Infestation and natural parasitism of aphids in single and mixed pastures of black oats and ryegrass

Some species of aphids are major pests on cereal crops and grass pastures. Usually these pests are not adequately controlled in pasture lands that become sources of aphid infestations to cereal crops. The dynamics of aphids and the incidence of natural enemies are less known in pasture systems than in cereal fields. The objective of this work was to assess the aphid infestation and natural aphid parasitism in different pasture composition. Three hypotheses were tested: 1- the aphid species composition in pastures may vary according to the cereal species in the field; 2- the mixture of two plant species can modify the amount and diversity of aphids; 3- the plant species composition of pasture fields influences the parasitism of aphids. Empirical data were obtained from three Poaceae fields: black oats (Avena strigosa L.), ryegrass (Lolium multiflorum L.), and a mixed field of black oats and ryegrass. The most abundant aphid species was Rhopalosiphum padi followed by Sitobion avenae. Plant species composition increases the amount and the parasitism rates of aphids. The mixture of heavily infested black oats with a poorly infested ryegrass resulted in reduction of aphid infestation in comparison with heavily-infested single plant species field. This is possible because the conditions are favorable for the development of parasitoid populations. Aphidius colemani was the main parasitoid found in these areas.

Single mothers and incentives to work: The French experience

This paper analyzes the effect of the 1998 reform of the French single parents allowanceon the labor supply of single mothers with very young children. The reform aimed atencouraging participation by allowing eligible single parents to accumulate benefits andlabor earnings for a limited period of time. Using data from the French EmploymentSurvey, the analysis shows that single mothers affected by the reform had experienced asignificant increase in their employment rate four years after the reform wasimplemented. During the same period, the employment rate of married mothers withyoung children did not experience a significant change, suggesting that at least part ofthe increase was a consequence of the reform. These results provide some evidence thatbenefit schedules that provide financial incentives to work can have significant effectsin getting single moms back to work, even in the presence of very young children.

State of Iowa’s Single Audit Report for the year ended June 30, 2008

State of Iowa’s Single Audit Report for the year ended June 30, 2008

Oral Antibiotics for Fever in Low-Risk Neutropenic Patients With Cancer: A Double-Blind, Randomized, Multicenter Trial Comparing Single Daily Moxifloxacin With Twice Daily Ciprofloxacin Plus Amoxicillin/Clavulanic Acid Combination Therapy--EORTC Infectious Diseases Group Trial XV.

PURPOSE This double-blind, multicenter trial compared the efficacy and safety of a single daily oral dose of moxifloxacin with oral combination therapy in low-risk febrile neutropenic patients with cancer. PATIENTS AND METHODS Inclusion criteria were cancer, febrile neutropenia, low risk of complications as predicted by a Multinational Association for Supportive Care in Cancer (MASCC) score > 20, ability to swallow, and ≤ one single intravenous dose of empiric antibiotic therapy before study drug treatment initiation. Early discharge was encouraged when a set of predefined criteria was met. Patients received either moxifloxacin (400 mg once daily) monotherapy or oral ciprofloxacin (750 mg twice daily) plus amoxicillin/clavulanic acid (1,000 mg twice daily). The trial was designed to show equivalence of the two drug regimens in terms of therapy success, defined as defervescence and improvement in clinical status during study drug treatment (< 10% difference). Results Among the 333 patients evaluated in an intention-to-treat analysis, therapy success was observed in 80% of the patients administered moxifloxacin and in 82% of the patients administered combination therapy (95% CI for the difference, -10% to 8%, consistent with equivalence). Minor differences in tolerability, safety, and reasons for failure were observed. More than 50% of the patients in the two arms were discharged on protocol therapy, with 5% readmissions among those in either arm. Survival was similar (99%) in both arms. CONCLUSION Monotherapy with once daily oral moxifloxacin is efficacious and safe in low-risk febrile neutropenic patients identified with the help of the MASCC scoring system, discharged early, and observed as outpatients.

A single-base substitution within an intronic repetitive element causes dominant retinitis pigmentosa with reduced penetrance.

We report the study of a large American family displaying autosomal dominant retinitis pigmentosa with reduced penetrance, a form of hereditary retinal degeneration. Although the inheritance pattern and previous linkage mapping pointed to the involvement of the PRPF31 gene, extensive screening of all its exons and their boundaries failed in the past to reveal any mutation. In this work, we sequenced the entire PRPF31 genomic region by both the classical Sanger method and ultrahigh throughput (UHT) sequencing. Among the many variants identified, a single-base substitution (c.1374+654C>G) located deep within intron 13 and inside a repetitive DNA element was common to all patients and obligate asymptomatic carriers. This change created a new splice donor site leading to the synthesis of two mutant PRPF31 isoforms, degraded by nonsense-mediated mRNA decay. As a consequence, amounts of PRPF31 mRNA derived from the mutant allele were very reduced, with no evidence of mutant proteins being synthesized. Our results indicate that c.1374+654C>G causes retinitis pigmentosa via haploinsufficiency, similar to the vast majority of PRPF31 mutations described so far. We discuss the potential of UHT sequencing technologies in mutation screening and the continued identification of pathogenic splicing mutations buried deep within intronic regions.

Waveform inversion of crosshole georadar data: influence of source wavelet variability and the suitability of a single wavelet assumption

Waveform-based tomographic imaging of crosshole georadar data is a powerful method to investigate the shallow subsurface because of its ability to provide images of electrical properties in near-surface environments with unprecedented spatial resolution. A critical issue with waveform inversion is the a priori unknown source signal. Indeed, the estimation of the source pulse is notoriously difficult but essential for the effective application of this method. Here, we explore the viability and robustness of a recently proposed deconvolution-based procedure to estimate the source pulse during waveform inversion of crosshole georadar data, where changes in wavelet shape with location as a result of varying near-field conditions and differences in antenna coupling may be significant. Specifically, we examine whether a single, average estimated source current function can adequately represent the pulses radiated at all transmitter locations during a crosshole georadar survey, or whether a separate source wavelet estimation should be performed for each transmitter gather. Tests with synthetic and field data indicate that remarkably good tomographic reconstructions can be obtained using a single estimated source pulse when moderate to strong variability exists in the true source signal with antenna location. Only in the case of very strong variability in the true source pulse are tomographic reconstructions clearly improved by estimating a different source wavelet for each transmitter location.

Fuel metabolism during exercise in euglycaemia and hyperglycaemia in patients with type 1 diabetes mellitus--a prospective single-blinded randomised crossover trial.

Aims/hypothesis We assessed systemic and local muscle fuel metabolism during aerobic exercise in patients with type I diabetes at euglycaemia and hyperglycaemia with identical insulin levels.Methods This was a single-blinded randomised crossover study at a university diabetes unit in Switzerland. We studied seven physically active men with type I diabetes (mean +/- SEM age 33.5 +/- 2.4 years, diabetes duration 20.1 +/- 3.6 years, HbA(1c) 6.7 +/- 0.2% and peak oxygen uptake [VO2peak] 50.3 +/- 4.5 ml min(-1) kg(-1)). Men were studied twice while cycling for 120 min at 55 to 60% of VO2peak, with a blood glucose level randomly set either at 5 or 11 mmol/l and identical insulinaemia. The participants were blinded to the glycaemic level; allocation concealment was by opaque, sealed envelopes. Magnetic resonance spectroscopy was used to quantify intramyocellular glycogen and lipids before and after exercise. Indirect calorimetry and measurement of stable isotopes and counter-regulatory hormones complemented the assessment of local and systemic fuel metabolism.Results The contribution of lipid oxidation to overall energy metabolism was higher in euglycaemia than in hyperglycaemia (49.4 +/- 4.8 vs 30.6 +/- 4.2%; p<0.05). Carbohydrate oxidation accounted for 48.2 +/- 4.7 and 66.6 +/- 4.2% of total energy expenditure in euglycaemia and hyperglycaemia, respectively (p<0.05). The level of intramyocellular glycogen before exercise was higher in hyperglycaemia than in euglycaemia (3.4 +/- 0.3 vs 2.7 +/- 0.2 arbitrary units [AU]; p<0.05). Absolute glycogen consumption tended to be higher in hyperglycaemia than in euglycaemia (1.3 +/- 0.3 vs 0.9 +/- 0.1 AU). Cortisol and growth hormone increased more strongly in euglycaemia than in hyperglycaemia (levels at the end of exercise 634 52 vs 501 +/- 32 nmol/l and 15.5 +/- 4.5 vs 7.4 +/- 2.0 ng/ml, respectively; p<0.05).Conclusions/interpretation Substrate oxidation in type I diabetic patients performing aerobic exercise in euglycaemia is similar to that in healthy individuals revealing a shift towards lipid oxidation during exercise. In hyperglycaemia fuel metabolism in these patients is dominated by carbohydrate oxidation. Intramyocellular glycogen was not spared in hyperglycaemia.

Mutational analysis of class A and class B penicillin-binding proteins in Streptococcus gordonii.

High-molecular-weight (HMW) penicillin-binding proteins (PBPs) are divided into class A and class B PBPs, which are bifunctional transpeptidases/transglycosylases and monofunctional transpeptidases, respectively. We determined the sequences for the HMW PBP genes of Streptococcus gordonii, a gingivo-dental commensal related to Streptococcus pneumoniae. Five HMW PBPs were identified, including three class A (PBPs 1A, 1B, and 2A) and two class B (PBPs 2B and 2X) PBPs, by homology with those of S. pneumoniae and by radiolabeling with [3H]penicillin. Single and double deletions of each of them were achieved by allelic replacement. All could be deleted, except for PBP 2X, which was essential. Morphological alterations occurred after deletion of PBP 1A (lozenge shape), PBP 2A (separation defect and chaining), and PBP 2B (aberrant septation and premature lysis) but not PBP 1B. The muropeptide cross-link patterns remained similar in all strains, indicating that cross-linkage for one missing PBP could be replaced by others. However, PBP 1A mutants presented shorter glycan chains (by 30%) and a relative decrease (25%) in one monomer stem peptide. Growth rate and viability under aeration, hyperosmolarity, and penicillin exposure were affected primarily in PBP 2B-deleted mutants. In contrast, chain-forming PBP 2A-deleted mutants withstood better aeration, probably because they formed clusters that impaired oxygen diffusion. Double deletion could be generated with any PBP combination and resulted in more-altered mutants. Thus, single deletion of four of the five HMW genes had a detectable effect on the bacterial morphology and/or physiology, and only PBP 1B seemed redundant a priori.

Changing landscapes of Switzerland: assessing effects of historic and future land uses and land covers on the occurrence of selected butterfly species

Summary Landscapes are continuously changing. Natural forces of change such as heavy rainfall and fires can exert lasting influences on their physical form. However, changes related to human activities have often shaped landscapes more distinctly. In Western Europe, especially modern agricultural practices and the expanse of overbuilt land have left their marks in the landscapes since the middle of the 20th century. In the recent years men realised that mare and more changes that were formerly attributed to natural forces might indirectly be the result of their own action. Perhaps the most striking landscape change indirectly driven by human activity we can witness in these days is the large withdrawal of Alpine glaciers. Together with the landscapes also habitats of animal and plant species have undergone vast and sometimes rapid changes that have been hold responsible for the ongoing loss of biodiversity. Thereby, still little knowledge is available about probable effects of the rate of landscape change on species persistence and disappearance. Therefore, the development and speed of land use/land cover in the Swiss communes between the 1950s and 1990s were reconstructed using 10 parameters from agriculture and housing censuses, and were further correlated with changes in butterfly species occurrences. Cluster analyses were used to detect spatial patterns of change on broad spatial scales. Thereby, clusters of communes showing similar changes or transformation rates were identified for single decades and put into a temporally dynamic sequence. The obtained picture on the changes showed a prevalent replacement of non-intensive agriculture by intensive practices, a strong spreading of urban communes around city centres, and transitions towards larger farm sizes in the mountainous areas. Increasing transformation rates toward more intensive agricultural managements were especially found until the 1970s, whereas afterwards the trends were commonly negative. However, transformation rates representing the development of residential buildings showed positive courses at any time. The analyses concerning the butterfly species showed that grassland species reacted sensitively to the density of livestock in the communes. This might indicate the augmented use of dry grasslands as cattle pastures that show altered plant species compositions. Furthermore, these species also decreased in communes where farms with an agricultural area >5ha have disappeared. The species of the wetland habitats were favoured in communes with smaller fractions of agricultural areas and lower densities of large farms (>10ha) but did not show any correlation to transformation rates. It was concluded from these analyses that transformation rates might influence species disappearance to a certain extent but that states of the environmental predictors might generally outweigh the importance of the corresponding rates. Information on the current distribution of species is evident for nature conservation. Planning authorities that define priority areas for species protection or examine and authorise construction projects need to know about the spatial distribution of species. Hence, models that simulate the potential spatial distribution of species have become important decision tools. The underlying statistical analyses such as the widely used generalised linear models (GLM) often rely on binary species presence-absence data. However, often only species presence data have been colleted, especially for vagrant, rare or cryptic species such as butterflies or reptiles. Modellers have thus introduced randomly selected absence data to design distribution models. Yet, selecting false absence data might bias the model results. Therefore, we investigated several strategies to select more reliable absence data to model the distribution of butterfly species based on historical distribution data. The results showed that better models were obtained when historical data from longer time periods were considered. Furthermore, model performance was additionally increased when long-term data of species that show similar habitat requirements as the modelled species were used. This successful methodological approach was further applied to assess consequences of future landscape changes on the occurrence of butterfly species inhabiting dry grasslands or wetlands. These habitat types have been subjected to strong deterioration in the recent decades, what makes their protection a future mission. Four spatially explicit scenarios that described (i) ongoing land use changes as observed between 1985 and 1997, (ii) liberalised agricultural markets, and (iii) slightly and (iv) strongly lowered agricultural production provided probable directions of landscape change. Current species-environment relationships were derived from a statistical model and used to predict future occurrence probabilities in six major biogeographical regions in Switzerland, comprising the Jura Mountains, the Plateau, the Northern and Southern Alps, as well as the Western and Eastern Central Alps. The main results were that dry grasslands species profited from lowered agricultural production, whereas overgrowth of open areas in the liberalisation scenario might impair species occurrence. The wetland species mostly responded with decreases in their occurrence probabilities in the scenarios, due to a loss of their preferred habitat. Further analyses about factors currently influencing species occurrences confirmed anthropogenic causes such as urbanisation, abandonment of open land, and agricultural intensification. Hence, landscape planning should pay more attention to these forces in areas currently inhabited by these butterfly species to enable sustainable species persistence. In this thesis historical data were intensively used to reconstruct past developments and to make them useful for current investigations. Yet, the availability of historical data and the analyses on broader spatial scales has often limited the explanatory power of the conducted analyses. Meaningful descriptors of former habitat characteristics and abundant species distribution data are generally sparse, especially for fine scale analyses. However, this situation can be ameliorated by broadening the extent of the study site and the used grain size, as was done in this thesis by considering the whole of Switzerland with its communes. Nevertheless, current monitoring projects and data recording techniques are promising data sources that might allow more detailed analyses about effects of long-term species reactions on landscape changes in the near future. This work, however, also showed the value of historical species distribution data as for example their potential to locate still unknown species occurrences. The results might therefore contribute to further research activities that investigate current and future species distributions considering the immense richness of historical distribution data. Résumé Les paysages changent continuellement. Des farces naturelles comme des pluies violentes ou des feux peuvent avoir une influence durable sur la forme du paysage. Cependant, les changements attribués aux activités humaines ont souvent modelé les paysages plus profondément. Depuis les années 1950 surtout, les pratiques agricoles modernes ou l'expansion des surfaces d'habitat et d'infrastructure ont caractérisé le développement du paysage en Europe de l'Ouest. Ces dernières années, l'homme a commencé à réaliser que beaucoup de changements «naturels » pourraient indirectement résulter de ses propres activités. Le changement de paysage le plus apparent dont nous sommes témoins de nos jours est probablement l'immense retraite des glaciers alpins. Avec les paysages, les habitats des animaux et des plantes ont aussi été exposés à des changements vastes et quelquefois rapides, tenus pour coresponsable de la continuelle diminution de la biodiversité. Cependant, nous savons peu des effets probables de la rapidité des changements du paysage sur la persistance et la disparition des espèces. Le développement et la rapidité du changement de l'utilisation et de la couverture du sol dans les communes suisses entre les années 50 et 90 ont donc été reconstruits au moyen de 10 variables issues des recensements agricoles et résidentiels et ont été corrélés avec des changements de présence des papillons diurnes. Des analyses de groupes (Cluster analyses) ont été utilisées pour détecter des arrangements spatiaux de changements à l'échelle de la Suisse. Des communes avec des changements ou rapidités comparables ont été délimitées pour des décennies séparées et ont été placées en séquence temporelle, en rendrent une certaine dynamique du changement. Les résultats ont montré un remplacement répandu d'une agriculture extensive des pratiques intensives, une forte expansion des faubourgs urbains autour des grandes cités et des transitions vers de plus grandes surfaces d'exploitation dans les Alpes. Dans le cas des exploitations agricoles, des taux de changement croissants ont été observés jusqu'aux années 70, alors que la tendance a généralement été inversée dans les années suivantes. Par contre, la vitesse de construction des nouvelles maisons a montré des courbes positives pendant les 50 années. Les analyses sur la réaction des papillons diurnes ont montré que les espèces des prairies sèches supportaient une grande densité de bétail. Il est possible que dans ces communes beaucoup des prairies sèches aient été fertilisées et utilisées comme pâturages, qui ont une autre composition floristique. De plus, les espèces ont diminué dans les communes caractérisées par une rapide perte des fermes avec une surface cultivable supérieure à 5 ha. Les espèces des marais ont été favorisées dans des communes avec peu de surface cultivable et peu de grandes fermes, mais n'ont pas réagi aux taux de changement. Il en a donc été conclu que la rapidité des changements pourrait expliquer les disparitions d'espèces dans certains cas, mais que les variables prédictives qui expriment des états pourraient être des descripteurs plus importants. Des informations sur la distribution récente des espèces sont importantes par rapport aux mesures pour la conservation de la nature. Pour des autorités occupées à définir des zones de protection prioritaires ou à autoriser des projets de construction, ces informations sont indispensables. Les modèles de distribution spatiale d'espèces sont donc devenus des moyens de décision importants. Les méthodes statistiques courantes comme les modèles linéaires généralisés (GLM) demandent des données de présence et d'absence des espèces. Cependant, souvent seules les données de présence sont disponibles, surtout pour les animaux migrants, rares ou cryptiques comme des papillons ou des reptiles. C'est pourquoi certains modélisateurs ont choisi des absences au hasard, avec le risque d'influencer le résultat en choisissant des fausses absences. Nous avons établi plusieurs stratégies, basées sur des données de distribution historique des papillons diurnes, pour sélectionner des absences plus fiables. Les résultats ont démontré que de meilleurs modèles pouvaient être obtenus lorsque les données proviennent des périodes de temps plus longues. En plus, la performance des modèles a pu être augmentée en considérant des données de distribution à long terme d'espèces qui occupent des habitats similaires à ceux de l'espèce cible. Vu le succès de cette stratégie, elle a été utilisée pour évaluer les effets potentiels des changements de paysage futurs sur la distribution des papillons des prairies sèches et marais, deux habitats qui ont souffert de graves détériorations. Quatre scénarios spatialement explicites, décrivant (i) l'extrapolation des changements de l'utilisation de sol tels qu'observés entre 1985 et 1997, (ii) la libéralisation des marchés agricoles, et une production agricole (iii) légèrement amoindrie et (iv) fortement diminuée, ont été utilisés pour générer des directions de changement probables. Les relations actuelles entre la distribution des espèces et l'environnement ont été déterminées par le biais des modèles statistiques et ont été utilisées pour calculer des probabilités de présence selon les scénarios dans six régions biogéographiques majeures de la Suisse, comportant le Jura, le Plateau, les Alpes du Nord, du Sud, centrales orientales et centrales occidentales. Les résultats principaux ont montré que les espèces des prairies sèches pourraient profiter d'une diminution de la production agricole, mais qu'elles pourraient aussi disparaître à cause de l'embroussaillement des terres ouvertes dû à la libéralisation des marchés agricoles. La probabilité de présence des espèces de marais a décrû à cause d'une perte générale des habitats favorables. De plus, les analyses ont confirmé que des causes humaines comme l'urbanisation, l'abandon des terres ouvertes et l'intensification de l'agriculture affectent actuellement ces espèces. Ainsi ces forces devraient être mieux prises en compte lors de planifications paysagères, pour que ces papillons diurnes puissent survivre dans leurs habitats actuels. Dans ce travail de thèse, des données historiques ont été intensivement utilisées pour reconstruire des développements anciens et pour les rendre utiles à des recherches contemporaines. Cependant, la disponibilité des données historiques et les analyses à grande échelle ont souvent limité le pouvoir explicatif des analyses. Des descripteurs pertinents pour caractériser les habitats anciens et des données suffisantes sur la distribution des espèces sont généralement rares, spécialement pour des analyses à des échelles fores. Cette situation peut être améliorée en augmentant l'étendue du site d'étude et la résolution, comme il a été fait dans cette thèse en considérant toute la Suisse avec ses communes. Cependant, les récents projets de surveillance et les techniques de collecte de données sont des sources prometteuses, qui pourraient permettre des analyses plus détaillés sur les réactions à long terme des espèces aux changements de paysage dans le futur. Ce travail a aussi montré la valeur des anciennes données de distribution, par exemple leur potentiel pour aider à localiser des' présences d'espèces encore inconnues. Les résultats peuvent contribuer à des activités de recherche à venir, qui étudieraient les distributions récentes ou futures d'espèces en considérant l'immense richesse des données de distribution historiques.

Nanopore detection of single molecule RNAP-DNA transcription complex.

In the past decade, a number of single-molecule methods have been developed with the aim of investigating single protein and nucleic acid interactions. For the first time we use solid-state nanopore sensing to detect a single E. coli RNAP-DNA transcription complex and single E. coli RNAP enzyme. On the basis of their specific conductance translocation signature, we can discriminate and identify between those two types of molecular translocations and translocations of bare DNA. This opens up a new perspectives for investigating transcription processes at the single-molecule level.

Adenocarcinoma of the pancreas: Comparative single centre analysis between ductal and mucinous type.

1. Background¦Adenocarcinomas of the pancreas are exocrine tumors, originate from ductal system, including two morphologically distinct entities: the ductal adenocarcinoma and mucinous adenocarcinoma. Ductal adenocarcinoma is by far the most frequent malignant tumor in the pancreas, representing at least about 90% of all pancreas cancers. It is associated with very poor prognosis, due to the fact that actually there are no any biological markers or diagnostic tools for identification of the disease at an early stage. Most of the time the disease is extensive with vascular and nerves involvement or with metastatic spread at the time of diagnosis (1). The median survival is less than 5% at 5 years, placing it, at the fifth leading cause of death by cancer in the world (2). The mucinous form of pancreatic adenocarcinoma is less frequent, and seems to have a better prognosis with about 57% survival at 5 years (1)(3)(4).¦Each morphologic type of pancreatic adenocarcinoma is associated with particular preneoplastic lesions. Two types of preneoplastic lesions are described: firstly, pancreatic intra-epithelial neoplasia (PanIN) which affects the small and peripheral pancreatic ducts, and the intraductal papillary-mucinous neoplasm (IPMN) interested the main pancreatic ducts and its principal branches. Both of preneoplastic lesions lead by different mechanisms to the pancreatic adenocarcinoma (1)(2)(3)(4)(5)(6)(7)(8)(9)(10).¦The purpose of our study consists in a retrospective analysis of various clinical and histo-morphological parameters in order to assess a difference in survival between these two morphological types of pancreatic adenocarcinomas.¦1.2 Material and methods¦We conducted a retrospective analysis including 35 patients, (20 men and 15 women), beneficed the surgical treatment for pancreas adenocarcinoma at the Surgical Department of University Hospital in Lausanne. The patients involved in our study have been treated between 2003 and 2008, permitting at least 5-years mean follow up. For each patient the following parameters were analysed: age, gender, type of operation, type of preneoplastic lesions, TNM stage, histological grade of the tumor, vascular invasion, lymphatic and perineural invasion, resection margins, and adjuvant treatment.¦The results from these observations were included in a univariate and multivariate statistical analysis and compared with overall survival, as well as specific survival for each morphologic subtype of adenocarcinoma.¦As a low number of mucinous adenocarcinomas (n=5) was insufficient to conduct a pertinent statistical analysis, we compared the data obtained from adenocarcinomas developed on PanIN with adenocarcinomas developed on IPMN including both, ductal or mucinous types.¦1.3 Result¦Our results show that adenocarcinomas developed on pre-existing IPMN including both morphologic types (ductal and mucinous form) are associated with a better survival and prognosis than adenocarciomas developed on PanIN.¦1.4 Conclusion¦This study reflects that the most relevant parameter in survival in pancreatic adenocarcinoma seems to be the type of preneoplastic lesion. The significant difference in survival was noted between adenocarcinomas developing on PanIN as compared to adenocarcinomas developed on IPMN precursor lesions. Ductal adenocarcinomas developped on IPMN present significantly longer survival than those developed on PanIN lesions (P value= 0,01). Therefore we can suggest that the histological type of preneoplastic lesion rather than the histological type of adenocarcinoma should be the determinant prognosis factor in survival of pancreatic adenocarcinoma.

Critical appraisal of single port access cholecystectomy.

BACKGROUND: Single port access (SPA) cholecystectomy is a new concept in laparoscopic surgery. A review of existing results was performed to evaluate critically the current state of SPA with specific reference to feasibility, safety, learning curve, indications and cost-effectiveness. METHODS: All papers identified in MEDLINE until 15 February 2010 and all other relevant papers obtained from cited references were reviewed, without any language restriction. Case reports and series of fewer than three patients were excluded. RESULTS: After selection, 24 studies including 895 patients were analysed. None was randomized. Feasibility seems to be established, with a conversion rate of 2 per cent. SPA was not standardized and there was much technical variation. The learning curve could not be determined. Median follow-up time was 3 (range 0.25-12) months. The overall published complication rate was 5.4 per cent and the biliary complication rate 0.7 per cent. The rate of umbilical complications ranged from 2 to 10 per cent. CONCLUSION: SPA cholecystectomy seems feasible, but standardization, safety and the real benefits for patients need further assessment. Uncontrolled wide adoption of this approach may be responsible for a rise in biliary complications.

Can smaller-scale comprehensive cancer centers provide outstanding care in abdominal and thoracic pediatric solid tumor surgery? Results of a 14-year retrospective single-center analysis.

PURPOSE: Quality of care and its measurement represent a considerable challenge for pediatric smaller-scale comprehensive cancer centers (pSSCC) providing surgical oncology services. It remains unclear whether center size and/or yearly case-flow numbers influence the quality of care, and therefore impact outcomes for this population of patients. PATIENTS AND METHODS: We performed a 14-year, retrospective, single-center analysis, assessing adherence to treatment protocols and surgical adverse events as quality indicators in abdominal and thoracic pediatric solid tumor surgery. RESULTS: Forty-eight patients, enrolled in a research-associated treatment protocol, underwent 51 cancer-oriented surgical procedures. All the protocols contain precise technical criteria, indications, and instructions for tumor surgery. Overall, compliance with such items was very high, with 997/1,035 items (95 %) meeting protocol requirements. There was no surgical mortality. Twenty-one patients (43 %) had one or more complications, for a total of 34 complications (66 % of procedures). Overall, 85 % of complications were grade 1 or 2 according to Clavien-Dindo classification requiring observation or minor medical treatment. Case-sample and outcome/effectiveness data were comparable to published series. Overall, our data suggest that even with the modest caseload of a pSSCC within a Swiss tertiary academic hospital, compliance with international standards can be very high, and the incidence of adverse events can be kept minimal. CONCLUSION: Open and objective data sharing, and discussion between pSSCCs, will ultimately benefit our patient populations. Our study is an initial step towards the enhancement of critical self-review and quality-of-care measurements in this setting.

De Novo Assembly of the Pneumocystis jirovecii Genome from a Single Bronchoalveolar Lavage Fluid Specimen from a Patient.

ABSTRACT Pneumocystis jirovecii is a fungus that causes severe pneumonia in immunocompromised patients. However, its study is hindered by the lack of an in vitro culture method. We report here the genome of P. jirovecii that was obtained from a single bronchoalveolar lavage fluid specimen from a patient. The major challenge was the in silico sorting of the reads from a mixture representing the different organisms of the lung microbiome. This genome lacks virulence factors and most amino acid biosynthesis enzymes and presents reduced GC content and size. Together with epidemiological observations, these features suggest that P. jirovecii is an obligate parasite specialized in the colonization of human lungs, which causes disease only in immune-deficient individuals. This genome sequence will boost research on this deadly pathogen. IMPORTANCE Pneumocystis pneumonia is a major cause of mortality in patients with impaired immune systems. The availability of the P. jirovecii genome sequence allows new analyses to be performed which open avenues to solve critical issues for this deadly human disease. The most important ones are (i) identification of nutritional supplements for development of culture in vitro, which is still lacking 100 years after discovery of the pathogen; (ii) identification of new targets for development of new drugs, given the paucity of present treatments and emerging resistance; and (iii) identification of targets for development of vaccines.