bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Adult Learning Systems: an emerging political economy
Authors: Rees Gareth
Published: May 2013

Adult learning systems have come to be dominated by the view that the essential role of adult learning is to generate the high levels of skills deemed necessary for competitiveness and growth in the globalised economy. This ‘education gospel’ is underpinned by human capital theory (HCT) and its contemporary conceptualisation in terms of the knowledge‐based economy. Nevertheless, it remains the case that there are significant differences in the strategies of national governments towards adult learning and in patterns of engagement with the learning opportunities that are made available.

This paper sets out to explore how this diversity in national systems of adult learning might be addressed analytically. Adult learning is embedded in characteristic regimes of economic and social institutions, which can be understood in terms of a systematic international political economy. In particular, adult learning systems are explored by reference to the models of capitalist organisation elaborated in the neo‐institutionalist analysis of ‘varieties of capitalism’ (Hall andSoskice, 2001): the liberal market economy and the co‐ordinated market economy. A major alternative is provided byEsping‐Anderson's (1990; 1999) analysis of ‘welfare state regimes’. Moreover,Rubenson andDesjardins (2009) have used this theoretical framework as a means of analysing systematic variations between national adult learning systems.

These analyses raise questions about the use of national states as the key unit of analysis. Significant divergences in institutional arrangements and access to opportunities for adult learning (by social group or locality, for example) may be obscured by this method of comparative analysis. Moreover, consideration of the micro‐theoretical foundations of these approaches highlights the difficulties in moving beyond the economistic ‘rationality’ ofHCT. The issue here is the extent to which norms of behaviour in relation to engaging in adult learning can be appropriately understood in terms of a relatively homogeneous, national social system, rather than in terms of a much more socially differentiated repertoire of norm‐based orientations.
A Comparative Exploration of Learning Pathways and Transition Systems in Denmark and Australia
Authors: Murray Philomena , Polesel John
Published: May 2013

In the area of education and training, different configurations of government with different institutional structures may produce similar or quite different educational and employment outcomes. Other factors come into play in assessing outcomes. For example, young people's transitions from education to work are shaped by a variety of structural and institutional relations in education and the labour market. We argue that analysis of developments in approaches to education and training benefits from including these perspectives. This article explores these differences and similarities in a comparative transnational context across two continents. The article suggests that it not useful, whether from a policy or scholarly perspective, to link education and employment without examining the role and type of the welfare state, including the role and type of capitalism within that state, and the relationship of the welfare state to transition systems. With these concerns as our focus, the article has two objectives. The first is to establish some links between comparative research on transition systems and the literatures on welfare state regimes and varieties of capitalism. The second is to draw out some of these links with two concrete and contrasting examples in a comparative manner, focussing on Denmark and Australia.
Underground signals carried through common mycelial networks warn neighbouring plants of aphid attack
Authors: Babikova Zdenka , Gilbert Lucy , Bruce Toby J. A. , Birkett Michael , Caulfield John C. , Woodcock Christine , Pickett John A. , Johnson David
Published: May 2013

The roots of most land plants are colonised by mycorrhizal fungi that provide mineral nutrients in exchange for carbon. Here, we show that mycorrhizal mycelia can also act as a conduit for signalling between plants, acting as an early warning system for herbivore attack. Insect herbivory causes systemic changes in the production of plant volatiles, particularly methyl salicylate, making bean plants, Vicia faba, repellent to aphids but attractive to aphid enemies such as parasitoids. We demonstrate that these effects can also occur in aphid‐free plants but only when they are connected to aphid‐infested plants via a common mycorrhizal mycelial network. This underground messaging system allows neighbouring plants to invoke herbivore defences before attack. Our findings demonstrate that common mycorrhizal mycelial networks can determine the outcome of multitrophic interactions by communicating information on herbivore attack between plants, thereby influencing the behaviour of both herbivores and their natural enemies.
Temporary zinc oxide–eugenol cement: eugenol quantity in dentin and bond strength of resin composite
Authors: Koch Tamara , Peutzfeldt Anne , Malinovskii Vladimir , Flury Simon , Häner Robert , Lussi Adrian
Published: May 2013

Uptake of eugenol from eugenol‐containing temporary materials may reduce the adhesion of subsequent resin‐based restorations. This study investigated the effect of duration of exposure to zinc oxide–eugenol (ZOE) cement on the quantity of eugenol retained in dentin and on the microtensile bond strength (μTBS) of the resin composite. The ZOE cement (IRM Caps) was applied onto the dentin of human molars (21 per group) for 1, 7, or 28 d. One half of each molar was used to determine the quantity of eugenol (by spectrofluorimetry) and the other half was used for μTBS testing. The ZOE‐exposed dentin was treated with either OptiBond FL using phosphoric acid (H3PO4) or with Gluma Classic using ethylenediaminetetraacetic acid (EDTA) conditioning. One group without conditioning (for eugenol quantity) and two groups not exposed to ZOE (for eugenol quantity and μTBS testing) served as controls. The quantity of eugenol ranged between 0.33 and 2.9 nmol mg−1 of dentin (median values). No effect of the duration of exposure to ZOE was found. Conditioning with H3PO4 or EDTA significantly reduced the quantity of eugenol in dentin. Nevertheless, for OptiBond FL, exposure to ZOE significantly decreased the μTBS, regardless of the duration of exposure. For Gluma Classic, the μTBS decreased after exposure to ZOE for 7 and 28 d. OptiBond FL yielded a significantly higher μTBS than did Gluma Classic. Thus, ZOE should be avoided in cavities later to be restored with resin‐based materials.
Single rice growth period was prolonged by cultivars shifts, but yield was damaged by climate change during 1981–2009 in China, and late rice was just opposite
Authors: Tao Fulu , Zhang Zhao , Shi Wenjiao , Liu Yujie , Xiao Dengpan , Zhang Shuai , Zhu Zhu , Wang Meng , Liu Fengshan
Published: May 2013

Based on the crop trial data during 1981–2009 at 57 agricultural experimental stations across the North Eastern China Plain (NECP) and the middle and lower reaches of Yangtze River (MLRYR), we investigated how major climate variables had changed and how the climate change had affected crop growth and yield in a setting in which agronomic management practices were taken based on actual weather. We found a significant warming trend during rice growing season, and a general decreasing trend in solar radiation (SRD) in the MLRYR during 1981–2009. Rice transplanting, heading, and maturity dates were generally advanced, but the heading and maturity dates of single rice in the MLRYR (YZ_SR) and NECP (NE_SR) were delayed. Climate warming had a negative impact on growth period lengths at about 80% of the investigated stations. Nevertheless, the actual growth period lengths of YZ_SR and NE_SR, as well as the actual length of reproductive growth period (RGP) of early rice in the MLRYR (YZ_ER), were generally prolonged due to adoption of cultivars with longer growth period to obtain higher yield. In contrast, the actual growth period length of late rice in the MLRYR (YZ_LR) was shortened by both climate warming and adoption of early mature cultivars to prevent cold damage and obtain higher yield. During 1981–2009, climate warming and decrease in SRD changed the yield of YZ_ER by −0.59 to 2.4%; climate warming during RGP increased the yield of YZ_LR by 8.38–9.56%; climate warming and decrease in SRD jointly reduced yield of YZ_SR by 7.14–9.68%; climate warming and increase in SRD jointly increased the yield of NE_SR by 1.01–3.29%. Our study suggests that rice production in China has been affected by climate change, yet at the same time changes in varieties continue to be the major factor driving yield and growing period trends.
Natural variation and the capacity to adapt to ocean acidification in the keystone sea urchin Strongylocentrotus purpuratus
Authors: Kelly Morgan W. , Padilla‐Gamiño Jacqueline L. , Hofmann Gretchen E.
Published: May 2013

A rapidly growing body of literature documents the potential negative effects of CO2‐driven ocean acidification (OA) on marine organisms. However, nearly all this work has focused on the effects of future conditions on modern populations, neglecting the role of adaptation. Rapid evolution can alter demographic responses to environmental change, ultimately affecting the likelihood of population persistence, but the capacity for adaptation will differ among populations and species. Here, we measure the capacity of the ecologically important purple sea urchin Strongylocentrotus purpuratus to adapt to OA, using a breeding experiment to estimate additive genetic variance for larval size (an important component of fitness) under future high‐pCO2/low‐pH conditions. Although larvae reared under future conditions were smaller than those reared under present‐day conditions, we show that there is also abundant genetic variation for body size under elevated pCO2, indicating that this trait can evolve. The observed heritability of size was 0.40 ± 0.32 (95% CI) under low pCO2, and 0.50 ± 0.30 under high‐pCO2 conditions. Accounting for the observed genetic variation in models of future larval size and demographic rates substantially alters projections of performance for this species in the future ocean. Importantly, our model shows that after incorporating the effects of adaptation, the OA‐driven decrease in population growth rate is up to 50% smaller, than that predicted by the ‘no‐adaptation’ scenario. Adults used in the experiment were collected from two sites on the coast of the Northeast Pacific that are characterized by different pH regimes, as measured by autonomous sensors. Comparing results between sites, we also found subtle differences in larval size under high‐pCO2 rearing conditions, consistent with local adaptation to carbonate chemistry in the field. These results suggest that spatially varying selection may help to maintain genetic variation necessary for adaptation to future OA.
Greater phenological sensitivity to temperature on higher Scottish mountains: new insights from remote sensing
Authors: Chapman Daniel S.
Published: May 2013

Mountain plants are considered among the species most vulnerable to climate change, especially at high latitudes where there is little potential for poleward or uphill dispersal. Satellite monitoring can reveal spatiotemporal variation in vegetation activity, offering a largely unexploited potential for studying responses of montane ecosystems to temperature and predicting phenological shifts driven by climate change. Here, a novel remote‐sensing phenology approach is developed that advances existing techniques by considering variation in vegetation activity across the whole year, rather than just focusing on event dates (e.g. start and end of season). Time series of two vegetation indices (VI), normalized difference VI (NDVI) and enhanced VI (EVI) were obtained from the moderate resolution imaging spectroradiometer MODIS satellite for 2786 Scottish mountain summits (600–1344 m elevation) in the years 2000–2011. NDVI and EVI time series were temporally interpolated to derive values on the first day of each month, for comparison with gridded monthly temperatures from the preceding period. These were regressed against temperature in the previous months, elevation and their interaction, showing significant variation in temperature sensitivity between months. Warm years were associated with high NDVI and EVI in spring and summer, whereas there was little effect of temperature in autumn and a negative effect in winter. Elevation was shown to mediate phenological change via a magnification of temperature responses on the highest mountains. Together, these predict that climate change will drive substantial changes in mountain summit phenology, especially by advancing spring growth at high elevations. The phenological plasticity underlying these temperature responses may allow long‐lived alpine plants to acclimate to warmer temperatures. Conversely, longer growing seasons may facilitate colonization and competitive exclusion by species currently restricted to lower elevations. In either case, these results show previously unreported seasonal and elevational variation in the temperature sensitivity of mountain vegetation activity.
Interplay between yield, nitrogen application, and logistics on the potential energetic and greenhouse gas emissions from biomass crops
Authors: Montross Michael D , De Bolt Seth , Adams William C.
Published: May 2013

The interplay between nitrogen fertilization (N), yield, nitrous oxide emissions (N2O), and diesel fuel utilization associated with harvest and transport logistics of biomass crops remains poorly understood. In this research, we show that intensification (in terms of N) of bioenergy cropping to maximize yield supports not only minimized land use but also maximized logistics efficiency in terms of diesel use. This paradigm was examined within the scope of the billion‐ton biofuels vision and the Energy Independence and Security Act of 2007 using potential yields on marginal and prime agricultural land. Sixteen scenarios were investigated that considered the primary factors with agriculture bioenergy; biomass yield (11.2 and 22.4 Mg ha−1 yr−1), two nitrogen fertilizer application rates (50 and 100 kg N ha−1 yr−1), two Greenhouse Gas Emissions (GHGE) factors for synthetic nitrogen to nitrous oxide (1.5 and 5%), and three harvest/transportation efficiencies (50, 65, and 80%). These scenarios resulted in energy consumption between 747 and 1351 MJ Mg−1 and GHGE between 72 and 311 kg CO2 eq Mg−1. GHGE emissions are strongly related to the emission of nitrous oxide from soils due to nitrogen fertilization and could represent over 80% of the GHGE relative to biomass harvest logistics. These data imply that synthetic N supplementation to maximize yield could reduce the burden due to diesel fuel for harvest, but would rapidly become the most significant contributor to GHGE. Minimizing the impact of N fertilization will be critical for reducing the GHGE associated with biomass production.
Switchgrass in California: where, and at what price?
Authors: Yi Fujin , Mérel Pierre , Lee Juhwan , Farzin Y. Hossein , Six Johan
Published: May 2013

This article assesses the potential of California agriculture to supply biofuel feedstock in the form of switchgrass. We construct a fully calibrated, multiregion, multi‐input and multioutput model of agricultural supply for California's Central Valley based on the principles of positive mathematical programming. We exploit agronomic information obtained from a biophysical model to estimate regional production functions for switchgrass. The model predicts the extent and location of potential feedstock production in the Central Valley. Our results suggest that switchgrass adoption rates differ widely among agricultural regions, and that switchgrass is not likely to displace specialty crops by much statewide.
Performance of hybrid poplar clones in short rotation coppice in Mediterranean environments: analysis of genotypic stability
Authors: Sixto Hortensia , Gil Paula , Ciria Pilar , Camps Francesc , Sánchez Mario , Cañellas Isabel , Voltas Jordi
Published: May 2013

Improving production in short rotation coppice (SRC) plantations requires, among other elements, a proper understanding of clonal performance. Genotypic stability over a range of environments is a factor of concern for breeding and recommendation purposes. Most common stability measures can be embedded in a mixed‐model framework accounting for interaction and heterocedasticity in genotype‐by‐environment tables. Data from nine hybrid poplars of different taxonomic background were tested in four Mediterranean sites under three agronomic practices (control, herbicide application, and supplementary fertilization) for total biomass (TB), stem biomass (SB), and branch biomass (BB) at the end of the first rotation. Stability models (stability variance, Finlay–Wilkinson and Eberhart–Russell) were compared, also allowing for the definition of groups of genotypes with distinct taxonomic backgrounds and a priori different variabilities. Results showed that genotype‐by‐environment (GE) interactions were associated with factors inherent to evaluation sites rather than to the agronomic practices tested. Depending on biomass fraction, regression models provided appropriate stability measures. Highly reactive clones to improving environmental conditions (e.g., ‘AF2’) tended to show the largest meanTB. However, this was not always the case, as clone ‘Monviso’ showed both intermediate reactivity (i.e., stablesensuEberhart–Russell) and enhanced overall performance. The taxonomic group was relevant for explaining stability patterns forSB. The stability assessment forBBindicated different patterns in biomass allocation. Present findings point to the feasibility of either exploiting specific adaptation (in which case hybrid type may play a relevant role) or searching for broadly adapted, stable material exhibiting good performance in Mediterranean conditions.
Reconciling Flexible Staffing Models with Inclusive Governance and Management
Authors: Whitchurch Celia , Gordon George
Published: May 2013

Higher education managers are under increasing pressure from governments to reduce costs by adopting more flexible staffing practices and tensions can arise as institutions seek to sustain motivation and morale across a diversifying workforce. This paper considers how institutional management and governance practices facilitate innovative developments whilst also providing a supportive and inclusive environment. It draws on interviews in seven institutions to describe three models that reflect integrated, private‐sector and partnership approaches, exploring the implications of these for the psychological contract between institutions and their staff, including different interpretations of the employment package; the establishment of processes that are seen as equitable and transparent, although not necessary identical; and the adoption of a range of communication channels, both at the level of the individual and collectively.
Follicle‐stimulating hormone receptor expression in soft tissue sarcomas
Authors: Renner Marcus , Goeppert Benjamin , Siraj Muhammad Ahsan , Radu Aurelian , Penzel Roland , Wardelmann Eva , Lehner Burkhard , Ulrich Alexis , Stenzinger Albrecht , Warth Arne , Vogel Monika Nadja , Weichert Wilko , Schirmacher Peter , Mechtersheimer Gunhild , Ghinea Nicolae
Published: May 2013

Aims

In adult humans, the follicle‐stimulating hormone receptor (FSHR) is expressed only in the granulosa cells of the ovary and the Sertoli cells of the testis. Recently, it has been shown that FSHR is expressed selectively on the surface of blood vessels in a wide range of tumours. So far, the expression of FSHR in mesenchymal tumours has not been studied.

Methods and results

We performed a semiquantitative evaluation of FSHR protein expression in a large cohort of soft tissue sarcomas (STS; n = 335), including 11 subtypes. FSHR‐positive vessels were detected in all sarcoma subtypes analysed. Among liposarcomas, significantly more cases of dedifferentiated liposarcomas (28 of 44) showed FSHR expression compared to well‐differentiated liposarcomas (WDLS; four of 21; P < 0.001). Vessels in lipomas (n = 9) and non‐neoplastic fat were FSHR‐negative. FSHR expression was also detected in tumour cells of all sarcoma subtypes examined, with the lowest incidence in WDLS (three of 21; 14.3%) and the highest frequency in undifferentiated high‐grade pleomorphic sarcomas (41 of 60; 68.3%).

Conclusions

These data supplement the previously reported results of FSHR expression in endothelial cells of various cancer types and form a solid basis for further studies of FSHR in mesenchymal neoplasms.
REPRESENTATION AS A COGNITIVE INSTRUMENT
Authors: ANKERSMIT FRANK
Published: May 2013

This essay discusses the role of the notions of reference, truth, and meaning in historical representation. Four major claims will be argued. First, conditional for all meaningful discussion of historical representation is that one radically discards from one's mind the paradigm of the true statement and all the epistemological and ontological problems occasioned by it. Second, representation is not a two‐place, but a three‐place operator: in representation a represented reality (1) is represented by a representation (2) focusing on certain aspects of represented reality (3). Third, applying the notions of reference, truth, and meaning to historical representations compels us to give them a content basically different from the ones they have in contemporary philosophy of language and science. Fourth, it will be shown that in (historical) representation, meaning precedes truth—and not the other way around as in most of contemporary philosophy of language.
REOCCUPYING SECULARIZATION: SCHMITT AND KOSELLECK ON BLUMENBERG'S CHALLENGE
Authors: PANKAKOSKI TIMO
Published: May 2013

This article analyzes the compound of the categories of secularization and reoccupation in its variations from Hans Blumenberg's philosophy to Carl Schmitt's political theory and, ultimately, to Reinhart Koselleck's conceptual history. By revisiting the debate between Blumenberg and Schmitt on secularization and political theology with regard to the political‐theoretical aspects of secularization and the methodological aspects of reoccupation, I will provide conceptual tools that illuminate the partly tension‐ridden elements at play in Koselleck's theorizing of modernity, history, and concepts. For Schmitt, secularization is inherently related to the question of political conflict, and, correspondingly, he attempts to discredit Blumenberg's criticism of secularization as an indirectly aggressive, and thereby hypocritical, attempt to escape the political. To this end, I argue, Schmitt appropriates Blumenberg's concept of “reoccupation” and uses it alternately in the three distinct senses of “absorption,”“reappropriation,” and “revaluation.” Schmitt's famous thesis of political concepts as secularized theological concepts contains an unmistakable methodological element and a research program. The analysis therefore shows the relevance of the Blumenberg/Schmitt debate for the mostly tacit dialogue between Blumenberg and Koselleck. I scrutinize Koselleck's understanding of secularization from his early Schmittian and Löwithian theory of modernity to his later essays on temporalization of history and concepts. Despite Blumenberg's criticism, Koselleck holds onto the category of secularization throughout, but gradually relativizes it into a research hypothesis among others. Simultaneously, Koselleck formalizes, alongside other elements, the Schmittian account of reoccupation into his method of conceptual analysis and uses the term in the same three senses—thus making “reoccupation” conceptually compatible with “secularization,” despite the former notion's initial critical function in Blumenberg's theory. The examination highlights a Schmittian residue that accounts for Koselleck's reserved attitude toward Blumenberg's metaphorology, regardless of a significant methodological overlap.
Description of the Western Sydney and Nepean Blue Mountains local health districts' influenza prevention programme
Authors: Brown M. , Sheppeard V. , Gabriel S. , Thomas J.
Published: May 2013

Background

Influenza is a major cause of morbidity and mortality. In 2011, influenza vaccination was provided free for people at greatest risk of severe disease: people aged 65 years and over, Aboriginal Australians 15 years and older, pregnant women, and individuals aged 6 months and over who suffered chronic medical conditions.

Aims

To evaluate the Western Sydney and Nepean Blue Mountains Local Health District Influenza Prevention Program and to identify some of the enablers and barriers to vaccination in the hospital outpatient setting.

Methods

Western Sydney and Nepean Blue Mountains local health districts' influenza prevention programme provided influenza vaccine in hospital outpatient settings between 21 March 2011 and 30 June 2011. Accredited nurse immunisers vaccinated 2824 individuals and recorded their primary reason for vaccination. Nurse immunisers were interviewed to identify barriers and enablers to influenza immunisation uptake.

Results

Two thousand, eight hundred and twenty‐four doses of influenza vaccine were administered to people at high risk of influenza in four hospitals in the region: two tertiary facilities and two district hospitals. The primary indication for vaccination was chronic disease in 50% and pregnancy in 37%. Estimated direct cost of the programme was $19 per dose.

Conclusions: 

A hospital‐based influenza vaccination programme can be an effective way to improve influenza vaccination rates among specific population groups at high risk of severe disease with influenza, particularly pregnant women and those younger than 65 years with a chronic medical condition.
Predictive gene testing for Huntington disease and other neurodegenerative disorders
Authors: Wedderburn S. , Panegyres P. K. , Andrew S. , Goldblatt J. , Liebeck T. , McGrath F. , Wiltshire M. , Pestell C. , Lee J. , Beilby J.
Published: May 2013

Background

Controversies exist around predictive testing (PT) programmes in neurodegenerative disorders.

Aims

This study sets out to answer the following questions relating to Huntington disease (HD) and other neurodegenerative disorders: differences between these patients in their PT journeys, why and when individuals withdraw from PT, and decision‐making processes regarding reproductive genetic testing.

Methods

A case series analysis of patients having PT from the multidisciplinary Western Australian centre for PT over the past 20 years was performed using internationally recognised guidelines for predictive gene testing in neurodegenerative disorders.

Results

Of 740 at‐risk patients, 518 applied for PT: 466 at risk of HD, 52 at risk of other neurodegenerative disorders – spinocerebellar ataxias, hereditary prion disease and familial Alzheimer disease. Thirteen per cent withdrew from PT – 80.32% of withdrawals occurred during counselling stages. Major withdrawal reasons related to timing in the patients' lives or unknown as the patient did not disclose the reason. Thirty‐eight HD individuals had reproductive genetic testing: 34 initiated prenatal testing (of which eight withdrew from the process) and four initiated pre‐implantation genetic diagnosis. There was no recorded or other evidence of major psychological reactions or suicides during PT.

Conclusions

People withdrew from PT in relation to life stages and reasons that are unknown. Our findings emphasise the importance of: (i) adherence to internationally recommended guidelines for PT; (ii) the role of the multidisciplinary team in risk minimisation; and (iii) patient selection.
Survival times of women with metastatic breast cancer starting first‐line chemotherapy in routine clinical practice versus contemporary randomised trials
Authors: Thientosapol E. S. , Tran T. T. , Della‐Fiorentina S. A. , Adams D. H. , Chantrill L. , Stockler M. R. , Kiely B. E.
Published: May 2013

Background

Survival times of women starting first‐line chemotherapy for metastatic breast cancer (MBC) in routine clinical practice were determined and compared with those from a systematic review of randomised clinical trials.

Methods

We identified women with MBC starting first‐line chemotherapy from June 2003 to February 2011 and recorded their demographics, tumour and treatment characteristics, and survival times from the start of chemotherapy. Their survival distribution was summarised by the following percentiles (represented scenarios for survival): 90th (worst‐case), 75th (lower‐typical), 25th (upper‐typical) and 10th (best‐case), which were compared with the same percentiles from our systematic review of first‐line chemotherapy trials.

Results

The 273 women had a median age of 56 years, and a median time from diagnosis of MBC of 3 months. Eastern Cooperative Oncology Group performance status was 0–1 in 80%. Tumours were hormone receptor positive in 69%, human epidermal growth factor receptor 2 (HER2)‐positive in 27% and triple negative in 13%. Survival times in months in routine clinical practice (vs the systematic review) were: 90th percentile 4 (6); 75th percentile 9 (12); median 20 (22); 25th percentile 36 (36) and 10th percentile 61 (56). Independent predictors of overall survival included HER2‐positive disease (hazard ratio (HR) 0.49, P = 0.0002), hormone receptor positive disease (HR 0.51, P = 0.0004), Eastern Cooperative Oncology Group performance status 0–1 (HR 0.36, P < 0.0001) and adjuvant chemotherapy (HR 1.86, P = 0.0002).

Conclusion

Median and better survival times in routine practice were similar to those from randomised clinical trials; however, survival times worse than the median were shorter, likely reflecting patient selection in trials. Oncologists should adjust trial‐based survival estimates for patients not meeting typical trial eligibility criteria.
Treatment of delirium with risperidone in cancer patients
Authors: Kishi Yasuhiro , Kato Masashi , Okuyama Toru , Thurber Steven
Published: May 2013

Aim:  Antipsychotic medications have frequently been regarded as the treatment of choice for delirium. This study examined the clinical efficacy of risperidone for the treatment of delirium in cancer patients, combined with a repeated assessment of underlying medical severity levels.

Methods:  The study included consecutive referrals of 29 delirious cancer patients (mean age, 68.9 ± 12.5 years; male, 69%) to the psychiatric consultation service. Risperidone was given orally once per day (mean dosage, 1.4 ± 1.3 mg/day). Study participants were assessed using quantitative standardized scales of cognitive function, delirium, and physical impairment at baseline and at the end of the study (seventh day).

Results:  Risperidone with routine clinical management was effective for the treatment of delirium: 48% of the patients responded and 38% achieved remission. The reduction of delirium severity occurred in 79% of the patients. Changes in delirium severity were unrelated to age, gender, general cognitive dysfunction, or to severity of attendant medical conditions. In addition to changes in agitation and perceptional disturbances, risperidone was also effective for other specific delirium symptoms.

Conclusions:  Risperidone with routine clinical management is effective in the treatment of delirium in advanced cancer patients, independent of changes in the underlying medical condition.
Associations between hypothalamic–pituitary–adrenal axis function and facial emotion processing in depressed and control participants
Authors: Douglas Katie M. , Porter Richard J.
Published: May 2013

Aim:  The current study examined the relation between facial emotion processing accuracy and an aspect of hypothalamic–pituitary–adrenal axis function in 64 inpatients with major depression and 49 healthy controls over a 2‐week period.

Methods:  The Dexamethasone Suppression Test and a Facial Expression Recognition Task were completed at baseline and 10–14 days after baseline. Treatment response was determined 6 weeks after baseline by change in the Montgomery–Asberg Depression Rating Scale.

Results:  Increased cortisol response to dexamethasone was significantly correlated with reduced ability to recognize facial expressions of anger, sadness and disgust within the total sample, but these correlations did not remain significant at 10–14 days. Surprisingly, cortisol response to dexamethasone was comparable in acutely depressed inpatients and healthy controls, and did not change over time in relation to treatment response.

Conclusion:  The study findings provide preliminary evidence that hypothalamic–pituitary–adrenal axis functioning and processing threat‐related facial expressions are related, perhaps through involvement of the amygdala.
Effects of antipsychotic polypharmacy on side‐effects and concurrent use of medications in schizophrenic outpatients
Authors: Hashimoto Yasuhiko , Uno Junji , Miwa Takaichi , Kurihara Masaaki , Tanifuji Hiroaki , Tensho Masami
Published: May 2013

Aims:  Medical therapy is the cornerstone of schizophrenia, but >50% of patients do not adhere to medication regimens. In previous reports, the reasons for non‐adherence were assessed only by medical staff. We think that patients have specific reasons for non‐adherence. We researched whether there was an association between patients' subjective opinions and the number of antipsychotics used.

Methods:  A self‐rating questionnaire survey was conducted on 252 outpatients with schizophrenia at five psychiatric hospitals in Japan. Based on patients' subjective opinions, we retrospectively analyzed the patients' medications: the number of antipsychotics, concurrently used agents, and dosages of antipsychotics.

Results:  There was no significant difference regarding attitudes toward medication between monotherapy and polypharmacy. The most common reason for not taking medications was ‘I sometimes forget’ followed by ‘side‐effects’. Of the latter, weight gain was the most common, and dry mouth (P < 0.05) and sexual dysfunction (P < 0.01) were significantly higher in polypharmacy. The dosages of antipsychotics (P < 0.01), concurrent use of anti‐Parkinsonian agents (P < 0.01), and the number of side‐effects (P < 0.01) were also higher in polypharmacy.

Conclusions:  Patients had good attitudes toward medication but a higher prevalence of side‐effects was seen in polypharmacy of antipsychotics. Hence, monotherapy may be a more appropriate prescription with respect to side‐effects. By using monotherapy, patients may reduce feelings of discomfort due to side‐effects.
Determinants of psychogeriatric inpatient length of stay and direct medical costs: A 6‐year longitudinal study using a national database in Taiwan
Authors: Liu Chin‐Ming , Li Chu‐Shiu , Liu Chwen‐Chi , Tu Chu‐Chin
Published: May 2013

Aims:  This research examined factors related to the average length of hospital stay (LOS) and average direct medical costs (DMC) for 2291 psychogeriatric inpatients (aged 65 and over) admitted for the first time to a psychiatric ward in 2002.

Methods:  Hospitalization claim data of these inpatients were traced for the subsequent 6 years (2002–2007) from the dataset of Taiwan's National Health Insurance program. Analysis was carried out using the t‐test, χ2‐test and zero truncated Tobit regression.

Results:  Mean LOS and mean DMC were significantly different according to sex, psychiatric diagnosis, institution type, ownership type, and number of hospitalizations, but age was the exception. Both LOS and DMC exhibited downward U‐shape for the number of hospitalizations. Factors significantly associated with longer LOS and higher DMC were: male sex; schizophrenic and delusional disorders (compared with dementia); and public institution (compared with private hospital). Compared with dementia, organic mental and anxiety disorders had significantly shorter LOS, and affective disorders had shorter LOS but higher DMC. Community and psychiatric hospitals (compared with general hospital) significantly influenced LOS but not DMC.

Conclusion:  Our results can be used as a reference for providers and policymakers to improve psychiatric care efficiency and carry out National Health Insurance financial reform for psychogeriatric inpatients.
Autoagglutination in Ejaculates Caused by Sperm‐Agglutinating Antibodies
Authors: FRIBERG JAN
Published: May 2013

ABSTRACT: Human spermatozoa may be agglutinated by bacteria, virus, and mycoplasmas, as well as by epithelial cells and cellular debris. Agglutination may also be caused by sperm‐agglutinating antibodies, but controversy exists as to its significance. One reason for the controversy is that the degree of agglutination has generally been evaluated in a wet smear. During this routine examination, the specimens are often shaken and a part of the specimen is usually transferred to a microscope slide before examination. Such mechanical agitation may cause the agglutinates to break up. Later, the spermatozoa reagglutinate but these agglutinates are usually smaller and may easily be overlooked and therefore, its significance has not been fully recognized.

In the present study, portions from ejaculates were obtained immediately after ejaculation and kept under liquid parafin oil in microchambers, a technique that permits the agglutination to proceed undisturbed, but still under observation. The degree of agglutination in ejaculates from 129 men with tail‐to‐tail (T‐T) and 36 men with head‐to‐head (H‐H) sperm‐agglutinating antibodies were compared with findings in 138 men without antibodies, and the influence of different titers evaluated. The results indicate that ejaculates from men with H‐H or low titers (≤ 1:32) of T‐T sperm‐agglutinating antibodies displayed the same degree of agglutination as was seen in the ejaculates from men without any antibodies. Patients with high T‐T titers (≥ 1:512) very often had a quite pronounced or complete agglutination in the ejaculates.

Evaluation of seminal fluid using anion exchange chromatography, gel filtration, and various absorption experiments indicated that the T‐T sperm‐agglutinating factor in the seminal fluid was caused by IgA antibodies and in a few samples the T‐T agglutination was also caused by IgG antibodies. Analysis of the T‐T sperm agglutination in male sera demonstrated that this factor was caused by IgG antibodies and that H‐H agglutination was caused by IgM antibodies. Head‐to‐head agglutination was not present in the seminal fluid, which is consistent with the fact that IgM antibodies do not penetrate to the seminal fluid.
Human Soluble Antigens and Their Use in Sperm Antibody Testing*
Authors: SHULMAN SIDNEY , KEANE THOMAS
Published: May 2013

ABSTRACT: Efforts were made to disrupt and solubilize human sperm cells and to evaluate the product for its content of infertility antibody‐related antigens. In the procedure that was developed, a well‐washed sperm sample is treated with 0.1 M dithiothreitol for 60 min, followed by trypsin at 0.1 mg/ml for 30 min, and then by soybean trypsin inhibitor. A mixture of DNAses I and II are added. After centrifuging, the resuspended pellet (RP) and the final supernatant (FS) show several degrees of cellular breakdown. Immunological evaluation was done with a strongly positive human serum containing sperm‐head antibody. From the inhibition of sperm agglutination, we could conclude that the desired soluble antigen was obtained in the FS fraction.
Effects of Sex Hormones on Some T and B Cell Functions, Evidenced by Differential Immune Expression Between Male and Female Mice and Cyclic Pattern of Immune Responsiveness During the Estrous Cycle in Female Mice*
Authors: KRZYCH URSZULA , STRAUSSER HELEN R. , BRESSLER JOSEPH P. , GOLDSTEIN ALLAN L.
Published: May 2013

ABSTRACT: The responses of spleen cells from male and female BALB/c mice were evaluated to determine if sex‐related variations in immune expression could be found. The immunologic assays used included blastogenic responses to mitogens, and direct and indirect measurement of plaque‐forming cells against particulate antigens. The results indicated that responses of spleen cells from young adult female mice were higher than those of males in all comparative tests. Newborn mice did not demonstrate the sex‐associated immune differences; and among the weanling mice slight differences between male and female spleen cells responsiveness to mitogenic agents were observed.

The blastogenic responsiveness of spleens from female BALB/c was greater at proestrus and metestrus, as compared to estrus and diestrus. The peaks of responsiveness corresponded to reported elevated levels of estrogen and pregnenolone during these phases of the cycle. Similar results were obtained with the IgM plaque‐forming cell responses, which were also increased at proestrus and metestrus. This study supports a role of sex hormones in modulation of immune expression.
Fetal and Maternal Red Cell Immune Adherence (RCIA) Receptors*
Authors: SIEGEL ISRAEL , GLEICHER NORBERT
Published: May 2013

ABSTRACT: The addition of autologous serum to mixtures containing human red cells, from pregnant and nonpregnant females, and sheep red cells resulted in the formation of mixed aggregates containing both human and sheep red cells. In contrast, no aggregate formation occurred when autologous cord serum was addded to mixtures containing cord red cells and sheep red cells. Heat inactivation of the adult serum or the presence of 0.15 M EDTA prevented the formation of mixed aggregates. These observations indicated that the mixed aggregates occurred through the complement‐dependent red cell immune adherence (RCIA) phenomenon. The addition of untreated cord serum to mixtures containing inactivated adult serum restored the formation of mixed aggregates, indicating that the cord serum contained sufficient complement for RCIA. Natural antibody against sheep red cells was present in adult sera but was absent in cord sera.

Using the RCIA receptor assay, the RCIA receptor activity of cord red cells was found to exceed significantly that of the adult pregnant cells (p < 0.0025). It is postulated that this may represent an aspect of immune adaptation between mother and fetus.
Cell‐Mediated Immunity to Cytomegalovirus in Pregnant Women
Authors: AGATSUMA YOSHITAKA , FITZPATRICK PAUL , LELE AMOL , KAUL ADITYA , OGRA PEARAY L.
Published: May 2013

ABSTRACT: Employing the techniques of in vitro lymphocyte transformation (LTF) and complement fixation, cell‐mediated immunity (CMI) and antibody to cytomegalovirus (CMV) were studied in pregnant and nonpregnant women. The LTF activity was determined by the whole blood microassay using four strains of CMV (AD‐169 and its early antigen [EA], Davis, Veca, and Towne strains), and phytohemagglutinin (PHA).

Lymphocyte transformation response to specific CMV antigens at 11–30 weeks of gestation and to nonspecific mitogen (PHA) in all pregnant and postpartum women were found to be significanty depressed compared with the nonpregnant women. The lower LTF responses to CMV antigen and PHA were found in specimens taken from pregnant women at 21–30 weeks of gestation. There were no significant differences in the mean complement‐fixing (CF) antibody titers and the percentage of E‐rosette‐forming T lymphocytes between subjects in various stages of pregnancy.

In addition, concanavalin A (Con A)‐generated suppressor T cell activity was evaluated in pregnant and nonpregnant women. The suppressor effect of Con A‐activated lymphocytes in pregnant women was somewhat higher than in nonpregnant women. These observations suggest that CMV‐specific suppression of cellular immunity may play an important role in reactivation of CMV in pregnancy.
On the Retention of the Fetus as a Homograft
Authors: STEIN‐WERBLOWSKY RACHEL
Published: May 2013

ABSTRACT: The conceptus is tolerated in spite of the antigenic dissimilarities between mother and fetus. A new hypothesis to account for this phenomenon is put forward. It is suggested that the vessels within the trophoblastic villi—analogous to the vessels of malignant tumors—are permeable to humoral substances but impervious to cellular elements. This property allows for the exchange of nutrients and metabolites but, at the same time, precludes the passage of leukocytes. The block to diapedesis is believed to be due to the deposition of an occlusive layer of alpha2‐macroglobulin on vascular endothelium. The source of this protide is the fetal liver. In the absence of diapedesis there is no homograft reaction within the placenta. The “graft” is tolerated.
Immunosuppression in the Mouse by Porcine Uterine Secretory Protein*
Authors: ALLEN REESE L. , MURRAY FINNIE A. , WIETSMA HANK T.
Published: May 2013

ABSTRACT: Experiments were performed to determine whether uterine secretory proteins (PAP) of the pig affect T cell or B cell functions in vivo. T cell functions examined were E‐rosette formation (ERF) and cutaneous reactivity (to phytohemagglutinin) in mature BALB/c females. Two ERF experiments of identical design were performed using five groups of ten mice each. Each mouse was presensitized with sheep erythrocytes (SRBC) designated as day 0; and the various groups were treated with saline, pig serum (PS), or PAP at different times. For cutaneous reactivity, the area of erythema at the sensitization site (pinnea of ear) was measured, and three groups of 11 mice were used. These groups also received either PS or PAP. B cell function was examined by measurements of hemagglutination titers to SRBC sensitization in BALB/c females treated in two experiments similar to the ERF. T cell functions examined were highly suppressed (p < 0.01) by PAP given hours, not days, prior to the measurement. The B cell function examined was not affected by PAP.
Modulatory Effects of Estrogen on Immunologic Responsiveness. III. Effect of Hormonal Versus Nonhormonal Therapy on Tumor‐Associated Immunity in Prostatic Cancer*
Authors: ABLIN RICHARD J.
Published: May 2013

ABSTRACT: In vitro pretreatment of peripheral blood leukocytes (PBL) from patients with prostatic cancer with therapeutically significant levels of diethylstilbestrol diphosphate (DES‐P) has been shown to suppress cell‐mediated tumor‐associated immunity (TAI). In the present retrospective evaluation of TAI in 27 patients with prostatic cancer, prior to and following the receipt of nonhormonal and hormonal, ie, estrogen and/or orchiectomy, therapy, patients receiving hormonal therapy possessed significantly (p < 0.05) lower levels of TAI, irrespective of the in vitro pretreatment of their PBL with DES‐P. Suppression of TAI by in vitro pretreatment of PBL with DES‐P and in prostatic cancer patients receiving estrogen therapy parallels and extends earlier observations of the estrogenic suppression of nonspecific, mitogen‐induced cellular responsiveness. The clinical relevancy of the immunosuppressive effects of hormonal therapy on tumor‐host responsiveness is considered in view of the present and previous studies.
Maternal Influence on the Expression of Immunoglobulins in Young Mice*
Authors: WEILER I. J. , SPRENGER R.
Published: May 2013

ABSTRACT: Maternal IgG persists longer in young mice (10–12 weeks) than would be predicted from the known half‐life of passively administered immunoglobulins. By monitoring maternal and infant allotypes independently, in foster‐nursing experiments, we investigated the potential participation of milk lymphocytes in this phenomenon.

When milk cells were experimentally excluded, maternal allotype vanished three weeks earlier than in controls. On the other hand, it was not possible to prolong survival of maternal IgG beyond nine weeks by weekly administration of foster‐strain cells or serum; final rejection is in this case preceded by a burst in endogenous IgG production.

Maternal influence initially depresses endogenous IgG production, even in normal F1 offspring. Typical for fostered offspring, which initially have lower levels of endogenous IgG than normal controls, is a burst in production at the age of 6–7 weeks; we speculate that final rejection of transplanted milk lymphocytes may take place concomitant with maturation of the infant's immune system.