Showing papers by "University of Zurich published in 2006"
TL;DR: It is shown that only very little is known about long-term effects of pharmaceuticals to aquatic organisms, in particular with respect to biological targets, and targeted ecotoxicological studies are needed focusing on subtle environmental effects.
2,844 citations
TL;DR: The first rigorous quantitative assessment of the relationship between biodiversity and ecosystem process rates through meta-analysis of experimental work spanning 50 years to June 2004 shows that biodiversity effects are weaker if biodiversity manipulations are less well controlled.
Abstract: Concern is growing about the consequences of biodiversity loss for ecosystem functioning, for the provision of ecosystem services, and for human well being. Experimental evidence for a relationship between biodiversity and ecosystem process rates is compelling, but the issue remains contentious. Here, we present the first rigorous quantitative assessment of this relationship through meta-analysis of experimental work spanning 50 years to June 2004. We analysed 446 measures of biodiversity effects (252 in grasslands), 319 of which involved primary producer manipulations or measurements. Our analyses show that: biodiversity effects are weaker if biodiversity manipulations are less well controlled; effects of biodiversity change on processes are weaker at the ecosystem compared with the community level and are negative at the population level; productivity-related effects decline with increasing number of trophic links between those elements manipulated and those measured; biodiversity effects on stability measures ('insurance' effects) are not stronger than biodiversity effects on performance measures. For those ecosystem services which could be assessed here, there is clear evidence that biodiversity has positive effects on most. Whilst such patterns should be further confirmed, a precautionary approach to biodiversity management would seem prudent in the meantime.
2,339 citations
TL;DR: Recent advances in mass spectrometry instrumentation are reviewed in the context of current and emerging research strategies in protein science.
Abstract: Mass spectrometry is a central analytical technique for protein research and for the study of biomolecules in general. Driven by the need to identify, characterize, and quantify proteins at ever increasing sensitivity and in ever more complex samples, a wide range of new mass spectrometry-based analytical platforms and experimental strategies have emerged. Here we review recent advances in mass spectrometry instrumentation in the context of current and emerging research strategies in protein science.
1,992 citations
TL;DR: In this paper, the authors present a formal theory of reciprocity, which takes into account that people evaluate the kindness of an action not only by its consequences but also by its underlying intention.
1,912 citations
TL;DR: Rituximab added to six cycles of CHOP is an effective treatment for young patients with good-prognosis diffuse large-B-cell lymphoma and the definition of two prognostic subgroups allows for a more refined therapeutic approach for these patients.
Abstract: Summary Background The role of rituximab in combination with diff erent CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like chemotherapy regimens in young patients with good-prognosis diff use large-B-cell lymphoma remains to be defi ned. We aimed to compare CHOP-like chemotherapy and rituximab with CHOP-like chemotherapy alone in these patients. Methods 824 patients who were from 18 countries; aged 18–60 years; and who had no risk factors or one risk factor according to age-adjusted International Prognostic Index (IPI), stage II–IV disease, or stage I disease with bulk were enrolled. These patients were randomly assigned to six cycles of CHOP-like chemotherapy and rituximab (n=413) or to six cycles of CHOP-like chemotherapy alone (n=411). Bulky and extranodal sites received additional radiotherapy. The primary endpoint was event-free survival; secondary endpoints were response, progression under therapy, progression-free survival, overall survival, and frequency of toxic eff ects. Analyses were done by intention to treat and per protocol. This trial is registered at http://www.clinicaltrials.gov, NCT 00064116. Findings After a median follow-up of 34 months (range 0·03–61), patients assigned chemotherapy and rituximab had increased 3-year event-free survival compared with those assigned chemotherapy alone (79% [95% CI 75–83] vs 59% [54–64]; diff erence between groups 20% [13–27], log-rank p<0·0001), and had increased 3-year overall survival (93% [90–95] vs 84% [80–88]; diff erence between groups 9% [3–13], log-rank p=0·0001). Event-free survival was aff ected by treatment group, presence of bulky disease, and age-adjusted IPI: after chemotherapy and rituximab, a favourable subgroup (ie, IPI=0, no bulk) could be defi ned from a less-favourable subgroup (ie, IPI=1 or bulk, or both). Groups did not diff er in the frequency of adverse events.
1,850 citations
TL;DR: Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed and some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.
1,599 citations
TL;DR: This work proposes two major roles for empathy; its epistemological role is to provide information about the future actions of other people, and important environmental properties, and proposes a contextual approach, suggesting several modulatory factors that might influence empathic brain responses.
1,404 citations
TL;DR: It is demonstrated that SIRT6 is a nuclear, chromatin-associated protein that promotes resistance to DNA damage and suppresses genomic instability in mouse cells, in association with a role in base excision repair (BER).
1,399 citations
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TL;DR: This article proposed a new approach, based on J?rgen Habermas's theory of democracy, and defined the new role of the business firm as a political actor in a globalizing society.
Abstract: We review two important schools within business and society research, which we label positivist and post-positivist corporate social responsibility (CSR). The former is criticized because of its instrumentalism and normative vacuity, and the latter because of its relativism, foundationalism, and utopianism. We propose a new approach, based on J?rgen Habermas's theory of democracy, and define the new role of the business firm as a political actor in a globalizing society.
1,344 citations
TL;DR: This article reviews the current understanding of this multifaceted DNA-repair system in human cells and investigates how MMR status affects meiotic and mitotic recombination, DNA-damage signalling, apoptosis and cell-type-specific processes.
Abstract: By removing biosynthetic errors from newly synthesized DNA, mismatch repair (MMR) improves the fidelity of DNA replication by several orders of magnitude. Loss of MMR brings about a mutator phenotype, which causes a predisposition to cancer. But MMR status also affects meiotic and mitotic recombination, DNA-damage signalling, apoptosis and cell-type-specific processes such as class-switch recombination, somatic hypermutation and triplet-repeat expansion. This article reviews our current understanding of this multifaceted DNA-repair system in human cells.
1,228 citations
TL;DR: The results suggest that gene therapy in combination with bone marrow conditioning can be successfully used to treat inherited diseases affecting the myeloid compartment such as CGD.
Abstract: Gene transfer into hematopoietic stem cells has been used successfully for correcting lymphoid but not myeloid immunodeficiencies. Here we report on two adults who received gene therapy after nonmyeloablative bone marrow conditioning for the treatment of X-linked chronic granulomatous disease (X-CGD), a primary immunodeficiency caused by a defect in the oxidative antimicrobial activity of phagocytes resulting from mutations in gp91(phox). We detected substantial gene transfer in both individuals' neutrophils that lead to a large number of functionally corrected phagocytes and notable clinical improvement. Large-scale retroviral integration site-distribution analysis showed activating insertions in MDS1-EVI1, PRDM16 or SETBP1 that had influenced regulation of long-term hematopoiesis by expanding gene-corrected myelopoiesis three- to four-fold in both individuals. Although insertional influences have probably reinforced the therapeutic efficacy in this trial, our results suggest that gene therapy in combination with bone marrow conditioning can be successfully used to treat inherited diseases affecting the myeloid compartment such as CGD.
TL;DR: Decompensated HF is the most common clinical presentation of acute heart failure patients, and the use of evidence-based HF medication was well adopted to clinical practice.
Abstract: Aims The objective of the EuroHeart Failure Survey II (EHFS II) was to assess patient characteristics, aetiology, treatment, and outcome of acute heart failure (AHF) in Europe in relation to the guidelines on the diagnosis and treatment of AHF published by the European Society of Cardiology.
Methods and results Patients hospitalized for AHF were recruited by 133 centres in 30 European countries. Three thousand five hundred and eighty patients were entered into the database by the end of August 2005. Mean age was 70 years, and 61% of patients were male. New-onset AHF ( de novo AHF) was diagnosed in 37%, of which 42% was due to acute coronary syndromes (ACS). Clinical classification according to the guidelines divided AHF patients into (i) decompensated HF (65%), (ii) pulmonary oedema (16%), (iii) HF and hypertension (11%), (iv) cardiogenic shock (4%), and (v) right HF (3%). Coronary heart disease, hypertension, and atrial fibrillation were the most common underlying conditions. Arrhythmias, valvular dysfunction, and ACS were each present as precipitating factor in one-third of cases. Preserved left ventricular ejection fraction (≥45%) was observed in 34%. Valvular disorders were common, especially mitral regurgitation (MR) which was reported on echocardiography in 80% of patients. Median length of stay was 9 days, and in-hospital mortality 6.7%. At discharge, 80% of patients were on angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers, whereas 61% were taking beta-blocker medication.
Conclusion Decompensated HF is the most common clinical presentation of AHF patients. More than one-third of AHF patients do not have a previous history of HF, and new-onset HF is often caused by ACS. Preserved systolic function is found in a substantial proportion of the patients. The prevalence of valvular dysfunction is strikingly high and contributes to the clinical presentation. The EHFS II on AHF verified that the use of evidence-based HF medication was well adopted to clinical practice.
TL;DR: In this article, the authors start from the assumption that the current process of globalization or denationalization leads to the formation of a new structural conflict in Western European countries, opposing those who benefit from this process against those who tend to lose in the course of the events.
Abstract: This article starts from the assumption that the current process of globalization or denationalization leads to the formation of a new structural conflict in Western European countries, opposing those who benefit from this process against those who tend to lose in the course of the events. The structural opposition between globalization 'winners' and 'losers' is expected to constitute potentials for political mobilization within national political contexts, the mobilization of which is expected to give rise to two intimately related dynamics: the transformation of the basic structure of the national political space and the strategic repositioning of the political parties within the transforming space. The article presents several hypotheses with regard to these two dynamics and tests them empirically on the basis of new data concerning the supply side of electoral politics from six Western European countries (Austria, Britain, France, Germany, the Netherlands and Switzerland). The results indicate that in all the countries, the new cleavage has become embedded into existing two-dimensional national political spaces, that the meaning of the original dimensions has been transformed, and that the configuration of the main parties has become triangular even in a country like France.
TL;DR: A strong association between immunodeficiency and risk of liver-related death was found and long-term follow-up is required to investigate whether clinically significant treatment-associated liver- related mortality will develop.
Abstract: Background An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. Methods We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow-up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. Results There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P = .008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P = .02). Conclusions Liver-related death was the most frequent cause of non-AIDS-related death. We found a strong association between immunodeficiency and risk of liver-related death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.
TL;DR: A two component cognitive model of PTG will be proposed that may explain the contradicting empirical findings in regard to the relationship between mental health and PTG.
TL;DR: This work uses environmental genomics—the reconstruction of genomic data directly from the environment—to assemble the genome of the uncultured anammox bacterium Kuenenia stuttgartiensis from a complex bioreactor community, and identifies candidate genes responsible for ladderane biosynthesis and biological hydrazine metabolism.
Abstract: Ten years ago a fortuitous discovery led to the identification of oceanic bacteria capable of anaerobic ammonium oxidation (anammox). It was soon recognized that the anammox reaction has great ecological significance, as it is responsible for removing up to 50% of fixed nitrogen from the oceans. The genome of the anammox bacterium Kuenenia stuttgartiensis has now been sequenced in a remarkable feat of what is called environmental genomics. Anammox bacteria grow very slowly and are not available in pure culture. For genome analysis an inoculum of wastewater sludge was grown in a bioreactor for one year, clocking up 10–15 generations. The DNA of the whole microbial community was sequenced and the genome of this one anammox bacterium was deduced from the results. With the genome sequence known, it will be possible to gain insight into the metabolism and evolution of these important bacteria. The genome of Kuenenia stuttgartiensis has been sequenced to learn more about anaerobic ammonium oxidation. Anaerobic ammonium oxidation (anammox) has become a main focus in oceanography and wastewater treatment1,2. It is also the nitrogen cycle's major remaining biochemical enigma. Among its features, the occurrence of hydrazine as a free intermediate of catabolism3,4, the biosynthesis of ladderane lipids5,6 and the role of cytoplasm differentiation7 are unique in biology. Here we use environmental genomics8,9—the reconstruction of genomic data directly from the environment—to assemble the genome of the uncultured anammox bacterium Kuenenia stuttgartiensis10 from a complex bioreactor community. The genome data illuminate the evolutionary history of the Planctomycetes and allow us to expose the genetic blueprint of the organism's special properties. Most significantly, we identified candidate genes responsible for ladderane biosynthesis and biological hydrazine metabolism, and discovered unexpected metabolic versatility.
TL;DR: A review of reflectance nomenclature used in remote sensing can be found in this paper, where the authors highlight the importance of a proper usage of definitions through quantitative comparison of different reflectance products with special emphasis on wavelength dependent effects.
TL;DR: A stepwise algorithm developed by consensus between a group of doctors interested in the epidemiology of vasculitis successfully categorises patients into a single classification of patients with Wegener’s granulomatosis, microscopic polyangiitis, Churg–Strauss syndrome and PAN into single clinically relevant categories.
Abstract: Background: The classification of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN) for epidemiology studies is confusing. The existing schemes such as American College of Rheumatology (ACR) criteria, Chapel Hill Consensus Conference (CHCC) definitions and Lanham criteria produce overlapping and conflicting classifications, making it difficult to compare incidence figures. Aim: To develop a consensus method of using these criteria and definitions for epidemiological studies to permit comparison without confounding by classification. Methods: A stepwise algorithm was developed by consensus between a group of doctors interested in the epidemiology of vasculitis. The aim was to categorise patients with Wegener’s granulomatosis, microscopic polyangiitis (MPA), Churg–Strauss syndrome (CSS) and PAN into single clinically relevant categories. The ACR and Lanham criteria for CSS, and ACR criteria for Wegener’s granulomatosis were applied first, as these were considered to be the most specific. Surrogate markers for Wegener’s granulomatosis were included to distinguish Wegener’s granulomatosis from MPA. MPA was classified using the CHCC definition and surrogate markers for renal vasculitis. Finally, PAN was classified using the CHCC definition. The algorithm was validated by application to 20 cases from each centre and 99 from a single centre, followed by a paper case exercise. Results: A four-step algorithm was devised. It successfully categorises patients into a single classification. There was good correlation between observers in the paper case exercise (91.5%; unweighted κ = 0.886). Conclusion: The algorithm achieves its aim of reliably classifying patients into a single category. The use of the algorithm in epidemiology studies should permit comparison between geographical areas.
TL;DR: This review describes how C. elegans models can be used to advance the understanding of the molecular mechanisms of drug action and disease pathogenesis and how these models are amenable to whole-organism high-throughput compound screens and large-scale target validation.
Abstract: Despite its apparent simplicity, the nematode worm Caenorhabditis elegans has developed into an important model for biomedical research, particularly in the functional characterization of novel drug targets that have been identified using genomics technologies. The cellular complexity and the conservation of disease pathways between C. elegans and higher organisms, together with the simplicity and cost-effectiveness of cultivation, make for an effective in vivo model that is amenable to whole-organism high-throughput compound screens and large-scale target validation. This review describes how C. elegans models can be used to advance our understanding of the molecular mechanisms of drug action and disease pathogenesis.
TL;DR: It is shown that disruption of the right, but not the left, dorsolateral prefrontal cortex (DLPFC) by low-frequency repetitive transcranial magnetic stimulation substantially reduces subjects' willingness to reject their partners' intentionally unfair offers, which suggests that subjects are less able to resist the economic temptation to accept these offers.
Abstract: Humans restrain self-interest with moral and social values. They are the only species known to exhibit reciprocal fairness, which implies the punishment of other individuals' unfair behaviors, even if it hurts the punisher's economic self-interest. Reciprocal fairness has been demonstrated in the Ultimatum Game, where players often reject their bargaining partner's unfair offers. Despite progress in recent years, however, little is known about how the human brain limits the impact of selfish motives and implements fair behavior. Here we show that disruption of the right, but not the left, dorsolateral prefrontal cortex (DLPFC) by low-frequency repetitive transcranial magnetic stimulation substantially reduces subjects' willingness to reject their partners' intentionally unfair offers, which suggests that subjects are less able to resist the economic temptation to accept these offers. Importantly, however, subjects still judge such offers as very unfair, which indicates that the right DLPFC plays a key role in the implementation of fairness-related behaviors.
TL;DR: In this article, a mixed-mode analog/digital VLSI device comprising an array of leaky integrate-and-fire (I&F) neurons, adaptive synapses with spike-timing dependent plasticity, and an asynchronous event based communication infrastructure is presented.
Abstract: We present a mixed-mode analog/digital VLSI device comprising an array of leaky integrate-and-fire (I&F) neurons, adaptive synapses with spike-timing dependent plasticity, and an asynchronous event based communication infrastructure that allows the user to (re)configure networks of spiking neurons with arbitrary topologies. The asynchronous communication protocol used by the silicon neurons to transmit spikes (events) off-chip and the silicon synapses to receive spikes from the outside is based on the "address-event representation" (AER). We describe the analog circuits designed to implement the silicon neurons and synapses and present experimental data showing the neuron's response properties and the synapses characteristics, in response to AER input spike trains. Our results indicate that these circuits can be used in massively parallel VLSI networks of I&F neurons to simulate real-time complex spike-based learning algorithms.
TL;DR: In this paper, a fundamental shift to moral legitimacy, from an output and power oriented approach to an input related and discursive concept of legitimacy is proposed, which involves organizations in processes of active justification vis-a-vis society rather than simply responding to the demands of powerful groups.
Abstract: Modern society is challenged by a loss of efficiency in national governance systems values, and lifestyles. Corporate social responsibility (CSR) discourse builds upon a conception of organizational legitimacy that does not appropriately reflect these changes. The problems arise from the a-political role of the corporation in the concepts of cognitive and pragmatic legitimacy, which are based on compliance to national law and on relatively homogeneous and stable societal expectations on the one hand and widely accepted rhetoric assuming that all members of society benefit from capitalist production on the other. We therefore propose a fundamental shift to moral legitimacy, from an output and power oriented approach to an input related and discursive concept of legitimacy. This shift creates a new basis of legitimacy and involves organizations in processes of active justification vis-a-vis society rather than simply responding to the demands of powerful groups. We consider this a step towards the politicization of the corporation and attempt to re-embed the debate on corporate legitimacy into its broader context of political theory, while reflecting the recent turn from a liberal to a deliberative concept of democracy.
TL;DR: A critical role is demonstrated in the consolidation of enduring synaptic plasticity and memory storage in Arc/Arg3.1 knockout mice that fail to form long-lasting memories for implicit and explicit learning tasks, despite intact short-term memory.
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TL;DR: This article proposed a model that generates an economic expansion in response to good news about future total factor productivity (TFP) or investment-specific technical change, without relying on negative productivity shocks.
Abstract: We propose a model that generates an economic expansion in response to good news about future total factor productivity (TFP) or investment-specific technical change. The model has three key elements: variable capital utilization, adjustment costs to investment, and preferences that exhibit a weak short-run wealth effect on the labour supply. These preferences nest the two classes of utility functions most widely used in the business cycle literature as special cases. Our model can generate recessions that resemble those of the post-war U.S. economy without relying on negative productivity shocks. The recessions are caused not by contemporaneous negative shocks but rather by lackluster news about future TFP or investment-specific technical change.
TL;DR: This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.
Abstract: Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by aetiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment of apical periodontitis has not adequately eliminated intraradicular infection. Problems that lead to persistent apical periodontitis include: inadequate aseptic control, poor access cavity design, missed canals, inadequate instrumentation, debridement and leaking temporary or permanent restorations. Even when the most stringent procedures are followed, apical periodontitis may still persist as asymptomatic radiolucencies, because of the complexity of the root canal system formed by the main and accessory canals, their ramifications and anastomoses where residual infection can persist. Further, there are extraradicular factors -- located within the inflamed periapical tissue -- that can interfere with post-treatment healing of apical periodontitis. The causes of apical periodontitis persisting after root canal treatment have not been well characterized. During the 1990s, a series of investigations have shown that there are six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment. These are: (i) intraradicular infection persisting in the complex apical root canal system; (ii) extraradicular infection, generally in the form of periapical actinomycosis; (iii) extruded root canal filling or other exogenous materials that cause a foreign body reaction; (iv) accumulation of endogenous cholesterol crystals that irritate periapical tissues; (v) true cystic lesions, and (vi) scar tissue healing of the lesion. This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.
TL;DR: This work states that individuals in small populations have lower fitness owing to environmental stress and genetic problems such as inbreeding, which can substantially increase the extinction probability of populations in changing environments.
Abstract: Small populations are predicted to have reduced capacity to adapt to environmental change for two reasons. First, population genetic models indicate that genetic variation and potential response to selection should be positively correlated with population size. The empirical support for this prediction is mixed: DNA markers usually reveal low heterozygosity in small populations, whereas quantitative traits show reduced heritability only in the smallest and most inbred populations. Quantitative variation can even increase in bottlenecked populations although this effect seems unlikely to increase the adaptive potential of populations. Second, individuals in small populations have lower fitness owing to environmental stress and genetic problems such as inbreeding, which can substantially increase the extinction probability of populations in changing environments. This second reason has not been included in assessments of critical population size assuring evolvability and makes it likely that many sm...
TL;DR: This novel approach may provide a standardized, objective, and reproducible assessment of pancreas surgery enabling meaningful comparison among centers and over time, and demonstrates the applicability and utility of a new classification in grading complications following pancreatic surgery.
Abstract: Mortality associated with pancreaticoduodenectomy (PD) has decreased dramatically to less than 5% over the past 2 decades in high-volume centers,1–6 but persistent high morbidity rates have remained an important concern for patients, healthcare providers, and payers. While mortality is an objective and easily quantifiable outcome parameter, morbidity is only poorly defined, and this shortcoming has severely hampered conclusive comparisons among centers and within the same institution over time.7–9 Similarly, the identification of risk factors related to specific complications has been difficult.
Recognizing this deficiency, there has been several recent attempts to define specific complications related to PD such as pancreatic fistula, either by individual groups10–14 or through consensus statements from a few experts.15 Although important, these definitions have focused only on one specific complication (pancreatic fistula), and typically lack a severity grading system. For example, when a pancreatic fistula is defined as the persistent drainage of amylase-rich fluid during the postoperative course or as radiologic evidence of pancreatic anastomotic disruption, no distinction is made between the minimal criteria and more severe manifestation leading to reoperation or even death. An attempt was recently made by a group of experts in pancreas surgery to grade pancreatic fistula by severity,15 but the grading system is complex, includes multiple subjective criteria, and is not applicable to other types of complications. Therefore, there is persistent need for the availability of a reproducible, simple, and widely acceptable system to grade all complications following PD.
A previously reported grading system7–9 was recently revisited and validated in a large cohort of patients undergoing general surgery. An international survey confirmed the simplicity and reproducibility of the new grading system.16 This classification was recently adopted by the International Transplantation Society17 to prospectively monitor the outcome of living liver donors. A key feature facilitating the use of the grading system is that it mostly relies on the therapies used to correct negative events. This is crucial to minimize down grading of complications as even nursing notes can be used to secure appropriate grading in retrospective analyses. Another attractive aspect of the new classification is that it considers the patient perspective through a strong emphasis on long lasting disability. Such a grading system can be adapted to any complication as long as the minimal criteria to define each specific complication are well described and widely accepted.
We adapted this novel classification of complications by severity16 to a large cohort of patients, who underwent a PD at Johns Hopkins Hospital, a high-volume center with the availability of a comprehensive database. We used the well-established Johns Hopkins definitions for pancreatic fistula and delayed gastric emptying (DGE),18,19 and stratified them according to severity criteria. Of importance, the John Hopkins definition of pancreatic fistula is consistent with a recent consensus statements.15
The primary aims of the study were to evaluate the feasibility of grading each recorded complication in the database according to the novel classification system, to present specific complications by severity, and to identify risk factors. A secondary aim was to test the novel classification system in comparing the incidence and severity of one type of complication, pancreatic fistula, with a previous series of patients in the same institution. Finally, an attempt was made to evaluate the impact of complications on long-term survival.
TL;DR: This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms, and outlines evidence‐based diagnostic approaches for different subtypes ofUrticaria.
Abstract: This guideline is the result of a consensus reached during a panel discussion at the 2nd International Consensus Meeting on Urticaria, Urticaria 2004, a joint initiative of the European Academy of Allergology and Clinical Immunology Dermatology Section and the European Union (EU)-funded network of excellence, GA2LEN. It covers the definition and classification of urticaria, taking into account the recent progress in identifying causes, eliciting factors and pathomechanisms of this disease. We have outlined useful diagnostic approaches for different subtypes of urticaria. This guideline was, in addition, accepted by the European Dermatology Forum (EDF) and was formally approved by the European Union of Medical Specialists (UEMS).
TL;DR: Because the human and economic losses of cystic echinococcosis are substantial, global prevention and control measures should be increased.
Abstract: Cystic echinococcosis (CE) is an emerging zoonotic parasitic disease throughout the world. Human incidence and livestock prevalence data of CE were gathered from published literature and the Office International des Epizooties databases. Disability-adjusted life years (DALYs) and monetary losses, resulting from human and livestock CE, were calculated from recorded human and livestock cases. Alternative values, assuming substantial underreporting, are also reported. When no underreporting is assumed, the estimated human burden of disease is 285,407 (95% confidence interval [CI], 218,515–366,133) DALYs or an annual loss of US $193,529,740 (95% CI, $171,567,331–$217,773,513). When underreporting is accounted for, this amount rises to 1,009,662 (95% CI, 862,119–1,175,654) DALYs or US $763,980,979 (95% CI, $676,048,731–$857,982,275). An annual livestock production loss of at least US $141,605,195 (95% CI, $101,011,553–$183,422,465) and possibly up to US $2,190,132,464 (95% CI, $1,572,373,055–$2,951,409,989) is also estimated. This initial valuation demonstrates the necessity for increased monitoring and global control of CE.
TL;DR: The discovery of a novel Wnt pathway component, Wntless (Wls/Evi), is described and it is shown that it is required for Wingless-dependent patterning processes in Drosophila, for MOM-2-governed polarization of blastomeres in C. elegans, and for Wnt3a-mediated communication between cultured human cells.