bluuebunny/crossref_metadata_2025 huggingface dataset:
Polymorphisms in the interferon‐induced helicase (IFIH1) locus and susceptibility to Addison's disease
Authors: Żurawek Magdalena , Fichna Marta , Januszkiewicz Danuta , Fichna Piotr , Nowak Jerzy
Published: July 2012

Objective

The interferon‐induced helicase C domain‐containing protein 1 (IFIH1) gene encodes a sensor for double‐stranded RNA that initiates antiviral activity against enteroviruses. Previous investigations have indicated a role for IFIH1 in autoimmunity, as common and rare polymorphisms in this gene have been associated with type 1 diabetes. We hypothesized that polymorphisms in the IFIH1 locus may play a role in the pathogenesis of autoimmune Addison's disease (AAD).

Design

We analysed the association of rs3747517, rs1990760, rs2111485 and rs13422767 single‐nucleotide polymorphisms (SNPs) in the IFIH1 gene and intergenic region with AAD in a Polish cohort. The study comprised 120 patients with AAD and 689 healthy control individuals. Genotyping was performed using TaqMan genotyping assays.

Results

The major AA genotype of the coding SNP rs1990760 appeared significantly more frequently in AAD compared with healthy individuals (AG vs AA OR 0·62, 95%CI 0·40–0·95, P = 0·03). We also observed a significant difference in the distribution of the rs13422767 SNP alleles. The major G allele was more frequent in the AAD group (A vs G OR 0·65, 95%CI 0·43–0·98, P = 0·04). Both statistically significant differences, for rs1990760 and rs13422767 SNPs, did not survive the Bonferroni correction (P = 0·11 and P = 0·15, for AA genotype and G allele, respectively). Subsequently, a meta‐analysis of 519 patients with AAD and 1362 controls from three different European populations was performed. Under a fixed‐effect model, a pooled OR for A allele and AA genotype of rs1990760 did not display any significant increase among AAD (OR = 1·05, P = 0·56 and OR = 1·08, P = 0·50, respectively).

Conclusion

The IFIH1 locus polymorphisms are unlikely to be associated with Addison's disease
Effects of functional groups and species richness on biomass constituents relevant for combustion: results from a grassland diversity experiment
Authors: Khalsa J. , Fricke T. , Weisser W. W. , Weigelt A. , Wachendorf M.
Published: July 2012

Grassland biomass has been identified as a potential energy source. The combustion of mature and fibrous biomass, as occurs in extensive grasslands managed with low cutting frequencies, is one possible conversion technique. This study tested the relationship between plant diversity and biomass constituents relevant for combustion, as they determine energy content, energy yield and emission and corrosion risks. The biomass from a biodiversity experiment, with a species richness (SR) gradient of 1–60 species from Central European mesophilic grasslands divided into four functional groups (grasses, legumes, small and tall herbs), was harvested twice a year (in 2008 and 2009). The higher heating value (HHV) was estimated from carbon, hydrogen and oxygen contents to give insight into the energy potential of the species mixtures. The potential risk of emission and corrosion was assessed by analysing ash content, potassium, calcium, magnesium, nitrogen, sulphur and chloride content. HHV was independent of SR, and the overall mean was 18·13 MJ kg−1 DM. Biomass and gross energy (GE) yield were positively affected by SR. The presence of legumes in a mixture resulted in increased HHV, biomass yield and GE, irrespective of the level of SR. Annual GE varied between 59 (average of monocultures) and 152 GJ ha−1 year−1 (mixture of sixty species). The concentration of ash‐forming elements was generally high, suggesting a pre‐treatment of the biomass prior to combustion. Emission‐ and corrosion‐related constituents were clearly affected by the different functional groups, and sulphur and nitrogen both declined with SR. The results of this study show that high SR in experimental grassland communities is beneficial for the energy output and that legumes play a key role for the energy potential. However, identifying a functional group as being solely beneficial or disadvantageous for fuel quality was difficult.
Fine‐scale quantification of floral and faunal breaks and their geographic correlates, with an example from south‐eastern Australia
Authors: Di Virgilio Giovanni , Laffan Shawn W. , Ebach Malte C.
Published: July 2012

Aim  We introduce a method to quantify shared breaks in aggregate biotic distributions and their relationships to geographic variables. The method is based on quantification of distributional taxic and abiotic data that can be applied over multiple spatial scales. We aim to show biogeographic breaks and varying transition zones at a fine level of detail (5‐km resolution) and develop an approach to assess existing bioregionalization schemes.

Location  Global applicability, using an example from New South Wales in south‐eastern Australia.

Methods  Moving window analyses, rotated in 15° increments through 360°, are used to assess the degree of anisotropic spatial turnover between sets of gridded cells containing georeferenced species observations. Patterns of biotic turnover are compared with equivalent analyses for elevation and lithology. Identified breaks are assessed against an existing bioregionalization scheme (Interim Biogeographic Regionalisation of Australia, IBRA).

Results  There was fine‐scale concordance between turnover patterns and several IBRA bioregions. Breaks in turnover of flora and fauna corresponded with the boundaries of the Hunter Valley and Sydney Basin regions, particularly the boundary between the Brigalow Belt South and Sydney Basin. Low‐turnover zones were quantified; prominent examples are the Sydney Cataract and Wyong bioregions. Turnover along many boundaries was gradational, confirming that mapped breaks are not abrupt. A previously unidentified break was identified in the South East Corner bioregion. Spatial turnover patterns were similar between biota and were reflected in mean correlation coefficients between turnover in each group: mammals–reptiles (r = 0.70, P << 0.01); mammals–flora (r = 0.56, P << 0.01); and reptiles–flora (r = 0.51, P << 0.01). Generally, patterns of abiotic turnover reflected biotic turnover, although mean turnover correlations were weaker than between biota.

Main conclusions  Using this method we were able to characterize taxic breaks and overlaps in detail and at a spatially fine resolution. For our study region, we confirm the overall integrity of the IBRA framework, but suggest that it may benefit from revision in some respects.
Experiences of caregivers of people with Parkinson’s disease in Singapore: a qualitative analysis
Authors: Tan Siok Bee , Williams Allison F , Morris Meg E
Published: July 2012

Aims and objectives.  To conduct an in‐depth qualitative examination of the experiences of Singaporean people caring for those with Parkinson’s disease (PD).

Background.  The need to provide care for people with PD will increase with the extended life expectancy of Singaporeans. Caring for people with PD in their own homes for as long as possible is argued to provide psychosocial benefits as well as benefiting the community by delayed institutionalisation and reduced healthcare costs.

Design.  This study reports the qualitative exploratory component of a large mixed method sequential explanatory design.

Methods.  Caregivers were selected through a purposive sampling technique and stratified based on the Hoehn and Yahr disease staging. Twenty‐one semi‐structured interviews were conducted in the home setting. Interviews were audio‐taped and transcribed verbatim. The qualitative data were analysed using Ritchie and Spencer’s framework method of qualitative analysis (1994, Analyzing Qualitative Data, Routledge, London).

Results.  Seventeen (81%) caregivers were women, and their ages ranged from 31 years to more than 71 years. The length of the interview ranged from 42–106 minutes. The interview transcriptions produced 1731 free nodes, and after careful scrutiny for redundancy, 11 sub‐themes were identified, which were organised into four key themes. These themes pertained to: (1) Coping and adaptation, (2) Challenges of caregiving, (3) Effects of caregiving on the caregivers and the (4) Need for better caregiver support.

Conclusion.  The results of this study have provided insights into the coping and well‐being of caregivers of people with PD. The progressive nature of PD placed a significant burden on caregivers’ emotional well‐being. The findings of this study underscore the need for formal caregiver support and education to reduce strain in caregivers targeted at every stage of PD as there is no clear pattern of disease progression.

Relevance to clinical practice.  This study has provided important findings that will inform the construction of interventional strategies to reduce caregiver burden and the provision of better support services for caregivers.
Tinkering and tailoring individual consultations: how practice nurses try to make cardiovascular risk communication meaningful
Authors: Boase Sue , Mason Dan , Sutton Stephen , Cohn Simon
Published: July 2012

Aims and objectives.  To explore the perspectives of practice nurses in their role of communicating cardiovascular risk to patients.

Background.  Nurses in primary care have for some time been engaged in cardiovascular risk discussions with patients. With the recent introduction of the NHS Health Checks, the focus on this work is set to increase.

Design.  Qualitative using a framework approach.

Methods.  Two focus groups and 16 semi‐structured interviews were conducted with nurses purposively sampled from those working in primary care.

Results.  The nurses’ accounts revealed the need to develop a relationship of trust and establish a level of relevance with each individual patient whilst discussing cardiovascular risk. Potential aspects of these discussions were as follows: working within a highly structured data‐collecting task; time constraints and consideration of the individual’s context. We used the idea of tailoring to describe how nurses navigate and constantly modify and pitch their approach for each patient they see in response to these constraints.

Conclusion.  We suggest that in order for risk to be made meaningful to patients, practice nurses recognise the need for such information to be embedded in the more reciprocal dynamics of nurse‐patient consultations. From their perspective, success is often as much about not saying something, or saying it in a particular way, as saying anything accurately or consistently.

Relevance to clinical practice.  For practice nurses to be instrumental in the successful delivery of health prevention policy initiatives such as the NHS Health Checks, it is important to acknowledge their views and perspectives in undertaking this work. This study suggests that the nurses recognised the need for further skills and a refinement of approach for those health professionals involved.
Oppression and exposure as differentiating predictors of types of workplace violence for nurses
Authors: Rodwell John , Demir Defne
Published: July 2012

Aims and objectives.  To extend a model of the antecedents of workplace bullying to apply to a wider range of types of workplace aggression, including bullying and several types of violence, among nurses.

Background.  Research that has focused on workplace bullying has found that the Demand‐Control‐Support model, negative affectivity and certain demographic factors play important roles as antecedents of bullying.

Design.  A cross‐sectional design.

Methods.  A validated questionnaire was sent to the work addresses of all nursing and midwifery staff in a medium‐to‐large hospital in Australia. A total of 273 nurses and midwives returned their completed questionnaires. Ordinal regressions were conducted to assess the antecedents of workplace aggression across bullying and violence.

Results.  Aspects of the Demand‐Control‐Support model and job tenure significantly predicted particular forms of violence, while negative affectivity and work schedule were significant for bullying.

Conclusions.  The patterns of the results suggest key mechanisms that characterise certain forms of violence and distinguish between bullying and types of violence across the range of workplace aggression. In particular, oppression and exposure appear to differentiate types of workplace violence.

Relevance to clinical practice.  The study suggests ways in which nursing and hospital managers may act to reduce the likelihood of certain forms of aggression, particularly violence, from occurring.
Lifestyle health promotion interventions for the nursing workforce: a systematic review
Authors: Chan Choi Wan , Perry Lin
Published: July 2012

Aims and objectives.  Study aims were to identify the efficacy of lifestyle health promotion interventions intended to improve behavioural health risk factors and/or behavioural or clinical outcomes of working‐age nurses.

Background.  Nurses constitute around half the health workforce but global shortages and an ageing profile challenge future supply. The occupational hazards and stresses of nursing are well known. Health promotion, possibly workplace‐based, presents opportunities to safeguard the health of nurses.

Design.  This was a systematic review undertaken in line with guidance for reviews in health care.

Methods.  Seven electronic databases were searched from 2000–2011 and references of relevant papers. Two reviewers independently reviewed and critiqued retrieved papers and extracted data. Methodological features were described using the CONSORT checklists; risk of bias was assessed using the Cochrane Handbook classification.

Results.  With design inclusion criteria relaxed to include an uncontrolled trial, only three intervention studies were retrieved, from the United States, Canada and Taiwan. All had limitations and high risk of bias, but benefits were reported. Outcomes included fewer cigarettes smoked during the intervention period, down from mean (SD) 20 (8)–12 (9) per day (p < 0·001); significantly reduced fat mass (0·68 vs. 0·07 kg; p = 0·028); and significant gains across a battery of fitness assessments. The paucity of work focused on nurses’ health behaviours was the important finding.

Conclusion.  The workplace is a potentially fruitful location for health promotion intervention but nurses have seldom been recognised as a target participant group. Given the international priority ascribed to nursing workforce retention, this is a missed opportunity for occupational health planning. Potential benefits to nurses’ welfare and well‐being may accrue from well‐designed intervention studies.

Relevance to clinical practice.  Nurse leaders have a key role in driving recognition, spearheading commitment and development of targeted, whole‐organisation programmes to promote health profile improvement for the nursing workforce.
Multiple rapid swallow responses segregate achalasia subtypes on high‐resolution manometry
Authors: Kushnir V. , Sayuk G. S. , Gyawali C. P.
Published: July 2012

Background  Multiple rapid swallows (MRS) inhibit esophageal peristalsis and lower esophageal sphincter (LES) tone; a rebound excitatory response then results in an exaggerated peristaltic sequence. Multiple rapid swallows responses are dependent on intact inhibitory and excitatory neural function and could vary by subtype in achalasia spectrum disorders.

Methods  Consecutive subjects with incomplete LES relaxation on high‐resolution manometry (HRM) (Sierra Scientific, Los Angeles, CA, USA) in the absence of mechanical obstruction were prospectively identified. Achalasia spectrum disorders were classified and HRM plots reviewed according to Chicago criteria. Esophageal peristaltic performance and LES function were assessed after 10 wet swallows and MRS (five 2 mL water swallows 2–3 s apart). Findings were compared with 18 healthy controls (28.5 ± 0.6 years, 44% women).

Key Results  A total of 46 subjects (57.1 ± 2.1 years, 52.2% women) met inclusion criteria. There was complete failure of peristalsis with MRS in all subjects with achalasia subtypes 1 and 2. In contrast, 80% of achalasia subtype 3 and incomplete LES relaxation (EGJ outflow obstruction) with preserved esophageal body peristalsis had a contractile response to MRS (P < 0.001 compared with subtypes 1 and 2); controls demonstrated 94.4% peristalsis. Percent decrease in LES residual pressure during MRS (compared to wet swallows) segregated achalasia subtypes; those with aperistalsis (subtypes 1 and 2) had a lesser decline (22.6%) compared to those with retained esophageal body peristalsis (40.5%) and controls (51.3%, P < 0.001 across groups).

Conclusions & Inferences  Multiple rapid swallow responses segregate achalasia spectrum disorders into two patterns differentiated by presence or absence of esophageal body contraction response to wet swallows. These findings support subtyping of achalasia, with pathophysiologic implications.
The Antimicrobial Peptide Thanatin Reduces Fungal Infections in Arabidopsis
Authors: Koch Aline , Khalifa Walaa , Langen Gregor , Vilcinskas Andreas , Kogel Karl‐Heinz , Imani Jafargholi
Published: July 2012

We explored the antifungal activity of thanatin, a 21 amino acid synthetic peptide from the hemipteran spined soldier bug Podisus maculiventris, against the mycotoxin‐producing plant pathogenic ascomycete Fusarium graminearum. In vitro germination assays showed complete inhibition of macroconidia germination and mycelia growth by >10 μm thanatin. Moreover, detached leaves of thanatin‐expressing Arabidopsis thaliana plants displayed enhanced resistance towards colonization with F. graminearum. Consistent with this, the plants showed also enhanced resistance of detached leaves to colonization with Botrytis cinerea. The results demonstrate a potential of thanatin for use in plant protection.
Catheter revision for the treatment of intractable exit site infection/tunnel infection in peritoneal dialysis patients: A single centre experience
Authors: CHO KYU‐HYANG , DO JUN‐YOUNG , PARK JONG‐WON , YOON KYUNG‐WOO
Published: July 2012

Aim:  Catheter‐related infection is a major cause of catheter loss in peritoneal dialysis (PD). We evaluated the effect of catheter revision on the treatment of intractable exit site infection (ESI)/tunnel infection (TI) in PD patients who required catheter removal.

Methods:  We reviewed the medical records of 764 continuous ambulatory peritoneal dialysis (CAPD) patients from May 1995 to April 2011 at our hospital. One hundred and twenty six patients had more than one occurrence of ESI. Catheter revision was performed to treat intractable ESI/TI. Incidence of ESI, causative organisms and the outcomes of catheter revision were analyzed.

Results:  The total PD duration of all patients was 32 581 months. Three hundred and twelve ESI episodes occurred in 126 patients and the incidence of ESI was 1/104 patient‐months (0.12/patient‐year). The most common causative organism was methicillin‐sensitive Staphylococcus aureus (MSSA) (98 episodes), followed by Pseudomonas aeruginosa (63 episodes) and methicillin‐resistant S. aureus (MRSA) (28 episodes). Among these, catheter revision was required due to intractable ESI/TI in 36 patients. The most common causative organism was MSSA (14 episodes) followed by P. aeruginosa (10 episodes) and MRSA (six episodes) in catheter revision cases. The outcomes of catheter revision were as follows: ESI relapsed in 11 patients (30.6%) after catheter revision. Among them, five patients were treated with antibiotic treatment, two patients required secondary catheter revision, four patients required catheter removal due to ESI/TI accompanying peritonitis. The catheter survival rate after catheter revision was 89.7% in one year. There were no statistical differences in the rates of ESI relapse after catheter revision between ESI caused by P. aeruginosa (5/10, 50%) and ESI caused by S. aureus (6/21, 28.6%).

Conclusion:  Catheter revision may be an alternative treatment option to treat intractable ESI/TI before catheter removal is considered in PD patients.
Comparison of endoscopic revision for failed primary external versus endoscopic dacryocystorhinostomy
Authors: Paik Ji‐Sun , Cho Won‐Kyung , Yang Suk‐Woo
Published: July 2012

Abstract

Backgound:  To compare differences in endoscopic revision after previously failed lacrimal surgery that involved either external or endoscopic dacryocystorhinostomy.

Design:  Retrospective, comparative, nonrandomized clinical study.

Participants:  We assessed 77 patients (82 surgeries) treated for recurrent nasolacrimal duct obstruction.

Methods:  Electronic medical records for patients with recurrent epiphora who underwent endoscopic revisional dacryocystorhinostomy, after previous external or endoscopic dacryocystorhinostomy at Seoul St. Mary's Hospital from 2004 to 2010, were reviewed.

Main Outcome Measures:  Data regarding the lacrimal drainage system, comprehensive eye examination, surgical outcome and preoperative/perioperative transnasal endoscopy were analysed.

Results:  In total, 77 patients underwent 82 endoscopic revisional dacryocystorhinostomy procedures. A success rate of 84% was achieved for cases of previous external dacryocystorhinostomy and 80.7% for previous endoscopic dacryocystorhinostomy (P = 0.722). For preoperative nasal endoscopy, more of the patients who underwent previous external dacryocystorhinostomy exhibited a hypertrophic middle turbinate and severe septal deviation when compared with patients who underwent previous endoscopic dacryocystorhinostomy (P = 0.031, P = 0.001, respectively). For perioperative nasal endoscopy, more of the patients who underwent previous endoscopic DCR exhibited a smaller ostium when compared with patients who underwent previous external dacryocystorhinostomy (P = 0.031).

Conclusions:  The success rate of revisional dacryocystorhinostomy in the previous external dacryocystorhinostomy group was slightly higher than that in the previous endoscopic dacryocystorhinostomy group. Differences in preoperative and perioperative endoscopic findings were detected between the groups. Clarifying these differences in endoscopic revision will help improve the surgical outcomes of primary surgery involving either external or endoscopic dacryocystorhinostomy.
Near‐vision impairment and unresolved vision problems in Indigenous Australian adults
Authors: Arnold Anna‐Lena MR , Goujon Nicolas , Busija Lucy , Fox Sarah , Xie Jing , Dunn Ross A , Keeffe Jill E , Taylor Hugh R
Published: July 2012

Abstract

Background:  To describe near‐vision impairment, self‐reported unresolved vision problems and barriers to having near‐vision correction in Indigenous Australians.

Design:  A nationwide population‐based study designed to determine the causes and prevalence of vision loss and utilization of eye care services.

Participants:  Indigenous Australians aged ≥40 years.

Methods:  Using a multistage random cluster sampling methodology, 30 geographical areas stratified by remoteness were selected to obtain a representation of Indigenous Australians. Visual acuity was conducted using a standard E chart. A questionnaire collected data on eye health, eye care service utilization and vision‐related quality of life.

Main Outcome Measures:  Near‐vision impairment defined as presenting binocular near visual acuity <N8. Self‐reported unresolved vision problems defined as anything considered an eye/vision problem by the participant, including distance and/or near‐vision impairments, not resolved after seeking care and quality‐of‐life scores.

Results:  Being aged 50–59 years (reference group 40–49 years), speaking a language other than English at home and vision loss (distance vision impairment and blindness) increased the odds of near‐vision impairment. Of those with near‐vision impairment, 37% (175/468) reported not having near‐vision correction. Being aged 60–69 years, speaking a language other than English at home and having vision loss decreased the odds of having near‐vision correction. Longer time since last consultation was associated with unresolved vision problems and worse quality‐of‐life scores.

Conclusion:  There remains a large unmet need in regard to near‐vision correction. Many Indigenous adults have unresolved vision problems that could be resolved with regular consultations with eye care services.
Central serous chorioretinopathy: a review of epidemiology and pathophysiology
Authors: Liew Gerald , Quin Godfrey , Gillies Mark , Fraser‐Bell Samantha
Published: July 2012

Abstract

Central serous chorioretinopathy (CSCR) is a common retinal cause of vision loss. This review surveys the epidemiology, risk factors, clinical presentation, natural history and pathophysiology of CSCR. Studies suggest an annual incidence rate of 10 per 100 000 in men, with CSCR occurring six times more commonly in men compared with women. Most acute CSCR cases resolve spontaneously within 2–3 months. Prognosis is highly dependent on presenting visual acuity; patients with initial visual acuities of 6/6 remain at that level, while patients with initial visual acuities of less than 6/9 recover on average two to three Snellen lines over the next few years. The main risk factors for CSCR are systemic corticosteroid use, type A personality, pregnancy and endogenous Cushing's syndrome. The pathophysiology of CSCR remains obscure, although disorders in both the choroidal circulation and retinal pigment epithelium are implicated.
Credentialing of surgeons: a systematic review across a number of jurisdictions
Authors: Gurgacz Stefanie L. , Smith Julian A. , Truskett Phil G. , Babidge Wendy J. , Maddern Guy J.
Published: July 2012

Background:  The purpose of credentialing is to ensure that clinicians provide safe, high‐quality health‐care services in accordance with good practice and legal requirements. This review assessed the institutional credentialing processes and governance structures required to support credentialing processes at an institutional, regional or health‐care system level.

Methods:  Searches of MEDLINE, EMBASE and PubMed were conducted. Additional grey literature searches were performed using the Google search engine and specific searches of government web sites were conducted. The inclusion criteria were developed a priori and standardized extraction of the information to appraise the research questions was conducted systematically.

Results:  A total of 33 white papers were included in this systematic literature review: 18 were published in Australia, 1 in New Zealand, 10 in the United Kingdom, 2 in the United States of America and 2 in Canada. Four key principles were common throughout all studies included in this review: clear lines of responsibility for the credentialing process and supportive governance structures, clear standards for credentialing, a culture of continuous improvement and evaluation of credentialing process outcomes.

Conclusions:  No data were available to evaluate the relationship between the credentialing process and the safety and quality of health‐care services or patient outcomes; and capturing such data is difficult because of the numerous factors that affect the relationship between credentialing, patient outcomes, and the safety and quality of health‐care services. Consequently, developing methods to measure the effectiveness of credentialing processes represents an area for further research.
Application technique: placement of a prostate–rectum spacer in men undergoing prostate radiation therapy
Authors: Hatiboglu Gencay , Pinkawa Michael , Vallée Jean‐Paul , Hadaschik Boris , Hohenfellner Markus
Published: July 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Different spacing agents have been tested to reduce incidential radiation exposure of the rectum during radiotherapy to the prostate. These agents all had certain drawbacks; either the created space was too small or the agents used did not stay in place during radiotherapy treatment.

The study describes the transperineal injection technique of a spacing agent in detail. Furthermore it shows the safety and efficacy of the spacing hydrogel used and shows that it overcomes some of the drawbacks of the previously examined spacing agents.

OBJECTIVE

To describe the technique used to apply a hydrogel spacer between the prostate and rectum so as to decrease the radiation dose to the rectum in patients with prostate cancer who are undergoing radiotherapy.

METHODS

A prospective study evaluating the safety and efficacy of prostate–rectum spacer injection was conducted in 29 male patients with prostate cancer scheduled for radiotherapy.

Spacing hydrogel was injected into the perirectal space using a transperineal approach under real‐time transrectal ultrasonography guidance.

With the needle tip positioned beyond the rectourethralis muscle, saline injection opened the space between Denonvilliers' fascia and the anterior rectal wall, allowing needle advancement to the mid‐prostate without rectal wall injury. Injection of hydrogel precursors further opened this space, which was then maintained as a result of hydrogel polymerization.

Procedure duration and adverse events were monitored. Computed tomography and/or magnetic resonance imaging simulation scans were performed before and after injection. The hydrogel‐created space was measured and the reduction in percent volume of the rectum receiving at least 70 Gy (rectal V70) was determined.

RESULTS

Hydrogel injection resulted in mean (sd) additional prostate–rectum space relative to baseline of 9.87 (5.92) mm.

The mean (sd) procedure time, as measured by needle insertion and removal, was 6.3 (3.2) min.

The relative reduction in rectal V70 was 60.6%.

There were no unanticipated adverse events associated with the hydrogel procedure or the hydrogel.

CONCLUSIONS

Hydrogel spacer injection using hydrodissection is a fast and effective procedure to separate the rectal wall from the prostate in order to avoid rectal toxicity.

Hydrogel spacer injection resulted in the addition of ∼1 cm of space

Computed incidental radiation exposure, the rectal V70, was substantially reduced.
Agriculture and Trade Opportunities for Tanzania: Past Volatility and Future Climate Change
Authors: Ahmed Syud Amer , Diffenbaugh Noah S. , Hertel Thomas W. , Martin William J.
Published: July 2012

Given global heterogeneity in climate‐induced agricultural variability, Tanzania has the potential to substantially increase its maize exports to other countries. If global maize production is lower than usual owing to supply shocks in major exporting regions, Tanzania may be able to export more maize at higher prices, even if it also experiences below‐trend productivity. Diverse destinations for exports can allow for enhanced trading opportunities when negative supply shocks affect the partners' usual import sources. Future climate predictions suggest that some of Tanzania's trading partners will experience severe dry conditions that may reduce agricultural production in years when Tanzania is only mildly affected. Tanzania could thus export grain to countries as climate change increases the likelihood of severe precipitation deficits in other countries while simultaneously decreasing the likelihood of severe precipitation deficits in Tanzania. Trade restrictions, like export bans, prevent Tanzania from taking advantage of these opportunities, foregoing significant economic benefits.
Power Ahead: Meeting Ethiopia's Energy Needs Under a Changing Climate
Authors: Block Paul , Strzepek Kenneth
Published: July 2012

Ethiopia is powering ahead with an energy development strategy that is highly reliant on abundant hydropower potential. A changing climate may pose a challenge to meeting expected targets. Bridging the modeling gaps between climate, energy, and economics, and effectively transforming climate changes into economic measures, is an emerging interdisciplinary field as nations attempt to position themselves for an uncertain future. Such a framework is adopted here to assess energy production and adaptation costs for four climate change scenarios over 2010–2049. Scenarios that favor a drying trend countrywide may lead to losses of 130–200 terawatt‐hours over the 40‐year period, translating to adaptation costs of US$2–4 billion, compared with a no climate change scenario. Even given these potential losses, energy development utilizing hydropower appears economically reasonable from this deterministic, sector‐independent evaluation. This development is desperately needed, independent of future climate change trends, with the hope of appreciably reducing vulnerability to variability.
A Dynamic General Equilibrium Analysis of Adaptation to Climate Change in Ethiopia
Authors: Robinson Sherman , Willenbockel Dirk , Strzepek Kenneth
Published: July 2012

This study links a multisectoral, regionalized, dynamic, computable general equilibrium (CGE) model of Ethiopia with a system country‐specific hydrology, crop, road, and hydropower engineering models to simulate the economic impacts of climate change scenarios from global circulation models (GCMs) to 2050. In the absence of externally funded, policy‐driven adaptation investments, Ethiopia's GDP in 2050 will be up to 10% below the counterfactual no climate change (historical climate) baseline. Suitably designed adaptation investments could restore aggregate welfare to baseline levels at a cost that is substantially lower than the welfare losses as a result of climate change. Such investments, even if funded from domestic resources, have benefits that greatly exceed their costs, and are largely consistent with Ethiopia's long‐run development strategy.
Recursion Operator of the Narita–Itoh–Bogoyavlensky Lattice
Authors: Wang Jing Ping
Published: July 2012

We construct a recursion operator for the family of Narita–Itoh–Bogoyavlensky infinite lattice equations using its Lax presentation and present their mastersymmetries and bi‐Hamiltonian structures. We show that this highly nonlocal recursion operator generates infinitely many local symmetries.
Ex Ante Versus Ex Post Equality of Opportunity
Authors: Fleurbaey Marc , Peragine Vito
Published: July 2012

We study the difference between the ex post and ex ante perspectives in equality of opportunity. We show that the well documented conflicts between compensation and reward are but an aspect of a broader conflict between ex ante and ex post perspectives. The literature that takes the goal of providing equal opportunities as the guiding principle generally considers that this is implemented only when, ex post, all individuals with the same effort obtain equal success. It is easy to believe that ex ante compensation is another natural embodiment of the same idea. We show that this is not true.
Real Output of Bank Services: What Counts is What Banks Do, Not What They Own
Authors: Inklaar Robert , Wang J. Christina
Published: July 2012

We argue that models of banks as processors of information and transactions imply a quantity measure of bank output based on transaction counts instead of balances of loans and deposits. Compiling new and comparable real output measures for the USA and a range of European countries, we show that counts‐based output series exhibit substantially different growth patterns than balances‐based output series. Since the US official statistics rely on counts while European statistics rely on balances, this implies that comparisons of bank output growth between Europe and the USA are biased.
Novel SPG10 mutation associated with dysautonomia, spinal cord atrophy, and skin biopsy abnormality
Authors: Collongues N. , Depienne C. , Boehm N. , Echaniz‐Laguna A. , Samama B. , Dürr A. , Stevanin G. , Leguern E. , Brice A. , Labauge P. , de Seze J.
Published: July 2012

Background

SPG10 is a rare form of autosomic dominant hereditary spastic paraplegia (HSP) caused by mutations in the KIF5A gene, which may be involved in axonal transport.

Methods

We report the characteristics of a French family with a novel missense mutation c.580 G>C in exon 7 of the KIF5A gene.

Results

The proband and his sister presented with an adult onset HSP, a sensory spinal cord‐like syndrome, dysautonomia, and severe axonal polyneuropathy. Contrary to the proband, his sister presented a secondary improvement in spasticity and walking. In the proband, MRI findings consisted in spinal cord atrophy and symmetric cerebral demyelination, whereas the skin biopsy suggested a defect in the number of vesicles and synaptophysin density at the pre‐synaptic membrane.

Conclusion

This study extends the phenotype of SPG10 and argues for abnormalities in the axonal vesicular transport.
Detection of intracranial circulatory arrest in brain death using cranial CT‐angiography
Authors: Welschehold S. , Kerz T. , Boor S. , Reuland K. , Thömke F. , Reuland A. , Beyer C. , Wagner W. , Müller‐Forell W. , Giese A.
Published: July 2012

Background and purpose

Computed tomographic‐angiography (CT‐A) is becoming more accepted in detecting intracranial circulatory arrest in brain death (BD). An international consensus about the use and the parameters of this technique is currently not established. We examined intracranial contrast enhancement in CT‐A after clinically confirmed BD, compared the results with electroencephalography (EEG) and Transcranial Doppler Ultrasonography (TCD) findings and developed a commonly applicable CT‐A protocol.

Methods

Prospective, monocentric study between April 2008 and October 2011. EEG, TCD and CT‐A were performed in 63 patients aged between 18 and 88 years (mean, 55 years) who fulfilled clinical criteria of BD. Evaluation of opacification of cerebral vascular territories in CT‐A was performed in arterial as well as in venous scanning series by a neuroradiologist and a neurointensivist/neurosurgeon together.

Results

CT‐A demonstrated a 95% sensitivity in detecting intracranial circulatory arrest when analysing arterial scanning series. We never observed venous blood return in internal cerebral veins. In three cases, BD confirmation by EEG failed because of artefacts. Confirmation of BD by TCD failed in two cases because of absent temporal window. In three cases, TCD demonstrated residual blood flow.

Conclusion

CT‐A is easily accessible in almost every hospital, offers a high spatio‐temporal resolution, is operator independent and inexpensive. The results of CT‐A are comparable to other established brain perfusion techniques in BD. An international consensus should be established to ascertain consistent parameters similar to fixed guidelines for other ancillary procedures to determine BD in order to prevent different scanning and evaluation protocols for detecting intracranial circulatory arrest.
Cerebral palsy, neurogenic bladder, and outcomes of lifetime care
Authors: MURPHY KEVIN P , BOUTIN SUSAN A , IDE KATHY R
Published: July 2012

Aim  To determine the prevalence of symptomatic neurogenic bladder (SNB) and social and functional variables in a large sample of people with cerebral palsy (CP).

Method  The medical records of 214 individuals (96 females, 118 males) with CP between the years 1990 and 2000 were retrospectively reviewed. Individuals with frequency, urgency, or incontinence were assigned Gross Motor Function Classification System levels and underwent cystometrogram/electromyelogram studies. Neurogenic bladders were classified according to the nomenclature of the International Continence Society.

Results  Fifty‐two patients had hemiplegia, 42 diplegia, 117 quadriplegia, and three dyskinesia. Educational levels ranged from full special education to those with graduate degrees. Thirty‐five individuals in our group aged 5 to 66 years had SNB with a prevalence of 16.4%. The median age for the entire population was 9 years 7 months and for those with SNB 12 years 4 months (range 5–57y). Over 80% of individuals who underwent investigation were found to have spastic hyper‐reflexic type bladders. Ninety‐one percent obtained total continence or major improvement with conservative care. SNB was documented across the lifespan, educational spectrum, and functional level. Upper urinary tract pathology was infrequent.

Interpretation  SNB is a common finding in individuals with CP. In most patients it is readily diagnosed and treated with conservative interventions.
Srp20 regulates TrkB pre‐mRNA splicing to generate TrkB‐Shc transcripts with implications for Alzheimer’s disease
Authors: Wong Jenny , Garner Brett , Halliday Glenda M. , Kwok John B. J.
Published: July 2012

Previously, we reported elevated levels of the neuron‐specific tropomyosin receptor kinase B (TrkB) transcript, TrkB‐ sarc homology containing (Shc) in the hippocampus of Alzheimer’s disease (AD) brains. In this study, we determined how TrkB‐Shc transcripts are increased in AD. Utilizing a TrkB minigene transiently transfected into SHSY5Y cells, we found increased exon 19 inclusion in TrkB minigene transcripts (to generate TrkB‐Shc) following cellular exposure to amyloid beta 1–42 (Αβ42). As this suggested altered TrkB pre‐mRNA splicing in AD, we conducted an in silico screening for putative splice regulatory protein‐binding sites in the intron/exon splice regulatory regions of exons 18 and 19 of the TrkB gene and then assessed their gene expression profiles using a microarray database of control/AD post‐mortem human hippocampal brain tissue. We found significant changes in serine/arginine protein 20 (Srp20) gene expression in AD cases and confirmed this using a second cohort of control/AD. In vitro, we found increased Srp20 mRNA levels in SHSY5Y cells treated with Αβ42 fibrils. Moreover, Srp20 over‐expression was found to increase exon 19 inclusion in TrkB minigene transcripts and ratio of endogenous TrkB‐Shc:TrkB‐TK+ mRNA expression. Conversely, Srp20 expression knockdown produced the opposite effects. Our findings suggest that dysregulation of factors regulating TrkB pre‐mRNA splicing may contribute to gene expression changes that occur in AD.
First record of an Early Barremian caprinid rudist from Japan – implications for the palaeobiogeography of the Caprinidae (Bivalvia)
Authors: SANO SHIN‐ICHI , SKELTON PETER W. , WATARAI MEGUMI , IBA YASUHIRO , KONDO YASUO , SATO YUICHIRO
Published: July 2012

Abstract:  Pachytraga Paquier, 1900, the stratigraphically oldest genus of caprinine caprinid rudist, was previously known from only two chronospecies from a single lineage, that is the Hauterivian P. tubiconcha Astre, 1961 and the early Aptian P. paradoxa (Pictet and Campiche, 1869). Here, a new species, Pachytraga? tanakahitoshii, is erected on the basis of isolated left valves recovered from the Osaka and Sanchu areas, south‐west Japan. This species has a moderate shell size (antero‐posterior commissural diameter c. 30 mm), and its left valve is characterized by at least one possibly autapomorphic character (narrow anterior myophore, inclined inwards), as well as a mosaic of primitive (single longitudinal carina developed on the anterior side) and derived (simple marginal canals in the antero‐dorsal valve margin) characters of Mediterranean and Middle East Tethyan Pachytraga. The Japanese Pachytraga? represents the first probable record of this genus outside the Mediterranean/Middle Eastern Tethyan province, and its early Barremian age partly fills the ‘gap’ in its previously known stratigraphical record, although the evolutionary relationship of the Japanese form with Mediterranean and Middle East Tethyan Pachytraga remains unsolved. However, the discovery of early Barremian Pachytraga? in Japan indicates that the evolutionary history of the genus is more complex than previously thought and should thus be discussed in a broader palaeogeographical context that must now include the Pacific.
World History, MesoAmerica, and the Native American Southwest
Authors: Dirk Raat W.
Published: July 2012

Until recently, the academic discipline of the New Archaeology has largely thought of the people of the American Southwest in small‐scale, regional, ahistorical, and cross‐cultural terms.1 Changes in contemporary historiography, especially the rise of a new world or global history (and world‐system analyses), are now affecting archaeological (and anthropological) thinking, and the result is a historically‐oriented sociology and archaeology of the indigenous Southwest that views regional groups in continental, and even, hemispheric terms. Thus the impact of Mesoamerica in general, and western Mexico in particular, on the American Southwest is becoming a common topic of current archaeological studies. The concern of this essay will be first, to summarize briefly these historiographical trends, then argue generally for the Mesoamerican (and western Mexican) connection.
Caste Politics and Partition in South Asian History
Authors: Sen Dwaipayan
Published: July 2012

Over approximately the last fifteen years, historians have increasingly sought to examine the effects and implications of Partition – the event that culminated in the formation of India and Pakistan in 1947 – for caste politics and the experience of caste. Along with the growth of scholarly attention to this question, historical debate has emerged about how most accurately to characterize these effects. This article surveys this body of research by charting the gradual emergence of differing interpretations on the entanglements of Partition, the transfer of power, and caste politics and experience in Bengal, Punjab, the United Provinces and India, more generally. It argues that whereas scholars have produced conflicting accounts, only further research and reflection on the wider significance of this intersection will lead to the emergence of a clearer picture about how caste politics were transformed over the cusp of Partition and the immediate context of the transition from colonial to postcolonial rule in South Asia.
Association Between the Part D Coverage Gap and Adverse Health Outcomes
Authors: Polinski Jennifer M. , Shrank William H. , Glynn Robert J. , Huskamp Haiden A. , Christopher Roebuck M. , Schneeweiss Sebastian
Published: July 2012

Objectives

To determine whether Part D coverage gap entry is associated with risk of death or hospitalization for cardiovascular outcomes.

Design

Prospective cohort study. Beneficiaries entered the study upon reaching the coverage gap spending threshold and were observed until an outcome reaching the threshold for catastrophic coverage occurred or year's end. Nine thousand four hundred thirty‐six exposed individuals (those who were responsible for drug costs in the gap) were compared with 9,436 unexposed individuals (those who received financial assistance) based on propensity score (PS) or high‐dimensional propensity score (hdPS).

Setting

Medicare Part D drug insurance.

Participants

Three hundred three thousand nine hundred seventy‐eight Medicare beneficiaries aged 65 and older in 2006 and 2007 with linked prescription and medical claims who enrolled in stand‐alone Part D or retiree drug plans and reached the gap spending threshold.

Measurements

Rates of death and hospitalization for any of five cardiovascular outcomes, including acute coronary syndrome with revascularization (ACS), after reaching the coverage gap spending threshold were compared using Cox proportional hazards models.

Results

In PS‐matched analyses, exposed beneficiaries had higher, albeit not significantly so, hazard of death (hazard ratio (HR) = 1.25, 95% confidence interval (CI) = 0.98–1.59) and ACS (HR = 1.16, 95% CI = 0.83–1.62) than unexposed beneficiaries. hdPS‐matched analyses minimized residual confounding and confirmed results (death: HR = 0.99, 95% CI = 0.78–1.24; ACS: HR = 1.07, 95% CI = 0.81–1.41). Exposed beneficiaries were no more or less likely to experience other outcomes than were those who were unexposed.

Conclusion

During the short‐term coverage gap period, having no financial assistance to pay for drugs was not associated with greater risk of death or hospitalization for cardiovascular causes, although long‐term health consequences remain unclear.