD163 expression. Conversely, macrophages challenged with mesoangioblasts engulf significantly better apoptotic cells in vitro. Collectively, the data reveal a feed-forward loop between macrophages and vessel-associated stem cells, which has implications for the skeletal muscle homeostatic response to sterile injury and for diseases in which homeostasis is jeopardized, including muscle dystrophies and inflammatory myopathies.
Esthetic outcome and alterations of soft tissue around single implant crowns: a 2‐year prospective study
Authors: Gu Ying‐Xin , Shi Jun‐Yu , Zhuang Long‐Fei , Qiao Shi‐Chong , Xu You‐You , Lai Hong‐Chang
Published: April 2014

Objective

The aim of this prospective study was to assess the esthetic outcome and alterations of peri‐implant soft tissue using tissue‐level implants. Furthermore, the influencing factors, including grafting and gingival biotype, of esthetic outcome of peri‐implant soft tissue were also evaluated.

Materials and methods

Of 38 patients with single missing anterior tooth in maxilla were treated with a Straumann ® Standard Plus SLA implant. Bone augmentation was performed in 24 patients. Follow‐up was conducted at 12 and 24 months after definitive crowns placement. Esthetic outcome using the pink esthetic score/white esthetic score (PES/WES) and clinical parameters were evaluated.

Results

The mean PES/WES value at baseline, 1‐year, and 2‐year examination was 13.79, 14.87, and 14.96. Significant improvement was found between baseline and 1‐year examination (P < 0.01). And the improvement between 1‐year and 2‐year examination was not significant (P = 0.40). The mean PES changing value in patients with thick biotype was significantly higher than those with thin biotype at 2‐year after definitive crowns placement (P = 0.03). Graft procedure had an unfavorable effect on mean PES value both at baseline and at follow‐up (P < 0.01). No implants were lost at 2‐year examination. Three patients experienced peri‐implant infection. No significant difference was found with the passage of time in modified plaque index (mPI), probing pocket depth (PPD), and modified bleeding index (mBI).

Conclusion

According to the present prospective clinical study, it can be concluded that it is feasible to use tissue‐level implant to support single crowns in esthetic area. Favorable short‐term esthetic outcome and stability of soft tissue around single implant crowns can be expected in patients with or without graft. However, graft procedures might have an unfavorable effect on the esthetic outcome. Gingival biotype can be considered as prognostic factor for esthetic outcome. RCTs with long‐term follow‐up are needed to provide evidence for the long‐term stability of peri‐implant soft tissue using tissue‐level implant systems.
Poor agreement between transcranial Doppler and near‐infrared spectroscopy‐based estimates of cerebral blood flow changes in sepsis
Authors: Toksvang Linea N. , Plovsing Ronni R. , Petersen Marie W. , Møller Kirsten , Berg Ronan M. G.
Published: April 2014

Background

Continuous monitoring of cerebral blood flow (CBF) may be valuable in critically ill patients with sepsis. In this study, we compared spatially resolved near‐infrared spectroscopy (NIRS) to transcranial Doppler ultrasound (TCD)‐derived estimates of noradrenaline‐associated changes in CBF in such patients.

Methods

Mean arterial blood pressure (MAP) was elevated by increasing the noradrenaline infusion rate in eight mechanically ventilated, critically ill patients diagnosed with severe sepsis or septic shock. The associated changes in CBF were assessed by simultaneous ipsilateral NIRS (ScO2) and TCD (middle cerebral artery blood flow velocity, MCAv) measurements.

Results

A total of fifteen simultaneous NIRS‐ and TCD‐derived assessments of noradrenaline‐associated changes in CBF were obtained. MAP was increased from 74 (median; interquartile range (IQR), 71–90) to 100 (median; IQR, 93–115) mmHg (P<0·05), which was associated with an increase in MCAv of 14% (median; IQR, 2–22; P<0·05), whereas no changes were observed in ScO2; 1% (median; IQR, [−4]–3; P = 0·96). A Bland–Altman plot was used to compare the two methods and showed a poor agreement between NIRS‐ and TCD‐derived estimates with a relative bias of 14% and limits of agreement of −18% to 45% change in CBF.

Conclusion

Our findings stress that TCD and NIRS cannot be used interchangeably for monitoring changes in cerebral haemodynamics in critically ill patients with sepsis receiving vasopressor treatment with noradrenaline.
The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention
Authors: Henriksen Ulrik L. , Henriksen Jens H.
Published: April 2014

In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin,99mTc‐DTPA,51Cr‐EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy between the total plasma clearance and the urinary plasma clearance. This is owing to delayed indicator distribution to smaller or larger parts of the interstitial space, which in patients with ascites may simulate a peritoneal dialysator. In patients with fluid retention, urinary plasma clearance should be assessed to obtain a correct measurement of the glomerular filtration rate (GFR). In theory, total plasma clearance with late samples (24‐h, 48‐h) may be applied in patients with fluid retention, but validation hereof has not been performed. Until such studies are completed, it is recommended that patients with fluid retention have theirGFRmeasured by a urinary plasma clearance technique with controlled quantitative urinary sampling within a few hours after indicator injection.
Cardiac remodelling and functional alterations in mild‐to‐moderate renal dysfunction: comparison with healthy subjects
Authors: Asp Anna M. , Wallquist Carin , Rickenlund Anette , Hylander Britta , Jacobson Stefan H. , Caidahl Kenneth , Eriksson Maria J.
Published: April 2014

Introduction

Left ventricular (LV) hypertrophy (LVH) and reduced LV function correlate with poor prognosis in patients with chronic kidney disease (CKD). Our aim is to investigate whether mild‐to‐moderate CKD is associated with cardiac abnormalities.

Methods

Echocardiography, including tissue Doppler imaging, was performed in 103 patients with CKD at stages 2–3 and 4–5, and in 53 healthy controls. The systolic (s′) and diastolic myocardial velocity (e′), and the transmitral diastolic flow velocity (E) were measured, and E/e′ was calculated.

Results

Patients with chronic kidney disease had higher mean E/e′ than controls (mean E/e′: controls 5·00 ± 1·23 versus CKD 4–5 6·36 ± 1·71, P<0·001 and versus CKD 2–3 5·69 ± 1·47, P = 0·05), indicating altered diastolic function in the patients. The CKD groups showed lower longitudinal systolic function than controls, as assessed by atrio‐ventricular plane displacement and s′ (mean s′: controls 11·5 ± 1·9 cm s−1 versus CKD 4–5 10·4 ± 2·1 cm s−1, P = 0·03 and versus CKD 2–3 10·4 ± 2·1 cm s−1, P = 0·02). The prevalence of LVH was higher in patients with CKD than in controls (controls 13% versus CKD 4–5 37%, P = 0·006 and versus CKD 2–3 30%, P = 0·03).

Conclusion

Alterations in systolic and diastolic myocardial function can be seen in mild‐to‐moderate CKD compared with controls, indicating that cardiac involvement starts early in CKD, which may be a precursor of premature cardiac morbidity.
Influence of skin blood flow and source‐detector distance on near‐infrared spectroscopy‐determined cerebral oxygenation in humans
Authors: Hirasawa Ai , Yanagisawa Shintaro , Tanaka Naoki , Funane Tsukasa , Kiguchi Masashi , Sørensen Henrik , Secher Niels H. , Ogoh Shigehiko
Published: April 2014

Most near‐infrared spectroscopy (NIRS) apparatus fails to isolate cerebral oxygenation from an extracranial contribution although they use different source‐detector distances. Nevertheless, the effect of different source‐detector distances and change in extracranial blood flow on the NIRS signal has not been identified in humans. This study evaluated the extracranial contribution, as indicated by forehead skin blood flow (SkBF) to changes in the NIRS‐determined cerebral oxyhaemoglobin concentration (O2Hb) by use of a custom‐made multidistance probe. Seven males (age 21 ± 1 year) were in a semi‐recumbent position, while extracranial blood flow was restricted by application of four different pressures (+20 to +80 mmHg) to the left temporal artery. The O2Hb was measured at the forehead via a multidistance probe (source‐detector distance; 15, 22·5 and 30 mm), and SkBF was determined by laser Doppler. Heart rate and blood pressure were unaffected by application of pressure to the temporal artery, while SkBF gradually decreased (P<0·001), indicating that extracranial blood flow was manipulated without haemodynamic changes. Also, O2Hb gradually decreased with increasing applied pressure (P<0·05), and the decrease was related to that in SkBF (r = 0·737, P<0·01) independent of the NIRS source to detector distance. These findings suggest that the NIRS‐determined cerebral oxyhaemoglobin is affected by change in extracranial blood flow independent of the source‐detector distance from 15 to 30 mm. Therefore, new algorithms need to be developed for unbiased NIRS detection of cerebral oxygenation.
Predictors of post‐traumatic psychological growth in the late years after lung transplantation
Authors: Fox Kristen R. , Posluszny Donna M. , DiMartini Andrea F. , DeVito Dabbs Annette J. , Rosenberger Emily M. , Zomak Rachelle A. , Bermudez Christian , Dew Mary Amanda
Published: April 2014

Background

Although lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late‐term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit – post‐traumatic growth (PTG) – and we focused on long‐term (>5 yr) survivors.

Methods

Among 178 patients from a prospective study of mental health during the first two yr post‐transplant, we recontacted survivors 6–11 yr post‐transplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses.

Results

Sixty‐four patients (86% of survivors) were assessed (M = 8.1 yr post‐transplant, SD = 1.2). Mean PTG exceeded the scale's midpoint (M = 38.6, SD = 10.0; scale midpoint = 25). Recipients experiencing greater PTG were female (p = 0.022), less educated (p = 0.014), and had a history of post‐transplant panic disorder (p = 0.005), greater friend support (p = 0.048), and better perceived health (p = 0.032). Neither other pre‐ or post‐transplant mood and anxiety disorders nor transplant‐related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG.

Conclusions

PTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long‐term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive post‐transplant psychosocial outcomes deserves attention.
Post‐transplant malignancy: a burdensome complication in renal allograft recipients in Korea
Authors: Kim Ji Hyun , Kim Seon‐Ok , Han Duck Jong , Park Su‐Kil
Published: April 2014

Cancer has been a serious complication of kidney transplantation ever since the outcome of this procedure improved. The incidence of cancer among kidney transplant (KT) recipients is increasing, and these patients have a higher risk of developing cancer than the general population. The present retrospective cohort study compared the cancer rate of kidney recipients in a single transplantation center in Korea with that in healthy Korean individuals using the standardized incidence ratio (SIR). The medical records of all 2365 patients who underwent renal transplantation between 1989 and 2009 were reviewed retrospectively. During the study period, 136 renal allograft recipients developed 140 malignancies. The cumulative cancer incidence one, five, 10, and 15 yr post‐transplantation was 0.60%, 3.24%, 5.69%, and 8.90%, respectively. Non‐Hodgkin lymphoma (NHL) and thyroid cancer were the most common cancers after renal transplantation, occurring significantly more frequently than in the general Korean population. The SIR of all cancers was 1.9 (women: 2.4; men: 1.6). Comparison with similar studies in Korea and other countries suggests transplant center‐related differences dictate post‐transplant malignancy incidence more strongly than ethnic or geographic factors. Early surveillance programs for de novo malignancies after kidney transplantation focusing on kidney‐transplantation‐related tumors and postoperative time period should be established.
Serum liver‐type fatty acid‐binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death
Authors: Kawai Akihiro , Kusaka Mamoru , Kitagawa Fumihiko , Ishii Junichi , Fukami Naohiko , Maruyama Takahiro , Sasaki Hitomi , Shiroki Ryoichi , Kurahashi Hiroki , Hoshinaga Kiyotaka
Published: April 2014

Kidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver‐type fatty acid‐binding protein (L‐FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L‐FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain‐dead donors (BD), or DCD were retrospectively enrolled. Serum L‐FABP levels were measured from samples collected before and after KTx. Serum L‐FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver‐operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post‐operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L‐FABP levels may predict graft recovery and need for HD after DCD KTx.
Metacommunity structure in a highly fragmented forest: has deforestation in the Atlantic Forest altered historic biogeographic patterns?
Authors: de la Sancha Noé U. , Higgins C. L. , Presley Steven J. , Strauss Richard E.
Published: April 2014

Aim

To determine whether there is evidence of changes in small mammals distributions and emergent metacommunity structure in the Atlantic Forest resulting from extensive habitat loss and fragmentation associated with anthropogenic activities.

Location

South American Atlantic Forest from northeastern Brazil to eastern Paraguay.

Methods

Using presence–absence data for non‐volant small mammals, we analysed metacommunity structure for communities from 76 fragments distributed throughout Atlantic Forest. We evaluated coherence, range turnover and range boundary clumping for the entire non‐volant small mammal assemblage, marsupials, rodents and sigmodontine rodents separately. β‐diversity based on the multiplicative model was used to estimate the number of compartments (groups of sites with similar species composition) in Clementsian structures, and cluster analysis identified which sites formed compartments. Canonical correspondence analysis determined which environmental factors were associated with the gradients along which metacommunities were structured. Distance‐decay analysis evaluated the spatial structure in small mammal and environmental data, and Mantel tests evaluated correlations between them.

Results

Rodent metacommunities had Clementsian structure, whereas marsupials had Gleasonian structure. Compartment locations for rodents were consistent with areas of endemism. Temperature seasonality was most associated with the gradients along which metacommunities were structured. Assemblage and environmental dissimilarity among sites had significant positive relationships with geographic distance.

Main conclusions

Compartment locations in Clementsian structures mirrored historical refugium locations and important vicariance events associated with large rivers. Despite extensive deforestation in Atlantic Forest, small mammal distributions are consistent with expectations based on historical biogeography, suggesting that anthropogenic activities have not yet greatly affected geographic distributions of emergent metacommunity structures. However, extinction debt associated with recent fragmentation and habitat loss may exist. Any effective conservation plan for large and fragmented biomes must consider areas of endemism to maintain regional biodiversity and maintain sufficiently large and connected fragments to facilitate rescue effects and minimize effects of extinction debt.
New Start or False Start? The ICC and Electoral Violence in Kenya
Authors: Höhn Sabine
Published: April 2014

This article investigates how far the International Criminal Court (ICC) trial of post‐election violence in Kenya represented a new start for Kenyan politics, for international criminal justice in Africa, and for the international response to democratic violence more broadly. For the first time an international criminal court investigated violence associated with the democratic process. The prosecution of instigators of violence was not only a demonstration of a far less patient international approach to a democratic process gone wrong; it also provided the internationally expected response to exceptional levels of violence in the face of domestic inaction. However, it is less clear whether the ICC case represents a new beginning for Kenya. It might be a new start for political accountability in the context of a weak domestic judiciary, but it cannot address the structural root causes of violence that require political reform rather than criminal prosecution.
New Law against an Old State: Land Restitution as a Transition to Justice in Post‐Apartheid South Africa?
Authors: Zenker Olaf
Published: April 2014

Based on a case study of the so‐called ‘Kafferskraal’ land claim, this article scrutinizes the ongoing land restitution process in post‐apartheid South Africa with regard to its capacity to provide a transition towards ‘justice’. After sketching the legal and institutional set‐up of land restitution, the justice of the actual restitution process is explored with reference to conflicting interpretations by various actors involved in this exemplary case. Here, a focus on divergent understandings of what historically constituted valid rights in land as well as forms of past compensation reveals continuing discrepancies regarding the legitimacy of various property regimes. These differences, leading to divergent evaluations of ‘the justice’ of this claim's final outcome, are shown to be ultimately rooted in incompatible logics of exceptionality and the ordinary, which conceive of land restitution in terms of either ‘law making’ or ‘law preserving’. The article concludes with a discussion of the implications of such a configuration of land restitution as a measure of transitional justice.
Transitional Justice, States of Emergency and Business as Usual in Sierra Leone
Authors: Anders Gerhard
Published: April 2014

This article situates the establishment of the Special Court for Sierra Leone in the wider context of the country's transitional period between 1999 and 2004. During this pivotal period, Sierra Leone experienced a massive state‐building intervention to establish the rule of law and introduce democracy. However, this new beginning was characterized by violent clashes between the leaders of the various warring factions who tried to secure political influence and security after the signing of the Lomé Peace Agreement in 1999. The article examines events that resulted in the unravelling of the peace agreement, the establishment of the Special Court and the arrests of hundreds of suspected rebels under a state of emergency, to show how they undermined the lofty promises of justice made by the representatives of the Special Court and the international community. It reveals the limited scope of the retributive project of international criminal justice at the intersections with the business‐as‐usual political manoeuvres that occurred after the end of the civil war.
Accounting Performance and Capacity Investment Decisions: Evidence from California Hospitals
Authors: Bai Ge , Hsu Sylvia H. , Krishnan Ranjani
Published: April 2014

Capacity decisions involve trade‐offs between the cost of capacity and the opportunity costs of lost sales. Accounting researchers posit that accounting performance provides sufficient information about these trade‐offs and thus can be used to formulate simple rules to assist capacity decisions. Empirical research has not examined the role of accounting information in capacity investment decisions at the department level in a multiproduct firm in the presence of social costs. Empirical analyses using department‐level data from California hospitals for the period 1998–2005 show that hospitals are more likely to make capacity investments in departments with high accounting performance. However, in the presence of demand variability, the association between accounting performance and capacity investment is attenuated because of the resulting increase in noise in accounting performance measures. Thus, the weight on accounting performance as a decision tool for capital investments reduces when there is demand variability. Another factor that reduces the weight on accounting performance is capacity utilization. Higher capacity utilization can lead to turning away or rerouting of patients to other hospitals and negatively impacts reputation and quality of care, which increases the hospital's social costs. Hence, hospitals do not require high accounting performance before investing in a department with high capacity utilization. This empirical evidence of the role of accounting performance in capacity investment decisions fills a gap in the capacity investment literature and furthers our understanding of the interactions between accounting performance and the operational determinants of firms’ capacity investment behavior.
Adoption of Mobile Telephony in Rural India: An Empirical Study
Authors: Gupta Ruchita , Jain Karuna
Published: April 2014

Mobile telephony has become one of the major factors driving the social and economic development of a country. The objective of this article is to identify factors affecting the adoption of mobile telephony in rural India and examine their impact on its adoption. An explanatory empirical methodology with sequential design was used for this purpose, and new factors that affect users’ decisions to adopt mobile telephony in rural India were identified. We extended the technology acceptance model by integrating new factors for a developing nation. This study found that ensuring service transparency and identifying opinion leaders in the local community are key requirements for increasing the speed of adoption in the rural India. The findings of this study will provide insights for service providers and policy makers to develop strategies and policies that will enhance mobile telephony adoption in rural India.
Advances in diagnostic endoscopy for duodenal, including ampullary, adenoma
Authors: Pittayanon Rapat , Imraporn Boonlert , Rerknimitr Rungsun , Kullavanijaya Pinit
Published: April 2014

Currently, the strategy for real‐time endoscopic diagnosis of duodenal, including ampullary, adenoma is still unclear. In the era of high‐definition and magnification endoscopy, using this modality for the detection and diagnosis of these neoplasms is very challenging for endoscopists. Over the past 10 years, many instruments have been developed to improve the detection rate of duodenal and ampullary polyps and to distinguish between adenoma and non‐adenoma. The present review will focus on these novel methods and their usefulness in the diagnosis of ampullary and non‐ampullary adenoma.
Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia
Authors: Makmun Dadang
Published: April 2014

Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85 000 general practitioners and 25 000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health‐care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3–6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures.
Short double‐balloon enteroscopy is feasible and effective for endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy
Authors: Kato Hironari , Tsutsumi Koichiro , Harada Ryo , Okada Hiroyuki , Yamamoto Kazuhide
Published: April 2014

Endoscopic retrograde cholangiopancreatography (ERCP) for patients with digestive tract reconstruction is a difficult procedure from an anatomical point of view. A short‐type double‐balloon enteroscope has a 2.8‐mm working channel and a 152‐cm working length, and its advantage is that it can accommodate most conventional devices for ERCP. Although the shorter length compared with the long‐type balloon‐assisted enteroscope (BAE) was suspected of making it difficult or impossible to reach the blind end, in fact, the success rate of reaching the blind end with the short type is similar to that with the long‐ type BAE. In addition, the success rate of ERCP‐related procedures with the short type is satisfactory. However, it remains controversial as to which BAE is more suitable for this procedure. Further randomized controlled trials by high‐volume centers are warranted.
Endoscopic tissue shielding with polyglycolic acid sheets, fibrin glue and clips to prevent delayed perforation after duodenal endoscopic resection
Authors: Doyama Hisashi , Tominaga Kei , Yoshida Naohiro , Takemura Kenichi , Yamada Shinya
Published: April 2014

The incidence of delayed perforation after endoscopic resection for superficial non‐ampullary duodenal epithelial tumors is extremely high. Endoscopic tissue shielding with polyglycolic acid (PGA) sheets and fibrin glue is a promising method to prevent delayed perforation after endoscopic resection in the duodenum. However, we often encounter difficulty when covering an artificial ulcer with PGA sheets after endoscopic resection. We report three cases of postoperative ulcers covered by PGA sheets, fibrin glue, and clips.
Duodenal adenomatosis in Japanese patients with familial adenomatous polyposis
Authors: Maehata Yuji , Esaki Motohiro , Hirahashi Minako , Kitazono Takanari , Matsumoto Takayuki
Published: April 2014

Duodenal adenomatosis is the most frequent extracolonic manifestation of familial adenomatous polyposis (FAP), and duodenal cancer has been assumed to be the second most significant cause of death in patients with the disease. To stratify the risk of duodenal cancer, Spigelman's classification was proposed for the staging of duodenal adenomatosis. According to Western guidelines, patients with stage IV of the classification are candidates for prophylactic duodenectomy. Since our institutional experience disclosed only 2% of duodenal or ampullary cancers among 130 patients with FAP, and because most duodenal adenomatosis remains unchanged under endoscopic surveillance, it seems likely that aggressive endoscopic or surgical removal is unnecessary for most FAP patients with duodenal adenomatosis. In the present article, we demonstrate our data and present our strategy for duodenal adenomatosis of FAP.
Short‐type and conventional single‐balloon enteroscopes for endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: Single‐center experience
Authors: Iwai Tomohisa , Kida Mitsuhiro , Yamauchi Hiroshi , Imaizumi Hiroshi , Koizumi Wasaburo
Published: April 2014

Background and Aim

Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with Roux‐en‐Y anastomosis and Billroth‐II anastomosis. Short‐type single‐balloon enteroscope (SBE) was developed to carry out ERCP in postoperative patients with a reconstructed intestine. It is useful because of its good rotational and straightening ability and the availability of various conventional ERCP accessories through the 3.2‐mm working channel, and it has a water‐jet channel.

Methods

In the present study, we compared outcomes between groups with short‐type SBE and conventional SBE.

Results

With regard to reaching the blind end, mean time to reach the blind end, diagnostic success rate, therapeutic success rate, mean procedure time, and complication rate, there were no statistical differences between the two groups.

Conclusion

The results suggest that both types of SBE are equally useful for ERCP in patients with a reconstructed intestine. Short‐type SBE may be more preferable because of its good specification and maneuverability.
Method and timing of resection of superficial non‐ampullary duodenal epithelial tumors
Authors: Kakushima Naomi , Ono Hiroyuki , Takao Toshitatsu , Kanemoto Hideyuki , Sasaki Keiko
Published: April 2014

Background and Aim

Non‐ampullary duodenal epithelial tumors (NADET) are rare, and there is no consensus regarding treatment indications and methods for superficial lesions. Records of patients with NADET over a 10‐year period were reviewed to clarify the present state of clinical management of superficial NADET.

Methods

Data related to clinicopathological characteristics, selection of treatment, and outcomes were collected and analyzed.

Results

Of 95 lesions, 73 were either adenoma or mucosal or submucosal invasive cancers. Half of the patients with a biopsy diagnosis of low‐grade adenoma were followed up without treatment. Results of endoscopic resection (ER), including endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) for patients with high‐grade adenoma (HGA) or cancer showed a high en bloc resection rate. However, the risk of perforation was high among ESD cases. Surgery was done for patients with a diagnosis of cT1a or cT1b cancer, of which half underwent local resection. An upgrade in pathology between preoperative biopsy and final pathology was observed in 11/13 lesions with a biopsy diagnosis of HGA.

Conclusions

Superficial NADET, including HGA, should be treated endoscopically or surgically. For lesions with no risk of metastasis, local resection by EMR may be reasonable or clinically sufficient regarding the high complication rate of ESD. However, surgery remains a standard treatment for lesions that are technically impossible to remove by ER.
Impact of instrument channel diameter on therapeutic endoscopic retrograde cholangiography using balloon‐assisted enteroscopy
Authors: Kawashima Hiroki , Nakamura Masanao , Ohno Eizaburo , Goto Hidemi , Hirooka Yoshiki
Published: April 2014

Background and Aim

In therapeutic endoscopic retrograde cholangiography (ERC) using a balloon‐assisted enteroscope, each instrument insertion requires a long time, which prolongs the duration of the procedure. We conducted a retrospective single‐center study to compare instrument insertability of a double‐balloon enteroscope (DBE) with a 2.8‐mm instrument channel diameter and a prototype short single‐balloon enteroscope (SBE) with a 3.2‐mm instrument channel diameter.

Methods

We used a stop‐watch to measure instrument insertion time from the instrument channel port to the tip of the enteroscope when balloon‐assisted ERC was done. The instruments were divided into two groups (outer diameter larger or smaller than 2 mm). Lengths from the instrument channel port to the tip of the DBE (EI‐530B; FUJIFILM, Tokyo, Japan) and the prototype SBE (SIF‐Y0004‐V01; Olympus Medical Systems, Tokyo, Japan) were identical (1680 mm). ERC using DBE was carried out in four cases, as was ERC using SBE.

Results

There was a significant time difference (P = 0.001) when using instruments whose outer diameters were >2 mm (53.5 ± 19.0 s in DBE vs 28.4 ± 8.4 s in SBE).

Conclusion

The prototype SBE with a 3.2‐mm channel demonstrated not only that many types of instrument can be used, but also that the time required to insert instruments may be shorter than that with DBE with a 2.8‐mm channel.
Surgical management of superficial non‐ampullary duodenal tumors
Authors: Abe Nobutsugu , Suzuki Yutaka , Masaki Tadahiko , Mori Toshiyuki , Sugiyama Masanori
Published: April 2014

Background and Aim

We present our experiences with the so‐called ‘limited resections’ such as transduodenal excision and local full‐thickness resection for superficial non‐ampullary duodenal tumors (SNADT). The optimal surgical management for SNADT is also discussed.

Methods

Six patients with SNADT (adenoma, n = 1; mucosal carcinomas, n = 2; submucosal carcinoma, n = 1; carcinoids, n = 2) were included in this study. Four patients underwent transduodenal excision, one local full‐thickness resection, and one laparoscopy‐assisted endoscopic full‐thickness resection as a modification of local full‐thickness resection.

Results

All patients were successfully treated by these limited resections without any adverse events.

Conclusions

Surgical resection is the treatment of choice for SNADT not amenable to endoscopic resection in terms of technical and/or oncological reasons. However, the optimal surgical management for SNADT remains controversial because of the complexity of the relevant anatomy of the duodenum, its rarity, the not well‐known incidence of nodal metastasis, and the wide spectrum of pathologies that can be encountered.
Endoscopic features and management of diminutive colorectal submucosal invasive carcinoma
Authors: Oka Shiro , Tanaka Shinji , Nakadoi Koichi , Asayama Naoki , Chayama Kazuaki
Published: April 2014

Background and Aim

The vast majority of diminutive (∼5 mm) colorectal tumors consist of a very low prevalence of advanced neoplasia, and a predict‐resect‐and‐discard policy has been proposed recently in Western countries. The histology of some diminutive colorectal tumors reveals carcinoma, not adenoma, although the frequency is relatively low. Clarifying the endoscopic features of diminutive submucosal invasive colorectal carcinoma (CRC) during colonoscopy is important for managing diminutive lesions.

Methods

A total of 111 cases of submucosal invasive CRC ≤10 mm were analyzed. The incidence of submucosal invasion in early CRC per gross type, size, location, pit pattern diagnosis, and rate of lymph node (LN) metastasis was evaluated.

Results

In diminutive tumors, the overall submucosal invasion rate in early CRC was 9.6%; however, depressed tumors had a significantly higher frequency of submucosal invasion than protruded or flat elevated tumors. There were no significant differences in the distribution of submucosal invasive CRC between the diminutive tumors and those that were 6–10 mm. The pit pattern diagnosis of diminutive submucosal invasive CRC was type VI pit pattern in all cases. Each case of submucosal invasive CRC was completely resected by en bloc endoscopic resection, and there were no cases of LN metastasis.

Conclusion

Diminutive tumors with depression have a high frequency of submucosal invasive CRC and an initial indication for endoscopic resection.
Diagnostic algorithm of magnifying endoscopy with narrow band imaging for superficial non‐ampullary duodenal epithelial tumors
Authors: Kikuchi Daisuke , Hoteya Shu , Iizuka Toshiro , Kimura Ryusuke , Kaise Mitsuru
Published: April 2014

Background and Aim

A novel diagnostic algorithm for magnifying endoscopy with narrow band imaging (ME‐NBI) for superficial non‐ampullary duodenal epithelial tumors (SNADET) is needed because of diagnostic difficulties.

Methods

In the present study, ME‐NBI images taken prior to endoscopic treatment were retrospectively analyzed to investigate the relationship between ME‐NBI findings and pathological findings. Lesions displaying a single surface pattern were classified as monotype, and those displaying multiple surface patterns as mixed type. Surface pattern was classified as preserved, micrified, or absent. In addition, vascular pattern was classified as absent, network, intrastructural vascular (ISV), or unclassified.

Results

According to the revised Vienna classification, 100% (23/23) of mixed‐type lesions were category 4/5 tumors, whereas approximately 50% (10/23) of monotype lesions were category 3 tumors. In the monotype lesions, the probability of category 4/5 tumor was 100% (2/2) in lesions with an unclassified vascular pattern, 64.3% (9/14) in lesions with an ISV pattern, 33.3% (1/3) in lesions with an absent pattern, and 25.0% (1/4) in lesions with a network pattern.

Conclusion

These findings suggest the possibility of developing an effective diagnostic algorithm for ME‐NBI for SNADET by determining their surface pattern and vascular pattern.