bluuebunny/crossref_metadata_2025 huggingface dataset:
Unquenched Flavor in the Gauge/Gravity Correspondence
Authors: Núñez Carlos , Paredes Ángel , Ramallo Alfonso V.
Published: August 2010

Within the AdS/CFT correspondence, we review the studies of field theories with a large number of adjoint and fundamental fields, in the Veneziano limit. We concentrate in set‐ups where the fundamentals are introduced by a smeared set of D‐branes. We make emphasis on the general ideas and then in subsequent chapters that can be read independently and describe particular considerations in various different models. Some new material is presented along the various sections.
Results of Short‐Period Helicopter System Identification Using Output‐Error and Hybrid Search‐Gradient Optimization Algorithm
Authors: Cruz Ronaldo Vieira , Sandoval Góes Luiz Carlos
Published: August 2010

This article focuses on the problem of parameter estimation of the uncoupled, linear, short‐period aerodynamic derivatives of a “Twin Squirrel” helicopter in level flight and constant speed. A flight test campaign is described with respect to maneuver specification, flight test instrumentation, and experimental data collection used to estimate the aerodynamic derivatives. The identification problem is solved in the time domain using the output‐error approach, with a combination of Genetic Algorithm (GA) and Levenberg‐Marquardt optimization algorithms. The advantages of this hybrid GA and gradient‐search methodology in helicopter system identification are discussed.
Endoscopic Treatment of Vesicoureteral Reflux in Children with Dextranomer/Hyaluronic Acid—A Single Surgeon's 6-Year Experience
Authors: Chen Hou-Chuan , Yeh Chou-Ming , Chou Chia-Man
Published: August 2010

Endoscopic treatment for vesicoureteral reflux (VUR) has become an established alternative to long-term antibiotic prophylaxis and ureteral reimplantation. We present the outcome of endoscopic treatment with dextranomer/hyaluronic acid copolymer (Deflux) for VUR in children by a single surgeon at our institute from October 2003 to October 2009. We reviewed the cases of 150 patients (total 239 ureters), 56 girls (37%) and 94 boys (63%), with a mean age of 2.2 years and a median followup of 2.5 years (range 3–68 months). Among the 239 ureters treated, 67.4% (161/239) were cured with a single injection, and a second and third injection raised the cure rate to 86.6% (207/239) and 88.3% (211/239), respectively. None had postoperative ureteral obstruction.
Cavitated Conglomerate Mass in Silicosis Indicating Associated Tuberculosis
Authors: Martins Pedro , Marchiori Edson , Zanetti Gláucia , Muccillo Antonio , Ventura Nina , Brandão Viviane , Pereira Mariana Leite , Constantino Carolina Pesce Lamas , Abdalla Guilherme , Varella de Oliveira Romulo , Canellas Rodrigo
Published: August 2010

Silicosis is the most common occupational lung disease worldwide. It leads to respiratory impairment and may have associated infections that decrease pulmonary function. We describe the case of a 55-year-old man with chronic silicosis who presented with hemoptysis and a cavitated conglomerate mass. The final diagnosis was silicotuberculosis.
Property "Equation missing" in "Equation missing" -Metric Spaces
Authors: Chugh Renu , Kadian Tamanna , Rani Anju , Rhoades BE
Published: August 2010

We prove two general fixed theorems for maps in "Equation missing"-metric spaces and then show that these maps satisfy property "Equation missing".
Fabrication and Electrical Characterization of Multiwalled Carbon Nanotube-Based Circuit at Room Temperature
Authors: Peng Yitian , Hu Yuanzhong , Lu Weibing
Published: August 2010

Multiwalled carbon nanotube (MWCNT) deposited on a pair of predetermined aluminum electrodes treated with the (3-Aminopropyl)-triethoxysilane (APTES) self-assembled monolayers (SAMs). The MWCNT bridges electrodes and forms electrode/MWCNT/electrode circuit on silicon with 500 nm silicon dioxide. Then the Metal (Ti/Au) pads were fabricated on MWCNT to bury the MWCNT into metal electrodes. The electrical properties of MWCNT-based circuits before and after the fabrication of metal pads were characterized. Results indicate that metal pads on MWCNT improved the electrical properties MWCNT-based circuit largely.
Preparation of Nanoporous Polymer Films for Real-Time Viability Monitoring of Cells
Authors: Chou Chia-Man , Wei Tong-You Wade , Chen Jou-May Maureen , Chang Wei-Ting , Yu Chang-Tze Ricky , Hsiao Vincent K. S.
Published: August 2010

We have demonstrated an alternative way to monitor the viability of cells adhered on a nanoporous polymer film in real time. The nanoporous polymer films were prepared by laser interference pattering. During exposure of holographic patterning, the dissolved solvents were phase separated with photocured polymer and the nanopores were created as the solvents evaporated. The diffracted spectra from the nanoporous polymer film responded to each activity of the cell cycle, from initial cell seeding, through growth, and eventual cell death. This cell-based biosensor uses a nanoporous polymer film to noninvasively monitor cell viability and may prove useful for biotechnological applications.
Coactivated Platelet-Derived Growth Factor Receptor α and Epidermal Growth Factor Receptor Are Potential Therapeutic Targets in Intimal Sarcoma
Authors: Dewaele Barbara , Floris Giuseppe , Finalet-Ferreiro Julio , Fletcher Christopher D. , Coindre Jean-Michel , Guillou Louis , Hogendoorn Pancras C.W. , Wozniak Agnieszka , Vanspauwen Vanessa , Schöffski Patrick , Marynen Peter , Vandenberghe Peter , Sciot Raf , Debiec-Rychter Maria
Published: August 2010

Intimal sarcoma (IS) is a rare, malignant, and aggressive tumor that shows a relentless course with a concomitant low survival rate and for which no effective treatment is available. In this study, 21 cases of large arterial blood vessel IS were analyzed by immunohistochemistry and fluorescence in situ hybridization and selectively by karyotyping, array comparative genomic hybridization, sequencing, phospho-kinase antibody arrays, and Western immunoblotting in search for novel diagnostic markers and potential molecular therapeutic targets. Ex vivo immunoassays were applied to test the sensitivity of IS primary tumor cells to the receptor tyrosine kinase (RTK) inhibitors imatinib and dasatinib. We showed that amplification of platelet-derived growth factor receptor α (PDGFRA) is a common finding in IS, which should be considered as a molecular hallmark of this entity. This amplification is consistently associated with PDGFRA activation. Furthermore, the tumors reveal persistent activation of the epidermal growth factor receptor (EGFR), concurrent to PDGFRA activation. Activated PDGFRA and EGFR frequently coexist with amplification and overexpression of the MDM2 oncogene. Ex vivo immunoassays on primary IS cells from one case showed the potency of dasatinib to inhibit PDGFRA and downstream signaling pathways. Our findings provide a rationale for investigating therapies that target PDGFRA, EGFR, or MDM2 in IS. Given the clonal heterogeneity of this tumor type and the potential cross-talk between the PDGFRA and EGFR signaling pathways, targeting multiple RTKs and aberrant downstream effectors might be required to improve the therapeutic outcome for patients with this disease. Cancer Res; 70(18); 7304–14. ©2010 AACR.
Neuropsychiatric Symptoms Underlying Caregiver Stress and Insight in Alzheimer’s Disease
Authors: Rocca Paola , Leotta Daniela , Liffredo Cesare , Mingrone Cinzia , Sigaudo Monica , Capellero Barbara , Rocca Giuseppe , Simoncini Mara , Pirfo Elvezio , Bogetto Filippo
Published: August 2010

Objective: Cluster analysis based on Alzheimer’s disease (AD) neuropsychiatric profile demonstrated validity on caregiver burden, nursing-home placement and survival. The aims of our study were to explore the validity of this approach on caregiver burden, lack of insight and cognitive impairment and to examine the impact of neuropsychiatric profiles on these variables. Method: A data-driven approach (two-step cluster analysis) identified groups of patients based on similarities of their neuropsychiatric symptom profile, as assessed by the Neuropsychiatric Inventory (NPI). ANOVAs and χ2 tests were used to compare groups with regard to continuous and categorical variables. Linear regressions tested the relationships between NPI and clinical variables. Results: Psychotic/behavioral, depressive and minimally symptomatic clusters differed for caregiver burden and lack of insight. Patients in the minimally symptomatic cluster showed better insight than those in the depressive cluster. Caregivers of the psychotic/behavioral cluster experienced the highest burden. We found positive relationships between NPI and lack of insight in the depressive and minimally symptomatic clusters and between NPI and caregiver burden in all three clusters. Caregiver burden was influenced by the type of symptoms. Conclusions: The cluster analysis was valid for lack of insight and caregiver burden. Symptoms predominant on caregiver burden could become targets for therapy.
Effects of Adenosine A2A and A2B Receptor Activation on Signaling Pathways and Cytokine Production in Human Uroepithelial Cells
Authors: Säve Susanne , Persson Katarina
Published: August 2010

Aims: Adenosine A2A and A2B receptor subtypes have both been implicated in the modulation of inflammation. We examined adenosine A2A and A2B receptor expression, signaling pathways and the effect of adenosine A2A and A2B receptor activation on the uropathogenic Escherichia coli (UPEC)-stimulated IL-8 response in human uroepithelial cells (UROtsa). Methods: Receptor expression was examined by RT-PCR and Western blot, and IL-8 production, intracellular cAMP levels and phosphoproteins were measured by ELISA, EIA and multiplex immunoassay, respectively. Results: The adenosine A1, A2A and A2B receptor subtypes were detected in UROtsa cells. The adenosine A2A receptor agonist CGS 21680 did not stimulate cAMP production but CREB phosphorylation was slightly increased. The adenosine A2 receptor agonist CPCA induced a pronounced cAMP and CREB response. Furthermore, CGS 21680 but not CPCA decreased ERK 1/2 and STAT3 phosphorylation. UPEC infection stimulated the host IL-8 production but CPCA or CGS 21680 did not affect UPEC-evoked IL-8 production. Conclusions: Our data identified differences in signaling pathways evoked by adenosine A2A and A2B receptor activation. Activation of the adenosine A2A receptor inhibited STAT3 and ERK 1/2 phosphorylation, while the cAMP-CREB pathway was induced by adenosine A2B receptor activation. No anti- or proinflammatory effects were found for uroepithelial adenosine A2A or A2B receptors.
Absolute Quantification in Proton Magnetic Resonance Spectroscopy Is Useful to Differentiate Amnesic Mild Cognitive Impairment from Alzheimer’s Disease and Healthy Aging
Authors: Watanabe Toshiyuki , Shiino Akihiko , Akiguchi Ichiro
Published: August 2010

Background/Aims: Amnesic mild cognitive impairment (aMCI) is thought to represent a transitional state between healthy aging and very mild Alzheimer’s disease (AD). It is very important to diagnose aMCI for early treatment. In order to investigate biochemical changes in aMCI, we measured metabolite concentrations using proton magnetic resonance spectroscopy (1H-MRS) from patients with aMCI and compared the results with healthy controls (HCs) and patients with AD. Methods: The subjects were 52 HCs, 70 AD patients and 47 aMCI patients. 1H-MR spectra with single-voxel point-resolved spectroscopy at a short echo time (TE) were acquired from 8 volumes of interest in the brain. Results: The bilateral hippocampal N-acetylaspartate (NAA) concentrations from aMCI patients showed intermediate values, which were lower than those from HC subjects but higher than those from AD patients. The patients with aMCI also had lower concentrations of NAA than HCs in the bilateral posterior periventricular and deep white matters (PDWM) and posterior cingulate gyrus and had lower levels of choline compounds in the left posterior PDWM. Conclusion: Using a single-voxel 1H-MRS at a short TE, we revealed that absolute quantification is useful to detect the characteristic patterns of metabolite concentrations in patients with aMCI as compared with AD patients and HCs.
Implications of the International Classification of Functioning, Disability and Health (ICF) for Test Development and Use
Authors: Carlson Janet F. , Benson Nicholas , Oakland Thomas
Published: August 2010

Implications of the International Classification of Functioning, Disability and Health (ICF) on the development and use of tests in school settings are enumerated. We predict increased demand for behavioural assessments that consider a person’s activities, participation and person-environment interactions, including measures that: (a) address contextual features; (b) rely on third-party respondents; (c) depend on observational approaches; (d) comprise batteries of tests developed simultaneously or co-normed and (e) emphasize process and progress monitoring. We review some tests from the United States that respond to each emerging demand and describe the international implications of these demands. We close by describing the implications of the ICF model and its associated changes in testing practices for service delivery and student outcomes.
Temperament Styles of Greek and US Children
Authors: Oakland Thomas , Hatzichristou Chryse
Published: August 2010

Age, gender and cross-national differences of children ages 8 through 16 in Greece ( n = 400) and the United States ( n = 5,400) are examined on four temperament styles: extroversion-introversion, practical-imaginative, thinking-feeling and organized-flexible styles. In general, Greek children prefer extroverted to introverted styles and organized to flexible styles. Their preferences for practical-imaginative and thinking-feeling styles are more balanced. Gender differences are found on thinking-feeling and organized-flexible styles. Age differences are found on practical-imaginative and organized-flexible styles. In contrast to children in the US, those in Greece are more likely to favour extroverted and practical styles. Gender differences appear with both national samples: girls are more likely to favour a feeling style and boys to favour a thinking style.
Psychometric Properties of Three Instruments to Measure Fatigue With Myocardial Infarction
Authors: Fink Anne M. , Eckhardt Ann L. , Fennessy Michelle M. , Jones Jessica , Kruse Donna , VanderZwan Kathryn J. , Ryan Catherine J. , Zerwic Julie J.
Published: August 2010

The purpose of this study was to evaluate the psychometric properties of three questionnaires to measure fatigue with myocardial infarction. The Fatigue Symptom Inventory Interference Scale, Profile of Moods States Fatigue subscale (POMS-F), and Short Form 36 (SF-36) Vitality Scale were completed during hospitalization ( n = 116) and 30 days after hospital admission ( n = 49). Moderate to strong correlations were found among each of these fatigue scales and between each fatigue scale and measures of other variables to include vigor, depressed mood, anxiety, and physical functioning. POMS-F scores decreased significantly at Time 2, but this decline in fatigue was not validated on the other fatigue scales. Patients’ Time 1 scores reflected significantly more fatigue compared to published scores for healthy adults. The ability to discriminate between groups suggests that the instruments may be useful for identifying patients with cardiovascular risk factors who report clinically significant fatigue.
Impact of enhanced secondary prevention on health behaviour in patients following minor stroke and transient ischaemic attack: a randomized controlled trial
Authors: Gillham Sarah , Endacott Ruth
Published: August 2010

Objective: To evaluate whether enhanced secondary prevention more significantly influences readiness to change health behaviour after minor stroke/transient ischaemic attack, compared with conventional stroke secondary prevention.

Design: Single-blind randomized control trial.

Setting: Rural district general hospital outpatient clinic.

Subjects: Fifteen women and 37 men with a mean age of 68.3 years with first minor stroke or transient ischaemic attack.

Interventions: The intervention group received ‘enhanced secondary prevention’ (additional advice, motivational interviewing and telephone support) to change health behaviour. Both groups received ‘conventional care’ which included advice given during routine care.

Main measures: The primary outcome was ‘readiness to change behaviour’ measured using a validated stroke specific score based on the transtheoretical model. Secondary outcomes were the Hospital Anxiety and Depression Scale, and self-reported alcohol consumption, smoking behaviour, exercise frequency, and fruit and vegetable consumption.

Results: Analysis of the data for the 52 participants showed no statistical difference in the groups for the primary outcome of readiness to change behaviour. Statistically significant improvements for change in self-reported exercise were demonstrated (P = 0.007); to 2—3 times per week in the intervention group compared to 0—1 times per week in the control group, and in fruit and vegetable consumption (P = 0.033); to 10 portions of fruit and vegetables consumed per week in the intervention group compared to 1 or 2 portions a week for the control group. No evidence of a difference between groups was seen for alcohol consumption or Hospital Anxiety and Depression Scale.

Conclusions: While no difference was demonstrated between the groups for readiness to change behaviour, a clinically significant effect in reported exercise behaviour and diet were demonstrated in the intervention group. This interesting finding indicates a dissonance between the behaviour scale and actual behaviour change, potentially indicating a lack of sensitivity of the scale to detect a change in this patient group.
Psychosocial adjustment in children and adolescents with a parent with multiple sclerosis: a systematic review
Authors: Bogosian Angeliki , Moss-Morris Rona , Hadwin Julie
Published: August 2010

Objective: This systematic review explored the potential impact of parental multiple sclerosis on their offspring. It considered adjustment to parental multiple sclerosis at different developmental stages and the factors associated with good versus poor adjustment.

Data sources: MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science were searched for studies on children with a parent with multiple sclerosis. Inclusion and exclusion criteria were formulated. Hand-searching journals and reference lists, contacting authors and multiple sclerosis societies for additional unpublished papers complemented the searches.

Review methods: Twenty studies that satisfied the inclusion criteria were included. The research articles were ranked according to a quality assessment checklist and were categorized as good, medium or poor quality.

Results: The review found good evidence to suggest that parental multiple sclerosis has a negative impact on children’s social and family relationships and their psychological well-being. The review also identified potential factors associated with poor adjustment. These factors included parental negative emotions, increased illness severity, family dysfunction, children’s lack of knowledge about the illness and lack of social support. Adolescent children also seemed to be more at risk for psychosocial problems than school-age children.

Conclusions: There is good evidence that parental multiple sclerosis has a negative psychosocial impact on children, especially on adolescents.
Active, passive and proprioceptive neuromuscular facilitation stretching are comparable in improving the knee flexion range in people with total knee replacement: a randomized controlled trial
Authors: Chow Tiffany PY , Ng Gabriel YF
Published: August 2010

Objective: To compare the immediate and medium-term effects of three stretching methods on the knee flexion range in people with a total knee replacement.

Design: Randomized clinical trial.

Setting: Rehabilitation hospital.

Subjects: 117 patients were recruited and 100 (mean age: 68.43 ± 7.95 years) of them completed the study.

Interventions: Patients receiving total knee replacement due to knee osteoarthritis were randomly assigned into 3 groups of: active stretching (group 1, n =32), passive stretching (group 2, n =35) and proprioceptive neuromuscular facilitation stretching (group 3, n =33).

Main measures: The immediate change in both active and passive knee flexion range after the first treatment session and the pattern of change in these ranges throughout the 2-week study period were compared among the three groups.

Results: All groups demonstrated significant improvement in knee ranges with time. The active range of group 1 improved by 19.9°, group 2 by 25.3° and group 3 by 22.5° throughout the 2-week period, whereas the improvements in the passive range were 18.8°, 24.5° and 22.7°, respectively. For between-group comparisons, no significant difference was found in both active (P = 0.647) and passive (P = 0.501) knee range immediately after stretching. For the changes at 2 weeks, there was also no significant difference among the groups in both active (P = 0.716) and passive (P = 0.959) knee ranges.

Conclusion: This study revealed that all three modes of stretching were associated with an increase in the knee flexion range of patients after total knee replacement, with no statistically significant differences between the changes seen.
Children with cerebral palsy: a systematic review and meta-analysis on gait and electrical stimulation
Authors: Cauraugh James H , Naik Sagar K , Wen Hao Hsu  , Coombes Stephen A , Holt Kenneth G
Published: August 2010

Objective: To conduct a systematic review and meta-analysis using the International Classification of Functioning to determine the summary effect of electrical stimulation on impairment and activity limitations relevant to gait problems of children with cerebral palsy.

Methods: We identified 40 cerebral palsy and electrical stimulation studies, and 17 gait studies qualified for inclusion. Applying enablement classification methods to walking abnormalities created two subgroups: impairment (N = 14) and activity limitations (N = 15). Overall, 238 participants experienced electrical stimulation treatments and 224 served as a no stimulation control group. Calculations followed conventional data extraction and meta-analysis techniques: (a) individual standardized mean differences, (b) summary effect size, (c) I 2heterogeneity test, (d) fail-safe N analysis and (e) moderator variable analyses.

Results: Common outcome measures associated with impairment (n = 3) and activity limitations (n = 6) were submitted to separate random effects models meta-analyses, and revealed significant cumulative effect sizes: (a) impairment = 0.616 (SE = 0.10) and (b) activity limitations = 0.635 (SE = 0.14). I 2indicated low and medium amounts of dispersion, whereas fail-safe analyses revealed high N-values for both disablement categories. Moderator variable analyses further confirmed the positive treatment effects from both functional and neuromuscular stimulation.

Conclusions: The present systematic review and meta-analyses determined medium effect sizes for electrical stimulation on walking impairment and activity limitations of children with cerebral palsy.
Commentary: Mouse Genetic Nomenclature
Authors: Sundberg J. P. , Schofield P. N.
Published: August 2010

The use of standard nomenclatures for describing the strains, genes, and proteins of species is vital for the interpretation, archiving, analysis, and recovery of experimental data on the laboratory mouse. At a time when sharing of data and meta-analysis of experimental results is becoming a dominant mode of scientific investigation, failure to respect formal nomenclatures can cause confusion and errors and, in some cases, contribute to poor science. Here, the authors present the basic nomenclature rules for laboratory mice and explain how these rules should be applied to complex genetic manipulations and crosses.
Mannheimia haemolytica
Authors: Singh K. , Ritchey J. W. , Confer A. W.
Published: August 2010

Mannheimia haemolytica serotype S1 is considered the predominant cause of bovine pneumonic pasteurellosis, or shipping fever. Various virulence factors allow M haemolytica to colonize the lungs and establish infection. These virulence factors include leukotoxin (LKT), lipopolysaccharide, adhesins, capsule, outer membrane proteins, and various proteases. The effects of LKT are species specific for ruminants, which stem from its unique interaction with the bovine β2 integrin receptor present on leukocytes. At low concentration, LKT can activate bovine leukocytes to undergo respiratory burst and degranulation and stimulate cytokine release from macrophages and histamine release from mast cells. At higher concentration, LKT induces formation of transmembrane pores and subsequent oncotic cell necrosis. The interaction of LKT with leukocytes is followed by activation of these leukocytes to undergo oxidative burst and release proinflammatory cytokines such as interleukins 1, 6, and 8 and tumor necrosis factor α. Tumor necrosis factor α and other proinflammatory cytokines contribute to the accumulation of leukocytes in the lung. Formation of transmembrane pores and subsequent cytolysis of activated leukocytes possibly cause leakage of products of respiratory burst and other inflammatory mediators into the surrounding pulmonary parenchyma and so give rise to fibrinous and necrotizing lobar pneumonia. The effects of LKT are enhanced by lipopolysaccharide, which is associated with the release of proinflammatory cytokines from the leukocytes, activation of complement and coagulation cascade, and cell cytolysis. Similarly, adhesins, capsule, outer membrane proteins, and proteases assist in pulmonary colonization, evasion of immune response, and establishment of the infection. This review focuses on the roles of these virulence factors in the pathogenesis of shipping fever.
Fixing families of mobile children: Recreating kinship and belonging among Maasai adoptees in Kenya
Authors: Archambault Caroline
Published: August 2010

Among the Maasai of southern Kenya, child circulation in the form of adoption is widespread. It persists despite increased family nuclearization and pervasive sedentarizing discourses depicting ‘modern’ family life as small, settled and nuclear. Through the perspectives and experiences of 10 families having undergone adoption, this article examines the processes by which parents and children attempt to recreate kinship and foster belonging. Emphasis on children’s sentiments and actions not only demonstrate children’s active role in the making and unmaking of kinship but also their resistance to development ideals of family and residential fixity.
Symbols of success: Youth, peer pressure and the role of adulthood among juvenile male return migrants in Ghana
Authors: Ungruhe Christian
Published: August 2010

Independent youth migration is socially embedded in many African societies. While it is often exclusively perceived of as a process of intergenerational negotiation which leads to higher social positions after returning home, this article points out that peer influences play a major role in the process of decision-making of leaving and returning among young northern Ghanaian males. Juvenile migrants make little effort to generate means to enter into adulthood but struggle to return with modern goods. Rather than being a means of achieving adulthood, enjoying youth and gaining recognition among friends are the prevailing motives for going and returning.
Clinical and immunoserological characteristics of the transition from primary to overlap antiphospholipid syndrome
Authors: Veres K. , Szodoray P. , Szekanecz Z. , Lakos G. , Kiss E. , Laczik R. , Sipka S. , Bodolay E. , Zeher M. , Muszbek L. , Szegedi G. , Soltész P.
Published: August 2010

Antiphospholipid syndrome (APS) is a distinct clinical entity characterized by arterial and venous thromboembolic events, recurrent fetal loss and the presence of antiphospholipid antibodies in the patients’ sera. In primary APS, there is no detectable underlying disease, while overlap APS is associated with clinical syndromes including systemic autoimmune diseases, infections, or malignancies. We carried out a retrospective analysis of serological and clinical manifestations as well as assessed outcome-measures in 165 patients with primary APS. Thrombotic manifestations and possible signs of autoimmune diseases were determined at the time of the diagnosis, followed by the analysis of recurrent thrombotic events and effects of therapy during the follow-up period. Among the 165 patients with primary APS at onset, 105 patients (63%) remained primary APS after a mean 5.2 years of follow-up. In 14% of the patients, subsequently APS became associated with various characteristics of undifferentiated connective tissue disease. Finally 23% of patients evolved into a definitive systemic autoimmune disease during a mean 9.75 years of follow-up. Recurrent thrombotic events were registered in 24% of patients. Our results suggest that primary APS may be considered as a potential early phase of a dynamic transition towards a well-defined systemic autoimmune disease.
Democratization and the Middle Class in China
Authors: Chen Jie , Lu Chunlong
Published: August 2010

Do the middle classes in authoritarian, late-developing countries support democratization? Among scholars, there seems no clear consensus on this question. To fill this gap, this article examines the case of the middle class in China, based on data collected from a probability-sample survey. The findings from this study indicate (1) the middle class does not necessarily support democratization in authoritarian developing countries, (2) there is a negative correlation between the middle class’s dependence on the state and its support for democracy, and (3) the middle class’s perceived social and economic well-being is also negatively associated with its democratic support.
Political Theory as Profession and as Subfield?
Authors: Kaufman-Osborn Timothy V.
Published: August 2010

How does the enterprise of political theory create and sustain the borders that account for its appearance as a distinguishable profession? In this article, the author considers and criticizes a recent effort to defend political theory’s right to exist in the form of one of several subfields constitutive of the academic discipline of professional political science in the United States. The author closes by suggesting that theorists might be better positioned to think critically about politics, and the politics of liberalism more particularly, if this self-representation were to be unsettled and possibly jettisoned altogether.
Scoring Subjectivity and Item Performance on Measures Used to Assess Violence Risk
Authors: Rufino Katrina A. , Boccaccini Marcus T. , Guy Laura S.
Published: August 2010

Although reliability is essential to validity, most research on violence risk assessment tools has paid little attention to strategies for improving rater agreement. The authors evaluated the degree to which perceived subjectivity in scoring guidelines for items from two measures—the Psychopathy Checklist–Revised (PCL-R) and the Historical, Clinical, Risk Management-20 (HCR-20)—were related to indices of interrater agreement reported in the research literature. Nine doctoral students with experience scoring the PCL-R and HCR-20 showed a high level of agreement with respect to the amount of subjectivity required to score items. Decreased subjectivity was associated with increased rater agreement for both tools. For the PCL-R, items on aggregate measures that have the strongest effects in predictive validity research (i.e., Factor 2, Facet 4) were rated as the least subjective. For the HCR-20, items on the Historical scale were rated as the least subjective. Implications for measure development and refinement are discussed.
Multiple sclerosis-associated retrovirus and progressive disability of multiple sclerosis
Authors: Sotgiu S. , Mameli G. , Serra C. , Zarbo IR , Arru G. , Dolei A.
Published: August 2010

Retrovirus-like particles containing the multiple sclerosis-associated retrovirus RNA, significantly found in the cerebrospinal fluid of patients with multiple sclerosis, have been preliminarily associated with a short-term poor clinical and radiological prognosis of the disease. We asked whether these prognostic indications are still measurable after a long-term clinical evaluation (10 years). Our 10-year blind observational study confirms that the presence of multiple sclerosis-associated retrovirus in the cerebrospinal fluid of early multiple sclerosis patients is associated with a significantly greater rate of relapse-unrelated unremitting disability and secondary progression of the disease.
Challenges in screening for depression in multiple sclerosis
Authors: Patten Scott B , Berzins Sandy , Metz Luanne M
Published: August 2010

Background: Screening has frequently been proposed as a strategy for detection of depression in multiple sclerosis (MS). In a recent study, we found a minimal impact of screening, even when this was coupled with rapidly responsive and evidence-based depression care.

Methods: In order to explore the challenges involved in screening we analyzed prospective data from the Canadian Impact of MS (CIMS) database, which provides annual ratings on a self-report depression rating scale, the Center for Epidemiologic Studies Depression Rating Scale (CES-D).

Results: Approximately 30% of respondents screened positive at each visit. CES-D ratings correlated fairly strongly from year to year, Pearson’s r ranged from 0.65 to 0.73. Approximately 10% of those below the CES-D cut-point at each assessment exceeded the cut-point when rated 1 year later, but only about half of these cases had large (≥10 points) increases in their scores.

Conclusions: Screening interventions are generally oriented towards early detection, whereas the longitudinal pattern of depressive symptoms in MS appears to be characterized more prominently by a persistent burden of depressive symptoms in a substantial proportion of the population. Resources invested in screening efforts can probably be more effectively deployed in other areas, such as improved long-term clinical management.
T2 hypointense rims and ring-enhancing lesions in MS
Authors: Llufriu Sara , Pujol Teresa , Blanco Yolanda , Hankiewicz Karolina , Squarcia Mattia , Berenguer Joan , Villoslada Pablo , Graus Francesc , Saiz Albert
Published: August 2010

Background: Hypointense rims peripherally on T2-weighted MRI (rim lesions) have been associated with gadolinium ring-enhancing lesions in multiple sclerosis (MS) in pathological studies. However, little is known about their frequency, we analyzed clinical significance in a cohort of MS sufferers according to routine clinical practice.

Methods: We retrospectively reviewed all available MRI scans performed on our MS patients between 2000 and 2009. A total of 580 MRI scans from 257 patients were analyzed. The presence of rim lesions and ring enhancement was assessed and counted blind. Furthermore, the correlation between both patterns, and with clinical characteristics, was evaluated.

Results: Thirty-five rim lesions were identified and 9% (24/257) of the patients showed at least one of these lesions. Forty ring-enhancing lesions were counted and 12% (29/245) of the patients who had undergone gadolinium MRI presented at least one such lesion. Thirteen lesions co-localized both patterns (40% of the rim lesions and 33% of the ring-enhancing lesions). Rim lesions and ring-enhancing lesions were observed in patients with clinically isolated syndrome (7%, 7%), relapsing—remitting (11%, 15%) and secondary progressive (13%, 9%) but none with primary progressive MS. Presence of ring-enhancing lesions was significantly associated with a shorter time to reach EDSS (Expanded Disability Status Scale) 4.0 and 6.0 (hazard ratio 7.6, 95% confidence interval 2.3—24.6).

Conclusions: Rim lesions and ring-enhancing lesions are present in close to 10% of patients with MS, and frequently both lesions appear independently one to the other. The association of ring enhancement with worst prognosis needs to be confirmed in prospective studies.
Dental Restorations for Dinka and Nuer Refugees: A Confluence of Culture and Healing
Authors: Fox Steven H. , Willis Mary S.
Published: August 2010

The Harvard Trauma Questionnaire, Hopkins Symptom Checklist-25, and the Self-reporting Questionnaire-24 were used to evaluate distress among 22 Dinka and Nuer refugees to the US before and after complete restoration of four to six lower front teeth that had been extracted during childhood in Sudan. Participants reported significant improvement in levels of distress following full restoration of missing teeth, including symptoms of PTSD. These results illustrate the value of incorporating community perspectives into the selection of health treatment options for newly arriving populations. But they also emphasize the unique situation faced by each refugee population as they embark on a wholly new cultural learning process.
TRAQ-D (Trinidad Risk Assessment Questionnaire for Type 2 Diabetes Mellitus): a cheap, reliable, non-invasive screening tool for diabetes
Authors: Latchan Zaafir , Seereeram Ragiv , Kamalodeen Aleema , Sanchez Sharlene , Deonarine Usha , Sinanan Ravi , Mungrue Kameel
Published: August 2010

The objective of this study was to design a reliable, valid and culturally appropriate risk questionnaire and determine its effectiveness as a tool for the early detection of type 2 diabetes mellitus in Trinidad. Initially, a questionnaire with 21 close-ended questions on known risk factors for diabetes was administered to 456 patients, and a series of logistic regressions extracted the most significant factors (p<0.05). These factors were scored using their odds ratio and a tool/questionnaire was created and administered to 232 patients. The scoring system was revised following logistic regressions using combined data from both phases and a cut-off score determined with suitable specificity/sensitivity ratios. Trinidad Risk Assessment Questionnaire for Diabetes (TRAQ-D) was compared to body mass index (BMI) and age independently, using receiver operating characteristic (ROC) curves. TRAQ-D, includes seven factors: age, sex, BMI, family history of diabetes, ethnicity, smoking and waist circumference. A score ≥ 17 was used to recommend further testing (specificity: 90.7%, sensitivity: 61.4%). Compared with BMI and age, the area under the ROC curve for TRAQ-D was significantly higher (0.884). TRAQ-D is the only currently available non-invasive screening tool for type 2 diabetes that has been created and tested in the Trinidad population. It is reliable, inexpensive and a useful indicator of the need for any further screening tests.
Philosophy, casuistry, and moral development
Authors: Fullinwider Robert K.
Published: August 2010

Moral educators have little to learn from the moral theories in which philosophers routinely trade. These theories — including those by Slote, Hume, and Kant — leave behind the concrete world in which the moral educator labors. As interesting as they may be, they merely devise alternative routes to the same destination — to the main general features of morality as we know it. It is not so much these general features but the particular forms of moral life under which children and their tutors live that give specificity to duties and rights, content to virtues, and shape to purpose. To navigate successfully through this stuff of moral life, the developing youth needs not only a good heart but a casuistical temper.
Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation
Authors: Janssen Daisy JA , Spruit Martijn A , Leue Carsten , Gijsen Candy , Hameleers Henry , Schols Jos MGA , Wouters Emiel FM ,   On behalf of the Ciro network
Published: August 2010

Chronic obstructive pulmonary disease (COPD) patients may suffer from symptoms of anxiety and depression. Whether and to what extent symptoms of anxiety and depression may be present in COPD patients entering pulmonary rehabilitation and which patient characteristics are associated with psychological distress remains currently unknown. The objective of the present study is to determine the prevalence and the determinants of clinically relevant symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Symptoms of anxiety and depression have been assessed in 701 COPD patients entering pulmonary rehabilitation using the Hospital Anxiety and Depression Scale. Additionally, disease-specific health status, pulmonary function, body composition, exercise capacity, co-existing morbidities, smoking status, symptoms, long-term oxygen therapy and the use of antidepressant and anxiolytic drugs have been recorded. Patients had mean anxiety scores of 7.6 points and mean depression scores of 7.2 points. Anxiety scores ≥10 points were present in 225 patients (32%) and depression scores ≥10 points were present in 192 patients (27%). Patients at risk of having symptoms of anxiety were female or used antidepressant or anxiolytic drugs. Patients at risk of having symptoms of depression experienced dyspnea, had a body mass index (BMI) <21 kg/m2 or used antidepressant or anxiolytic drugs. A considerable proportion of the COPD patients entering pulmonary rehabilitation report symptoms of anxiety and/or depression, which may significantly impair disease-specific health status. Patients at risk of having symptoms of anxiety and/or depression are female, experience dyspnea, have a low BMI or use antidepressant and/or anxiolytic drugs.
Effectiveness of a group opt-in session on uptake and graduation rates for pulmonary rehabilitation
Authors: Graves J. , Sandrey V. , Graves T. , Smith DL
Published: August 2010

Pulmonary rehabilitation (PR) is an effective intervention in the treatment of patients with chronic obstructive pulmonary disease (COPD). Unfortunately some patients offered this treatment either fail to take up the offer or fail to complete the course. Studies have indicated a number of factors influencing uptake and completion rates. We describe the introduction of an intervention, the group opt-in session (GOIS), prior to individualised baseline assessment and entry to the PR course, with the intention being to improve uptake and completion rates. A 1.5-hour-long GOIS was offered as the first face-to-face contact to all patients referred for PR. Drop-out rates at all stages of the pathway from referral to graduation were collected on 200 patients prior to the introduction of the GOIS (non-GOIS group) and compared to the first 400 patients following introduction (the GOIS group). Possible independent predictors of course uptake and completion were examined in the GOIS group. The proportion of referred patients taking up the offer of individualised baseline assessment or a GOIS was similar (75% vs. 72.2%, p value not significant [ns]). However, since in the GOIS group the opt-in session preceded the individualised baseline assessment and some patients opted-out, a smaller proportion of referred patients underwent this assessment than in the non-GOIS group (58.7% vs. 75%, p < 0.001). In addition, dropouts following individualised baseline assessments were also reduced (7% vs. 22%, p < 0.001). Both of these factors reduced ‘wasted’ assessments. Similar proportions of patients referred began the PR course in both groups (53% vs. 51.7%, ns), but a higher proportion of patients graduated in the GOIS group (87.9% vs. 76.4%, p < 0.05). Drop-out rates due to illness were similar in both groups (8.5% pre vs. 6.8% post, ns). However, drop-out rates not due to illness were much higher in the non-GOIS group (15.1% vs. 5.3%, p < 0.001). In the GOIS group, patients who did not attend the GOIS were, on average, younger (64.6 years vs. 69.7 years, p < 0.001) and had a higher mean percent predicted Forced Expiratory Volume (50.6% vs. 43.8%, p < 0.05) than those that did attend. A greater proportion of patients who opted in to the GOIS and attended the PR course lived less than 25 minutes from the PR centre than either those who did not attend the GOIS or who attended and then opted out (77.4% vs. 63%, p<0.005). The GOIS improved the graduation rates at The North Bristol Lung Centre PR Course and reduced wasted assessments. There was no effect on initial uptake. Analysis of the behaviour of patients invited to a GOIS suggested that age, lung function and travel distance were important factors influencing patient choice.
A threshold sample-enrichment approach in a clinical trial with heterogeneous subpopulations
Authors: Aiyi Liu  , Chunling Liu  , Qizhai Li  , Yu Kai F , Yuan Vivian W
Published: August 2010

Background Large comparative clinical trials usually target a wide-range of patients population in which subgroups exist according to certain patients’ characteristics. Often, scientific knowledge or existing empirical data support the assumption that patients’ improvement is larger among certain subgroups than others. Such information can be used to design a more cost-effective clinical trial.

Purpose The goal of the article is to use such information to design a more cost-effective clinical trial.

Methods A two-stage sample-enrichment design strategy is proposed that begins with enrollment from certain subgroup of patients and allows the trial to be terminated for futility in that subgroup.

Results Simulation studies show that the two-stage sample-enrichment strategy is cost-effective if indeed the null hypothesis of no treatment improvement is true, as also so illustrated with data from a completed trial of calcium to prevent preeclampsia.

Limitations Feasibility of the proposed enrichment design relies on the knowledge prior to the start of the trial that certain patients can benefit more than others from the treatment. Prolonged accrual and longer-waited outcomes may hinder utilization of the proposed design.

Conclusions The two-stage sample-enrichment approach borrows strength from treatment heterogeneity among target patients in a large-scale comparative clinical trial, and is more cost-effective if the treatment arms are indeed of no difference. Clinical Trials 2010; 7: 537—545. http://ctj.sagepub.com
Fetal globin expression is regulated by Friend of Prmt1
Authors: van Dijk Thamar Bryn , Gillemans Nynke , Pourfarzad Farzin , van Lom Kirsten , von Lindern Marieke , Grosveld Frank , Philipsen Sjaak
Published: August 2010

An estimated 6% to 7% of the earth's population carries a mutation affecting red blood cell function. The β-thalassemias and sickle cell disease are the most common monogenic disorders caused by these mutations. Increased levels of γ-globin ameliorate the severity of these diseases because fetal hemoglobin (HbF; α2γ2) can effectively replace adult hemoglobin (HbA; α2β2) and counteract polymerization of sickle hemoglobin (HbS; α2βS2). Therefore, understanding the molecular mechanism of globin switching is of biologic and clinical importance. Here, we show that the recently identified chromatin factor Friend of Prmt1 (FOP) is a critical modulator of γ-globin gene expression. Knockdown of FOP in adult erythroid progenitors strongly induces HbF. Importantly, γ-globin expression can be elevated in cells from β-thalassemic patients by reducing FOP levels. These observations identify FOP as a novel therapeutic target in β-hemoglobinopathies.