Status update on White-eared Night Heron Gorsachius magnificus in South China

White-eared Night Heron Gorsachius magnificus is probably the most threatened heron species in the world, and the highest priority for heron species conservation. From 1990 to 1998, there were sightings from only six localities in the wild. There are none in captivity. In 1998 a caged bird was found in a wildlife market in the city of Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China. This finding prompted a 12-month survey in 1998-1999 of both markets and potential habitats in Guangxi. Several captured birds provided direct evidence of the existence of small populations in Guangxi and Guangdong Provinces. The respective habitats were surveyed in spring 2000, with emphasis on observations at dusk. The species was seen at two locations. Although some of the captured birds came from highly degraded habitat, the best sites seemed to be in areas near extensive primary forests, with streams, rice fields and marshes. The information obtained will be used to compile a detailed Action Plan designed to prevent the extinction of the species.published_or_final_versio

Protocol of the Australasian Malignant Pleural Effusion (AMPLE) trial: a multicentre randomised study comparing indwelling pleural catheter versus talc pleurodesis

INTRODUCTION: Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate. Indwelling pleural catheters (IPCs) allow ambulatory fluid drainage without hospitalisation, and are increasingly employed for management of malignant effusions. Previous studies have only investigated the length of hospital care immediately related to IPC insertion. Whether IPC management reduces time spent in hospital in the patients' remaining lifespan is unknown. A strategy of malignant effusion management that reduces hospital admission days will allow patients to spend more time outside hospital, reduce costs and save healthcare resources. METHODS AND ANALYSIS: The Australasian Malignant Pleural Effusion (AMPLE) trial is a multicentred, randomised trial designed to compare IPC with talc pleurodesis for the management of malignant pleural effusion. This study will randomise 146 adults with malignant pleural effusions (1:1) to IPC management or talc slurry pleurodesis. The primary end point is the total number of days spent in hospital (for any admissions) from treatment procedure to death or end of study follow-up. Secondary end points include hospital days specific to pleural effusion management, adverse events, self-reported symptom and quality-of-life scores. ETHICS AND DISSEMINATION: The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study as have the ethics boards of all the participating hospitals. The trial results will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION NUMBERS: Australia New Zealand Clinical Trials Registry-ACTRN12611000567921; National Institutes of Health-NCT02045121.published_or_final_versio

Two-Stage Prosthetic Breast Reconstruction after Mastectomy with or without Prior Postmastectomy Radiotherapy

Background:. Two-stage prosthetic breast reconstruction with initial insertion of a tissue expander followed by an implant after a period of inflation is a well-established breast reconstruction option. Most of the current literature concentrates on the immediate setting, and there are only a few reports into delayed cases, especially after postmastectomy radiotherapy (RT). We performed a retrospective review of our experience over a 12.5-year period. Methods:. Between June 1998 and December 2010, a total of 671 patients received prosthetic-only breast reconstruction. Of these, 170 (25.3%) underwent delayed 2-stage prosthetic breast reconstruction after mastectomy for cancer. Patients were divided into group A, no postmastectomy RT (n = 150), and group B, postmastectomy RT (n = 20). The primary factor examined was the failure of the reconstruction from loss of prosthesis with or without smoking. Other complications, as well as rates of revisional surgery were also recorded. Results:. Expander or implant loss occurred in 3 of 150 patients in group A (2.0%) and 3 of 20 patients in group B (15%; P = 0.02). For nonsmokers, implant loss was 1.6% and 5.6%, respectively (P = NS). Smoking was associated with 1 of the 3 losses in group A and 2 of the 3 in group B (smokers, n = 2; P < 0.01). There was no significant difference in other complications such as seromas or minor wound infections. Conclusions:. Delayed 2-stage prosthetic breast reconstruction has a low failure rate. It can also be successfully completed in selected patients after postmastectomy RT, but care must be taken with patients who smoke

Constitutional Conflict in Hong Kong Under Chinese Sovereignty

© 2016, T.M.C. Asser Press.The protracted constitutional conflicts between the Chinese state and Hong Kong society over the pace and form of democratization have become a source of political instability. This article sheds new light on these dynamics by analyzing the two sides as locked in a coordination dilemma: both have important common interests to coordinate with each other, but both rank in divergent ways their preferences for and against introducing competitive electoral arrangements into Hong Kong. It is shown how the unwillingness of either side to compromise has caused the gradual breakdown of coordination as focal points like the Basic Law have eroded, culminating in the Umbrella Revolution of 2014, the largest and longest-lasting popular movement in Hong Kong history. The bloodless ending of the Movement is chronicled, along with the persistence of political stalemate in this highly anomalous polity, known throughout the world for its combination of genuine civil liberties with authoritarian rule.Link_to_subscribed_fulltex