bluuebunny/crossref_metadata_2025 huggingface dataset:
Agricultural Modernization and Climate Change in Vietnam's Post‐Socialist Transition
Authors: Fortier François , Thi Thu Trang Tran
Published: January 2013

This article presents a critique of Vietnam's agricultural modernization in the context of its post‐socialist transition and the emerging climate crisis. Agricultural modernization has led to impressive rates of wealth creation that have pulled many Vietnamese out of poverty and food insecurity over the past two decades. However, the model's own logic of accumulation has also made the country increasingly reliant on complex processes and has locked in various technological path dependencies. These include energy‐ and input‐intensive production, engineered landscapes, reduced agro‐biodiversity, and weakened social networks, knowledge and skills. As a result, Vietnam is becoming more sensitive and less able to adapt to structural shocks, notably that of climate change. Furthermore, and crucially, the post‐socialist transition since the launch of Đổi mới (market reform) has given rise to a political economy with dominant interests increasingly vested in the continuity of this modernization model. The article argues that it is this new dynamics of class and state–society relations that now represents the main obstacle to the development of credible solutions to the climate crisis.
No Way Back? Adaptation and Urbanization of IDP Livelihoods in the Darfur Region of Sudan
Authors: Young Helen , Jacobsen Karen
Published: January 2013

This article explores how people in conflict zones adapt their livelihoods after they migrate to urban areas. Drawing on case studies in two towns in the Darfur region of Sudan, the authors find that livelihood systems are in transition and have undergone fundamental changes resulting from displacement and the effects of conflict on dysfunctional and failing institutions. Urban migrants’ livelihood strategies evolve in a context of insecurity, distorted markets, lack of regulation and punitive rent‐seeking regimes such as protection payments. Maladaptive livelihood strategies emerge in response to the need for food and income in the short term. New strategies also can increase societal inequities and marginalization, and over‐exploit limited natural resources. Thus the ‘new’ livelihoods cannot be considered sustainable or equitable, or even able to provide food security in the short term. Locally appropriate and innovative approaches to support livelihoods are badly needed, but it is important to monitor and evaluate their impacts on livelihood groups, local economic recovery, environment and conflict.
Rethinking Power and Authority: Symbolic Violence and Subjectivity in Nepal's Terai Forests
Authors: Nightingale Andrea J. , Ojha Hemant R.
Published: January 2013

Recent work on authority, power and the state has opened up important avenues of inquiry into the practices and contexts through which power is exercised. Why certain forms of authority emerge as more durable and legitimate than others remains a challenge, however. In this article we bring together two bodies of thought to engage this issue, feminist theories of power and subjectivity and Bourdieu's ideas of symbolic violence, in order to explore how power and authority are reproduced and entrenched. Our purpose is to advance theorizing on power and authority in the context of contentious political situations and institutional emergence. This unusual theoretical synergy allows us to illustrate how power is exercised in relation to natural resource management and the ways in which the conflict/post‐conflict context creates institutional forms and spaces which simultaneously challenge and reinforce antecedent forms of authority. To animate our theoretical concerns, we draw on work in community‐based forestry in Nepal, with a focus on some of the conflicts that have arisen in relation to the valuableSalforests of the Terai, or lowland plains.
Social Capital and Post‐Conflict Reconstruction in Burundi: The Limits of Community‐based Reconstruction
Authors: Vervisch Thomas , Titeca Kristof , Vlassenroot Koen , Braeckman Johan
Published: January 2013

Using an examination of three NGO interventions in post‐conflict Burundi, this article questions community‐based reconstruction as a mechanism to rebuild social capital after conflicts, particularly when direct livelihood support is provided. The authors demonstrate a general shortcoming of the methodology employed in community‐based development (CBD), namely its focus on ‘technical procedural design’, which results in what may be termed ‘supply‐driven demand‐driven’ reconstruction. The findings suggest the need for a political economy perspective on social capital, which acknowledges that the effects on social capital are determined by the type of economic resource CBD gives access to. Through the use of a resource typology, the case studies show that the CBD methodology and the potential effects on social capital differ when applied to public and non‐strategic versus private and strategic resources. This has particular consequences for post‐conflict situations. A generalized application of CBD methodology to post‐conflict reconstruction programmes fails to take adequate account of the nature of the interventions and the challenges posed by the particular post‐conflict setting. The article therefore questions the current popular ‘social engineering’ approach to post‐conflict reconstruction.
Mechanism of bilateral communication in the suprachiasmatic nucleus
Authors: Michel Stephan , Marek Roger , vanderLeest Henk T. , vanSteensel Mariska J. , Schwartz William J. , Colwell Christopher S. , Meijer Johanna H.
Published: January 2013

The central circadian pacemaker of the suprachiasmatic nuclei (SCN) is a bilaterally symmetrical structure. Little is known about the physiological mechanisms underlying communication between the left and right SCN and yet the degree of synchronization between SCN neurons can have a critical impact on the properties of the circadian system. In this study, we used electrophysiological tools and calcium (Ca2+) imaging to examine the mechanisms underlying bilateral signaling in mouse SCN. Electrical stimulation of one SCN produced responses in the contralateral SCN with a short delay (approximately 5 ms) and Ca2+‐dependence that are consistent with action potential‐mediated chemical synaptic transmission. Patch‐clamp recordings of stimulated cells revealed excitatory postsynaptic inward‐currents (EPSCs), which were sufficient in magnitude to elicit action potentials. Electrical stimulation evoked tetrodotoxin‐dependent Ca2+ transients in about 30% of all contralateral SCN neurons recorded. The responding neurons were widely distributed within the SCN with a highest density in the posterior SCN. EPSCs and Ca2+ responses were significantly reduced after application of a glutamate receptor antagonist. Application of antagonists for receptors of other candidate transmitters inhibited the Ca2+ responses in some of the cells but overall the impact of these antagonists was variable. In a functional assay, electrical stimulation of the SCN produced phase shifts in the circadian rhythm in the frequency of multiunit activity rhythm in the contralateral SCN. These phase shifts were blocked by a glutamate receptor antagonist. Taken together, these results implicate glutamate as a transmitter required for communication between the left and right SCN.
Effect of stroke on arginase expression and localization in the rat brain
Authors: Quirié Aurore , Demougeot Céline , Bertrand Nathalie , Mossiat Claude , Garnier Philippe , Marie Christine , Prigent‐Tessier Anne
Published: January 2013

Because arginase and nitric oxide (NO) synthases (NOS) compete to degrade l‐arginine, arginase plays a crucial role in the modulation of NO production. Moreover, the arginase 1 isoform is a marker of M2 phenotype macrophages that play a key role in tissue remodeling and resolution of inflammation. While NO has been extensively investigated in ischemic stroke, the effect of stroke on the arginase pathway is unknown. The present study focuses on arginase expression/activity and localization before and after (1, 8, 15 and 30 days) the photothrombotic ischemic stroke model. This model results in a cortical lesion that reaches maximal volume at day 1 post‐stroke and then decreases as a result of astrocytic scar formation. Before stroke, arginase 1 and 2 expressions were restricted to neurons. Stroke resulted in up‐regulation of arginase 1 and increased arginase activity in the region centered on the lesion where inflammatory cells are present. These changes were associated with an early and long‐lasting arginase 1 up‐regulation in activated macrophages and astrocytes and a delayed arginase 1 down‐regulation in neurons at the vicinity of the lesion. A linear positive correlation was observed between expressions of arginase 1 and glial fibrillary acidic protein as a marker of activated astrocytes. Moreover, the pattern of arginase 1 and brain‐derived neurotrophic factor (BDNF) expressions in activated astrocytes was similar. Unlike arginase 1, arginase 2 expression was not changed by stroke. In conclusion, increased arginase 1 expression is not restricted to macrophages in inflammation elicited by stroke but also occurs in activated astrocytes where it may contribute to neuroplasticity through the control of BDNF production.
Organisation of koniocellular‐projecting ganglion cells and diffuse bipolar cells in the primate fovea
Authors: Percival Kumiko A. , Martin Paul R. , Grünert Ulrike
Published: January 2013

The roles of the midget and parasol pathways as the anatomical foundation for high‐acuity vision at the fovea are well established. There is also evidence for the presence of other (non‐midget, non‐parasol) ganglion cell types in the foveal retina, but it is not established whether these cells receive input from cone photoreceptors in the central few degrees of the visual field, i.e. the region most important for conscious visual perception. To address this question, we targeted injections of retrograde tracer to the koniocellular layers in the posterior aspect of the lateral geniculate nucleus, where the central visual field is represented, in marmoset monkeys (Callithrix jacchus). Labeled ganglion cells were photofilled to reveal their dendritic morphology. Potential inputs to foveal koniocellular cells from diffuse bipolar cells were investigated in vertical sections through the fovea of marmoset and macaque (Macaca fascicularis) monkey retinas using immunohistochemistry. Forty koniocellular‐projecting ganglion cells were analysed. We used an established model of marmoset foveal topography to show that all these koniocellular‐projecting cells receive cone inputs from the central‐most 6°, with about half the cells receiving input from below 2° eccentricity, in the rod‐free central bouquet of cones at the foveola. In addition, all diffuse bipolar types investigated were present in the fovea at stratification depths similar to those of their counterparts in the peripheral retina. We conclude that the diverse visual representations established for koniocellular pathways in the peripheral retina are also a feature of the fovea, suggesting that koniocellular pathways contribute to foveal vision.
Is Carrying Feathers a Sexually Selected Trait in House Sparrows?
Authors: García‐López de Hierro Lola , Moleón Marcos , Ryan Peter G.
Published: January 2013

Males in several avian groups carry specialised materials as part of their courtship display. Females may vary their investment in reproduction in relation to their mates' attractiveness. The house sparrow (Passer domesticus) population on Dassen Island, South Africa, builds domed nests in the branches of trees. These nests are more or less spherical structures with a deep cup lined largely with feathers. When males collect feathers, they call to females and display the feather before it is added to the nest. We examined whether carrying feathers provides females with an index of male quality, which correlates with their subsequent investment in parental care. Additionally, we studied the potential importance of feathers in nest insulation. Feathers were collected mainly by males. Males also brought larger feathers, and deposited more feathers in nests, than females. Number of trips with feathers – which increased after feathers were experimentally removed from nests – and number of feathers brought varied among males. Volume of feathers influenced females' investment in reproduction and positively correlated with clutch size and chick feeding rates. We found more feathers during incubation and immediately after chicks hatched, when nest heat requirements peak. Furthermore, number of trips with feathers and number and size of feathers were greater during incubation. Our results suggest that this feather‐carrying behaviour by male house sparrows influences maternal reproduction investment and could be a kind of parental careper seby supplementing nest insulation.
Pharmacokinetics of midazolam after intravenous administration to horses
Authors: Hubbell J. A. E. , Kelly E. M. , Aarnes T. K. , Bednarski R. M. , Lerche P. , Liu Z. , Lakritz J.
Published: January 2013

Reasons for performing the study

Midazolam is used to control seizures in horses and to enhance muscle relaxation, but its pharmacokinetics are unknown.

Objective

To determine the pharmacokinetics and sedative effects of midazolam in horses.

Study design

Blinded, randomised, crossover design.

Methods

Midazolam was administered i.v. at either 0.05 or 0.1 mg/kg bwt to 6 horses on 2 occasions at least 7 days apart using a crossover design. Blood samples were collected before and at predetermined times through 24 h after administration. Serum midazolam concentrations were determined by a liquid chromatography tandem‐mass spectrometry method. Heart and respiratory rates and indices of sedation, ataxia, and sensitivity to stimuli were recorded before and at predetermined times after midazolam administration.

Results

Pharmacokinetic analysis was performed on samples from 5 horses in each group. Median total clearance was 10.6 ml/min/kg (range 6.1–15.2 ml/min/kg) and 10.4 ml/min/kg (range 8.4–17.6 ml/min/kg), and median volume of distribution at steady state was 2094 ml/kg (range 2076–2413 ml/kg) and 2822 ml/kg (range 2270–7064 ml/kg) after the 0.05 mg/kg and 0.1 mg/kg bwt doses, respectively. Median distribution half‐life was 24 min (range 6–42 min) and 39 min (range 33.6–72 min) and median terminal half‐life was 216 min (range 120–248 min) and 408 min (range 192–924 min) after the 0.05 mg/kg and 0.1 mg/kg bwt doses, respectively. Cardiorespiratory parameters and sedation scores did not change. Midazolam caused agitation, postural sway, weakness, and one horse became recumbent after the 0.1 mg/kg bwt dose.

Conclusions

Midazolam produces ataxia and postural sway of short duration after i.v. administration to horses. Sedation was not evident after midazolam administration. Drug redistribution is likely the primary mechanism for the termination of effect.

Potential relevance

Midazolam produces muscle relaxation but not sedation in adult horses.
Trajectories of older adults' hearing difficulties: Examining the influence of health behaviors and social activity over 10 years
Authors: Heine Chyrisse , Browning Colette , Cowlishaw Sean , Kendig Hal
Published: January 2013

Aim

The aims of the present study were to describe the trajectories of self‐reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time.

Methods

As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self‐reported hearing difficulties, nutrition, smoking habits and level of social activity.

Results

Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time.

Conclusions

Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people. Geriatr Gerontol Int 2013; 13: 911–918.
Cytochrome P4502E1 inhibitor, chlormethiazole, decreases lipopolysaccharide‐induced inflammation in rat Kupffer cells with ethanol treatment
Authors: Ye Qinyuan , Wang Xiangdong , Wang Qing , Xia Min , Zhu Yanna , Lian Fuzhi , Ling Wenhua
Published: January 2013

Aim

To investigate the role of Cytochrome P4502E1 in sensitizing Kupffer cells to lipopolysaccharide (LPS)‐mediated inflammation after ethanol induction.

Methods

Sprague–Dawley rats were fed a liquid ethanol diet, control diet or ethanol diet supplemented with CYP2E1 inhibitor, chlormethiazole (CMZ), for 4 weeks. Hepatic CYP2E1 protein, nuclear factor‐kappa B (NF‐κB) p65 protein and tumor necrosis factor (TNF)‐α mRNA were measured. In vitro, isolated Kupffer cells from control rats were exposed to ethanol with different CMZ concentration; CYP2E1 expression and reactive oxygen species (ROS) generation were compared. The identified CMZ concentration was further utilized to evaluate the role of CYP2E1 on the sensitization of ethanol‐induced Kupffer cell to LPS. The effect of LPS alone was tested in controlled Kupffer cells without ethanol. TNF‐α, nuclear NF‐κB p65 and cytoplasm IκB‐α were monitored for all groups.

Results

Ethanol feeding increased hepatic CYP2E1 level, nuclear accumulation of NF‐κB p65 and TNF‐α expression in rats. These changes were inhibited by CMZ supplementation. In cultured Kupffer cells, increased CYP2E1 content and ROS production by in vitro ethanol induction were dose‐dependently inhibited by CMZ. Compared with LPS alone, the ethanol induction group produced significantly more TNF‐α, nuclear NF‐κB p65 and less cytoplasm IκB‐α under LPS stimuli. CMZ abolished the effects of ethanol on LPS‐stimulated NF‐κB translocation and TNF‐α generation in Kupffer cells.

Conclusion

In cultured Kupffer cell, using CMZ as inhibitor, ethanol‐induced CYP2E1 overexpression was proved to contribute to the sensitization of Kupffer cells to LPS stimuli, with amplification of ROS production and activation of NF‐κB, resulting in increased TNF‐α production.
Role of 6‐month abstinence rule in living donor liver transplantation for patients with alcoholic liver disease
Authors: Kawaguchi Yoshikuni , Sugawara Yasuhiko , Yamashiki Noriyo , Kaneko Junichi , Tamura Sumihito , Aoki Taku , Sakamoto Yoshihiro , Hasegawa Kiyoshi , Nojiri Kayo , Kokudo Norihiro
Published: January 2013

Aim

Although alcoholic liver disease (ALD) is an accepted indication for liver transplantation (LT), there are several controversial issues. The aim of this study is to examine the applicability of the 6‐month abstinence rule prior to LT and to evaluate the results in living donor LT for patients with ALD.

Methods

A retrospective study of 102 patients with ALD referred for LT was performed. Clinical data, including alcohol consumption history, were analyzed. A period of abstinence from drinking alcohol of at least 6 months was strictly required.

Results

Among 102 patients, 21 abstained from drinking for at least 6 months. Of these, 13 patients (12%) underwent LT, five patients (5%) recovered without LT and three patients (3%) were listed for deceased donor LT. LT was not indicated for the remaining 81 patients (80%). Eight patients died within 6 months of referral to our program. The Child–Pugh score was higher in these eight patients than in the 21 who achieved 6‐month abstinence, although the alcohol consumption history variables did not significantly differ between the two groups. The 5‐year overall survival rates after LT in 13 patients with ALD (91%) were similar to those in 387 non‐ALD patients (83%). The rate of alcohol consumption relapse after LT was 8% (n = 1/13).

Conclusion

Living donor LT for patients with ALD who complied with the 6‐month abstinence rule provides sufficient survival benefit with good compliance, compensating for the potential risks to the donors.
Relationship between urinary fractional excretion of sodium and life prognosis in liver cirrhosis patients
Authors: Ohashi Naro , Tsuji Naoko , Naito Yoshitaka , Iwakura Takamasa , Isobe Shinsuke , Ono Masafumi , Fujikura Tomoyuki , Tsuji Takayuki , Sakao Yukitoshi , Yasuda Hideo , Kawamura Kinya , Sakaguchi Takanori , Kato Akihiko , Fujigaki Yoshihide
Published: January 2013

Aim

Renal vasoconstriction in generalized vasodilatation with blood pooling and the consequent reduction in effective arterial volume is the pathophysiological basis of liver cirrhosis (LC). Low levels of fractional excretion of sodium (FENa) are an effective marker of hypoperfusion of the renal artery. However, the relationship between levels of FENa, LC severity and life prognosis has not yet been elucidated.

Methods

We examined 57 LC patients (39 men and 18 women; mean age, 70.5 ± 8.8 years; underlying liver disease, type B hepatitis in eight patients, type C hepatitis in 37, alcoholic hepatitis in four and others in eight) with renal dysfunction (estimated glomerular filtration rate (eGFR) <60 mL/min) who were admitted to our hospital.

Results

Nine patients died because of uremia, liver failure, gastrointestinal bleeding and infection. No differences were found in patient background and blood pressure. However, in addition to differences in the levels of aspartate aminotransferase (AST), cholinesterase, albumin, prothrombin time (PT), eGFR and Model for End‐Stage Liver Disease (MELD) score, the patients who died had significant differences in levels of FENa. The levels of FENa were significantly and inversely correlated with blood urea nitrogen, total bilirubin, AST, Child–Pugh score and MELD score, and were significantly and positively correlated with cholinesterase, albumin and PT. Moreover, the sensitivity (88%) and specificity (93%) of the levels of FENa of less than 0.4% to predict death were remarkably high.

Conclusion

Levels of FENa may reflect LC severity and may be associated with the life prognosis of LC patients.
Sodium‐coupled neutral amino acid transporter 4 functions as a regulator of protein synthesis during liver development
Authors: Kondou Hiroki , Kawai Masanobu , Tachikawa Kanako , Kimoto Akihito , Yamagata Masayo , Koinuma Tomoko , Yamazaki Miwa , Nakayama Masahiro , Mushiake Sotaro , Ozono Keiichi , Michigami Toshimi
Published: January 2013

Aim

The molecular mechanisms by which hepatocyte nuclear factor (HNF)4α regulates fetal liver development have not been fully elucidated. We screened the downstream molecules of HNF4α during liver development and identified sodium‐coupled neutral amino acid transporter (SNAT)4. The aim of this study is to investigate the regulation of SNAT4 by HNF4α and to clarify its roles in differentiating hepatocytes.

Methods

HNF4α was overexpressed in cultured liver buds using adenovirus, and suppression subtractive hybridization screening was performed. Temporal and spatial expression of SNAT4 during liver development was investigated. Regulation of SNAT4 by HNF4α was examined by promoter analyses and electrophoretic mobility shift assays (EMSA). Metabolic labeling and western blotting were carried out using primary hepatoblasts with SNAT4 overexpression.

Results

The expression of Slc38a4 encoding SNAT4 showed a marked perinatal increase, and was predominant among system A amino acid transporters. It was first detected in embryonic day 18.5 liver, and found in most hepatocytes after birth. Three alternative first exons were found in the SNAT4 gene. Promoter analyses using approximately 3‐kb fragments corresponding to each first exon (AP1, AP2, AP3) revealed that AP1 and AP2 exhibited strong promoter activity in mouse hepatoblasts with endogenous HNF4α. Transactivation of AP2 was upregulated by HNF4α in HeLa cells without endogenous HNF4α. EMSA has demonstrated that HNF4α directly binds to cis‐elements in AP2. Overexpression of SNAT4 facilitated amino acid uptake and de novo protein synthesis in primary hepatoblasts.

Conclusion

SNAT4 functions downstream of HNF4α and plays significant roles in liver development through mechanisms of amino acid uptake and protein synthesis.
Hepatic triglyceride lipase plays an essential role in changing the lipid metabolism in genotype 1b hepatitis C virus replicon cells and hepatitis C patients
Authors: Shinohara Yoshiyasu , Imajo Kento , Yoneda Masato , Tomeno Wataru , Ogawa Yuji , Fujita Koji , Kirikoshi Hiroyuki , Takahashi Junichiro , Funakoshi Kengo , Ikeda Masanori , Kato Nobuyuki , Nakajima Atsushi , Saito Satoru
Published: January 2013

Aim

Recently, several studies have shown the existence of associations between lipoprotein profiles and hepatitis C virus (HCV), although only a limited amount of information is available about the mechanisms underlying the changes in the lipoprotein profiles associated with HCV. In this study, we investigated the association between lipoprotein profile, classified according to the particle size, and lipoprotein metabolism.

Methods

We used four kinds of cells for this experiment; full‐length genome HCV RNA replicon cells (OR6), sub‐genomic HCV RNA replicon cells (sO), and OR6c cells and sOc cells, which were the same cell lines treated with interferon‐α. The triglyceride (TG) levels in the lipoprotein subclasses of the culture medium were measured by high‐performance liquid chromatography. The mRNA expression levels of several molecules associated with lipoprotein metabolism were measured in the OR6, OR6c, sO and sOc cells. To confirm some of the results obtained using the in vitro system, liver biopsy samples obtained from the patients were also examined.

Results

The content of TG in the large low‐density lipoprotein (LDL) and medium LDL in the culture medium was increased only in the OR6 cells. The hepatic triglyceride lipase (HTGL) mRNA expression levels were lower in the OR6 cells than in the OR6c cells (P < 0.01). Examination of the HTGL expression levels in the patients' livers revealed a decrease in HTGL expression in the chronic hepatitis C liver as compared with that in the chronic hepatitis B or non‐alcoholic steatohepatitis liver (P < 0.01).

Conclusion

We showed that HCV inhibits HTGL production in hepatocytes, inducing a change of the lipoprotein profile.
Parents' experiences of living with a child with a long‐term condition: a rapid structured review of the literature
Authors: Smith Joanna , Cheater Francine , Bekker Hilary
Published: January 2013

Background

Living with a child with a long‐term condition can result in challenges above usual parenting because of illness‐specific demands. A critical evaluation of research exploring parents' experiences of living with a child with a long‐term condition is timely because international health policy advocates that patients with long‐term conditions become active collaborators in care decisions.

Methods

A rapid structured review was undertaken (January 1999–December 2009) in accordance with theUnitedKingdomCentre forReviews andDissemination guidance. Three data bases (MEDLINE,CINAHL,PSYCINFO) were searched and also hand searching of theJournal ofAdvancedNursing andChild:Care,Health andDevelopment. Primary research studies written inEnglish language describing parents' experiences of living with a child with a long‐term condition were included. Thematic analysis underpinned data synthesis. Quality appraisal involved assessing each study against predetermined criteria.

Results

Thirty‐four studies met the inclusion criteria. The impact of living with a child with a long‐term condition related to dealing with immediate concerns following the child's diagnosis and responding to the challenges of integrating the child's needs into family life. Parents' perceived they are not always supported in their quest for information and forming effective relationships with health‐care professionals can be stressful. Although having ultimate responsibility for their child's health can be overwhelming, parents developed considerable expertise in managing their child's condition.

Conclusion

Parents' accounts suggest they not always supported in their role as manager for their child's long‐term condition and their expertise, and contribution to care is not always valued.
Self‐care support in paediatric patients with type 1 diabetes: bridging the gap between patient education and health promotion? A review
Authors: Pelicand Julie , Fournier Cécile , Le Rhun Anne , Aujoulat Isabelle
Published: January 2013

Background

This study examines how the term ‘self‐care’ imported from health promotion has been used in the context of patient education interventions for paediatric patients with type 1 diabetes.

Methods

Thirty articles over the last decade were analysed, using a qualitative method of thematic coding and categorizing.

Results

The term ‘self‐care’ has been mainly used as a synonym for self‐management of one's condition and treatment. Indeed, the activities performed by paediatric patients independently or with the help of their parents under the term ‘self‐care’ fail to explicitly take into account the general health and life dimensions of self‐care, as defined in health promotion. Although such dimensions are implicitly present when it comes to define the parents' and health‐care providers' roles in supporting the children's emerging self‐care capacity, their importance is acknowledged as a way of strengthening the children's and their families' capacity to respond to illness demands, rather than in relation to their general well‐being.

Conclusion

The discourse on self‐care in the field of paediatric diabetes therefore appears to be oriented more towards disease and prevention, rather than health promotion. The psychosocial dimension of self‐care should be particularly investigated, as young patients need to be supported in their efforts to gain autonomy not only in relation to the management of their condition, but in their lives in general.
Designing a placebo device: involving service users in clinical trial design
Authors: Gooberman‐Hill Rachael , Jinks Clare , Bouças Sofia Barbosa , Hislop Kelly , Dziedzic Krysia S. , Rhodes Carol , Burston Amanda , Adams Jo
Published: January 2013

Background

Service users are increasingly involved in the design of clinical trials and in product and device development. Service user involvement in placebo development is crucial to a credible and acceptable placebo for clinical trials, but such involvement has not yet been reported.

Aims

To enhance the design of a future clinical trial of hand splints for thumb‐base osteoarthritis (OA), service users were involved in splint selection and design of a placebo splint. This article describes and reflects on this process.

Design

Two fora of service users were convened in 2011. Service users who had been prescribed a thumb splint for thumb‐base OA were approached about involvement by Occupational Therapy (OT) practitioners.

Content of the fora

A total of eight service users took part in the fora. Service users discussed their experience of OA and their own splints and then tried a variety of alternative splints. Through this they identified the active features of splints alongside acceptable and unacceptable design features. Service users focused on wearability and support with or without immobilization. Fora discussed whether a placebo group (‘arm’) was an acceptable feature of a future trial, and service users developed a potential design for a placebo splint.

Conclusion and discussion

This is the first project that to involve service users in placebo design. Service users are increasingly involved in product and device design and are ideally placed to identify features to make a placebo credible yet lacking key active ingredients. The future trial will include research into its acceptability.
Optimization of sexual function outcome after radical prostatectomy using phosphodiesterase type 5 inhibitors
Authors: Kaiho Yasuhiro , Yamashita Shinichi , Arai Yoichi
Published: January 2013

Erectile dysfunction after radical prostatectomy is a major complication affecting postoperative quality of life. For early recovery from postoperative erectile dysfunction, attention has focused on penile rehabilitation using vacuum devices, prostaglandin E1 injection into the corpus cavernosum of the penis or transurethral administration, and oral drugs such as phosphodiesterase type 5 inhibitors. Phosphodiesterase type 5 inhibitors have been used clinically based on the results of animal experiments that showed a preventive effect on fibrosis and loss of intracorporeal smooth muscle. Small randomized studies had reported a benefit from penile rehabilitation using phosphodiesterase type 5 inhibitors after radical prostatectomy. However, the largest trial to date, carried out in 2008, failed to show that daily phosphodiesterase type 5 inhibitor treatment was superior to on‐demand phosphodiesterase type 5 inhibitor treatment for erectile function recovery after radical prostatectomy. Thus, debate continues as to its efficacy in humans. Reports on penile rehabilitation using phosphodiesterase type 5 inhibitors have appeared after these negative results, and phosphodiesterase type 5 inhibitors are still widely used as first‐line treatment in penile rehabilitation.
CD8+ CD122+ regulatory T cells contain clonally expanded cells with identical CDR3 sequences of the T‐cell receptor β‐chain
Authors: Okuno Yusuke , Murakoshi Ayako , Negita Masashi , Akane Kazuyuki , Kojima Seiji , Suzuki Haruhiko
Published: January 2013

We identified CD8+ CD122+ regulatory T cells (CD8+ CD122+ Treg cells) and reported their importance in maintaining immune homeostasis. The absence of CD8+ CD122+ Treg cells has been shown to lead to severe systemic autoimmunity in several mouse models, including inflammatory bowel diseases and experimental autoimmune encephalomyelitis. The T‐cell receptors (TCRs) expressed on CD8+ CD122+ Treg cells recognize the target cells to be regulated. To aid in the identification of the target antigen(s) recognized by TCRs of CD8+ CD122+ Treg cells, we compared the TCR diversity of CD8+ CD122+ T cells with that of conventional, naive T cells in mice. We analysed the use of TCR‐Vβ in the interleukin 10‐producing population of CD8+ CD122+ T cells marked by high levels of CD49d expression, and found the significantly increased use of Vβ13 in these cells. Immunoscope analysis of the complementarity‐determining region 3 (CDR3) of the TCR β‐chain revealed remarkable skewing in a pair of Vβ regions, suggesting the existence of clonally expanded cells in CD8+ CD122+ T cells. Clonal expansion in Vβ13+ cells was confirmed by determining the DNA sequences of the CDR3s. The characteristic TCR found in this study is an important building block for further studies to identify the target antigen recognized by CD8+ CD122+ Treg cells.
Epidemiologic study of molar‐incisor hypomineralization in 8‐year‐old Spanish children
Authors: Garcia‐Margarit Miriam , Catalá‐Pizarro Monserrat , Montiel‐Company José María , Almerich‐Silla José Manuel
Published: January 2013

Aim

To find the prevalence of molar‐incisor hypomineralization (MIH) in a random sample of Spanish children, and to investigate the gender influence, distribution of defects, the treatment need associated and the relation between this disorder and dental caries.

Design

A cross‐sectional study was carried out to determine MIH and caries prevalence in a randomly selected sample of 840 children from the 8‐year‐old population of the Valencia region of Spain. The examinations were carried out in the children's schools by one examiner who had previously been calibrated with the MIH diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD).

Results

The percentage of children with MIH was 21.8% (95% CI 19.1–24.7), with a mean 3.5 teeth affected (2.4 molars and 1.1 incisors) been the maxillary molars the most affected. No gender differences were found. Of those with MIH, 56.8% presented lesions in both molars and incisors Children with MIH needed significantly more urgent and non‐urgent treatment than those without MIH (chi‐squared test P‐value < 0.005). Both caries indices were significantly higher (Student's t‐test P‐value < 0.05) in the children with MIH than in the healthy children: the DMFT scores were 0.513 and 0.237 and the DMFS scores 1.20 and 0.79, respectively.

Conclusions

Molar‐incisor hypomineralization prevalence is high in the child population of this region and equally affects boys and girls. The condition increases significantly the need of treatment of affected children. A significant association with dental caries was observed.
Association between Intrapartum Interventions and Breastfeeding Duration
Authors: Bai Dorothy Li , Wu Kendra M. , Tarrant Marie
Published: January 2013

Introduction: Few women who reside in Hong Kong exclusively breastfeed, and one‐half stop breastfeeding within the first few months. There is little research in this population on the association between intrapartum interventions and breastfeeding duration.

Methods: A sample of 1280 mother‐infant pairs were recruited from the obstetric units of 4 public hospitals in Hong Kong and followed prospectively for 12 months or until the infant was weaned. The outcome variables for this analysis were the duration of any and exclusive breastfeeding. Predictor variables were 4 intrapartum interventions: receipt of opioid pain medication, induction versus spontaneous labor, epidural administration, and mode of birth. We used Cox proportional hazards modeling to assess the impact of intrapartum interventions on the duration of any and exclusive breastfeeding, and we constructed Kaplan‐Meier survival curves to evaluate the cumulative impact of multiple intrapartum interventions on breastfeeding outcomes.

Results: Bivariate analysis showed that induction of labor (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.09‐1.41), opioid pain medication (HR, 1.21; 95% CI, 1.06‐1.37), and having an emergency cesarean birth (HR, 1.22; 95% CI, 1.01‐1.48) were associated with a shorter duration of any breastfeeding. Induction of labor (HR, 1.23; 95% CI, 1.08‐1.39) and having an emergency cesarean birth (HR, 1.25; 95% CI, 1.05‐1.51) were associated with a shorter duration of exclusive breastfeeding. After controlling for known confounding variables, there was no longer any association between individual intrapartum interventions and the duration of any or exclusive breastfeeding. The median duration of breastfeeding for participants who experienced a natural birth with no intrapartum interventions was 9 weeks compared with 5 weeks for participants who experienced at least 3 intrapartum interventions.

Discussion: Clinicians working with new breastfeeding mothers should focus on providing additional support to mothers who experience a difficult labor and birth with multiple interventions to improve their breastfeeding experiences.
Anterior Inferior Cerebellar Artery Aneurysms Mimicking Vestibular Schwannomas
Authors: Marchini Aïda Kawkabani , Mosimann Pascal J , Guichard Jean‐Pierre , Boukobza Monique , Houdart Emmanuel
Published: January 2013

BACKGROUND AND PURPOSE

Unruptured anterior inferior cerebellar artery (AICA) aneurysms are rare but potentially lethal cerebellopontine angle (CPA) lesions that may be misdiagnosed as vestibular schwannomas when they present with vestibulo‐cochlear symptoms.

METHODS

We report two cases of unruptured but symptomatic AICA aneurysms initially referred to us as atypical vestibular schwannomas requiring surgery. Two discriminant MR features are described.

RESULTS

One patient refused treatment. The other was successfully treated by coil occlusion.

CONCLUSIONS

Caution is advised before suspecting a CPA mass to be a purely extra‐canalicular schwannoma, given its extreme rarity. Deafness and cerebellar ischemia may be prevented if AICA aneurysms are correctly identified preoperatively. In the absence of specific arterial imaging, two MR features may distinguish them from vestibular schwannomas: (1) the absence of internal auditory canal enlargement and (2) the “blurry dot sign,” representing blood flow artefacts on pre‐ and postcontrast studies.
No Regional Gray Matter Atrophy Differences between Pediatric‐ and Adult‐Onset Relapsing‐Remitting Multiple Sclerosis
Authors: Donohue Katelyn , Cox Jennifer L. , Dwyer Michael G. , Aliotta Rachel , Corwin Melanie , Weinstock‐Guttman Bianca , Ann Yeh E. , Zivadinov Robert
Published: January 2013

OBJECTIVE

To investigate differences in region‐specific gray matter (GM) damage between adults with pediatric‐onset (PO) multiple sclerosis (MS) and adult‐onset (AO) MS.

METHODS

Twenty‐four relapsing‐remitting (RR) adults with POMS (mean age = 35 years, mean disease duration = 18.4 years) were compared to 23 age‐matched (AOA, mean age = 33.9 years, mean disease duration = 2.4 years) and 24 disease‐duration matched (AOD, mean age = 45.9 years, mean disease duration = 18.5 years) RRMS adults who developed MS after the age of 18. Three‐dimensional‐T1‐weighted images were acquired on a 1.5 T MRI. Image analysis was conducted using voxel‐based morphometry (Statistical Parametric Mapping 8).

RESULTS

There were no regional GM atrophy differences between POMS and AODMS groups. No regional GM atrophy differences were found between POMS and AOAMS patients when disease duration was included as a covariate.

CONCLUSIONS

Regional GM differences were not found between POMS adults and MS controls matched for age or disease duration. Although of limited sample size, these findings suggest that there are no regional GM atrophy differences between RR POMS and AOMS.
Computed Tomography and Transcranial Doppler Findings in Acute and Subacute Phases of Intracerebral Hemorrhagic Stroke
Authors: Fülesdi Béla , Réka Kovács Katalin , Bereczki Dániel , Bágyi Péter , Fekete István , Csiba László
Published: January 2013

BACKGROUND AND PURPOSE

The hematoma volume is an important determinant of outcome and a predictor of clinical deterioration in patients with intracerebral hemorrhage (ICH). Our goal was to evaluate alterations in the cerebral circulation, in respect to hemorrhage and edema volume changes, using transcranial Doppler (TCD).

METHODS

Twenty patients with acute supratentorial ICH were examined. Brain, hematoma, and edema volumes were calculated from CT scans performed at admission and 2 weeks later. Data were compared with those obtained from bilateral TCD recordings of the middle cerebral arteries.

RESULTS

During TCD examination, blood flow velocities did not change, cerebral perfusion pressure (CPP) and resistance area product (RAP) decreased (P = .006, P = .002) while cerebral blood flow index (CBFI) remained constant on the affected side. Although hemorrhage volume did not correlate with RAP in the acute phase, correlation was found in the subacute phase (r = −.44, P = .04).

CONCLUSIONS

TCD monitoring sensitively demonstrates the hemodynamic change caused by ICH but the severity of the changes does not correlate with the volume of the ICH in acute stage. The CPP, RAP, and CBFI values are more sensitive parameters than the absolute velocity values, therefore they contribute more to the understanding of hemodynamic changes developed after spontaneous ICH.
Rural AIDS Diagnoses in Florida: Changing Demographics and Factors Associated With Survival
Authors: Trepka Mary Jo , Niyonsenga Theophile , Maddox Lorene M. , Lieb Spencer
Published: January 2013

Purpose

To compare demographic characteristics and predictors of survival of rural residents diagnosed with acquired immunodeficiency syndrome (AIDS) with those of urban residents.

Methods

Florida surveillance data for people diagnosed with AIDS during 1993‐2007 were merged with 2000 Census data using ZIP code tabulation areas (ZCTAs). Rural status was classified based on the ZCTA's rural‐urban commuting area classification. Survival rates were compared between rural and urban areas using survival curves and Cox proportional hazards models controlling for demographic, clinical, and area‐level socioeconomic and health care access factors.

Findings

Of the 73,590 people diagnosed with AIDS, 1,991 (2.7%) resided in rural areas. People in the most recent rural cohorts were more likely than those in earlier cohorts to be female, non‐Hispanic black, older, and have a reported transmission mode of heterosexual sex. There were no statistically significant differences in the 3‐, 5‐, or 10‐year survival rates between rural and urban residents. Older age at the time of diagnosis, diagnosis during the 1993‐1995 period, other/unknown transmission mode, and lower CD4 count/percent categories were associated with lower survival in both rural and urban areas. In urban areas only, being non‐Hispanic black or Hispanic, being US born, more poverty, less community social support, and lower physician density were also associated with lower survival.

Conclusions

In rural Florida, the demographic characteristics of people diagnosed with AIDS have been changing, which may necessitate modifications in the delivery of AIDS‐related services. Rural residents diagnosed with AIDS did not have a significant survival disadvantage relative to urban residents.
Behind the Scenes at a Climate Change Knowledge Sharing Network: IDS Insights from Phase One of AfricaAdapt
Authors: Fisher Catherine , Harvey Blane
Published: January 2013

Knowledge sharing networks are increasingly recognised as means of mobilising the knowledge and capacities needed to respond to complex and changing realities, such as the challenges posed by climate change. AfricaAdapt is one such network that describes its aim as ‘facilitating the flow of climate change adaptation knowledge for sustainable livelihoods between researchers, policy makers, civil society organisations and communities who are vulnerable to climate variability and change across the [African] continent’. This paper takes a ‘behind the scenes’ look at the AfricaAdapt Network and the partnerships on which it is based and is thus intended to be useful for others seeking to collaboratively develop knowledge sharing networks.

We focus on the dynamics of design and implementation of a knowledge sharing network in a distributed partnership, from the perspective of the former lead partner. Rather than looking at the delivery and outcomes of network activities, we explore the way in which the partners sought to develop sustainable relationships and ways of working to underpin the network, areas that are frequently under‐examined, particularly among practitioners. Areas covered include: governance and management, staffing and planning, financial management, partnership dynamics, learning, capacity development, monitoring and evaluation.

Although all knowledge sharing networks are different we have tried to identify insights and principles from this specific example that can be adapted and applied in other contexts. We hope that these insights will provide a useful contribution to the broader body of theory and experience around networks and knowledge sharing.