bluuebunny/crossref_metadata_2025 huggingface dataset:
The Chinese Paradox of High Growth and Low Quality of Government: The Cadre Organization Meets Max Weber
Authors: Rothstein Bo
Published: November 2014

Much research has argued for the importance of state's administrative capacity for development. Disregard for the rule of law and failure to get corruption under control are seen as detrimental to economic and social development. The China paradox refers to the fact that in all commonly used measures of levels of corruption and the quality of government, China is a country that scores quite low. China also lacks the Weberian model of bureaucracy that is seen as central for development. It is argued that this paradox is the result of disregarding the existence of a different public administration model in China—the cadre organization. Instead of rule following, this organization is marked by high commitment to a specific policy doctrine. The argument is that while very different from Weberian bureaucracy, this organization is well suited for effectively implementing policies for economic and social development.
Dyskerin expression in human fetal, adult and neoplastic intrahepatic bile ducts: correlations with cholangiocarcinoma aggressiveness
Authors: Vasuri Francesco , Rocchi Laura , Degiovanni Alessio , Giunchi Francesca , Brandi Giovanni , Treré Davide , Montanaro Lorenzo , D'Errico‐Grigioni Antonia
Published: November 2014

Aims

To investigate the immunohistochemical expression of dyskerin, a biomarker involved in ribosome production and telomere maintenance, in human fetal, adult and neoplastic bile ducts, and possible correlations with cholangiocarcinoma aggressiveness.

Methods and results

Sixty consecutive intrahepatic cholangiocarcinomas were collected and used for tissue microarray construction (total: 176 cores); clinical data and follow‐up were also collected. Five fetal and 10 normal adult livers were included as controls. Automated immunohistochemistry for dyskerin, p53, and Ki67, and nucleolar silver staining, were performed. In normal livers, dyskerin expression was negative in smaller bile ducts (mean 44.8 μm) and positive in bile ducts of larger diameter (mean 116.1 μm; P < 0.001). Expression was positive in 56.7% of cholangiocarcinomas, and correlated with p53 mutation (P = 0.008) and a higher proliferative (Ki67) index (P = 0.003), which were included as markers of tumour aggressiveness. Finally, dyskerin‐positive cholangiocarcinomas showed a negative trend in disease‐free survival (P = 0.078) on univariate analysis.

Conclusions

The non‐neoplastic biliary tree seems to progressively lose dyskerin expression from the major branches to the peripheral portal bile ducts. Similarly, intrahepatic cholangiocarcinomas showed two patterns of dyskerin expression, and the dyskerin‐positive phenotype seemed to characterize more aggressive cholangiocarcinomas.
Composite metamorphic history recorded in garnet porphyroblasts of Sambagawa metasediments in the Besshi region, central Shikoku, Southwest Japan
Authors: Kouketsu Yui , Enami Masaki , Mouri Takashi , Okamura Mitsuya , Sakurai Tsuyoshi
Published: November 2014

This report describes an investigation of the composite metamorphic history recorded in garnet porphyroblasts of Sambagawa metasediments, and presents discussions of the possible distribution of eclogite facies lithologies in the Besshi region, central Shikoku, southwest Japan. Garnet grains usually show chemically composite zoning with resolved inner and overgrown outer segments, respectively. The inner segment usually contains paragonite as a sodic phase inclusion and rarely contains omphacite or glaucophane, whereas the outer segment rarely includes albite but no paragonite. The inner segment often includes quartz grains that preserve high residual pressures corresponding to the eclogite facies conditions, whereas the outer segment includes quartz grains that preserve lower residual pressures corresponding to the epidote–amphibolite facies conditions. For this composite‐zoned garnet, the assemblage of sodic phase inclusions and the values of the residual pressure of quartz inclusions imply the following successive metamorphic path: prograde eclogite facies stage → decompression and hydration reaction stage → prograde epidote–amphibolite facies stage. Metasediments containing this composite‐zoned garnet with such evidence for eclogite facies conditions are more widely distributed than the eclogitic lithologies that contain the assemblage of omphacite + garnet. These results imply that the combination of (i) the chemical composite zoning of garnet, (ii) the nature of sodic phase inclusions, and (iii) the residual pressure of quartz inclusions is useful as criteria to ascertain the true distribution of the lithologies that have experienced eclogite facies metamorphism for the Sambagawa metasediments, which was difficult to recognize in earlier studies.
Sudanese community pharmacy practice and its readiness for change to patient care
Authors: Mohamed Sumia S E , Mahmoud Adil A , Ali Abdulazim A
Published: November 2014

Objectives

This study aims to describe the current state of Sudanese community pharmacy practice and explore the capacity of existing community pharmacies to foster the change to pharmaceutical care (PC) and to assess attitude and knowledge of community pharmacists regarding PC and identify barriers.

Methods

A structured, self-administered, piloted questionnaire was distributed to the pharmacists in charge of 274, randomly selected, community pharmacies in Khartoum state. The questionnaire included six domains: demographic characteristics, organizational structure of community pharmacies, current activities of community pharmacists, their attitudes and knowledge regarding PC, and potential barriers. Attitude responses were measured by a 5-point Likert scale.

Key findings

Response rate was 67%. Community pharmacies are short on some tools that are deemed necessary for PC implementation, e.g. consultation areas. Community pharmacists provide mainly product-focused services with no or little PC activities. However, there is a highly positive attitude among the majority of respondents towards practice change to include PC (mean positive score ± standard deviation = 4.39 ± 0.73, frequency (%) = 89%). Many barriers to implementation of PC were identified, e.g. pharmacists' clinical knowledge and lack of understanding of pharmacist’s new role.

Conclusion

Sudanese community pharmacists favour practice change to include PC. Successful implementation of PC requires substantial organizational and structural changes in community pharmacies, including provision of clinical knowledge, strengthening of clinical training and new practice standards. This change in practice could benefit from involvement of academia, governmental bodies and professional organizations working together for the pharmacy profession.
Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia
Authors: Xu S. , Alexander K. , Bryant W. , Cohen N. , Craig M. E. , Forbes M. , Fulcher G. , Greenaway T. , Harrison N. , Holmes‐Walker D. J. , Howard G. , Jackson J. , Jenkins A. , Kamp M. , Kaye J. , Sinha A. , Stranks S. , O'Neal D. , Colman P. ,   Australian National Adult Insulin Pump Therapy Working Group
Published: November 2014

Background

Healthcare professional (HCP) time supporting insulin pump therapy (IPT) has not been documented, yet it is important in planning and allocating resources for effective care.

Aim

This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery.

Methods

Twenty‐four Australian adult IPT‐experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP–patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre‐pump education until stable on IPT.

Results

Data on 2577 HCP‐adult patient interactions (62% face‐to‐face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre‐pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0–20.9), 2.4 (0.5–6.0) and 1.8 (0.5–5.4) hours per patient from nurses, dietitians and doctors respectively.

Conclusions

IPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources.
Dose tailoring of anti‐tumour necrosis factor‐alpha therapy delivers useful clinical efficacy in Crohn disease patients experiencing loss of response
Authors: Ghaly S. , Costello S. , Beswick L. , Pudipeddi A. , Agarwal A. , Sechi A. , Antoniades S. , Headon B. , Connor S. , Lawrance I. C. , Sparrow M. , Walsh A. J. , Andrews J. M. ,   AIBDA
Published: November 2014

Background

‘Dose tailoring’ of anti‐tumour necrosis factor alpha (TNF‐α) therapy in Crohn disease (CD), by dose escalation, or shortening of dosing intervals, has been suggested to regain clinical response following a flare in a proportion of patients. However, reported outcome data are sparse and none exists from Australia.

Method

In an observational multicentre, retrospective study, the impact of anti‐TNF‐α dose tailoring on corticosteroid use, the need for surgery and physician perception of clinical efficacy was examined in a real‐world setting at six Australian adult teaching hospitals. Demographics, disease characteristics, medications, indication for and duration of dose tailoring were documented.

Results

Fifty‐five CD patients were identified as requiring dose tailoring and secondary loss of response was the indication in 96%. Either adalimumab (64%) or infliximab (36%) was dose escalated for a median of 5 months (range 1–47), with a median of 20 months follow up (range 3–65). At 3 months, dose tailoring reduced the mean number of days on high‐dose corticosteroids (45 vs 23, P = 0.01). Most (78%) patients remained resection free, and 73% of physicians reported good clinical efficacy of dose tailoring. Of those who de‐escalated therapy due to induction of remission, long‐term (>12 months) follow up and complete data on steroid use were available in 15/28, with 12/15 (80%) remaining steroid free at 1 year.

Conclusion

Short‐term dose tailoring regains disease response in the majority of patients with CD. Of these, most will remain free of corticosteroids at 1 year after de‐escalating therapy.
Clinical outcome of drug‐eluting versus bare‐metal stents in patients with calcified coronary lesions: a meta‐analysis
Authors: Zhang B.‐C. , Wang C. , Li W.‐H. , Li D.‐Y.
Published: November 2014

Background

The relative safety and efficacy of drug‐eluting stents (DES) versus bare‐metal stents (BMS) in patients with calcified coronary lesions is still debated.

Aims

To evaluate clinical outcome of DES versus BMS in patients with calcified coronary lesions using a meta‐analysis of the current literature.

Methods

We performed a systematic literature search using Medline, Embase, Cochrane and several other databases. Randomised controlled trials, prospective and retrospective cohort studies with a mean follow‐up period >6 months were included. Primary efficacy was target lesions revascularisation (TLR) and primary end‐point for safety was stent thrombosis. Secondary end‐points were cardiac death and recurrent myocardial infarction (MI).

Results

Five trials were included in the meta‐analysis, including 2440 patients (1230 in the DES group, 1210 in the BMS group). TLR was significantly lower in patients treated with DES as compared with patients treated with BMS (8.5% vs 16.0%; odds ratio (OR) = 0.50; 95% confidence interval (CI) 0.38–0.65; P < 0.00001). There were no significant differences in the incidence of stent thrombosis (0.9% vs 0.3%; OR = 2.01; 95% CI 0.34–11.88; P = 0.44), cardiac death (3.3% vs 4.2%; OR = 0.81; 95% CI 0.50–1.30; P = 0.38) and recurrent MI (5.0% vs 5.2%; OR = 0.99; 95% CI, 0.66–1.49; P = 0.97) between the two groups. Subgroup analysis by the sample size and follow‐up duration showed that the associations were similar between DES versus BMS.

Conclusions

DES significantly reduces TLR rates as compared with BMS in patients with calcified coronary lesions, with non‐significant differences in terms of stent thrombosis, cardiac death and MI.
Clinical outcomes of chronic hepatitis C patients related to baseline liver fibrosis stage: a hospital‐based linkage study
Authors: Huang Y. , de Boer W. B. , Adams L. A. , MacQuillan G. , Bulsara M. K. , Jeffrey G. P.
Published: November 2014

Background and Aims

Rates of long‐term clinical outcomes of chronic hepatitis C in patients with none, mild or severe liver fibrosis are required to determine benefits of anti‐viral therapies. This study evaluated long‐term outcomes for chronic hepatitis C stratified by all Metavir fibrosis stages.

Methods

Clinical outcomes were determined using population‐based data linkage methodology for 880 hepatitis C patients who had a liver biopsy performed from 1992 to 2012.

Results

During 9386 person‐years of follow up, 28 patients developed hepatocellular carcinoma, 58 developed liver decompensation and 122 died or underwent liver transplantation. There was no significant difference in liver‐related death for those with F0–F2 with an 18‐year survival probability >94%. Hazard ratio of liver‐related death for F3 compared with F0–F2 was 4.24 (P = 0.003), with no significant difference in the first 13‐year follow up. The 15‐year decompensation‐free survival for F0, F1 and F2 was 100%, 96% and 94% respectively and for hepatocellular carcinoma‐free survival was 100%, 99% and 98%. Hazard ratio of liver complication (hepatocellular carcinoma or decompensation)‐free survival for F3 compared with F0–F2 was 3.22 (P = 0.001), with no significant difference during the first 7‐year follow up. F4 had significantly higher risk of liver‐related death, decompensation and hepatocellular carcinoma than F3 (P < 0.001).

Conclusions

Chronic hepatitis C patients with F2 or less had few liver complications after 15 years. For F3 patients, the significant increase in liver‐related death occurred after 13 years and for liver complications after 7 years.
Different genetic impact in the development of renal length and width: a twin study
Authors: Tarnoki D. L. , Tarnoki A. D. , Bata P. , Littvay L. , Garami Z. , Berczi V. , Karlinger K.
Published: November 2014

Background

Ultrasound measurements of renal dimensions are conventionally limited to renal length, shape and cortical thickness. These are regarded as adequate for normal therapeutic decision‐making and volume measurements are reserved for a few clinical trials. However, there is no evidence concerning the degree to which renal length or volume is independently susceptible to heritable and environmental influences.

Aim

We aimed to determine whether renal length or width (as a surrogate of volume) was more influenced by heritability.

Methods

A single operator measured renal length and width in 114 adult monozygotic and same‐sex dizygotic Hungarian twin pairs (mean age 43.6 ± 16.3 years), using an Esaote MyLab 70X ultrasound machine with curved array transducer (1–8 MHz, CA431).

Results

Analysis of within‐pair co‐twin correlations adjusted for age and gender showed that the age‐ and sex‐adjusted heritability of average renal length was 51% (95% confidence interval, 29–72%). Renal width showed negligible genetic influence. Common environmental effects had no influence, and unshared environments were responsible for 49–80% of the variance, mainly renal width.

Conclusions

This study is the first to demonstrate the moderate heritability and limited environmental influence on renal length, and the contrasting lack of heritability of renal width, which is mainly influenced by unshared environmental components, that is lifestyle habits. Renal width therefore better represents the influence of modifiable environmental factors than renal length. The results suggest that renal width not length should be reported to facilitate early detection and monitoring of renal disease.
Rules of Procedure as a Cause of Legislative Paralysis: The Case of Costa Rica, 2002–2012
Authors: Borges Fabián A.
Published: November 2014

Research on executive-legislative relations in Latin America has focused on the impact of minority presidents and multiparty legislatures on legislative productivity. But an additional deadlock scenario, the blocking of a majority president by a minority through filibustering, has been understudied. This article analyzes filibustering in Costa Rica and explains the legislative paralysis in the wake of the nation's transition to a multiparty system in 2002. Legislative paralysis is seen as a product of the interaction between increased legislative fragmentation and polarization and the legislature's preexisting rules of procedure, which enable legislators easily to block bills they oppose, even when those bills are supported by supermajorities. This argument is tested through a comparison of major economic reforms in the 2000s to the reforms tackled in the 1990s. The role of filibustering, well acknowledged in U.S. politics, should also be studied in comparative politics.
Pre‐clinical evaluation of the osteogenic potential of bone morphogenetic protein‐2 loaded onto a particulate porcine bone biomaterial
Authors: Yon Jeyoung , Lee Jung‐Seok , Lim Hyun‐Chang , Kim Min‐Soo , Hong Ji‐Youn , Choi Seong‐Ho , Jung Ui‐Won
Published: November 2014

Aim

The objective of study was to determine the osteogenic potential of bone morphogenetic protein‐2 (BMP‐2) loaded onto a particulate porcine bone mineral (PBM) biomaterial using a sinus augmentation model.

Methods

Release kinetics of BMP‐2/PBM was determined in vitro. Eight rabbits received BMP‐2/PBM or PBM alone into contra‐lateral sinus sites. The animals were killed following a 2‐week healing interval for micro‐CT and histometrical analysis.

Results

Approximately 40% of the BMP‐2 was released from PBM over the first 3 days in vitro; release maintained at a reduced level through day 21. In vivo, total augmented implant volume did not differ significantly between treatments. However, local bone formation was enhanced in the BMP‐2/PBM group compared with PBM control (10.5% versus 6.6%; p = 0.03), specifically in the central aspect of the PBM implant (14.2% versus 5.5%; p < 0.01) and adjoining the Schneiderian membrane (11.9% versus 5.0%; p < 0.05). There were no significant overall differences in residual biomaterial and fibrovascular tissue.

Conclusion

Bone morphogenetic protein‐2 enhanced local bone formation in the rabbit maxillary sinus model following implantation using a PBM carrier.
Teaching dermatoscopy of pigmented skin tumours to novices: comparison of analytic vs. heuristic approach
Authors: Tschandl P. , Kittler H. , Schmid K. , Zalaudek I. , Argenziano G.
Published: November 2014

Background

There are two strategies to approach the dermatoscopic diagnosis of pigmented skin tumours, namely the verbal‐based analytic and the more visual‐global heuristic method. It is not known if one or the other is more efficient in teaching dermatoscopy.

Objective

To compare two teaching methods in short‐term training of dermatoscopy to medical students.

Methods

Fifty‐seven medical students in the last year of the curriculum were given a 1‐h lecture of either the heuristic‐ or the analytic‐based teaching of dermatoscopy. Before and after this session, they were shown the same 50 lesions and asked to diagnose them and rate for chance of malignancy. Test lesions consisted of melanomas, basal cell carcinomas, nevi, seborrhoeic keratoses, benign vascular tumours and dermatofibromas. Performance measures were diagnostic accuracy regarding malignancy as measured by the area under the curves of receiver operating curves (range: 0–1), as well as per cent correct diagnoses (range: 0–100%).

Results

Diagnostic accuracy as well as per cent correct diagnoses increased by +0.21 and +32.9% (heuristic teaching) and +0.19 and +35.7% (analytic teaching) respectively (P for all <0.001). Neither for diagnostic accuracy (P = 0.585), nor for per cent correct diagnoses (P = 0.298) was a difference between the two groups.

Conclusions

Short‐term training of dermatoscopy to medical students allows significant improvement in diagnostic abilities. Choosing a heuristic or analytic method does not have an influence on this effect in short training using common pigmented skin lesions.
PASI90 response: the new standard in therapeutic efficacy for psoriasis
Authors: Puig L.
Published: November 2014

In a non‐life‐threatening disease such as psoriasis, treatment goals should be referred to the improvement in severity and extent of the disease and their impact on patients’ perceived health‐related quality of life (HRQoL), usually measured by the Dermatology Life Quality Index (DLQI). The ultimate goal of therapy is blanching, and an improvement of 90% or better (PASI90 response) with respect to baseline Psoriasis Area and Severity Index (PASI) is considered as treatment success by the European Medicines Agency. PASI75 response has become accepted as a less stringent reasonable therapeutic goal, but absolute PASI values might provide a better benchmark, irrespective of baseline PASI. Anyway, objective measures of psoriasis involvement are clinically meaningful only if they correlate with significant improvements in DLQI, and especially with the achievement of a DLQI = 0–1 status, corresponding to lack of effect of the disease on patient's HRQoL. Even though PASI75 response meets therapeutic expectations in most patients, PASI90 response or better has a significantly higher impact on DLQI improvement and is associated with significantly higher DLQI = 0–1 response rates. The introduction of anti‐IL17 drugs in clinical practice bears the promise of achieving PASI90 response or better in the majority of patients, and initial data suggest that the PASI90 benchmark provides better discriminatory value as regards achievement of DLQI = 0–1 response. Further research is required to confirm the value of absolute PASI cut‐offs as a measure of therapeutic success independent of baseline and duration of treatment, and to develop newer, more practical and more accurate measures of psoriasis severity.
Ecomorphological variation in male and female wall lizards and the macroevolution of sexual dimorphism in relation to habitat use
Authors: Kaliontzopoulou A. , Carretero M. A. , Adams D. C.
Published: November 2014

Understanding how phenotypic diversity evolves is a major interest of evolutionary biology. Habitat use is an important factor in the evolution of phenotypic diversity of many animal species. Interestingly, male and female phenotypes have been frequently shown to respond differently to environmental variation. At the macroevolutionary level, this difference between the sexes is frequently analysed using phylogenetic comparative tools to assess variation in sexual dimorphism (SD) across taxa in relation to habitat. A shortcoming of such analyses is that they evaluate the degree of dimorphism itself and therefore they do not provide access to the evolutionary trajectories of each sex. As such, the relative contribution of male and female phenotypes on macroevolutionary patterns of sexual dimorphism cannot be directly assessed. Here, we investigate how habitat use shapes phenotypic diversity in wall lizards using phylogenetic comparative tools to simultaneously assess the tempo and mode of evolution in males, females and the degree of sexual dimorphism. We find that both sexes have globally diversified under similar, but not identical, processes, where habitat use seems to drive macroevolutionary variation in head shape, but not in body size or relative limb length. However, we also observe small differences in the evolutionary dynamics of male and female phenotypes that have a marked impact on macroevolutionary patterns ofSD, with important implications for our interpretation of what drives phenotypic diversification within and between the sexes.
A resource for those preparing for and responding to natural disasters, humanitarian crises, and major healthcare emergencies
Authors: Allen Claire
Published: November 2014

This article describes the dissemination and knowledge transfer activities of Evidence Aid, which was established after the Indian Ocean tsunami of December 2004 to provide a single source of evidence that would help people make well‐informed decisions when preparing for and responding to disasters. Evidence Aid has a dedicated website (www.EvidenceAid.org) to provide access to more than 160 systematic reviews and several other documents relevant to people working on disaster risk reduction, planning, response, recovery, rehabilitation, and resilience. It combines this with a social media presence and Special Collections that bundle together related Cochrane Reviews (www.TheCochraneLibrary.com). The aim is to make it easier for users who need this evidence and don't have time to browse through multiple documents and distill them before making their decisions. Evidence Aid will continue to identify and share resources and knowledge with those who most need it at the time that they need it most. It is working with several partners to identify relevant Cochrane and non‐Cochrane systematic reviews and is engaging with users who, by sharing their information and their knowledge needs, will allow Evidence Aid to target its efforts to these priority areas.
Clues to the signals for chloroplast photo‐relocation from the lifetimes of accumulation and avoidance responses
Authors: Higa Takeshi , Wada Masamitsu
Published: November 2014

Chloroplast photo‐relocation movement is crucial for plant survival; however, the mechanism of this phenomenon is still poorly understood. Especially, the signal that goes from photoreceptor to chloroplast is unknown, although the photoreceptors (phototropin 1 and 2) have been identified and an actin structure (chloroplast actin filaments) has been characterized that is specific for chloroplast movement. Here, in gametophytes of the fern Adiantum capillus‐veneris, gametophores of the moss Physcomiterella patens, and leaves of the seed plant Arabidopsis thaliana, we sought to characterize the signaling system by measuring the lifetime of the induced response. Chloroplast movements were induced by microbeam irradiation with high‐intensity blue light and recorded. The lifetime of the avoidance state was measured as a lag time between switching off the beam and the loss of avoidance behavior, and that of the accumulation state was measured as the duration of accumulation behavior following the extinction of the beam. The lifetime for the avoidance response state is approximately 3–4 min and that for the accumulation response is 19–28 min. These data suggest that the two responses are based on distinct signals.
Major Changes in Diagnosis and Management of Preeclampsia
Authors: Snydal Susan
Published: November 2014

Preeclampsia and eclampsia continue to be major contributors to maternal mortality and morbidity. Lack of appreciation for the multi‐organ involvement of preeclampsia, combined with overly rigid criteria for diagnosis, may hinder early diagnosis and appropriate management. Recently, the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy evaluated the evidence and formulated new recommendations for diagnosis and management. This article reviews some of these recommended changes, including the new classification of the hypertensive diseases of pregnancy. Systolic blood pressure has been shown to be as important as diastolic blood pressure in the diagnosis of preeclampsia. Changes in proteinuria are not predictive of disease severity or maternal or fetal complications; therefore, the magnitude of proteinuria or changes in the amount should not dictate diagnosis or management. Instead, symptoms of cerebral involvement, such as headache and visual changes or signs of end‐organ involvement including abnormal laboratory tests (elevated serum creatinine or liver function tests, low platelet count), are evidence of preeclampsia with severe features. Immediate induction of labor is recommended for women with gestational hypertension or preeclampsia at 37 weeks’ gestation or later. Pregnant and postpartum women need to know important warning signs and symptoms of preeclampsia. Prompt diagnosis of preeclampsia and appropriate management will improve the quality of care for women.
Considering the prominent complaint as a guide in medical therapy for overactive bladder syndrome in women over 45 years
Authors: Jafarabadi Mina , Jafarabadi Ladan , Shariat Mamak , Rabie Salehi Gelareh , Haghollahi Fedyeh , Rashidi Batool Hossein
Published: November 2014

Aim

The aim of this study was to evaluate the response of women over 45 years with overactive bladder and detrusor overactivity to a 12‐week course of oxybutynin or tolterodine treatment.

Material and Methods

A total of 301 eligible Iranian women were studied. In this double‐blinded trial, data were analyzed from 3‐day urinary diaries from before and after 12 weeks of treatment in which patients were randomly assigned to receive oxybutynin or tolterodine in recommended doses. Patients' convenience and the drugs' side‐effects were assessed by a monthly clinical appointment. End‐points were changed from baseline to week 12 in bladder‐diary variables and all observed or reported adverse events. The effectiveness of each drug was studied using the paired t‐test and improvement after treatment between the two groups was compared by independent t‐test.

Results

Mean improvements in the terms of urgency (P = 0.64) and urge incontinence (P = 0.75) showed an insignificantly larger score in patients who were treated by oxybutynin. Improvement in night‐time urinary urgency and nocturia (41.2% and 54.3% vs 39.7% and 40.1% in oxybutynin vs tolterodine groups, respectively) were shown to be more improved by tolterodine in comparison to oxybutynin (P = 0.72 and 0.04 for night‐time urinary urgency and nocturia, respectively). Discontinuation of treatment due to adverse events was not significantly different in the two groups.

Conclusions

Oxybutynin and tolterodine showed similar efficacy on daytime symptoms of overactive bladder and similar side‐effects in perimenopausal patients. For patients with the chief complaint of nocturnal frequency, prescription of tolterodine is preferably suggested.
Abnormal cervicovaginal cytology, unsatisfactory colposcopy and the use of vaginal estrogen cream: An observational study of clinical outcomes for women in low estrogen states
Authors: Richards Anthony , Dalrymple Chris
Published: November 2014

Aim

To determine the effectiveness of vaginal estrogen cream to improve the rate of satisfactory colposcopy and subsequent smear result in patients in a hypoestrogenic state and an abnormal Papanicolaou smear. To delineate between abnormal smears secondary to atrophy and inflammation from preneoplastic change and suggest an effective treatment strategy to deal with this challenging situation.

Methods

Patients with abnormal cervicovaginal smears who were in a low estrogen state (postmenopausal or amenorrheic postnatal) undergoing colposcopy were identified. All patients had an unsatisfactory colposcopy and were treated with vaginal estrogen cream twice per week for 6 weeks and underwent repeat colposcopy, smear and targeted biopsy where required.

Results

Fifty‐four patients had an abnormal smear and were clinically in a low estrogen state, with four having previously had a hysterectomy. After 6 weeks of vaginal estrogen therapy, 32 out of 50 patients' colposcopic examinations were satisfactory. Also, 40 out of 54 patients' smears returned to normal after treatment. Of the 14 patients with persistent smear abnormalities, only three were diagnosed with true high‐grade pre‐invasive disease.

Conclusion

The use of vaginal estrogen cream for patients with smear abnormalities and a low estrogen status improves the satisfactory colposcopy rate and improves the accuracy of the prediction of true high‐grade pre‐invasive disease. This treatment may then reduce the number of patients that require definitive treatment for their screen‐detected abnormalities in this patient population.
Purse‐string double‐layer closure: A novel technique for repairing the uterine incision during cesarean section
Authors: Turan Cem , Büyükbayrak Esra Esim , Onan Yilmaz Aylin , Karageyim Karsidag Yasemin , Pirimoglu Meltem
Published: November 2014

Aim

To compare the classical double‐layer uterine closure to a double‐layer purse‐string uterine closure (Turan technique) in cesarean section regarding short‐ and long‐term results.

Methods

Patients were randomized into either the double‐layer purse‐string uterine closure arm (study group, 84 patients) or the classical double‐layer uterine closure arm (control group, 84 patients). For short‐term comparison, a detailed transvaginal ultrasound examination was planned in all patients 6 weeks after the operation and a wedge‐shaped defect in the uterine incision scar was accepted as uterine scar defect and recorded. For the long‐term comparison, subsequent pregnancies of these patients were followed up for any complication.

Results

The number of patients with ultrasonographically visible uterine scar defect was 12 (23.5% of all scar defects) in the study group whereas it was 39 (76.5% of all scar defects) in the control group (P < 0.001, χ2 = 15.42). Demographic data, operation time, hospitalization time, preoperative and postoperative hemoglobin values were not significantly different between the groups. During the 2‐year of the follow‐up period, five patients in the study group and six patients in the control group became pregnant again. No complication during their pregnancies and second cesarean operation were encountered.

Conclusion

With the Turan technique, the uterine incision length becomes shorter, and the frequency of uterine scar defect is lower regarding short‐term results. More data is needed for long‐term results. ClinicalTrials.gov NCT01287611
Enhancement of ovarian cancer chemotherapy by delivery of multidrug‐resistance gene small interfering RNA using tumor targeting Salmonella
Authors: Deng Jiaqi , Guo Yi , Jiang Zhongmin , Yang Min , Li Huaifang , Wang Jianjun
Published: November 2014

Aim

The aim of this study was to observe the effect of attenuated Salmonella typhi as a tumor‐targeting delivery vector for multidrug‐resistance gene (MDR1) small interfering RNA (siRNA).

Material and Methods

The cisplatin (DDP)‐resistant ovarian cancer cell line SKOV‐3/DDP was established by treatment with gradually increasing concentrations of cisplatin. MDR1 siRNA expression plasmid containing short hairpin RNA (shRNA) of MDR1 gene was constructed and transformed into attenuated Salmonella typhi strain SL7207. SKOV‐3/DDP cells were incubated with recombinant Salmonella and then subjected to analysis of MDR1 expression by real‐time polymerase chain reaction and Western blot. SKOV‐3/DDP tumor‐bearing mice were established by subcutaneously injecting BALB/c nude mice with SKOV‐3/DDP cells, and were orally inoculated with Salmonella carrying MDR1 siRNA plasmid and simultaneously injected intraperitoneally with cisplatin. Tumor growth and mouse survival were observed.

Results

Compared with parental cell line, the DDP‐resistant SKOV‐3/DDP cells expressed a much higher level of MDR1. The expression of MDR1 in SKOV‐3/DDP cells infected with the Salmonella strain bearing MDR1 siRNA plasmid in vitro was detected to be downregulated and DDP tolerance of these cells was reversed. Tumor‐bearing nude mice that were orally receiving recombinant Salmonella experienced a slow tumor growth and became more sensitive to DDP.

Conclusion

Attenuated Salmonella typhi may represent a promising vector for in vivo administration of RNA interference therapy against malignant tumors.
Recurrent pregnancy loss is associated with increased red cell distribution width and platelet distribution width
Authors: Dundar Ozgur , Pektas Mıne Kanat , Bodur Serkan , Bakır Lale Vuslat , Cetin Ahmet
Published: November 2014

Aim

The present study aims to evaluate how components of complete blood count are altered in women with a history of recurrent pregnancy loss.

Material and Methods

This was a retrospective evaluation of 60 women who had a history of recurrent pregnancy loss, 60 healthy women who had a first trimester pregnancy and 60 healthy parous women.

Results

When compared with pregnant women and healthy controls, the women with a history of recurrent pregnancy loss had significantly higher red cell distribution width (RDW) and platelet distribution width (PDW) (P = 0.001 for both). Thrombophilia was detected in 31.7% of the women who had a history of recurrent pregnancy loss (19 out of 60). When compared to the women without thrombophilia, the women with thrombophilia had significantly lower body mass index (P = 0.034) but significantly higher RDW, PDW and plateletcrit (respectively, P = 0.043, P = 0.001 and P = 0.002). There were significant and positive correlations between RDW and PDW (r = 0.615, P = 0.001), RDW and plateletcrit (r = 0.343, P = 0.007) and PDW and plateletcrit (r = 0.340, P = 0.008) in women with a history of recurrent pregnancy loss.

Conclusion

An elevation in PDW and RDW values was found to be associated with recurrent pregnancy loss.
Assessment of the hemodynamic profile in periodontal tissues of diabetic subjects with periodontitis by optical spectroscopy
Authors: Duarte P. M. , Sowa M. G. , Xiang X. , Zhang C. , Santos V. R. , Miranda T. S. , Reis A. F. , Liu K.‐Z.
Published: November 2014

Background and Objective

The influence of diabetes mellitus (DM) on the hemodynamics of periodontal tissues has not been assessed previously. The primary objective of this study was to validate optical spectroscopy as a periodontal diagnostic tool for subjects with type 2DMand chronic periodontitis.

Material and Methods

Using a portable optical near‐infrared spectrometer, optical spectra were obtained from healthy (n = 127), gingivitis (n = 115), and periodontitis (n = 109) sites of 65 subjects with type 2DMand chronic periodontitis. Healthy (n = 65) sites of 15 nondiabetic subjects without periodontitis were used as controls. A modified Beer–Lambert unmixing model that incorporates a nonparametric scattering‐loss function was used to determine the relative contribution of deoxygenated hemoglobin and oxygenated hemoglobin (HbO2) to the overall spectrum. The balance between tissue oxygen delivery and oxygen utilization in periodontal tissues was assessed.

Results

In diabetic subjects, tissue oxygen saturation and HbO2concentration were significantly decreased in the periodontitis sites (p < 0.01) compared with the healthy and gingivitis sites. Furthermore, tissue oxygenation in healthy sites of control subjects was significantly higher than that in sites of diabetic subjects (p < 0.01).

Conclusion

In summary, the results of this study suggest that optical spectroscopy can monitor the hemodynamic profile in diabetic subjects with chronic periodontitis. Furthermore, healthy sites of diabetic subjects presented lower tissue oxygenation than did those of nondiabetic subjects.
Complementarity of statistical treatments to reconstruct worldwide routes of invasion: the case of the Asian ladybird Harmonia axyridis
Authors: Lombaert Eric , Guillemaud Thomas , Lundgren Jonathan , Koch Robert , Facon Benoît , Grez Audrey , Loomans Antoon , Malausa Thibaut , Nedved Oldrich , Rhule Emma , Staverlokk Arnstein , Steenberg Tove , Estoup Arnaud
Published: November 2014

Inferences about introduction histories of invasive species remain challenging because of the stochastic demographic processes involved. Approximate Bayesian computation (ABC) can help to overcome these problems, but such method requires a prior understanding of population structure over the study area, necessitating the use of alternative methods and an intense sampling design. In this study, we made inferences about the worldwide invasion history of the ladybird Harmonia axyridis by various population genetics statistical methods, using a large set of sampling sites distributed over most of the species’ native and invaded areas. We evaluated the complementarity of the statistical methods and the consequences of using different sets of site samples for ABC inferences. We found that the H. axyridis invasion has involved two bridgehead invasive populations in North America, which have served as the source populations for at least six independent introductions into other continents. We also identified several situations of genetic admixture between differentiated sources. Our results highlight the importance of coupling ABC methods with more traditional statistical approaches. We found that the choice of site samples could affect the conclusions of ABC analyses comparing possible scenarios. Approaches involving independent ABC analyses on several sample sets constitute a sensible solution, complementary to standard quality controls based on the analysis of pseudo‐observed data sets, to minimize erroneous conclusions. This study provides biologists without expertise in this area with detailed methodological and conceptual guidelines for making inferences about invasion routes when dealing with a large number of sampling sites and complex population genetic structures.
Genic rather than genome‐wide differences between sexually deceptiveOphrysorchids with different pollinators
Authors: Sedeek Khalid E. M. , Scopece Giovanni , Staedler Yannick M. , Schönenberger Jürg , Cozzolino Salvatore , Schiestl Florian P. , Schlüter Philipp M.
Published: November 2014

High pollinator specificity and the potential for simple genetic changes to affect pollinator attraction make sexually deceptive orchids an ideal system for the study of ecological speciation, in which change of flower odour is likely important. This study surveys reproductive barriers and differences in floral phenotypes in a group of four closely related, coflowering sympatricOphrysspecies and uses a genotyping‐by‐sequencing (GBS) approach to obtain information on the proportion of the genome that is differentiated between species.Ophrysspecies were found to effectively lack postpollination barriers, but are strongly isolated by their different pollinators (floral isolation) and, to a smaller extent, by shifts in flowering time (temporal isolation). Although flower morphology and perhaps labellum coloration may contribute to floral isolation, reproductive barriers may largely be due to differences in flower odour chemistry.GBSrevealed shared polymorphism throughout theOphrysgenome, with very little population structure between species. Genome scans forFSToutliers identified few markers that are highly differentiated between species and repeatable in several populations. These genome scans also revealed highly differentiated polymorphisms in genes with putative involvement in floral odour production, including a previously identified candidate gene thought to be involved in the biosynthesis of pseudo‐pheromones by the orchid flowers. Taken together, these data suggest that ecological speciation associated with different pollinators in sexually deceptive orchids has a genic rather than a genomic basis, placing these species at an early phase of genomic divergence within the ‘speciation continuum’.
Ecotypes of an ecologically dominant prairie grass (Andropogon gerardii) exhibit genetic divergence across the U.S. Midwest grasslands' environmental gradient
Authors: Gray Miranda M. , St. Amand Paul , Bello Nora M. , Galliart Matthew B. , Knapp Mary , Garrett Karen A. , Morgan Theodore J. , Baer Sara G. , Maricle Brian R. , Akhunov Eduard D. , Johnson Loretta C.
Published: November 2014

Big bluestem (Andropogon gerardii) is an ecologically dominant grass with wide distribution across the environmental gradient of U.S. Midwest grasslands. This system offers an ideal natural laboratory to study population divergence and adaptation in spatially varying climates. Objectives were to: (i) characterize neutral genetic diversity and structure within and among three regional ecotypes derived from 11 prairies across the U.S. Midwest environmental gradient, (ii) distinguish between the relative roles of isolation by distance (IBD) vs. isolation by environment (IBE) on ecotype divergence, (iii) identify outlier loci under selection and (iv) assess the association between outlier loci and climate. Using two primer sets, we genotyped 378 plants at 384 polymorphic AFLP loci across regional ecotypes from central and eastern Kansas and Illinois. Neighbour‐joining tree and PCoA revealed strong genetic differentiation between Kansas and Illinois ecotypes, which was better explained by IBE than IBD. We found high genetic variability within prairies (80%) and even fragmented Illinois prairies, surprisingly, contained high within‐prairie genetic diversity (92%). Using Bayenv2, 14 top‐ranked outlier loci among ecotypes were associated with temperature and precipitation variables. Six of seven BayeScanFST outliers were in common with Bayenv2 outliers. High genetic diversity may enable big bluestem populations to better withstand changing climates; however, population divergence supports the use of local ecotypes in grassland restoration. Knowledge of genetic variation in this ecological dominant and other grassland species will be critical to understanding grassland response and restoration challenges in the face of a changing climate.
Presupposition and Context Sensitivity
Authors: Lepore Ernie , Sennet Adam
Published: November 2014

We argue there is a clash between the standard treatments of context sensitivity and presupposition triggering. We use this criticism to motivate a defense of an often‐discarded view about how to represent context sensitivity, according to which there are more lexically implicit items in logical form than has been appreciated.