bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of local surface changes in Borneo on atmospheric composition at wider spatial scales: coastal processes, land-use change and air quality
Authors: Pyle J. A. , Warwick N. J. , Harris N. R. P. , Abas Mohd Radzi , Archibald A. T. , Ashfold M. J. , Ashworth K. , Barkley Michael P. , Carver G. D. , Chance K. , Dorsey J. R. , Fowler D. , Gonzi S. , Gostlow B. , Hewitt C. N. , Kurosu T. P. , Lee J. D. , Langford S. B. , Mills G. , Moller S. , MacKenzie A. R. , Manning A. J. , Misztal P. , Nadzir Mohd Shahrul Mohd , Nemitz E. , Newton H. M. , O'Brien L. M. , Ong Simon , Oram D. , Palmer P. I. , Peng Leong Kok , Phang Siew Moi , Pike R. , Pugh T. A. M. , Rahman Noorsaadah Abdul , Robinson A. D. , Sentian J. , Samah Azizan Abu , Skiba U. , Ung Huan Eng , Yong Sei Eng , Young P. J.
Published: October 2011

We present results from the OP3 campaign in Sabah during 2008 that allow us to study the impact of local emission changes over Borneo on atmospheric composition at the regional and wider scale. OP3 constituent data provide an important constraint on model performance. Treatment of boundary layer processes is highlighted as an important area of model uncertainty. Model studies of land-use change confirm earlier work, indicating that further changes to intensive oil palm agriculture in South East Asia, and the tropics in general, could have important impacts on air quality, with the biggest factor being the concomitant changes in NO

x

emissions. With the model scenarios used here, local increases in ozone of around 50 per cent could occur. We also report measurements of short-lived brominated compounds around Sabah suggesting that oceanic (and, especially, coastal) emission sources dominate locally. The concentration of bromine in short-lived halocarbons measured at the surface during OP3 amounted to about 7 ppt, setting an upper limit on the amount of these species that can reach the lower stratosphere.
The allocation of ecosystem net primary productivity in tropical forests
Authors: Malhi Yadvinder , Doughty Christopher , Galbraith David
Published: October 2011

The allocation of the net primary productivity (NPP) of an ecosystem between canopy, woody tissue and fine roots is an important descriptor of the functioning of that ecosystem, and an important feature to correctly represent in terrestrial ecosystem models. Here, we collate and analyse a global dataset of NPP allocation in tropical forests, and compare this with the representation of NPP allocation in 13 terrestrial ecosystem models. On average, the data suggest an equal partitioning of allocation between all three main components (mean 34 ± 6% canopy, 39 ± 10% wood, 27 ± 11% fine roots), but there is substantial site-to-site variation in allocation to woody tissue versus allocation to fine roots. Allocation to canopy (leaves, flowers and fruit) shows much less variance. The mean allocation of the ecosystem models is close to the mean of the data, but the spread is much greater, with several models reporting allocation partitioning outside of the spread of the data. Where all main components of NPP cannot be measured, litterfall is a good predictor of overall NPP (
r
2
= 0.83 for linear fit forced through origin), stem growth is a moderate predictor and fine root production a poor predictor. Across sites the major component of variation of allocation is a shifting allocation between wood and fine roots, with allocation to the canopy being a relatively invariant component of total NPP. This suggests the dominant allocation trade-off is a ‘fine root versus wood’ trade-off, as opposed to the expected ‘root–shoot’ trade-off; such a trade-off has recently been posited on theoretical grounds for old-growth forest stands. We conclude by discussing the systematic biases in estimates of allocation introduced by missing NPP components, including herbivory, large leaf litter and root exudates production. These biases have a moderate effect on overall carbon allocation estimates, but are smaller than the observed range in allocation values across sites.
The Sabah Biodiversity Experiment: a long-term test of the role of tree diversity in restoring tropical forest structure and functioning
Authors: Hector Andy , Philipson Christopher , Saner Philippe , Chamagne Juliette , Dzulkifli Dzaeman , O'Brien Michael , Snaddon Jake L. , Ulok Philip , Weilenmann Maja , Reynolds Glen , Godfray H. Charles J.
Published: October 2011

Relatively, little is known about the relationship between biodiversity and ecosystem functioning in forests, especially in the tropics. We describe the Sabah Biodiversity Experiment: a large-scale, long-term field study on the island of Borneo. The project aims at understanding the relationship between tree species diversity and the functioning of lowland dipterocarp rainforest during restoration following selective logging. The experiment is planned to run for several decades (from seed to adult tree), so here we focus on introducing the project and its experimental design and on assessing initial conditions and the potential for restoration of the structure and functioning of the study system, the Malua Forest Reserve. We estimate residual impacts 22 years after selective logging by comparison with an appropriate neighbouring area of primary forest in Danum Valley of similar conditions. There was no difference in the alpha or beta species diversity of transect plots in the two forest types, probably owing to the selective nature of the logging and potential effects of competitive release. However, despite equal total stem density, forest structure differed as expected with a deficit of large trees and a surfeit of saplings in selectively logged areas. These impacts on structure have the potential to influence ecosystem functioning. In particular, above-ground biomass and carbon pools in selectively logged areas were only 60 per cent of those in the primary forest even after 22 years of recovery. Our results establish the initial conditions for the Sabah Biodiversity Experiment and confirm the potential to accelerate restoration by using enrichment planting of dipterocarps to overcome recruitment limitation. What role dipterocarp diversity plays in restoration only will become clear with long-term results.
Changes in forest land use and management in Sabah, Malaysian Borneo, 1990–2010, with a focus on the Danum Valley region
Authors: Reynolds Glen , Payne Junaidi , Sinun Waidi , Mosigil Gregory , Walsh Rory P. D.
Published: October 2011

In an earlier special issue of this journal, Marsh & Greer summarized forest land use in Sabah at that time and gave an introduction to the Danum Valley Conservation Area. Since that assessment, during the period 1990–2010, the forests of Sabah and particularly those of the
ca
10 000 km
2
concession managed on behalf of the State by Yayasan Sabah (the Sabah Foundation) have been subject to continual, industrial harvesting, including the premature re-logging of extensive tracts of previously only once-logged forest and large-scale conversion of natural forests to agricultural plantations. Over the same period, however, significant areas of previously unprotected pristine forest have been formally gazetted as conservation areas, while much of the forest to the north, the south and the east of the Danum Valley Conservation Area (the Ulu Segama and Malua Forest Reserves) has been given added protection and new forest restoration initiatives have been launched. This paper analyses these forest-management and land-use changes in Sabah during the period 1990–2010, with a focus on the Yayasan Sabah Forest Management Area. Important new conservation and forest restoration and rehabilitation initiatives within its borders are given particular emphasis.
Serotonergic Dysfunction in Parkinson's Disease and Its Relevance to Disability
Authors: Politis Marios , Loane Clare
Published: October 2011

Growing evidence suggests that Parkinson's disease is not solely affecting the dopaminergic system. Results from biochemical, animal,postmortem, and functional imaging studies have revealed that other neurotransmitter systems are affected as well, including the serotonergic system. With the use ofin vivopositron emission tomography functional imaging, it has been shown that serotonergic terminals are affected at a varying, nonlinear degree starting early in the clinical course of Parkinson's disease. Tremor and the majority of nonmotor symptoms do not seem to respond adequately to dopaminergic medication. Recent studies suggest that serotonergic dysfunction has a direct relevance to Parkinson's disease symptoms, the so-called nonmotor symptoms, including depression, fatigue, weight changes, and visual hallucinations. Thesein vivofindings indicate that agents acting on the serotonergic system could help towards alleviating these symptoms. This paper aims to review the current literature and to highlight the need for furtherin vivoinvestigations.
A novel anti‐peroxiredoxin autoantibody in patients with Kawasaki disease
Authors: Fujieda Mikiya , Karasawa Rie , Takasugi Hisashi , Yamamoto Masaki , Kataoka Koichi , Yudoh Kazuo , Kato Tomohiro , Ozaki Shoichi , Wakiguchi Hiroshi
Published: October 2011

Antibodies to the anti‐oxidative peroxiredoxin (Prx) enzymes occur in both systemic autoimmune disease and vasculitis in adulthood. Because increased oxidative stress induces vasculitis in Kawasaki disease (KD), autoimmunity to Prxs in patients with KD was investigated. The presence of antibodies to Prx 1, 2 and 4 was analyzed by ELISA and Western blot. Of 30 patients with KD, 13 (43.3%) possessed antibodies to Prx 2, whereas these antibodies were present in only 1 of 10 patients (10.0%) with sepsis (4 with purulent meningitis and 6 with septicemia). In contrast, antibodies to Prx 1 and 4 were not detected in either group. There was no significant correlation among the titers of the three antibodies. Clinical parameters were compared between anti‐Prx 2‐positive and ‐negative patients. The presence of anti‐Prx 2 antibodies correlated with a longer period of fever and poor response to high‐dose γ‐globulin therapy in patients with KD. Anti‐Prx 2‐positive patients had significantly greater excretion of urinary 8‐isoprostaglandin than did anti‐Prx 2‐negative patients. These results provide the first evidence for an antibody to Prx 2 in patients with KD. They also suggest that this antibody might serve as a marker of disease severity and be involved in the pathophysiology of vasculitis in some patients with KD.
Randomised clinical trial: escitalopram for the prevention of psychiatric adverse events during treatment with peginterferon‐alfa‐2a and ribavirin for chronic hepatitis C
Authors: de Knegt R. J. , Bezemer G. , Van Gool A. R. , Drenth J. P. H. , Hansen B. E. , Droogleever Fortuyn H. A. , Weegink C. J. , Hengeveld M. W. , Janssen H. L. A.
Published: October 2011

Aliment Pharmacol Ther 2011; 34: 1306–1317

Background  Treatment of hepatitis C with peginterferon and ribavirin is associated with psychiatric side‐effects, frequently necessitating dose reduction or therapy cessation.

Aim  To assess the efficacy of prophylactic escitalopram to prevent psychiatric side‐effects during peginterferon and ribavirin treatment in a randomised, double‐blind, placebo‐controlled trial.

Methods  Seventy‐nine hepatitis C patients were treated with peginterferon and ribavirin. Patients received escitalopram (n = 40, 10 mg) or placebo (n = 39), which was initiated together with peginterferon and ribavirin. Primary outcomes were an increase of two points or more on the items reported sadness, inner tension and impaired concentration of the Montgomery‐Asberg Depression Rating Scale, and hostile feelings of the Brief Anxiety Scale. Secondary outcome was the development of depression diagnosed by the Mini‐International Neuropsychiatric Interview. Measurements were performed at baseline, week 4, 12 and 24 during anti‐viral treatment, and 24 weeks thereafter.

Results  The incidence of psychiatric side‐effects was significantly lower in patients treated with escitalopram compared with placebo for all primary and secondary outcomes, except for impaired concentration: reported sadness 27.5 vs. 48.7% (P = 0.052), inner tension 17.5 vs. 38.5% (P = 0.038), impaired concentration 55.0 vs. 66.7% (P = 0.288) and hostile feelings 22.5 vs. 43.6% (P = 0.046) (escitalopram vs. placebo, Chi‐squared test). The sum scores of all four endpoints showed an overall beneficial effect of escitalopram (P = 0.009, Mann–Whitney U‐test). Depression occurred in 12.5% of the patients in the escitalopram‐group vs. 35.9% in the placebo‐group (P = 0.015, Chi‐squared test).

Conclusions  Prophylactic treatment with escitalopram is effective in the prevention of psychiatric side‐effects during interferon‐based treatment of hepatitis C.
Systematic review: the relationship between interstitial lung diseases and gastro‐oesophageal reflux disease
Authors: Hershcovici T. , Jha L. K. , Johnson T. , Gerson L. , Stave C. , Malo J. , Knox K. S. , Quan S. , Fass R.
Published: October 2011

Aliment Pharmacol Ther 2011; 34: 1295–1305

Background  A potential relationship has been suggested between gastro‐oesophageal reflux disease (GERD) and interstitial lung diseases (ILDs).

Aim  To evaluate whether there is a causal relationship between GERD and different ILDs.

Methods  We conducted a systematic search of literature published between 1980 and 2010. After a review by two independent authors, each study was assigned an evidence‐based rating according to a standard scoring system.

Results  We identified 319 publications and 22 of them met the entry criteria. Of those, the relationship between GERD and idiopathic pulmonary fibrosis (IPF) was investigated in 14 articles, pulmonary involvement in systemic sclerosis (SSc) in six articles and pulmonary involvement in mixed connective tissue disease (MCTD) in two articles. We found the prevalence of GERD and/or oesophageal dysmotility to be higher in patients with different types of ILD as compared with those without ILD [Evidence B]. Among patients with IPF, 67–76% demonstrated abnormal oesophageal acid exposure off PPI treatment. No relationship was demonstrated between severity of GERD and severity of IPF [Evidence B]. Data are scant on outcomes of antireflux treatment in patients with IPF. There is a correlation between the severity of ILD and the degree of oesophageal motor impairment in patients with SSc and MCTD [Evidence B].

Conclusions  Based on the currently available data, a causal relationship between GERD and idiopathic pulmonary fibrosis cannot be established. There is scant evidence about antireflux therapy in idiopathic pulmonary fibrosis patients. There may be an association between lung and oesophageal involvement in systemic sclerosis and mixed connective tissue disease, but a causal relationship cannot be established.
Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection
Authors: Bavishi C. , DuPont H. L.
Published: October 2011

Aliment Pharmacol Ther 2011; 34: 1269–1281

Background  The use of proton pump inhibitors (PPIs) is increasing worldwide. Suppression of gastric acid alters the susceptibility to enteric bacterial pathogens.

Aim  This systematic review was undertaken to examine the relationship between PPI use and susceptibility to enteric infections by a specific pathogen based on published literature and to discuss the potential mechanisms of PPI enhanced pathogenesis of enteric infections.

Methods  PubMed, OVID Medline Databases were searched. Search terms included proton pump inhibitors and mechanisms of, actions of, gastric acid, enteric infections, diarrhoea, Clostridium difficile, Salmonella, Shigella and Campylobacter.

Results  The use of PPIs increases gastric pH, encourages growth of the gut microflora, increases bacterial translocation and alters various immunomodulatory and anti‐inflammatory effects. Enteric pathogens show variable gastric acid pH susceptibility and acid tolerance levels. By multiple mechanisms, PPIs appear to increase susceptibility to the following bacterial enteropathogens: Salmonella, Campylobacter jejuni, invasive strains of Escherichia coli, vegetative cells of Clostridium difficile, Vibrio cholerae and Listeria. We describe the available evidence for enhanced susceptibility to enteric infection caused by Salmonella, Campylobacter and C. difficile by PPI use, with adjusted relative risk ranges of 4.2–8.3 (two studies); 3.5–11.7 (four studies); and 1.2–5.0 (17 of 27 studies) for the three respective organisms.

Conclusions  Severe hypochlorhydria generated by PPI use leads to bacterial colonisation and increased susceptibility to enteric bacterial infection. The clinical implication of chronic PPI use among hospitalized patients placed on antibiotics and travellers departing for areas with high incidence of diarrhoea should be considered by their physicians.
Pulp canal obliteration: an endodontic diagnosis and treatment challenge
Authors: McCabe P. S. , Dummer P. M. H.
Published: October 2011

McCabe PS, Dummer PMH. Pulp canal obliteration: an endodontic diagnosis and treatment challenge. International Endodontic Journal, 45, 177–197, 2012.

Aim  To review the literature on pulp chamber and root canal obliteration in anterior teeth and to establish a clear protocol for managing teeth with fine, tortuous canal systems.

Summary  Pulp canal obliteration (PCO) occurs commonly following traumatic injuries to teeth. Approximately 4–24% of traumatized teeth develop varying degrees of pulpal obliteration that is characterized by the apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. These teeth provide an endodontic treatment challenge; the critical management decision being whether to treat these teeth endodontically immediately upon detection of the pulpal obliteration or to wait until symptoms or signs of pulp and or periapical disease occur. The inevitable lack of responses to normal sensibility tests and the crown discoloration add uncertainty to the management; however, only approximately 7–27% of teeth with PCO will develop pulp necrosis with radiographic signs of periapical disease. Root canal treatment of teeth with pulpal obliteration is often challenging. This article discusses the various management approaches and highlights treatment strategies for overcoming potential complications.

Key learning points 

 Up to 25% of traumatized anterior teeth can develop pulp canal obliteration;

 Discolouration is a common clinical finding in teeth with pulp canal obliteration;

 Up to 75% of teeth with pulp canal obliterations are symptom‐free and require no treatment other than radiographic monitoring;

 Routine pulp sensibility tests are unreliable in the presence of pulp canal obliteration;

 Teeth with pulp canal obliteration in need of root canal treatment pose particular diagnostic and treatment challenges.
Impact of interocclusal contacts on infrared laser fluorescence in pits of sound first permanent molars in children
Authors: MORITA ICHIZO , NONOYAMA KAORU , OKAMOTO TAKAYO , NAKAGAKI HARUO , MUKAI MASAMI , LUSSI ADRIAN
Published: October 2011

International Journal of Paediatric Dentistry 2012; 22: 265–270

Background.  A device based on infrared laser fluorescence (IRLF) has become available as an adjunct for the diagnosis of dental caries.

Aims.  The objective of this study was to clarify the differences of IRLF readings in the mesial, central and distal occlusal pits of first permanent molars.

Design.  Sixty‐four children (average age 8.0 years) were examined using IRLF. The mesial, central and distal pits of clinically healthy first permanent molars were measured. The instrument provides measurements in arbitrary units on an open‐ended interval scale.

Results.  Mean (± SE) IRLF values in the mesial pits were 4.9 ± 0.4 (upper) and 6.5 ± 0.4 (lower) and were significantly lower than those in the central (8.8 ± 0.6 and 11.5 ± 0.9) and distal (9.6 ± 0.7 and 10.4 ± 0.8) pits in the maxilla and mandible. There was no significant difference between the right (7.3 ± 0.5, 9.4 ± 0.6) and left (8.2 ± 0.5, 9.5 ± 0.6) dental arches. IRLF measurements in the mesial pits of human first permanent sound molars were lower than the central and distal pits in children whose second molars had not erupted.

Conclusions.  The inherently higher IRLF values of some sites should not be misinterpreted and trigger early invasive treatment.
Comparative phylogeography of three common Neotropical tree species
Authors: Poelchau Monica F. , Hamrick J. L.
Published: October 2011

Aim  To determine spatial and temporal commonalities in patterns of chloroplast DNA (cpDNA) variation in three widespread Neotropical tree species. We examine whether patterns of genetic variation are more consistent with Pliocene or Pleistocene divergence.

Location  Central American forests, located in El Salvador, Nicaragua, Costa Rica and Panama.

Methods  We collected sequences from two cpDNA loci from c. 30 locations for each of three species –Bursera simaruba (Burseraceae; n = 278), Brosimum alicastrum (Moraceae; n = 210) and Ficus insipida (Moraceae; n = 222) – and additionally sequenced one nuclear locus for Bursera simaruba (n = 45). We used Monmonier’s algorithm to detect genetic barriers between regions. Divergence times between these regions were estimated using coalescent analyses.

Results  Spatial genetic boundaries were found in similar areas for these species, namely between Costa Rica and Nicaragua for all three species, and between El Salvador and Nicaragua for two species. These boundaries visually coincide with the spatial delimitations of Pliocene islands and previously hypothesized Pleistocene refugia. Divergence time estimates between regions are more consistent with Pleistocene divergence in two of the three species.

Main conclusions  Our results point to strong commonalities in the spatial locations of genetic boundaries in these three species, despite the complex geological and climatological history of this region, and ecological differences between the species. While spatial genetic boundaries coincide conspicuously with possible Pliocene and Pleistocene barriers to gene flow, we cannot distinguish between the two scenarios because of the strong spatial overlap of both barriers. However, the temporal data tentatively suggest that some of this divergence occurred in the Pleistocene, although limitations in the analysis cannot confirm Pleistocene divergence without external, corroborating data. While we cannot definitively implicate a single historical process as driving patterns of genetic differentiation in all three species, our results represent an initial step towards identifying a common history of Central American tree species.
Were Ediacaran siliciclastics of South Australia coastal or deep marine?
Authors: RETALLACK GREGORY J.
Published: October 2011

The Late Neoproterozoic Ediacara Member of the Rawnsley Quartzite in South Australia has been considered aeolian, fluvial, intertidal and deep marine by various authors. Palaeosols would not be expected for the deep marine interpretation, but some palaeosols should be evident for the aeolian–fluvial–intertidal interpretations, and this is the first study to examine the Ediacara Member at a petrographic and geochemical scale appropriate to recognize potential palaeosols. Recognition of palaeosols and floodplain facies in Neoproterozoic rocks is a challenge because such rocks are too ancient for diagnostic non‐marine fossils such as root traces. The varied thickness of Ediacara Member red siltstones and white sandstones is distinct from laterally persistent overlying and underlying grey shales and limestones with acritarchs, stromatolites and other marine fossils. The sandstones are trough cross‐bedded and fill palaeovalleys. The red siltstones have poorly sorted, highly angular, silt‐size grains characteristic of loess. Particular sandy and silty beds were sampled for detailed petrographic and geochemical studies, because they include desiccation cracks, sand crystals, ice cracks, carbonate nodules and soft‐sediment deformation like those of palaeosols. Chemical and grain‐size variations within these beds reveal surficial clay formation and oxidation from feldspar as in soils. Petrographic studies also revealed surficial disruption of these palaeosols by filamentous structures comparable with microbial ropes of biological soil crusts. This array of palaeosol features may be of use for recognizing palaeosols in other Neoproterozoic siliciclastic sequences.
An efficient Agrobacterium‐mediated transient transformation of Arabidopsis
Authors: Tsuda Kenichi , Qi Yiping , Nguyen Le V. , Bethke Gerit , Tsuda Yayoi , Glazebrook Jane , Katagiri Fumiaki
Published: October 2011

Agrobacterium tumefaciens‐mediated transient transformation has been a useful procedure for characterization of proteins and their functions in plants, including analysis of protein–protein interactions. Agrobacterium‐mediated transient transformation of Nicotiana benthamiana by leaf infiltration has been widely used due to its ease and high efficiency. However, in Arabidopsis this procedure has been challenging. Previous studies suggested that this difficulty was caused by plant immune responses triggered by perception of Agrobacterium. Here, we report a simple and robust method for Agrobacterium‐mediated transient transformation in Arabidopsis. AvrPto is an effector protein from the bacterial plant pathogen Pseudomonas syringae that suppresses plant immunity by interfering with plant immune receptors. We used transgenic Arabidopsis plants that conditionally express AvrPto under the control of a dexamethasone (DEX)‐inducible promoter. When the transgenic plants were pretreated with DEX prior to infection with Agrobacterium carrying a β‐glucuronidase (GUS, uidA) gene with an artificial intron and driven by the CaMV 35S promoter, transient GUS expression was dramatically enhanced compared to that in mock‐pretreated plants. This transient expression system was successfully applied to analysis of the subcellular localization of a cyan fluorescent protein (CFP) fusion and a protein–protein interaction in Arabidopsis. Our findings enable efficient use of Agrobacterium‐mediated transient transformation in Arabidopsis thaliana.
Antithrombin therapy in pancreas retransplantation and pancreas‐after‐kidney/pancreas‐transplantation‐alone patients
Authors: Fertmann Jan M. , Arbogast Helmut P. , Illner Wolf‐Dieter , Tarabichi Anwar , Dieterle Christoph , Land Walter , Jauch Karl‐Walter , Hoffmann Johannes N.
Published: October 2011

Fertmann JM, Arbogast HP, Illner W‐D, Tarabichi A, Dieterle C, Land W, Jauch K‐W, Hoffmann JN. Antithrombin therapy in pancreas retransplantation and pancreas‐after‐kidney/pancreas‐transplantation‐alone patients. Clin Transplant 2011: 25: E499–E508. © 2011 John Wiley & Sons A/S.

Abstract:  Antithrombin (AT) is a coagulatory inhibitor with pleiotropic activities. AT reduces ischemia/reperfusion injury and has been successfully used in patients with simultaneous pancreas kidney transplantation. This study retrospectively analyzes prophylactic high‐dose AT application in patients with solitary pancreas transplantation traditionally related to suboptimal results. In our center, 31 patients received solitary pancreas transplantation between 7/1994 and 7/2005 (pancreas retransplantation, PAK/PTA). The perioperative treatment protocol was modified in 5/2002 now including application of 3000 IU. AT was given intravenously before pancreatic reperfusion (AT, n = 18). Patients receiving standard therapy served as controls (n = 13). Daily blood sampling was performed during five postoperative days. Standard coagulatory parameters and number of transfused red blood cell units were not altered by AT. In AT patients serum amylase (p < 0.01) and lipase (p < 0.01) on postoperative days 1, 2 and 3 were significantly reduced. Our actual perioperative management protocol including high dose AT application in human solitary pancreas transplantation reduced postoperative liberation of pancreatic enzymes in this pilot study. Prophylactic AT application should deserve further clinical testing in a randomized controlled trial.
Risk factors for late renal dysfunction after pediatric heart transplantation: A multi‐institutional study
Authors: Feingold Brian , Zheng Jie , Law Yuk M. , Morrow W. Robert , Hoffman Timothy M. , Schechtman Kenneth B. , Dipchand Anne I. , Canter Charles E. ,   and the Pediatric Heart Transplant Study Investigators
Published: October 2011

Feingold B, Zheng J, Law YM, Morrow WR, Hoffman TM, Schechtman KB, Dipchand AI, Canter CE and the Pediatric Heart Transplant Study Investigators. Risk factors for late renal dysfunction after pediatric heart transplantation: A multi‐institutional study. Pediatr Transplantation 2011: 15: 699–705. © 2011 John Wiley & Sons A/S.

Abstract:  Renal dysfunction is a major determinant of outcome after HTx. Using a large, multi‐institutional database, we sought to identify factors associated with late renal dysfunction after pediatric HTx. All patients in the PHTS database with eGFR ≥60 mL/min/1.73 m2 at one yr post‐HTx (n = 812) were analyzed by Cox regression for association with risk factors for eGFR <60 mL/min/1.73 m2 at >1 yr after HTx. Freedom from late renal dysfunction was 71% and 57% at five and 10 yr. Multivariate risk factors for late renal dysfunction were earlier era of HTx (HR 1.84; p < 0.001), black race (HR 1.42; p = 0.048), rejection with hemodynamic compromise in the first year after HTx (HR 1.74; p = 0.038), and lowest quartile eGFR at one yr post‐HTx (HR 1.83; p < 0.001). Renal function at HTx was not associated with onset of late renal dysfunction. Eleven patients (1.4%) required chronic dialysis and/or renal transplant during median follow‐up of 4.1 yr (1.5–12.6). Late renal dysfunction is common after pediatric HTx, with blacks at increased risk. Decreased eGFR at one yr post‐HTx, but not at HTx, predicts onset of late renal dysfunction. Future research on strategies to minimize late renal dysfunction after pediatric HTx may be of greatest benefit if focused on these subgroups.
Sirolimus in pediatric renal transplantation
Authors: Kasap Belde
Published: October 2011

Kasap B. Sirolimus in pediatric renal transplantation.  Pediatr Transplantation 2011: 15: 673–685. © 2011 John Wiley & Sons A/S.

Abstract:  SRL, an mTOR inhibitor that inhibits cell cycle progression, represents an important alternative to CNIs, which are still the cornerstones of pediatric solid organ tx. Because there are still limited data on SRL use among pediatric solid organ recipients, further studies are needed to verify the efficacy and safety of SRL. It has unique pharmacokinetic characteristics concerning dosing intervals and reduction of the dose in combination with other immunosuppressants. SRL also has antineoplastic, antiviral, and antiatherogenic advantages over other immunosuppressive agents. The adverse effects of SRL including thrombocytopenia, hyperlipidemia, proteinuria, impaired wound healing, mouth ulcers, edema, male hypogonadism, TMA, and interstitial pneumonitis must be considered carefully in pediatric population. This article reviews the most recent data on SRL application in the field of pediatric renal tx.
Otomycosis in Shanghai: aetiology, clinical features and therapy
Authors: Jia Xianhao , Liang Qin , Chi Fanglu , Cao Wenjun
Published: October 2011

Otomycosis is frequently seen in Shanghai and is a challenging problem due to recurrence and resistance to therapy. The aims of this study were to determine the pattern of fungal agents, sex distribution, clinical presentation, predisposing factors, complications and treatment outcomes of otomycosis. Retrospective review of 108 patients with a clinical diagnosis of otomycosis treated from September 2009 to September 2010 in otolaryngology outpatient department. It has been found to be more prevalent in female patients than male patients with a sex ratio (F : M) of 2 : 1. Aspergillus niger (54.78%) followed by Candida albicans (16.52%) were the dominant fungi. Pruritus and otorrhea were the most common presenting complaints. The predisposing factors included frequent scratching of the external ear canal (79.63%), taking ototopical and/or oral antimicrobials (24.07%), diabetes (11.11%) and otologic procedures (7.41%). Residual disease was observed in 9.26% and recurrence in 8.89% of the subjects. Topical Fluconazole ear drops and mechanical debridement of visible fungal elements in the external auditory canal were all relatively effective with 83.33% resolution rate on initial application. The diagnosis of otomycosis requires vigilance from clinicians given its non‐specific symptoms. Sometimes mycological examinations are necessary. Treatment regimens such as topical fluconazole coupled with mechanical debridement are generally effective. However, recurrence is not uncommon and eradication of disease can be particularly difficult in patients with diabetes and a mastoid cavity.
Immunopathogenesis and prognostic immune markers of chronic hepatitis B virus infection
Authors: Zhang Zheng , Zhang Ji‐Yuan , Wang Li‐Feng , Wang Fu‐Sheng
Published: October 2011

Host immune responses induced by hepatitis B virus (HBV) infection not only substantially drive disease progression, but also significantly influence efficacy of antiviral treatments in HBV‐infected individuals. Therefore, it is important to fully understand the course of immune pathogenesis and to find efficient immunological markers that can predict the disease progression of chronic HBV infection. This review introduces the current progress in clinical immunology and analyzes the mechanisms of antiviral effects and liver injury, which are induced by both innate and adaptive immune responses. The recently identified immunological markers indicated to be closely correlated with disease progression and antiviral efficacy during HBV infection are also summarized. Careful monitoring of these immune markers may help physicians to make decisions on when to begin or withdraw antiviral drugs, or to formulate the prognosis of acute‐on‐chronic liver failure (ACLF) patients in the clinic. Finally, this review highlights some novel therapeutic strategies to modulate host immunity that have been proposed to sustain antiviral control of chronic HBV infection, as well as the challenges that we are presently facing in the field.
Matched case‐control study comparing endoscopic submucosal dissection and endoscopic mucosal resection for colorectal tumors
Authors: Kobayashi Nozomu , Yoshitake Naoto , Hirahara Yoshitaka , Konishi Jun , Saito Yutaka , Matsuda Takahisa , Ishikawa Tsutomu , Sekiguchi Ryuzo , Fujimori Takahiro
Published: October 2011

Background and Aim:  For large colorectal tumors, the en bloc resection rate achieved by endoscopic mucosal resection (EMR) is insufficient, and this leads to a high rate of local recurrence. As endoscopic submucosal dissection (ESD) has been reported to achieve a higher rate of en bloc resection and a lower rate of local recurrence in the short‐term, it is expected to overcome the limitations of EMR. We conducted a matched case‐control study between ESD and EMR to clarify the effectiveness of ESD for colorectal tumors.

Methods:  Between April 2005 and February 2009, a total of 28 colorectal tumors in 28 patients were resected by ESD and were followed up by colonoscopy at least once. As a control group, 56 EMR cases from our prospectively completed database were matched. En bloc resection, complication and recurrence rates were compared between the two groups.

Results:  The mean sizes of the lesions were 27.1 mm in the ESD group and 25.0 mm in the EMR group. The en bloc resection rate was significantly higher in the ESD group (92.9% vs 37.5% with ESD vs EMR), and the rate of perforation was also significantly higher (10.7% vs 0%). All cases of perforation were managed conservatively. No recurrence was observed in the ESD group, whereas local recurrences were detected in 12 EMR cases (21.4%). Eleven of the 12 recurrences (91.7%) were managed endoscopically, and one required surgical resection.

Conclusions:  Endoscopic submucosal dissection is a promising technique for the treatment of colorectal tumors, giving an excellent outcome in comparison with EMR.
Late evening snack: Exploiting a period of anabolic opportunity in cirrhosis
Authors: Tsien Cynthia D , McCullough Arthur J , Dasarathy Srinivasan
Published: October 2011

Background and Aim:  Cirrhosis is a state of accelerated starvation with impaired protein synthesis. Increased rate of gluconeogenesis and alterations in skeletal muscle signaling pathways result in anabolic resistance and consequent loss of muscle mass or sarcopenia in cirrhosis. Late evening snack (LES) is an intervention to reduce the postabsorptive (fasting) phase with the potential to improve substrate utilization and reverse sarcopenia. Published reports were evaluated to examine the effect of LES on regulation of substrate utilization (short‐term studies) and nutritional outcomes (long‐term studies).

Methods:  PubMed, EMBASE, Google scholar and OVID databases were searched. All studies published on LES in cirrhosis were included. Studies that included few (n < 3) subjects and patients with hepatocellular carcinoma were excluded.

Results:  Late evening snack decreased lipid oxidation and improved nitrogen balance, irrespective of the composition or type of formulation used. Daytime isocaloric isonitrogenous snacks did not have the metabolic or clinical benefit of LES. LES decreased skeletal muscle proteolysis. No studies have examined its effect on muscle protein synthesis. There was inconsistent translation into an increase in lean body or skeletal muscle mass. Improved quality of life occurs but decreased mortality or need for transplantation has not been reported. The optimal composition of LES has not been defined, but based on mechanistic considerations, a branched chain supplemented LES holds most promise.

Conclusions:  Late evening snack holds the most promise as an intervention to reverse anabolic resistance and sarcopenia of cirrhosis with improved quality of life in patients with cirrhosis. Long term benefit and improved survival need critical evaluation.
Clinical spectrum of microsporidial keratoconjunctivitis
Authors: Tham Alex Chengyao , Sanjay Srinivasan
Published: October 2011

Abstract

The purpose of this paper was to analyse the causes, pathogenesis, diagnostic modalities and treatment outcomes of microsporidial keratoconjunctivitis (MKC). Microsporidia are increasingly recognized as opportunistic infectious pathogens in immunocompromized patients causing keratoconjunctivitis. In the recent years, there has been a surge in reports of MKC in immunocompetent individuals presenting with stromal keratitis. A detailed literature search was done using Medline, OVID, Cochrane Library, UptoDate and Google Scholar databases with the terms microsporidia, keratitis, conjunctivitis, immunocompromized and immunocompetent. The articles were reviewed to determine the spectrum of clinical presentation, disease course, investigations, treatment modalities and outcome. Thirty‐six publications were reviewed, and 151 cases of MKC were included for this review. The main presenting features included pain, redness, photophobia, epiphora and blurring of vision. Duration of the symptoms lasted between 4 days and 18 months. Light microscopy with modified trichrome stain was most commonly used to diagnose MKC. Resolution of symptoms was most commonly achieved with oral albendazole and/or topical fumidil B. Topical fluoroquinolones are also effective as a monotherapy as suggested by recent studies. Clinical outcome was good (visual acuity ≤ 6/12) for the patients who presented earlier (≤1 month) (75% of cases with documented final best‐corrected visual acuity). MKC occurs more commonly in immunocompetent individuals than expected and can be diagnosed in earlier stages. From our review, we conclude that the patients, who were diagnosed early and treated, had complete resolution of symptoms with a better clinical outcome.
Central retinal vein occlusion: a review
Authors: McAllister Ian L
Published: October 2011

Abstract

Central retinal vein occlusion remains a common cause of unilateral visual loss. Until recently, our treatment options for this condition were limited only to laser photocoagulation for the devastating end sequelae of anterior segment neovascularization. Over the last 2 years, a number of randomized controlled trials have given us significant new treatment options to address not only visual loss from macular oedema but also the ability to create a bypass around the obstruction in the central retinal vein and to address the raised venous hydrostatic pressure. In the future, it is likely that combination approaches to the management of central retinal vein occlusion will develop using specific agents and techniques to address the components of macular oedema, retinal ischaemia and raised venous hydrostatic pressure, all of which combine to produce the clinical picture and the reduction in vision seen in this condition.
Becoming an expert: a review of adult learning theory and implications for vocational training in ophthalmology
Authors: Roberts Timothy V , Gustavs Julie , Mack Heather G
Published: October 2011

Abstract

One of the key responsibilities of professional bodies, such as the Royal Australian and New Zealand College of Ophthalmologists, is to determine, teach and assess the competencies required for trainees to reach an expert level. Vocational training programs (VTP) need to incorporate advances in educational research and reflect changes in generational thinking and learning styles to provide the most optimal learning environment to meet the desired educational outcomes. This paper seeks to introduce some of the important concepts of adult educational theory and to explain how they connect to four strategic areas in the development and implementation of the VTP:

1 What are the learning needs of trainees?

2 What educational methods best address these needs?

3 What assessment methods best test the acquisition of the desired learning outcomes?

4 What are the needs of supervisors and teachers?
Do gender inequities exist in cataract surgical coverage? Meta‐analysis in Latin America
Authors: Carter Marissa J , Limburg Hans , Lansingh Van C , Silva Juan C , Resnikoff Serge
Published: October 2011

Abstract

Background:  To determine if gender inequities exist in Latin America in regard to cataract surgery.

Design:  Meta‐analysis.

Participants:  Total of 38 992 subjects participating in epidemiological surveys; summary measures were used (not patient‐level data).

Methods:  A literature search and knowledge of rapid assessment of cataract surgical services/rapid assessment of avoidable blindness studies carried out in Latin America found 11 studies with complete cataract surgical coverage (CSC) data. Using summary original study data, a meta‐analysis (random effects model) was conducted to analyse the differences in CSC between males and females. Results were adjusted for design effect.

Main Outcome Measures:  Odds ratio (OR) of receiving cataract surgery comparing women with men.

Results:  CSC with a visual acuity (VA) <3/60 on an eye basis showed a non‐statistically significant OR of 1.01 (95% confidence intervals [CI]: 0.86–1.18) for women receiving cataract surgery in comparison with men. For VA < 6/18, a non‐statistically significant OR of 0.94 (95% CI: 0.83–1.07) was obtained for women receiving cataract surgery. On a person basis at a VA of <3/60 and <6/18, non‐statistically significant ORs of 1.12 (95% CI: 0.78–1.63) and 0.94 (95% CI: 0.77–1.15) were obtained for women receiving cataract surgery, respectively. Statistical heterogeneity was 0% (I2 statistic), except for results at a VA of <3/60 on a person basis (I2 = 30%).

Conclusions:  In the Latin American countries in which CSC was assessed, gender does not appear to be a significant factor in receiving cataract surgery. However, more data are required to confirm these results.
Effects of historical forest contraction on the phylogeographic structure of Australo‐Papuan populations of the red‐legged pademelon (Macropodidae: Thylogale stigmatica)
Authors: MACQUEEN PEGGY , SEDDON JENNIFER M. , GOLDIZEN ANNE W.
Published: October 2011

Geographic patterns of genetic variation are strongly influenced by historical changes in species habitats. Whether such patterns are common to co‐distributed taxa may depend on the extent to which species vary in ecology and vagility. We investigated whether broad‐scale phylogeographic patterns common to a number of small‐bodied vertebrate and invertebrate species in eastern Australian forests were reflected in the population genetic structure of an Australo‐Papuan forest marsupial, the red‐legged pademelon (Macropodidae: Thylogale stigmatica). Strong genetic structuring of mtDNA haplotypes indicated the persistence of T. stigmatica populations across eastern Australia and southern New Guinea in Pleistocene refugial areas consistent with those inferred from studies of smaller, poorly dispersing species. However, there was limited divergence of haplotypes across two known historical barriers in the northeastern Wet Tropics (Black Mountain Barrier) and coastal mideastern Queensland (Burdekin Gap) regions. Lack of divergence across these barriers may reflect post‐glacial recolonization of forests from a large, central refugium in the Wet Tropics. Additionally, genetic structure is not consistent with the present delimitation of subspecies T. s. wilcoxi and T. s. stigmatica across the Burdekin Gap. Instead, the genetic division occurs further to the south in mideastern Queensland. Thus, while larger‐bodied marsupials such as T. stigmatica did persist in Pleistocene refugia common to a number of other forest‐restricted species, species‐specific local extinction and recolonization events have resulted in cryptic patterns of genetic variation. Our study demonstrates the importance of understanding individualistic responses to historical climate change in order to adequately conserve genetic diversity and the evolutionary potential of species.
What is a common factor in different areas?: The case of depression among caregivers of the frail elderly in Sapporo and Kochi, Japan
Authors: Oura Asae , Mori Mitsuru , Yasuda Nobufumi , Miyano Ichiro , Izumi Hisako , Washio Masakazu
Published: October 2011

Aim:  Depression affecting caregivers is a risk factor for discontinuing at‐home care. The present cross‐sectional study was conducted to evaluate factors related to depression among family caregivers.

Methods:  A cross‐sectional study was conducted to evaluate factors related to depression among family caregivers of the frail elderly. The study included caregivers whose relatives received periodic visits from a nurse from one of seven Sapporo‐based home‐visiting nursing service stations in October 2008 or from one of nine Kochi‐based home‐visiting nursing service stations between June 2009 and March 2010. Caregivers were asked to answer a self‐administered questionnaire about various factors that might affect their depression and to complete a Center for Epidemiologic Studies Depression Scale evaluation. We analyzed 127 pairs of responses in total.

Results:  After we adjusted the results for the caregivers' gender and age, the factors that decreased the risk of depression in the Sapporo group related to relieving the stress that results from being a caregiver (OR = 0.12, 95%CI = [0.03, 0.42]) and the ability to independently pay more than ¥10 000 for part of care service costs (OR = 0.17, 95%CI = [0.05, 0.58]). In contrast, feeling ill was a factor that increased caregivers' risk of depression in the Kochi group (OR = 4.23, 95%CI = [1.29, 13.9]), but not in Sapporo group (OR = 2.53, 95%CI = [0.91, 7.08]). Caregivers in the Sapporo group were more likely to feel ill (P < 0.01) than their counterparts in Kochi.

Conclusion:  The Japanese government should take measures to reduce caregivers' depression. Otherwise family members will increasingly discontinue to provide at‐home care. Geriatr Gerontol Int 2012; 12: 230–237.