Laos in 1997: Into ASEAN

Membership in ASEAN will have a long-term effect on the direction of Laos's economic development. Laos has been given until 2008 to meet ASEAN Free Trade Area (AFTA) requirements to reduce tariffs on most goods to below 5%. This should encourage both trade and investment but will force the government to introduce fiscal reforms to make up for the 20% of total revenue it currently derives from tariffs. Laos will also become more fully integrated with its ASEAN neighbors. Overland routes through Laos are seen as essential to increase trade between Thailand and Vietnam and between Thailand and southern China (Yunnan). Bridge and road construction are now priorities, with aid donors and international lending institutions concentrating on infrastructure development. ASEAN membership is already having an impact on Laos's foreign relations. Throughout the year a string of ASEAN heads of state, prime ministers, and foreign ministers visited Vientiane. President Suharto of Indonesia led the way in February, followed by Prime Minister Goh Chok Tong of Singapore in March, Thai Prime Minister Chavalit Youngchaiyudh in June, Vietnamese Prime Minister Vo Van Kiet in August, and President Fidel Ramos of the Philippines in October. Agreements on agriculture, health, narcotics control, and cultural exchange were signed. Singapore has opened an embassy in Vientiane, and Brunei is to follow suit

Effectiveness and cost of radiofrequency ablation and stereotactic body radiotherapy for treatment of early‐stage hepatocellular carcinoma: An analysis of SEER‐medicare

IntroductionFor early‐stage hepatocellular carcinoma (HCC) patients, ablative strategies are potentially curative treatment options. Stereotactic body radiotherapy (SBRT) has emerged as a promising ablative therapy, although its comparison with radiofrequency ablation (RFA) remains confined to a single institution retrospective review. We sought to characterize the comparative outcomes and cost between the two treatment strategies.MethodsWe conducted a secondary analysis of the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (2004–2011) and identified adult patients with stage I or II HCC and treated with RFA or SBRT as the initial treatment within 6 months of diagnosis. Survival analysis was conducted using Kaplan–Meier curves and multivariate Cox proportional hazard analysis. Factors associated with overall survival and 90‐day hospital admission post‐treatment were identified using propensity score (PS) adjusted multivariate analysis. We performed costs analysis and calculated incremental cost‐effectiveness ratios (ICER).ResultsFour hundred and forty patients were identified, 408 treated with RFA and 32 SBRT. In the overall cohort, 90‐day hospitalization and 1‐year mortality were similar between groups but RFA patients had better overall survival (P < 0.001). Multivariate analysis showed advanced age, higher stage, decompensated cirrhosis, and treatment with SBRT (HR 1.80; 95%CI: 1.15–2.82) was associated with worse survival, but in the PS adjusted analysis, survival and costs were similar between the two groups.ConclusionIn a national cohort of early stage HCC patients, treatment with RFA vs SBRT resulted in no significant difference in survival, 90‐day hospitalization, or costs. These data highlight the need for a randomized clinical trial comparing these two modalities.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146355/1/jmiro12754_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146355/2/jmiro12754.pd

Variation in Phenotype, Parasite Load and Male Competitive Ability across a Cryptic Hybrid Zone

BackgroundMolecular genetic studies are revealing an increasing number of cryptic lineages or species, which are highly genetically divergent but apparently cannot be distinguished morphologically. This observation gives rise to three important questions: 1) have these cryptic lineages diverged in phenotypic traits that may not be obvious to humans; 2) when cryptic lineages come into secondary contact, what are the evolutionary consequences: stable co-existence, replacement, admixture or differentiation and 3) what processes influence the evolutionary dynamics of these secondary contact zones?Methodology/principal findingsTo address these questions, we first tested whether males of the Iberian lizard Lacerta schreiberi from two highly genetically divergent, yet morphologically cryptic lineages on either side of an east-west secondary contact could be differentiated based on detailed analysis of morphology, coloration and parasite load. Next, we tested whether these differences could be driven by pre-copulatory intra-sexual selection (male-male competition). Compared to eastern males, western males had fewer parasites, were in better body condition and were more intensely coloured. Although subtle environmental variation across the hybrid zone could explain the differences in parasite load and body condition, these were uncorrelated with colour expression, suggesting that the differences in coloration reflect heritable divergence. The lineages did not differ in their aggressive behaviour or competitive ability. However, body size, which predicted male aggressiveness, was positively correlated with the colour traits that differed between genetic backgrounds.Conclusions/significanceOur study confirms that these cryptic lineages differ in several aspects that are likely to influence fitness. Although there were no clear differences in male competitive ability, our results suggest a potential indirect role for intra-sexual selection. Specifically, if lizards use the colour traits that differ between genetic backgrounds to assess the size of potential rivals or mates, the resulting fitness differential favouring western males could result in net male-mediated gene flow from west to east across the current hybrid zone.Devi Stuart-Fox, Raquel Godinho, Joëlle Goüy de Bellocq, Nancy R. Irwin, José Carlos Brito, Adnan Moussalli, Pavel Široký, Andrew F. Hugall and Stuart J. E. Bair

Assessing the efficacy, safety and utility of 6-month day-and-night automated closed-loop insulin delivery under free-living conditions compared with insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, multicentre, multinational, single-period, randomised, parallel group study protocol.

INTRODUCTION: Closed-loop systems titrate insulin based on sensor glucose levels, providing novel means to reduce the risk of hypoglycaemia while improving glycaemic control. We will assess effectiveness of 6-month day-and-night closed-loop insulin delivery compared with usual care (conventional or sensor-augmented pump therapy) in children and adolescents with type 1 diabetes. METHODS AND ANALYSIS: The trial adopts an open-label, multicentre, multinational (UK and USA), randomised, single-period, parallel design. Participants (n=130) are children and adolescents (aged ≥6 and 16.7 mmol/L (300 mg/dL), area under the curve of glucose >10.0 mmol/L (180 mg/dL), total, basal and bolus insulin dose, body mass index z-score and blood pressure. Cognitive, emotional and behavioural characteristics of participants and caregivers and their responses to the closed-loop and clinical trial will be assessed. An incremental cost-effectiveness ratio for closed-loop will be estimated. ETHICS AND DISSEMINATION: Cambridge South Research Ethics Committee and Jaeb Center for Health Research Institutional Review Office approved the study. The findings will be disseminated by peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT02925299; Pre-results

Lack of support for Rensch's rule in an intraspecific test using red flour beetle (Tribolium castaneum) populations

Rensch's rule proposes a universal allometric scaling phenomenon across species where sexual size dimorphism (SSD) has evolved: in taxa with male‐biased dimorphism, degree of SSD should increase with overall body size, and in taxa with female‐biased dimorphism, degree of SSD should decrease with increasing average body size. Rensch's rule appears to hold widely across taxa where SSD is male‐biased, but not consistently when SSD is female‐biased. Furthermore, studies addressing this question within species are rare, so it remains unclear whether this rule applies at the intraspecific level. We assess body size and SSD within Tribolium castaneum (Herbst), a species where females are larger than males, using 21 populations derived from separate locations across the world, and maintained in isolated laboratory culture for at least 20 years. Body size, and hence SSD patterns, are highly susceptible to variations in temperature, diet quality and other environmental factors. Crucially, here we nullify interference of such confounds as all populations were maintained under identical conditions (similar densities, standard diet and exposed to identical temperature, relative humidity and photoperiod). We measured thirty beetles of each sex for all populations, and found body size variation across populations, and (as expected) female‐biased SSD in all populations. We test whether Rensch's rule holds for our populations, but find isometry, i.e. no allometry for SSD. Our results thus show that Rensch's rule does not hold across populations within this species. Our intraspecific test matches previous interspecific studies showing that Rensch's rule fails in species with female‐biased SSD.The authors further thank NERC (Standard research grant to MJGG, BCE and OYM), Swiss National Science Foundation (postdoctoral fellowships and Ambizione grants to OYM), the University of East Anglia and ETH Zürich for support.Peer Reviewe

Exceptional freshening and cooling in the eastern subpolar North Atlantic caused by reduced Labrador Sea surface heat loss

Observations of the eastern subpolar North Atlantic in the 2010s show exceptional freshening and cooling of the upper ocean, peaking in 2016 with the lowest salinities recorded for 120 years. Published theories for the mechanisms driving the freshening include: reduced transport of saltier, warmer surface waters northwards from the subtropics associated with reduced meridional overturning; shifts in the pathways of fresher, cooler surface water from the Labrador Sea driven by changing patterns of wind stress; and the eastward expansion of the subpolar gyre. Using output from a high-resolution hindcast model simulation, we propose that the primary cause of the exceptional freshening and cooling is reduced surface heat loss in the Labrador Sea. Tracking virtual fluid particles in the model backwards from the eastern subpolar North Atlantic between 1990 and 2020 shows the major cause of the freshening and cooling to be an increased outflow of relatively fresh and cold surface waters from the Labrador Sea; with a minor contribution from reduced transport of warmer, saltier surface water northward from the subtropics. The cooling, but not the freshening, produced by these changing proportions of waters of subpolar and subtropical origin is mitigated by reduced along-track heat loss to the atmosphere in the North Atlantic Current. We analyse modelled boundary exchanges and water mass transformation in the Labrador Sea to show that since 2000, while inflows of lighter surface waters remain steady, the increasing output of these waters is due to reduced surface heat loss in the Labrador Sea beginning in the early 2000s. Tracking particles further upstream reveals that the primary source of the increased volume of lighter water transported out of the Labrador Sea is increased recirculation of water, and therefore longer residence times, in the upper 500–1000 m of the subpolar gyre