bluuebunny/crossref_metadata_2025 huggingface dataset:
Dilemmas of Democratisation: Media Regulation and Reform in Argentina
Authors: MACRORY ROBBIE
Published: October 2012

The relationship between the state and the media has become a key political battleground in a number of Latin American countries in recent years. Using controversial changes to broadcasting regulation in Argentina as a case study, this article examines regional trends in this field. This article argues that despite criticism of the political motivations that led to its implementation, the Audiovisual Communications Law (popularly known as theley de medios) has the potential to rebalance Argentina's media landscape. Moreover, it should not be equated with developments in Venezuelan media regulation, which do raise concerns about freedom of expression.
Australian Real‐Time Database: An Overview and an Illustration of its Use in Business Cycle Analysis*
Authors: LEE KEVIN , OLEKALNS NILSS , SHIELDS KALVINDER , WANG ZHENG
Published: October 2012

This article describes a newly constructed macroeconomic database for Australia including measures of gross domestic product (GDP), its components, prices and key monetary and labour market statistics over the last 50 years as published and revised in real time. Data vintages are collated from various sources and accommodate multiple definitional changes, providing a comprehensive description of the macroeconomic environment actually experienced by Australian policy‐ and decision‐makers. The database exposes the difficulties in drawing inferences and decision‐making based on macroeconomic data that is subsequently revised. Methods are described that can exploit the real‐time dataset and they are illustrated through an analysis of the Australian output gap.
RHD and RHCE variant and zygosity genotyping via multiplex ligation–dependent probe amplification
Authors: Haer‐Wigman Lonneke , Veldhuisen Barbera , Jonkers Remco , Lodén Martin , Madgett Tracey E. , Avent Neil D. , de Haas Masja , van der Schoot C. Ellen
Published: October 2012

Background

The presence of a D variant may hamper correct serologic D typing, which may result in D immunization. D variants can be determined via RHD genotyping. However, a convenient single assay to identify D variants is still lacking. We developed and evaluated a multiplex ligation–dependent probe amplification (MLPA) assay to determine clinically relevant RHD and RHCE variant alleles and RHD zygosity.

Study design and methods

We analyzed 236 cases (73 normal and 163 selected samples) with the RH‐MLPA assay, which is able to determine 79 RHD and 17 RHCE variant alleles and RHD zygosity. To confirm the results, mutations were verified by RHD and/or RHCE exon–specific sequencing and RHD zygosity was verified by quantitative real‐time polymerase chain reaction (PCR) for 18 cases.

Results

In 99% of the cases, the RH‐MLPA assay correctly determined whether a person carried only wild‐type RHD and RHCE alleles (n = 69) or (a) variant RHD allele(s) and/or (a) variant RHCE allele(s) (n = 164). In only three cases, including two new RHD variant alleles, the variant allele was not identified, due to lack of detecting probes. These were RHD*DCS2, a new partial RHD allele, RHD*525T (Phe175Leu), and a new D– null allele, RHD*443G (Thr148Arg). All RHD (n = 175) and RHCE variant alleles (n = 79) indicated by the RH‐MLPA assay were confirmed by sequencing. RHD zygosity was confirmed by quantitative PCR. Two hematopoietic chimeras were recognized.

Conclusion

The RH‐MLPA genotyping assay is a fast, easy, and reliable method to determine almost all clinically relevant RHD and RHCE variant alleles, RHD zygosity, and RHD+/RHD– chimeras in blood donors, blood recipients, and pregnant women.
Creating Opportunities? Bipartisanship in the Early Obama Presidency
Authors: Edwards George C.
Published: October 2012

Objective

I investigate whether it was possible for President Obama to create an opportunity for change by obtaining bipartisan support for his initiatives.

Methods

I analyze the theoretical prospects for Republican support and then examine the president's level of success in obtaining it.

Results

I find the president rarely received bipartisan support and that his efforts to obtain it were costly.

Conclusion

The president, like all presidents, could not create opportunities for change. Instead, he was dependent on exploiting the opportunities presented by those disposed to support his initiatives.
Coping with drought with innovative pricing systems: the case of two irrigation water management companies in France
Authors: Sidibé Yoro , Terreaux Jean‐Philippe , Tidball Mabel , Reynaud Arnaud
Published: October 2012

In recent years, France has been facing particularly severe drought periods especially in summer. In a country where agriculture is the largest water user, some irrigation management companies have implemented innovative pricing systems to handle this situation. The objective of this article is to analyze the impact of these new management systems on farmers’ incomes, the revenue of the management companies, and the amount of water used. To do that, we develop a methodology using a stochastic model that simulates the representative farmer's optimal behavior in a context of climatic variability. An empirical application is made with a crop growth model and data collected from the Midi‐Pyrenees region. The results show that using these specific nonlinear pricing systems allow irrigation water managers to reduce the impact of drought on production. Moreover, the type of pricing implemented depends on the characteristics and capabilities of the water company. More particularly, these pricing systems can be used to anticipate agricultural water demand in order to avoid imbalance with water availability.
Rainfall, geology and landscape position generate large‐scale spatiotemporal fire pattern heterogeneity in an African savanna
Authors: Smit Izak P. J. , Smit Chris F. , Govender Navashni , Linde Mike van der , MacFadyen Sandra
Published: October 2012

Fire is considered a critical management tool in fire prone landscapes. Often studies and policies relating to fire focus on why and how the fire regime should be managed, often neglecting to subsequently evaluate management's ability to achieve these objectives over long temporal and large spatial scales. This study explores to what extent the long‐term spatio‐temporal fire patterns recorded in the Kruger National Park, South Africa has been influenced by management policies and to what extent it was dictated by underlying variability in the abiotic template. This was done using a spatially explicit fire‐scar database from 1941 to 2006 across the 2 million ha Park. Fire extent (ha burnt per annum) 1) is correlated with rainfall cycles 2) exhibits no long‐term trend and 3) is largely non‐responsive to prevailing fire management policies. Rainfall, geology and distance from the closest perennial river and the interactions between these variables influence large‐scale fire pattern heterogeneity: areas with higher rainfall, on basaltic substrates and far from rivers are more fire prone and have less heterogeneous fire regimes than areas with lower rainfall, on granitic substrates and closer to rivers. This study is the first to illustrate that under a range of rainfall and geological conditions, perennial rivers influence long‐term, landscape‐scale fire patterns well beyond the riparian zone (typically up to 15 km from the river). It was concluded that despite fire management policies which historically aimed for largely homogeneous fire return regimes, spatially and temporally heterogeneous patterns have emerged. This is primarily because of differences in rainfall, geology and distance from perennial rivers. We postulate that large‐scale spatio‐temporal fire pattern heterogeneity is implicit to heterogeneous savannas, even under largely homogenizing fire policies. Management should be informed by these patterns, embracing the natural heterogeneity‐producing template. We therefore suggest that management actions will be better directed when operating at appropriate scales, nested within the broader implicit landscape patterns, and when focusing on fire regime parameters over which they have more influence (e.g. fire season).
Migratory strategies of waterbirds shape the continental‐scale dispersal of aquatic organisms
Authors: Viana Duarte S. , Santamaría Luis , Michot Thomas C. , Figuerola Jordi
Published: October 2012

Long distance dispersal (LDD) of propagules is an important determinant of population dynamics, community structuring and biodiversity distribution at landscape, and sometimes continental, scale. Although migratory animals are potential LDD vectors, migratory movement data have never been integrated in estimates of propagule dispersal distances and LDD probability. Here we integrated migratory movement data of two waterbird species (mallard and teal) over two continents (Europe and North America) and gut retention time of different propagules to build a simple mechanistic model of passive dispersal of aquatic plants and zooplankton. Distance and frequency of migratory movements differed both between waterbird species and continents, which in turn resulted in changes in the shapes of propagule dispersal curves. Dispersal distances and the frequency of LDD events (generated by migratory movements) were mainly determined by the disperser species and, to a lesser extent, by the continent. The gut retention time of propagules also exerted a significant effect, which was mediated by the propagule characteristics (e.g. seeds were dispersed farther than Artemia cysts). All estimated dispersal curves were skewed towards local‐scale dispersal and, although dispersal distances were lower than previous estimates based only on the vector flight speed, had fat tails produced by LDD events that ranged from 230 to 1209 km. Our results suggest that propagule dispersal curves are determined by the migratory strategy of the disperser species, the region (or flyway) through which the disperser population moves, and the propagule characteristics. Waterbirds in particular may frequently link wetlands separated by hundreds of kilometres, contributing to the maintenance of biodiversity and, given the large geographic scale of the dispersal events, to the readjustment of species distributions in the face of climate change.
Militancy in the Magic Kingdom: Why Mickey, Goofy and Snow White Struck Disney
Authors: Watts Steven
Published: October 2012

The remarkable story of the 1941 animators walkout that ended in victory over Walt Disney's red‐baiting and paternalism.
Life Support
Authors: Gordon Suzanne
Published: October 2012

Nurses are on the front lines, fighting against disease, callous care, and the profit motive. What will it take to win the war?.
Taxing Our Patience: Why Workers Pay More and the Rich Pay Less
Authors: Friedman Sheldon
Published: October 2012

Despite getting much of last year's tax cut, the corporations and the wealthy want to lower their taxes even more. But labor has an agenda for real tax reform.
Lessons from the Victory at Phillips Van Heusen
Authors: Moberg David
Published: October 2012

In Guatemala, international solidarity helped garment workers win a union contract. What can we learn from this success?
Can Unions Find a Strategy For Labor Market Strength?
Authors: Aronowitz Stanley , Cutler Jonathan
Published: October 2012

Shorter working time could boost labor's bargaining power. It would tighten labor markets without the exclusivist results of craft unionism, nativism, racism, and sexism.
BOOK REVIEW
Authors: Witt Matt
Published: October 2012

Book reviewed in this article:

Made Possible By …: The Death of Public Broadcasting in the United States: By James Ledbetter, Verso, 1997

Public Television: Politics & the Battle Over Documentary Film: By B.J. Bullert, Rutgers University Press, 1997

Public Radio and Television in America: By Ralph Engelman, Sage Publications, 1996
Unions and Technology: Manufacturing Better Jobs
Authors: Ewing Linda , Friedman Sheldon , Markell Brad , Yudken Joel
Published: October 2012

Taxpayer‐funded technology centers are helping smaller manufacturing firms modernize, but unions must push to ensure workers and the community reap benefits as well.
Dismantling the Myth of the ‘New’ American Economy
Authors: Mishel Lawrence , Bernstein Jared , Schmitt John
Published: October 2012

Finally, unemployment is down and real wages are up. But working families continue to suffer from job insecurity and income/wealth inequality.
Labor's Crucial Stake in the Fight for Immigrant Rights
Authors: Bacon David
Published: October 2012

Undocumented workers can be a source of new ideas and militancy for unions, which must do more to oppose anti‐immigrant hysteria.
Skilled Work in an Era Of Management‐By‐Stress
Authors: Parker Mike
Published: October 2012

Corporate strategies for work organization, such as lean production, demand a labor response aimed at greater skills, better jobs, and more power for union members.
How Labor Defeated California's Proposition 226
Authors: Grossinger Ken
Published: October 2012

An inside look at how unions achieved “a modern political miracle.”
Not Just 9 to 5: The Problems of Nonstandard Working Hours
Authors: Kahn Peggy , Blum Linda M.
Published: October 2012

Parents, particularly low‐paid women, often get shift work that makes child care a nightmare. Should seniority systems change?
Drug Testing: Does it Really Improve Labor Productivity?
Authors: Shepard Edward , Clifton Thomas
Published: October 2012

A new study casts doubt on company claims that testing of workers for illicit drug use results in enhanced productivity.
Changing the Way Unions Do Politics
Authors: Gerber Robin
Published: October 2012

Politicians must be held accountable not just on legislation, but on the broader agenda of organizing, bargaining, and worker rights.
How Teamsters Took the UPS Strike Overseas
Authors: Russo John , Banks Andy
Published: October 2012

Labor won't win many key bargaining and organizing struggles unless it develops new international strategies.
Every Worker is An Organizer
Authors: Bacon David
Published: October 2012

Farm Labor and the Resurgence of the United Farm Workers
Should American Labor Turn to Turn?
Authors: Wheeler Hoyt N.
Published: October 2012

An innovative grass‐roots labor network in Europe has won gains for workers on economic development and training.
Public Employees Confront The Perils of Privatization
Authors: Martin Brendan
Published: October 2012

When free‐market zealots succeed in turning over government services to profit‐making corporations, workers and citizens often suffer.
Alliances Across the Border: U.S. Labor in the Era of Globalization
Authors: Nissen Bruce
Published: October 2012

Unions need to expand international solidarity activities if workers are to counter the growing power of transnational companies.
Labor Rights Are Human Rights
Authors: Adams Roy J.
Published: October 2012

Freedom of association and collective bargaining have won international status as human rights. Americans shouldn't let companies violate them with impunity.
Teacher Unions in Popular Culture: Individualism and the Absence of Collectivity
Authors: Rousmaniere Kate
Published: October 2012

Media today falsely portray education unions as too militant and hostile to their communities.
Prothymosin α plays multifunctional cell robustness roles in genomic, epigenetic, and nongenomic mechanisms
Authors: Ueda Hiroshi , Matsunaga Hayato , Halder Sebok Kumar
Published: October 2012

Prothymosin α (ProTα) possesses multiple functions for cell robustness. This protein functions intracellularly to stimulate cell proliferation and differentiation through epigenetic or genomic mechanisms. ProTα also regulates the cell defensive mechanisms through an interaction with the Nrf2‐Keap1 system. Under the apoptotic conditions, it inhibits apoptosome formation by binding to Apaf‐1. Regarding extracellular functions, ProTα is extracellularly released from the nucleus upon necrosis‐inducing ischemia stress in a manner of nonclassical release, and thereby inhibits necrosis. However, under the condition of apoptosis, the C‐terminus of ProTα is cleaved off and loses binding activity to cargo protein S100A13 for nonclassical release. However, cleaved ProTα is retained in the cytosol and inhibits apoptosome formation. ProTα was recently reported to cause immunological actions through the Toll‐like receptor 4. However, the authors also suggest the possible existence of additional receptors for robust cell activities against ischemia stress.
Protective effects of thymosin β4 in a mouse model of lung fibrosis
Authors: Conte Enrico , Genovese Tiziana , Gili Elisa , Esposito Emanuela , Iemmolo Maria , Fruciano Mary , Fagone Evelina , Pistorio Maria Provvidenza , Crimi Nunzio , Cuzzocrea Salvatore , Vancheri Carlo
Published: October 2012

Thymosin β4 (Tβ4) has been found to have several biological activities related to antiscarring and reduced fibrosis. For example, the anti‐inflammatory properties of Tβ4 and its splice variant have been shown in the eye and skin. Moreover, Tβ4 treatment prevents profibrotic gene expression in cardiac and in hepatic cells in vitro and in vivo. In a recent study on scleroderma patients it was hypothesized that Tβ4 may exert a protective effect during human lung injury. In an ongoing study, we have explored the putative Tβ4 protective role in the lung context by utilizing a well‐known in vivo model. We have observed significant protective effects of Tβ4 on bleomycin‐induced lung damage, the main outcomes being the halting of the inflammatory process and a substantial reduction of histological evidence of lung injury.
Jack of all trades: thymosin α1 and its pleiotropy
Authors: Romani Luigina , Moretti Silvia , Fallarino Francesca , Bozza Silvia , Ruggeri Loredana , Casagrande Andrea , Aversa Franco , Bistoni Francesco , Velardi Andrea , Garaci Enrico
Published: October 2012

Thymosin α1 (Tα1), a thymosin‐related 28‐mer synthetic amino‐terminal acetylated peptide, has gained increasing interest in recent years, due to its pleiotropy. The peptide has been used worldwide as an adjuvant or immunotherapeutic agent to treat disparate human diseases, including viral infections, immunodeficiencies, and malignancies. The peptide can enhance T cell, dendritic cell (DC), and antibody responses, modulate cytokine and chemokine production, and block steroid‐induced apoptosis of thymocytes. Its central role in modulating DC function and activating multiple signaling pathways that contribute to different functions may offer a plausible explanation for its pleiotropic action. Additionally, the ability of Tα1 to activate the indoleamine 2,3‐dioxygenase enzyme—which confers immune tolerance during transplantation and restrains the vicious circle of chronic inflammation—has been a turning point, suggesting a potential, specific function in immunity. Accordingly, Tα1 has recently been shown to promote immune reconstitution and improve survival of recipients of HLA‐matched sibling T cell–depleted stem cell transplants in a phase I/II clinical trial. Thus, Tα1 continues to live up to its promises.
Protective effects of thymosin β4 on carbon tetrachloride‐induced acute hepatotoxicity in rats
Authors: Reyes‐Gordillo Karina , Shah Ruchi , Arellanes‐Robledo Jaime , Rojkind Marcos , Lakshman M. Raj
Published: October 2012

Thymosin β4 (Tβ4) plays a role in fibrosis, inflammation, and in the reparative process of injured cells and tissues. Here, we discuss our preliminary work on the protective effect of Tβ4 on carbon tetrachloride (CCl4)‐induced acute hepatotoxicity. Our studies thus far indicate that Tβ4 can prevent necrosis, inflammatory infiltration, and upregulation of α1(and 2) collagen, α‐SMA, PDGF‐β receptor, and fibronectin mRNA expression; in addition, Tβ4 can prevent downregulation of PPARγ and upregulation of MECP2 mRNA levels in acute liver injury. Our initial work therefore indicates that Tβ4 can prevent the alteration of markers of hepatic stellate cell transdifferentiation, which suggests that Tβ4 could maintain the quiescent phenotypic state of hepatic stellate cells in the rat livers by restoring PPARγ and downregulating MeCP2 expression levels. More specifically, these preliminary studies suggest that Tβ4 might be an effective anti‐inflammatory and antifibrotic drug for the treatment of liver fibrogenesis.
Use of stereotactic body radiation therapy for medically inoperable multiple primary lung cancer
Authors: Matthiesen Chance , Thompson J Spencer , De La Fuente Herman Tania , Ahmad Salahuddin , Herman Terence
Published: October 2012

Introduction: To review outcomes of medically inoperable patients treated with stereotactic body radiation therapy (SBRT) for multiple primary lung cancer (MPLC).

Methods: We retrospectively reviewed the charts of 10 patients (21 lesions) treated with SBRT for synchronous (seven), metachronous (one) or synchronous/metachronous lung cancers. All patients were male, medically inoperable and had a median age of 66 years. Eight patients had bilateral disease and two had unilateral disease. All patients had a histological diagnosis in at least one of the two lesions and four patients (44.4%) had both lesions biopsied. There were 18 T1 lesions and three T2 lesions. SBRT was in three fractions of 20 Gy or five fractions of 11–12 Gy to each lesion.

Results: Mean and median follow up were 18.8 and 15.5 months, respectively. At analysis, six patients (60.0%) are alive, and five of these living patients (83.3%) have no evidence of disease recurrence or progression. Four patients (44.4%) developed distant metastatic disease. Twenty lesions (95.2%) achieved in‐field local control. No patients experienced acute pulmonary complications and only two patients (22.2%) experienced late grade I lung toxicity as per the Radiation Therapy Oncology Group toxicity criteria.

Conclusion: SBRT for MPLC in medically inoperable patients is a safe, feasible and effective treatment approach.
Radioembolisation with Yttrium‐90 microspheres: An effective treatment modality for unresectable liver metastases
Authors: Bester Lourens , Meteling Baerbel , Pocock Nicholas , Saxena Akshat , Chua Terence C , Morris David L
Published: October 2012

Purpose

To compare the outcomes (survival and adverse events) of the authors' use of 90Y microsphere radioembolisation in patients with chemotherapy‐refractory liver metastases with published data from other groups using radioembolisation. To retrospectively evaluate the efficiency, in particular survival benefits, of radioembolisation in the treatment of liver metastases.

Methods and Materials

Over 5 years, 339 patients underwent 90Y microsphere radioembolisation for unresectable liver metastases and were evaluated for adverse events at the time of treatment and 1 and 3 months after treatment. Overall survival (OS) was calculated by the Kaplan–Meier method. The results from the present retrospective study were compared with a number of prospective and retrospective clinical trials which have addressed the use of 90Y microspheres as a salvage treatment for liver metastases.

Results

The OS time of the present study (12.0 months) compares favourably with survival times reported by other groups. The incidence of late grade 2 adverse events (e.g. duodenal or gastric ulceration, radiation‐induced liver disease, gall bladder complications) is comparable to previous studies, with a lower prevalence of grade 2/3 ulcerations (3.7%) at our centre.

Conclusions

The survival results, together with the low acute and late toxicity observed in our data and previous studies, support the use of radioembolisation to aid in the local control of unresectable liver metastases in the salvage setting. The present study contributes to the growing evidence for efficiency, in particular survival gains, of radioembolisation in the treatment of liver metastases.
Exploring the utility of three nuclear regions to reconstruct reticulate evolution in the fern genus Asplenium
Authors: SCHNEIDER Harald , NAVARRO‐GOMEZ Adriana , RUSSELL Stephen J. , ANSELL Stephen , GRUNDMANN Michal , VOGEL Johannes
Published: October 2012

Three nuclear regions nuclear ribosomal internal transcribed spacer (nrITS) and intron regions of two nuclear low‐copy genes—gapCp, and pgiC, in combination with one chloroplast genome region were employed to explore patterns of reticulate evolution in the fern genus Asplenium. This is the one of the first studies using DNA sequences of multiple nuclear markers in ferns. All three nuclear markers amplified well with PCR and several copies were recovered by cloning PCR products. All three nuclear regions showed congruent results by recovering the neo‐allotetraploid Asplenium adulterinum as the hybrid of diploid A. trichomanes and diploid A. viride. Conflicting results were obtained for several nodes. First, gapCp did not discriminate between A. aethiopicum and A. praegracile whereas the other markers recovered these two taxa as distinct. Conflicts among gene‐trees were found in respect to A. monanthes, chloroplast and pgiC suggested a sister relationship of A. monanthes and A. trichomanes but gapCp and nrITS nested A. monanthes within A. normale. Our results confirm: (i) the usefulness of several nuclear regions, in particular gapCp and pgiC, to unravel reticulate evolution in ferns and species differentiation and (ii) highlights the need to employ more than one nuclear region to obtain reliable hypotheses on reticulate events versus incomplete lineage sorting. Especially, if one assumes that the reticulation event might have occurred in the more distant past. Considering the expected high frequency of reticulate evolution in ferns, the establishment of robust and informative nuclear genomic markers is critical to achieve further progress in our efforts to elucidate fern evolution.
Is the haematopoietic effect of testosterone mediated by erythropoietin? The results of a clinical trial in older men
Authors: Maggio M. , Snyder P. J. , Ceda G. P. , Milaneschi Y. , Luci M. , Cattabiani C. , Masoni S. , Vignali A. , Volpi R. , Lauretani F. , Peachey H. , Valenti G. , Cappola A. R. , Longo D. , Ferrucci L.
Published: October 2012

The stimulatory effects of testosterone on erythropoiesis are very well known, but the mechanisms underlying the erythropoietic action of testosterone are still poorly understood, although erythropoietin has long been considered a potential mediator. A total of 108 healthy men >65 years old with serum testosterone concentration <475 ng/dL were recruited by direct mailings to alumni of the University of Pennsylvania and Temple University, and randomized to receive a 60‐cm2 testosterone or placebo patch for 36 months. Ninety‐six subjects completed the trial. We used information and stored serum specimens from this trial to test the hypothesis that increasing testosterone increases haemoglobin by stimulating erythropoietin production. We used information of 67 men, 43 in the testosterone group and 24 in the placebo group who had banked specimens available for assays of testosterone, haemoglobin and erythropoietin at baseline and after 36 months. The original randomized clinical study was primarily designed to verify the effects of testosterone on bone mineral density. The primary outcome of this report was to investigate whether or not transdermal testosterone increases haemoglobin by increasing erythropoietin levels. The mean age ± SD of the 67 subjects at baseline was 71.8 ± 4.9 years. Testosterone replacement therapy for 36 months, as compared with placebo, induced a significant increase in haemoglobin (0.86 ± 0.31 g/dL, p = 0.01), but no change in erythropoietin levels (−0.24 ± 2.16 mIU/mL, p = 0.91). Included time‐varying measure of erythropoietin did not significantly account for the effect of testosterone on haemoglobin (Treatment‐by‐time: β = 0.93, SE = 0.33, p = 0.01). No serious adverse effect was observed. Transdermal testosterone treatment of older men for 36 months significantly increased haemoglobin, but not erythropoietin levels. The haematopoietic effect of testosterone does not appear to be mediated by stimulation of erythropoietin production.
Ultrasonographic determination of caput epididymis diameter is strongly predictive of obstruction in the genital tract in azoospermic men with normal serum FSH
Authors: Pezzella A. , Barbonetti A. , Micillo A. , D'Andrea S. , Necozione S. , Gandini L. , Lenzi A. , Francavilla F. , Francavilla S.
Published: October 2012

The relationship between epididymis ultrasonography (US) and infertility is poorly defined probably owing to lack of objective and reproducible criteria of US evaluation. Here, we evaluated US size of testes, caput and of corpus epididymis in infertile men: 165 with total sperm count ≥39 × 106, 187 with total sperm count <39 × 106 and 75 azoospermic men. Blood levels of follicle stimulating hormone (FSH) and of total testosterone were also evaluated. US measures obtained using a high‐frequency (12 MHz) linear array transducer, included the mean value of bilateral testicular volumes (mL) (Testes‐M), of bilateral longitudinal diameter of caput epididymis (mm) (Caput‐M) and of the bilateral antero‐posterior diameter of the corpus measured on a longitudinal scan (mm) (Corpus‐M). Testicular histology of azoospermic men was obtained and the percentage of seminiferous tubules with elongated spermatids (%T) was used to classify cases with normal spermatogenesis (obstructive azoospermia) (n = 17; %T ≥ 80), or with deranged spermatogenesis (n = 58; %T ≤ 33). Caput‐M was correlated with Testes‐M (p = 0.0003; r = 0.17) and with FSH serum levels (p = 0.024; r = −0.14) but not with semen parameters. Caput‐M but not Corpus‐M values resulted greater in obstructive azoospermia compared with other groups, but difference was not significant. Cut‐off values of Testes‐M, Caput‐M and of FSH correctly classified cases of obstructive azoospermia (AUC > 0.5). A patient with FSH < 7.8 IU/mL had a 63.6% chance (CI 40.1–83.2%) of being affected by obstructive azoospermia. US Caput‐M ≥10.85 mm, which represented the cut‐off value with the highest combination of sensitivity (58.8%, CI 32.9–81.6%) and specificity (91.4%, CI 81.0–97.1%) applied in cases with FSH < 7.8 IU/mL increased the probability for obstructive azoospermia from 63.6% up to 92.3% (CI 76.5–98.8%). US evaluation of the caput epididymis diameter helped in predicting the obstructive origin of azoospermia when FSH was not increased, whereas it was not relevant in non‐azoospermic men.
Optimizing TESE‐ICSI by laser‐assisted selection of immotile spermatozoa and polarization microscopy for selection of oocytes
Authors: Nordhoff V. , Schüring A. N. , Krallmann C. , Zitzmann M. , Schlatt S. , Kiesel L. , Kliesch S.
Published: October 2012

Summary

For most azoospermic men testicular sperm extraction (TESE) is the only treatment, however it presents challenges for the ART laboratory, as the retrieval of motile spermatozoa is difficult. In the absence of sperm movement no unequivocal distinction can be made between either dead or immotile, but vital spermatozoa. However, a single laser shot directed to the tip of the tail allows recognition of viability because the flagellum coils at the area of impact. To rank the quality and the maturity of oocytes, polarization microscopy can be used. The zona score and the visualization of the meiotic spindle correlate with implantation and pregnancy rates. We compared 65 TESE‐ICSI cycles of the years 2007 and 2008 (Group 1, G1) with 58 TESE‐ICSI cycles of the years 2009 and 2010 (Group 2, G2). Testicular spermatozoa were injected according to motility and morphology into selected oocytes. In G1 both, oocyte and spermatozoa were rated using light microscopy only, whereas in G2 the laser was used for sperm selection and the oocytes were rated by light and polarization microscopy. In G2 we enhanced our fertilization rate (FR) significantly in comparison to G1 (G1 42.1% vs. G2 52.7%, p < 0.001). The fertilization rate with immotile, but vital spermatozoa improved significantly when applying laser‐based selection (p = 0.006). The laser selection of immotile spermatozoa and the use of polarization microscopy can enhance the FR of TESE‐ICSI. No negative effect of the laser was seen on birth rates. The FR with immotile, but vital spermatozoa clearly benefits from laser selection and is a non‐hazardous and safe method for the selection of viable but immotile sperm. To our knowledge this is the first report using new technology creating novel endpoints for the analysis of spermatozoa and oocytes in TESE‐ICSI.
Musing about Time and Museums
Authors: Bedford Leslie
Published: October 2012

Abstract   The author considers the question of how museums engage visitors in thinking about the meaning of time (personal and universal) and the role played by objects, text, designed settings, and artistry in bringing the process to life, a theme inspired by an article, “The Mindful Museum” (2007), by Adam Gopnik.
For Whom Are We Building These Gems? Redefining Impact at the Museo Textil de Oaxaca
Authors: Reisman Leah
Published: October 2012

Abstract   Can museums still be valuable to populations that don’t visit them? The city of Oaxaca, Mexico is home to a flourishing museum scene, but despite a desire by those museum professionals to serve the Oaxacan community, the city’s museums largely lack a local visiting base. This article, which reflects on ethnographic fieldwork conducted in Oaxaca in 2010, explores the implications of the disjunction between intention, assumption, and reality in some of Oaxaca’s museums, especially the Museo Textil de Oaxaca, a small private textile museum in the city’s historical center. By considering the museum’s inherent value and its innovative attempts to tangibly impact a specific community outside of the museum edifice, I suggest a way to rethink impact in museums by, in effect, turning them inside out: shifting the focus away from “public value driven by a universal right to cultural access” (Stein 2012, 219), toward more tangible, external outcomes, including direct interventions in the dynamic world beyond the quiet galleries.
Touring Yuzi Paradise Art Park, Guilin, China
Authors: Carrier David
Published: October 2012

Abstract   Guilin, a small city in subtropical southwest China, is an hour’s flight north from Guangzhou or Hong Kong. This region, famous for its mountains, which appear in some important Chinese old master scrolls and also on the 20 RMB currency note of the People’s Republic, is nicely described by a popular saying: “Guilin’s scenery is best among all under heaven.” An art park, Yuzi Paradise, founded in 1997 by Tsao Ryh‐Chang, a wealthy Taiwanese entrepreneur, occupies 1,300 acres of land in this remote area. Ten percent of the acreage is the art park; the rest is mostly untouched landscape. Sculptors from 30 nations were invited to more than a dozen symposiums at the park and were given the means to create art. Recently, the site was opened to the public.
Applying Visitor Preference Criteria to Choose Pro‐wildlife Behaviors to Ask of Zoo Visitors
Authors: Smith Liam , Weiler Betty , Smith Amy , van Dijk Pieter
Published: October 2012

Abstract   Many zoos now emphasize that their role in conservation includes influencing the behavior of their visitors for the benefit of wild animals. However, there is limited evidence of behavioral change to support this emphasis; one reason may be that requested behaviors are not viewed favorably by zoo visitors. The purpose of the present study was to involve zoo staff in a process of identifying and prioritizing pro‐wildlife behaviors using a set of criteria that noted what zoo visitors prefer. This was achieved by replicating Smith’s (2009a) study but including visitor‐preferred attributes identified in Smith, Curtis, and van Dijk (2010). Across several zoos in Australia, 152 staff members participated in seven Nominal Group Technique workshops. Initially over 500 behaviors were identified and prioritized, first by filtering behavior lists, then by participants voting on behaviors. When voting, participants tended to choose behaviors promoting wildlife‐friendly consumerism and donations.
Disagreement Makes Us Strong?
Authors: Sandahl Jette
Published: October 2012

Abstract   Museums are mirrors of national, regional, and local identities, functioning as self portraits of nations, regions, and cities. But to what extent do city museums, for instance, actively and consciously reflect the ethical, political, or social dilemmas, contradictions, and conflicts that drive and impact the cities they serve? As concepts of democracy expand in the twenty‐first century, can museums be platforms for dialogue and solution‐building? What hinders museums in facilitating equal access to culture for everyone and encouraging a plurality of voices to speak? Like many other city museums, the Museum of Copenhagen is forced, enticed, and lured by the complexity, richness, and challenges of contemporary urban cultures to re‐examine its vision and methods, seeking a new relevance and presence for itself within the city.
Blood Pressure Measurement Device, Number and Timing of Visits, and Intra‐Individual Visit‐to‐Visit Variability of Blood Pressure
Authors: Levitan Emily B. , Kaciroti Niko , Oparil Suzanne , Julius Stevo , Muntner Paul
Published: October 2012

J Clin Hypertens (Greenwich). 2012;14:744–750. ©2012 Wiley Periodicals, Inc.

Visit‐to‐visit variability (VVV) of blood pressure is associated with cardiovascular disease. The authors examined the effects of visit number and timing and automated or manual measurement device on VVV in the placebo arm of the Trial of Preventing Hypertension (TROPHY) (N=225) and simulations. VVV was assessed using intra‐individual standard deviation (SD), range, maximum, coefficient of variation, successive variation, and average real variability of systolic blood pressure. VVV increased with number of visits used to calculate it in the TROPHY population (P for trend <.05 for all metrics) and simulations. Using consecutive visits in TROPHY, average SD was 5.6 mm Hg from 3 visits, 6.8 mm Hg from 7 visits, and 7.7 mm Hg from 18 visits. When 7 visits were spread out across 4 years, the average SD was higher (7.5 mm Hg) than when visits were consecutive over 18 months (P<.001). SD was higher using a single blood pressure measurement per visit (compared with the mean of 3 measurements per visit P<.001) and with automated vs manual devices (P<.001). In summary, number and timing of visits and device used to measure blood pressure influence VVV and need to be considered when designing, interpreting, and comparing studies.
Is Isolated Systolic Hypertension Worse Than Combined Systolic/Diastolic Hypertension?
Authors: Ma Yonggang , Yabluchanskiy Andriy , Lindsey Merry L. , Chilton Robert J.
Published: October 2012

J Clin Hypertens (Greenwich). 2012;14:808–809. ©2012 Wiley Periodicals, Inc.

New developments in cardiovascular translational sciences have significantly advanced our understanding of the endovascular biology of blood pressure. Reductions in vascular elasticity and vessel compliance of conduit arteries are key components of both ISH and SDH. Vascular changes from the matrix metalloproteinase family of enzymes are involved in arterial wall remodeling and vascular stiffness. This new translational information helps further our understanding of both ISH and SDH.
Sustained Blood Pressure–Lowering Effect of Aliskiren Compared With Telmisartan After a Single Missed Dose
Authors: Düsing Rainer , Brunel Patrick , Baek InYoung , Baschiera Fabio
Published: October 2012

Poor adherence to antihypertensive drug treatment is common and is often associated with marked prolongations of the dosing interval. Hence, selecting a treatment that has the potential to provide a sustained blood pressure (BP)–lowering effect is important. The objective of this analysis is to compare the sustained efficacy of aliskiren with telmisartan after a single missed dose. This is part of a 12‐week double‐blind study conducted in patients with mild to moderate hypertension randomized to once‐daily aliskiren 150 mg or telmisartan 40 mg for 2 weeks, force‐titrated to double the doses for 10 weeks, followed by placebo for 1 week. The changes in BP from the end of active treatment (EOA) to 48 hours after treatment withdrawal (day 2) were analyzed. Demographic and baseline characteristics were comparable between the treatment groups. Aliskiren continued to show significantly greater reductions in mean sitting systolic BP (−0.7 vs +1.3 mm Hg; P<.05), 24‐hour mean ambulatory systolic BP (−3.6 vs +2.6 mm Hg; P<.01), and 24‐hour mean ambulatory diastolic BP (−3.7 vs +0.4 mm Hg; P<.01) compared with telmisartan from EOA to day 2, despite the similar BP reductions from randomization to EOA. In conclusion, aliskiren sustained the BP‐lowering efficacy better than telmisartan after a single missed dose.
Effect of Valsartan With Bedtime Dosing on Chronic Kidney Disease Patients With Nondipping Blood Pressure Pattern
Authors: Wang Cheng , Zhang Jun , Liu Xun , Li Cui‐Cui , Ye Zeng Chun , Peng Hui , Chen Zhujiang , Lou Tanqi
Published: October 2012

Nondipping blood pressure (BP) pattern is a potential independent risk factor for chronic kidney disease (CKD). Bedtime administration of valsartan is considered to normalize circadian rhythm and protect the kidneys and heart in CKD patients. However, more clinical trials are needed to confirm this benefit. Sixty patients with nondipping BP pattern and thirty patients with dipping BP pattern were enrolled in this study, and the patients with nondipping BP pattern were randomly divided into two groups and treated with bedtime or awakening doses of valsartan (80–320 mg). Nondipping BP patients treated with bedtime doses of valsartan showed a greater reduction in 24‐hour proteinuria and bedtime proteinuria, a greater delayed decline in estimated glomerular filtration rate, and more protection against myocardial hypertrophy (P<.05) compared with patients with the nondipping BP pattern treated with the awakening dose (P<.05). This was similar to patients with dipping BP. No severe clinical complications were recorded in these patients. Valsartan with bedtime dosing in CKD patients with the nondipping BP pattern have better renal and cardiovascular protection. Antihypertensive “chronotherapy” may be useful in clinical practice for CKD patients.
Efficacy and safety of intraoperative dexmedetomidine for acute postoperative pain in children: a meta‐analysis of randomized controlled trials
Authors: Schnabel Alexander , Reichl Sylvia U. , Poepping Daniel M. , Kranke Peter , Pogatzki‐Zahn Esther M. , Zahn Peter K.
Published: October 2012

Background

Aim of the current meta‐analysis was to assess the effects of intraoperative dexmedetomidine on postoperative pain, analgesic consumption, and adverse events in comparison with placebo or opioids in children undergoing surgery.

Methods

This meta‐analysis was performed according to the recommendations of the PRISMA statement and the Cochrane collaboration. For dichotomous and continuous outcomes of efficacy and adverse events, the Revman® (The Nordic Cochrane Centre, Copenhagen, Denmark) statistical software was used to calculate relative risk (RR), mean difference (MD), and 95% confidence intervals (CI).

Results

We included 11 randomized controlled trials – 434 children received dexmedetomidine, 440 received control. In comparison with placebo, children receiving dexmedetomidine showed a reduced RR for postoperative opioids (0.4; 95% CI: 0.26–0.62; P < 0.00001) and postoperative pain (0.51; 95% CI: 0.32–0.81; P = 0.004). Similar results were obtained for the comparison with intraoperative opioids: reduced RR for postoperative pain (0.49; 95% CI: 0.25–0.94; P = 0.03) and the need for postoperative opioids (0.77; 95% CI: 0.60–1.09; P = 0.05).

Conclusions

This meta‐analysis revealed a lower risk for postoperative pain and the need for postoperative opioids following intraoperative dexmedeto‐midine in comparison with placebo or opioids in children undergoing surgery; however, the influence of dexmedetomidine on postoperative opioid consumption is less clear. Although there were only a limited number of adverse events, further studies focusing on procedure specific dexmedetomidine dosing and adverse events are urgently needed.
Surfactant deactivation in a pediatric model induces hypovolemia and fluid shift to the extravascular lung compartment
Authors: Díaz Franco , Erranz Benjamín , Donoso Alejandro , Carvajal Cristóbal , Salomón Tatiana , Torres María , Cruces Pablo
Published: October 2012

Background

Surfactant deficiency is the pivotal abnormality in Neonatal and Acute Respiratory Distress Syndrome. Surfactant deactivation can produce hypoxemia, loss of lung compliance, and pulmonary edema, but its circulatory consequences are less understood.

Objective

To describe the sequential hemodynamic changes and pulmonary edema formation after surfactant deactivation in piglets.

Methods

Surfactant deactivation was induced by tracheal instillation of polysorbate 20 in 15 anesthetized and mechanically ventilated Large White piglets. The hemodynamic consequences of surfactant deactivation were assessed at 30, 120, and 240 min by transpulmonary thermodilution and traditional methods.

Results

Surfactant deactivation caused hypoxemia, reduced lung compliance, and progressively increased lung water content (P < 0.01). Early hypovolemia was observed, with reductions of the global end‐diastolic volume and stroke volume (P < 0.05). Reduced cardiac output was observed at the end of the study (P < 0.05). Standard monitoring was unable to detect these early preload alterations. Surprisingly, the bronchoalveolar protein content was greatly increased at the end of the study compared with baseline levels (P < 0.01). This finding was inconsistent with the notion that the pulmonary edema induced by surfactant deactivation was exclusively caused by high surface tension.

Conclusions

Hypovolemia develops early after surfactant deactivation, in part due to the resulting fluid shift from the intravascular compartment to the lungs.
Emergence delirium in children: a comparison of sevoflurane and desflurane anesthesia using the Paediatric Anesthesia Emergence Delirium scale
Authors: Locatelli Bruno G. , Ingelmo Pablo M. , Emre Sahillioğlu , Meroni Veronica , Minardi Carmelo , Frawley Geoff , Benigni Alberto , Di Marco Salvatore , Spotti Angelica , Busi Ilaria , Sonzogni Valter
Published: October 2012

Objectives/Aim

This randomized control trial was designed to evaluate the incidence of emergence delirium (ED) in preschool children receiving sevoflurane or desflurane anesthesia combined with an effective caudal block.

Background

While ED has been described in children receiving sevoflurane or desflurane anesthesia, a direct comparison between the two agents using a validated ED assessment tool has not been reported previously.

Methods/Materials

Two hundred and sixty preschool children scheduled for elective sub‐umbilical surgery were randomized to receive sevoflurane or desflurane anesthesia combined with a caudal block. ED was defined as a Paediatric Anesthesia Emergence Delirium scale (PAED) ≥10 points. A delirium‐specific score (ED I) was calculated from the first three items of the PAED score (eye contact, purposeful actions, awareness of the surroundings) and a nonspecific score (ED II) from the last two items on the PAED score (restlessness and inconsolability) to test the hypothesis that some items of the PAED scale may better reflect clinical ED than others.

Results

Thirty‐one (25%) children in each group demonstrated ED after awakening with ED being of shorter duration in the desflurane group than the sevoflurane group. An ED I score of nine points had a sensitivity of 0.93 and a specificity of 0.94 for ED. An ED II score of five points had a sensitivity of 0.34 and specificity of 0.95 for ED.

Conclusion

Sevoflurane and desflurane anesthesia were associated with similar incidences of ED in children undergoing sub‐umbilical surgery and receiving effective regional anesthesia. High scores on the first three items of the PAED scale were highly correlated with ED. The items restlessness and inconsolability had lower sensitivity for the diagnosis of ED.