A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic, inflammatory and oxidative markers in patients with predicted severe acute pancreatitis (APACHE II >= 66)

Background: Total enteral nutrition (TEN) within 48 h of admission has recently been shown to be safe and efficacious as part of the management of severe acute pancreatitis. Our aim was to ascertain the safety of immediate TEN in these patients and the effect of TEN on systemic inflammation, psychological state, oxidative stress, plasma glutamine levels and endotoxaemia. Methods: Patients admitted with predicted severe acute pancreatitis (APACHE II score 15) were randomised to total enteral (TEN; n = 8) or total parenteral nutrition (TPN; n = 9). Measurements of systemic inflammation (C-reactive protein), fatigue ( visual analogue scale), oxidative stress ( plasma thiobarbituric acid- reactive substances), plasma glutamine and anti-endotoxin IgG and IgM antibody concentrations were made on admission and repeated on days 3 and 7 thereafter. Clinical progress was monitored using APACHE II score. Organ failure and complications were recorded. Results: All patients tolerated the feeding regime well with few nutrition-related complications. Fatigue improved in both groups but more rapidly in the TEN group. Oxidative stress was high on admission and rose by similar amounts in both groups. Plasma glutamine concentrations did not change significantly in either group. In the TPN group, 3 patients developed respiratory failure and 3 developed non-respiratory single organ failure. There were no such complications in the TEN group. Hospital stay was shorter in the TEN group [ 7 (4-14) vs. 10 (7-26) days; p = 0.05] as was time to passing flatus and time to opening bowels [1 (0-2) vs. 2 (1-5) days; p = 0.01]. The cost of TEN was considerably less than of TPN. Conclusion: Immediate institution of nutritional support in the form of TEN is safe in predicted severe acute pancreatitis. It is as safe and as efficacious as TPN and may be beneficial in the clinical course of this disease. Copyright (C) 2003 S. Karger AG, Basel and IAP.

Increased n-6 polyunsaturated fatty acids do not attenuate the effects of long-chain n-3 polyunsaturated fatty acids on insulin sensitivity or triacylglycerol reduction in Indian Asians

Background: Indian Asians in Western countries have a higher rate of coronary artery disease than do the indigenous white populations, and this higher rate may be influenced by a dietary imbalance of n-6 and n-3 polyunsaturated fatty acids (PUFAs). Objective: The objective of the study was to test the hypothesis that a high background dietary intake of n-6 PUFA attenuates the effects of fish-oil supplementation on insulin sensitivity and associated blood lipids of the metabolic syndrome. Design: Twenty-nine Indian Asian men were recruited to participate in a 12-wk dietary intervention trial. Volunteers were randomly assigned to receive either a moderate or a high n-6 PUFA diet featuring modified oils and spreads over a 6-wk period. After this 6-wk period, both groups were supplemented with 4.0 g fish oil/d (2.5 g eicosapentaenoic acid + docosahexaenoic acid) for an additional 6 wk in combination with the dietary treatment. Volunteers participated in a postprandial study and an insulin sensitivity test after the 6-wk dietary intervention and again after the fish-oil supplementation period. Results: There was no significant time X treatment interaction for blood lipids or insulin action after dietary intervention with the moderate or high n-6 PUFA diets in combination with fish oil. After the 6-wk period of fish oil supplementation, fasting and postprandial plasma triacylglycerol concentrations decreased significantly. Conclusion: The background dietary n-6 PUFA concentration did not modulate the effect of fish-oil supplementation on blood lipids or measures of insulin sensitivity in this ethnic group.

The effects of landscape modifications on the long-term persistence of animal populations

Background: The effects of landscape modifications on the long-term persistence of wild animal populations is of crucial importance to wildlife managers and conservation biologists, but obtaining experimental evidence using real landscapes is usually impossible. To circumvent this problem we used individual-based models (IBMs) of interacting animals in experimental modifications of a real Danish landscape. The models incorporate as much as possible of the behaviour and ecology of four species with contrasting life-history characteristics: skylark (Alauda arvensis), vole (Microtus agrestis), a ground beetle (Bembidion lampros) and a linyphiid spider (Erigone atra). This allows us to quantify the population implications of experimental modifications of landscape configuration and composition. Methodology/Principal Findings: Starting with a real agricultural landscape, we progressively reduced landscape complexity by (i) homogenizing habitat patch shapes, (ii) randomizing the locations of the patches, and (iii) randomizing the size of the patches. The first two steps increased landscape fragmentation. We assessed the effects of these manipulations on the long-term persistence of animal populations by measuring equilibrium population sizes and time to recovery after disturbance. Patch rearrangement and the presence of corridors had a large effect on the population dynamics of species whose local success depends on the surrounding terrain. Landscape modifications that reduced population sizes increased recovery times in the short-dispersing species, making small populations vulnerable to increasing disturbance. The species that were most strongly affected by large disturbances fluctuated little in population sizes in years when no perturbations took place. Significance: Traditional approaches to the management and conservation of populations use either classical methods of population analysis, which fail to adequately account for the spatial configurations of landscapes, or landscape ecology, which accounts for landscape structure but has difficulty predicting the dynamics of populations living in them. Here we show how realistic and replicable individual-based models can bridge the gap between non-spatial population theory and non-dynamic landscape ecology. A major strength of the approach is its ability to identify population vulnerabilities not detected by standard population viability analyses.

Understanding the long term success of UK construction firms: the extent and role of 'hidden' corporate social responsibility

The construction sector is often described as lagging behind other major industries. At first this appears fair when considering the concept of corporate social responsibility (CSR). It is argued that CSR is ill-defined, with firms struggling to make sense of and engage with it. Literature suggests that the short-termism view of construction firms renders the long-term, triple-bottom-line principle of CSR untenable. This seems to be borne out by literature indicating that construction firms typically adopt a compliance-based approach to CSR instead of discretionary CSR which is regarded as adding most value to firms and benefiting the broadest group of stakeholders. However, this research conducted in the UK using a regional construction firm offers a counter argument whereby discretionary CSR approaches are well embedded and enacted within the firms’ business operations even though they are not formally articulated as CSR strategies and thus remain 'hidden'. This raises questions in the current CSR debate. First, is ‘hidden’ CSR relevant to the long term success of construction firms? and to what extent do these firms need to reinvent themselves to formally take advantage of the CSR agenda?

Cronaca, narrativa, and the unstable foundations of the Institution of Neorealism

The author contends that many of the conventions of Italian film studies derive from the conflicts and the critical vocabulary that shaped the Italian reception of neorealism in the first decade after the Second World War. Those conflicts, and that critical vocabulary, which lie at the foundation of what has been called the ‘institution of neorealism,’ established an irreconcilable binary: Cronaca and Narrativa. For the neorealists and their critics, Cronaca stood for the effort to record data faithfully, while Narrativa represented the effort to employ the shaping force of human invention in the representation of information. This essay’s first section analyzes the earliest reviews of Rossellini’s Roma città aperta alongside the contemporaneous literary debates over Cronaca and Narrativa. The second section reconsiders the reception of Pratolini’s Metello and Visconti’s Senso, which similarly centered upon the conflict between Cronaca and Narrativa. The third section proposes that the concepts which have often been employed to unify neorealism are destabilized by the Cronaca/Narrativa binary. In search of a solution to neorealism’s conceptual instability, this essay proposes more critical and purposeful appropriations of the movement’s problematic genealogy.

The sample autocorrelation function and the detection of long-memory processes

The detection of long-range dependence in time series analysis is an important task to which this paper contributes by showing that whilst the theoretical definition of a long-memory (or long-range dependent) process is based on the autocorrelation function, it is not possible for long memory to be identified using the sum of the sample autocorrelations, as usually defined. The reason for this is that the sample sum is a predetermined constant for any stationary time series; a result that is independent of the sample size. Diagnostic or estimation procedures, such as those in the frequency domain, that embed this sum are equally open to this criticism. We develop this result in the context of long memory, extending it to the implications for the spectral density function and the variance of partial sums of a stationary stochastic process. The results are further extended to higher order sample autocorrelations and the bispectral density. The corresponding result is that the sum of the third order sample (auto) bicorrelations at lags h,k≥1, is also a predetermined constant, different from that in the second order case, for any stationary time series of arbitrary length.

Risking the ire of investors in pursuit of long-term value: an interview with Cynthia Carroll, the CEO of Anglo American plc

Purpose – The purpose of this paper is to demonstrate how key strategic decisions are made in practice at successful FTSE 100 companies. Design/methodology/approach – The paper is based on a semi-structured interview with Ms Cynthia Carroll, Chief Executive of Anglo American plc. Findings – The interview outlines a number of important factors on: the evolution of strategy within Anglo American, strategy execution, leadership at board and executive levels, and capturing synergies within the company. Originality/value – The paper bridges the gap between theory and practice. It provides a practical view and demonstrates how corporate leaders think about key strategic issues

What it means to stay: reterritorialising the Black Atlantic in Erna Brodber's writing of the local

The emphasis on migratory subjectivities within postcolonial studies has come from many directions—Bhabha, Gilroy, Appadurai, Boyce Davies—and their convergence has created a critical practice in which diaspora studies takes centre stage. More specifically the way in which the Caribbean person is given emblematic status as the metropolitan migrant is made clear in James Clifford's declaration that ‘We are all Caribbeans now…in our urban archipelagos'. This paper examines the serious impact on the critical reception of Caribbean writings that has been made as a result of the fact that metropolitan diasporas are now the privileged places in which to be properly ‘postcolonial’. It is my aim to show how Erna Brodber's culturally specific studies have enormous value in the face of the more general and flattened enunciations of diaspora and creolisation which are being circulated at a theoretical level. I shall look at two fairly recent pieces of writing by Brodber: a pamphlet entitled ‘The people of my Jamaican village (1817 – 1948)’ and an essay entitled ‘Where are all the others?’ in the book Caribbean Creolisation1

Multiple origins of vagrant Subantarctic fur seals: A long journey to the Brazilian coast detected by molecular markers

In this study, we present the first data about putative source populations of the vagrant Subantarctic fur seal, Arctocephalus tropicalis, found on the Brazilian coast, through the comparison of their mitochondrial DNA control sequences to exclusive haplotypes from the main breeding colonies of the species. The results indicated that, despite the majority of the vagrant individuals are from Gough Island (the closest breeding site to the Brazilian coast), they also come from other reproductive colonies, such as Crozet Island, a distance around 16,500 km from the Brazilian coast. Furthermore, the molecular data identified three possible management units: (1) Gough, (2) Amsterdam, and (3) Marion, Macquarie and Crozet. This significant genetic subdivision must be taken into account in any future management plan for the species conservation, including rehabilitation and even reintroduction of vagrant fur seals.

Effects of long-term diabetes on the structure and cell proliferation of the myometrium in the early pregnancy of mice

P>It is known that the development of diabetic complications in human pregnancy is directly related to the severity and the duration of this pathology. In this study, we developed a model of long-term type 1 diabetes to investigate its effects on the cytoarchitecture, extracellular matrix and cell proliferation during the first adaptation phase of the myometrium for pregnancy. A single dose of alloxan was used to induce diabetes in mice prior to pregnancy. To identify the temporal effects of diabetes the mice were divided into two groups: Group D1 (females that became pregnant 90-100 days after alloxan); Group D2 (females that became pregnant 100-110 days after alloxan). Uterine samples were collected after 168 h of pregnancy and processed for light and electron microscopy. In both groups the histomorphometric evaluation showed that diabetes promoted narrowing of the myometrial muscle layers which was correlated with decreased cell proliferation demonstrated by PCNA immunodetection. In D1, diabetes increased the distance between muscle layers and promoted oedema. Contrarily, in D2 the distance between muscle layers decreased and, instead of oedema, there was a markedly deposition of collagen in the myometrium. Ultrastructural analysis showed that diabetes affects the organization of the smooth muscle cells and their myofilaments. Consistently, the immunoreaction for smooth muscle alpha-actin revealed clear disorganization of the contractile apparatus in both diabetic groups. In conclusion, the present model demonstrated that long-term diabetes promotes significant alterations in the myometrium in a time-sensitive manner. Together, these alterations indicate that diabetes impairs the first phenotypic adaptation phase of the pregnant myometrium.

On the unification of long-term survival models

In this paper we extend the long-term survival model proposed by Chen et al. [Chen, M.-H., Ibrahim, J.G., Sinha, D., 1999. A new Bayesian model for survival data with a surviving fraction. journal of the American Statistical Association 94, 909-919] via the generating function of a real sequence introduced by Feller [Feller, W., 1968. An Introduction to Probability Theory and its Applications, third ed., vol. 1, Wiley, New York]. A direct consequence of this new formulation is the unification of the long-term survival models proposed by Berkson and Gage [Berkson, J., Gage, R.P., 1952. Survival cure for cancer patients following treatment. journal of the American Statistical Association 47, 501-515] and Chen et al. (see citation above). Also, we show that the long-term survival function formulated in this paper satisfies the proportional hazards property if, and only if, the number of competing causes related to the occurrence of an event of interest follows a Poisson distribution. Furthermore, a more flexible model than the one proposed by Yin and Ibrahim [Yin, G., Ibrahim, J.G., 2005. Cure rate models: A unified approach. The Canadian journal of Statistics 33, 559-570] is introduced and, motivated by Feller`s results, a very useful competing index is defined. (c) 2008 Elsevier B.V. All rights reserved.

The Long Game: Hamas, The IRA, and the Politics of Radicalization in Palestine and Northern Ireland

The value of a comparative study of the two conflicts stems from a remarkable similarity in the structural organization of political violence by its most influential practitioners: the IRA and Hamas. At the core, I have merely tried my best to approach a beguiling question in a fresh, dynamic way. The stultifying discourse of conflict that serves as lingua franca for the Israeli‐Palestinian issue has largely reduced strategic debate to how best the conflict can be managed – not ended. Prime Minister Benjamin Netanyahu’s focus on “economic peace” and unwillingness to commit to a two‐state solution – the consensus that has governed peacemaking for decades – belies such thinking. The Clinton Administration’s cadre of Mideast negotiators operated amidst the most rapid institutionalization of Palestinian democracy in history ‐ yet remained obsessed with Israeli‐Arab “confidence‐building” measures, doing little to legitimize the gains of Oslo. So long as Palestinians continue to view the creation of Israel as “al‐Nakba” – the catastrophe – whilst successive Israeli governments refuse to grant their aspirations any legitimacy, there can be no progress. Peace requires empathy, a substantial compromise in the context of internecine conflict. The “long war” both conflicts have become mandates an equally expansive, broad‐based and labor‐intensive approach – a demanding process that can only be called The Long Game.

The reinstatement of amphetamine-induced place preference is long-lasting and related to decreased expression of AMPA receptors in the nucleus accumbens

A great deal of effort has been devoted to elucidating the psychopharmacology underlying addiction and relapse. Long-term neuroadaptations in glutamate transmission seem to be of great relevance for relapse to stimulant abuse. In this study, we investigated amphetamine-induced conditioned place preference during adolescence and the reinstatement of the conditioned behavior following a priming injection of the drug 1 day (adolescence), 30 days (early adulthood) and 60 days (adulthood) after the extinction test. The nucleus accumbens was dissected immediately after the reinstatement test to examine alterations in GluR1 and NR1 subunits of glutamatergic receptors. Our results showed that a priming injection of amphetamine was able to reinstate the CPP 1 and 30 days after extinction. However, it failed to reinstate the conditioned response after 60 days. GluR1 levels were decreased on days 1 and 30 but not on day 60 while NR1 levels were unaltered in the reinstatement test. Using a relapse model we found that reinstatement of amphetamine-induced conditioning place preference during adolescence is long lasting and persists through early adulthood. Decreased levels of GluR1 in the nucleus accumbens might be related to the reinstatement of amphetamine-induced conditioning place preference. (C) 2008 IBRO. Published by Elsevier Ltd. All rights reserved.