bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Dam‐Induced Landscape Fragmentation on Amazonian Ant–Plant Mutualistic Networks
Authors: EMER CARINE , VENTICINQUE EDUARDO MARTINS , FONSECA CARLOS ROBERTO
Published: April 2013

Mutualistic networks are critical to biological diversity maintenance; however, their structures and functionality may be threatened by a swiftly changing world. In the Amazon, the increasing number of dams poses a large threat to biological diversity because they greatly alter and fragment the surrounding landscape. Tight coevolutionary interactions typical of tropical forests, such as the ant–myrmecophyte mutualism, where the myrmecophyte plants provide domatia nesting space to their symbiotic ants, may be jeopardized by the landscape changes caused by dams. We analyzed 31 ant–myrmecophyte mutualistic networks in undisturbed and disturbed sites surrounding Balbina, the largest Central Amazonian dam. We tested how ant–myrmecophyte networks differ among dam‐induced islands, lake edges, and undisturbed forests in terms of species richness, composition, structure, and robustness (number of species remaining in the network after partner extinctions). We also tested how landscape configuration in terms of area, isolation, shape, and neighborhood alters the structure of the ant–myrmecophyte networks on islands. Ant–myrmecophytic networks were highly compartmentalized in undisturbed forests, and the compartments had few strongly connected mutualistic partners. In contrast, networks at lake edges and on islands were not compartmentalized and were negatively affected by island area and isolation in terms of species richness, density, and composition. Habitat loss and fragmentation led to coextinction cascades that contributed to the elimination of entire ant–plant compartments. Furthermore, many myrmecophytic plants in disturbed sites lost their mutualistic ant partners or were colonized by opportunistic, nonspecialized ants. Robustness of ant–myrmecophyte networks on islands was lower than robustness near lake edges and in undisturbed forest and was particularly susceptible to the extinction of plants. Beyond the immediate habitat loss caused by the building of large dams in Amazonia, persistent edge effects and habitat fragmentation associated with dams had large negative effects on animal–plant mutualistic networks.

Efectos de la Fragmentación del Paisaje Inducida por Presas sobre Redes Mutualistas Hormiga‐Planta Amazónicas
A Small‐Scale Land‐Sparing Approach to Conserving Biological Diversity in Tropical Agricultural Landscapes
Authors: CHANDLER RICHARD B. , KING DAVID I. , RAUDALES RAUL , TRUBEY RICHARD , CHANDLER CARLIN , ARCE CHÁVEZ VÍCTOR JULIO
Published: April 2013

Two contrasting strategies have been proposed for conserving biological diversity while meeting the increasing demand for agricultural products: land sparing and land sharing production systems. Land sparing involves increasing yield to reduce the amount of land needed for agriculture, whereas land‐sharing agricultural practices incorporate elements of native ecosystems into the production system itself. Although the conservation value of these systems has been extensively debated, empirical studies are lacking. We compared bird communities in shade coffee, a widely practiced land‐sharing system in which shade trees are maintained within the coffee plantation, with bird communities in a novel, small‐scale, land‐sparing coffee‐production system (integrated open canopy or IOC coffee) in which farmers obtain higher yields under little or no shade while conserving an area of forest equal to the area under cultivation. Species richness and diversity of forest‐dependent birds were higher in the IOC coffee farms than in the shade coffee farms, and community composition was more similar between IOC coffee and primary forest than between shade coffee and primary forest. Our study represents the first empirical comparison of well‐defined land sparing and land sharing production systems. Because IOC coffee farms can be established by allowing forest to regenerate on degraded land, widespread adoption of this system could lead to substantial increases in forest cover and carbon sequestration without compromising agricultural yield or threatening the livelihoods of traditional small farmers. However, we studied small farms (<5 ha); thus, our results may not generalize to large‐scale land‐sharing systems. Furthermore, rather than concluding that land sparing is generally superior to land sharing, we suggest that the optimal approach depends on the crop, local climate, and existing land‐use patterns.

Un Método para Reservar Tierras a Pequeña Escala para Conservar la Biodiversidad en Paisajes Agrícolas Tropicales
Estimating Extinction Risk with Metapopulation Models of Large‐Scale Fragmentation
Authors: SCHNELL JESSICA K. , HARRIS GRANT M. , PIMM STUART L. , RUSSELL GARETH J.
Published: April 2013

Habitat loss is the principal threat to species. How much habitat remains—and how quickly it is shrinking—are implicitly included in the way the International Union for Conservation of Nature determines a species’ risk of extinction. Many endangered species have habitats that are also fragmented to different extents. Thus, ideally, fragmentation should be quantified in a standard way in risk assessments. Although mapping fragmentation from satellite imagery is easy, efficient techniques for relating maps of remaining habitat to extinction risk are few. Purely spatial metrics from landscape ecology are hard to interpret and do not address extinction directly. Spatially explicit metapopulation models link fragmentation to extinction risk, but standard models work only at small scales. Counterintuitively, these models predict that a species in a large, contiguous habitat will fare worse than one in 2 tiny patches. This occurs because although the species in the large, contiguous habitat has a low probability of extinction, recolonization cannot occur if there are no other patches to provide colonists for a rescue effect. For 4 ecologically comparable bird species of the North Central American highland forests, we devised metapopulation models with area‐weighted self‐colonization terms; this reflected repopulation of a patch from a remnant of individuals that survived an adverse event. Use of this term gives extra weight to a patch in its own rescue effect. Species assigned least risk status were comparable in long‐term extinction risk with those ranked as threatened. This finding suggests that fragmentation has had a substantial negative effect on them that is not accounted for in their Red List category.

Estimación del Riesgo de Extinción Mediante Modelos Metapoblacionales de Fragmentación a Gran Escala
Women with metabolic syndrome present different autonomic modulation and blood pressure response to an acute resistance exercise session compared with women without metabolic syndrome
Authors: Tibana Ramires A. , Boullosa Daniel A. , Leicht Anthony S. , Prestes Jonato
Published: April 2013

Metabolic syndrome (MetS) is a cluster of risk factors in individuals with high risk of diabetes and heart disease. Resistance training (RT) has been proposed to be a safe, effective and worthwhile method for the prevention and treatment of metabolic and cardiovascular diseases. However, no study has analysed the acute response of blood pressure (BP) and autonomic control of heart rate (HR) after a RT session in female patients with MetS. The aim of the present study was to analyse the response of laboratory assessed and ambulatory BP and cardiac autonomic modulation after a RT session in women with MetS. Nine women without MetS (35·0 ± 6·7 years) and 10 women with MetS (34·1 ± 9·4 years) completed one experimental exercise session and a control session. Laboratory BP, heart rate variability (HRV) and ambulatory BP of each subject were measured at rest, over 60 min, and for 24 h after the end of the sessions, respectively. There was a significant reduction in systolic blood pressure (SBP), night time diastolic blood pressure (DBP) and mean blood pressure (MBP) only for women with MetS, for all periods after the RT session when compared with the control session (P<0·05). Significantly lower laboratory values of SBP and DBP (10, 30 and 40 min postexercise) and MBP (10, 40 and 50 min postexercise) were observed in women with MetS (P<0·05). Patients with MetS exhibited significant lower basal HRV and a lower autonomic responsiveness during the 60 min of acute recovery. These results confirmed that an acute session of resistance exercise induced a lower BP during day time and sleeping hours in women with MetS that may offer a cardio‐protective effect. Women with MetS exhibited an impaired autonomic modulation at rest and a lower acute autonomic responsiveness to a RT session. The dissociation between BP and HRV responses suggests that other factors than autonomic control could be involved in the hypotensive effect of a RT session in MetS patients.
CD34‐positive superficial myxofibrosarcoma: a potential diagnostic pitfall
Authors: Smith Steven C. , Poznanski Ann A. , Fullen Douglas R. , Ma Linglei , McHugh Jonathan B. , Lucas David R. , Patel Rajiv M.
Published: April 2013

Background

Myxofibrosarcoma (MFS) arises most commonly in the proximal extremities of the elderly, where it may involve subcutaneous and dermal tissues and masquerade as benign entities in limited biopsy samples. We encountered such a case, in which positivity for CD34 and morphologic features were initially wrongly interpreted as a ‘low‐fat/fat‐free’ spindle cell/pleomorphic lipoma. Case series have not assessed prevalence of CD34 reactivity among cutaneous examples of MFS.

Methods

We performed a systematic review of our institution's experience, selecting from among unequivocal MFS resection specimens those superficial cases in which a limited biopsy sample might prove difficult to interpret. These cases were immunostained for CD34 and tabulated for clinicopathologic characteristics.

Results

After review of all MFS diagnoses over 5 years (n = 56), we identified a study group of superficial MFS for comparison to the index case (total n = 8). Of these, the index and three additional cases (4 of 8, 50%; 2 low, 2 high grade) demonstrated positive staining for CD34, with diffuse staining of spindled cells including cellular processes. Four additional cases showed no or equivocal/rare staining.

Conclusions

CD34 positivity should be recognized as prevalent among such cases and should not be inappropriately construed as inveighing against a diagnosis of MFS in favor of benign entities.
ALK rearrangements in EBUS‐derived transbronchial needle aspiration cytology in lung cancer
Authors: Neat M. J. , Foot N. J. , Hicks A. , Breen R. , Wilkins B. , McLean E. , Santis G.
Published: April 2013

Objectives

Patients with non‐small cell lung cancer (NSCLC) positive for anaplastic lymphoma kinase (ALK) gene rearrangements may be treated successfully with the ALK inhibitor crizotinib. ALK copy‐number abnormalities have also been described. In this study, we evaluated the suitability of fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) to determine ALK status in endobronchial ultrasound (EBUS)‐derived cytology samples.

Methods

Samples were obtained from 55 consecutive patients with NSCLC who had undergone EBUS‐transbronchial needle aspiration (TBNA) according to our standard clinical protocols. All tumours had been screened previously for epithelial growth factor receptor (EGFR) and v‐Ki‐ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations. FISH, using commercially available ALK rearrangement‐specific probes, was employed to assess ALK status. IHC using the ALK‐1 monoclonal antibody (DAKO) was also performed.

Results

FISH analysis was successful in 52 of 55 samples (94.5%); ALK rearrangement was demonstrated in 3 of 52 samples from patients with NSCLC (5.7%). ALK amplification was observed in 3 of 52 patient samples (5.7%) and an increase in ALK copy number was found in 28 of 52 patient samples (53.8%). IHC on cell blocks demonstrated ALK expression in one of three samples with ALK rearrangement. One patient sample had concomitant ALK rearrangement and KRAS mutation.

Conclusions

We found FISH to be superior to IHC using the ALK‐1 monoclonal antibody for the detection of ALK rearrangement in EBUS‐TBNA cytology specimens in NSCLC, and also that ALK rearrangement can co‐exist with KRAS mutation in the same tumour.
Probabilistic cost‐benefit analysis of disaster risk management in a development context
Authors: Kull Daniel , Mechler Reinhard , Hochrainer‐Stigler Stefan
Published: April 2013

Limited studies have shown that disaster risk management (DRM) can be cost‐efficient in a development context. Cost–benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost‐effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results.
Plasma sRAGE and N‐(carboxymethyl) lysine in patients with CHF and/or COPD
Authors: Boschetto Piera , Campo Ilaria , Stendardo Mariarita , Casimirri Enrico , Tinelli Carmine , Gorrini Marina , Ceconi Claudio , Fucili Alessandro , Potena Alfredo , Papi Alberto , Ballerin Licia , Fabbri Leonardo M. , Luisetti Maurizio
Published: April 2013

Background

Knowledge of the role of the receptor for advanced glycation end products (RAGE), particularly its soluble form (sRAGE), and of its advanced glycation end product (AGE) ligand, N‐(carboxymethyl)lysine adducts (CML), is limited in chronic heart failure (CHF) and in chronic obstructive pulmonary disease (COPD). We evaluated whether the AGE/RAGE system is activated in stable CHF and COPD, and whether plasma sRAGE and CML levels are affected by clinical and functional parameters.

Materials and methods

We measured plasma levels of sRAGE and CML using a sandwich enzyme‐linked immunosorbent assay (ELISA) in 143 subjects, aged ≥ 65 years, divided into five groups: 58 with CHF, 23 with COPD, 27 with CHF+COPD and 35 controls (17 healthy smokers and 18 healthy nonsmokers). Individuals with diabetes were excluded from the study.

Results

Plasma levels of sRAGE and CML were higher in CHF patients than in controls [sRAGE: 0·48 (0·37–0·83) vs. 0·42 (0·29–0·52) ng/mL, P = 0·01; CML: 1·95 (1·58–2·38) vs. 1·68 (1·43–2·00) ng/mL, P = 0·01]. By contrast, sRAGE and CML were not different between both COPD and CHF+COPD patients and controls (P > 0·05). N‐terminal pro‐brain natriuretic peptide (Nt‐pro BNP) correlated with sRAGE, but not with CML, in the patient groups: CHF (r = 0·43, P < 0·001), COPD (r = 0·77, P < 0·0001) and CHF/COPD (r = 0·43, P = 0·003).

Conclusions

Plasma levels of sRAGE and CML are increased in CHF, but not in COPD patients. The robust association between NT‐pro BNP, a diagnostic and prognostic marker in CHF, and sRAGE concentrations might suggest a possible BNP pathway of amplification of inflammation via the AGE/RAGE system.
Bone marrow osteoblast vulnerability to chemotherapy
Authors: Gencheva Marieta , Hare Ian , Kurian Susan , Fortney Jim , Piktel Debbie , Wysolmerski Robert , Gibson Laura F.
Published: April 2013

Osteoblasts are a major component of the bone marrow microenvironment, which provide support for hematopoietic cell development. Functional disruption of any element of the bone marrow niche, including osteoblasts, can potentially impair hematopoiesis. We have studied the effect of two widely used drugs with different mechanisms of action, etoposide (VP16) and melphalan, on murine osteoblasts at distinct stages of maturation. VP16 and melphalan delayed maturation of preosteoblasts and altered CXCL12 protein levels, a key regulator of hematopoietic cell homing to the bone marrow. Sublethal concentrations of VP16 and melphalan also decreased the levels of several transcripts which contribute to the composition of the extracellular matrix (ECM) including osteopontin (OPN), osteocalcin (OCN), and collagen 1A1 (Col1a1). The impact of chemotherapy on message and protein levels for some targets was not always aligned, suggesting differential responses at the transcription and translation or protein stability levels. As one of the main functions of a mature osteoblast is to synthesize ECM of a defined composition, disruption of the ratio of its components may be one mechanism by which chemotherapy affects the ability of osteoblasts to support hematopoietic recovery coincident with altered marrow architecture. Collectively, these observations suggest that the osteoblast compartment of the marrow hematopoietic niche is vulnerable to functional dysregulation by damage imposed by agents frequently used in clinical settings. Understanding the mechanistic underpinning of chemotherapy‐induced changes on the hematopoietic support capacity of the marrow microenvironment may contribute to improved strategies to optimize patient recovery post‐transplantation.
A Consulting Giant; a Disgruntled Client: A ‘Failed’ Attempt to Change Management Controls in a Public Sector Organisation
Authors: Junaid Ashraf M. , Uddin Shahzad
Published: April 2013

There has been very little research into management consulting interventions in public sector organisations, especially in emerging economies. This paper aims to fill this void by narrating the empirics of a consulting assignment carried out by a large international consulting firm in a Pakistani public sector organisation. The study found that consultants’ recommendations of ‘businesslike’ management controls, such as a modern performance measurement system and a ‘state‐of‐the‐art’ information system, were rejected outright by the client management. Employing a critical realist perspective that focuses on the structural conditions facing both the client and the consultants, and on the strategies adopted by both parties, the study aims to explain the empirics of the case. Through structural and strategic analysis, this paper aims to enhance our understanding of the dynamics of management consulting in public sector organisations, especially in emerging economies.
‘Too Big to Fail and Too Big to Succeed': Accounting and Privatisation in the Prison Service of England and Wales
Authors: Mennicken Andrea
Published: April 2013

This paper is concerned with the challenges involved in the transformation of the prison into a performance‐oriented accounting entity. It examines the implication of private sector accounting and consulting expertise in redefining prison values and prison performance, and it discusses the consequences this had for definitions of risk and responsibility. The paper shows how the reforms promoted a systemic decentring of Prison Service accountability. Prison managers and regulators came to be inserted into hierarchies of expertise and credibility shaped by quests for commensuration and auditability. Further, the paper shows how the reform attempts brought about a situation of institutional lock‐in by contributing, as the outgoing HM Chief Inspector of Prisons Anne Owers has put it in 2010, to the creation of an inflated prison system ‘too big to fail, and too big to succeed'.
Complex dynamics may limit prediction in marine fisheries
Authors: Glaser Sarah M , Fogarty Michael J , Liu Hui , Altman Irit , Hsieh Chih‐Hao , Kaufman Les , MacCall Alec D , Rosenberg Andrew A , Ye Hao , Sugihara George
Published: April 2013

Complex nonlinear dynamics in marine fisheries create challenges for prediction and management, yet the extent to which they occur in fisheries is not well known. Using nonlinear forecasting models, we analysed over 200 time series of survey abundance and landings from two distinct ecosystems for patterns of dynamic complexity (dimensionality and nonlinear dynamics) and predictability. Differences in system dimensionality and nonlinear dynamics were associated with time series that reflected human intervention via fishing effort, implying the coupling between human and natural systems generated dynamics distinct from those detected in the natural resource subsystem alone. Estimated dimensionality was highest for landings and higher in abundance indices of unfished species than fished species. Fished species were more likely to display nonlinear dynamics than unfished species, and landings were significantly less predictable than abundance indices. Results were robust to variation in life history characteristics. Dynamics were predictable over a 1‐year time horizon in seventy percent of time series, but predictability declined exponentially over a 5‐year horizon. The ability to make predictions in fisheries systems is therefore extremely limited. To our knowledge, this is the first cross‐system comparative study, and the first at the scale of individual species, to analyse empirically the dynamic complexity observed in fisheries data and to quantify predictability broadly. We outline one application of short‐term forecasts to a precautionary approach to fisheries management that could improve how uncertainty and forecast error are incorporated into assessment through catch limit buffers.
How long should we ignore imperfect detection of species in the marine environment when modelling their distribution?
Authors: Monk Jacquomo
Published: April 2013

The application of the ‘ecosystem approach’ to marine conservation management demands knowledge of the distribution patterns of the target species or communities. This information is commonly obtained from species distribution models (SDMs). This article explores an important but rarely acknowledged assumption in these models: almost all species may be present, but simply not detected by the particular survey method. However, nearly all of these SDM approaches neglect this important characteristic. This leads to the violation of a fundamental assumption of these models, which presuppose the detection of a species is equal to one (i.e. at each survey locality, a species is perfectly detected). In this article, the concept of imperfect detection is discussed, how it potentially influences the prediction of species' distributions is examined, and some statistical methods that could be used to incorporate the detection probability of species in estimates of their distribution are suggested. The approaches discussed here could improve the collection and interpretation of marine biological survey data and provide a coherent way to incorporate detection probability estimates in the modelling of species distributions. This will ultimately lead to an unbiased and more rigorous understanding of the distribution of species in the marine environment.
Relationships between nutrient enrichment, pleurocerid snail density and trematode infection rate in streams
Authors: Ciparis Serena , Iwanowicz Deborah D. , Voshell J. Reese
Published: April 2013

Nutrient enrichment is a widespread environmental problem in freshwater ecosystems. Eutrophic conditions caused by nutrient enrichment may result in a higher prevalence of infection by trematode parasites in host populations, due to greater resource availability for the molluscan first intermediate hosts.

This study examined relationships among land use, environmental variables indicating eutrophication, population density of the pleurocerid snail, Leptoxis carinata, and trematode infections. Fifteen study sites were located in streams within the Shenandoah River catchment (Virginia, U.S.A.), where widespread nutrient enrichment has occurred.

Snail population density had a weak positive relationship with stream water nutrient concentration. Snail population density also increased as human activities within stream catchments increased, but density did not continue to increase in catchments where anthropogenic disturbance was greatest.

Cercariae from five families of trematodes were identified in L. carinata, and infection rate was generally low (<10%). Neither total infection rate nor the infection rate of individual trematode types showed a positive relationship with snail population density, nutrients or land use.

There were statistically significant but weak relationships between the prevalence of infection by two trematode families and physical and biological variables. The prevalence of Notocotylidae was positively related to water depth, which may be related to habitat use by definitive hosts. Prevalence of Opecoelidae had a negative relationship with orthophosphate concentration and a polynomial relationship with chlorophyll a concentration. Transmission of Opecoelid trematodes between hosts may be inhibited by eutrophic conditions.

Leptoxis carinata appears to be a useful species for monitoring the biological effects of eutrophication and investigating trematode transmission dynamics in lotic systems.
Functional aging impairs the role of feedback in motor learning
Authors: Liu Yu , Cao Chunmei , Yan Jin H
Published: April 2013

Aim

Optimal motor skill acquisition frequently requires augmented feedback or knowledge of results (KR). However, the effect of functional declines on the benefits of KR remains to be determined. The objective of this research was to examine how cognitive and motor deficits of older adults influence the use of KR for motor skill learning.

Methods

A total of 57 older adults (mean 73.1 years; SD 4.2) received both cognitive and eye–hand coordination assessments, whereas 55 young controls (mean 25.8 years; SD 3.8) took only the eye–hand coordination test. All young and older participants learned a time‐constrained arm movement through KR in three pre‐KR and post‐KR intervals.

Results

In the subsequent no‐KR skill retests, absolute and variable time errors were not significantly reduced for the older learners who had KR during skill practice, especially for those with cognitive and motor dysfunctions. The finding suggests that KR results in no measureable improvement for older adults with cognitive and motor functional deficiencies. More importantly, for the older adults, longer post‐KR intervals showed greater detrimental effects on feedback‐based motor learning than shorter pauses after KR delivery.

Discussion

The findings support the hypothesis about the effects of cognitive and motor deficits on KR in motor skill learning of older adults. The dynamics of cognitive and motor aging, external feedback and internal control mechanisms collectively explain the deterioration in the sensory‐motor learning of older adults. The theoretical implications and practical relevance of functional aging for motor skill learning are discussed. Geriatr Gerontol Int 2013; 13: 849–859.
First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan
Authors: Yagi Takahito , Nobuoka Daisuke , Shinoura Susumu , Umeda Yuzo , Sato Daisuke , Yoshida Ryuichi , Utsumi Masashi , Fuji Tomokazu , Sadamori Hiroshi , Fujiwara Toshiyoshi
Published: April 2013

Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50‐year‐old woman who had undergone living donor liver transplantation at the age of 38 years for management of post‐partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End‐stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno‐venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.
Effect of treatment with branched‐chain amino acids during sorafenib therapy for unresectable hepatocellular carcinoma
Authors: Takeda Haruhiko , Nishikawa Hiroki , Iguchi Eriko , Ohara Yoshiaki , Sakamoto Azusa , Saito Sumio , Nishijima Norihiro , Nasu Akihiro , Komekado Hideyuki , Kita Ryuichi , Kimura Toru , Osaki Yukio
Published: April 2013

Aim

To examine the effect of branched‐chain amino acid (BCAA) therapy for patients with unresectable hepatocellular carcinoma (HCC) treated with sorafenib.

Methods

Seventy‐eight subjects with unresectable HCC with a serum level of albumin of 3.5 g/dL or less treated with sorafenib were evaluated. They were classified into two groups: those receiving BCAA granules (n = 34; BCAA group) or a regular diet (n = 44; control group). We compared overall survival and administration period of sorafenib, and analyzed absolute changes in serum levels of albumin during sorafenib therapy in 41 patients who continued sorafenib therapy for 1 month or more with a follow up of more than 3 months.

Results

Median survival time (MST) in BCAA and control groups was 350 and 143 days (P = 0.007), respectively. Median administration period of sorafenib in the two groups was 59 and 41 days (P = 0.018). In the 41 patients described above, at 1 month, there was no significant change in the serum level of albumin between the two groups, but at 3 months, the difference in the absolute change in the serum level of albumin in the two groups reached significance (P = 0.023). In these subgroup analyses, the administration period of sorafenib as well as the MST in the BCAA group were significantly longer than those in the control group (P = 0.020 and = 0.004).

Conclusion

BCAA treatment during sorafenib therapy in HCC patients is useful for maintaining hepatic functional reserve, which may help to avoid early discontinuance of sorafenib therapy and improve survival.
Characterization of HLA‐F polymorphism in four distinct populations in Mainland China
Authors: Pan F. H. , Liu X. X. , Tian W.
Published: April 2013

Currently, there is a lack of information on polymorphism of human leucocyte antigen‐F (HLA‐F) gene in ethnically diverse human populations. In this study, HLA‐F allelic typing was performed for 690 individuals representing two southern Chinese Han populations (Hunan Han and Guangdong Han) and two northern Chinese populations (Inner Mongolia Han and Inner Mongolia Mongol), using polymerase chain reaction‐sequence‐specific priming (PCR‐SSP) and PCR‐sequencing methods. Our results showed that (i) HLA‐F*01 : 01 predominated in each population with a frequency >0.94 and HLA‐F*01 : 03 was relatively more common in the two northern Chinese populations with a frequency of approximately 0.05; (ii) both geographical and ethnical factors are related to HLA‐F allelic distribution, as evidenced by the significant difference in HLA‐F allelic distribution between the Hunan Han population and the two northern Chinese populations; (iii) significant linkage disequilibrium (LD) was observed for haplotype HLA‐A*03‐F*01 : 03 in three populations. In most cases, this haplotype extended to HLA‐E*01 : 03; and (iv) Ewens–Watterson homozygosity statistic at the HLA‐F locus did not depart significantly from expectation in each of the four populations. Our data revealed a low level of HLA‐F allelic variation in Chinese populations, suggesting that HLA‐F gene may have existed before some of the HLA‐A polymorphism and have been evolving under neutrality.
Household assets, school enrollment, and parental aspirations for children's education in rural China: Does gender matter?
Authors: Deng Suo , Huang Jin , Jin Minchao , Sherraden Michael
Published: April 2013

Using rural household data from the China Household Income Project (CHIP) 2002, this article provides an analysis of different effects of household assets independent of family income on children's school enrollment and parental aspirations for education, examining both outcomes by children's gender. The study first compared the responsiveness of boys' and girls' enrollment with the improvement of household assets, measured as liquid assets and net worth, relative to family income. The multivariate regression analysis further detected the effects of household assets on both boys' and girls' school enrollment and parental aspirations for their future education. Statistical results show that, compared with family income, household assets matter more for girls' schooling than for boys'. In addition, household net worth was found to be significantly associated with parental aspirations for children's education regardless of gender. This study, albeit exploratory, sheds light on child welfare and education policies in rural China.
Support needs of caregivers: case studies in South Africa
Authors: Sandy P.T. , Kgole J.C. , Mavundla T.R.
Published: April 2013

Background

Limpopo is one of the poorest provinces in South Africa with limited resources to support caregivers and individuals who are learning disabled. Offering support and care to children with learning disabilities can be a complex and difficult task to achieve. Caregivers carry great responsibility for ensuring the needs of children in their care are met. Such responsibility can generate great amounts of stress that may negatively impact caregivers' day‐to‐day functioning. Yet, research concerning how to support caregivers in meeting the needs of this group of children in Limpopo has never before been carried out.

Aim

To investigate the support needs of caregivers caring for children with learning disabilities.

Methods

A case study design of three families of children with learning disabilities was used. Data were generated in two phases using a semi‐structured interview format. In phase 1, participants were interviewed in their homes. Phase 2 relates to follow‐up interviews of participants in a community clinic. All data were analysed using Interpretative Phenomenological Analysis.

Findings

The study identified a range of support needs for caregivers. Examples of these include financial, emotional, practical support, training, respite care, affiliate stigma and partnership working.

Discussion

Caring for children with learning disabilities was perceived as difficult and frustrating, yet rewarding. This difficulty was noted to be compounded by caregivers' lack of skills and knowledge of caring for these children. They also had experiences of stigma, which sometimes involves overt acts of discrimination and social exclusion that further added to their frustration.

Conclusions

The study findings have implications for practice and policy. Regular training and support should be offered to caregivers in order to broaden their understanding of learning disabilities and enhance their caring ability. Nurses are the main source of training and support and offer these during clinic‐based engagement and home visits.
Safety, efficacy and pitfalls of fibrocyte application in the treatment of diabetic foot ulcer
Authors: Behjati Mohaddeseh , Hashemi Mohammad , Shoarayenejati Alireza , Karbalaie Khadijeh , Nasr‐Esfahani Mohammad H
Published: April 2013

Fibrocytes are unique bone marrow‐derived cells with great potential in wound healing. Hence, the aim of this study was to determine the safety and efficacy of the applied circulating fibrocytes in the treatment of non healing diabetic foot ulcers. Peripheral blood mononuclear cells were isolated by centrifugation through Ficoll–Paque method. After 3 days, the non adherent cells were removed by a single, gentle aspiration. Adherent cells were cultured in the same medium for 10 days. The cells were characterised using mouse anti‐human‐CD45‐fluorescein isothiocyanate (FITC) and mouse anti‐human–collagen I, and also characterised by immunofluorescence microscopy using the above mentioned antibodies. Sterility measures were applied for clinical evaluation. Based on the literature review, cell transplantation generally requires at least 3 × 106 cells regarding efficacy measures. As fibrocytes are non proliferating cells, 350 ml patient's blood is required to prepare patient‐specific serum before cell isolation and culture, and 85 ml patient's blood is needed for cell isolation and differentiation on cell transplantation applications. In our survey, no diabetic patient was inclined to be donor of such blood volume, mainly because of their pre‐assumption that they are anaemic. It is concluded that fibrocytes do not seem to be candidate cells for cell therapy in the treatment of diabetic foot ulcers because of the rarity of this cell population in circulation.
Phase 1 prospective evaluation of the oncological adequacy of robotic assisted video‐endoscopic inguinal lymphadenectomy in patients with penile carcinoma
Authors: Matin Surena F. , Cormier Janice N. , Ward John F. , Pisters Louis L. , Wood Christopher G. , Dinney Colin P.N. , Royal Richard E. , Huang Xuelin , Pettaway Curtis A.
Published: April 2013

What's known on the subject? and What does the study add?

Several lymph node staging strategies have been proposed as a response to the high morbidity seen after standard inguinal lymphadenectomy for penile cancer. A video‐endoscopic (laparoscopic and robotic) approach has been proposed as a less morbid procedure in several retrospective studies. To date, none has evaluated the oncological adequacy with regard to whether all relevant nodes have been removed.

To the authors’ knowledge this is the first prospective study of a robotic or laparoscopic inguinal lymphadenectomy that evaluates the oncological adequacy of this approach for penile cancer. The study shows that robotic inguinal lymphadenectomy allowed adequate staging of disease in the inguinal region by removing all relevant lymph nodes as assessed by an independent evaluating urological oncologist.

Objective

To prospectively determine the oncological adequacy of robotic assisted video‐endoscopic inguinal lymphadenectomy (RAVEIL).

Patients and Methods

Patients with T1‐3N0 penile cancer were enrolled into a prospective phase I trial at a tertiary care institution from March 2010 to January 2012. All patients underwent an initial RAVEIL approach.

Verification of adequacy of dissection was performed by an independent surgeon via a separate open incision at the conclusion of the RAVEIL procedure.

Out of 10 patients, if more than two superficial inguinal fields with ≥2 nodes or more than four with ≥1 node remained within the superficial dissection field, the study would not proceed to phase II.

Results

Of 10 enrolled patients two had inguinal metastases and all positive nodes were detected by RAVEIL. The remaining eight patients had no metastases, with a mean of nine (range 5–21) left and nine (range 6–17) right nodes removed. One inguinal field RAVEIL was converted to an open dissection.

The verifying surgeon confirmed that 18 of 19 inguinal fields (94.7% in nine patients) had an adequate dissection. Two benign nodes were found just beneath Scarpa's fascia above the inguinal dissection field.

Limitations of the study include an inability to determine decisively what specific wound complications were related to RAVEIL because of the protocol‐specified creation of a small inguinal incision for verification of adequate dissection.

Conclusion

RAVEIL allowed adequate staging of disease in the inguinal region among patients with penile cancer at risk for inguinal metastases.
THE POLITICS OF POLITICIZATION IN SWEDEN
Authors: DAHLSTRÖM CARL , NIKLASSON BIRGITTA
Published: April 2013

Previous research has described, theoretically and empirically, the negative consequences of a politicized civil service, recruited on political instead of professional merits. However, we know very little about what explains politicization, especially outside the context of theUSA. This study reviews literature in the field and identifies three commonly used explanations that are then tested in a study of recruitment of agency heads in Sweden between 1960 and 2010. For this purpose, we collected new data that includes information about 1,812 agency heads' political and/or professional backgrounds and 1,608 appointments to agency head positions. Our study demonstrates that none of the previously used explanations – ideological bias of the government, the number of years that the government has been in power, and the parliamentarian support for the government – holds. Our general conclusion is therefore negative and emphasizes the need for more systematic research on this question.
Validation of Fear of Partner Scale
Authors: O'Leary K. Daniel , Foran Heather , Cohen Shiri
Published: April 2013

Therapists have a responsibility to ascertain if psychological aggression, physical aggression, sexual aggression exist, and if there is fear of the partner. A fear of partner measure was evaluated in 100 couples who sought relationship feedback. Fear of partner's psychological, physical, and sexual aggression was related to actual reports of such behavior. For both men and women, fear of speaking in front of partner and fear of being in therapy with partner were related to reports of psychological aggression perpetrated by the partner, dominance, and isolation by the partner, and one's own marital dissatisfaction. Among respondents who were aggressed against, more men than women reported fear of participating in therapy with their partner. The measure herein can be used to determine the extent of fear of aggression by partners and to assist in the decision‐making about the appropriateness of marital therapy and divorce mediation.
REFRACTORY HENOCH–SCHÖNLEIN PURPURA: ATYPICAL AETIOLOGY AND MANAGEMENT
Authors: El‐Husseini Amr , Ahmed Ahmed , Sabucedo Alberto , Fabulo Edward
Published: April 2013

Background

A 27‐year‐old white male was referred with recently diagnosed refractory Henoch–Schönlein purpura nephritis (HSPN). He had a past medical history of hypertension of four years duration and was prescribed lisinopril. He was switched from a brand to a generic lisinopril two days before the onset of first symptoms. On two occasions symptoms had worsened while trying to switch back to the generic drug. He had 9 g/day protein in his urine with haematuria and serum creatinine was up to 123.76 µmol/l (normal value < 106 µmol/l).

Treatment

The patient underwent two renal biopsies; the first was carried out early after having HSP symptoms and the second was performed a month later. The first biopsy showed mild segmental endocapillary hypercellularity with IgA deposits consistent with HSPN. The second biopsy showed proliferative IgA nephropathy with focal active cellular crescent formation in 38% of the glomeruli.

Results

He did not respond to steroids, cyclophosphamide and plamapheresis. However, his renal and extra‐renal manifestations eventually improved after he had received three doses of 1,000 mg rituximab by infusion, two weeks apart.

Conclusion

Rituximab might be efficacious in treatment of hspn, more studies are needed to assess long‐term safetey and efficacy.
CALCIPHYLAXIS AND SODIUM THIOSULPHATE: A GLIMMER OF HOPE IN DESPERATE SITUATION
Authors: Burnie Robert , Smail Sarah , Javaid Muhammad M.
Published: April 2013

Background

Calciphylaxis is an uncommon and often under diagnosed condition affecting patients undergoing chronic dialysis. Its pathogenesis is poorly understood. The abnormalities of calcium, phosphate and parathyroid hormone homeostasis leading to vascular calcification and ischaemic skin necrosis are thought to be the central problem. Meticulous wound care and aggressive metabolic control remain the cornerstone of the treatment; however, the overall benefit of these treatment options remains low and mortality and morbidity remain very high. Sodium thiosulphate is an inorganic salt, which is used for treating acute cyanide poisoning, recurrent calcium urolithiasis and nephrocalcinosis. Recently, it has also been reported to be useful in treating severe cases of calciphylaxis with promising results.

Methods

A resistant case of calciphylaxis in a patient on long‐term haemodialysis was treated with sodium thiosulphate (50 ml solution with 50% sodium thiosulphate) three times a week during the end of each dialysis session.

Results

The skin lesions started to heal after two weeks and completely resolved after five months of treatment.

Conclusions

Sodium thiosulphate can be a safe and effective treatment option for resistant and severe cases of calciphylaxis
Increased serum IgG and IgA in overweight children relate to a less favourable metabolic phenotype
Authors: Bassols J. , Prats‐Puig A. , Gispert‐Saüch M. , Crehuet‐Almirall M. , Carreras‐Badosa G. , Díaz‐Roldán F. , Montesinos‐Costa M. , de Zegher F. , Ibáñez L. , López‐Bermejo A.
Published: April 2013

What is already known about this subject

The adaptive immune system has been shown to be a novel modulator of insulin resistance.

Increased activation of B lymphocytes has been described in obese mice and in obese and type 2 diabetic patients.

B lymphocytes promote insulin resistance by accumulating in adipose tissue and producing pathogenic antibodies.

What this study adds

Increased serum concentrations of IgG and IgA were found in overweight pre‐pubertal children.

Increasing concentrations of IgG and IgA were in obese, but not in lean pre‐pubertal children, associated with a less favourable metabolic phenotype, consisting of increased insulin resistance and a more adverse lipid profile.

Background

The adaptive immune system has emerged as an unexpected modulator of insulin resistance. B lymphocytes accumulate in adipose tissue and produce pathogenic antibodies that cause insulin resistance.

Objective

We studied whether circulating immunoglobulins (IgG, IgA and IgM) were related to metabolic risk markers in pre‐pubertal children with and without overweight.

Design and methods

Subjects were 270 asymptomatic pre‐pubertal Caucasian children (145 lean, 125 overweight) recruited in a primary care setting. Assessments included serum IgG, IgA and IgM concentrations (nephelometry), insulin resistance (HOMA‐IR) and fasting lipids (triacylglycerol and high‐density lipoprotein [HDL]‐cholesterol).

Results

Overweight children had higher IgG and IgA serum levels than lean children (P ≤ 0.01). Increasing serum IgG and IgA, but not IgM, were associated with a less favourable metabolic phenotype, consisting of higher HOMA‐IR and triacylglycerol and lower HDL‐cholesterol, particularly in obese children, in whom serum IgG and IgA were both independently associated with HOMA‐IR (β = 0.308, P = 0.017, r2 = 9.5% and β = 0.361, P = 0.005, r2 = 13.0%, respectively) and triacylglycerol (β = 0.343, P = 0.006, r2 = 11.1% and β = 0.354, P = 0.003, r2 = 12.2%, respectively).

Conclusions

Increased circulating IgG and IgA in overweight children are associated with a less favourable metabolic phenotype, particularly in obese children. These results suggest a relationship between adaptive immunity and insulin resistance in childhood obesity.