Chronological Order of Appearance of Extraintestinal Manifestations Relative to the Time of IBD Diagnosis in the Swiss Inflammatory Bowel Disease Cohort.

BACKGROUND Data evaluating the chronological order of appearance of extraintestinal manifestations (EIMs) relative to the time of inflammatory bowel disease (IBD) diagnosis is currently lacking. We aimed to assess the type, frequency, and chronological order of appearance of EIMs in patients with IBD. METHODS Data from the Swiss Inflammatory Bowel Disease Cohort Study were analyzed. RESULTS The data on 1249 patients were analyzed (49.8% female, median age: 40 [interquartile range, 30-51 yr], 735 [58.8%] with Crohn's disease, 483 [38.7%] with ulcerative colitis, and 31 [2.5%] with indeterminate colitis). A total of 366 patients presented with EIMs (29.3%). Of those, 63.4% presented with 1, 26.5% with 2, 4.9% with 3, 2.5% with 4, and 2.7% with 5 EIMs during their lifetime. Patients presented with the following diseases as first EIMs: peripheral arthritis 70.0%, aphthous stomatitis 21.6%, axial arthropathy/ankylosing spondylitis 16.4%, uveitis 13.7%, erythema nodosum 12.6%, primary sclerosing cholangitis 6.6%, pyoderma gangrenosum 4.9%, and psoriasis 2.7%. In 25.8% of cases, patients presented with their first EIM before IBD was diagnosed (median time 5 mo before IBD diagnosis: range, 0-25 mo), and in 74.2% of cases, the first EIM manifested itself after IBD diagnosis (median: 92 mo; range, 29-183 mo). CONCLUSIONS In one quarter of patients with IBD, EIMs appeared before the time of IBD diagnosis. Occurrence of EIMs should prompt physicians to look for potential underlying IBD.

Operationalizing ecosystem services for the mitigation of soil threats: A proposed framework

Despite numerous research efforts over the last decades, integrating the concept of ecosystem servicesinto land management decision-making continues to pose considerable challenges. Researchers havedeveloped many different frameworks to operationalize the concept, but these are often specific to acertain issue and each has their own definitions and understandings of particular terms. Based on acomprehensive review of the current scientific debate, the EU FP7 project RECARE proposes an adaptedframework for soil-related ecosystem services that is suited for practical application in the preventionand remediation of soil degradation across Europe. We have adapted existing frameworks by integratingcomponents from soil science while attempting to introduce a consistent terminology that is understand-able to a variety of stakeholders. RECARE aims to assess how soil threats and prevention and remediationmeasures affect ecosystem services. Changes in the natural capital’s properties influence soil processes,which support the provision of ecosystem services. The benefits produced by these ecosystem servicesare explicitly or implicitly valued by individuals and society. This can influence decision- and policymak-ing at different scales, potentially leading to a societal response, such as improved land management.The proposed ecosystem services framework will be applied by the RECARE project in a transdisciplinaryprocess. It will assist in singling out the most beneficial land management measures and in identifyingtrade-offs and win–win situations resulting from and impacted by European policies. The framework thusreflects the specific contributions soils make to ecosystem services and helps reveal changes in ecosystemservices caused by soil management and policies impacting on soil. At the same time, the framework issimple and robust enough for practical application in assessing soil threats and their management withstakeholders at various levels.

Impacts of Technology Adoption: Comparing Returns to the Farming Sector in Maine under Alternative Technology Regimes

This thesis tests if certain technology choices are associated with a reduction in the proportion of farming activities in the agro-food system in Maine. Goodman, Sorj, and Wilkinson define appropriationism as the replacement of farming sector activities by industrial inputs. Based on the concept of appropriationism, industrial fanning systems using large amounts of synthetic inputs contribute less to fanning than more agrarian systems, like organic fanning. Thus, returns to the farming sector should be greater for organic compared with conventional potato fanning in Maine since organic farming uses fewer industrial inputs. Goodman et. al. define substitutionism as the displacement of farming sector commodities and activities by industrial processes in the marketing sector. Based on the concept of substitutionism, returns to the farming sector should be greater for Lay's Classic®™ potato chips made from natural potatoes compared with Baked Lay's®™ potato crisps manufactured from processed dehydrated potatoes. Returns to the farming sector are defined as returns to the farmer or farm family from farming activities, returns to farm labor, and returns to farmers and farm labor producing inputs used on the farm. Results show absolute returns to the farming sector are less for organic compared to conventional tablestock potato farms in Maine. However as a proportion of farm revenues, large organic farms that market at least 25% of their produce to retail stores or directly to consumers do as well as conventional farms. When comparing returns as a proportion of consumer expenditures, these organic farms do better than conventional farms. Returns to the farming sector are less for organic because of yield penalties, cost of marketing services, and diseconomies of size for organic tablestock potato farms. Expanding acreage and reintegrating livestock with cropping systems may increase returns to the fanning sector. Organic farming demonstrates difficulties in providing marketing services at the farm level. Providing marketing services limits the ability to expand production to capture economies of size. Maine organic potato farmers emphasize non-monetary values such as supporting sustainable agriculture, self-sufficiency, the intrinsic value of work, and close community and family connections. Returns to the farming sector as a proportion of consumer expenditures are about three times greater for Lay's Classic®™ potato chips than for Baked Lay's®™ potato crisps, since the value that farmers receive for potatoes used to produce dehydrated potato flakes in one pound of crisps is about half of the value that farmers receive for potatoes used to make one pound of chips. However, this assumes farmers assign a cost to producing low-grade potatoes for dehydration proportionate to their value. Premium potatoes are used to produce potato chips. Low-grade potatoes are used to produce the dehydrated potato flakes used to make potato crisps. Returns to the farming sector are slightly greater for potato crisps if no costs are allocated to producing low-grade potatoes for dehydration. A shift in consumer preferences from potato chips to crisps may result in a geographical shift of potato production from Maine to the Pacific Northwest assuming no food-grade dehydration facilities are built in Maine.

Procedure for the identification of population characteristics for targeting intervention services on the basis of outcome-goal priorities: Case management services for the chronic mentally ill

Although the processes involved in rational patient targeting may be obvious for certain services, for others, both the appropriate sub-populations to receive services and the procedures to be used for their identification may be unclear. This project was designed to address several research questions which arise in the attempt to deliver appropriate services to specific populations. The related difficulties are particularly evident for those interventions about which findings regarding effectiveness are conflicting. When an intervention clearly is not beneficial (or is dangerous) to a large, diverse population, consensus regarding withholding the intervention from dissemination can easily be reached. When findings are ambiguous, however, conclusions may be impossible.^ When characteristics of patients likely to benefit from an intervention are not obvious, and when the intervention is not significantly invasive or dangerous, the strategy proposed herein may be used to identify specific characteristics of sub-populations which may benefit from the intervention. The identification of these populations may be used both in further informing decisions regarding distribution of the intervention and for purposes of planning implementation of the intervention by identifying specific target populations for service delivery.^ This project explores a method for identifying such sub-populations through the use of related datasets generated from clinical trials conducted to test the effectiveness of an intervention. The method is specified in detail and tested using the example intervention of case management for outpatient treatment of populations with chronic mental illness. These analyses were applied in order to identify any characteristics which distinguish specific sub-populations who are more likely to benefit from case management service, despite conflicting findings regarding its effectiveness for the aggregate population, as reported in the body of related research. However, in addition to a limited set of characteristics associated with benefit, the findings generated, a larger set of characteristics of patients likely to experience greater improvement without intervention. ^

The impact of traditional psychiatric services and case management services on the functioning of people with schizophrenia: A cross-national study in Nova Scotia and Texas

The purpose of this study was to determine the impact of traditional psychiatric services with case management services on the functioning of people with schizophrenia. Traditional services were defined as routine clinic services consisting of medication follow-along, psychotherapy, and support services. Case management consisted of activities involved in linking, planning, and monitoring services for the outpatient client who has schizophrenia. The target population was adult schizophrenics who had been receiving outpatient clinic services for a minimum of six months. Structured interviews were conducted using standardized scales (e.g., Quality of Life, Self-Efficacy, and Brief Symptom Inventory) with 78 outpatient client volunteers from two sites: Nova Scotia (Canada) and Texas (USA). The researcher tested for differences in psychiatric symptomatology, recidivism, and quality of life for persons with schizophrenia receiving traditional psychiatric services in Nova Scotia and traditional plus case management services in Texas. Data were collected from the structured interviews and medical records review forms. Types of services were blocked into low and high levels of Intensity (frequency x minutes) and compared to determine the relative contribution of each. Finally, the role of clients' self-efficacy was tested as an intervening variable. Although the findings did not support the hypotheses in the direction anticipated, there were some interesting and useful results. From the Nova Scotia site, clients who received low levels of services were hospitalized less compared to the Texas site. The more psychotic a patient was the higher their involvement in medication follow-along and the more monitoring they received. The more psychotherapy received, the lower the reported satisfaction with social relationships. Of particular interest is the role that self-efficacy played in improved client outcomes. Although self-efficacy scores were related to improved functioning, the mechanism for this still needs to be clarified through subsequent research. ^

Policy analysis of shifting to the state-run Texas women's health program

During the 82nd Texas legislature, state leaders passed a provision stating that healthcare providers, who perform, promote, or affiliate with providers who perform or promote elective abortion services may not be eligible to participate in the Texas Medicaid Women's Health Program (WHP). The federal government reacted to this new provision by vowing to eliminate its 90% share of program support on the grounds that the provision violated a patient's freedom to choose a provider; a right protected by the Social Security Act. Texas leaders stated that the Women's Health Program would continue without federal support, financed exclusively with state funds.^ The following policy analysis compares the projected impact of the current Medicaid Women's Health Program to the proposed state-run program using the criteria-alternative matrix framework. The criteria used to evaluate the program alternatives include population affected, unintended pregnancy and abortion impact, impact on cervical cancer rate, and state-level government expenditures. Each criterion was defined by selected measures. The population affected was measured by the number of women served in the programs. Government expenditures were measured in terms of payments for program costs, Medicaid delivery costs, and cervical cancer diagnostic costs. Unintended pregnancy impact was measured by the number of projected unplanned pregnancies and abortions under each alternative. The impact on cervical cancer was projected in terms of the number of new cervical cancer cases under each alternative. Differences in the projections with respect to each criterion were compared to assess the impact of shifting to the state-only policy.^ After examining program alternatives, it is highly recommended that Texas retain the Medicaid WHP. If the state does decide to move forward with the state-run WHP, it is recommended that the program run at its previous capacity. Furthermore, for the purpose of addressing the relatively high cervical cancer incidence rate in Texas, incorporating HPV vaccination coverage for women ages 18-26 as part of the Women's Health Program is recommended.^

(Table 1) Elemental composition, pyrite-Fe and degree of pyritisation in Upper Pliensbachian and Lower Toarcian sediments from the costal section of Yorkshire

Profiles of Mo/total organic carbon (TOC) through the Lower Toarcian black shales of the Cleveland Basin, Yorkshire, United Kingdom, and the Posidonia shale of Germany and Switzerland reveal water mass restriction during the interval from late tenuicostatum Zone times to early bifrons Zone times, times which include that of the putative Early Toarcian oceanic anoxic event. The degree of restriction is revealed by crossplots of Mo and TOC concentrations for the Cleveland Basin, which define two linear arrays with regression slopes (ppm/%) of 0.5 and 17. The slope of 0.5 applies to sediment from the upper semicelatum and exaratum Subzones. This value, which is one tenth of that for modern sediments from the Black Sea (Mo/TOC regression slope 4.5), reveals that water mass restriction during this interval was around 10 times more severe than in the modern Black Sea; the renewal frequency of the water mass was between 4 and 40 ka. The Mo/TOC regression slope of 17 applies to the overlying falciferum and commune subzones: the value shows that restriction in this interval was less severe and that the renewal frequency of the water mass was between 10 and 130 years. The more restricted of the two intervals has been termed the Early Toarcian oceanic anoxic event but is shown to be an event caused by basin restriction local to NW Europe. Crossplots of Re, Os, and Mo against TOC show similar trends of increasing element concentration with increase in TOC but with differing slopes. Together with modeling of 187Os/188Os and d98Mo, the element/TOC trends show that drawdown of Re, Os, and Mo was essentially complete during upper semicelatum and exaratum Subzone times (Mo/TOC regression slope of 0.5). Drawdown sensitized the restricted water mass to isotopic change forced by freshwater mixing so that continental inputs of Re, Os, and Mo, via a low-salinity surface layer, created isotopic excursions of up to 1.3 per mil in d98Mo and up to 0.6 per mil for 187Os/188Os. Restriction thereby compromises attempts to date Toarcian black shales, and possibly all black shales, using Re-Os chronology and introduces a confounding influence in the attempts to use d98Mo and initial 187Os/188Os for palaeo-oceanographic interpretation.

Bulk sedimentology from Sites M0002 and M0004 of the ACEX (Exp302) expedition to the Arctic Ocean

Except for a few discontinuous fragments of the Late Cretaceous/Early Cenozoic climate history and depositional environment, the paleoenvironmental evolution of the pre-Neogene central Arctic Ocean was virtually unknown prior to the IODP Expedition 302 (Arctic Ocean Coring Expedition - ACEX) drilling campaign on Lomonosov Ridge in 2004. Here we present detailed organic carbon (OC) records from the entire ca. 200 m thick Paleogene OC-rich section of the ACEX drill sites. These records indicate euxinic "Black Sea-type" conditions favorable for the preservation of labile aquatic (marine algae-type) OC occur throughout the upper part of the early Eocene and the middle Eocene, explained by salinity stratification due to freshwater discharge. The superimposed short-term ("Milankovitch-type") variability in amount and composition of OC is related to changes in primary production and terrigenous input. Prominent early Eocene events of algae-type OC preservation coincide with global d13C events such as the PETM and Elmo events. The Elmo d13C Event has been identified in the Arctic Ocean for the first time.

Chemical composition of bottom sediments along the Transpacific section

Distribution of Fe, Mn, Ti, Cu, Ni, Co, V, Cr, Mo, As in bottom sediments of a section from the Hawaiian Islands to the coast of Mexico. In the surface layer and isochronic layers of sediments from biogenic-terrigenous sediments of the Mexico coast to pelagic red clays of the Northeast Basin contents of all studied elements increase, and more sharply for mobile ones - Mn, Mo, Cu, Ni, Co, As. In near Hawaii sediments rich in coarsely fragmented volcanic-terrigenous and pyroclastic material of basalt composition enriched in Ti, Fe, Cr, V, P contents of these elements in surface sediments and in sediment mass increase and contents of Mn, Mo, Ni, Co, Cu, As (for the same reason) decrease compared to red clays. An area of hemipelagic and transition sediments is identified; these sediments have much higher contents of Mn, Fe, Cu, Ni, Mo, As, (Ba) than red clays and similar sediments of the Northwest Pacific Ocean. This is due to hydrothermal activity in the tectonically active zone at the northern extension of the East Pacific Rise. Similar character of distribution of the elements in the surface layer and in the isochrone layers of bottom sediments along the most part of the section is shown. Similarity between distribution of the elements in sediments of the western and the eastern parts of the Transpacific section is established.

Accumulation, velocities, fluxes and mass balance of glacial tributaries to the Lambert Glacier-Amery Ice Shelf system, Antarctica

By incorporating recently available remote sensing data, we investigated the mass balance for all individual tributary glacial basins of the Lambert Glacier-Amery Ice Shelf system, East Antarctica. On the basis of the ice flow information derived from SAR interferometry and ICESat laser altimetry, we have determined the spatial configuration of eight tributary drainage basins of the Lambert-Amery glacial system. By combining the coherence information from SAR interferometry and the texture information from SAR and MODIS images, we have interpreted and refined the grounding line position. We calculated ice volume flux of each tributary glacial basin based on the ice velocity field derived from Radarsat three-pass interferometry together with ice thickness data interpolated from Australian and Russian airborne radio echo sounding (RES) surveys and inferred from ICESat laser altimetry data. Our analysis reveals that three tributary basins have a significant net positive imbalance, while five other subbasins are slightly positive or close to zero balance. Overall, in contrast to previous studies, we find that the grounded ice in Lambert Glacier-Amery Ice Shelf system has a positive mass imbalance of 22.9 ± 4.4 Gt/a. The net basal melting for the entire Amery Ice Shelf is estimated to be 27.0 ± 7.0 Gt/a. The melting rate decreases rapidly from the grounding zone to the ice shelf front. Significant basal refreezing is detected in the downstream section of the ice shelf. The mass balance estimates for both the grounded ice sheet and the ice shelf mass differ substantially from other recent estimates.

Miocene microflora and palaeoclimatic estimates of the Stetten section (Austria)

Pollen analyses have been proven to possess the possibility to decipher rapid vegetational and climate shifts in Neogene sedimentary records. Herein, a c. 21-kyr-long transgression-regression cycle from the Lower Austrian locality Stetten is analysed in detail to evaluate climatic benchmarks for the early phase of the Middle Miocene Climate Optimum and to estimate the pace of environmental change. Based on the Coexistence Approach, a very clear signal of seasonality can be reconstructed. A warm and wet summer season with c. 204-236 mm precipitation during the wettest month was opposed by a rather dry winter season with precipitation of c. 9-24 mm during the driest month. The mean annual temperature ranged between 15.7 and 20.8 °C, with about 9.6-13.3 °C during the cold season and 24.7-27.9 °C during the warmest month. In contrast, today's climate of this area, with an annual temperature of 9.8 °C and 660 mm rainfall, is characterized by the winter season (mean temperature: -1.4 °C, mean precipitation: 39 mm) and a summer mean temperature of 19.9 °C (mean precipitation: 84 mm). Different modes of environmental shifts shaped the composition of the vegetation. Within few millennia, marshes and salt marshes with abundant Cyperaceae rapidly graded into Taxodiaceae swamps. This quick but gradual process was interrupted by swift marine ingressions which took place on a decadal to centennial scale. The transgression is accompanied by blooms of dinoflagellates and of the green alga Prasinophyta and an increase in Abies and Picea. Afterwards, the retreat of the sea and the progradation of estuarine and wetland settings were a gradual progress again. Despite a clear sedimentological cyclicity, which is related to the 21-kyr precessional forcing, the climate data show little variation. This missing pattern might be due to the buffering of the precessional-related climate signal by the subtropical vegetation. Another explanation could be the method-inherent broad range of climate-parameter estimates that could cover small scale climatic changes.

Partial pressure of carbon dioxide along the Transatlantic section from 7 November till 19 December 2000

Along a transatlantic section from 57°N to 60°S that was carried out from November 7 till December 19, 2000 on board R/V Horizont II concentrations of CO2 were measured in the near-water layer of the air and differences between partial pressures in water and air in various climatic zones were calculated. It was shown that variations of CO2 concentrations in the near-water layer of air and those of values of water-air partial pressure difference were from 324x10**-6 to 426x10**-6 and from 150x10**-6 to 100x10**-6 atm, respectively. Maximum value of CO2 partial pressure in air in the near-water layer (426x10**-6 atm) was noted at 45°-47°N; minimum of 324x10**-6 atm was found in Antarctica at 59°S. During measurenents maximum value of CO2 partial pressure difference in water and air (150 x10**-6) was observed at 45°-48°N; maximum flux in this case was directed from the atmosphere to water. Maximum value of CO2 partial pressure difference in water and air for flux directed from the ocean to air (100 x10**-6) was observed at 59°-60°S. Comparison of calculated values of partial pressure difference in water and air with previous data points to more intense exchange of CO2 between the ocean and atmosphere during the survey period was considered. According to values of CO2 partial pressure difference in air and water as compared to 1975, exchange intensity in the Northern Hemisphere (absorption from the atmosphere) increased. A well-pronounced latitudinal effect of distribution of CO2 partial pressure in air was observed. Along the route variations in CO2 concentrations in zones of water divergence and convergence were registered.

Stable carbon and oxygen isotope compositions of bulk rock samples analyzed from the Zumaia section

Astronomical tuning of sedimentary records to precise orbital solutions has led to unprecedented resolution in the geological time scale. However, the construction of a consistent astronomical time scale for the Paleocene is controversial due to uncertainties in the recognition of the exact number of 405-kyr eccentricity cycles and accurate correlation between key records. Here, we present a new Danian integrated stratigraphic framework using the land-based Zumaia and Sopelana hemipelagic sections from the Basque Basin and deep-sea records drilled during Ocean Drilling Program (ODP) Legs 198 (Shatsky Rise, North Pacific) and 208 (Walvis Ridge, South Atlantic) that solves previous discrepancies. The new coherent stratigraphy utilises composite images from ODP cores, a new whole-rock d13C isotope record at Zumaia and new magnetostratigraphic data from Sopelana. We consistently observe 11 405-kyr eccentricity cycles in all studied Danian successions. We achieve a robust correlation of bioevents and stable isotope events between all studied sections at the ~100-kyr short-eccentricity level, a prerequisite for paleoclimatic interpretations. Comparison with and subsequent tuning of the records to the latest orbital solution La2011 provides astronomically calibrated ages of 66.022 ± 0.040 Ma and 61.607 ± 0.040 Ma for the Cretaceous-Paleogene (K-Pg) and Danian-Selandian 105 (D-S) boundaries respectively. Low sedimentation rates appear common in all records in the mid-Danian interval, including conspicuous condensed intervals in the oceanic records that in the past have hampered the proper identification of cycles. The comprehensive interbasinal approach applied here reveals pitfalls in time scale construction, filtering techniques in particular, and indicates that some caution and scrutiny has to be applied when building orbital chronologies. Finally, the Zumaia section, already hosting the Selandian Global Boundary Stratotype Section and Point (GSSP), could serve as the global Danian unit stratotype in the future.