bluuebunny/crossref_metadata_2025 huggingface dataset:
The Civic World of International Communism: Taiwanese communists and the Comintern (1921–1931)
Authors: BELOGUROVA ANNA
Published: August 2012

The short history of the Taiwanese Communist Party (Taiwan gongchandang台 灣 共 產 黨) (1928–1931) offers a window into the negotiative polity of international communism during the Third Period (1928–1934). The Party was established during the time when the Comintern intensified its operations in colonies and promoted the organization of communist parties there. Its demise was the result of government suppression that occurred as a reaction to their increased public activity in 1931, allegedly at the direction of the Comintern. This paper examines the Comintern's role in the Taiwanese communist movement and shows that the Taiwanese communists were active agents (rather than passive tools) in their relationship with the Comintern.
Similarities among ectoparasite fauna of sigmodontine rodents: phylogenetic and geographical influences
Authors: CRUZ LEONARDO DOMINICI , FERNANDES FERNANDA RODRIGUES , LINHARES ARÍCIO XAVIER
Published: August 2012

Phylogenetic and geographical overlaps in host distributions influence the compositional similarity of ectoparasite fauna in a host–parasite system. In these systems, hosts that are more closely related (phylogenetically) are expected to share more parasitic species than more distantly related hosts. Similarly, hosts sharing a larger geographical distribution overlap are expected to have similar ectoparasites. This study investigated the influence of phylogeny (divergence time) and geographical overlap of some neotropical sigmodontine rodent species on the similarities among their ectoparasite fauna (Mesostigmata and Siphonaptera), using a partial Mantel test. Divergence time was the only significant factor that influenced the similarity among the ectoparasites, when mites and fleas were analysed together. Host species that had diverged more recently displayed ectoparasite fauna that were similar. The similarities of the flea species showed similar results in both separate and joint analyses, but neither phylogenetic nor geographical overlap influenced the similarity in mite species. Fleas were shown to be more host-specific than were mesostigmate mites, probably because of the increased influence of host phylogeny.
Vulnerability to psychotogenic effects of ketamine is associated with elevated D2/3-receptor availability
Authors: Vernaleken Ingo , Klomp Majken , Moeller Olaf , Raptis Mardjan , Nagels Arne , Rösch Frank , Schaefer Wolfgang M. , Cumming Paul , Gründer Gerhard
Published: August 2012

Previous positron emission tomography (PET) studies employing competition paradigms have shown either no change or substantial declines in striatal [11C]-raclopride binding after challenge with psychotogenic doses of the N-methyl-d-aspartate antagonist ketamine. We sought to probe the relationship between the severity of ketamine-induced psychotic symptoms and altered dopamine D2/3 receptor availability throughout brain using the high affinity ligand [18F]-fallypride (FP). PET recordings were obtained in a group of 10 healthy, young male volunteers, in a placebo condition, and in the course of an infusion with ketamine at a psychotomimetic dose. Administration of the Positive and Negative Syndrome Scale and the Thought and Language Index in both conditions revealed a substantial emergence of mainly negative symptoms of schizophrenia, persisting until the end of the 3 h PET recordings. The baseline FP binding in cortex, caudate nucleus and other brain regions was highly predictive of the individual severity of psychotic symptoms in the ketamine condition. However, there was no evidence of ketamine-evoked reductions in FP binding. In the context of earlier findings, we speculate that high baseline D2/3-receptor availability may impart benefits with regard to cognitive flexibility, but increases the risk of maladaptive information processing in the face of environmental stresses and challenges.
Laser induced avalanche ionization in gases or gas mixtures with resonantly enhanced multiphoton ionization or femtosecond laser pulse pre-ionization
Authors: Shneider Mikhail N. , Miles Richard B.
Published: August 2012

The paper discusses the requirements for avalanche ionization in gas or gas mixtures initiated by REMPI or femtosecond-laser pre-ionization. Numerical examples of dependencies on partial composition for Ar:Xe gas mixture with REMPI of argon and subsequent classic avalanche ionization of Xe are presented.
The impact of visa status and Medicare eligibility on people diagnosed with HIV in Western Australia: a qualitative report
Authors: Herrmann Susan , Wardrop Joan , John Mina , Gaudieri Silvana , Lucas Michaela , Mallal Simon , Nolan David
Published: August 2012

Background: In Australia, temporary visa holders are ineligible for Medicare and subsidised antiretroviral drugs. Additionally, HIV testing is not mandatory for visas unless applicants seek work in the health sector. We sought to understand the impact of HIV and issues of access and adherence to antiretroviral therapy (ART) in people holding temporary visas and permanent residents. Methods: Data were gathered from interviews with 22 participants. Information concerning medication adherence, side effects, CD4 T-cell count, viral load and rate of response to generic drugs were collected. Results: The mean age was 33.4 years (±s.d. = 6.0), 21 out of 22 were from HIV-prevalent areas in East Africa and Asia, 14 out of 22 were on temporary visas, 12 were ineligible for Medicare, 14 out of 22 were diagnosed during health screening, 19 out of 22 risk exposures were in country of origin, 8 out of 17 were taking generic ART at an average cost of $180 per month, adherence was excellent and self-reported side-effects were relatively infrequent. Participants applying for visa continuations and permanent residency were fearful, believing their HIV serostatus would prejudice their applications. Patients cited belief in ART efficacy, were motivated to maintain therapy and were anxious about lack of access to treatment in their countries of origin. Conclusion: Adherence to antiretroviral drugs in Medicare-ineligible HIV-infected individuals is excellent despite limited access to treatment. The threat of visa non-renewal and the likely failure of applications for permanent residency result in considerable anxiety and confidentiality concerns.
Preverbal no-negation in Gullah
Authors: Troike Rudolph C.
Published: August 2012

Modern Sea Island Gullah is unusual among Atlantic English-based creoles in reportedly not having no as a preverbal negator, ẽ or ɛ̃ ‘ain’t’ being used instead, and doubts have been expressed about any earlier extensive use of no. However, important authentic evidence of its earlier use is provided by the 1838–39 journal of Fanny Kemble (1863) and by letters written during Northern occupation in the Civil War. Among literary writers, Simms (1839/1845) used no 22% of the time vs. 8% for ain’t, while no is near-categorical in Harris (1881), though rare in Jones (1888), and absent in Christensen (1892) and Gonzales (1922). Turner (1949) recorded preverbal no co-occurring with another signature creole marker, Subject me, suggesting code-switching to a basilectal grammar. Hancock (1987) also found no in Gullah. The dominant use of preverbal no in Texas Afro-Seminole (Hancock 2006) could reflect its earlier greater prevalence in the Sea Islands. The evidence raises the possibility that Gullah speakers’ practice of avoiding basilectal use with outside interlocutors (the ‘observer’s paradox’) may have obscured recognition of its modern survival.
The role of power and magnetic connection to the active antenna in the suppression of intermittent structures by ion cyclotron resonance heating
Authors: Antar G.Y. , Goniche M. , Ekedahl A. , Colas L.
Published: August 2012

The effect of the ion cyclotron resonance heating (ICRH) on the scrape-off layer (SOL) is still an open issue, where, lately it was shown on the ASDEX-Upgrade tokamak that turbulence large-scale structures, known as blobs or avaloids, are suppressed by ICRH (Antar et al 2010 Phys. Rev. Lett.
105 165001). Furthermore, it was shown that the edge localized mode-induced turbulent transport is also reduced significantly. However, the reasons behind this interaction remain unknown. On the Tore Supra tokamak, we confirm that the ICRH suppresses large-scale structures while small-scale structures are enhanced; overall, the turbulence level of fluctuations is reported to drop from about 40% to 25%. This confirms that the effects on turbulence are independent of the type of plasma confinement, L-mode on Tore Supra versus H-mode on ASDEX-Upgrade. The dependence on the ICRH power showed that if a threshold existed it would be below 500 kW and that above this power, no additional effects on the SOL turbulence are reported. The other study reported in this paper deals with the importance of the magnetic field line connections or, in other words, whether the interaction between ICRH and turbulence is global, affecting the whole plasma, or local, affecting regions that are magnetically connected to the active antenna. We found that the toroidal connection to the active antenna is not critical in the sense that turbulence in regions close to the antenna but not necessarily connected are affected. For regions that are not connected and far from the active antenna, turbulence does not change much when applying ICRH.
Outer divertor of ASDEX Upgrade in low-density L-mode discharges in forward and reversed magnetic field: II. Analysis of local impurity migration
Authors: Aho-Mantila L. , Wischmeier M. , Krieger K. , Rohde V. , Hakola A. , Potzel S. , Kirschner A. , Borodin D.
Published: August 2012

Part I (Aho-Mantila L. et al 2012 Nucl. Fusion

52 103006) presented a detailed analysis of outer divertor plasma conditions in low-density L-mode discharges in ASDEX Upgrade. In this paper, we analyse the local migration of carbon that originates from 13CH4 injected into these plasmas from the vertical outer target. Notable changes are observed in the local carbon deposition patterns when reversing the magnetic field in the experiments. Kinetic impurity-following simulations are performed using the 3D ERO code package with 2D background plasma solutions calculated with the SOLPS5.0 code package. The modelling shows that the measured changes are due to the changes in plasma collisionality, dissociation and ionization rates, and
E
 × 
B
drift of the impurities. These conditions affect the direction and rate of impurity migration inside and out of the divertor, having wider consequences on the global migration of impurities in a divertor tokamak. It is further shown that the migration pathways are largely determined by carbon ions and, hence, relevant for impurities in general. Neutral carbon and hydrocarbons are deposited only in the near vicinity of the injection, where they affect the local re-deposition efficiency. In this limited region, a perturbation of the local plasma conditions by the methane puff appears likely, yielding a significant uncertainty for interpreting the deposition efficiencies. The local deposition is largely influenced by the magnetic presheath electric field, the structure of which is the main uncertainty in the SOLPS5.0-ERO simulations.
Emergence of a classical Universe from quantum gravity and cosmology
Authors: Kiefer Claus
Published: August 2012

I describe how we can understand the classical appearance of our world from a universal quantum theory. The essential ingredient is the process of decoherence. I start with a general discussion in ordinary quantum theory and then turn to quantum gravity and quantum cosmology. There is a whole hierarchy of classicality from the global gravitational field to the fluctuations in the cosmic microwave background, which serve as the seeds for the structure in the Universe.
Urinary incontinence and diarrhoea associated with the switch from oral to injectable risperidone
Authors: Rosa Enrica Di , Caldirola Daniela , Motta Achille , Perna Giampaolo
Published: August 2012

Objective

Urgency, urinary incontinence and bowel disturbances are distressing side effects that have been observed during treatment with risperidone and other antipsychotics probably due to the receptor affinity profile. This occurrence can lead to poor compliance and therefore impair clinical outcome.

Method

We report the case of a 50 year‐old lady, who experienced urinary incontinence and diarrhoea, when switching from oral to injectable risperidone, which ceased when discontinuing the drug.

Results and conclusions

It should be taken into account that some side effects can be revealed when switching from oral to depot formulations due to non‐compliance to orals; nevertheless dose‐dependent mechanisms and individual metabolic variability must be considered when observing idiosyncratic reactions to drugs.
Clinical and sociodemographic comparison of people at high‐risk for psychosis and with first‐episode psychosis
Authors: Zimbrón J. , Ruiz de Azúa S. , Khandaker G. M. , Gandamaneni P. K. , Crane C. M. , González‐Pinto A. , Stochl J. , Jones P. B. , Pérez J.
Published: August 2012

Zimbrón J, Ruiz de Azúa S, Khandaker GM, Gandamaneni PK, Crane CM, González‐Pinto A, Stochl J, Jones PB, Pérez J. Clinical and sociodemographic comparison of people at high‐risk for psychosis and with first‐episode psychosis.

Objective:  To compare clinical and sociodemographic characteristics previously associated with psychosis, between individuals at high‐risk for psychosis (HR) and patients experiencing a first episode psychosis (FEP), to achieve a better understanding of factors associated with psychosis.

Method:  Cross‐sectional comparison of 30 individuals at HR with 30 age‐gender matched FEP, presenting to an early intervention service for psychosis. Participants were followed‐up for 2 years to establish the proportion of HR who made the transition into FEP.

Results:  Both groups showed similar socio‐clinical characteristics, including immigration status, employment history, marital status, family history of psychotic illness, self‐harm and alcohol and drug use. The HR group had a lower level of education, higher burden of trauma, earlier onset of psychiatric symptoms and a longer delay in accessing specialised services. A younger onset of symptoms was associated with a longer delay in accessing services in both groups. After a 2 year follow‐up, only three (10%) of the HR group made a transition into FEP.

Conclusion:  The similarities observed between individuals at HR and those with FEP suggest that known variables associated with psychosis may be equally prevalent in people at HR who do not develop a psychotic disorder.
Phylogenetic placement of pelican spiders (Archaeidae, Araneae), with insight into evolution of the “neck” and predatory behaviours of the superfamily Palpimanoidea
Authors: Wood Hannah Marie , Griswold Charles E. , Gillespie Rosemary G.
Published: August 2012

Phylogenetic relationships among archaeid spider lineages, as well as the placement of archaeids within the Araneomorphae, present a problem in the systematics of spiders. We investigate these relationships by broadly sampling taxa from the Araneomorphae and superfamily Palpimanoidea, as well as from extant and fossil archaeid lineages. Using parsimony and Bayesian methods we perform a total‐evidence analysis that includes 126 morphological characters and over 4000 bases from one mitochondrial and three nuclear molecular markers. Phylogenetic analysis results in a delimitation of the superfamily Palpimanoidea to contain five families: Archaeidae, Mecysmaucheniidae, Stenochilidae, Palpimanidae and Huttoniidae. We also find the extant archaeids, which are restricted to the southern hemisphere, to be monophyletic, with the fossil archaeids paraphyletic. This phylogenetic framework is then used to interpret a novel morphological character, the highly modified and elevated cephalic area and elongated chelicerae (jaws), coupled with prey choice observations in the field and observations of chelicerae movements during predatory attacks. We conclude that the evolution of the elevated cephalic area, which reoriented the chelicerae muscles, led to highly manoeuvrable chelicerae and associated novel prey capture strategies. All members of Palpimanoidea appear to have modifications to the cephalic area, such as a diastema or sclerotization around the chelicerae bases, and furthermore, members appear to have evolved prey specialization.
Impact of eastern dwarf mistletoe (Arceuthobium pusillum) on host white spruce (Picea glauca) development, growth and performance across multiple scales
Authors: Logan Barry A. , Reblin Jaret S. , Zonana David M. , Dunlavey Ryan F. , Hricko Carolyn R. , Hall Adam W. , Schmiege Stephanie C. , Butschek Ross A. , Duran Kristy L. , Emery R. J. Neil , Kurepin Leonid V. , Lewis James D. , Pharis Richard P. , Phillips Nathan G. , Tissue David T.
Published: August 2012

Infection by eastern dwarf mistletoe (Arceuthobium pusillum) modifies needle and branch morphology and hastens white spruce (Picea glauca) mortality. We examined potential causal mechanisms and assessed the impacts of infection‐induced alterations to host development and performance across scales ranging from needle hormone contents to bole expansion. Needles on infected branches (IBs) possessed higher total cytokinin (CK) and lower abscisic acid contents than needles on uninfected branches (UBs). IBs exhibited greater xylem growth than same‐aged UBs, which is consistent with the promotive effect of CKs on vascular differentiation and organ sink strength. Elevated CK content may also explain the dense secondary and tertiary branching observed at the site of infection, i.e. the formation of ‘witches’ brooms' with significantly lower light capture efficiencies. Observed hormone perturbations were consistent with higher rates of transpiration, lower water use efficiencies (WUEs) and more negative needle carbon isotope ratios observed for IBs. Observed reductions in needle size allowed IBs to compensate for reduced hydraulic conductivity. Severe infections resulted in dramatically decreased diameter growth of the bole. It seems likely that the modifications to host hormone contents by eastern dwarf mistletoe infection led white spruce trees to dedicate a disproportionate fraction of their photoassimilate and other resources to self‐shaded branches with low WUE. This would have decreased the potential for fixed carbon accumulation, generating a decline in the whole‐tree resource pool. As mistletoe infections grew in size and the number of IBs increased, this burden was manifested as increasingly greater reductions in bole growth.
The disparity of priapulid, archaeopriapulid and palaeoscolecid worms in the light of new data
Authors: Wills M. A. , Gerber S. , Ruta M. , Hughes M.
Published: August 2012

Priapulids and their extinct relatives, the archaeopriapulids and palaeoscolecids, are vermiform, carnivorous ecdysozoans with an armoured, extensible proboscis. These worms were an important component of marine communities during thePalaeozoic, but were especially abundant and diverse in theCambrian. Today, they comprise just seven genera in four families. Priapulids were among the first groups used to test hypotheses concerning the morphological disparity ofCambrian fossils relative to the extant fauna. A previous study sampled at the generic level, concluding thatCambrian genera embodied marginally less morphological diversity than their extant counterparts. Here, we sample predominantly at the species level and include numerous fossils and some extant forms described in the last fifteen years. Empirical morphospaces for priapulids, archaeopriapulids and palaeoscolecids are relatively insensitive to changes in the taxon or character sample: their overall form has altered little, despite the markedly improved sampling. Cambrian and post‐Cambrian genera occupy adjacent rather than broadly overlapping regions of these spaces, andCambrian species still show lower morphological disparity than their post‐Cambrian counterparts. Crucially, the significance of this difference has increased with improved taxon sampling over research time. In contrast with empirical morphospaces, the phylogeny of priapulids, archaeopriapulids and palaeoscolecids derived from morphological characters is extremely sensitive to details of taxon sampling and the manner in which characters are weighted. However, the extant Priapulidae and Halicryptidae invariably resolve as sister families, with this entire clade subsequently being sister group to theMaccabeidae. In our most inclusive trees, the extantTubiluchidae are separated from these other living taxa by a number of small, intervening fossil clades.
The roles of ecological fitting, phylogeny and physiological equivalence in understanding realized and fundamental host ranges in endoparasitoid wasps
Authors: Harvey J. A. , Ximénez de Embún M. G. , Bukovinszky T. , Gols R.
Published: August 2012

Co‐evolutionary theory underpins our understanding of interactions in nature involving plant–herbivore and host–parasite interactions. However, many studies that are published in the empirical literature that have explored life history and development strategies between endoparasitoid wasps and their hosts are based on species that have no evolutionary history with one another. Here, we investigated novel associations involving two closely related solitary endoparasitoids that originate from Europe and North America and several of their natural and factitious hosts from both continents. The natural hosts of both species are also closely related, all being members of the same family. We compared development and survival of both parasitoids on the four host species and predicted that parasitoid performance is better on their own natural hosts. In contrast with this expectation, survival, adult size and development time of both parasitoids were similar on all (with one exception) hosts, irrespective as to their geographic origin. Our results show that phylogenetic affinity among the natural and factitious hosts plays an important role in their nutritional suitability for related parasitoids. Evolved traits in parasitoids, such as immune suppression and development, thus enable them to successfully develop in novel host species with which they have no evolutionary history. Our results show that host suitability for specialized organisms like endoparasitoids is closely linked with phylogenetic history and macro‐evolution as well as local adaptation and micro‐evolution. We argue that the importance of novel interactions and ‘ecological fitting’ based on phylogeny is a greatly underappreciated concept in many resource–consumer studies.
Effects of nectar robbing on pollinator behavior and plant reproductive success of Pitcairnia angustifolia (Bromeliaceae)
Authors: FUMERO‐CABÁN JOSÉ J. , MELÉNDEZ‐ACKERMAN ELVIA J.
Published: August 2012

Nectar robbers may have direct and indirect effects on plant reproductive success but the presence of nectar robbing is not proof of negative fitness effects. We combined census data and field experiments to disentangle the complex effects of nectar robbing on nectar production rates, pollinator behavior, pollen export, and female reproductive success of Pitcairnia angustifolia. Under natural conditions flowers were visited by four different animal species including a robber‐like pollinator and a secondary robber. Natural levels of nectar robbing ranged from 40 to 100%. Natural variation in nectar robbing was not associated with fruit set in any year whereas seed set was weakly positively associated for 1 year only. Artificial nectar robbing did not increase nectar production or concentration, did not affect the behavior of long‐billed hummingbirds, and when faced with artificially robbed flowers, these visitors behaved as secondary nectar robbers. The number of stigmas within a patch that received pollen dye analogs and the average distance traveled by these analogs were not significantly different between robbing treatments (robbed flowers versus unrobbed flowers), but the maximum distance traveled by these pollen analogs was higher when nectar robbing was not prevented. Overall, the proportion of robbed flowers on an inflorescence had a neutral effect to a weak positive effect on the reproduction of individual plants (i.e. positive association between nectar robbing and fruit set in 2002) even when it clearly changed the behavior of its most efficient pollinator potentially increasing the frequency of nectar robbing within a plant.
Decomposition dynamics of Phragmites australis litter in Lake Burullus, Egypt
Authors: Eid Ebrahem M. , Shaltout Kamal H. , Al‐Sodany Yassin M.
Published: August 2012

This study estimated the decomposition rate and nutrient dynamics of Phragmites australis litter in Lake Burullus (Egypt) and investigated the amount of nutrients released back into the water after the decomposition of the dead tissues. Phragmites australis detritus decomposition was studied from April to September 2003 utilizing the leaf, stem, and rhizome litterbags technique with coarse mesh (5 mm) bags on five sampling dates and with nine replicate packs per sample. All samples were dried, weighed and analyzed for N, P, Ca, Mg, Na, and K concentrations. The exponential breakdown rate of leaves (−0.0117/day) was significantly higher than that of rhizomes (−0.0040/day) and stems (−0.0036/day). N, Na and K mineralization were the highest from leaf litter, followed by rhizomes and stems, while P, Ca and Mg mineralization were the highest from rhizomes, followed by leaves and stems. The dead shoot biomass at the end of 2003 amounted to 4550 g DM/m2 which enters the decomposition process. By using the decay rate of 0.0117 and 0.0036/day for the leaves and stems, 3487 g DM/m2 is decomposed in a year, leaving only 1063 g DM/m2 after 1 year. This is mainly equivalent to releasing the following nutrients into surrounding water (in g/m2): 24.4 N, 1.1 P, 15.5 Ca, 3.5 Mg, 11.3 Na and 16.7 K. In conclusion, the present study indicates a significant difference in relation to the type of litter; these breakdown rates were generally greater than most rates reported in previous studies that used the same technique and mesh size.
Factors leading to the use of alternate treatment modalities following transoral laser excision of T1 and T2 glottic squamous cell carcinoma
Authors: Pham Truong An , De Freitas Ryan , Sigston Elizabeth , Vallance Neil
Published: August 2012

Background

CO2 transoral laser surgery and radiotherapy are both recognized as acceptable treatments for early glottic squamous cell carcinoma (SCC) with similar rates of cure. The reasons why some of the patients in our series undergoing laser resection as their primary modality of treatment subsequently underwent radiotherapy or chemoradiotherapy will be discussed.

Methods

Retrospective study between January 2003 and August 2010 of all T1 and T2 glottic SCCs treated with laser resection at a major tertiary centre. Tis lesions were excluded. A review of the cases in which primary control with laser resection was not achieved was undertaken. Failure was defined as patients treated initially with laser resection who subsequently received radiotherapy, combined chemoradiotherapy or open surgery for the same tumour. Factors leading to failure were analysed, including tumour location, histology, stage and patient factors.

Results

Thirty‐one patients were identified, with the majority (27) having T1 disease. Mean number of laser excisions per patient was 1.7. Local control rate was 71% with laser alone. One patient had nodal recurrence with no primary recurrence. Mean follow‐up was 32 months. Of the nine patients in whom local control was not achieved with laser alone, all had tumour at or crossing the anterior commissure. Four patients were deemed potentially curable with further excision but chose radiotherapy. Two patients were deemed appropriate for radiotherapy and chemoradiotherapy. Three patients had loco‐regional recurrence and underwent laryngectomy. All had anterior commissure involvement.

Conclusion

Transoral laser excision is a safe, function‐preserving treatment of early glottic SCC. Anterior commissure involvement was the major factor for potential failure with laser resection in T1 and T2 glottic tumours.
Pathological confirmation of nerve‐sparing types performed during robot‐assisted radical prostatectomy (RARP)
Authors: Ko Woo Jin , Hruby Gregory W. , Turk Andrew T. , Landman Jaime , Badani Ketan K.
Published: August 2012

What's known on the subject? and What does the study add?

Incremental nerve‐sparing techniques (NSTs) improve postoperative erectile function after robot‐assisted radical prostatectomy (RARP).

However, there are no studies to date that histologically confirm the surgeon intended NST. Thus, in the present study, we histologically confirmed that the surgeon performed the nerve preservation as his intended NSTs during RARP. Also, we found that there was more variability in fascia width outcome on the left side compared with the right. Therefore, when performing nerve preservation on the surgeon's non‐dominant side, we need to pay more close attention.

Objectives

To confirm that the surgeon achieved true intended histological nerve sparing during robot‐assisted radical prostatectomy (RARP) by studying RP specimens.

To aid the novice robotic surgeon to develop the skills of RARP.

Patients and Methods

Between June 2008 and May 2009, 122 consecutive patients underwent RARP by a single surgeon (K.K.B.). The degree of nerve sparing (wide resection [WR], interfascial nerve sparing [ITE‐NS], intrafascial nerve sparing [ITR‐NS]) on both sides was recorded. The posterior sectors of RP specimens from distal, mid, and proximal parts were evaluated.

Fascia width (FW) of each position in RP specimens were compared across nerve‐sparing types (NSTs). FW was recorded at 15 ° intervals (3–9 o'clock position), measured as the distance between the outermost prostate gland and surgical margin.

The slides were reviewed by an experienced uropathologist who was ‘blinded’ to the NST.

Results

In all, 93 men were included. The overall mean (sd) FW was the greatest in the order of WR, ITE‐NS, and ITR‐NS, at 2.42 (1.62), 1.71 (1.40) and 1.16 (1.08) mm, respectively (P < 0.001).

FW was statistically significantly correlated with the surgical technique used. When the surgeon intended to perform various levels of nerve sparing, these were reflected in the FW.

Interestingly, the left‐side FW showed more variability than the right side. We suspect that this was a result of the surgeon's right‐hand dominance.

Erectile function (EF) recovery rate according to NST was 88.9%, 77.3%, 65.6%, 56.3%, and 0% in bilateral ITR‐NS, ITR‐NS/ITE‐NS, bilateral ITE‐NS, ITE‐NS/WR, and bilateral WR, respectively.

To further validate and confirm these preliminary findings, additional studies involving multicentre cohorts would be required.

Conclusions

The surgeon intended dissection and FW correlate, with ITR‐NS providing the narrowest FW and the EF recovery rate was the highest in bilateral ITR‐NS. There was more variability in FW outcome on the left side than the right.

The novice robotic surgeon should consider this variability when performing RARP. It may have implications for technique improvement on nerve preservation for EF.
Where There is Discord, Can They Bring Harmony? Managing Intra-Party Dissent on European Integration in the Conservative Party
Authors: Lynch Philip , Whitaker Richard
Published: August 2012

Research Highlights and Abstract

The Conservative Party became more united around a soft Eurosceptic position in opposition, but internal divisions are evident on the scale and pace of change to the UK's relationship with the EU. Conservative Party leaders have employed a range of methods to manage intra-party dissent on European integration: intervention in candidate selection, patronage, discipline, policy compromises, permitting low-cost dissent, referendum pledges and reducing issue salience. Dissent on European integration tends to be higher when the Conservatives are in office because governing parties cannot individually control the EU agenda, must take difficult decisions and may have to sacrifice their preferred positions to broker compromises. Eurosceptic dissent has increased because Conservative policy has been diluted in coalition and the crisis in the Eurozone has raised the salience of the EU issue, but Eurosceptic rebels are not a cohesive group and this limits their influence.

Divisions on European integration were prominent in the Conservative Party in the 1990s, but abated in opposition. In this period, the party became more cohesive in terms of attitudes on Europe as it embraced soft Euroscepticism. However, differences over the desired scale and pace of changes to Britain's relationship with the European Union saw dissent increase as the party entered coalition government with the Liberal Democrats. This article examines the effectiveness of various approaches to management of dissent on Europe utilised by the party leadership: intervention in candidate selection; patronage and discipline; permitting limited dissent; policy compromise and deferred decisions; pledging referendums; and agenda setting and issue salience. It shows that intra-party divisions on European integration are particularly difficult to manage and suggests that dissent on the issue may often be higher in governing parties than those in opposition.
Contextual task difficulty modulates stimulus discrimination: Electrophysiological evidence for interaction between sensory and executive processes
Authors: Fedota John R. , McDonald Craig G. , Roberts Daniel M. , Parasuraman Raja
Published: August 2012

The occipital‐temporal N1 component of the event‐related potential (ERP) has previously been shown to index a stimulus discrimination process. However, the N1 has not consistently been shown to be sensitive to the difficulty of stimulus discrimination. Here, we manipulated the difficulty of stimulus discrimination by modulating the similarity between serially presented targets and nontargets. The same target stimulus was employed in both easy and difficult discrimination contexts, and these physically identical target stimuli elicited a larger N1 and smaller P3b in the difficult task context. Moreover, when targets were incorrectly categorized, N1 amplitude was diminished and a P3b was not elicited. These findings provide evidence that the N1 component reflects a sensory discrimination process that is modulated by executive control, and that this component can index discrimination errors when stimulus discrimination is difficult.
Factors influencing choice of surgical route of repair of genitourinary fistula, and the influence of route of repair on surgical outcomes: findings from a prospective cohort study
Authors: Frajzyngier V , Ruminjo J , Asiimwe F , Barry TH , Bello A , Danladi D , Ganda SO , Idris S , Inoussa M , Lynch M , Mussell F , Podder DC , Barone MA
Published: August 2012

Please cite this paper as: Frajzyngier V, Ruminjo J, Asiimwe F, Barry T, Bello A, Danladi D, Ganda S, Idris S, Inoussa M, Lynch M, Mussell F, Podder D, Barone M. Factors influencing choice of surgical route of repair of genitourinary fistula, and the influence of route of repair on surgical outcomes: findings from a prospective cohort study. BJOG 2012;119:1344–1353.

Objective  The abdominal route of genitourinary fistula repair may be associated with longer term hospitalisation, hospital‐associated infection and increased resource requirements. We examined: (1) the factors influencing the route of repair; (2) the influence of the route of repair on fistula closure 3 months following surgery; and (3) whether the influence of the route of repair on repair outcome varied by whether or not women met the published indications for abdominal repair.

Design  Prospective cohort study.

Setting  Eleven health facilities in sub‐Saharan Africa and Asia.

Population  The 1274 women with genitourinary fistula presenting for surgical repair services.

Methods  Risk ratios (RRs) and 95% confidence intervals (95% CIs) were generated using log‐binomial and Poisson (log‐link) regression. Multivariable regression and propensity score matching were employed to adjust for confounding.

Main outcome measures  Abdominal route of repair and fistula closure at 3 months following fistula repair surgery.

Results  Published indications for abdominal route of repair (extensive scarring or tissue loss, genital infibulation, ureteric involvement, trigonal, supratrigonal, vesico‐uterine or intracervical location or other abdominal pathology) predicted the abdominal route [adjusted risk ratio (ARR), 15.56; 95% CI, 2.12–114.00]. A vaginal route of repair was associated with increased risk of failed closure (ARR, 1.41; 95% CI, 1.05–1.88); stratified analyses suggested elevated risk among women meeting indications for the abdominal route.

Conclusions  Additional studies powered to test effect modification hypotheses are warranted to confirm whether the abdominal route of repair is beneficial for certain women.
Who can provide effective and safe termination of pregnancy care? A systematic review*
Authors: Renner R‐M , Brahmi D , Kapp N
Published: August 2012

Background  Unsafe termination of pregnancy is a major contributor to maternal morbidity and mortality. Task sharing termination of pregnancy services between physicians and mid‐level providers, a heterogeneous group of trained healthcare providers, such as nurses, midwives and physician assistants, has become a key strategy to increase access to safe pregnancy termination care.

Objectives  To systematically review the evidence to assess whether termination of pregnancy services by nonphysician providers can be performed safely and effectively.

Search strategy  We searched the Cochrane Central Register of Controlled Trials, MEDLINE, MEDLINE in process and other nonindexed citations and POPLINE.

Selection criteria  We included randomised controlled trials (RCTs), as well as clinical studies, using study designs that compared efficacy, safety and acceptability of termination of pregnancy services by physicians versus other provider groups.

Data collection and analysis  Two reviewers independently extracted the data, and we performed a meta‐analysis where appropriate using RevMan. Quality assessment of the data used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Main results  We identified five controlled studies comprising 8908 women undergoing first‐trimester surgical termination of pregnancy (one RCT and three prospective cohort studies) and medical termination of pregnancy (one RCT). The mid‐level provider group included midwives, nurses, auxiliary nurse midwives and physician assistants trained in termination of pregnancy services. Safety and efficacy outcomes, including incomplete termination of pregnancy, haemorrhage, injury to the uterus or cervix, did not differ significantly between providers.

Author’s conclusions  Limited evidence indicates that trained mid‐level providers may effectively and safely provide first‐trimester surgical and medical termination of pregnancy services. Data are limited by the scarcity of RCTs and biases of the cohort studies.
Patterns of Distribution and Environmental Correlates of Macroalgal Assemblages and Sediment Chlorophyll A in Oregon Tidal Wetlands
Authors: Janousek Christopher N. , Folger Christina L.
Published: August 2012

Algae have important functional roles in estuarine wetlands. We quantified differences in macroalgal abundance, composition and diversity, and sediment chl a and pheophytin a (pheo a) among three National Wetlands Inventory (NWI) emergent marsh classes in four Oregon estuaries spanning a range of riverine to marine dominance. We also assessed the strength of macroalgal‐vascular plant associations and the degree to which environmental variables correlated with algal community metrics in marsh and woody wetlands. The frequency of occurrence of most macroalgal genera, total benthic macroalgal cover, macroalgal diversity, and sediment chl a content were several times higher in low emergent marsh than in high marsh or palustrine tidal marsh. Conversely, pheo a: chl a ratios were highest in high and palustrine marsh. Attached macroalgae (Fucus and Vaucheria) were strongly associated with plants common at lower tidal elevations such as Sarcocornia perennis and Jaumea carnosa; Ulva (an unattached alga) was not strongly associated with any common low marsh plants. In structural equation models, intertidal elevation was the most influential predictor of macroalgal cover and richness and chl a; light availability and soil salinity played secondary roles. Although common taxa such as Ulva spp. occurred across a broad range of salinities, wetlands with oligohaline soils (salinity < 5) had the lowest macroalgal diversity and lower sediment chl a. These types of baseline data on algal distributions are critical for evaluating the structural and functional impacts of future changes to coastal estuaries including sea‐level rise (SLR), altered salinity dynamics, and habitat modification.
Prefrailty and Chronic Morbidity in the Youngest Old: An Insight from the Lausanne Cohort Lc65+
Authors: Danon‐Hersch Nadia , Rodondi Nicolas , Spagnoli Jacques , Santos‐Eggimann Brigitte
Published: August 2012

Objectives

To estimate the prevalence of prefrailty, frailty, comorbidity, and disability in the youngest old and to identify chronic diseases associated with individual frailty criteria.

Design

Population‐based cohort study of noninstitutionalized elderly adults at baseline; cross‐sectional analysis.

Setting

Lausanne, Switzerland.

Participants

One thousand two hundred eighty‐three individuals with complete data on frailty, aged 65 to 70 (58.5% women).

Measurements

Frailty was assessed according to an adaptation of Fried's criteria (shrinking, weakness, exhaustion, slowness, and low activity, three criteria needed for the diagnosis of frailty, 1 to 2 for prefrailty). Other outcomes were diseases diagnosed by a doctor (≥2 chronic diseases: comorbidity) and limitations in activities of daily living (ADLs, basic and instrumental).

Results

At baseline, of 1,283 participants 71.1% were classified as nonfrail, 26.4% as prefrail, and 2.5% as frail. The proportion of women increased across these three groups (56.5%, 62.8%, and 71.9%, respectively; P = .01), as did the proportion of individuals with one or more chronic diseases (68.0%, 82.8%, and 90.6%, respectively; P < .001) and the proportion with basic or instrumental ADL disability (1.6%, 10.3%, and 59.4%, respectively; P < .001). Weakness (low grip strength) was the most frequent criterion (14.3%). Prefrail participants had significantly more comorbidity and ADL disability than nonfrail participants (P < .001). When present in isolation, weakness was associated with two to three times greater prevalence of coronary heart disease, other heart diseases, diabetes mellitus, and arthritis. Similarly, a significant association was identified between exhaustion and depression.

Conclusion

Prefrailty is common in the youngest old. The most prevalent frailty criterion is weakness, which is associated with cardiovascular diseases. Longitudinal studies of the evolution of prefrailty should explore the role of potential interactions between individual frailty criteria and specific chronic diseases.
Do Depressive Symptoms and Gait Speed Impairment Predict Each Other's Incidence? A 16‐Year Prospective Study in the Community
Authors: Sanders Joost B. , Bremmer Marijke A. , Deeg Dorly J. H. , Beekman Aartjan T. F.
Published: August 2012

Objectives

To investigate whether gait speed predicts incident depressive symptoms and whether depressive symptoms predict incident gait speed impairment; to ascertain the presence of shared risk factors for these associations.

Design

TheLongitudinalAgingStudyAmsterdam, a prospective cohort study with five follow‐up cycles over 16 years.

Setting

Population based.

Participants

One thousand nine hundred twenty‐eight respondents for incident depressive symptoms (mean age 68.9 ± 8.5) and 1,855 respondents for incident gait speed impairment (mean age 68.0 ± 8.2).

Measurements

Depressive symptoms were measured using theCenter forEpidemiologicStudiesDepressionScale; gait speed was measured, back and forth, during a 3‐m walk as quickly as possible, with a 180° turn. Multivariate analyses were performed for both sexes usingCox regression.

Results

Incident depressive symptoms occurred in 24% of respondents. In univariate analyses, gait speed at baseline predicted incident depressive symptoms in men and women; after adjustment for covariates, this association persisted in men only. Examining the reverse association, 34% of respondents developed gait speed impairment. Depressive symptoms at baseline were univariately associated with incident gait speed impairment in women but not in men; this association did not persist after adjustment. The bidirectional associations did not share the same explanatory variables.

Conclusion

Gait speed predicts depressive symptoms in men. The geriatric giants of depressive symptoms and slowed gait speed in late life appear to result from different pathologies, both of which therefore require their own treatment strategies.
Serum Albumin in Relation to Change in Muscle Mass, Muscle Strength, and Muscle Power in Older Men
Authors: Snyder Caryn K. , Lapidus Jodi A. , Cawthon Peggy M. , Dam Thuy‐Tien L. , Sakai Lynn Y. , Marshall Lynn M.
Published: August 2012

Objectives

To investigate the relationship between serum albumin and change in muscle mass, grip strength, and leg power.

Design

Prospective cohort.

Setting

Six U.S. academic medical centers.

Participants

Community‐dwelling men aged 65 and older participating in the Osteoporotic Fractures in Men (MrOS) Study.

Measurements

Serum albumin was measured at baseline in 5,534 participants. Baseline serum albumin was examined in relation to change in appendicular skeletal muscle (ASM) mass, grip strength, and leg power after 2 and 4.6 years. Two‐year change in serum albumin was examined with respect to simultaneous change in these outcomes in 1,267 participants.

Results

Baseline serum albumin <40 g/L was not associated with 2‐ or 4.6‐year change in ASM mass, grip strength, or leg power before or after adjustment for confounders. There was no association between serum albumin change and change in grip strength. A statistically significant trend was observed between serum albumin change and change in ASM mass, but there was substantial overlap across confidence intervals (CIs). Participants with a marked decrease (>3 g/L) and mild decrease (1–2 g/L) in serum albumin over 2 years exhibited a modest change of −8.9 W (95% CI = −25.6 to −7.8 W) and −6.3 W (95% CI = −21.2 to −8.5 W) of leg power, respectively (P for trend = .02), compared with those with no decrease in albumin concentration.

Conclusion

Serum albumin demonstrated modest and inconsistent trends with loss of muscle mass and function. Low serum albumin within the normal range is not a risk factor for this process in elderly men.