bluuebunny/crossref_metadata_2025 huggingface dataset:
Insulin resistance increases the risk of urinary stone formation in a rat model of metabolic syndrome
Authors: Iba Akinori , Kohjimoto Yasuo , Mori Takashi , Kuramoto Tomomi , Nishizawa Satoshi , Fujii Reona , Nanpo Yoshihito , Matsumura Nagahide , Shintani Yasuyo , Inagaki Takeshi , Hara Isao
Published: February 2010

OBJECTIVE

To investigate the association between metabolic syndrome and urinary stone disease, and whether insulin resistance associated with adiposity affects the risk of urinary stone formation, using a rat model of metabolic syndrome.

MATERIALS AND METHODS

Four‐week‐old male Otsuka Long‐Evans Tokushima ‘Fatty’ (OLETF, a model of human type 2 diabetes and metabolic syndrome) rats, and Long‐Evans Tokushima (LETO, a non‐diabetic control) rats (10 each) were given a standardized diet and free access to water. Body weight and serum and urinary biochemistry were determined every 4 weeks. Ten‐week‐old male OLETF and LETO rats were divided into three groups of nine each and treated with vehicle or oral administration of 3 or 10 mg/kg/day pioglitazone, an agent that improves insulin resistance. After 4 weeks, body weight and serum and urinary biochemistry were determined.

RESULTS

The OLETF rats had significantly lower urinary pH and citrate excretion, and higher urinary uric acid and calcium excretion, than the LETO rats, with increases in body weight, serum triglyceride, glucose and insulin. The administration of pioglitazone to the OLETF rats for 4 weeks significantly increased urinary pH dose‐dependently. There was no change in the urinary excretion of citrate, uric acid, calcium, oxalate or magnesium.

CONCLUSION

These results indicate that metabolic syndrome causes the changes in urinary constituents, leading to increased risk of both uric acid and calcium stone formation. Improvement in insulin resistance, a central cause of metabolic syndrome, might prevent uric acid stone formation by raising urinary pH.
Embedding the War on Terror: State and Civil Society Relations
Authors: Fowler Alan , Sen Kasturi
Published: February 2010

The global war on terror was used by the Bush administration and its allies to defend a US dominated geopolitical configuration. To this end, counter‐terrorism measures (CTMs) were introduced which strengthened the alignment of development aid with diplomacy and defence. The broad, adverse effects of CTMs on civil liberties and human rights are well documented. Despite the advent of a new US administration and a ‘soft power’ approach to international relations, the legacy of the war on terror remains embedded in the laws, policies and attitudes of many states and regimes that continue to enclose the lives of citizens. This article describes the experiences of civil society organizations (CSOs) as ‘securitization’ processes unfolded. Studies over two years involving some forty countries provide an on‐the‐ground view to probe the gains and losses of securitization, both for governments in the US‐led ‘coalition of the willing’ and for civil society in terms of the pressures emerging from a development‐for‐security agenda. The authors identify some of the perverse zero‐sum effects on governments of CTM philosophy and the means employed. Findings also show asymmetry between northern and southern CSOs in terms of their negative‐sum subordination, found in the definition of security and in the vulnerability to new risks involved in undertaking development work.
Elites in Local Development in the Philippines
Authors: Lange Andreas
Published: February 2010

For many Philippine provinces, decentralization and more autonomous local development planning did not lead to the desired outcomes. This article examines the experiences of the two provinces of Cebu and Leyte. While Cebu became a centre of trade and industry, Leyte is still struggling with its local economy oriented to natural resources. A main reason for the divergent development paths of the two islands can be found in the emergence of different elite structures, which resulted in different path‐dependent patterns of economic specialization. Despite this different historical experience, both provinces today suffer from similar institutional infirmities in their planning system for promoting local development. Local planning capacity constraints, such as regional and local co‐ordination and co‐operation patterns, local finances, human capital and knowledge are analysed. The Cebuano elites used the room for manoeuvre provided by decentralization reforms more successfully than elites in Leyte. This created pockets of efficiency in Cebu leading to more development‐friendly investment policies. In order to increase local and regional planning capacity, short‐term interventions and policy reforms at the local, regional and national level are discussed.
The Changing Accessibility of Educational Opportunities in Southern Sri Lanka
Authors: Lindberg Jonas
Published: February 2010

To handle the double challenge of economic competitiveness and poverty alleviation, there are increasing calls for dual education strategies designed to handle both these issues simultaneously. Based on field research in rural Sri Lanka, this article aims to contribute to the understanding of how educational opportunities of different groups in different areas are shifting in the context of a changing world of work and new skill requirements in the global economy. An ongoing stratification of educational opportunities is identified, based on the growth of private tuition and English‐medium education, as well as a rationalization of the education system. The article shows that future attempts to reform the education system in Sri Lanka must be better rooted in the preferences and aspirations of poor groups in rural areas, and that educational opportunities must be seen as relative, relational and contextual.
The Regulatory State and Turkish Banking Reforms in the Age of Post‐Washington Consensus
Authors: Bakir Caner , Öniş Ziya
Published: February 2010

The new era of the Post‐Washington Consensus (PWC), promoted under the auspices of International Financial Institutions such as the International Monetary Fund and the World Bank, centres on the need to develop sound financial regulation and strong regulatory institutions, especially in the realm of banking and finance in post‐financial crisis developing countries. This article uses an examination of the Turkish banking sector experience with the PWC in the aftermath of the 2001 financial crisis to show its considerable strengths and weaknesses. The authors argue that the emergent regulatory state in the bank‐based financial system has a narrow focus on strengthening prudential regulation, whilst ignoring the increased ‘financialization’ of the Turkish economy. They identify the positive features of the new era of the PWC in terms of prudential regulation, which has become much more robust in its ability to withstand external shocks. At the same time, however, the article highlights some of the limitations of the new era which resemble the limitations of the PWC. These include the distributional impact of the regulatory reforms within the banking sector, and notably the emergence of foreign banks as the major beneficiaries of this process; weaknesses in promoting productive bank intermediation that finance the real economy and economic growth, leading to poverty reduction via growth of employment whilst stimulating financialization within the economy; and finally, the exclusive focus on prudential regulation, whilst ignoring regulatory costs, consumer protection and competition regulation.
The economics of knowledge regulation: an empirical analysis of knowledge flows
Authors: Häussler Carolin
Published: February 2010

Successful innovation depends on the management of a firm's knowledge base. This paper empirically investigates the determinants of knowledge regulation. Using a unique survey dataset, the analysis suggests that research and development managers do not leak knowledge randomly, but rather regulate knowledge consciously. I find that the source and the channel of knowledge inflows impact knowledge regulation. The findings reveal that the more a firm profits from knowledge inflows from competitors, the fewer actions it takes to regulate outgoing knowledge. I do not find that the extent of knowledge inflows from collaborating firms impacts knowledge regulation. However, the type of channel being used to acquire knowledge matters. Compared with public channels, the different types of private channels used to access knowledge inflow and the type of the competitive relationship influence the firms' decision to regulate knowledge outflow in the following way: concerning relationships with competitors, firms regulate knowledge outflow more when using formal channels, but less when using informal channels; concerning collaborative relationships, firms regulate knowledge outflow less regardless of whether they are using formal or informal private channels compared with using public channels. Presumably, firms that acquire knowledge from competing firms through formal private channels try to establish opaque and soundproof fences to surround them, whereas firms that acquire knowledge from collaborating firms through formal or informal private channels do not want to restrict circulation, but rather facilitate inter‐firm knowledge exchange.
Adult mortality in Russia
Authors: Denisova Irina
Published: February 2010

This paper studies the determinants of Russian adult mortality controlling for both individual and household heterogeneity. We employ survival analysis and utilize 12 rounds of the Russian Longitudinal Monitoring Survey spanning a 14‐year period. Although confirming the crucial role of excessive alcohol consumption in shaping adult mortality risks in Russia, the results are original in several other respects. We find empirical support for the importance of relative status measured in non‐income terms in shaping mortality hazards. We find evidence of the influence of labour market behaviour, and sectoral and occupational mobility in particular, on longevity. The detrimental role of smoking to health is found to be comparable with the role of excess alcohol consumption, which is novel in the Russian context where the influence of smoking is typically downplayed in comparison with alcoholism. Finally, we find no micro evidence in support of the political economy view based on a positive correlation between low alcohol prices and high mortality rates found in regional‐level data.
Comparison of the WAIS‐III and WISC‐IV in 16‐Year‐Old Special Education Students
Authors: Gordon Shirley , Duff Simon , Davidson Terry , Whitaker Simon
Published: February 2010

Background  Previous research with earlier versions of the WISC and WAIS has demonstrated that when administered to people who have intellectual disabilities, the WAIS produced higher IQ scores than the WISC. The aim of this study was to examine whether these differences still exist. A comparison of the Wechsler Adult Intelligence Scale – Third Edition (WAIS‐III) with the Wechsler Intelligence Scale for Children – Fourth Edition (WISC‐IV) was conducted with individuals who were 16 years old and receiving special education.

Materials and Methods  All participants completed the WAIS‐III (UK) and WISC‐IV (UK). The order of administration was counterbalanced; the mean Full Scale IQ and Index scores on the WAIS‐III and WISC‐IV were compared.

Results  The WAIS‐III mean Full Scale IQ was 11.82 points higher than the mean Full Scale IQ score on the WISC‐IV. Significant differences were also found between the Verbal Comprehension Index, Perceptual Reasoning/Organization Index and Processing Speed Index on the WAIS‐III and WISC‐IV, all with the WAIS‐III scoring higher.

Conclusions  The findings suggest that the WAIS‐III produces higher scores than the WISC‐IV in people with intellectual disabilities. This has implications for definitions of intellectual disability and suggests that Psychologists should be cautious when interpreting and reporting IQ scores on the WAIS‐III and WISC‐IV.
Clinical and geographical variation in prophylactic and therapeutic treatments for pre‐eclampsia in the UK
Authors: Chappell LC , Seed P , Enye S , Briley AL , Poston L , Shennan AH
Published: February 2010

Please cite this paper as: Chappell L, Seed P, Enye S, Briley A, Poston L, Shennan A. Clinical and geographical variation in prophylactic and therapeutic treatments for pre‐eclampsia in the UK. BJOG 2010; DOI: 10.1111/j.1471‐0528.2010.02507.x.

Objective  To evaluate the clinical and geographical variation in the use of aspirin in women at high risk of pre‐eclampsia, and in the use of antihypertensive drugs and magnesium sulphate in women with established pre‐eclampsia.

Design  Analysis of vitamins in pre‐eclampsia (VIP) trial database.

Sample  A total of 2399 women at increased risk of pre‐eclampsia in 25 UK hospitals.

Methods  An analysis of a large prospectively validated database of high‐risk women in the UK was undertaken to assess aspirin use across different risk groups and to evaluate the use of antihypertensives and magnesium sulphate in 370 women who developed pre‐eclampsia. Logistic regression was employed to compare drug use between region and by recognised clinical indicators.

Main outcome measures  Usage of aspirin, antihypertensive drugs and magnesium sulphate.

Results  Of the women with known risk factors at trial entry, 24% (569/2399) received low‐dose aspirin. Aspirin usage varied widely between risk groups [from 5% (19/378) in women with multiple pregnancy to 94% (50/53) in women with antiphospholipid syndrome] and between geographical regions [from 8% (20/248) to 49% (95/193)]. Three hundred and seventy women developed pre‐eclampsia, 52% (n = 193) of whom received new or additional antihypertensives after 20 weeks of gestation; 34% (77/224) with a maximum recorded systolic blood pressure of ≥160 mmHg in the second half of pregnancy did not receive antihypertensive treatment; 17% (62/370) of women with pre‐eclampsia received magnesium sulphate prophylactically.

Conclusions  Prophylactic and treatment regimes for pre‐eclampsia in the UK vary by region and risk group.
A series of 400 laparoscopic hysterectomies for benign disease: a single centre, single surgeon prospective study of complications confirming previous retrospective study
Authors: Donnez O , Donnez J
Published: February 2010

Please cite this paper as: Donnez O, Donnez J. A series of 400 laparoscopic hysterectomies for benign disease: a single centre, single surgeon prospective study of complications confirming previous retrospective study. BJOG 2010; DOI: 10.1111/j.1471‐0528.2010.02520.x.

The aim of this study was to evaluate the complication rate after total and subtotal laparoscopic hysterectomy for benign disease performed by the same surgeon after an adequate learning curve. We conducted a prospective evaluation of complications in a continuous series of 400 women undergoing laparoscopic subtotal hysterectomy (LASH) or total laparoscopic hysterectomy (TLH) between October 2005 and January 2009. In the LASH group (n = 148), both the minor and major complication rates were 1.35% (n = 2; n = 2), whereas in the TLH group (n = 252), the rate was 1.59% for major complications (n = 4) and 0% for minor complications, clearly confirming that laparoscopic hysterectomy is safe in experienced hands, especially in terms of urinary tract injuries.
Thermogeography predicts the potential global range of the invasive European green crab (Carcinus maenas)
Authors: Compton T. J. , Leathwick J. R. , Inglis G. J.
Published: February 2010

Aim  The highly adaptable estuarine crab (Carcinus maenas) has successfully invaded five temperate geographic regions outside of its native Europe. Here, we determine which environmental factors predict the current distribution of C. maenas and what the potential geographic range of this species might be. We also investigated whether the invasion potential of C. maenas differs with respect to the origin of a native subpopulation.

Location  Models were developed using global observation records of C. maenas.

Methods  Boosted regression trees were used to model observations from the (1) native, (2) invasive, (3) southern European, (4) northern European and (5) the combined native and invasive geographic ranges of C. maenas.

Results  Most established invasions were predicted mainly based on temperature. Interestingly, the environment encountered by established invasions failed to predict the majority of northern European populations; suggesting that invasion potential may differ between distinct native populations. Supporting this suggestion, a model of northern European populations, distinguished from southern European populations based on genetic structure, only predicted established invasions south of Nova Scotia. By contrast, a model of southern European populations predicted most established invasions.

Main conclusions  These results suggest that invasion potential depends on the European origin of an invasive population and that most invasions have arisen from southern Europe. Finally, a model based on combined native and invasive ranges of C. maenas identified potential geographic range extension along many currently invaded coastlines and the potential invasion of countries like Chile, China, Russia, Namibia and New Zealand.
Spreading to a limit: the time required for a neophyte to reach its maximum range
Authors: Gassó Núria , Pyšek Petr , Vilà Montserrat , Williamson Mark
Published: February 2010

The average range size of alien plants in Spain reaches a maximum at 143 years. This is consistent with estimates of such a maximum in Ireland, Britain, Germany and the Czech Republic. A round figure of about 150 years on average for neophytes to reach their maximum range in European countries is indicated.
French summaries of product characteristics: content in relation to therapeutic monitoring of psychotropic drugs
Authors: Rougemont Michael , Ulrich Sven , Hiemke Christoph , Corruble Emmanuelle , Baumann Pierre
Published: February 2010

The prescription information (summary of product characteristics, SPC) is compiled by the pharmaceutical industry as required by the national regulatory authorities. They vary in their content about the properties of drugs and about the usefulness of therapeutic drug monitoring (TDM) in the blood of patients. Based on a previous study carried out in Germany, the degree of agreement of French SPC for 59 psychotropic drugs with the existing medico‐scientific evidence in the area of TDM was examined using a recently developed instrument. A summary score of SPC content (SPCC) related to TDM (SPCCTDM) has been calculated and compared with the level of recommendation of TDM of the AGNP‐TDM expert group consensus guidelines for TDM in psychiatry [AGNP: Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (Association for neuropsychopharmacology and pharmacopsychiatry)]. Among the antidepressants, antipsychotics, tranquillizers/hypnotic agents and mood stabilizers, the highest SPCCTDM scores in the French SPC were reached for imipramine (16), haloperidol (6), clonazepam (8) and lithium (23), respectively. Results were similar to those obtained from the analysis of German SPC, and considerable disagreement was found between the information on TDM in SPC and existing medico‐scientific evidence, albeit less in the case of mood stabilizers. Taking into account the recommendations of the AGNP‐TDM expert group guidelines, there is a deficit in the French SPC concerning TDM‐relevant information. An amelioration of this situation could help to improve the clinical practice of TDM of psychotropic drugs, as the SPC is a widely used tool.
Expression of differential genes involved in the maintenance of water balance in human skin by Piptadenia colubrina extract
Authors: Del Carmen Velazquez Pereda Maria , De Campos Dieamant Gustavo , Eberlin Samara , Werka Rejane Maria , Colombi Débora , De Souza Queiroz Mary Luci , Di Stasi Luiz Claudio
Published: February 2010

Background  Hydration and integrity of the stratum corneum (SC) is an important determinant of skin appearance, metabolism, mechanical properties, and barrier function. The presence of aquaglyceroporins and envelope proteins are crucial to provide greater corneocyte cohesion to keep water and other moisturizers in the skin.

Aims  In this study, we evaluated the ability of Piptadenia colubrina, a plant native of South American rain forests, in the expression of genes involved in skin capacitance and SC integrity.

Methods  The expression of genes for aquaporin‐3 (AQP3), loricrin, involucrin (INV), and filaggrin (FLG) was measured by real‐time PCR, using an in vitro model of human keratinocytes incubated with concentrations of 2.5, 5, 10, and 20 mg/mL of a hydroglycolic extract of P. colubrina (HEPC). The amount of AQP3 protein was also tested by immunohistochemistry in human skin explants. Clinical trials were conducted to evaluate the effects of a gel‐cream containing HEPC on the glycerol index and skin capacitance.

Results  Hydroglycolic extract of P. colubrina increased both the expression and immunoreactivity of AQP3 in cultured keratinocytes and human skin explants. The gene induction to envelope proteins FLG and INV was also observed after cell incubation with HEPC. Skin capacitance was significantly improved in human volunteers under treatment with HEPC‐containing cream.

Conclusions  The extract of P. colubrina promotes cellular hydration and induces gene expression of envelope proteins providing greater corneocyte cohesion to keep water and other moisturizers in the skin and an appropriate epidermal adhesion. The in vitro findings were clinically confirmed and encourage the clinical use of this compound in skin care products.
Camouflage for patients with vitiligo vulgaris improved their quality of life
Authors: Tanioka Miki , Yamamoto Yosuke , Kato Mayumi , Miyachi Yoshiki
Published: February 2010

Background  Cosmetic camouflage is important for patients with vitiligo vulgaris. However, few studies have investigated its benefit for vitiligo patients.

Objectives  To analyze the psychological effects on patients with vitiligo vulgaris by camouflage lessons performed in vitiligo clinics in Kyoto University Hospital and Fukui Red Cross Hospital, Dermatological Life Quality Index (DLQI) questionnaires were collected before and 1 month after camouflage lessons.

Patients  Patients with vitiligo vulgaris, who visited our clinics in 2008 and had never experienced camouflage, were enrolled in this study. They took camouflage lessons and continued subsequent self‐camouflage for 1 month. Control patients took no lessons and no camouflage.

Results  Camouflage improved the scores of DLQI when compared with those without camouflage (P = 0.005). Camouflage improved DLQI scores from 5.90 to 4.48. In DLQI subcategories, camouflage lessons improved a subcategory of “symptoms and feelings” (P = 0.0037).

Conclusions  These data supported the idea that camouflage for patients with vitiligo not only covers the white patches but also improves their quality of life.
Longevity of effects of hyaluronic acid plus lidocaine facial filler
Authors: Raspaldo Hervé , De Boulle Koen , Levy Phillip M
Published: February 2010

Background  A new hyaluronic acid filler containing pre‐incorporated 0.3% lidocaine reduces pain and enhances patient comfort. In vitro studies confirm functional equivalence with non‐lidocaine‐containing products, but only limited data are available on the long‐term effects of lidocaine on filler performance in the clinical setting.

Aims  To investigate whether inclusion of lidocaine impacts the longevity of hyaluronic acid fillers.

Patients/Methods  60 patients with moderate–severe bilateral nasolabial folds received 24 mg/mL hyaluronic acid with pre‐incorporated lidocaine or an equivalent product without lidocaine and were followed‐up for up to 76 weeks.

Results  Significantly better results were found in favor of HA gel with pre‐incorporated lidocaine for physician assessment of injection pain and patient pain assessment after injection (both P < 0.001). Long‐term follow‐up of patients after almost a year showed that 91% (52/57) of patients had no evidence of facial asymmetry, and investigators confirmed lidocaine had no effect on filler longevity. High levels of patient satisfaction and prolonged benefits due to persistence of the product were noted, with those patients needing additional treatment requiring ‘top‐up’ rather than full re‐treatment.

Conclusions  The addition of 0.3% lidocaine does not affect product longevity and the small volume required for ‘touch‐up’ also suggests that longevity is maintained.
TIN ISOTOPY—A NEW METHOD FOR SOLVING OLD QUESTIONS
Authors: HAUSTEIN M. , GILLIS C. , PERNICKA E.
Published: February 2010

Tin was a vital commodity in times past. In central Europe, the earliest finds of tin‐bronze date to about 2200 bc, while in Greece they are c. 400–500 years earlier. While there is evidence for prehistoric copper mining—for example, in the Alps or mainland Greece, among other places—the provenance of the contemporary tin is still an unsolved problem. This work deals with a new approach for tracing the ancient tin via tin isotope signatures. The tin isotope ratios of 50 tin ores from the Erzgebirge region (D) and 30 tin ores from Cornwall (GB) were measured by MC–ICP–MS. Most ore deposits were found to be quite homogeneous regarding their tin isotope composition, but significant differences were observed between several deposits. This fact may be used to distinguish different tin deposits and thus form the basis for the investigation of the provenance of ancient tin that has been sought for more than a century. Furthermore, the tin‐isotope ratio of the ‘Himmelsscheibe von Nebra’ will be presented: the value fits well with the bulk of investigated tin ores from Cornwall.
Selectivity in Mammalian Extinction Risk and Threat Types: a New Measure of Phylogenetic Signal Strength in Binary Traits
Authors: FRITZ SUSANNE A. , PURVIS ANDY
Published: February 2010

Abstract:  The strength of phylogenetic signal in extinction risk can give insight into the mechanisms behind species’ declines. Nevertheless, no existing measure of phylogenetic pattern in a binary trait, such as extinction‐risk status, measures signal strength in a way that can be compared among data sets. We developed a new measure for phylogenetic signal of binary traits, D, which simulations show gives robust results with data sets of more than 50 species, even when the proportion of threatened species is low. We applied D to the red‐list status of British birds and the world's mammals and found that the threat status for both groups exhibited moderately strong phylogenetic clumping. We also tested the hypothesis that the phylogenetic pattern of species threatened by harvesting will be more strongly clumped than for those species threatened by either habitat loss or invasive species because the life‐history traits mediating the effects of harvesting show strong evolutionary pattern. For mammals, our results supported our hypothesis; there was significant but weaker phylogenetic signal in the risk caused by the other two drivers (habitat loss and invasive species). We conclude that D is likely to be a useful measure of the strength of phylogenetic pattern in many binary traits.
Understanding the Lessons and Limitations of Conservation and Development
Authors: OLDEKOP JOHAN A. , BEBBINGTON ANTHONY J. , BROCKINGTON DAN , PREZIOSI RICHARD F.
Published: February 2010

Abstract: The lack of concrete instances in which conservation and development have been successfully merged has strengthened arguments for strict exclusionist conservation policies. Research has focused more on social cooperation and conflict of different management regimes and less on how these factors actually affect the natural environments they seek to conserve. Consequently, it is still unknown which strategies yield better conservation outcomes? We conducted a meta‐analysis of 116 published case studies on common resource management regimes from Africa, south and central America, and southern and Southeast Asia. Using ranked sociodemographic, political, and ecological data, we analyzed the effect of land tenure, population size, social heterogeneity, as well as internally devised resource‐management rules and regulations (institutions) on conservation outcome. Although land tenure, population size, and social heterogeneity did not significantly affect conservation outcome, institutions were positively associated with better conservation outcomes. There was also a significant interaction effect between population size and institutions, which implies complex relationships between population size and conservation outcome. Our results suggest that communities managing a common resource can play a significant role in conservation and that institutions lead to management regimes with lower environmental impacts.
Management and Recovery Options for Ural River Beluga Sturgeon
Authors: DOUKAKIS PHAEDRA , BABCOCK ELIZABETH A. , PIKITCH ELLEN K. , SHAROV ALEXEI R. , BAIMUKHANOV MIRGALY , ERBULEKOV SAGIDEN , BOKOVA YELENA , NIMATOV AKHAT
Published: February 2010

Abstract: Management of declining fisheries of anadromous species sometimes relies heavily on supplementation of populations with captive breeding, despite evidence that captive breeding can have negative consequences and may not address the root cause of decline. The beluga sturgeon (Huso huso), a species threatened by the market for black caviar and reductions in habitat quality, is managed through harvest control and hatchery supplementation, with an emphasis on the latter. We used yield per recruit and elasticity analyses to evaluate the population status and current levels of fishing and to identify the life‐history stages that are the best targets for conservation of beluga of the Ural River. Harvest rates in recent years were four to five times higher than rates that would sustain population abundance. Sustainable rates of fishing mortality are similar to those for other long‐lived marine species such as sharks and mammals. Yield per recruit, which is maximized if fish are first harvested at age 31 years, would be greatly enhanced by raising minimum size limits or reducing illegal take of subadults. Improving the survival of subadult and adult females would increase population productivity by 10 times that achieved by improving fecundity and survival from egg to age 1 year (i.e., hatchery supplementation). These results suggest that reducing mortality of subadults and adult wild fish is a more effective conservation strategy than hatchery supplementation. Because genetics is not factored into hatchery management practices, supplementation may even reduce the viability of the beluga sturgeon.
Effects of Forest Fragmentation on Seed Dispersal and Seedling Establishment in Ornithochorous Trees
Authors: HERRERA JOSÉ MANUEL , GARCÍA DANIEL
Published: February 2010

Abstract:  Habitat fragmentation increases seed dispersal limitation across the landscape and may also affect subsequent demographic stages such as seedling establishment. Thus, the development of adequate plans for forest restoration requires an understanding of mechanisms by which fragmentation hampers seed delivery to deforested areas and knowledge of how fragmentation affects the relationship between seed‐deposition patterns and seedling establishment. We evaluated the dispersal and recruitment of two bird‐dispersed, fleshy‐fruited tree species (Crataegus monogyna and Ilex aquifolium) in fragmented secondary forests of northern Spain. Forest fragmentation reduced the probability of seed deposition for both trees because of decreased availability of woody perches and fruit‐rich neighborhoods for seed dispersers, rather than because of reductions in tree cover by itself. The effects of fragmentation went beyond effects on the dispersal stage in Crataegus because seedling establishment was proportional to the quantities of bird‐dispersed seeds arriving at microsites. In contrast, postdispersal mortality in Ilex was so high that it obscured the seed‐to‐seedling transition. These results suggest that the effects of fragmentation are not necessarily consistent across stages of recruitment across species. Habitat management seeking to overcome barriers to forest recovery must include the preservation, and even the planting, of fleshy‐fruited trees in the unforested matrix as a measure to encourage frugivorous birds to enter into open and degraded areas. An integrative management strategy should also explicitly consider seed‐survival expectancies at microhabitats to preserve plant‐population dynamics and community structure in fragmented landscapes.
Sustaining a Hemodialysis Exercise Program: A Review
Authors: Bennett Paul N. , Breugelmans Leo , Barnard Robert , Agius Megan , Chan Danwin , Fraser Doug , McNeill Liz , Potter Lauren
Published: February 2010

This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980–February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand‐searched for further publications. Criteria for inclusion included full‐text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis.
Calcific Uremic Arteriolopathy – The Argument for Hyperbaric Oxygen and Sodium Thiosulfate
Authors: Rogers Natasha M. , Coates P. Toby H.
Published: February 2010

Calcific uremic arteriolopathy (CUA) is a rare event primarily in patients with end‐stage kidney disease which is charaterized by small vessel media calcification, panniculitis, dermal necrosis producing exquisitely painful difficult to heal wounds. Mortality rates may be as high as 80%, predominantly due to intervening sepsis. This clinical phenomenon is being increasingly reported and treated with a widening number of agents. Recent case reports highlight the benefit of two modalities that have been employed as adjuvant therapy with significant success in the treatment of CUA. Hyperbaric oxygen (HBO) is capable of enhancing oxygen delivery to the ulcerating lesions that characterize CUA. Chronic hypoxia can be reversed using HBO to facilitate growth factor production, neoangiogenesis, fibroblast proliferation, and collagen synthesis that may facilitate all aspects of wound healing. Sodium thiosulfate appears to chelate and solubilize calcium ions, reducing the calcium vascular load that appears to participate in the obliterative small vessel disease. There is a rapid analgesic effect and slower regression of cutaneous calcific nodules. The authors advocate for aggressive treatment of CUA, using all available therapies.
A Dialysis Case Presentation and Discussion Edited by Roger A. Rodby: Bullous Skin Lesions in a Patient Undergoing Chronic Hemodialysis
Authors: Ryali Madhavi E. , Whittier William L.
Published: February 2010

Porphyria cutanea tarda (PCT) is a vesiculobullous skin disorder characterized by a defect in heme biosynthesis. Reduced activity of the hepatic enzyme uroporphyrinogen decarboxylase (URO‐D) results in accumulation of photosensitive porphyrins; this ultimately leads to the skin fragility and blistering that is characteristic of this disease. The majority of cases of PCT are associated with acquired deficiencies of the enzyme URO‐D, secondary to hepatic injury precipitated by medications or infections. Less commonly, PCT has been documented in patients with end‐stage renal disease. The pathogenesis of PCT in long‐term hemodialysis (HD) has been attributed to many factors, but the following mechanisms have been implicated: (i) decreased hepatic URO‐D activity due to suppressive effects of iron and other hepatotoxins and (ii) poor porphyrin clearance by renal replacement therapies. We report a case of PCT that developed in a patient on maintenance HD for 4 years. He had a history of hepatitis C and evidence of iron overload. However, as the patient was anemic, therapeutic phlebotomy was problematic and therefore erythrocyte‐stimulating agents were maximized to mobilize iron stores and allow phlebotomy. With this treatment, the patient’s skin lesions improved in conjunction with decreasing ferritin levels.
Diabetic CKD/ESRD 2010: A Progress Report?
Authors: Williams Mark E.
Published: February 2010

Both in the United States and many regions of the world, chronic kidney disease and end‐stage renal disease (ESRD) in patients with diabetes mellitus have reached epidemic proportions in recent years. The large prevalent diabetic ESRD population in the US involves remarkable risk in African Americans and an increasing population of elderly diabetic patients, including many octogenarians. In the US and globally, over 90% of diabetic ESRD patients have type 2 diabetes. The multinational epidemic of diabetic ESRD has been linked to increases in the prevalence of diabetes in many populations, related to obesity, ageing, and physical inactivity. It is anticipated that the worldwide prevalence of diabetes over the next 20 years will reach a level twice that of the year 2000. The excessive morbidity and mortality of the diabetic ESRD population are well documented. However, the growth in incidence and prevalence rates for diabetic ESRD has remained somewhat stable in the US in recent years, and new data suggest that the incidence of ESRD expressed per diabetic population may finally be declining, suggesting that proven therapies are making “progress on progression.”
Continuously Evolving Management Concepts for Diabetic CKD and ESRD
Authors: Friedman Eli A.
Published: February 2010

During the past 50 years, a global pandemic of kidney failure attributed to diabetes mellitus provoked continuously changing treatment strategies based in the belief that micro‐ and macrovascular complications of diabetes may be preventable. Both patient and physician have revised, and sometimes reversed drug regimens based on inferences extracted from prospective, controlled, properly populated trials. Illustrating this dilemma is a newly relaxed target for glycosylated hemoglobin (HbA1c) of 7%, introduced because of the greater rate of cardiovascular complications noted when striving to reduce attained HbA1c to ≤6.5%. Our concept of the natural history of kidney disease in diabetes has repeatedly been modified by a rising mean age of those developing uremia (now 64.5 years). Underscoring the reality that the majority of diabetic kidney failure patients fall within the geriatric age group. An encouraging finding first reported in 2005 and continuing through 2009 is a declining incidence rate of irreversible advanced kidney failure in individuals known to have diabetes. That this “good news” results from appropriate renoprotective treatment is as yet unsubstantiated wishful thinking.
Selection and Dosing of Medications for Management of Diabetes in Patients with Advanced Kidney Disease
Authors: Reilly James B. , Berns Jeffrey S.
Published: February 2010

Diabetes mellitus is a leading cause of kidney disease worldwide. A large and expanding array of treatments for diabetes is available to improve glycemic control, including newer classes of drugs, such as thiazolidinediones and incretin‐based therapies. The presence of impaired kidney function with reduced glomerular filtration rate should influence choices, dosing, and monitoring of hypoglycemic agents, as some agents require a dosing adjustment in patients with kidney disease and some are entirely contraindicated. This article reviews the clinical use of insulin and other antidiabetic therapies, focusing on pharmacokinetic properties and dosing in patients with advanced kidney disease.
How Can Prognosis for Diabetic ESRD Be Improved?
Authors: Locatelli Francesco , Del Vecchio Lucia , Cavalli Andrea
Published: February 2010

Although the prognosis of patients who have diabetes and are receiving renal replacement therapy has greatly improved, survival and medical rehabilitation rates continue to be significantly worse than those of nondiabetic patients, mainly because of pre‐existing severely compromised cardiovascular conditions. In this scenario, the nephrology community had to do its best in order to offer the best treatment options to these patients using a multifaceted approach. The most common RRT modality in patients with diabetes is still hemodialysis, but it gives rise to a number of clinical problems, in particular difficulties in the management of the vascular access and high frequency of intradialytic hypotension. Recent data suggest that efficient high‐flux treatments have the potential of improving morbidity and mortality of diabetics with ESRD. Sodium profiling during the dialysis session may be also of importance in reducing intradialytic hypotension and helping in achieving the prescribed body weight. Patients who have diabetes and are on peritoneal dialysis have to face a progressive increase in peritoneal permeability, loss of ultrafiltration, and peritoneal fibrosis, all phenomena being accelerated in patients with diabetes and ultimately leading to an increased technique failure. However, the two dialytic modalities are comparable in terms of outcomes in the short term.
Development and Validation of Quality Indicators for Dementia Diagnosis and Management in a Primary Care Setting
Authors: Perry Marieke , Drašković Irena , van Achterberg Theo , van Eijken Monique , Lucassen Peter , Vernooij‐Dassen Myrra , Olde Rikkert Marcel
Published: February 2010

OBJECTIVES: To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting.

DESIGN: RAND modified Delphi method, including a postal survey, a stakeholders consensus meeting, a scientific expert consensus meeting, and a demonstration project.

SETTING: Primary care.

PARTICIPANTS: General practitioners (GPs), primary care nurses (PCNs), and informal caregivers (ICs) in postal survey and stakeholders consensus meeting. Eight national dementia experts in scientific consensus meeting. Thirteen GPs in the demonstration project.

MEASUREMENTS: Mean face validity and feasibility scores. Compliance rates using GPs' electronic medical record data.

RESULTS: The initial set consisted of 31 QIs. Most indicators showed moderate or good face validity and feasibility scores. Consensus panels reduced the preliminary set used in the demonstration project to 24 QIs. The overall compliance to the QIs was 45.3%. Discriminative validity of the set was good; significant differences in adherence were found between GPs with high and low levels of patients aged 65 and older in their practice, with and without PCNs, and with positive and negative attitudes toward dementia (all P<.05). Based on the demonstration project, one QI was excluded. The final set consisted of 23 QIs; 15 QIs contained innovative quality criteria on collaboration between GPs and PCNs, referral criteria, and assessment of caregivers' needs.

CONCLUSION: This new set of dementia QIs is feasible, reliable, and valid and can be used to improve primary dementia care. Because of the innovative quality criteria, the set is complementary to the existing dementia QIs.
The role of HIF prolyl hydroxylases in tumour growth
Authors: Jokilehto Terhi , Jaakkola Panu M.
Published: February 2010

Hypoxia in tumours

Overview of the oxygen‐sensing mechanisms

The family of HIF hydroxylases

Expression of PHDs in normal tissues

Regulation of PHDs

PHDs in cell growth and differentiation

Expression of PHDs in cancer

Function of the PHDs in cancer

Other dioxygenase targets in cancer and future directions

Tumour hypoxia is a well‐known microenvironmental factor that causes cancer progression and resistance to cancer treatment. This involves multiple mechanisms of which the best‐understood ones are mediated through transcriptional gene activation by the hypoxia‐inducible factors (HIFs). HIFs in turn are regulated in response to oxygen availability by a family of iron‐ and 2‐oxoglutarate‐dependent dioxygenases, the HIF prolyl hydroxylases (PHDs). PHDs inactivate HIFs in normoxia by activating degradation of the HIF‐α subunit but release HIF activation in poorly oxygenated conditions. The function of HIF in tumours is fairly well characterized but our understanding on the outcome of PHDs in tumours is much more limited. Here we review the function of PHDs on the HIF system, the expression of PHDs in human tumours as well as their putative function in cancer. The PHDs may have either tumour promoting or suppressing activity. Their outcome in cancer depends on the cell and cancer type‐specific expression and on the availability of diverse natural PHD inhibitors in tumours. Moreover, besides the action of PHDs on HIF, recent data suggest PHD function in non‐HIF signalling. Together the data illustrate a complex operation of the oxygen sensors in cancer.
Maternal plasma level of antimicrobial peptide LL37 is a major determinant factor of neonatal plasma LL37 level
Authors: Mandic Havelka A , Yektaei‐Karin E , Hultenby K , Sørensen OE , Lundahl J , Berggren V , Marchini G
Published: February 2010

Aim:  To determine cathelicidin antimicrobial peptide LL37subcellular distribution in cord neutrophils and normal plasma LL37 levels in mothers and neonates, relate them to delivery mode and relevant biochemical markers, including 25‐OHvitamin D [25(OH)D] as this molecules increases cathelicidin gene expression.

Methods:  A total of 115 infants were included, n = 68 with normal delivery and n = 47 with elective Caesarean section (C‐section), a subset of these being 50 mother–infant pairs. Biomarkers were determined in maternal and cord blood. Subcellular peptide LL37 distribution was analysed with immunoelectron microscopy.

Results:  Cord plasma LL37 levels were three‐times higher after normal delivery compared with C‐section. A highly significant correlation was observed between maternal and cord plasma LL37 levels, regardless of delivery mode. No relationship was found between LL37 and 25(OH)D levels. Neutrophils from cord blood after normal delivery contained 10‐times more cytoplasmatic cathelicidin peptide compared with corresponding cells after C‐section where a strict granular localization was found.

Conclusion:  These data are consistent with a placental transfer of LL37 and identifies maternal stores as the critical factor determining neonatal plasma LL37 level. An additional enhancement of neonatal cathelicidin mobilization and release is connected to normal delivery stress.