[Pelvimetrics measures as predictives factors of positives surgical margins after robot-assisted laparoscopic prostatectomy]. / Mesures pelvimétriques prédictives de marges chirurgicales au décours d'une prostatectomie totale robot-assitée pour cancer prostatique.

INTRODUCTION: Anthropometric data report that pelvic bone of African subjects are narrower and the pelvic cavity is deeper. The aim of the study was to evaluate the influence of pelvic dimensions (PD) on Positive surgical margins (PSM) rate in Afro-Caribbean population after robot-assisted laparoscopic prostatectomy (RALP). PATIENTS AND METHODS: Preoperative pelvic MRI of all patients who have had RALP at the University Hospital Center of Guadeloupe between January 2013 and December 2015 was retrospectively analyzed. PD, including the Height of the upper edge of the prostate (HP), the Apical Depth (AD) and Ischial Spines Distance (ISD), and indexes (prostate volumetric index [ISD/VP], apical depth index [ISD/AD] and prostate depth index [ISD/(AD/HP)]) were compared according to the presence or absence of PSM with uni and multivariate analysis. RESULTS: One hundred and seventy-eight patients were included in the study, of whom 60 (33.7%) presented PSM. In univariate analysis, significant differences between the presence or absence of PSM were observed on the AD (30.3±8.7mm versus 24.8±8.0mm, P<0.001), the HP (9.5±8.5mm versus 16.8±11.9mm, P<0.001) and the ISD (89.6±8.8mm versus 96.1±8.4mm) as well as the indexes of apical depth and prostatic depth. In multivariate logistic regression, the ISD (P<0.001) and HP (P=0.02) were associated with increased likelihood of PSM, but not AD or indexes. CONCLUSION: This study suggests that interspinous distance is the best predictor of PSM during RALP in Afro-Caribbean patients. This measure may be useful to define the therapeutic pattern of patients with prostate cancer. A prospective study with a larger population, comparing RALP in Afro-Caribbean and in caucasians patients, would be needed.

Lactic acidosis: relationship between metformin levels, lactate concentration and mortality.

AIM: The role of metformin in lactic acidosis is regularly questioned. Arguments against a causal role for metformin in lactic acidosis occurrence are the lack of correlation between plasma metformin and lactate levels, as well as between metformin plasma levels and mortality. We aim to analyse these correlations in a large series of lactic acidosis cases recorded in the French nationwide pharmacovigilance database. METHODS: All cases of lactic acidosis spontaneously reported between 1985 and October 2013 associated with metformin exposure were extracted from the pharmacovigilance database. We assessed the statistical correlations between prescribed daily doses of metformin, plasma concentrations of metformin and lactate, pH and plasma creatinine, as well as the relationship between mortality and these variables. RESULTS: Seven hundred and twenty-seven cases of lactic acidosis were reported during the period. Metformin plasma concentration was documented for 260 patients, lactate plasma concentration for 556 patients, pH for 502 patients, creatinine for 397 patients and the vital outcome for 713 patients. Metformin plasma concentration, lactate concentration, pH and plasma creatinine were all correlated (P < 0.001). There were significant differences between surviving and deceased patients in terms of metformin plasma levels (25.2 vs. 37.4 mg/l, P = 0.002) and lactate concentrations (10.8 vs. 16.3 mmol/l, P < 0.001). Thirty per cent of patients died when metformin concentration was > 5 mg/l compared with 11% for patients with concentration < 5 mg/l (P = 0.003). CONCLUSIONS: Our data suggest that metformin accumulation contributes to the pathogenesis and prognosis of lactic acidosis.

Impacts of invading alien plant species on water flows at stand and catchment scales.

There have been many studies of the diverse impacts of invasions by alien plants but few have assessed impacts on water resources. We reviewed the information on the impacts of invasions on surface runoff and groundwater resources at stand to catchment scales and covering a full annual cycle. Most of the research is South African so the emphasis is on South Africa's major invaders with data from commercial forest plantations where relevant. Catchment studies worldwide have shown that changes in vegetation structure and the physiology of the dominant plant species result in changes in surface runoff and groundwater discharge, whether they involve native or alien plant species. Where there is little change in vegetation structure [e.g. leaf area (index), height, rooting depth and seasonality] the effects of invasions generally are small or undetectable. In South Africa, the most important woody invaders typically are taller and deeper rooted than the native species. The impacts of changes in evaporation (and thus runoff) in dryland settings are constrained by water availability to the plants and, thus, by rainfall. Where the dryland invaders are evergreen and the native vegetation (grass) is seasonal, the increases can reach 300-400 mm/year. Where the native vegetation is evergreen (shrublands) the increases are ∼200-300 mm/year. Where water availability is greater (riparian settings or shallow water tables), invading tree water-use can reach 1.5-2.0 times that of the same species in a dryland setting. So, riparian invasions have a much greater impact per unit area invaded than dryland invasions. The available data are scattered and incomplete, and there are many gaps and issues that must be addressed before a thorough understanding of the impacts at the site scale can be gained and used in extrapolating to watershed scales, and in converting changes in flows to water supply system yields.

System dynamic modelling to assess economic viability and risk trade-offs for ecological restoration in South Africa.

Can markets assist by providing support for ecological restoration, and if so, under what conditions? The first step in addressing this question is to develop a consistent methodology for economic evaluation of ecological restoration projects. A risk analysis process was followed in which a system dynamics model was constructed for eight diverse case study sites where ecological restoration is currently being pursued. Restoration costs vary across each of these sites, as do the benefits associated with restored ecosystem functioning. The system dynamics model simulates the ecological, hydrological and economic benefits of ecological restoration and informs a portfolio mapping exercise where payoffs are matched against the likelihood of success of a project, as well as a number of other factors (such as project costs and risk measures). This is the first known application that couples ecological restoration with system dynamics and portfolio mapping. The results suggest an approach that is able to move beyond traditional indicators of project success, since the effect of discounting is virtually eliminated. We conclude that systems dynamic modelling with portfolio mapping can guide decisions on when markets for restoration activities may be feasible.

Four-jet production at the Large Hadron Collider at next-to-leading order in QCD.

We present the cross sections for production of up to four jets at the Large Hadron Collider, at next-to-leading order in the QCD coupling. We use the BLACKHAT library in conjunction with SHERPA and a recently developed algorithm for assembling primitive amplitudes into color-dressed amplitudes. We adopt the cuts used by ATLAS in their study of multijet events in pp collisions at √s=7 TeV. We include estimates of nonperturbative corrections and compare to ATLAS data. We store intermediate results in a framework that allows the inexpensive computation of additional results for different choices of scale or parton distributions.

The prioritisation of invasive alien plant control projects using a multi-criteria decision model informed by stakeholder input and spatial data.

Invasions by alien plants are a significant threat to the biodiversity and functioning of ecosystems and the services they provide. The South African Working for Water program was established to address this problem. It needs to formulate objective and transparent priorities for clearing in the face of multiple and sometimes conflicting demands. This study used the analytic hierarchy process (a multi-criteria decision support technique) to develop and rank criteria for prioritising alien plant control operations in the Western Cape, South Africa. Stakeholder workshops were held to identify a goal and criteria and to conduct pair-wise comparisons to weight the criteria with respect to invasive alien plant control. The combination of stakeholder input (to develop decision models) with data-driven model solutions enabled us to include many alternatives (water catchments), that would otherwise not have been feasible. The most important criteria included the capacity to maintain gains made through control operations, the potential to enhance water resources and conserve biodiversity, and threats from priority invasive alien plant species. We selected spatial datasets and used them to generate weights that could be used to objectively compare alternatives with respect to agreed criteria. The analysis showed that there are many high priority catchments which are not receiving any funding and low priority catchments which are receiving substantial allocations. Clearly, there is a need for realigning priorities, including directing sufficient funds to the highest priority catchments to provide effective control. This approach provided a tractable, consensus-based solution that can be used to direct clearing operations.

Incorporating stakeholder preferences in the selection of technologies for using invasive alien plants as a bio-energy feedstock: applying the analytical hierarchy process.

Invasive alien plants (IAPs) impose significant social costs on the population of the Agulhas Plain region in South Africa due to their adverse impacts on ecosystem goods and services (decreased water supply and increased fire risk). While the cost of clearing IAPs is considerable, this paper assesses opportunities to reduce some of the social and environmental burdens (e.g. disruptions of ecosystems which have negative impacts on livelihoods) by using IAP biomass to produce bio-energy. However, such an initiative could increase financial dependency on these plants and is thus considered to be a major risk factor which could create adverse incentives to illegally grow these plants. A participatory decision-making process with active stakeholder participation is a key element in managing such an initiative. We used a multi-stakeholder engagement process and the analytical hierarchy process to define and weigh suitable criteria for the assessment of different "IAP biomass to bio-energy" technology scenarios on the Agulhas Plain. Feasible scenarios were constructed by means of an expert panel which were then ranked according to stakeholder preference. The six criteria were: minimising impacts on natural resources; job creation; certainty of benefits to local people in the study area; development of skills for life; technology performance and cost efficiency. This ranking was largely determined by the preference for resource efficiency in terms of minimising impacts on natural ecosystems and the localisation of benefits. The smaller, modular technologies were consequently preferred since these realise direct local benefits while developing local skills and capacity in their manufacture, sales and maintenance. The rankings as obtained in this study are context-bound, which implies that the findings only have limited application to areas with similar biophysical and socio-economic characteristics. However, the method itself is fully generalisable, and the same prioritisation process can be followed in any study area to ensure that a participatory decision-making process fulfils local energy needs and contributes to sustainable development.

Precise predictions for W+4-jet production at the large hadron collider.

We present the next-to-leading order (NLO) QCD results for W+4-jet production at hadron colliders. This is the first hadron-collider process with five final-state objects to be computed at NLO. It represents an important background to many searches for new physics at the energy frontier. Total cross sections, as well as distributions in the jet transverse momenta, are provided for the initial LHC energy of √s = 7 TeV. We use a leading-color approximation, known to be accurate to 3% for W production with fewer jets. The calculation uses the BLACKHAT library along with the SHERPA package.

Precise predictions for w+3 jet production at hadron colliders.

We report on the first next-to-leading order QCD computation of W+3-jet production in hadronic collisions including all partonic subprocesses. We compare the results with data from the Tevatron and find excellent agreement. The required one-loop matrix elements are computed using on-shell methods, implemented in a numerical program, BlackHat. We use the SHERPA package to generate the real-emission contributions and to integrate the various contributions over phase space. We use a leading-color (large-N_{c}) approximation for the virtual part, which we confirm in W+1, 2-jet production to be valid to within three percent.

A biome-scale assessment of the impact of invasive alien plants on ecosystem services in South Africa.

This paper reports an assessment of the current and potential impacts of invasive alien plants on selected ecosystem services in South Africa. We used data on the current and potential future distribution of 56 invasive alien plant species to estimate their impact on four services (surface water runoff, groundwater recharge, livestock production and biodiversity) in five terrestrial biomes. The estimated reductions in surface water runoff as a result of current invasions were >3000 million m(3) (about 7% of the national total), most of which is from the fynbos (shrubland) and grassland biomes; the potential reductions would be more than eight times greater if invasive alien plants were to occupy the full extent of their potential range. Impacts on groundwater recharge would be less severe, potentially amounting to approximately 1.5% of the estimated maximum reductions in surface water runoff. Reductions in grazing capacity as a result of current levels of invasion amounted to just over 1% of the potential number of livestock that could be supported. However, future impacts could increase to 71%. A 'biodiversity intactness index' (the remaining proportion of pre-modern populations) ranged from 89% to 71% for the five biomes. With the exception of the fynbos biome, current invasions have almost no impact on biodiversity intactness. Under future levels of invasion, however, these intactness values decrease to around 30% for the savanna, fynbos and grassland biomes, but to even lower values (13% and 4%) for the two karoo biomes. Thus, while the current impacts of invasive alien plants are relatively low (with the exception of those on surface water runoff), the future impacts could be very high. While the errors in these estimates are likely to be substantial, the predicted impacts are sufficiently large to suggest that there is serious cause for concern.

Effect on platelet adhesiveness in diabetics after long-term treatment with a new oral hypoglycaemic agent, gliclazide.

Gliclazide is an oral hypoglycaemic agent which has been shown in animal models to reduce platelet adhesiveness. In this study, 50 patients with maturity onset diabetes treated with gliclazide (80 mg/day) were followed up for 6 months to 1 year to assess the effect on platelet adhesiveness and control of blood sugar. A significant fall in mean platelet adhesiveness from 29% before treatment to 19.5% after 1 year (p less than 0.001) was achieved without any deleterious effect on normal haemostasis. The drug was well tolerated and achieved a satisfactory control of blood sugar levels at the dosages used.