bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous administration of praziquantel, ivermectin and albendazole, in a community in rural northern Ghana endemic for schistosomiasis, onchocerciasis and lymphatic filariasis
Authors: Anto Francis , Asoala Victor , Anyorigiya Thomas , Oduro Abraham , Adjuik Martin , Akweongo Patricia , Aborigo Raymond , Bimi Langbong , Amankwa Joseph , Hodgson Abraham
Published: June 2011

Objectives  To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and (ii) coverage by volunteers distributing three or two drugs.

Methods  Two‐arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co‐administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline.

Results  Prevalence of Schistosoma haematobium infection among 1001 (boys: 47.9% girls: 52.1%) school‐age children (6–15 years) [intervention: 30.0% (CI: 23.1–34.2); control: 23.0% (CI: 18.9–27.0)], mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15 020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P < 0.001). The numbers of adverse effects were similar (intervention: 50/6896; control: 130/15 020). The most reported adverse effects was headache (intervention: 14/50; control: 13/130), followed by body weakness, which was reported more from the intervention group (intervention: 13/50, 95% CI: 14.6–40.3; control: 6/130, 95% CI: 1.7–9.8]. Sixty‐six per cent (6896/10 441) of the eligible population received praziquantel.

Conclusions  Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.
Epstein–Barr virus DNA load in peripheral blood mononuclear cells and whole blood from pediatric transplant recipients
Authors: Kasztelewicz B. , Jankowska I. , Pawłowska J. , Teisseyre J. , Grenda R. , Pronicki M. , Dzierżanowska‐Fangrat K.
Published: June 2011

B. Kasztelewicz, I. Jankowska, J. Pawłowska, J. Teisseyre, R. Grenda, M. Pronicki, K. Dzierżanowska‐Fangrat. Epstein–Barr virus DNA load in peripheral blood mononuclear cells and whole blood from pediatric transplant recipients. Transpl Infect Dis 2011: 13: 471–479. All rights reserved

Abstract: Monitoring of circulating Epstein–Barr virus (EBV) DNA in pediatric transplant patients has been shown to be useful in post‐transplant patient management. It still remains unclear which blood sample type is more suitable, and how EBV DNA levels in whole blood (WB) correlate with those in peripheral blood mononuclear cells (PBMCs). The aim of this study was to compare EBV DNA load in WB and PBMCs of pediatric transplant recipients. After liver, kidney, or combined liver–kidney transplantation, 172 matched WB and PBMCs samples were collected from 84 children (130 samples from 42 patients consisted of multiple collections). The EBV DNA level in PBMCs was determined by home‐made real‐time polymerase chain reaction using TaqMan chemistry. In parallel, the viral load (VL) in WB was measured by a commercial LightCycler EBV Quant Kit. The EBV DNA levels and dynamics of VL changes were assessed and compared between WB and PBMCs. The overall correlation between EBV DNA level in PBMCs and WB was statistically significant and high, r2=0.87 (P<0.001). However, the sensitivity of EBV detection was lower in WB (93.9%). Longitudinal analysis of EBV DNA load dynamics in PBMCs and WB indicated that EBV DNA load fluctuations were larger in WB, but the trend of decreases and increases, with minor exceptions, was similar in both sample types. The high correlation of EBV DNA levels, as well as the similar dynamics of EBV DNA changes in both sample types, make WB a good alternative to EBV DNA monitoring in PBMCs of pediatric transplant recipients. However, the subtle increase of the VL may be detected earlier in PBMCs.
Phytate and phytase in fish nutrition
Authors: Kumar V. , Sinha A. K. , Makkar H. P. S. , De Boeck G. , Becker K.
Published: June 2011

Phytate formed during maturation of plant seeds and grains is a common constituent of plant‐derived fish feed. Phytate‐bound phosphorus (P) is not available to gastric or agastric fish. A major concern about the presence of phytate in the aquafeed is its negative effect on growth performance, nutrient and energy utilization, and mineral uptake. Bound phytate‐P, can be effectively converted to available‐P by phytase. During the last decade, phytase has been used by aqua feed industries to enhance the growth performance, nutrient utilization and bioavailability of macro and micro minerals in fish and also to reduce the P pollution into the aquatic environment. Phytase activity is highly dependent on the pH of the fish gut. Unlike mammals, fish are either gastric or agastric, and hence, the action of dietary phytase varies from species to species. In comparison to poultry and swine production, the use of phytase in fish feed is still in an unproven stage. This review discusses effects of phytate on fish, dephytinisation processes, phytase and pathway for phytate degradation, phytase production systems, mode of phytase application, bioefficacy of phytase, effects of phytase on growth performance, nutrient utilization and aquatic environment pollution, and optimum dosage of phytase in fish diets.
How to set up a severe asthma service
Authors: MCDONALD VANESSA M. , VERTIGAN ANNE E. , GIBSON PETER G.
Published: June 2011

Severe asthma affects 5–20% of the asthma population but is discordantly responsible for the major burden of illness and impairment to quality of life. Patients with severe asthma continue to experience ongoing symptoms despite maximal therapy. A severe asthma service provides a systematic approach to the management of the disease and aids in confirming the correct diagnosis, managing comorbid conditions that may mimic or aggravate asthma, and provides the environment to optimize treatment and asthma self‐management skills and education. A severe asthma service is also the ideal environment for trialling add‐on therapies and hence can improve patient outcomes and clinical practice. Within such a service there are many opportunities for training and research. In this article we describe the purpose of a severe asthma clinic, the necessary components of a service including staffing and facilities and the processes for trialling additional therapies used in the management of severe asthma.
Risk factors for pelvic lymphoceles post‐radical prostatectomy
Authors: Khoder Wael Y , Trottmann Matthias , Buchner Alexander , Stuber Andrea , Hoffmann Sabine , Stief Christian G , Becker Armin J
Published: June 2011

Background:  Lymphoceles (LC) represent a well‐described rare complication post‐radical prostatectomy (RP). Our aim was to determine risk factors and to develop possible prevention strategies for LC in a community‐based study.

Methods:  Data from 1163 RP‐patients from 67 clinics between January 2002 and December 2004 were retrospectively evaluated. Patients underwent pelvic imaging procedures/LC‐management during 3 weeks of rehabilitation post‐RP.

Results:  LC were identified in 304 patients (26%). Lymphadenectomy was carried out in 92% of patients (1001/1086 patients), from which 28% had LC (n = 277) versus 14% without lymphadenectomy (12/85, P = 0.007). Complications (lower limb edema, pain, thrombosis, infection and bladder compression) were observed in 9% of patients (28/304; 2.4% of total patients); necessitating therapy. LC therapy was carried out in 59 patients (5.9%) with pelvic lymph node dissection (PLND) and in no patients (0%) without PLND (P = 0.021). Risk factors included were patients' age, body mass index, prostate volume, TNM‐classification, number of removed lymph nodes, previous surgery/therapy, heparin prophylaxis, surgical instruments and pelvic lymphadenectomy. Univariate analysis showed lymphadenectomy as the only significant risk factor for the development of LC post‐RP (P = 0.007). When applying multivariate analyses using stepwise logistic regression, only lymphadenectomy was associated with a significant risk for lymphoceles (odds ratio = 2.6, 95% CI = 1.3–4.9, P = 0.004). Adjusting for other factors, no other factor came close to being significant (P < 0.05). All symptomatic LC were successfully treated without further sequelae.

Conclusions:  Subclinical LC post‐RP are more common than thought, and rarely necessitate intervention. Pelvic lymphadenectomy represents the only significant factor contributing to LC‐development. Because of this, prevention remains difficult.
A damage model for fatigue crack propagation from moderate to high ΔK levels
Authors: HAMON F. , HENAFF G. , HALM D. , GUEGUEN M. , BILLAUDEAU T.
Published: June 2011

Different approaches have been developed to address the difficult issue of crack propagation simulation under monotonic loading. However, numerical models that can also account for crack growth under cyclic loading are much less numerous. The aim of the paper is to develop a numerical model to predict the behaviour of cracked panels under monotonic as well as under cyclic loading. In particular, the model has to simulate fatigue crack propagation at high ΔK levels for a wide variety of metallic alloys including aluminium alloys, titanium alloys and steels. An advanced fatigue model, developed in the framework of Continuum damage mechanics (CDM), is discussed in this paper. The CDM approach, initially proposed by Lemaitre, considers the effects associated to a given damage configuration through the definition of a thermodynamic state variable. This proper thermodynamic framework provides numerical robustness. This study examines the possibility to use such models to simulate fatigue crack propagation. The analysis of fracture modes and of –ΔK curves at different load ratios suggests that two damage mechanisms are involved in fatigue crack propagation. To improve the damage description of the Lemaitre model, two distinct damage variables are introduced. The evolution of the first one, called ‘static damage’, follows the classical Lemaitre formulation. The second one, ‘cyclic damage’ is related to cyclic cumulated plastic strain.
Fiber‐optic assessment of LMA position in children: a randomized crossover comparison of two techniques
Authors: Ghai Babita , Ram Jagat , Makkar Jeetinder K. , Wig Jyotsna
Published: June 2011

Background:  This crossover study compared fiber‐optic assessment of laryngeal mask airway (LMA) position in children using two LMA insertion techniques, i.e., standard and rotational.

Methods:  Seventy‐eight ASA I children, aged 2.5 months to 10 years, undergoing elective cataract surgery were included in this study. LMA was inserted in random order using either standard or rotational technique, removed, and thereafter crossed over to alternate technique. Positioning of LMA was assessed using fiber‐optic bronchoscope with each technique. Change in the incidence of fiber‐optic assessment grades 1 and 2 between two insertion techniques was measured as the primary outcome. Secondary outcome measures studied were first‐attempt success rate, overall success rate, time for successful insertion, visual analogue scale for placement, complications, and maneuvers used to relieve airway obstruction.

Results:  Incidence of fiber‐optic grades 1 and 2 was 61.5% with standard technique and increased to 92.3% with rotational technique (P < 0.001, McNemar’s test) (RR 3.0, 95% CI 2.2–4.2). Median (IQR) fiber‐optic grading was significantly better with rotational technique [2 (1–2)] as compared to standard technique [2 (2–3)], (P < 0.001, Wilcoxon signed rank test). First‐attempt success rate was significantly higher (96.2%) with rotational technique compared with standard technique (80.7%) (P = 0.04, McNemar’s test). Overall success rate (i.e., successful insertion with two attempts) was 100% with rotational technique compared with 89.7% with standard technique (P = 0.003, Fischer’s exact test). Time for successful insertion and incidence of complications were significantly lesser with rotational technique.

Conclusion:  Rotational technique of LMA insertion in children is associated with better seating of LMA (as observed on fiber‐optic assessment) compared with the standard technique. Also, it is associated with higher success rate and lower incidence of complications.
Leukocyte telomere length is associated with complications of Type 2 diabetes mellitus
Authors: Testa R. , Olivieri F. , Sirolla C. , Spazzafumo L. , Rippo M. R. , Marra M. , Bonfigli A. R. , Ceriello A. , Antonicelli R. , Franceschi C. , Castellucci C. , Testa I. , Procopio A. D.
Published: June 2011

Diabet. Med. 28, 1388–1394 (2011)

Objective  The key goal of diabetes management is to prevent complications. While the patho‐physiological mechanisms responsible for diabetes complications have been extensively studied, at present it is impossible to predict which patient with diabetes could develop complications. In recent years, the role of leukocyte telomere length in the pathogenesis of cardiovascular disease and Type 2 diabetes has been investigated. However, studies aiming to investigate the role of telomeres in the development and progression of Type 2 diabetes, as well as diabetic complications, are still lacking. As a consequence, this study aimed to verify whether leukocyte telomere length is associated with the presence and the number of diabetic complications in a sample of patients with Type 2 diabetes.

Methods  This is a cross‐sectional study. Nine hundred and one subjects were enrolled, including 501 patients with Type 2 diabetes, of whom 284 had at least one complication and 217 were without complications, and 400 control subjects. Leukocyte telomere length was measured by quantitative real‐time PCR.

Results  Patients with diabetes complications had significantly shorter leukocyte telomere length than both patients without diabetes complications and healthy control subjects. Moreover, among patients with diabetes complications, leukocyte telomere length became significantly and gradually shorter with the increasing number of diabetes complications. The magnitude of the effect of the decrease of the abundance of telomeric template vs. a single‐copy gene length (T/S ratio) on complications is described by the estimated odds ratio OR = 5.44 (95% CI 3.52–8.42).

Conclusions  The results of the study support the hypothesis that telomere attrition may be a marker associated with the presence and the number of diabetic complications.
Domesticated crop richness in human subsistence cultivation systems: a test of macroecological and economic determinants
Authors: Freeman Jacob
Published: June 2011

Aim  To describe patterns of crop richness at a global scale and investigate the potential influence of energy, water, habitat heterogeneity, area and economic commitment to agricultural practices on patterns of crop species richness.

Location  World‐wide.

Methods  Ethnographic literature for 86 subsistence‐oriented societies was surveyed; 55 of these societies grow crops and 31 do not. These 86 societies occupy the range of latitudes at which subsistence‐oriented groups manage domesticated plant species. The number of domesticated plants that each society cultivates is reported. Regression analyses were conducted to evaluate predictions for relationships between crop richness, energy, area, habitat heterogeneity, commitment to cultivation and species taxonomic descriptions.

Results  Crop richness is positively and significantly related to energy availability and commitment to cultivation. The warmer the environment in which cultivators live, the more crop species cultivators grow. The more subsistence farmers commit to cultivation, the more crop species subsistence farmers grow. Above a threshold of 500 m in elevation range, crop richness is positively related to topographic heterogeneity. Mean annual rainfall, elevation, area, commitment to domesticated animals and exchange are not significantly related to crop richness.

Main conclusions  Crop richness in subsistence‐oriented farming systems is conditioned by energy availability via the physiological tolerances of crop species. Crop richness is secondarily conditioned by topographic heterogeneity, which may serve as an estimate of spatial climatic heterogeneity. Where energy availability is a relatively weak constraint on crop production, commitment to cultivation for subsistence strongly conditions how much effort producers invest in diversifying their crop base. It is postulated that tolerance to freezing temperatures limits the ranges of domesticated plant species. This range limitation might be the result of niche conservation among domesticated crop species and a legacy of greater rates of speciation and lower rates of extinction among ‘free living’ species in tropical settings.
Global and grain‐specific accumulation of glycoside hydrolase family 10 xylanases in transgenic maize (Zea mays)
Authors: Gray Benjamin N. , Bougri Oleg , Carlson Alvar R. , Meissner Judy , Pan Shihao , Parker Matthew H. , Zhang Dongcheng , Samoylov Vladimir , Ekborg Nathan A. , Michael Raab R.
Published: June 2011

In planta expression of cell wall degrading enzymes is a promising approach for developing optimized biomass feedstocks that enable low‐cost cellulosic biofuels production. Transgenic plants could serve as either an enzyme source for the hydrolysis of pretreated biomass or as the primary biomass feedstock in an autohydrolysis process. In this study, two xylanase genes, Bacillus sp. NG‐27 bsx and Clostridium stercorarium xynB, were expressed in maize (Zea mays) under the control of two different promoters. Severe phenotypic effects were associated with xylanase accumulation in maize, including stunted plants and sterile grains. Global expression of these xylanases from the rice ubiquitin 3 promoter (rubi3) resulted in enzyme accumulation of approximately 0.01 mg enzyme per gram dry weight, or approximately 0.1% of total soluble protein (TSP). Grain‐specific expression of these enzymes from the rice glutelin 4 promoter (GluB‐4) resulted in higher‐level accumulation of active enzyme, with BSX and XynB accumulating up to 4.0% TSP and 16.4% TSP, respectively, in shriveled grains from selected T0 plants. These results demonstrate the potential utility of the GluB‐4 promoter for biotechnological applications. The phenotypic effects of xylanase expression in maize presented here demonstrate the difficulties of hemicellulase expression in an important crop for cellulosic biofuels production. Potential alternate approaches to achieve xylanase accumulation in planta without the accompanying negative phenotypes are discussed.
Barriers to Exporting: What are They and Who do They Matter to?
Authors: Kneller Richard , Pisu Mauro
Published: June 2011

The international trade literatures on gravity modelling and firm‐level export behaviour have established that nontariff barriers are important impediments to international trade flows. In this paper, we provide fresh evidence on the actual barriers to exports firms face and how they vary with firm‐level characteristics. Our results indicate that the higher the export experience of firms the lower are the trade costs they face. These barriers are not related to other firm‐level characteristics, such as productivity and size, found by the literature to be associated with export market entry. Overall, these results suggest the existence of a process of learning to export whereby firms learn how to cope with export barriers through direct experience in export markets.
Globalisation, Growth and Convergence
Authors: Villaverde José , Maza Adolfo
Published: June 2011

This paper, devoted to the study of globalisation, analyses two distinct but closely related issues: First, it aims at evaluating disparities in the degree of globalisation observed in a sample of 101 countries over the period 1970–2005. Second, the paper tries to shed some light to the much debated issue of whether globalisation affects economic growth and, in so doing, whether convergence in globalisation brings about convergence in per capita income. The results obtained are both encouraging: on the one side, as it is shown that there has been a clear process of globalisation convergence; on the other, the paper concludes that globalisation has been one of the main drivers of economic growth, thus fostering convergence in per capita income.
The effectiveness of anticellulite treatment using tripolar radiofrequency monitored by classic and high‐frequency ultrasound
Authors: Mlosek R.K. , Woźniak W. , Malinowska S. , Lewandowski M. , Nowicki A.
Published: June 2011

Background  Cellulite affects nearly 85% of the female population. Given the size of the phenomenon, we are continuously looking for effective ways to reduce cellulite. Reliable monitoring of anticellulite treatment remains a problem.

Objective  The main aim of the study was to evaluate the effectiveness of anticellulite treatment carried out using radiofrequency (RF), which was monitored by classical and high‐frequency ultrasound.

Methods  Twenty‐eight women underwent anticellulite treatment using RF, 17 women were in the placebo group. The therapy was monitored by classical and high‐frequency ultrasound. The examinations evaluated the thickness of the epidermal echo, dermis thickness, dermis echogenicity, the length of the subcutaneous tissue bands growing into the dermis, the presence or absence of oedema, the thickness of subcutaneous tissue as well as thigh circumference and the stage of cellulite (according to the Nürnberger–Müller scale).

Results  Cellulite was reduced in 89.286% of the women who underwent RF treatment. After the therapy, the following observations were made: a decrease in the thickness of the dermis and subcutaneous tissue, an increase in echogenicity reflecting on the increase in the number of collagen fibres, decreased subcutaneous tissue growing into bands in the dermis, and the reduction of oedema. In the placebo group, no statistically significant changes of the above parameters were observed.

Conclusion  Radiofrequency enables cellulite reduction. A crucial aspect is proper monitoring of the progress of such therapy, which ultrasound allows.
Excision of apocrine glands and axillary superficial fascia as a single entity for the treatment of axillary bromhidrosis
Authors: He J. , Wang T. , Dong J.
Published: June 2011

Background  Surgical excision of apocrine glands is the effective treatment for axillary bromhidrosis. Skin necrosis, the most serious adverse result observed postoperatively, results in a prolonged wound healing and leads to unsightly scars in the axillary fossae. It is mainly caused by the skin damage during the operation and postoperative seroma or haematoma formation.

Objective  To investigate the effects and complications of our surgical modality for axillary bromhidrosis.

Methods  Sixty‐three patients with bromhidrosis were treated. An incision about two‐thirds of the length of the widest transverse diameter was made on the axillary crease. The loosened layers between the dermis and axillary superficial fascia containing apocrine glands were carefully undermined with an iris scissor. The entire apocrine glands‐axillary superficial fascia complex was dissected from the centre to the superior and inferior margins with an electrosurgical pencil.

Results  Of the 126 axillae, malodour was eradicated in 112 axillae and reduced sharply in 14. There were three cases of skin necroses. The Dermatology Life Quality Index score decreased significantly and the quality of life improved after the operation.

Conclusion  Our surgical technique can achieve minimal tissue damage and maintain no hematoma postoperatively. The rate of skin necrosis was low. Quality of life improved after the procedure in this patient population.
Is atopy and autoimmunity more prevalent in patients with alopecia areata? A comparative study
Authors: Serarslan G. , Savaş N. , Yenin J.Z.
Published: June 2011

Objective  We aimed to determine whether there was a difference between adult and paediatric alopecia areata patients with respect to the severity and pattern of the disease, nail changes and personal and family history of autoimmune diseases and also in comparison with controls.

Methods  Two groups were included: patients with onset of alopecia before the age of ≤18 years and >18 years. The total number of the patients were 124. The control group was comprised of 114 age‐ and gender‐matched patients.

Results  There were 81 adults and 43 children. No statistically significant difference was present between disease severity and gender, age, personal and family history of autoimmune disease in the adult and paediatric group (P > 0.5). Thirteen adults with scalp involvement had nail changes. 61.5% had mild and 38.46% had severe disease (P > 0.5). Of the 43 paediatric patients, 10 patients had nail changes. Severe alopecia was present in 40% of patients with nail changes; however, 9.1% had severe alopecia in patients without nail changes (P = 0.04). There was no statistical significance in patients with and without familial autoimmune diseases when compared with pattern and severity of the diseases between the two groups.

Conclusion  The frequencies of autoimmune and atopic diseases were not different between adult and paediatric patients and the control group. We did not find a statistically significance between disease severity and personal and family history of autoimmune disease in the two groups. Disease severity was not related to nail changes in the adult group. However, severe alopecia areata was more prevalent in children with nail changes. Furthermore, ophiasis pattern was more prevalent in the paediatric group with nail changes compared with the adult group.
Associated comorbidities in psoriasis and inflammatory bowel disease
Authors: Binus A.M. , Han J. , Qamar A.A. , Mody E.A. , Holt E.W. , Qureshi A.A.
Published: June 2011

Background  The association between psoriasis and inflammatory bowel disease (IBD) has been previously reported although a great deal remains unknown about associated comorbidities.

Objectives  The aim of this study was to examine comorbidities in individuals diagnosed with both psoriasis and IBD, and to compare those with individuals diagnosed with psoriasis‐only. We also looked at differences within the IBD group by clearly defining that cohort.

Methods  We included 146 patients diagnosed with both psoriasis and IBD and 146 controls diagnosed of psoriasis‐only without previous records of IBD, matched by gender, ethnicity and age (±5 years). Patients were obtained from the research patient data repository of Brigham and Women’s Hospital (BWH) and Massachusetts General Hospital. Controls were obtained from the psoriatic arthritis and psoriasis follow‐up study (PAFS) at BWH. The comparison between the two groups included socio‐demographics, comorbidities and laboratory inflammation parameters.

Results  Compared to individuals with psoriasis‐only, patients with both psoriasis and IBD had significantly higher rates of autoimmune thyroiditis (2.1% vs. 6.8%), hepatitis (0.7 vs. 6.2%) and diabetes (11.0% vs. 26.7%). In addition, of the 146 patients with psoriasis and IBD, 60 (41.1%) were diagnosed with seronegative arthritis. The average C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of the last visits in our clinics were significantly elevated compared to the individuals with psoriasis‐only (ESR, 33.5 vs. 4.0 mm/h; CRP, 9.1 vs. 2.3 mg/L; both P‐values <0.0001).

Conclusions  We found that patients with both, psoriasis and IBD have a number of further associated comorbidities, some at significantly higher levels than individuals with psoriasis‐only. Common inflammatory pathways and genetic predispositions for specific patterns in the immune response may play an important role in the evolution of associated conditions.
The 1990–92 Massacres in Rwanda: A Case of Spatial and Social Engineering?
Authors: VERWIMP PHILIP
Published: June 2011

Until now, two main sets of arguments have dominated the debate on the nature of the massacres that were perpetrated in Rwanda before the 1994 genocide. The first one maintains that they constituted a response to prior attacks by the RPF, implying that they should be regarded as military operations, rather than as acts of ethnic cleansing. The second common line of argument is that these massacres served as pilot runs for the subsequent genocide, implying that they were part of a plan that was not to see its full implementation until 1994. This paper puts forth a third, alternative interpretation of these massacres. The first of the aforementioned arguments, it is contended, does not take into account the detailed evidence that is available on the killings: the fact that they took place in the context of the civil war accounts for the timing of the massacres, but not for their genocidal character. In turn, the second interpretation fails to situate these massacres against the agro‐pastoral and ideological background of the regime that committed them. By contrast, this paper shows that the massacres took place in areas characterized by a specific history of spatial and social engineering. They are best understood against the background of the processes of land colonization, resettlement, depredation and dispossession of cattle and land that were under way in the areas where the land was most scarce, and where the peasant society was being subject to rationalization and remodelling from above. The paper concludes that pastoralism was sentenced to disappear from Rwanda and that the massacres should be considered instances of ethnic cleansing.
Potentiation of μ‐opioid receptor‐mediated signaling by ketamine
Authors: Gupta Achla , Devi Lakshmi A. , Gomes Ivone
Published: June 2011

J. Neurochem. (2011) 119, 294–302.

Ketamine, a clinically relevant drug, has been shown to enhance opioid‐induced analgesia and prevent hyperalgesia. However, the molecular mechanisms involved are not clearly understood. As previous studies found that activation of opioid receptors leads to the phosphorylation of mitogen‐activated protein kinases, we investigated whether ketamine could modulate μ‐opioid receptor (μOR)‐mediated ERK1/2 phosphorylation. We find that acute treatment with ketamine enhances (∼2‐ to 3‐fold) the levels of opioid‐induced ERK1/2 phosphorylation in recombinant as well as cells endogenously expressing μOR. Interestingly, we find that in the absence of ketamine ERK1/2 signaling is desensitized 10 min after opioid exposure whereas in its presence significant levels (∼3‐fold over basal) are detected. In addition, ketamine increases the rate of resensitization of opioid‐mediated ERK1/2 signaling (15 min in its presence vs. 30 min in its absence). These results suggest that ketamine increases the effectiveness of opiate‐induced signaling by affecting multiple mechanisms. In addition, these effects are observed in heterologous cells expressing μOR suggesting a non‐NMDA receptor‐mediated action of ketamine. Together this could, in part, account for the observed effects of ketamine on the enhancement of the analgesic effects of opiates as well as in the duration of opiate‐induced analgesia.
Repeated exposure to cocaine alters medial prefrontal cortex dopamine D2‐like receptor modulation of glutamate and dopamine neurotransmission within the mesocorticolimbic system
Authors: Liu Kun , Steketee Jeffery D.
Published: June 2011

J. Neurochem. (2011) 119, 332–341.

Repeated exposure to cocaine progressively increases drug‐induced locomotor activity, which is termed behavioral sensitization. Previous studies have demonstrated that sensitization to cocaine is associated with a decrease in dopamine D2 receptor function in the medial prefrontal cortex. The present report tested the hypothesis that reduced medial prefrontal cortex D2 receptor function as a result of repeated cocaine exposure results in augmented excitatory transmission to the nucleus accumbens and ventral tegmental area, possibly as a partial result of enhanced inhibition of local dopamine release. Dual probe microdialysis experiments were conducted in male Sprague–Dawley rats 1, 7 or 30 days following the last of four daily injections of saline (1.0 mL/kg) or cocaine (15 mg/kg). Infusion of quinpirole (0.01, 1.0 and 100 μM), a D2‐like receptor agonist, into the medial prefrontal cortex produced a dose‐dependent decrease in cortical, nucleus accumbens and ventral tegmental area extracellular glutamate levels in control but not sensitized animals. Quinpirole also reduced basal dopamine levels in the medial prefrontal cortex in sensitized animals following 1 day of withdrawal from cocaine. Following 30 days of withdrawal, quinpirole also reduced dopamine levels in sensitized animals relative to saline controls, but not relative to baseline levels. These findings indicate that the expression of sensitization to cocaine is associated with altered modulation of mesocorticolimbic glutamatergic transmission at the level of the medial prefrontal cortex.
Differences in spirometry and diffusing capacity after a 3‐h wet or dry oxygen dive with a PO2 of 150 kPa
Authors: van Ooij P. J. A. M. , van Hulst R. A. , Houtkooper A. , Sterk P. J.
Published: June 2011

Rationale:  Breathing oxygen with a partial pressure of >50 kPa causes pulmonary oxygen toxicity (POT), resulting in a decrease in vital capacity (VC) and in diffusing capacity for carbon monoxide (DLco). As submersion is thought to potentiate POT, we hypothesized that submerged oxygen divers are at increased risk for POT.

Objective:  To compare changes in lung function after submerged (wet) and non‐submerged (dry) oxygen dives.

Method:  Thirteen healthy male divers (mean ± SD: 25 ± 2 years, 184 ± 7 cm, 85 ± 10 kg) made a dry and a wet dive to 150 kPa for 3 h, during which they breathed 100% oxygen. At baseline, within 1 and 4 h after their dives, spirometry and diffusing capacity were measured. Data were analysed with ANOVA using Bonferroni correction and paired t‐tests.

Results:  Compared with baseline, there was a significant reduction in DLco (−1·6 mmol kPa−1 min−1) after a wet oxygen dive but not after a dry dive. In addition, relative to baseline, there was a significant difference in ΔDLco and ΔVC when comparing wet and dry oxygen dives.

Conclusion:  Diffusing capacity is more impaired after a wet oxygen dive than after a dry one. This suggests that wet oxygen divers are at increased risk for POT. Monitoring studies during daily practice of professional divers are mandatory to determine the exact operational relevance of the present findings.
Networks of power and corruption: the trade of Japanese used cars to Mozambique
Authors: BROOKS ANDREW
Published: June 2011

The trade in used commodities has received limited geographical attention. The global production network (GPN) approach offers a theoretical frame through which to explore how second‐hand goods, such as used cars, are traded internationally. The structure of a trade network and the tensions within it are researched through an inductive empirical GPN method and the embeddedness of powerful actors is related to context specific discourse. This article contributes to the analysis of the links between production and consumption through investigating informal and corrupt economic networks and exploring how a trade flow is embedded in a patrimonial state. The empirical case study demonstrates how used commodities are re‐produced through political and cultural processes. In Japan a strict inspection regime excludes many used cars from the domestic market, some of which are exported via South Africa for sale in Mozambique. Embedded actors, including Pakistani trading families, play key roles in the governance of this international trade network. Corrupt individuals within the Mozambican customs service exert power at the import node to extract rent from this trade network, but the official neoliberal narrative of ‘development success’ in Mozambique constrains space for critique of their actions. Discussing the example of used car imports demonstrates how there are political structures which enable actors to have agency in trade networks and this shows how studies of international commodity flows have to stretch beyond the immediate manifestation of trade networks and chains to capture the dynamics of power relations.
The impact of depression and anxiety disorder symptoms on the health‐related quality of life of children and adolescents with epilepsy
Authors: Stevanovic Dejan , Jancic Jasna , Lakic Aneta
Published: June 2011

This study evaluated the effects of depression and anxiety disorder symptoms on the health‐related quality of life (HRQOL) of children and adolescents with epilepsy. Sixty children and adolescents and their parents participated in the study. Symptoms of anxiety disorders were identified by the Screen for Child Anxiety Related Emotional Disorders questionnaire (SCARED) and symptoms of depression by the Mood and Feeling Questionnaire (MFQ). The Pediatric Quality of Life Inventory (PedsQL) was used for HRQOL assessments. A series of simple and partial correlations revealed that the levels of HRQOL significantly decrease as symptoms of depression or anxiety disorders increase and vice versa. Stepwise regression method of children’s ratings resulted in a final model of school achievement and symptoms of generalized anxiety and separation anxiety disorder as predictors that explain 50.9% of the variation in HRQOL (F = 11.21, p < 0.000). For parents’ ratings, the final model included symptoms of depression and separation anxiety disorder as predictors that explain 38.4% of the variation in HRQOL (F = 10.82, p < 0.000). In summary, symptoms of depression and generalized and separation anxiety disorders have the most significant impact on HRQOL.
A retrospective population‐based study on seizures related to childhood vaccination
Authors: von Spiczak Sarah , Helbig Ingo , Drechsel‐Baeuerle Ursula , Muhle Hiltrud , van Baalen Andreas , van Kempen Marjan J. , Lindhout Dick , Scheffer Ingrid E. , Berkovic Samuel F. , Stephani Ulrich , Keller‐Stanislawski Brigitte
Published: June 2011

Purpose:  Cases of severe childhood epilepsies in temporal association with vaccination have great impact on the acceptance of vaccination programs by parents and health care providers. However, little is known about the type and frequency of seizures and epilepsy syndromes following vaccination. This study aims to describe the clinical features of children presenting with seizures after vaccination using a register‐based cohort.

Methods:  We surveyed the national German database of adverse events following immunization (AEFI) for reported seizures and epilepsies in children aged 0–6 years. All cases reported in 2006–2008 were analyzed retrospectively; available clinical information was reevaluated and classified by seizure type and epilepsy syndrome.

Key Findings:  In total, 328 cases reported between 2006 and 2008 were included. Data supportive of seizures or epilepsy were present in 247 (75.3%) of 328 patients with a mean interval between the vaccination and the epileptic event of 24 h and 7.5 days for inactivated and attenuated vaccines, respectively. Fifty‐one (15.5%) of 328 patients presented with syncope, hypotonic–hyporesponsive episodes, or other nonepileptic events. Information was insufficient for classification into epileptic versus nonepileptic events in 30 (11.3%) of 328 patients. For cases with confirmed seizures, febrile seizures were present in 121 (49%) of 247 cases, and 38 (15.4%) of 247 patients had single afebrile seizures. Status epilepticus was described in 21 (8.5%) of 247 patients. Thirty‐one (12.6%) of 247 patients presented with various pediatric epilepsy syndromes. Severe childhood epilepsies (Dravet syndrome, West syndrome, Lennox–Gastaut syndrome, or Doose syndrome) were diagnosed in 29 (11.7%) of 247 patients, with the vaccination‐associated event being the first documented seizure in 15 (51.7%) of 29 patients.

Significance:  Vaccination‐associated seizures present in the setting of various epilepsy syndromes, including severe childhood epilepsies in >10% of cases. Early diagnosis of the corresponding epilepsy syndromes and confirmation of an underlying etiology is important for treatment decisions, genetic counseling, and public health evaluation of vaccine safety.
Epilepsy causing pupillary hippus: an unusual semiology
Authors: Centeno Maria , Feldmann Maria , Harrison Neil A. , Rugg‐Gunn Fergus J. , Chaudhary Umair , Falcon Carles , Lemieux Louis , Thom Maria , Smith Shelagh J.M. , Sisodiya Sanjay M.
Published: June 2011

Altered pupillary behavior is commonly present during and following epileptic seizures, but symptomatic pupillary hippus as the main feature of a seizure has not been reported in the modern literature. We present the case of a woman with epileptic seizures consisting of sustained fluctuation of perception of brightness. Bilateral pupillary hippus is the main semiologic feature.This autonomic phenomenon is selective for the pupils and does not involve other autonomic‐mediated responses. An ictal video illustrates this phenomenon. The epileptogenic region, determined by ictal scalp and intracranial electroencephalography (EEG), is localized in the right posterior parietooccipital areas. Pupillary reflexes can be overridden by cortical input; here authors review the literature and discus the physiologic mechanisms underlying this autonomic phenomenon. Fluctuation in perceptual brightness during epileptic seizures may have a basis in ictal pupillary hippus.
Acute Pain Management Curriculum for Emergency Medicine Residency Programs
Authors: Motov Sergey M. , Marshall John P.
Published: June 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:S87–S91 © 2011 by the Society for Academic Emergency Medicine

Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs possess inadequate knowledge and lack formal training in acute pain management. The purpose of this article is to create a formal educational curriculum that would assist emergency medicine (EM) residents in proper assessment and treatment of acute pain, as well as in providing a solid theoretical and practical knowledge base for managing acute pain in the ED. The authors propose a series of lectures, case‐oriented study groups, practical small group sessions, and class‐specific didactics with the goal of enhancing the theoretical and practical knowledge of acute pain management in the ED.
Water channels in platelet volume regulation
Authors: Lee Jin‐Sook , Agrawal Shivani , von Turkovich Michele , Taatjes Douglas J. , Walz Daniel A. , Jena Bhanu P.
Published: June 2011

The regulation of platelet volume significantly affects its function. Because water is the major molecule in cells and its active transport via water channels called aquaporins (AQPs) have been implicated in cellular and organelle volume regulation, the presence of water channels in platelets and their potential role in platelet volume regulation was investigated. G‐protein–mediated AQP regulation in secretory vesicle swelling has previously been reported in neurons and in pancreatic acinar cells. Mercuric chloride has been demonstrated to inhibit most AQPs except AQP6, which is stimulated by the compound. Exposure of platelets to HgCl2‐induced swelling in a dose‐dependent manner, suggesting the presence of AQP6 in platelets. Immunoblot analysis of platelet protein confirmed the presence of AQP6, and also of Gαo, Gαi–1 and Gαi–3 proteins. Results from this study demonstrate for the first time that in platelets AQP6 is involved in cell volume regulation via a G‐protein–mediated pathway.
Affinity and kinetics of proprotein convertase subtilisin/kexin type 9 binding to low‐density lipoprotein receptors on HepG2 cells
Authors: Mousavi Seyed A. , Berge Knut E. , Berg Trond , Leren Trond P.
Published: June 2011

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a secreted protein that regulates the number of cell surface low‐density lipoprotein receptors (LDLRs) and the levels of low‐density lipoprotein cholesterol in plasma. Intact cells have not previously been used to determine the characteristics of binding of PCSK9 to LDLR. Using PCSK9 iodinated by the tyramine cellobiose (TC) method ([125I]TC‐PCSK9), we measured the affinity and kinetics of binding of PCSK9 to LDLR on HepG2 cells at 4 °C. The extent of [125I]TC‐PCSK9 binding increased as cell surface LDLR density increased. Unlabeled wild‐type and two gain‐of‐function mutants of PCSK9 reduced binding of [125I]TC‐PCSK9. The Scatchard plot of the binding‐inhibition curve was curvilinear, indicative of high‐affinity and low‐affinity sites for PCSK9 binding on HepG2 cells. Nonlinear regression analysis of the binding data also indicated that a two‐site model better fitted the data. The time course of [125I]TC‐PCSK9 binding showed two phases in the association kinetics. Dissociation of [125I]TC‐PCSK9 also occurred in two phases. Unlabeled PCSK9 accelerated the dissociation of [125I]TC‐PCSK9. At low pH, only one phase of dissociation was apparent. Furthermore, the dissociation of [125I]TC‐PCSK9 under pre‐equilibrium conditions was faster than under equilibrium conditions. Overall, the data suggest that PCSK9 binding to cell surface LDLR cannot be described by a simple bimolecular reaction. Possible interpretations that can account for these observations are discussed.
Beyond social mobility
Authors: Pearce Nick
Published: June 2011

Nick Pearce charts the Coalition's reframing of social mobility in increasingly narrow terms and suggests that the concept may be of more limited utility in the coming years. He calls for a richer progressive account of opportunity and fairness.
Crossing the line
Authors: Murphy Jim , Smith Dan , Harvey Michael
Published: June 2011

The use of military force has long represented a key foreign policy schism on the left and the legacy of two unpopular wars has widened this schism. Whether it is Libya today, or Afghanistan, Iraq, Rwanda or the Balkans over the past two decades, military intervention on humanitarian grounds provokes fierce debate among progressives.

How do international obligations and the moral imperative to protect the innocent relate to the rights and expectations of other states and their citizens and the demands of domestic politics and policymaking?

Shadow defence secretary Jim Murphy makes the case for intervention, applauding the principles behind the UN's Responsibility to Protect and arguing that popular anger at the war in Iraq should not be allowed to trump international shame at events in Rwanda.

By contrast, Dan Smith of International Alert expresses deep reservations, highlighting the need for humility when using lethal force in another sovereign nation and arguing that the duty to intervene comes only with the capacity to do so.

Finally, Michael Harvey places the debate on progressive interventionism in the wider political context of traditional and new thinking on the British left and Labour's foreign policy for the future.
The retreat of the state: Conservative ‘modernisation’ and the public services
Authors: Griffiths Simon
Published: June 2011

Simon Griffiths reviews a year of public services under the Coalition and tries to square the radical programme of reforms with the pre‐election notion of Cameron as a ‘One Nation’ Conservative. If Labour is to effectively challenge the Coalition's anti‐state arguments, he says, it needs to find a compelling narrative about the role of the public services and the place of the state in their provision.