bluuebunny/crossref_metadata_2025 huggingface dataset:
Imagining flood futures: risk assessment and management in practice
Authors: Lane Stuart N. , Landström Catharina , Whatmore Sarah J.
Published: April 2011

The mantra that policy and management should be ‘evidence-based’ is well established. Less so are the implications that follow from ‘evidence’ being predictions of the future (forecasts, scenarios, horizons) even though such futures define the actions taken today to make the future sustainable. Here, we consider the tension between ‘evidence’, reliable because it is observed, and predictions of the future, unobservable in conventional terms. For flood risk management in England and Wales, we show that futures are actively constituted, and so imagined, through ‘suites of practices’ entwining policy, management and scientific analysis. Management has to constrain analysis because of the many ways in which flood futures can be constructed, but also because of commitment to an accounting calculus, which requires risk to be expressed in monetary terms. It is grounded in numerical simulation, undertaken by scientific consultants who follow policy/management guidelines that define the futures to be considered. Historical evidence is needed to deal with process and parameter uncertainties and the futures imagined are tied to pasts experienced. Reliance on past events is a challenge for prediction, given changing probability (e.g. climate change) and consequence (e.g. development on floodplains). So, risk management allows some elements of risk analysis to become unstable (notably in relation to climate change) but forces others to remain stable (e.g. invoking regulation to prevent inappropriate floodplain development). We conclude that the assumed separation of risk assessment and management is false because the risk calculation has to be defined by management. Making this process accountable requires openness about the procedures that make flood risk analysis more (or less) reliable to those we entrust to produce and act upon them such that, unlike the ‘pseudosciences’, they can be put to the test of public interrogation by those who have to live with their consequences.
Plants: biofactories for a sustainable future?
Authors: Jenkins Thomas , Bovi Aurélie , Edwards Robert
Published: April 2011

Depletion of oil reserves and the associated effects on climate change have prompted a re-examination of the use of plant biomass as a sustainable source of organic carbon for the large-scale production of chemicals and materials. While initial emphasis has been placed on biofuel production from edible plant sugars, the drive to reduce the competition between crop usage for food and non-food applications has prompted massive research efforts to access the less digestible saccharides in cell walls (lignocellulosics). This in turn has prompted an examination of the use of other plant-derived metabolites for the production of chemicals spanning the high-value speciality sectors through to platform intermediates required for bulk production. The associated science of biorefining, whereby all plant biomass can be used efficiently to derive such chemicals, is now rapidly developing around the world. However, it is clear that the heterogeneity and distribution of organic carbon between valuable products and waste streams are suboptimal. As an alternative, we now propose the use of synthetic biology approaches to ‘re-construct’ plant feedstocks for optimal processing of biomass for non-food applications. Promising themes identified include re-engineering polysaccharides, deriving artificial organelles, and the reprogramming of plant signalling and secondary metabolism.
Global health and climate change: moving from denial and catastrophic fatalism to positive action
Authors: Costello Anthony , Maslin Mark , Montgomery Hugh , Johnson Anne M. , Ekins Paul
Published: April 2011

The health effects of climate change have had relatively little attention from climate scientists and governments. Climate change will be a major threat to population health in the current century through its potential effects on communicable disease, heat stress, food and water security, extreme weather events, vulnerable shelter and population migration. This paper addresses three health-sector strategies to manage the health effects of climate change—promotion of mitigation, tackling the pathways that lead to ill-health and strengthening health systems. Mitigation of greenhouse gas (GHG) emissions is affordable, and low-carbon technologies are available now or will be in the near future. Pathways to ill-health can be managed through better information, poverty reduction, technological innovation, social and cultural change and greater coordination of national and international institutions. Strengthening health systems requires increased investment in order to provide effective public health responses to climate-induced threats to health, equitable treatment of illness, promotion of low-carbon lifestyles and renewable energy solutions within health facilities. Mitigation and adaptation strategies will produce substantial benefits for health, such as reductions in obesity and heart disease, diabetes, stress and depression, pneumonia and asthma, as well as potential cost savings within the health sector. The case for mitigating climate change by reducing GHGs is overwhelming. The need to build population resilience to the global health threat from already unavoidable climate change is real and urgent. Action must not be delayed by contrarians, nor by catastrophic fatalists who say it is all too late.
Disease appearance and evolution against a background of climate change and reduced resources
Authors: Yacoub Sophie , Kotit Susy , Yacoub Magdi H.
Published: April 2011

Global health continues to face increasing challenges owing to a variety of reasons that include the almost constant changes in disease appearance and evolution. Most, but not all, of these changes affect low-income countries and are influenced by climate change. Tracking the recent and anticipated changes in the demographics and global distribution of these changes is essential for evolving effective new methods for dealing with the problems. The recent recognition by the United Nations of the importance of non-communicable diseases is a major positive step. For the sake of this paper, the following diseases were chosen: dengue and malaria, to highlight the role of climate change on vector-borne diseases. Drug-resistant tuberculosis illustrates the role of globalization and reduced resources on disease evolution. The continuing rise in cardiovascular mortality and morbidity, particularly in resource-poor countries is largely attributed to lack of preventive and therapeutic measures against such conditions as hypertension, diabetes, atherosclerosis and congenital heart disease as well as neglected diseases, of which Chagas and rheumatic heart disease will be discussed further.
Alternative life histories in Xiphophorus multilineatus: evidence for different ages at sexual maturity and growth responses in the wild
Authors: Bono L. M. , Rios‐Cardenas O. , Morris M. R.
Published: April 2011

In order to examine potential trade‐offs in alternative life histories of the high‐backed pygmy swordtail Xiphophorus multilineatus, otoliths were used from wild‐caught males to determine if sneaker males had the advantage of maturing earlier in natural environments. The sneakers matured significantly earlier than courters, but there was no difference among the three courter variants. In addition, analyses suggested that the effect of the pituitary locus on size at sexual maturity and growth rates was a consequence of age at sexual maturity. Finally, one of the courter variants had a significantly different relationship between age and size at sexual maturity than the other variants, suggesting that in this variant, age at sexual maturity may be more closely related to size and therefore may be less plastic in its growth responses.
Ontogeny of swimming speed, schooling behaviour and jellyfish avoidance by Japanese anchovy Engraulis japonicus
Authors: Masuda R.
Published: April 2011

The ontogeny of swimming speed, schooling behaviour and jellyfish avoidance was studied in hatchery‐reared Japanese anchovy Engraulis japonicus to compare its life‐history strategy with two other common pelagic fishes, jack mackerel Trachurus japonicus and chub mackerel Scomber japonicus. Cruise swimming speed of E. japonicus increased allometrically from 1·4 to 3·9 standard length (LS) per s (LS s−1) from early larval to metamorphosing stage. Burst swimming speed also increased from 6·1 to 28 LS s−1 in these stages. Cruise speed was inferior to that of S. japonicus, as was burst speed to that of T. japonicus. Engraulis japonicus larvae were highly vulnerable to predation by moon jellyfish Aurelia aurita and were readily eaten until they reached 23 mm LS, but not at 26 mm LS. Schooling behaviour (indicated by parallel swimming) started at c. 17 mm LS. Average distance to the nearest neighbour was shorter than values reported in other pelagic fishes. The relatively low predator avoidance capability of E. japonicus may be compensated for by their transparent and thus less conspicuous body, in addition to their early maturation and high fecundity.
Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China
Authors: Li Jian , Liu Hongjie , Li Jianhua , Luo Jian , Koram Nana , Detels Roger
Published: April 2011

Aims  To investigate the patterns of concurrent sexual partnerships among young opiate users and sexual transmissibility of human immunodeficiency virus (HIV) in concurrent sexual partnerships in drug‐use and sexual networks.

Design  Cross‐sectional design.

Participants  A total of 426 young opiate users in Yunnan, China.

Setting  Young opiate users recruited from their network ties.

Measurement  Respondent‐driven sampling (RDS) was used to recruit participants. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with egocentric social network components, risky sexual behavior for HIV and drug‐use practices.

Findings  The RDS‐adjusted prevalence of concurrent sexual partners was 42.9% among opiate users. Opiate users with concurrent sexual partnerships were more likely to engage in risky HIV‐related sexual behavior, compared to those without. Specifically, they were more likely to report having had four or more sexual partners (26.3% versus 2.0%), having had a spouse or boy/girlfriends who also had concurrent sexual partnerships (28.1% versus 8.2%), having exchanged drug for sex (12.4% versus 3.8%), having had sexual partners who were non‐injection drug users (22.6% versus 10.1%), having had sexual partners who were injection drug users (25.3% versus 13.5%) and having used club drugs (26.3% versus 13.5%). There were no significant differences in consistent condom use between opiate users with sexual concurrency and those without. The same proportion (25.8%) of opiate users in the two groups reported having consistently used condoms when having sex with regular partners, and 46.3% of opiate users with sexual concurrency and 36.4% of those without such concurrency consistently used condoms with non‐regular partners.

Conclusion  The expansion of the human immunodeficiency virus epidemic from high‐risk populations to the general population in China may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated into harm reduction programmes.
Comparison of analgesic efficacy of subcostal transversus abdominis plane blocks with epidural analgesia following upper abdominal surgery
Authors: Niraj G. , Kelkar A. , Jeyapalan I. , Graff‐Baker P. , Williams O. , Darbar A. , Maheshwaran A. , Powell R.
Published: April 2011

Subcostal transversus abdominis plane (TAP) catheters have been reported to be an effective method of providing analgesia after upper abdominal surgery. We compared their analgesic efficacy with that of epidural analgesia after major upper abdominal surgery in a randomised controlled trial. Adult patients undergoing elective open hepatobiliary or renal surgery were randomly allocated to receive subcostal TAP catheters (n = 29) or epidural analgesia (n = 33), in addition to a standard postoperative analgesic regimen comprising of regular paracetamol and tramadol as required. The TAP group patients received bilateral subcostal TAP catheters and 1 mg.kg−1 bupivacaine 0.375% bilaterally every 8 h. The epidural group patients received an infusion of bupivacaine 0.125% with fentanyl 2 μg.ml−1. The primary outcome measure was visual analogue pain scores during coughing at 8, 24, 48 and 72 h after surgery. We found no significant differences in median (IQR [range]) visual analogue scores during coughing at 8 h between the TAP group (4.0 (2.3–6.0 [0–7.5])) and epidural group (4.0 (2.5–5.3) [0–8.5])) and at 72 h (2.0 (0.8–4.0 [0–5]) and 2.5 (1.0–5.0 [0–6]), respectively). Tramadol consumption was significantly greater in the TAP group (p = 0.002). Subcostal TAP catheter boluses may be an effective alternative to epidural infusions for providing postoperative analgesia after upper abdominal surgery.
Anaesthesia for a patient with paraneoplastic limbic encephalitis with ovarian teratoma: relationship to anti‐N‐methyl‐d‐aspartate receptor antibodies
Authors: Kawano H. , Hamaguchi E. , Kawahito S. , Tsutsumi Y. M. , Tanaka K. , Kitahata H. , Oshita S.
Published: April 2011

Paraneoplastic limbic encephalitis associated with ovarian teratoma has recently been related to the development of antibodies to specific heteromers of the N‐methyl‐d‐aspartate receptor and exhibits various manifestations including psychiatric symptoms, hypoventilation, seizures and derangement of autonomic nervous system function. Although recovery can sometimes occur spontaneously, early tumour resection with immunotherapy facilitates earlier recovery. Herein, we describe anaesthetic management of a 20‐year‐old woman who developed general convulsions and decreased level of consciousness, whom we suspected of having paraneoplastic limbic encephalitis and was scheduled for left ovarian tumour resection. Anaesthetic management was successful with no complications but the case acts as focus of discussion for the potential interaction of N‐methyl‐d‐aspartate receptors and anaesthetic sensitivity.
Late-onset Fabry disease associated with angiokeratoma of Fordyce and multiple cherry angiomas
Authors: Hogarth V. , Dhoat S. , Mehta A. B. , Orteu C. H.
Published: April 2011

Fabry disease (FD) is a lysosomal storage disorder. The prevalence and clinical spectrum is higher than previously thought. The average time between onset of symptoms and diagnosis is 10 years. Early identification of patients is essential to institute enzyme therapy and reduce morbidity. We report the case of a 76-year-old man, who presented with loss of consciousness following exertional chest pain. He was found to have tortuous corneal vessels, > 100 cherry angiomas on his trunk, and angiokeratomas on his scrotum. The latter were indistinguishable from angiokeratoma of Fordyce, a diagnosis reported in 15% of men over the age of 50 years, and generally ignored by them. The patient’s α-galactosidase levels were low, and a mutation in exon 5 of the GLA gene was identified on DNA analysis, confirming the diagnosis of FD. This case highlights the importance of considering a diagnosis of FD in all male patients with angiokeratoma. It also raises the question of whether the presence of multiple cherry angiomas in patients with cardiac disease should raise the possible diagnosis of FD.
Joint elastic‐electrical effective medium models of reservoir sandstones
Authors: Han Tongcheng , Best Angus I. , MacGregor Lucy M. , Sothcott Jeremy , Minshull Tim A.
Published: April 2011

Improvements in the joint inversion of seismic and marine controlled source electromagnetic data sets will require better constrained models of the joint elastic‐electrical properties of reservoir rocks. Various effective medium models were compared to a novel laboratory data set of elastic velocity and electrical resistivity (obtained on 67 reservoir sandstone samples saturated with 35 g/l brine at a differential pressure of 8 MPa) with mixed results. Hence, we developed a new three‐phase effective medium model for sandstones with pore‐filling clay minerals based on the combined self‐consistent approximation and differential effective medium model. We found that using a critical porosity of 0.5 and an aspect ratio of 1 for all three components, the proposed model gave accurate model predictions of the observed magnitudes of P‐wave velocity and electrical resistivity and of the divergent trends of clean and clay‐rich sandstones at higher porosities. Using only a few well‐constrained input parameters, the new model offers a practical way to predict in situ porosity and clay content in brine saturated sandstones from co‐located P‐wave velocity and electrical resistivity data sets.
A systematic review of the management and outcomes of pregnancy in Glanzmann thrombasthenia
Authors: SIDDIQ S. , CLARK A. , MUMFORD A.
Published: April 2011

Summary.  Glanzmann Thrombasthenia (GT) is a rare autosomal recessive disorder which usually manifests as severe mucocutaneous bleeding and is caused by deficiency of the platelet glycoprotein IIb‐IIIa. Pregnancy in women with GT presents particular challenges as there is increased risk of both maternal and foetal bleeding. To improve understanding and clarify the optimum management of pregnancy in this disorder, we performed a systematic review of the world literature of pregnancy and GT. This identified three single‐centre case series of patients with GT that included brief descriptions of women in pregnancy and 31 detailed case reports of 40 pregnancies in 35 women that resulted in 38 live births. Among the detailed case reports, ante‐natal bleeding was described in 50% of pregnancies but was usually mild and occurred at mucocutaneous sites. Primary postpartum haemorrhage (PPH) was reported in 34% of pregnancies and secondary PPH in 24%. PPH was frequently severe and occurred up to 20 days after delivery. There was a wide variation in approach to prevention and treatment of PPH but most women received platelet transfusion, sometimes with additional recombinant FVIIa and anti‐fibrinolytics. Maternal alloimmunization against platelet antigens was reported in 73% of pregnancies and was associated with four neonatal deaths. These data emphasize the need for multidisciplinary management of pregnancy in women with GT. Delivery plans should recognize the need for prevention and aggressive treatment of PPH and should minimize foetal bleeding risk in pregnancies complicated by alloimmunization.
The use of the new ReFacto AF Laboratory Standard allows reliable measurement of FVIII:C levels in ReFacto AF mock plasma samples by a one‐stage clotting assay
Authors: POUPLARD C. , CARON C. , AILLAUD M. F. , TERNISIEN C. , DESCONCLOIS C. , DUBANCHET A. , SOBAS F.
Published: April 2011

Summary.  Factor VIII coagulant (FVIII:C) levels measured in patients receiving ReFacto® (B‐domain‐deleted recombinant FVIII) using chromogenic substrate assay (CSA) and one‐stage clotting assay (OSA) have frequently shown discrepancies, and the use of the ReFacto Laboratory Standard (RLS) has therefore been recommended to minimize these differences. The potency of ReFacto AF®, the albumin‐free successor of ReFacto®, is determined using CSA for the titration of vials, and a new standard (RLS‐AF) was developed to measure its biological efficacy using OSA. This multicentre study therefore evaluated the efficacy of this new RLS in minimizing differences between OSA and CSA when measuring FVIII:C levels in plasma. Mock plasma samples were prepared by diluting ReFacto AF® in FVIII‐deficient plasma to obtain four concentrations ranging from 15 to 90 IU dL−1. FVIII:C levels were then measured in six laboratories on four separate days using three different procedures, i.e. OSA with a plasma standard (PS) as reference, OSA with RLS‐AF and CSA with PS. The inter‐centre standard deviation ranged from 1.4 to 5.5 IU dL−1. However, FVIII:C levels measured with OSA were closer to the expected values when RLS‐AF was used. In addition, the uncertainty of measurement, reflecting the inter‐method discrepancy was greatly reduced when RLS‐AF was employed in OSA (15%) in place of PS (33%). This study demonstrates that the OSA performed with RLS‐AF to establish calibration curves provides a valuable alternative to CSA to measure FVIII:C in ReFacto‐AF‐treated patients.
The association between blood pressure in adolescents and the consumption of fruits, vegetables and fruit juice – an exploratory study
Authors: Damasceno Marta MC , de Araújo Márcio FM , Freire de Freitas Roberto WJ , de Almeida Paulo C , Zanetti Maria L
Published: April 2011

Objective.  The objective of this study was to correlate blood pressure levels with the consumption of fruit, vegetables and pulses and fruit juice among Brazilian adolescents.

Background.  Scientific evidence has shown a relationship between the regular consumption of vegetables and the prevention of cardiovascular disturbances, such as arterial hypertension, cerebrovascular disease and dyslipidemia.

Design.  A cross‐sectional and correlational study was designed involving a random sample of 794 adolescents from 12 private schools located in a metropolitan area in the north‐east of Brazil.

Method.  The subjects responded to a questionnaire structured so as to investigate their regular consumption of fruits, vegetables, pulses and juice. Blood pressure was measured three times, with an interval of one minute between each measurement. The average of the last two measurements was used for the study. The chi‐square test, Kruskal–Wallis test and Spearman’s rank correlation were used to investigate the association between blood pressure and the consumption of fruit, vegetables, pulses and juice.

Results.  Lower values of systolic and diastolic blood pressure were identified in adolescents with a consumption of fruit ≥twice daily (p < 0·001). In the case of vegetables and pulses, systolic blood pressure was lower among adolescents who consumed more of this type of food (p = 0·021).

Conclusions.  This study concluded that adolescents who consume more fruit have lower systolic and diastolic blood pressure, while those who regularly consume vegetables and pulses also had lower levels of systolic pressure.

Relevance to clinical practice.  The results of this study suggest that nurses can develop health education activities in schools to encourage the consumption of fruits, vegetables, pulses and fruit juices, especially among those adolescents who are more likely to develop arterial hypertension.
Phylogeography of the Atlanto‐Mediterranean sea cucumber Holothuria (Holothuria) mammata: the combined effects of historical processes and current oceanographical pattern
Authors: BORRERO‐PÉREZ G. H. , GONZÁLEZ‐WANGÜEMERT M. , MARCOS C. , PÉREZ‐RUZAFA A.
Published: April 2011

We assessed the genetic structure of populations of the widely distributed sea cucumber Holothuria (Holothuria) mammata Grube, 1840, and investigated the effects of marine barriers to gene flow and historical processes. Several potential genetic breaks were considered, which would separate the Atlantic and Mediterranean basins, the isolated Macaronesian Islands from the other locations analysed, and the Western Mediterranean and Aegean Sea (Eastern Mediterranean). We analysed mitochondrial 16S and COI gene sequences from 177 individuals from four Atlantic locations and four Mediterranean locations. Haplotype diversity was high (H = 0.9307 for 16S and 0.9203 for COI), and the haplotypes were closely related (π = 0.0058 for 16S and 0.0071 for COI). The lowest genetic diversities were found in the Aegean Sea population. Our results showed that the COI gene was more variable and more useful for the detection of population structure than the 16S gene. The distribution of mtDNA haplotypes, the pairwise FST values and the results of exact tests and amova revealed: (i) a significant genetic break between the population in the Aegean Sea and those in the other locations, as supported by both mitochondrial genes, and (ii) weak differentiation of the Canary and Azores Islands from the other populations; however, the populations from the Macaronesian Islands, Algarve and West Mediterranean could be considered to be a panmictic metapopulation. Isolation by distance was not identified in H. (H.) mammata. Historical events behind the observed findings, together with the current oceanographic patterns, were proposed and discussed as the main factors that determine the population structure and genetic signature of H. (H.) mammata.
Patterns of alcohol consumption among pregnant African‐American women in Washington, DC, USA
Authors: Kiely Michele , Thornberry Jutta S. , Bhaskar Brinda , Rodan Margaret F.
Published: April 2011

Kiely M, Thornberry JS, Bhaskar B, Rodan MF. Patterns of alcohol consumption among pregnant African‐American women in Washington, DC, USA. Paediatric and Perinatal Epidemiology 2011; 25: 328–339.

The objective of this paper is to describe the patterns and associated behaviours related to alcohol consumption among a selected sample of pregnant women seeking prenatal care in inner city Washington DC. Women receiving prenatal care at one of nine sites completed an anonymous alcohol‐screening questionnaire. Questions concerned the amount, type and pattern of alcohol consumption. Women were categorised as at no, low, moderate or high risk for alcohol consumption during pregnancy. For comparisons of risk levels of drinking, bivariate associations were examined using Fisher's exact test. Odds ratios (ORs) and 95% confidence intervals (CIs) were also computed. Although 31% of current/recent drinkers stated that they continued to drink during pregnancy, responses to quantity/frequency questions revealed that 42% continued to do so. Women who were at high compared with moderate risk acknowledged that others were worried about their consumption [OR = 4.0, 95% CI 1.5, 10.6], that they drank upon rising [OR = 6.7, 95% CI 1.8, 26.9], had a need to reduce drinking [OR = 3.2, 95% CI 1.3, 8.1] and in the past 5 years had had fractures [OR = 4.2, 95% CI 1.0, 17.8] or a road traffic injury [OR = 3.4, 95% CI 1.0, 12.2]. Women in the high/moderate compared with low‐risk group were more likely to have been injured in a fight or assault [OR = 2.7, 95% CI 1.3, 5.6]. This study validated the usefulness of our questionnaire in identifying women who were at risk for alcohol consumption during pregnancy across a range of consumption levels. Using our screening tool, women were willing to disclose their drinking habits. This low‐cost method identifies women appropriate for targeting of interventions.
Cardiac allograft vasculopathy: current knowledge and future direction
Authors: Colvin‐Adams Monica , Agnihotri Adheesh
Published: April 2011

Colvin‐Adams M, Agnihotri A. Cardiac allograft vasculopathy: current knowledge and future direction. Clin Transplant 2011: 25: 175–184. © 2011 John Wiley & Sons A/S.

Abstract:  Cardiac allograft vasculopathy (CAV) is a unique form of coronary artery disease affecting heart transplant recipients. Although prognosis of heart transplant recipients has improved over time, CAV remains a significant cause of mortality beyond the first year of cardiac transplantation. Many traditional and non‐traditional risk factors for the development of CAV have been described. Traditional risk factors include dyslipidemia, diabetes and hypertension. Non‐traditional risk factors include cytomegalovirus infection, HLA mismatch, antibody‐mediated rejection, and mode of donor brain death. There is a complex interplay between immunological and non‐immunological factors ultimately leading to endothelial injury and exaggerated repair response. Pathologically, CAV manifests as fibroelastic proliferation of intima and luminal stenosis. Early diagnosis is paramount as heart transplant recipients are frequently asymptomatic owing to cardiac denervation related to the transplant surgery. Intravascular ultrasound (IVUS) offers many advantages over conventional angiography and is an excellent predictor of prognosis in heart transplant recipients. Many non‐invasive diagnostic tests including dobutamine stress echocardiography, CT angiography, and MRI are available; though, none has replaced angiography. This review discusses the risk factors, pathogenesis, and diagnosis of CAV and highlights some current concepts and recent developments in this field.
Serum albumin, subjective global assessment, body mass index and the bioimpedance analysis in the assessment of malnutrition in patients up to 15 years after liver transplantation
Authors: Wagner D. , Adunka C. , Kniepeiss D. , Jakoby E. , Schaffellner S. , Kandlbauer M. , Fahrleitner‐Pammer A. , Roller R.E. , Kornprat P. , Müller H. , Iberer F. , Tscheliessnigg K.H.
Published: April 2011

Wagner D, Adunka C, Kniepeiss D, Jakoby E, Schaffellner S, Kandlbauer M, Fahrleitner‐Pammer A, Roller RE, Kornprat P, Müller H, Iberer F, Tscheliessnigg KH. Serum albumin, subjective global assessment, body mass index and the bioimpedance analysis in the assessment of malnutrition in patients up to 15 years after liver transplantation. Clin Transplant 2011: 25: E396–E3400. © 2011 John Wiley & Sons A/S.

Abstract:  Background:  The subjective global assessment (SGA) or the body mass index (BMI) is used to determine the nutritional state after LTX. Bioelectrical impedance analysis (BIA) is used as tool to determine body composition by nutritional care professionals.

Methods:  BIA, SGA, BMI, and serum albumin (SA) levels were performed to assess malnutrition following liver transplantation. BIA measurement was used as reference standard to determine existing malnutrition. A phase angle (PA) <5 was used to define potentially existing chronic disease‐related malnutrition as a standard. All other measured parameters were compared with respect to their prognostic accuracy regarding the prediction of malnutrition as compared to the mentioned standard.

Results:  Seventy‐one recipients (51 men, 20 women) were included. Median age was 58, weight 77 kg, BMI 26 kg/m2, PA 4.1°, and SA 4.3 g/dL. According to the Nutritional Risk Screening 2002, 9.4% (6/71), to BMI 15.4% (11/71), to SA 30.9% (22/71), and to BIA 36.5% (28/71) of the patients were malnourished. PA did not correlate with BMI or NA, there was a significant correlation with SA (p = 0.001). Univariate analysis revealed SA as independent predictor for malnutrition. ROC analysis for all parameters revealed a significantly (p < 0.05) better area under the receiver operating characteristic curve for SA (0.812) than for BMI (0.603) for the prediction of malnutrition.

Conclusion:  SGA or BMI calculation alone does not suffice to evaluate the nutritional status. SA seems to play a crucial role in the prediction of severe disease‐related malnutrition in this special patient cohort.
Conversion from sirolimus to everolimus in kidney transplant recipients receiving a calcineurin‐free regimen
Authors: Carvalho Catarina , Coentrão Luis , Bustorff Manuela , Patrício Emilia , Sampaio Susana , Santos Joana , Oliveira Gerardo , Pestana Manuel
Published: April 2011

Carvalho C, Coentrão L, Bustorff M, Patrício E, Sampaio S, Santos J, Oliveira G, Pestana M. Conversion from sirolimus to everolimus in kidney transplant recipients receiving a calcineurin‐free regimen. Clin Transplant 2011: 25: E401–E405. © 2011 John Wiley & Sons A/S.

Abstract:  Background:  Everolimus (EVL) and sirolimus (SRL) were introduced into immunosuppressive regimens, in an attempt to replace or reduce the dose of the nephrotoxic calcineurin inhibitors (CNI). In our institution, due to an administrative decision, conversion from SRL to EVL, was carried out, providing us the opportunity to investigate the effectiveness and safety profile of both drugs and to review the practical conversion dose between them.

Methods:  We retrospectively analyzed the medical records of 51 maintenance kidney transplant recipients receiving an SRL‐based CNI‐free regimen, who were switched to EVL. SRL dose was concentration controlled to a through level of 4–8 ng/mL. Patients were converted to a variable dose of EVL that was adjusted to achieve a trough concentration of 3–8 ng/mL.

Results:  SRL mean dose at time of conversion was 2.0 ± 0.9 mg/d. Initial EVL mean dose was 1.3 ± 0.5 mg/d. Six months after conversion, mean EVL trough level was 6.2 ± 2.8 ng/mL. EVL dose at this point was 2.0 ± 0.9 mg/d, which was not statistically different from SRL dose at the time of conversion (p = 0.575), suggesting a conversion factor of 1:1. During this six month period post conversion, no significant changes were observed in serum creatinine, hematocrit level, platelet count, proteinuria or lipid levels. No patient experienced an acute rejection episode.

Conclusions:  Conversion from SRL to EVL in renal transplant recipients receiving a CNI‐free immunosuppressive regimen can be performed safely with a low trough level range of EVL. We report for the first time a conversion factor between SRL and EVL.
Two new HLA‐C alleles identified in one volunteer bone marrow donor: C*15:44 and C*07:137:02
Authors: Froelich N. , Weschler B. , Hanau D. , Parissiadis A. , Tourne S.
Published: April 2011

Two new HLA‐C alleles were identified in a volunteer bone marrow donor by sequence‐based typing.
Identification of a novel HLA‐C allele, HLA‐C*04:82, by sequence‐based typing in a Chinese individual
Authors: Li Jian , Liu Ying , Zhang Caifen , Zhang Xiandong , Chen Shiping
Published: April 2011

A novel HLA allele, C*04:82, was identified in a Chinese individual, which has nine nucleotides insertion compared with the closest matching allele HLA‐C*04:01:01 in exon 5, resulting in three amino acid insertions: 301 Ala, 302 Val and 303 Leu.
Eight new alleles found in Flanders (Belgium), including the HLA‐DRB1*12:24N allele
Authors: Van Sandt V. S. T. , Mahieu S. , Emonds M. P.
Published: April 2011

Human leukocyte antigen (HLA) high‐resolution matching is routinely performed in the case of hematopoietic stem cell transplantation. Misdiagnosis of rare or new variants will result in additional unknown mismatches that can trigger graft versus host disease and/or graft failure. Using a mono allelic sequencing strategy, we obtained >90% first‐step sequence‐based high‐resolution typing results, conforming to the standards set down by the European Federation for Immunogenetics. During this routine analysis, eight new HLA alleles were identified, including one DRB1*12 null variant, DRB1*12:24N and three other coding mutants, resulting in a change of properties of the corresponding antigens.
Systematic analysis of swine leukocyte antigen‐DRB1 nucleotide polymorphisms using genomic DNA‐based high‐resolution genotyping and identification of new alleles
Authors: Thong L. Minh , Choi H. , Kwon O.‐J. , Kim J.‐H. , Kim Y.‐B. , Oh J.‐W. , Seo K. , Yeom S.‐C. , Lee W.‐J. , Park C.
Published: April 2011

In an attempt to enable comprehensive high‐resolution genotyping of the swine leukocyte antigen (SLA) gene, we performed a systemic analysis of nucleotide polymorphisms at introns 1 and 2 and exon 2 from diverse alleles of SLA‐DRB1 and DRB1 pseudogenes. We amplified and cloned 16 partial sequences of SLA‐DRB1 and DRB2 introns 1 and 2 from different alleles, and analyzed them together with sequences of four reported SLA‐DRB pseudogenes, DRB2, 3, 4, and 5. The results showed the presence of extreme nucleotide variations within introns 1 and 2 of SLA‐DRB‐related genes including substitutions and deletions. On the basis of these results, we developed a comprehensive genotyping method for SLA‐DRB1 by genomic polymerase chain reaction (PCR) and subsequent direct sequencing. A total of 415 animals were genotyped and 67 allelic combinations from 18 DRB1 alleles were identified. Among them, two alleles, SLA‐DRB1*kn04 and *kn05, were previously unreported. SLA‐DRB1 genotyping results from this study combined with those of SLA‐DQB1 from our previous study presented 10 SLA class II haplotypes, three of which were previously unreported. Population analysis using seven different pig breeds showed differences in the allele frequency of SLA‐DRB1 among breeds. Our results should benefit biological experiments requiring sequence‐level genotyping results of SLA‐DRB1 and further study of the complete genetic diversity of SLA‐DRB1 using field samples.
Identification of a novel HLA‐B*40 null allele, HLAB*40:155N
Authors: Ko S.‐Y. , Oh H.‐B. , Cho M.‐C. , Park N. , Kwon O.‐J.
Published: April 2011

The new allele B*40:155N showed five nucleotide insertion between nucleotide 594 and 595 (codon 174 and 175) compared to B*40:01:01.
Comprehensive environmental management of asthma and pediatric preventive care
Authors: Roy Angkana , Downes Martin J. , Wisnivesky Juan P.
Published: April 2011

To cite this article: Roy A, Downes MJ, Wisnivesky JP. Comprehensive environmental management of asthma and pediatric preventive care. Pediatr Allergy Immunol 2011; 22: 277–282.

Indoor environmental triggers can increase asthma morbidity. National guidelines recommend comprehensive use of environmental control practices (ECPs) as a component of asthma management. The purpose of this study was to examine the association between preventive asthma care and comprehensive ECP use among children with asthma. We used data from the National Asthma Survey, including 1,921 children with asthma. Comprehensive use was defined as using at least five of eight ECPs: (i) air filter, (ii) dehumidifier, (iii) mattress cover, (iv) pillow cover, (v) pet avoidance, (vi) smoke avoidance, (vii) removing carpets, and (viii) washing sheets in hot water. Univariate and multiple regression analyses were conducted to examine the association between comprehensive use of ECPs and receipt of preventive asthma care, as measured by number of routine asthma visits in the prior year and physician advice to modify the environment. Overall, 17% (95% CI: 14–19%) of participants had comprehensive ECP use. The most commonly used practices were ‘smoke avoidance’ (85%), ‘pet avoidance’ (59%), and ‘washing sheets in hot water’ (46%). Comprehensive use of ECPs was associated with having received physician advice [odds ratio (OR) 3.1, 95% CI: 2.2–4.4] and increased asthma visits (1–2 visits: OR 1.5, 95% CI: 1.0–2.4; 3–4 visits: OR 2.2, 95% CI: 1.3–3.8; ≥5 visits: OR 2.7, 95% CI: 1.5–4.8). Only a minority of parents implement comprehensive ECPs, and receipt of preventive asthma care is associated with comprehensive use. Further research is needed to determine the factors mediating these associations in order to inform more effective asthma counseling.
Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10–12 years old children: the PANACEA study
Authors: Arvaniti Fotini , Priftis Kostas N. , Papadimitriou Anastasios , Papadopoulos Marios , Roma Eleftheria , Kapsokefalou Maria , Anthracopoulos Michael B. , Panagiotakos Demosthenes B.
Published: April 2011

To cite this article: Arvaniti F, Priftis KN, Papadimitriou A, Papadopoulos M, Roma E, Kapsokefalou M, Antracopoulos MB, Panagiotakos DB. Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10–12 years old children: the PANACEA study. Pediatr Allergy Immunol 2011; 22: 283–289.

Epidemiological studies have shown several associations between asthma symptoms and dietary factors. The aim of this work was to evaluate the relationship between adherence to the Mediterranean diet and childhood asthma. A cross‐sectional analysis was performed on 700 children (323 boys), 10–12 yr old, selected from 18 schools located in Athens greater area. Children and their parents completed questionnaires, which evaluated, among others, dietary habits. Asthma was defined according to ISAAC II criteria. Adherence to the Mediterranean diet was evaluated using the KIDMED score (theoretical range 0–12). Higher KIDMED score corresponds to greater adherence to the Mediterranean diet. Greater adherence to the Mediterranean diet was inversely associated with ever had wheeze (p = 0.001), exercise wheeze (p = 0.004), ever had diagnosed asthma (p = 0.002) and with any asthma symptoms (p < 0.001). One‐unit increase in the KIDMED score was associated with 14% lower likelihood of having asthma symptoms (odds ratio = 0.86, 95% confidence interval 0.75–0.98), after adjusting for various confounders. No significant associations were found between asthma symptoms and consumption of fruits (p = 0.25), vegetables (p = 0.97), legumes (p = 0.76), cereals (p = 0.71), dairy (p = 0.61), salty snacks (p = 0.53), or margarine/butter (p = 0.42) consumption, while increased fish and meat intake was associated with less asthma symptoms (p = 0.04 and p = 0.01, respectively). Our findings suggest an inverse relationship between level of adherence to the Mediterranean diet and prevalence of asthma in school‐aged children.
The link between otitis media with effusion and allergy: A potential role for intranasal corticosteroids
Authors: Lack Gideon , Caulfield Helen , Penagos Martin
Published: April 2011

To cite this article: Lack G, Caulfield H, Penagos M. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids. Pediatr Allergy Immunol 2011; 22: 258–266.

We reviewed the evidence linking otitis media with effusion (OME) and atopy, with the goal of clarifying the possible role of intranasal corticosteroids (INSs) in OME treatment. In August 2009, the MEDLINE database was searched for primary studies on OME epidemiology, pathophysiology, and treatment. Relevant clinical guidelines were obtained. Interpreting OME research is complicated by variable disease definitions, patient populations, methodologies, and outcomes assessments, along with the possibility of spontaneous resolution. However, evidence links OME with atopic conditions including allergic rhinitis; observed prevalence of allergic rhinitis in patients with chronic or recurrent OME ranges from 24% to 89%. Such findings have prompted evaluations of common allergy medications for OME treatment. While short‐term use of INSs alone or combined with antibiotics has shown benefit in some studies, more prolonged treatment protocols and long‐term clinical outcomes will require critical assessment. Evidence suggesting epidemiologic and pathophysiologic links between allergy and OME has prompted investigation into a potential role for INSs in OME management, with promising initial results. Benefits of considering medical treatment in patients with OME prior to surgery include both the potential reductions in allergic inflammation and the naturally occurring spontaneous resolution of OME in these patients.
Aspergillus vertebral osteomyelitis and ureteral obstruction after liver transplantation
Authors: Zhu L.‐P. , Chen X.‐S. , Wu J.‐Q. , Yang F.‐F. , Weng X.‐H.
Published: April 2011

L.‐P. Zhu, X.‐S. Chen, J.‐Q. Wu, F.‐F. Yang, X.‐H. Weng. Aspergillus vertebral osteomyelitis and ureteral obstruction after liver transplantation. Transpl Infect Dis 2011: 13: 192–199. All rights reserved

Abstract: Aspergillus osteomyelitis has been reported as a result of dissemination in solid organ transplant recipients. Vertebral osteomyelitis is one of the most common forms of Aspergillus osteomyelitis. An Aspergillus fungal ball is a rare cause of ureteral obstruction. We describe an unusual case of simultaneous vertebral osteomyelitis and ureteral obstruction caused by A. flavus in a hepatic transplant recipient, who was successfully treated with sequential intravenous and oral itraconazole solution.
Assessment of benthic ecosystem functioning through trophic web modelling: the example of the eastern basin of the English Channel and the Southern Bight of the North Sea
Authors: Garcia Clément , Chardy Pierre , Dewarumez Jean‐Marie , Dauvin Jean‐Claude
Published: April 2011

Benthic organisms appear to be accurate proxies for assessing coastal ecosystem structures and changes due to climatic and anthropogenic stresses. Functional studies of benthic systems are relatively recent, mainly because of the difficulties in obtaining the basic parameters for each benthic compartment (i.e. detritus, bacteria, meiofauna and macrofauna). Our study focuses on the eastern basin of the English Channel and the Southern Bight of the North Sea. Trophic web modelling was used to assess the functioning of the three main benthic community assemblages. To test and assess the relative importance of factors assumed to influence trophic structure (geographical environment and sedimentary particle size distribution), the study area was subdivided into divisions defined a priori according to the two main structural factors of community distribution; geographic distribution and sedimentary patterns. Then, a steady state trophic model utilising the inverse method was applied to a diagram composed of eight compartments, including detritus, bacteria, meiofauna, macrobenthos and fish. For each compartment, six physiological parameters were assessed, based on our own data, empirical relationships and literature data. This method allowed estimation of the flux of matter and energy within and between the units of the benthic system and assessment of the amount of trophic energy stored in these units (available mostly to fish). Our results showed that suspension‐feeders control most of the matter transfer through the macrobenthic food‐web, except in the fine sand community, where deposit‐feeders play a dominant role. The results also showed that, whatever the geographic area, trophic structure is strongly linked to the sedimentary conditions. As benthic communities are connected through hydrodynamics, a model of the entire eastern basin of the English Channel would appear to be acceptable. However, the main sediment types must be taken into account when establishing relationships between the functional units.
mtDNA differentiation in the mussel Mytilus galloprovincialis Lmk. on the Iberian Peninsula coast: first results
Authors: Luis Javier R. , Comesaña Angel S. , Sanjuan Andrés
Published: April 2011

The nucleotide sequence of the VD1 domain of the Long Unassigned Region in the F mitochondrial DNA genome was studied for 135 Iberian mussels, 78 from the Atlantic and 57 from the Mediterranean. Significant genetic differentiation between Atlantic and Mediterranean Mytilus galloprovincialis samples was found (FST = 0.262, P < 0.00001). The four main clusters observed in the neighbor‐joining tree of haplotypes were not exclusive for a specific region, but a clear geographic pattern could be observed. One of the clusters contained 86% of the Atlantic individuals and the remaining three clusters were predominantly Mediterranean. The Atlantic–Mediterranean differentiation of the mitochondrial DNA haplotypes was in agreement with previous data describing the same partitioning in M. galloprovincialis and in many other marine organisms, using different kinds of genetic markers. In all cases the Almeria Oran Oceanographic front has been associated to this genetic discontinuity.