bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of inborn and transported extremely premature very‐low‐birthweight infants in Hawai‘i
Authors: Kuo Sheree , Kimata Chieko , Akamine Kristie , Young Brandon , Balaraman Venkataraman
Published: January 2012

Background:  Delivery of premature infants outside tertiary care centers is not always preventable. The aim of this study was to compare rates of survival and common morbidities in extremely premature babies transported to a level III facility versus those born at the level III center.

Methods:  Retrospective chart review was performed on all neonates born at ≤ 28 weeks of gestation with birthweight ≤1500 g who were admitted to the Newborn Intensive Care Unit at Kapi‘olani Medical Center for Women and Children (KMCWC) between 1 January 2000 and 31 December 2005. Infants were divided into two groups, those born at KMCWC (Inborn) and those born at level I institutions and subsequently transported (Transport) to KMCWC.

Results:  A total of 394 neonates met the study criteria; 349 were inborn while 45 were transported. Survival rates were identical for both groups. However, the Transport group survivors displayed a significantly longer mean length of stay and higher rate of severe retinopathy of prematurity than those in the Inborn group (P≤ 0.01).

Conclusion:  Identical rates of survival in both groups suggest that community medical professionals are providing satisfactory care to stabilize critical neonates without reducing their chances of survival. However, increased length of stay and higher rate of retinopathy of prematurity in the Transport group suggest that differences in medical management during the first few hours of life may adversely affect outcomes.
The effect of long‐term repeated burning and fire exclusion on above‐ and below‐ground Blackbutt (Eucalyptus pilularis) forest vegetation assemblages
Authors: LEWIS TOM , REIF MICHAEL , PRENDERGAST ELLY , TRAN CUONG
Published: January 2012

We used a long‐term fire experiment in south‐east Queensland, Australia, to determine the effects of frequent prescribed burning and fire exclusion on understorey vegetation (<7.5 m) richness and density in Eucalyptus pilularis forest. Our study provided a point in time assessment of the standing vegetation and soil‐stored vegetation at two experimental sites with treatments of biennial burning, quadrennial burning since 1971–1972 and no burning since 1969. Vegetation composition, density and richness of certain plant groups in the standing and soil‐stored vegetation were influenced by fire treatments. The density of resprouting plants <3 m in height was higher in the biennially burnt treatment than in the unburnt treatment, but resprouters 3–7.5 m in height were absent from the biennial burning treatment. Obligate seeder richness and density in the standing vegetation was not significantly influenced by the fire treatments, but richness of this plant group in the seed bank was higher in the quadrennial treatment at one site and in the long unburnt treatment at the other site. Long unburnt treatments had an understorey of rainforest species, while biennial burning at one site and quadrennial burning at the other site were associated with greater standing grass density relative to the unburnt treatment. This difference in vegetation composition due to fire regime potentially influences the flammability of the standing understorey vegetation. Significant interactions between fire regime and site, apparent in the standing and soil‐stored vegetation, demonstrate the high degree of natural variability in vegetation community responses to fire regimes.
Is top‐down control by predators driving insect abundance and herbivory rates in fragmented forests?
Authors: DE LA VEGA XAVIERA , GREZ AUDREY A. , SIMONETTI JAVIER A.
Published: January 2012

The effects of forest fragmentation on ecological interactions and particularly on food webs have scarcely been analysed. There is usually less herbivory in forest fragments than in continuous forests. Here we hypothesize that forest fragmentation enhances top‐down control of herbivory through an increase in insectivorous birds and a decrease in herbivorous insects, with a consequent decrease in plant reproductive success in small forest fragments. In the Maulino forest in central Chile, we experimentally excluded birds from Aristotelia chilensis (Elaeocarpaceae) trees in both forest fragments and continuous forest, and analysed herbivore insect abundance, herbivory and plant reproductive success during two consecutive growing seasons. We expected that insect abundance and herbivory would increase, and reproductive success would decrease in A. chilensis from which birds have been excluded, particularly in forest fragments where bird abundance and predation pressure on insects is higher. The abundance of herbivorous insects was lower in the forest fragments than in the continuous forest only in the first season, and herbivory was lower in forest fragments than in the continuous forest throughout the study. Moreover, during the second growing season herbivory was greater in the excluded trees than in the control trees, and as expected, there was a greater difference in the fragments than in the continuous forest, but this was not statistically significant. Exclusion of birds did not affect the reproductive success of A. chilensis. Our results, after 2 years of study, demonstrate that birds affect the levels of herbivory on A. chilensis in the Maulino forest, but do not support our hypothesis of enhanced top‐down control in fragmented forests, as the strength of the effect of excluding birds did not vary with fragmentation.
Bimodal electric tissue ablation (BETA) compared with the Cool‐Tip RFA system
Authors: Tiong Leong Ung , Field John B. F. , Maddern Guy J.
Published: January 2012

Background:  Bimodal electric tissue ablation (BETA) incorporates the process of electrolysis into radiofrequency ablation (RFA) to increase the size of tissue ablation. This study investigated whether BETA could increase the efficacy of the Cool‐Tip RF system (Covidien, Boulder, CO, USA) to produce larger ablations. It also investigated whether applying electrolysis only during the pretreatment phase (called electrochemical treatment (ECT)/RFA group) is as effective as BETA (where electrolysis was used during both the pretreatment and RFA phases).

Methods:  A Cool‐Tip RF system (Covidien) was used to test three types of ablations (RFA, BETA, and ECT/RFA) in a pig liver model. In BETA, 9 V of direct current was provided for 10 min, after which the RF generator was started and both electrical circuits were allowed to run concurrently. In ECT/RFA, however, the direct current circuit was switched off after 10 min of pretreatment and only RFA was performed as described above. Ablation sizes were measured in three dimensions.

Results:  The size of ablations (transverse diameter A and B) produced by BETA and ECT/RFA was significantly larger compared with standard RFA (P < 0/001). BETA also created larger ablations compared with ECT/RFA (P < 0.001).

Conclusion:  BETA could improve the efficacy of the Cool‐Tip RF system (Covidien) to achieve larger ablations. The increased tissue hydration improved delivery of electrical energy to the tissues and delayed the process of desiccation, thus allowing the ablation process to continue for longer periods of time to produce larger ablations. BETA could be used to treat larger liver tumours more effectively than standard RFA.
Use of trastuzumab in Australia and New Zealand: results from the National Breast Cancer Audit
Authors: Whitfield Robert , Kollias James , De Silva Primali , Zorbas Helen , Maddern Guy
Published: January 2012

Background:  Trastuzumab increases disease‐free and overall survival in HER‐2‐positive, early breast cancer. In 2007, the National Breast and Ovarian Cancer Centre recommended that patients with HER‐2 positive cancers (node positive or node negative tumours >1 cm) be offered adjuvant trastuzumab with chemotherapy. The aim of this study was to evaluate recent trends in trastuzumab therapy in Australia and New Zealand.

Methods:  Following data were obtained from the National Breast Cancer Audit for patients treated between 2006 and 2008: tumour size, number of cases recorded per surgeon per year, location of hospital, HER‐2 receptor status, age, lymph node status, chemotherapy and trastuzumab treatment.

Results:  Data were available from 23 290 patients. During the study period, the percentage of breast cancers tested for HER‐2 rose from 77% to 91%. Patients over 70 had fewer HER‐2 tests than their younger counterparts. Fourteen percent of tumours were HER‐2 positive; the proportion treated with trastuzumab in 2006, 2007 and 2008 was 50%, 66% and 74%, respectively. Significantly more node‐positive patients (77%) were given trastuzumab than node‐negative patients (52%). All the patients prescribed trastuzumab also received chemotherapy. Patients under 70 years, patients treated in Australia and patients treated by higher caseload surgeons were more likely to be prescribed trastuzumab than those over 70, patients in New Zealand and patients treated by lower caseload surgeons.

Conclusions:  Trastuzumab‐prescribing trends conform to the published guidelines. However, older patients and those with HER‐2 positive, node‐negative tumours >1 cm may be undertreated in some cases.
The marketing of responsible drinking: Competing voices and interests
Authors: WETTLAUFER ASHLEY , CUKIER SAMANTHA , GIESBRECHT NORMAN , GREENFIELD THOMAS K.
Published: January 2012

Introduction and Aims. This paper contrasts health‐oriented low‐risk drinking guidelines (LRDGs) with social drinking marketing and popular advice on the amount of alcohol to be provided for social occasions. The questions addressed include: What is the underlying evidence base and rationale for health‐oriented versus socially oriented drinking guidelines? What are the recommended amounts of alcohol per person from the LRDGs and from popular advice?

Design and Methods. This paper draws on existing research, archival data, websites, print media and key informant interviews. The focus is on recent information on LRDGs and social drinking indicators in Canada, the USA, Australia and the UK.

Results. There is extensive epidemiological research indicating the associations between drinking pattern and risk for chronic disease and trauma as well as certain potential health benefits from drinking small amounts regularly. This body of evidence is one resource for government or medically sanctioned LRDGs in many jurisdictions. In contrast, for those planning social events where liquor is served, information is available from the hospitality industry, retailers and liquor control boards. While some overlap exists between these two sources of information, in some contexts normative recommendations support drinking at potentially dangerous levels.

Discussion and Conclusions. The inconsistency among the different guidelines highlights one of the challenges of conveying health information on a drug that is integrated into social life and used extensively. It also reflects a siloed approach to alcohol policy—where retailing and harm reduction practices are managed by different sectors of government that seldom reflect a coordinated response.[Wettlaufer A, Cukier S, Giesbrecht N, Greenfield TK. The marketing of responsible drinking: Competing voices and interests. Drug Alcohol Rev 2012;31:231–239]
The Agrarian Roots of Industrial Growth: Rural Development in South‐East Asia and sub‐Saharan Africa
Authors: Henley David
Published: January 2012

There is an influential view that South‐East Asia's economic success is based on export‐oriented industrialisation, and that African states should above all imitate this aspect of Asian development strategy. This article, however, uses evidence from Indonesia, Nigeria, Malaysia and Kenya to argue: (i) that the historical roots of South‐East Asian economic success actually lie in pro‐poor agricultural and rural development; (ii) that even when it has been pro‐rural, as in the case of Kenya, African development strategy has not been pro‐poor; and (iii) that pro‐poor agricultural development, not export‐oriented industrialisation, should be the first priority of African states seeking to achieve sustained growth and poverty reduction.
The HIV Epidemic, Skill Heterogeneity, and Output
Authors: de Araujo Pedro
Published: January 2012

This paper investigates the effect of HIV/AIDS on output using an overlapping generations model with heterogeneous agents calibrated to sub‐Saharan Africa. Output is found to be below a no‐AIDS output in a range between 3% (10%), when only unskilled workers are affected, and 10% (28%), when only skilled workers are affected, whenever the overall infection rate is 7% (20%). When investigating the hypothesis that AIDS affects skilled workers more severely than unskilled at the beginning of the epidemic, with the effect switching as the epidemic becomes more mature, the findings are that the economy can be 8% smaller along the transition path. In all scenarios where the epidemic is temporary, it would take four to five generations or about 90 years for sub‐Saharan Africa to recover.
Technological Progress with Segmented Labor Markets
Authors: Beladi Hamid , De la Vina Lynda , Marjit Sugata
Published: January 2012

It is argued here that with segmented labor markets, all types of technological progress in the fixed wage organized sector always hurts the unorganized or informal workers. However, such technical progress in the informal sector always helps the informal workers. This result is independent of the factor intensity ranking between the sectors.
Wage Inequality and Returns to Education in Turkey: A Quantile Regression Analysis
Authors: Tansel Aysit , Bodur Fatma Bircan
Published: January 2012

This paper investigates the male wage inequality and its evolution over the 1994–2002 period in Turkey by estimating Mincerian wage equations using ordinary least squares and quantile regression techniques. Male wage inequality is high in Turkey. While it declined at the lower end of the wage distribution it increased at the top end of wage distribution. Education contributed to higher wage inequality through both within and between dimensions. The within‐groups inequality increased and between‐groups inequality decreased over the study period. The latter factor may have dominated the former contributing to the observed decline in the male wage inequality over the 1994–2002. Further results are provided for the wage effects of experience, public sector employment, geographic location, firm size, industry of employment and their contribution to wage inequality. Recent increases in foreign direct investiment inflows, openness to trade and global technological developments are discussed as contributing factors to the recent rising within‐groups wage inequality.
Marshall's Scissors: The Gains and Losses from Trade
Authors: Ruffin Roy J. , Dogan Can
Published: January 2012

In a Ricardian two‐factor endowment model with Cobb–Douglas tastes and many goods, this paper describesthe interaction of the demand and supply sides to determine the gains and losses from trade. If the abundant factor has a sufficiently rich profile of comparative advantages, trade causesthe proportionate gain to the abundant factor to be smaller than the proportionate loss to the scarce factor. However, if the abundant factor has sufficiently skewed comparative advantages toward the best goods, then the opposite will hold. Some examples suggest that these patterns may have something to do with the selection of trade regimes. In the usual one‐factor Ricardian model the gains from trade to a country are enhanced by higher demand shares for imports, but such gains from trade from imports to a country is not the case in a factor endowment model.
International Capital Mobility and Free Trade Once Again*
Authors: Batra Ravi , Beladi Hamid
Published: January 2012

Using a Heckscher–Ohlin model, this paper re‐examines Robert Mundell's famous thesis that free trade and unimpeded capital mobility are perfect substitutes. Under very general conditions which, according to many economists, have caused international convergence of factor rewards, we show that in a polluted environment free trade is inferior to free international investment. This happens even though commodity prices and factor rewards are the same with both policies. The practical side of our thesis is that the world will be better off by reducing the volume of trade while removing all barriers to foreign direct investment that at present hamper the service industries.
The Impact of Differential Falls in Offshoring Costs on Welfare
Authors: Ngienthi Wanida , Dei Fumio
Published: January 2012

We highlight the fact that offshoring firms and local firms that do not offshore coexist in the North. Adopting the O‐ring production function approach to offshoring, we demonstrate that a fall in offshoring costs in any sector makes the South better off and that if offshoring costs in a high‐technology sector fall at a faster rate, the North is worse off, and vice versa.
Democracies, Politics, and Arms Supply
Authors: Comola Margherita
Published: January 2012

Throughout the 20th century arms have not only been tradable goods, but also policy instruments. This paper focuses on countries supplying major conventional weapons (MCW), and investigates whether changes in political conditions impact the quantity of MCW supplied to third countries. In particular, it concentrates on democratic exporters and estimates a gravity‐type panel tobit for the years 1975–2004. Results suggest that the exporter's chief executive, being right‐wing, has a positive and significant impact on MCW exports. This may reflect a general right‐wing tendency to support national industry and deregulate heavy industry exports. It is also found that higher concentration of power is associated with lower MCW exports, and that executives which serve the last year of their term and can run for re‐election tend to decrease MCW exports.
Cleaning data: guess the olympian
Authors: Richards Kate , Davies Neville
Published: January 2012

This article tackles the problem of what should be done with real textual data that are contaminated by errors of recording, particularly when the data contain words that are misspelt, unintentionally or otherwise.
Robert Musil und die Zahl:Anmerkungen zum Verhältnis von funktionaler Denkweise und stilistisch‐semantischen Disparitäten bei Robert Musil
Authors: Leśniak Sławomir
Published: January 2012

The language of Robert Musil's prose is characterised by the two sharply drawn stylistic and semantic contradictions observable between two forms of identity or unity – that of number (conceptual) and that of ‘utopian moment’ (affective). The aim of the present paper is not to define Musil's attitude to mathematics and technique, but rather to explore the mechanism of ‘pure function’ reasoning which endows Musil's stylistic‐semantic contradictions with dynamism and structure, both in his essays and in his novel Der Mann ohne Eigenschaften. The analyses attempted here are founded on the logical‐mathematical concept that presupposes two types of mental operations as functions of number: limiting‐defining and restricting‐isolating. The main conclusion resulting from these analyses points to the restricting‐isolating operation as the basic stylistic‐semantic aspect of Musil's prose. That condition, as utopian experience of affective‐spiritual oneness or unity (Agathe and Ulrich in the novel Der Mann ohne Eigenschaften) is transformed into something general and fantastic and therefore acquires the function of number; in his essays, on the other hand, one detects that characteristic indefiniteness typical of Musil's prose, a hesitation or vacillation between that which is personal and that which is (non)‐supra personal, between the incalculable multiplicity of evaluative possibilities on the one hand and precise observation on the other.

Die Prosa Robert Musils ist durch scharf ausgeprägte, stilistisch‐semantische Disparitäten zwischen zwei Einheiten gekennzeichnet – der Einheit der Zahl (begrifflich‐funktionale Identität) und der des ‘utopischen Augenblicks’ (affektiv‐seelische Identität). Ziel der Arbeit ist nicht die Erforschung von Musils Verhältnis zur Mathematik und Technik, sondern die Erhellung der Denkmethodik, der die reine Funktion zugrunde liegt und die den stilistisch‐semantischen Disparitäten in seinen Essays sowie dem Roman Der Mann ohne Eigenschaften Dynamik und Struktur verleiht. Den Ausgangspunkt der Analysen bildet ein logisch‐mathematisches Schema, das zwei Denkoperationen als Funktion der Zahl voraussetzt: die eingrenzend‐präzisierende und abgrenzend‐isolierende. Die Überlegungen münden in die These, dass in der Prosa Musils die abgrenzend‐isolierende Operationsweise als ihre stilistisch‐semantische Dominante vorherrscht. Dieser Zustand als eine negative Dialektik von Analogie und Differenz hat für das Verhältnis von Sprache und Denken bei Musil zweierlei Implikationen: Das utopische Erlebnis der affektiv‐seelischen Einheit (Agathe und Ulrich im Roman Der Mann ohne Eigenschaften) wird zu etwas Allgemein‐Fantastischem und geht damit in die Zahlfunktion mit ein. Im Essay dagegen lässt sich eine für Musil charakteristische Unbestimmtheit beobachten, ein Schwanken zwischen Persönlichem und (Nicht)‐Überpersönlichem, zwischen unzählbarer Mannigfaltigkeit von Wertungsmöglichkeiten und übersichtlichem Zusammenhang.
The German Drang nach Osten:Linguistic Perspectives on Historical stereotyping1
Authors: Leuschner Torsten
Published: January 2012

One of the most enduring stereotypes concerning the history of Central and Eastern Europe is the notion of a German Drang nach Osten. While the German impact on the region is beyond doubt, its alleged motivation in terms of a ‘drive to the East’ has been dismissed almost universally by historians (especially in Germany and Poland) as a ‘myth’ that obscures the complexities of history more than it illuminates them. Starting from this observation, the present article approaches the phrase Drang nach Osten from a linguistic point of view for the first time. The historical content and background of Drang nach Osten are surveyed first, including its origin in the crisis of German‐Polish relations during the 1848 revolution. Three linguistic approaches to stereotyping are then presented with regard to their application to Drang nach Osten. Starting from general cognitive‐discursive strategies of stereotyping, Drang nach Osten is defined linguistically as a ‘Nominationsstereotyp’; its characteristic syntactic and semantic stabilisation is explicated in frame‐semantic terms, and its use as a German phrase in non‐German discourse is analysed from a semiotic point of view. The paper closes with thoughts concerning the interdisciplinary nature of ‘Stereotypenforschung’.

Ein besonders hartnäckiges Stereotyp in Ost‐ und Ostmitteleuropa ist die Vorstellung, die Geschichte dieser Region sei in hohem Maße von einem deutschen Drang nach Osten geformt worden. Nachdem der Begriff Drang nach Osten als motivationale Kategorie von Historikern nahezu einhellig ins Reich der Mythen verwiesen worden ist, die die unzweifelhafte Komplexität und Ambivalenz der historischen Wirklichkeit eher verdunkeln als erhellen, versucht der vorliegende Beitrag, sich dem Ausdruck Drang nach Osten erstmals aus linguistischer Sicht zu nähern. Zuerst wird kurz der historische Gehalt und Hintergrund des Ausdrucks Drang nach Osten dargestellt, ausgehend von der Krise der deutsch‐polnischen Beziehungen in der Revolution von 1848. Danach werden drei verschiedene linguistische Annäherungen an sprachliche Stereotypisierung im Hinblick auf Drang nach Osten diskutiert. Ausgehend von allgemeinen kognitiv‐diskursiven Stereotypisierungsstrategien wird Drang nach Osten als Nominationsstereotyp definiert, dessen semantische und syntaktische Stabilisierung in frame‐semantischen Kategorien beschreibbar ist; zusätzlich wird die Verwendung des deutschen Ausdrucks Drang nach Osten in nicht‐deutschsprachigen Diskursen aus semiotischer Sicht interpretiert. Überlegungen zu den interdisziplinären Aspekten einer historisch‐linguistischen Stereotypenforschung runden den Beitrag ab.
Hans Christoph Buch's Sansibar Blues and the Fascination of Cross‐Cultural Experience in Contemporary German Historical Novels about Colonialism
Authors: Göttsche Dirk
Published: January 2012

This article maps four different types of cross‐cultural experience in contemporary historical novels about colonial Africa (colonialist, exoticist, intercultural, and transcultural) before focusing on H. C. Buch's Sansibar Blues (2008) as a case study in German postcolonial memory and the literary use of transcultural voices. Together with Ilija Trojanow's Der Weltensammler (2006), Sansibar Blues marks a new departure in the history of writing cross‐cultural experience and representing the ‘Other’, but, unlike Trojanow, Buch uses partially authentic non‐European voices that draw on the autobiographies of two prominent nineteenth‐century figures in the linked histories of Zanzibar and Germany: Emily Ruete alias Princess Sayyida Salme of Oman and Zanzibar, and the ivory dealer Tippu Tip alias Hamed bin Mohammed. The article includes a detailed analysis of Buch's adaptation of these sources.

Dieser Aufsatz arbeitet in den neuen historischen Afrika‐Romanen zur Kolonialzeit vier unterschiedliche Modi der Darstellung interkultureller Erfahrung heraus (kolonial, exotistisch, interkulturell im programmatischen Sinne und transkulturell), um sich dann in der Form einer Fallstudie zu H. C. Buchs Sansibar Blues (2008) der Frage postkolonialer Gedächtnisarbeit und der Verwendung transkultureller Stimmen zuzuwenden. Gemeinsam mit Ilija Trojanows Bestseller Der Weltensammler (2006) markiert Sansibar Blues durch die neuartige Berücksichtigung der ‘anderen’, afrikanischen bzw. arabischen Perspektiven einen Neuansatz in der Gestaltung von kolonialer Interkulturalität. Anders als Trojanow verwendet Buch teilweise authentische nicht‐europäische Stimmen auf der Grundlage der Autobiographien zweier prominenter Gestalten in der Beziehung zwischen Sansibar und Deutschland im 19. Jahrhundert: Emily Ruete alias Prinzessin Sayyida Salme von Oman und Sansibar, und den Elfenbeinhändler Tippu Tip alias Hamed bin Mohammed. Die Studie enthält u.a. eine kritische Analyse von Buchs literarischer Adaptierung dieser Quellen.
Childhood presentation of COL4A1 mutations
Authors: SHAH SIDDHARTH , ELLARD SIAN , KNEEN RACHEL , LIM MING , OSBORNE NIGEL , RANKIN JULIA , STOODLEY NEIL , VAN DER KNAAP MARJO , WHITNEY ANDREA , JARDINE PHILIP
Published: January 2012

Aim  To describe the clinical and radiological features of four new families with a childhood presentation of COL4A1 mutation.

Method  We retrospectively reviewed the clinical presentation. Investigations included radiological findings and COL4A1 mutation analysis of the four cases. Affected family members were identified. COL4A1 mutation analysis was performed in all index cases and, where possible, in affected family members.

Results  The three male and one female index cases presented with recurrent childhood‐onset stroke, infantile hemiplegia/spastic quadriplegia, and infantile spasms. Additional features such as congenital cataracts and anterior segment dysgenesis were present. Microcephaly and developmental delay/learning difficulties were present in three cases. Three cases had one or more family member affected in multiple generations, with a total of 11 such individuals identified. The clinical features showed a wide intrafamilial variation. Magnetic resonance imaging (MRI) showed bilateral white matter change in all cases, except in one mutation‐positive family member. Unilateral or bilateral porencephaly was present in cases with infantile hemiplegia, and a diagnosis of clinical stroke was supported by the presence of intracerebral haemorrhage. The age at diagnosis was between 1 year and 6 years for the children with presentation in infancy and 12 months after stroke in a 14‐year‐old male. Three new pathogenic mutations were identified in the COL4A1 gene.

Interpretation  COL4A1 mutations can present in children with infantile hemiplegia/quadriplegia, stroke or epilepsy, and a motor disorder. The presence of eye features and white matter change on MRI in childhood can help point towards the diagnosis. Once the diagnosis is made, a careful search can identify affected family members.
Beneficial Impact of Prolonged Dual Antiplatelet Therapy after Drug‐Eluting Stent Implantation
Authors: SARDELLA GENNARO , MANCONE MASSIMO , BIONDI‐ZOCCAI GIUSEPPE , CONTI GIULIA , CANALI EMANUELE , STIO ROCCO , LUCISANO LUIGI , CALCAGNO SIMONE , DE CARLO CARLOTTA , FEDELE FRANCESCO
Published: January 2012

Background:
 Twelve‐month dual antiplatelet therapy (DAT) with aspirin and clopidogrel after drug‐eluting stent (DES) implantation is routinely recommended. It is unclear if prolonged (>12‐month) DAT is also favorable. We compared the outcome of patients discontinuing DAT 12 months after off‐label DES implantation versus those with DAT for >12 months.

Methods:
 Baseline, treatment, and outcome data of patients undergoing off‐label DES implantation and free from events 11.5 months after index procedure were retrospectively retrieved. Those discontinuing DAT between 11.5 and 12.5 months (12‐month DAT group) were compared to those discontinuing DAT after 12.5 months (>12‐month DAT group). The primary end‐point was the long‐term (>24‐month) rate of major adverse cerebro‐cardiovascular events (MACCE).

Results:
 Two hundred seventy‐two patients met study inclusion criteria: 133 (48.9%) in the 12‐month DAT group and 139 (51.1%) in the >12‐month DAT group (who were on DAT for an average of 24 months). After an average of 36 months after DES implantation, 14 patients (5.1%) developed MACCE, with 6 (3.5%) cardiac deaths, 7 (2.2%) myocardial infarctions, no stroke, and 5 (1.8%) repeat revascularizations. The >12‐month DAT group had a significantly lower risk of MACCE (1 [0.7%] vs. 13 [9.8%] in the 12‐month DAT group, P < 0.001) and myocardial infarction (0 vs. 7 [5.3%], P = 0.006), with such differences confirmed at multivariable propensity‐adjusted analyses. No significant differences in terms of minor or major bleedings occurred.

Conclusions:
 In this retrospective registry, patients with off‐label DES implantation receiving prolonged (>12 months) DAT presented with lower rates of MACCE and myocardial infarction. (J Interven Cardiol 2012;25:596–603)
Placental Villous Expression of TNFα and IL‐10 and Effect of Oxygen Tension in Euploid Early Pregnancy Failure
Authors: Calleja‐Agius Jean , Jauniaux Eric , Muttukrishna Shanthi
Published: January 2012

Problem

The objective was to investigate placental inflammation in chromosomally normal miscarriages in vivo and in vitro.

Method of study

Chorionic villous tissue was collected from missed miscarriages and normal gestation‐matched controls and cultured at 6 and 20% O2 concentrations. Tissue was karyotyped. Flowcytometric bead arrays and real‐time PCR were carried out for protein and gene expression studies.

Results

The levels of TNFα and IL‐10 were significantly (P < 0.005 and P < 0.05) higher, and the levels of TNF‐R1 and TNF‐R2 were significantly (P < 0.01 and P < 0.05) lower in culture conditioned medium of villous explants of miscarriages compared to control group. Villous tissue homogenates from miscarriages contained significantly (P < 0.005) lower levels of TNF‐R1. There was a significant O2‐dependent increase in the secretion of IL‐10 (P < 0.01) and decrease in TNFα/IL‐10 ratio (P < 0.005) in the culture medium in both groups.

Conclusion

Increased levels of TNFα and decreased levels of receptors in miscarriage villous tissue confirm an excessive placental inflammation in miscarriage patients.
Marathon of eponyms: 23 Wegener granulomatosis
Authors: Scully C , Langdon J , Evans J
Published: January 2012

Oral Diseases (2012) 18, 214–216

The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology and oral, oral and maxillofacial radiology and maxillofacial surgery) and particularly by hospital‐centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarizes data about Wegener granulomatosis.
A first formal classification of the Hardeveld vegetation in Namaqualand, South Africa
Authors: Luther‐Mosebach Jona , Dengler Jürgen , Schmiedel Ute , Röwer Inga Ute , Labitzky Timo , Gröngröft Alexander
Published: January 2012

Questions

The Succulent Karoo is a winter‐rainfall desert in southern Africa with a highly diverse flora. Which environmental factors differentiate vegetation composition at the plot level: How can compositional pattern be best represented by a formal phytosociological classification.

Location

Soebatsfontein communal area and surroundings in the Namaqualand Hardeveld Bioregion of the Succulent Karoo Biome, Northern Cape Province, South Africa.

Methods

We recorded vascular plant species composition, together with a range of structural and soil parameters as well as grazing intensity, in 355 plots of 100 m² size. This sample covered all vegetation types of the study area except those of river beds and anthropogenic sites. Vegetation classification was carried out using modified TWINSPAN followed by manual re‐arrangement of a subset of plots with the aim of increasing floristic distinctiveness of the vegetation units. For the final vegetation units, we determined diagnostic species and environmental parameters, according to phi‐values and ANOVA, respectively, and translated these into a phytosociological classification.

Results

The major factor influencing species composition and richness was soil salinity. At a broad scale, the less saline sites could be differentiated into sandy plains and rocky hills, and the saline sites into quartz fields, the centres of heuweltjies (termitaria) and the matrix between. We translated these patterns into two phytosociological classes with four orders, six alliances and 16 associations. Most of the syntaxa are very well defined in floristic terms, and all except the Othonnion cylindricae are new to science. The Hermannio trifurcae‐Zygophylletea morgsanae represents the zonal vegetation of marginally saline soils, the Didelto carnosae‐Cephalophylletea inaequalis the vegetation of saline soils. The vegetation of the extremely saline quartz patches probably belongs to a third class not described here due to the scarcity of representative plots.

Conclusions

Our phytosociological approach allowed the various degrees of ecological and floristic similarity to be represented by syntaxa of different ranks. A comparison with previous classifications from the Succulent Karoo revealed a high spatial turnover, with only two of our alliances and none of our associations coinciding with those found in previously studied areas of the Succulent Karoo. Our formal classification has the potential to be a powerful tool for local land use, ecological comparison and conservation, and to contribute to a future national phytosociological classification of South Africa.
The fencing paradigm in woodland conservation: consequences for recruitment of a semi‐arid tree
Authors: Aschero Valeria , García Daniel
Published: January 2012

Question

How does long‐term fencing against large domestic herbivores affect regeneration of the dominant tree,Prosopis flexuosa, and hence the structure of semi‐arid woodlands?

Location

Woodlands in theCentralMonteDesert biome ofArgentina,ÑacuñánMan and theBiosphereReserve area (34° 20′ S, 67° 58′ W) and surrounding cattle‐grazed ranches.

Methods

We compared seedling emergence and survival, the spatial distribution of seedlings and saplings, and the population stage‐based structure ofP. flexuosabetween paired sites inside and outside theReserve ofÑacuñán (Argentina), which has been fenced to exclude domestic cattle for ca. 40 yr.

Results

Reserve sites had lower tree recruitment and seedling emergence, in spite of having greater seed production and seedling survival. Outside the reserve, survival was higher for seedlings in high‐density clumps than for isolated seedlings. Seedling clumps occurred mostly near adult individuals, where cattle dung was abundant, suggesting an effect of cattle on seed dispersal. The balance between the effects of cattle exclusion on seedling emergence and on seedling survival was reflected in the stage structure ofP. flexuosawoodlands, as populations at fenced sites were dominated by adult individuals, whereas those at cattle‐grazed areas presented greater proportions of seedlings and saplings.

Conclusion

Fencing is a common practice used worldwide to exclude conservation areas from human disturbance. For example, it is assumed that disturbed woodlands may recover after fencing, thanks to increased tree recruitment after the exclusion of large herbivores. However, the actual effectiveness of fencing as a tool for forest conservation in overgrazed environments could be controversial because sequential effects of herbivores during the tree regeneration cycle may hamper predictions of the overall balance of the recruitment process. Our results suggest that dispersal by cattle influences the regeneration ofP. flexuosawoodlands, and that the positive effects of cattle on seedling emergence compensate for the negative effects on seed production and seedling and sapling survival. Future management ofP. flexuosawoodlands in theCentralMonteDesert should consider that tree recruitment is closely related to land use, and that cattle exclusion does not necessarily guarantee woodland recovery in the long term.
EVALUATION OF THE NUTRITIONAL QUALITY OF NONTOXIC KERNEL FLOUR FROM JATROPHA CURCAS L. IN RATS
Authors: MARTINEZ HERRERA JORGE , JIMENEZ MARTINEZ CRISTIAN , MARTINEZ AYALA ALMA , GARDUÑO SICILIANO LETICIA , MORA ESCOBEDO ROSALVA , DAVILA ORTIZ GLORIA , CHAMORRO CEVALLOS GERMAN , MAKKAR HARINDER , FRANCIS GEORGE , BECKER KLAUS
Published: January 2012

The origin of Jatropha curcas L. is in Central America, probably Mexico, although it is also distributed in South America, Africa and Asia. In Mexico, it grows as nontoxic and toxic J. curcas genotypes. In this work, the protein quality including protein efficiency ratio (PER), net protein ratio (NPR) and true digestibility (TD) of nontoxic genotype defatted flour was assessed using Wistar rats. The probed diets contained flour (3), flour‐lysine, 1% (4), flour‐phytase, 500 FTU (5) and two control diets: nitrogen‐free (1) and casein (2). The rats were fed for 28 days. The PER (1.37, 1.77 and 1.61) and NPR (1.80, 2.29 and 2.12) obtained values for diets (3.4 and 5) were lower than those obtained for casein (2.07 and 2.46), respectively. No statistical differences were found in TD.

PRACTICAL APPLICATIONS

Jatropha curcas defatted flour may be used in the food industry for the development of diets for human and animal consumption. Besides achieving fortification of foods that are made from wheat, which has a low protein content, with the addition of Jatropha meal, these foods will improve the protein quality of many food products.
Perceived weight gain, risk, and nutrition in pregnancy in five racial groups
Authors: Brooten Dorothy , Youngblut JoAnne M. , Golembeski Susan , Magnus Marcia H. , Hannan Jean
Published: January 2012

Objective: Examine perceived pregnancy weight gain needed, perceived risks to mother, and infant of excessive weight and underweight, perceptions of actual, ideal, realistic body size, nutritional intake in five racial/ethnic groups.

Design: Cross‐sectional

Setting: Physicians’ offices

Participants: A total of 54 women <20 weeks gestation

Methods: Questionnaires‐perceived weight gain needed, risks of weight gain for mother, infant, perceptions of body size, food frequency.

Results: A total of 39% of women are overweight or obese (57% Caribbean Black, 50% African American). Perceived pregnancy weight gain needed highest in Central American Hispanic women, lowest Caribbean Black women. African‐American women had low perceived risk for mother and infant of gaining too much pregnancy weight, highest perceived risk for both of gaining too little. Caribbean Black women perceived highest risk to mother of gaining too much pregnancy weight, highest risk to infant of gaining too little. White Non‐Hispanic women reported smaller prepregnant, ideal, realistic body sizes than other four groups. Daily caloric intake ranged from 599 to 5856 calories. African‐American women had significantly more calories; protein, total fats, monounsaturated, polyunsaturated, and saturated fats; carbohydrates, sugar; and iron than White Non‐Hispanic women. Women in each racial/ethnic group had less than recommended intake of protein, carbohydrates, calcium, iron, folate, and fiber.

Conclusions: Education is needed to raise awareness of risks of prepregnancy weight and excessive weight gain for mother and infant. The need for prenatal nutritional counseling to reduce the intake of calories, fats, sweets, and snacks; increase intake of vegetables, fruits, foods with iron, folate, and fiber.
Prehypertension: A literature‐documented public health concern
Authors: Hernandez Johnanna , Anderson Stoerm
Published: January 2012

Purpose: To provide nurse practitioners (NPs) with an overview of prehypertension identification and management. Additionally, the article serves to highlight the prevalence and impact of prehypertension in the United States.

Data sources: A comprehensive review of the literature was conducted using multiple databases, including PubMed, Medline, CINAHL, and SAGE Health Sciences databases. The review was not limited by discipline, year of publication, or type of research. Key words used to obtain relevant articles included prehypertension, nurse practitioner, health promotion, disease prevention, hypertension, and chronic disease.

Conclusions: Approximately 70 million individuals have been recognized as prehypertensive in the United States, placing them at increased risk for hypertension and cardiovascular disease. Identifying and managing prehypertension has been recognized in national health policy as a priority to improve public health. Prehypertension is managed primarily by eliminating risk factors and implementing lifestyle modification.

Implications for practice: Health promotion and disease prevention form the cornerstone of the NP role. The designation of prehypertension serves as an opportunity for NPs to assist in decreasing the burden on the health system from chronic disease and improve patient quality of life.
Exercise‐induced bronchospasm: A case study in a nonasthmatic patient
Authors: Hayden Mary Lou , Stoloff Stuart W. , Colice Gene L. , Ostrom Nancy K. , Eid Nemr S. , Parsons Jonathan P.
Published: January 2012

Purpose: To provide an overview of the clinical presentation, diagnosis, and management of exercise‐induced bronchospasm (EIB) without underlying asthma.

Data sources: Case presentation and review of the EIB Landmark Survey.

Conclusions: EIB is a common and well‐described occurrence in patients with asthma, as well as in patients with no overt respiratory condition. Treatment with a short‐acting beta‐agonist before starting exercise is effective, yet this treatment approach is underutilized in the majority of patients with asthma.

Implications for practice: This case highlights the implications of undermanaged EIB and the disconnect between healthcare provider recommendations and the beliefs and behaviors in patients with EIB. Inhaled short‐acting beta‐agonists can attenuate EIB in 80%–95% of patients and are effective during 2–3 h of exercise. Patients with a compromised level of physical activity because of EIB who do not respond to conventional treatment strategies should be referred to a respiratory specialist for diagnostic evaluation and confirmation of underlying asthma. Nurse practitioners should remain vigilant to identify untreated EIB and ensure that affected patients understand the condition and appropriate treatment options.
Trust and Treason: Social Network Structure as a Source of Flexibility in Peace Negotiations
Authors: Lilja Jannie
Published: January 2012

To reach a negotiated peace settlement, the parties to the conflict have to show flexibility in their negotiation positions. This article examines why some rebel groups are flexible on the main issue of contention, whereas others are not. The study explores rebels’ social network structure as a source of negotiation flexibility. The proposition that a rebel group structured as a “trust network” can manage the risks of peace making through a “trust mechanism” of information sharing, verification, and mutual influence between rebel negotiators and non‐negotiating rebel leaders, is consistent with a procedural justice logic. The proposition is analyzed for negotiations between LTTE and the Sri Lankan government, and Gerakan Aceh Merdeka (GAM) and the Indonesian government. The findings support the proposition, and highlight the potential of social network analysis to further the understanding of conflict resolution. Policy wise, the evolution of network structure implies that the likelihood of negotiation success varies over time.
Effects of Substituents on Synthetic Analogs of Chlorophylls. Part 3: The Distinctive Impact of Auxochromes at the 7‐ versus 3‐Positions
Authors: Springer Joseph W. , Faries Kaitlyn M. , Diers James R. , Muthiah Chinnasamy , Mass Olga , Kee Hooi Ling , Kirmaier Christine , Lindsey Jonathan S. , Bocian David F. , Holten Dewey
Published: January 2012

Assessing the effects of substituents on the spectra of chlorophylls is essential for gaining a deep understanding of photosynthetic processes. Chlorophyll a and b differ solely in the nature of the 7‐substituent (methyl versus formyl), whereas chlorophyll a and d differ solely in the 3‐substituent (vinyl versus formyl), yet have distinct long‐wavelength absorption maxima: 665 (a) 646 (b) and 692 nm (d). Herein, the spectra, singlet excited‐state decay characteristics, and results from DFT calculations are examined for synthetic chlorins and 131‐oxophorbines that contain ethynyl, acetyl, formyl and other groups at the 3‐, 7‐ and/or 13‐positions. Substituent effects on the absorption spectra are well accounted for using Gouterman’s four‐orbital model. Key findings are that (1) the dramatic difference in auxochromic effects of a given substituent at the 7‐ versus3‐ or 13‐positions primarily derives from relative effects on the LUMO+1 and LUMO; (2) formyl at the 7‐ or 8‐position effectively “porphyrinizes” the chlorin and (3) the substituent effect increases in the order of vinyl < ethynyl < acetyl < formyl. Thus, the spectral properties are governed by an intricate interplay of electronic effects of substituents at particular sites on the four frontier MOs of the chlorin macrocycle.