bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoendoscopic single‐site versus conventional laparoscopic pyeloplasty: A matched pair analysis
Authors: Naitoh Yasuyuki , Kawauchi Akihiro , Yamada Yasuhiro , Fujihara Atsuko , Hongo Fumiya , Kamoi Kazumi , Okihara Koji , Miki Tsuneharu
Published: March 2014

Objective

To compare the outcomes of laparoendoscopic single‐site pyeloplasty versus those of conventional laparoscopic pyeloplasty.

Methods

A total of 26 laparoendoscopic single‐site pyeloplasty cases carried out in University Hospital: Kyoto Prefectural University of Medicine, Kyoto, Japan, from 2008 to 2013 were compared with a control group of 26 age‐matched laparoscopic pyeloplasty cases carried out during the same study period.

Results

The mean age of the patients was 20.4 years (range 1–56 years). Laparoendoscopic single‐site pyeloplasty was carried out on the right in nine cases and on the left in 17 cases. The operative time was 246 ± 68 min. Regarding the 14 pediatric patients, the mean age was 7.1 years (range 1–14 years). The operative time was 243 ± 49 min. As for the 12 adult patients, the mean age was 35.8 years (range 16–56 years). The operative time was 248 ± 86 min. The mean operative time of the control group in age‐matched laparoscopic pyeloplasty was 239 ± 51 min. Times were 229 ± 54 min for the pediatric patients and 253 ± 45 min for the adult patients. There was no significant difference in the operative time between the control group and the laparoendoscopic single‐site group for both adults and children. Blood loss was minimal, and no intraoperative and postoperative complications were observed in the 26 laparoendoscopic single‐site pyeloplasty cases.

Conclusion

The present findings suggest that laparoendoscopic single‐site pyeloplasty can be used in both pediatric and adult patients, offering a superior cosmetic outcome than conventional laparoscopic pyeloplasty, and a lower degree of postoperative pain. A large‐scale prospective, randomized study is required to confirm these findings, and to define the future role of laparoendoscopic single‐site pyeloplasty.
1α,25‐dihydroxyvitamin D3 in combination with transforming growth factor‐β increases the frequency of Foxp3+ regulatory T cells through preferential expansion and usage of interleukin‐2
Authors: Chambers Emma S. , Suwannasaen Duangchan , Mann Elizabeth H. , Urry Zoe , Richards David F. , Lertmemongkolchai Ganjana , Hawrylowicz Catherine M.
Published: March 2014

A high prevalence of vitamin D insufficiency and deficiency exists worldwide, which is associated with an increased incidence and severity of a range of immune‐mediated diseases. This has resulted in considerable interest in the immunodulatory functions of vitamin D. The active form of vitamin D, 1α,25‐dihydroxyvitamin D3 [1,25(OH)2D3], has been shown to increase the frequency of Foxp3+ CD4+ T regulatory (Treg) cells when present at high concentrations or under strong T‐cell stimulation in culture. Supporting evidence exists in vivo for a positive association between serum 25(OH)D and Foxp3+ Treg cell numbers in humans. The aim of this work was to identify the cytokine milieu required in vitro to promote Foxp3+ Treg cells in cultures containing 1,25(OH)2D3 at more moderate concentrations (10−7 m). Stimulation of human CD4+ T cells with a combination of 1,25(OH)2D3 and transforming growth factor‐β (TGF‐β) greatly increased the frequency of Foxp3+ Treg cells, which is proposed to result from the preferential expansion of Foxp3+ Treg cells, as compared with the Foxp3− effector T cells, in culture. The differential effect on proliferation may result from enhanced availability and usage of interleukin‐2 by the Foxp3+ Treg cells compared with Foxp3− effector T cells. In summary, modulation of the cytokine environment to one high in TGF‐β in the presence of 1,25(OH)2D3 (10−7 m) significantly increased Foxp3+ Treg cell frequency. These data provide additional evidence for the important immunomodulatory properties of 1,25(OH)2D3 that exist and may help to control inflammatory diseases.
Health promotion strategies for families with adolescents orphaned by HIV and AIDS
Authors: Peu M.D.
Published: March 2014

Purpose

This paper aims to explore and describe health promotion strategies for adolescents orphaned by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), as well as the evaluation thereof.

Introduction and Background

Among the Sub‐Saharan countries, such as Swaziland, Botswana and Lesotho, South Africa is rated as fourth in the list of countries with the highest number of people living with HIV and AIDS.

Method

The study employed phenomenological qualitative design. The population consisted of the purposively selected health promoters working in the Hammanskraal region, directly and indirectly involved with families with adolescents orphaned by HIV and AIDS. Following the focus group interviews, data were analysed using the seven steps of Colaizzi.

Results

Four categories and eight subcategories were concluded as the strategies for adolescents orphaned by HIV and AIDS as well as the evaluation thereof. The main categories identified were: the door‐to‐door outcome, workshop outputs, statistical data and community projects.

Discussion

It is evident that the health promotion strategies informed by the four themes will be implemented. The outcomes may raise an awareness in the community, support families and provide statistics on the impact of HIV and AIDS on families.

Study Limitations

The study was limited to one subdistrict and to health promoters in a rural area, therefore the results cannot be generalized to all other subdistricts including health promoters, especially those in urban areas.

Conclusion

The successful evaluation programme will pin out the strong points and challenges while assisting in improving the quality of work provided in the communities.

Implication for nursing and health policy

Continuing professional and practice development are required to maintain the standard of health care in South Africa. Therefore the policymakers need to include relevant information regarding health promotion strategies in reducing the statistics of people living with HIV and AIDS.
High Night Temperatures During the Floral Bud Stage Increase the Abscission of Reproductive Structures in Cotton
Authors: Echer F. R. , Oosterhuis D. M. , Loka D. A. , Rosolem C. A.
Published: March 2014

Cotton‐producing regions throughout the world often experience high night temperatures (HNTs), affecting flowering and yield in cotton (Gossypium hirsutum). The objective of this study was to quantify the effects of high nighttime temperatures on the physiological and biochemical characteristics of cotton during the floral bud and flowering stages. Growth chamber experiments were conducted in 2011–2012 and treatments included a control (day/night temperature of 32/24 °C) and two HNT treatments (32/29 °C from 8:00 pm to 12:00 am) for 3 weeks from the beginning of each phenological stage, i.e., first floral bud (B1) and first flower (F1). The results indicated that increased night temperatures (NTs) during the floral bud and flowering stages increased the rate of flower production per plant. However, no increase was observed in the final number of reproductive structures because the rate of floral abortion also increased for both treatments compared to the control. Additionally, the increase in night temperature during the floral bud stage reduced the sucrose content in the flower, resulting in decreased pollen viability and premature abortion of reproductive structures while the onset of flowering period was also delayed and lower accumulation of reproductive dry matter was observed. HNTs during the flowering stage reduced the number of seeds per locule and the number of seeds per boll. In general, higher than optimum NTs affected sucrose metabolism of the cotton flower and consequently its pollen viability. As a result the flowering period was delayed and a reduction in reproductive dry matter accumulation was observed due to premature abortion of reproductive structures. Finally, cotton is more sensitive to HNT at floral bud stage and this finding may be important to adjust cotton planting date, management and breeding.
Phase Transformations in Calcium‐Substituted Lanthanum Ferrite
Authors: Price Patrick M. , Rabenberg Ellen , Thomsen David , Misture Scott T. , Butt Darryl P.
Published: March 2014

Phase equilibria in the La1−xCaxFeO3−δ (LCF) system were assessed at temperatures below 1350°C in both simulated air and argon atmospheres using a combination of differential scanning calorimetry, thermogravimetric analysis, scanning electron microscopy, and high‐temperature X‐ray diffraction. The solubility limit of Ca in the perovskite structure was determined to be 38% A‐site substitution. A high‐temperature orthorhombic to rhombohedral transition was identified and the dependence on oxygen partial pressure and effect on thermal expansion were characterized. A partial, pseudobinary LaFeO3–CaFeO2.5 phase diagram is presented that is based on these analyses combined with data available in the open literature.
Polar Nanoregions and Dielectric Properties of BaTiO3‐Based Y5V Multilayer Ceramic Capacitors
Authors: Hong Jian‐Yu , Lu Hong‐Yang
Published: March 2014

Commercial EIA‐Y5V base‐metal‐electrode multilayer ceramic capacitors (BME‐MLCCs) made of (CaO+ZrO2)‐doped BaTiO3 are analyzed for the microstructure and investigated for its relation to dielectric properties. The characteristic diffuse scattering (DS) intensities observed in BaTiO3 ceramics and the featureless “solid‐solution” grains in Y5V capacitor chips are originated from multiple Ti sites in the dynamic BaTiO3 structure. The pseudo‐cubic (PC)‐grains retaining the overall cubic (C‐) symmetry metastably at room temperature are embedded with polar nanoregions (PNRs) in the ferroelectric (FE) tetragonal (T‐), and rhombohedral (R‐) phases, as revealed by high‐resolution transmission electron microscopy (HRTEM). The presence of PNRs contributes effectively to large relative permittivity εr ≈ 13 200 at 25°C. The FE T‐domains grow from within PC‐grains at the expense of embedded PNRs after prolonged annealing by extending “oxidizing firing” at 950°C in pO2 = 10−7 atm. These domains contain less Zr with otherwise homogeneously distributed solutes in PNR‐dispersed PC‐grains. Although preserving the relaxors characteristics, εr is reduced to ~11 000 after 12 h, and then to ~9000 after 24 h annealing. The reduction in εr is attributed to the annealing‐induced FE T‐domains grown at the expense of PNRs in PC‐grains. The Vögel–Fulcher analysis indicates that Y5V ceramics are in the relaxor FE category, containing PNRs derived from polarization frustration.
TiB2 Powders Synthesis by Borothermal Reduction in TiO2 Under Vacuum
Authors: Guo Wei‐Ming , Zhang Guo‐Jun , You Yang , Wu Shang‐Hua , Lin Hua‐Tay
Published: March 2014

TiB2 powders were synthesized by borothermal reduction in nanoscale TiO2 with boron under vacuum. Reaction processes were investigated, and the effect of by‐product B2O3 was evaluated. Results showed that TiO2 was firstly reduced by boron to form TiBO3 and Ti2O3, and then to produce TiB2 and B2O3 with increasing temperature. The reaction processes of TiB2 powders synthesis included two‐step reduction in TiO2 by boron and the removal of B2O3. The presence of B2O3, which was previously reported as the most important factor in promoting the coarsening of ZrB2 and HfB2 powders by borothermal reduction, did not lead to significant coarsening of TiB2 powders. Due to the minor effect of B2O3, TiB2 powders with small particle size and low oxygen content could be prepared by direct heat treatment of TiO2 and boron at 1550°C under vacuum for 1 h. The particle size and oxygen content of synthesized TiB2 powders were ~0.9 μm and ~1.7 wt%, respectively.
Mechanisms for Variability of ZrB2‐30 vol% SiC Oxidation Kinetics
Authors: Shugart Kathleen , Patterson Brandon , Lichtman David , Liu Siying , Opila Elizabeth
Published: March 2014

The oxidation kinetics of ZrB2‐30 vol% SiC were analyzed statistically with the goal of understanding the underlying mechanisms for observed variability. A box furnace was used to oxidize specimens for times between 30 s and 100 h at temperatures of 1300°C–1550°C in air. The specimens were characterized to determine weight change, scale thickness, and scale composition to quantify the oxidation behavior. Weight gain measurements of different specimens after 100 min of exposure showed differences of up to 2 mg/cm2 for the same testing conditions where the average weight gain was 2.54 mg/cm2. Variation of 30%–80% was observed in the average thickness of each layer of the oxide within a single specimen. Viscous glass flow was ruled out as a potential mechanism. Glass bubble formation was proposed as the main cause for oxidation kinetics variability.
Microwave Dielectric Properties of Scheelite Structured PbMoO4 Ceramic with Ultralow Sintering Temperature
Authors: Xi Hai‐Hong , Zhou Di , He Bin , Xie Hui‐Dong
Published: March 2014

In this work, a low‐firing microwave dielectric ceramic PbMoO4 with tetragonal structure was prepared via a solid‐state reaction method. The sintering temperature ranges from 570°C to 670°C. Ceramic samples with relative densities above 97% were obtained when sintering temperature was around 600°C. The best microwave dielectric properties were obtained in the ceramic sintered at 650°C for 2 h with a permittivity ~26.7, a Q × f value about 42 830 GHz (at 6.2 GHz) and a temperature coefficient value of 6.2 ppm/°C. From the X‐ray diffraction, backscattered electron imaging results of the cofired sample with 30 wt% silver and aluminum additive, the PbMoO4 ceramic was found not to react with Ag and Al at 630°C. The microwave dielectric properties and low sintering temperature of PbMoO4 ceramic make it a candidate for low‐temperature cofired ceramic applications.
Aldosterone to Active Renin Ratio Is Associated With Nocturnal Blood Pressure in Obese and Treated Hypertensive Patients: The Styrian Hypertension Study
Authors: Grübler Martin R. , Kienreich Katharina , Gaksch Martin , Verheyen Nicolas , Fahrleitner‐Pammer Astrid , Schmid Johannes , Grogorenz Jana , Ablasser Klemens , Pieske Burkert , Tomaschitz Andreas , Pilz Stefan
Published: March 2014

High aldosterone levels are considered to play a key role in arterial hypertension. Data on the relationship between the aldosterone to active renin ratio (AARR), a quantity of aldosterone excess, and ambulatory blood pressure (BP) monitoring (ABPM) during the night are, however, sparse. Hypertensive patients were recruited from local outpatient clinics who underwent 24‐hour urine collection and in parallel ABPM. Plasma aldosterone and renin concentrations were measured by radioimmunoassay. A total of 211 patients (age, 60.2±10.2 years; 51.9% female) with a mean systolic/diastolic ABPM value of 128.7±12.8/77.1±9.2 mm Hg were evaluated. In backwards linear regression analyses adjusted for age, sex, body mass index, smoking, glomerular filtration rate, hemoglobin A1c, N‐terminal prohormone of brain natriuretic peptide, urinary sodium/potassium ratio, and ongoing antihypertensive medication, AARR was significantly associated with nocturnal systolic (ß‐coefficient: 0.177; P=.017) and diastolic BP (ß‐coefficient: 0.162; P=.027). In patients with arterial hypertension, a significant association between AARR and nighttime BP even after adjustment for a broad panel of confounders was found.
Serum Uric Acid and Hypertension in Adults: A Paradoxical Relationship in Type 1 Diabetes
Authors: Bjornstad Petter , Paul Wadwa R. , Sirota Jeffrey C. , Snell‐Bergeon Janet K. , McFann Kimberly , Rewers Marian , Rivard Christopher J. , Jalal Diana , Chonchol Michel B. , Johnson Richard J. , Maahs David M.
Published: March 2014

Adults with type 1 diabetes have lower serum uric acid levels compared with nondiabetic adults. Little is known about the relationship between serum uric acid and blood pressure in type 1 diabetes and whether it differs from the positive relationship found in nondiabetic adults. The authors assessed the cross‐sectional and longitudinal relationships over 6 years between serum uric acid and blood pressure in adults with (35±9 years [n=393]) and without (38±9 years [n=685]) type 1 diabetes in the Coronary Artery Calcification in Type 1 Diabetes study. In nondiabetic adults, serum uric acid was associated with systolic blood pressure in multivariable models adjusted for cardiovascular risk factors. In adults with type 1 diabetes, a negative association was observed between serum uric acid and systolic blood pressure after multivariable adjustments. A positive association was observed between serum uric acid and systolic blood pressure in nondiabetic adults. In contrast, an inverse relationship was demonstrated after multivariable adjustments in type 1 diabetes.
Who Decides WhatEUIssues Ministers Talk About? Explaining GovernmentalEUPolicy Co‐Ordination inFinland
Authors: Hyvärinen Anna , Raunio Tapio
Published: March 2014

The political dynamics ofEuropeanUnion (EU) governance has arguably strengthened the role of civil servants at the expense of democratically elected office‐holders. However, whether this applies to intra‐cabinetEUdecision‐making is more difficult to analyze. Drawing on the agendas (1995–2012) of the Finnish ministerialEUCommittee and on interviews with key civil servants, this article examines whether the interests of governing parties or bureaucratic procedures are more important in determining whichEUpolicies are debated by the government and which in turn are decentralized to individual ministries. The analysis confirms the strong influence of both established administrative procedures and of a small elite of civil servants in setting the agenda of governmentalEUpolicy formulation. The paper also shows that intra‐cabinet co‐ordination focuses on high politics issues, with individualEUlaws seldom discussed by the government – a finding that raises important questions about the accountability of domesticEUco‐ordination.
Genetic causes of transitions from sexual reproduction to asexuality in plants and animals
Authors: Neiman M. , Sharbel T. F. , Schwander T.
Published: March 2014

The persistence of sexual reproduction in the face of competition from asexual invaders is more likely if asexual lineages are produced infrequently or have low fitness. The generation rate and success of new asexual lineages will be influenced by the proximate mechanisms underlying transitions to asexuality. As such, characterization of these mechanisms can help explain the distribution of reproductive modes among natural populations. Here, we synthesize the literature addressing proximate causes of transitions from sexual to asexual reproduction in plants and animals. In cyclical and facultatively asexual taxa, individual mutations can cause obligate asexuality. The evolution of asexuality in obligately sexual groups is more complex, requiring the simultaneous acquisition of two traits generally controlled by different genetic factors: unreduced gamete formation and spontaneous development of unfertilized gametes. At least three ‘pre‐adaptations’ could favour transitions to obligate asexuality in obligate sexuals. First, linkage among loci affecting separate key components of asexuality facilitates its spread, with evidence for these linkage blocks in plants. Second, asexuality should evolve more readily in haplodiploids; support for this hypothesis comes from two examples where a single locus causes transitions to asexuality. Third, standing genetic variation for the production of unreduced gametes could facilitate transitions to asexuality, but whether the ability to produce unreduced gametes contributes to the evolution of obligate asexuality remains unclear. We close by reviewing the associations between asexuality, hybridization and polyploidy, and argue that current data suggest that hybridization is more likely to play a causal role in transitions to asexuality than polyploidy.
Cooperative personalities and social niche specialization in female meerkats
Authors: Carter A. J. , English S. , Clutton‐Brock T. H.
Published: March 2014

The social niche specialization hypothesis predicts that group‐living animals should specialize in particular social roles to avoid social conflict, resulting in alternative life‐history strategies for different roles. Social niche specialization, coupled with role‐specific life‐history trade‐offs, should thus generate between‐individual differences in behaviour that persist through time, or distinct personalities, as individuals specialize in particular nonoverlapping social roles. We tested for support for the social niche specialization hypothesis in cooperative personality traits in wild female meerkats (Suricata suricatta) that compete for access to dominant social roles. As cooperation is costly and dominance is acquired by heavier females, we predicted that females that ultimately acquired dominant roles would show noncooperative personality types early in life and before and after role acquisition. Although we found large individual differences in repeatable cooperative behaviours, there was no indication that individuals that ultimately acquired dominance differed from unsuccessful individuals in their cooperative behaviour. Early‐life behaviour did not predict social role acquisition later in life, nor was cooperative behaviour before and after role acquisition correlated in the same individuals. We suggest that female meerkats do not show social niche specialization resulting in cooperative personalities, but that they exhibit an adaptive response in personality at role acquisition.
Alternative intrapopulation life‐history strategies and their trade‐offs in an African annual fish
Authors: Polačik M. , Blažek R. , Řežucha R. , Vrtílek M. , Terzibasi Tozzini E. , Reichard M.
Published: March 2014

In ephemeral habitats, the same genotypes cope with unpredictable environmental conditions, favouring the evolution of developmental plasticity and alternative life‐history strategies (ALHS). We tested the existence of intrapopulation ALHS in an annual killifish, Nothobranchius furzeri, inhabiting temporary pools. The pools are either primary (persisting throughout the whole rainy season) or secondary (refilled after desiccation of the initial pool), representing alternative niches. The unpredictable conditions led to the evolution of reproductive bet‐hedging with asynchronous embryonic development. We used a common garden experiment to test whether the duration of embryonic period is associated with post‐embryonic life‐history traits. Fish with rapid embryonic development (secondary pool strategy, high risk of desiccation) produced phenotypes with more rapid life‐history traits than fish with slow embryonic development (primary pool strategy). The fast fish were smaller at hatching but had larger yolk sac reserves. Their post‐hatching growth was more rapid, and they matured earlier. Further, fast fish grew to a smaller body size and died earlier than slow fish. No differences in fecundity, propensity to mate or physiological ageing were found, demonstrating a combination of plastic responses and constraints. Such developmentally related within‐population plasticity in life history is exceptional among vertebrates.
Roles of small RNAs in plant disease resistance
Authors: Yang Li , Huang Hai
Published: March 2014

The interaction between plants and pathogens represents a dynamic competition between a robust immune system and efficient infectious strategies. Plant innate immunity is composed of complex and highly regulated molecular networks, which can be triggered by the perception of either conserved or race‐specific pathogenic molecular signatures. Small RNAs are emerging as versatile regulators of plant development, growth and response to biotic and abiotic stresses. They act in different tiers of plant immunity, including the pathogen‐associated molecular pattern‐triggered and the effector‐triggered immunity. On the other hand, pathogens have evolved effector molecules to suppress or hijack the host small RNA pathways. This leads to an arms race between plants and pathogens at the level of small RNA‐mediated defense. Here, we review recent advances in small RNA‐mediated defense responses and discuss the challenging questions in this area.
Financial Aspects of Business Cycles: An Analysis of Balance Sheet Adjustments of U.S. Nonfinancial Enterprises over the Twentieth Century
Authors: KRAINER ROBERT E.
Published: March 2014

This paper formulates and tests a model of asset and financing adjustments of nonfinancial enterprises over the twentieth century. Asset adjustments change the expected income and operating risk of firms while financing adjustments change financial risk. To protect debt and equity investors from a conflict of interest problem, an up‐front contract develops an “assignment” rule for managing the firm's balance sheet whereby managers make investment decisions that conform to the risk aversion of stockholders and financing decisions that offset changes in operating risk resulting from investment decisions. Empirical evidence gathered in this paper fails to reject the predictions of the model.
Reason for Reserve? Reserve Requirements and Credit
Authors: MORA NADA
Published: March 2014

This paper considers the impact of a regulatory policy action on bank credit and traces its incidence across banks. I make use of a reserve requirement increase in Lebanon that was considerably greater on foreign currency deposits than on domestic currency deposits. All banks cut lending as they scrambled to adjust portfolios. But the policy shock disproportionately affected banks with a greater reliance on dollar funding and with low buffers of dollar liquid assets. Exposed domestic‐owned banks also adjusted more slowly than similar foreign‐owned banks that obtained outside funding. Descriptive firm–bank matching evidence reveals a disproportionate impact on small firms.
How Stable Are Corporate Capital Structures?
Authors: DeANGELO HARRY , ROLL RICHARD
Published: March 2014

Leverage cross‐sections more than a few years apart differ markedly, with similarities evaporating as the time between them lengthens. Many firms have high and low leverage at different times, but few keep debt‐to‐assets ratios consistently above 0.500. Capital structure stability is the exception, not the rule, occurs primarily at low leverage, and is virtually always temporary, with many firms abandoning low leverage during the post‐war boom. Industry‐median leverage varies widely over time. Target‐leverage models that place little or no weight on maintaining a particular ratio do a good job replicating the substantial instability of the actual leverage cross‐section.
MOTHERS REQUIRING DIALYSIS: PARENTING AND END‐STAGE KIDNEY DISEASE
Authors: Wadd Kaylene M. , Bennett Paul N. , Grant Julian
Published: March 2014

Background

Mothers requiring dialysis to treat end‐stage kidney disease face the challenging demands of the disease and dialysis treatment in addition to their role as a parent.

Objective

To describe the experience of mothers who require haemodialysis.

Methods

Four mothers receiving haemodialysis treatment for end‐stage kidney disease in regional Australia were interviewed to explore the mothers' experiences, attitudes, beliefs and values of their dual role as mothers and haemodialysis recipients.

Results

The overarching theme emerging from the data was the competing roles of motherhood and dialysis. Four key sub‐themes emerged: fitting everything in, internal family challenges, lost connections and striving for normality.

Conclusion

Being a mother adds a range of complexities to being on dialysis. While managing dialysis, mothers struggle to care for their children and stay connected with family life. Nephrology health professionals are uniquely placed to support mothers and need to develop strategies to ease their burdens of care.
Kidney injury in cirrhosis: pathophysiological and therapeutic aspects of hepatorenal syndromes
Authors: Møller Søren , Krag Aleksander , Bendtsen Flemming
Published: March 2014

Acute kidney injury (AKI) is frequent in patients with cirrhosis. AKI and hyponatraemia are major determinants of the poor prognosis in advanced cirrhosis. The hepatorenal syndrome (HRS) denotes a functional and potential reversible impairment of renal function. Type 1 HRS, a special type of AKI, is a rapidly progressive AKI, whereas the renal function in type 2 HRS decreases more slowly. HRS is precipitated by factors such as sepsis that aggravate the effective hypovolaemia in decompensated cirrhosis, by lowering arterial pressure and cardiac output and enhanced sympathetic nervous activity. Therefore, attempts to prevent and treat HRS should seek to improve liver function and to ameliorate arterial hypotension, central hypovolaemia and cardiac output, and to reduce renal vasoconstriction. Ample treatment of HRS is important to prevent further progression and death, but as medical treatment only modestly improves long‐term survival, these patients should always be considered for liver transplantation. Hyponatraemia, defined as serum sodium <130 mmol/L, is common in patients with decompensated cirrhosis. From a pathophysiological point of view, hyponatraemia is related to an impairment of renal solute‐free water excretion most likely caused by an increased vasopressin secretion. Patients with cirrhosis mainly develop hypervolaemic hyponatraemia. Current evidence does not support routine use of vaptans in the management of hyponatraemia in cirrhosis.
Dynamic enhancement pattern of HCC smaller than 3 cm in diameter on gadoxetic acid‐enhanced MRI: comparison with multiphasic MDCT
Authors: Park Vivian Y. , Choi Jin‐Young , Chung Yong Eun , Kim Honsoul , Park Mi‐Suk , Lim Joon Seok , Kim Ki Whang , Kim Myeong‐Jin
Published: March 2014

Background & Aims

The dynamic enhancement pattern of HCCs smaller than 3 cm in diameter on gadoxetic acid‐enhanced magnetic resonance imaging (MRI) have not been extensively investigated. We aimed to evaluate the dynamic enhancement patterns of small HCCs (≤3 cm) on gadoxetic acid‐enhanced magnetic resonance imaging (MRI) and compare enhancement patterns with multiphasic multidetector computed tomography (MDCT) based on tumour cellular differentiation and size.

Methods

We retrospectively included 55 patients with 67 surgically confirmed small HCCs (≤3 cm) who underwent multiphasic MDCT and gadoxetic acid‐enhanced MRI. Dynamic enhancement patterns were analysed according to tumour cellular differentiation and size. Hepatobiliary phase images were also analysed to assess their additional value.

Results

The proportion of small HCCs demonstrating the typical enhancement pattern differed depending on tumour cellular differentiation on both MRI (P = 0.001) and MDCT (P = 0.001), but differed depending on tumour size only on CT (P = 0.008). Gadoxetic acid‐enhanced MRI more sensitively depicted the typical enhancement pattern than CT for all tumours (P = 0.001), for moderately or poorly differentiated HCCs (P = 0.021) and for HCCs ≤2 cm (P = 0.001). 80% of tumours with atypical enhancement could be diagnosed as HCC based on tumour size and hepatobiliary phase images.

Conclusions

On both gadoxetic acid‐enhanced MRI and multiphasic CT, the dynamic enhancement patterns of small HCCs (≤3 cm) differed according to tumour cellular differentiation. Gadoxetic acid‐enhanced MRI more frequently demonstrated the typical HCC enhancement pattern than CT in small HCCs.
Pool and conquer: new tricks for (c)old problems
Authors: Navarro Arcadi , Faria Rui
Published: March 2014

The early period of genetics is closely associated with the study of chromosomal inversions. For almost a century, evolutionary biologists found evidence for the role of inversions in central processes such as adaptation and speciation. In spite of huge efforts, many questions remain about the evolutionary forces underlying the distribution and dynamics of inversions in natural populations. Fortunately, old problems can be solved with new tools. In this issue, Kapun et al. () present a remarkable combination of resources and techniques, including publicly available data, karyotyping, statistical estimation of haplotypes, Pool‐Seq data and experimental evolution, setting the ground for exciting developments in the field.
Phylogeography of Ramalina menziesii, a widely distributed lichen‐forming fungus in western North America
Authors: Sork Victoria L. , Werth Silke
Published: March 2014

The complex topography and climate history of western North America offer a setting where lineage formation, accumulation and migration have led to elevated inter‐ and intraspecific biodiversity in many taxa. Here, we study Ramalina menziesii, an epiphytic lichenized fungus with a range encompassing major ecosystems from Baja California to Alaska to explore the predictions of two hypotheses: (i) that the widespread distribution of R. menziesii is due to a single migration episode from a single lineage and (ii) that the widespread distribution is due to the formation and persistence of multiple lineages structured throughout the species' range. To obtain evidence for these predictions, we first construct a phylogenetic tree and identify multiple lineages structured throughout the species' range – some ancient ones that are localized and other more recent lineages that are widely distributed. Second, we use an isolation with migration model to show that sets of ecoregion populations diverged from each other at different times, demonstrating the importance of historical and current barriers to gene flow. Third, we estimated migration rates among ecoregions and find that Baja California populations are relatively isolated, that inland California ecoregion populations do not send out emigrants and that migration out of California coastal and Pacific Northwest populations into inland California ecoregions is high. Such intraspecific geographical patterns of population persistence and dispersal both contribute to the wide range of this genetically diverse lichen fungus and provide insight into the evolutionary processes that enhance species diversity of the California Floristic Province.
Caffeine stabilizes Cdc25 independently of Rad3 in Schizosaccharomyces pombe contributing to checkpoint override
Authors: Alao John P. , Sjölander Johanna J. , Baar Juliane , Özbaki‐Yagan Nejla , Kakoschky Bianca , Sunnerhagen Per
Published: March 2014

Cdc25 is required for Cdc2 dephosphorylation and is thus essential for cell cycle progression. Checkpoint activation requires dual inhibition of Cdc25 and Cdc2 in a Rad3‐dependent manner. Caffeine is believed to override activation of the replication and DNA damage checkpoints by inhibiting Rad3‐related proteins in both Schizosaccharomyces pombe and mammalian cells. In this study, we have investigated the impact of caffeine on Cdc25 stability, cell cycle progression and checkpoint override. Caffeine induced Cdc25 accumulation in S. pombe independently of Rad3. Caffeine delayed cell cycle progression under normal conditions but advanced mitosis in cells treated with replication inhibitors and DNA‐damaging agents. In the absence of Cdc25, caffeine inhibited cell cycle progression even in the presence of hydroxyurea or phleomycin. Caffeine induces Cdc25 accumulation in S. pombe by suppressing its degradation independently of Rad3. The induction of Cdc25 accumulation was not associated with accelerated progression through mitosis, but rather with delayed progression through cytokinesis. Caffeine‐induced Cdc25 accumulation appears to underlie its ability to override cell cycle checkpoints. The impact of Cdc25 accumulation on cell cycle progression is attenuated by Srk1 and Mad2. Together our findings suggest that caffeine overrides checkpoint enforcement by inducing the inappropriate nuclear localization of Cdc25.
Type 1 collagen as a potential niche component for CD133‐positive glioblastoma cells
Authors: Motegi Hiroaki , Kamoshima Yuuta , Terasaka Shunsuke , Kobayashi Hiroyuki , Houkin Kiyohiro
Published: March 2014

Cancer stem cells are thought to be closely related to tumor progression and recurrence, making them attractive therapeutic targets. Stem cells of various tissues exist within niches maintaining their stemness. Glioblastoma stem cells (GSCs) are located at tumor capillaries and the perivascular niche, which are considered to have an important role in maintaining GSCs. There were some extracellular matrices (ECM) on the perivascular connective tissue, including type 1 collagen. We here evaluated whether type 1 collagen has a potential niche for GSCs. Imunohistochemical staining of type 1 collagen and CD133, one of the GSCs markers, on glioblastoma (GBM) tissues showed CD133‐positive cells were located in immediate proximity to type 1 collagen around tumor vessels. We cultured human GBM cell lines, U87MG and GBM cells obtained from fresh surgical tissues, T472 and T555, with serum‐containing medium (SCM) or serum‐free medium with some growth factors (SFM) and in non‐coated (Non‐coat) or type 1 collagen‐coated plates (Col). The RNA expression levels of CD133 and Nestin as stem cell markers in each condition were examined. The Col condition not only with SFM but SCM made GBM cells more enhanced in RNA expression of CD133, compared to Non‐coat/SCM. Semi‐quantitative measurement of CD133‐positive cells by immunocytochemistry showed a statistically significant increase of CD133‐positive cells in Col/SFM. In addition, T472 cell line cultured in the Col/SFM had capabilities of sphere formation and tumorigenesis. Type 1 collagen was found in the perivascular area and showed a possibility to maintain GSCs. These findings suggest that type 1 collagen could be one important niche component for CD133‐positive GSCs and maintain GSCs in adherent culture.
The science and policy of critical loads of pollutant deposition to protect ecosystems in New York
Authors: Sullivan Timothy J. , Jenkins Jerry
Published: March 2014

We discuss the potential for adopting a critical load (CL) of air pollutant–deposition approach to inform natural resource protection and management in New York. The CL reflects the quantitative exposure to pollutants below which significant harmful effects on specified sensitive elements of the environment do not occur. Here, we discuss how CLs can be used to protect sensitive ecosystems against the harmful effects of atmospheric sulfur and nitrogen deposition and associated soil and water acidification and nutrient enrichment. The CL can be used diagnostically to determine resources at risk and prescriptively to evaluate the effectiveness of regulations and to manage resources.
Adaptive parental effects: the importance of estimating environmental predictability and offspring fitness appropriately
Authors: Burgess Scott C. , Marshall Dustin J.
Published: March 2014

Anticipatory parental effects (APE's) occur when parents adjust the phenotype of their offspring to match the local environment, so as to increase the fitness of both parents and offspring. APE's, as in the evolution of adaptive phenotypic plasticity more generally, are predicated on the idea that the parental environment is a reliable predictor of the offspring environment. Most studies on APE's fail to explicitly consider environmental predictability so risk searching for APE's under circumstances where they are unlikely to occur. This failure is perhaps one of the major reasons for mixed evidence for APE's in a recent meta‐analysis. Here, we highlight some often‐overlooked assumptions in studies of APE's and provide a framework for identifying and testing APE's. Our review highlights the importance of measuring environmental predictability, outlines the minimal requirements for experimental designs, explains the important differences between relative and absolute measures of offspring fitness, and highlights some potential issues in assigning components of offspring fitness to parental fitness. Our recommendations should result in more targeted and effective tests of APE's.

Synthesis

A decent set of theory is available to understand when certain kinds of parental effects might act to increase parental fitness (i.e. be ‘adaptive’). This theory could be better incorporated into empirical studies on anticipatory parental effects (APE's). Here, we provide practical advice for how empirical studies can more closely align with the theoretical underpinnings of adaptive parental effects. In short, robust inferences on APE's require quantitative estimates of environmental predictability in the field over the space and time scales relevant to the life history of the study organism as well as an understanding of when to use absolute or relative offspring fitness.
Significance of Repeat Programmed Ventricular Stimulation at Electrophysiology Study for Arrhythmia Prediction after Acute Myocardial Infarction
Authors: ZAMAN SARAH , NARAYAN ARUN , THIAGALINGAM ARAVINDA , SIVAGANGABALAN GOPAL , THOMAS STUART , ROSS DAVID L. , KOVOOR PRAMESH
Published: March 2014

Background

The prognostic significance of a second programmed ventricular stimulation (PVS) at electrophysiology study (EPS), when the first PVS is negative for inducible ventricular tachycardia (VT), in patients following myocardial infarction (MI) is unknown.

Methods

Consecutive ST‐elevation MI patients with left ventricular ejection fraction ≤40% following revascularization underwent early EPS. An implantable cardioverter defibrillator (ICD) was implanted for a positive (inducible monomorphic VT) but not a negative (no arrhythmia or inducible ventricular fibrillation [VF]/flutter) EPS. The combined primary end point of death or arrhythmia (sudden death, resuscitated cardiac arrest, and spontaneous VT/VF) was assessed in EPS‐positive patients grouped according to if VT was induced on the first PVS application, or the second PVS application, when the first was negative.

Results

EPS performed a median 8 days post‐MI in 290 patients was negative in 70% (n = 203) and positive in 30% (n = 87). In patients with a positive EPS, VT was induced on the first PVS in 67% (n = 58) and the second PVS, after the first was negative, in 33% (n = 29). Predischarge ICD was implanted in 79 of 87 patients with a positive EPS. Three‐year primary end point occurred in 20.9 ± 5.6% and 38.3 ± 9.7% of patients with VT induced by the first and second PVS, respectively (P = 0.042) and in 6.3 ± 1.9% of electrophysiology‐negative patients (P < 0.001).

Conclusions

In patients with post‐MI left ventricular dysfunction, VT can be induced in a significant proportion with a second PVS when negative on the first. These patients have a similar higher risk of death or arrhythmia compared to patients with VT induced on the first PVS.
The pharmacokinetics of methadone and its metabolites in neonates, infants, and children
Authors: Ward Robert M. , Drover David R. , Hammer Gregory B. , Stemland Christopher J. , Kern Steve , Tristani‐Firouzi Martin , Lugo Ralph A. , Satterfield Kristin , Anderson Brian J.
Published: March 2014

Background

The lack of methadone pharmacokinetic data in children and neonates restrains dosing to achieve the target concentration in these populations. A minimum effective analgesic concentration of methadone in opioid naïve adults is 0.058 mg·l−1, while no withdrawal symptoms were observed in neonates suffering opioid withdrawal if plasma concentrations of methadone were above 0.06 mg·l−1. The racemate of methadone which is commonly used in pediatric and anesthetic care is metabolized to 2‐ethylidine‐1,5‐dimethyl‐3,3‐diphenylpyrrolidine (EDDP) and 2‐ethyl‐5‐methyl‐3,3‐diphenylpyrroline (EMDP).

Methods

Data from four studies (age 33‐week PMA‐15 years) were pooled (n = 56) for compartment analysis using nonlinear mixed effects modeling. Parameter estimates were standardized to a 70‐kg person using an allometric model approach. Investigation was made of the racemate and metabolite (EDDP and EMDP) dispositions. In addition, neonatal data (n = 7) allowed further study of R‐ and S‐enantiomer pharmacokinetics.

Results

A three‐compartment linear disposition model best described the observed time–concentration profiles with additional compartments for metabolites. Population parameter estimates (between‐subject variability) were central volume (V1) 21.5 (29%) l·70 kg−1, peripheral volumes of distribution V2 75.1 (23%) l·70 kg−1 and V3 484 (8%) l·70 kg−1, clearance (CL) 9.45 (11%)l·h−1·70 kg−1, and intercompartment clearances Q2 325 (21%) l·h−1·70 kg−1 and Q3 136 (14%) l·h−1·70 kg−1. EDDP formation clearance was 9.1 (11%) l·h−1·70 kg−1, formation clearance of EMDP from EDDP 7.4 (63%)l·h−1·70 kg−1, elimination clearance of EDDP was 40.9 (26%) l·h−1·70 kg−1 and the rate constant for intermediate compartments 2.17 (43%) h−1.

Conclusions

Current pharmacokinetic parameter estimates in children and neonates are similar to those reported in adults. There was no clearance maturation with age. Neonatal enantiomer clearances were similar to those described in adults. A regimen of 0.2 mg·kg−1 per 8 h in neonates achieves a target concentration of 0.06 mg·l−1 within 36 h. Infusion, rather than intermittent dosing, should be considered if this target is to be achieved in older children after cardiac surgery.
The effect of fentanyl and clonidine on early postoperative negative behavior in children: a double‐blind placebo controlled trial
Authors: Bortone Luciano , Bertolizio Gianluca , Engelhardt Thomas , Frawley Geoff , Somaini Marta , Ingelmo Pablo M.
Published: March 2014

Background

Early negative postoperative behavior (e‐PONB) is common in children and manifests itself as emergence agitation (EA), emergence delirium (ED), and pain. The objective of this prospective double blind, randomized, placebo‐controlled trial was to determine whether IV clonidine or IV fentanyl prior to surgery modifies e‐PONB in children.

Methods

Ninety children scheduled for subumbilical surgery under sevoflurane anesthesia supplemented with regional anesthesia were randomized to either receive IV clonidine 2 mcg·kg−1, IV fentanyl 2 mcg·kg−1 or placebo (IV saline) before surgery. Primary outcome measures were the incidence of EA, ED and pain during the first hour after awakening. Secondary outcome measures were side effects such as nausea and vomiting and delayed discharge from PACU.

Results

Eighty‐seven children (n = 29 per group) completed the study. EA was present in 10 children (six clonidine, none fentanyl, and four placebo, P = 0.04) whereas ED was observed in 20 children (nine clonidine, three fentanyl, and eight placebo P = 0.13). Sixteen children who received placebo had a CHIPPS score of ≥4 compared with nine children in fentanyl group and 18 children receiving clonidine (P = 0.04). Ten children receiving fentanyl vomited during the first postoperative day, compared with six children in placebo group and none in clonidine group (P = 0.003). Discharge from PACU was not affected.

Conclusions

IV fentanyl before surgery but not IV clonidine modifies e‐PONB in children undergoing lower abdominal surgery under general anesthesia supplemented with regional anesthesia. The use of fentanyl in this population was also associated with reduced pain scores after awakening but with significantly greater incidence of PONV.
Transient abdominal wall deformity in an infant Blaming the caudal?
Authors: Tosetti Sylvain , Frigon Chantal
Published: March 2014

Locoregional anesthesia is an important aspect of perioperative analgesia. It decreases requirements for anesthetic agents and opioids, decreases the surgical stress response, and provides postoperative analgesia. Nonetheless, pediatric patients, especially infants, demonstrate specificities towards regional anesthesia techniques, as an increased sensitivity to local anesthetics (LA) and a higher ease of LA spread especially when using blocks that rely on the volume of LA and its spread as those used for abdominal wall analgesia or caudal. Thus, we present a case of transient abdominal wall deformity following caudal anesthesia in an infant.