bluuebunny/crossref_metadata_2025 huggingface dataset:
Women and Men on the Move
Authors: Chandra Dharma
Published: November 2005

Fiji Indians emigrated to Australia, New Zealand, Canada and United States of America as early as 1970 when Fiji gained its independence. Emigration has continued since then with peaks during times of political crises, such as the coups of 1987 and 2000, and periods of political uncertainty, such as national elections and the formulation of a discriminatory Constitution in 1990. It has experienced troughs during periods of political stability and economic growth. Emigration is fundamentally the consequence of deficits in human development, especially in relation to human insecurity encompassing political exclusiveness and socio-political and economic insecurity arising from discriminatory socio-economic policies. This article outlines the magnitude and nature of emigration of Fiji Indians. It also discusses the trends, motivations and consequences of their emigration.
Striving for Emotional Survival in Palliative Cancer Nursing
Authors: Sandgren Anna , Thulesius Hans , Fridlund Bengt , Petersson Kerstin
Published: November 2005

In this grounded theory study, the authors analyze interviews and participant observation data related to palliative cancer nursing in hospitals. Striving for Emotional Survival emerged as the pattern of behavior through which nurses deal with their main concern, the risk of being emotionally overloaded by their work. It involved three main strategies: Emotional Shielding through Professional Shielding or Cold Shielding; Emotional Processing through Chatting, Confirmation Seeking, Self-Reflecting, or Ruminating; and Emotional Postponing through Storing or Stashing. Emotional Competence is a property of Striving for Emotional Survival that explains more or less adequate ways of dealing with emotional overload. The theory Striving for Emotional Survival can be useful in the nurses' daily work and provides a comprehensive framework for understanding how nurses deal with emotional difficulties. The authors suggest that health care organizations encourage self-care, prioritize time to talk, and offer counseling to nursing staff with emotionally difficult working conditions.
The Inextricable Link in Caring for Families of Critically Burned Children
Authors: Zengerle-Levy Karla
Published: November 2005

Advances in burn care have made recovery possible for children with burns on up to 99% of their body surface, which has prompted investigation of the psychosocial well-being of survivors. Although therapies have been suggested, no researchers have acknowledged or recognized nurses' potential contributions to children's and families' recovery. In this article, the author examines the lived experiences of 16 pediatric nurses on a burn intensive care unit. The purpose of the study was to articulate practices that helped critically burned children to heal holistically. Data showed that while helping burned children to heal holistically, the nurses simultaneously supported families to heal holistically. Nurses were observed laughing, talking, and crying with families, as well as role-modeling ways of being with and caring for the children. These practices illustrated the nurses' understanding that care of the children was inextricably linked to care of the families.
Carspecken's Five-Stage Critical Qualitative Research Method: An Application to Nursing Research
Authors: Hardcastle Mary-Ann , Usher Kim , Holmes Colin
Published: November 2005

In this article, the authors provide an account of Carspecken's (1996) five-stage approach to “doing” critical ethnography, or what he has termed critical qualitative research (CQR). They provide the reader with an overview of the concepts presented in Carspecken's book Critical Ethnography in Educational Research and describe how they applied several of his ideas within a research project that explored renal nurses' decision making using a critical ethnographic approach. They briefly describe the five stages of CQR and incorporate within the article an example of how they applied the stages. They propose this approach as a useful method for nursing and other health-related research.
Genetic Testing for Hereditary Breast and Ovarian Cancer: Responsibility and Choice
Authors: d'Agincourt-Canning Lori
Published: November 2005

Genetic testing for hereditary breast-ovarian cancer has become an important part of clinical genetics practice. Although considerable work has focused on the psychological impact of this technology, there has been little research into the moral implications of genetic information on hereditary cancer families. In this article, the author examines moral issues related to individuals' decisions to seek or decline testing. In-depth interviews with 53 participants make up the core of the research. Analysis of participants' accounts illustrates how the decision to be tested (or not) interconnects with moral agency and aspects of self (embodied, familial-relational, and civic self). The findings form the foundation for inquiry into conceptualization of moral responsibility, autonomy, and choice. They also provide insight that might assist clinicians to understand more fully the needs and responses of those who seek genetic testing for hereditary breast-ovarian cancer.
Waiting for a Liver Transplant
Authors: Brown Jill , Sorrell James H. , McClaren Jason , Creswell John W.
Published: November 2005

The waiting period for liver transplantation is a difficult time fraught with uncertainty and associated with a high rate of morbidity and mortality. To understand better what it means for a transplant patient to wait, the authors explore in this phenomenological study the meaning that people with liver failure ascribe to the experience of waiting for a transplant. They conducted 9 interviews using phenomenological methods of inquiry as a guide for analysis. Eight core themes emerged from 146 significant statements and corresponding meaning units. The experience of waiting includes transformations, doctors, teams and trust, elation to despair, loss, questioning the process, searching, coping, and the paradox of time. The essence of the experience is discussed in light of the theory of chronic illness as a disruption of biographical narrative. The authors highlight implications for the transplant teams and other health care providers.
Images of Cloning and Stem Cell Research in Editorial Cartoons in the United States
Authors: Giarelli Ellen
Published: November 2005

Through semiotic analysis of manifest and latent meanings in editorial cartoons, the author uncovers how cloning and stem cell research are represented in a popular mass medium. She identified 86 editorial cartoons published in the United States between 2001 and 2004 that referred to cloning and 20 that referred to stem cell research. Cartoonists portrayed people individually 224 times and 4 times in groups of more than 10. Men were portrayed in64% of cartoons. Stem cell research was depicted as having a potential positive value, and cloning was depicted negatively. Some major messages are that cloning will lead to the mass production of evil, cloning creates monsters, and politics will influence who or what will be cloned. Analyzing popular images can allow access to public understanding about genetic technology and evaluation of public beliefs, preconceptions, and expectations as the public is educated on the use and value of services.
The Construction of Troubled and Credible Patients: A Study of Emotion Talk in Palliative Care Settings
Authors: Li Sarah , Arber Anne
Published: November 2005

In this article, the authors select two categories of dying patients, “troubled” and “credible,” from two larger studies conducted in three palliative care settings. They explore how nurses construct dying patients' moral identities and how they use emotion talk to interpret patients' behavior. The authors carried out a microanalysis of talk-in-action using discourse analysis and conversation analysis. Strategies used for the construction of moral identities include the production of atrocity stories and emotional editing. The authors identify moments when emotions are made relevant in palliative care nurses' daily practices, which serve to smooth social interaction and give a voice to dying patients' words and actions. The dying trajectory, the deteriorating emotional body, and the sound mind are resources used in the characterization of the credible and troubled patient. The authors argue that emotion talk is significant because it reveals how nurses manage conflict and tension in talk-ininteraction.
Developing Optimal Search Strategies for Retrieving Clinically Relevant Qualitative Studies in EMBASE
Authors: Walters Leslie A. , Wilczynski Nancy L. , Haynes R. Brian
Published: November 2005

Qualitative researchers address many issues relevant to patient health care. Their studies appear in an array of journals, making literature searching difficult. Large databases such as EMBASE provide a means of retrieving qualitative research, but these studies represent only a minuscule fraction of published articles, making electronic retrieval problematic. Little work has been done on developing search strategies for the detection of qualitative studies. The objective of this study was to develop optimal search strategies to retrieve qualitative studies in EMBASE for the 2000 publishing year. The authors conducted an analytic survey, comparing hand searches of journals with retrievals from EMBASE for candidate search terms and combinations. Search strategies reached peak sensitivities at 94.2% and peak specificities of 99.7%. Combining search terms to optimize the combination of sensitivity and specificity resulted in values over 89% for both. The authors identified search strategies with high performance for retrieving qualitative studies in EMBASE.
“You're Either In or You're Out”
Authors: Stoudt Brett G.
Published: November 2005

School violence has not been studied widely across schools and communities. This article examines hegemonic masculinity and its relationship to violence through the peer disciplining (hazing, teasing, bullying) that occurs among students who attend an elite suburban boys'school. Using a combination of quantitative and qualitative methods, the analysis suggests that violence is embedded in the social fabric of the school and implicated in power relations between both peers and their institution. Emotionally ambiguous, “you're either in or you're out” distinctions made by peer disciplining can produce shame, fear, and hurt alongside friendship, intimacy, and bonding. The normalcy with which hegemonic values are practiced makes it difficult, though not impossible, to contest. If we are to find viable alternatives to dominant masculinities, which are restrictive for most, it will be important to ask which boys and under what conditions are they able to resist its mandates.
Split Ends
Authors: Missildine Whitney , Parsons Jeffrey T. , Knight Kelly
Published: November 2005

Examining the narratives of eighteen heterosexual drug-injecting men living with HIV, this study seeks to understand how HIV-positive men negotiate issues of masculinity, sexuality, and emotional intimacy. It focuses specifically on strategies HIV-positive men use to manage emotional vulnerability in sexual encounters. We identify a core theme of “splitting,” in which men compartmentalize the domains of sexuality and emotional intimacy. We examine how this aspect of masculinity is at times exacerbated as a strategy to minimize emotional investment in sexual partners. By splitting the emotional and sexual domains, the men are able to perform sexually with casual sex partners while minimizing both the risk of infecting intimate partners and a fear of rejection from those they care about or desire most. However, the tensions created by splitting the emotional and sexual domains may disintegrate intimate interpersonal relationships that serve as a base of much-needed emotional support.
Reflections on Patterns of Masculinity in School Settings
Authors: Swain Jon
Published: November 2005

This article is based on an ethnographic exploration into the construction of masculinities among ten-and eleven-year-old boys in three schools in the United Kingdom between 1998 and 1999. The research found that there were different patterns of masculinity both between and within each setting that drew on the resources and storylines available. The author discusses the way the research was theorized, particularly in relation to the concept of hegemonic masculinity and its link with the body. He interrogates the use of typologies and outlines the reasons why he found them unsatisfactory. Although the terms “hegemonic,” “complicit,” and “subordinate” masculinity are borrowed from Connell, the author found it necessary to propose another form of masculinity, which he calls “personalized.” This was made up from boys who appeared content to pursue their own types of identity, and did not aspire to, or imitate, the leading form. Finally, the author briefly discusses the implications of this research for schools.
States and Transnational Actors: Who’s Influencing Whom? A Case Study in Jewish Diaspora Politics during the Cold War
Authors: Hägel Peter , Peretz Pauline
Published: November 2005

Transnational actors are often assumed to be autonomous in their attempts to influence states. But whenever both share common interests, opportunities for mutual influences exist and states can try to use transnational actors to further their own objectives. Whereas the theoretical discussion in IR has largely overlooked this possibility, it is no stranger to scholars of diasporas and nationalism. Informed by this literature, we apply our notion of state-influenced non-governmental organizations to the field of transnational diaspora politics with its complex relationships between diasporas and their homeland and host states. Our historical case study demonstrates how Israel, via its secret office ‘Nativ’, significantly influenced the Jewish diaspora and other transnational actors in the mobilization for Soviet Jewish emigration during the Cold War. States are thus not only targets of transnational actors — they can also influence and even initiate transnational movements. In our conclusion, we discuss why such reciprocal relationships should be generally taken into account in the study of transnational relations.
State Sovereignty, Federation and Kantian Cosmopolitanism
Authors: Brown Garrett Wallace
Published: November 2005

This article examines the role of states in Kantian cosmopolitanism and seeks to clarify the relationship between the rights of states and the concept of cosmopolitan law. The argument is made that states play an important role within Kantian theory, but that the concept of absolute sovereignty is also ultimately rejected. The article examines the Kantian argument for domestic right, international right and cosmopolitan right, and provides an alternative view of these conceptions against the argument that Kantianism involves the removal of states and the creation of an overarching global government. It establishes that Kantian cosmopolitanism provides a normative ethical global order without the existence of a world government. From this discussion, the relevance of Kantian cosmopolitanism is also examined in relation to contemporary International Relations theory.
Foreign Economic Liberalization and Peace: The Case of Sub-Saharan Africa
Authors: Bussmann Margit , Schneider Gerald , Wiesehomeier Nina
Published: November 2005

A typical adage of the globalization literature is that foreign economic liberalization undermines the social fabric of developing countries. This article examines this claim for the sub-Saharan African countries and thus the continent that experienced both low economic growth and a high incidence of armed conflict during the 1990s. Our results yield support for the assertion that economic openness durably pacifies countries once the restructuring of the economy is over. We can, however, not reject the possibility that the distributional consequences of foreign economic liberalization increase the risk of civil war during the implementation of the reform measures. We contrast this ‘distributional’ model with alternative explanations such as the role of the International Monetary Fund and the level of democracy. A comparative case study on Guinea and Guinea-Bissau lends some illustrative evidence to the claim that compensating the losers of globalization can pacify intrastate relations.
Foreign Capital Inflows and Growth in Pakistan
Authors: Yasmin Bushra
Published: November 2005

Developing countries have low levels of savings and investment. As a result most developing countries have to rely on Foreign Capital Inflows (FCI) to generate sufficient saving in order to achieve high levels of growth. Pakistan is one of those countries that rely heavily on external flows to supplement their savings and accelerate economic growth. The objective of this study is to find out the effect of FCI on the growth performance of Pakistan and vice versa. As the growth rate and FCI are expected to affect each other simultaneously, the Simultaneous Equation Model is applied on the aggregate time series data for the years 1970–71 to 2000–2001 for FCI, GNP and Savings. A positive and statistically significant relationship appears between FCI and growth. Further, it can be seen that Foreign Direct Investment (FDI) in FCI is highly significant and has contributed positively in the country's economic growth. The optimal policy which follows from these results is to bring changes in the composition of FCI and preferably to encourage FDI in order to enhance economic growth with the high growth level further affect FCI positively.
Trade Policy, Poverty and Inequity in Nepal
Authors: Sharma Kishor
Published: November 2005

The debate about the effects of globalization on poverty and inequity has attracted public attention in recent years in both developed and developing countries. While globalization has contributed to a rapid expansion in world output and trade, poverty remains a major development challenge, particularly in LDCs. Using the experience of Nepal this paper sheds light on this debate. Our analysis suggests that in Nepal the poor have not benefited much from global integration. Not only has poverty increased, but income inequality has also grown rapidly since the country embarked on policy reforms. The magnitude of poverty is higher in rural than in urban areas. Urban poverty has reduced mainly due to growth in labour-intensive manufacturing exports—motivated by the GSP quota—and an expansion in service related activities. Rural poverty appears to be linked with poor agricultural productivity.
Inequality in the Literacy Levels in Pakistan
Authors: Husain Fazal , Qasim Muhammad Ali
Published: November 2005

This paper attempts to identify the areas that are still lagging behind other parts of the country in terms of literacy levels and are unable to play their role in the development of human capital of the country. The analyses indicate that more than 75 per cent of the districts in the country are under-represented in terms of literacy levels. This includes a large portion of Balochistan province. A large proportion of the literate population is concentrated in the national and provincial capitals. In general, Sindh lags behind in case of rural areas and NWFP in case of females. The analyses also indicate that the areas that are backward in terms of economic development are also those with low levels of literacy. Balochistan is the province that needs the greatest attention. An encouraging sign is the general decline in disparities in literacy levels over time. Moreover, the least literate areas have shown a significant improvement over time. However, a lot of work needs to be put into these areas for them to come at par with other parts of the country.
The Burning Mirror: Photography in an Ambivalent Light
Authors: Miles Melissa
Published: November 2005

Photography’s etymology as light-writing is characterized by certain assumptions about the stability and transparency of light which underpin the relationship between light, truth and presence that deeply informs photography’s ontology and epistemology. Foreclosed in this photological schema is light’s disruptive potential. This article invokes a burning mirror to direct this capricious light onto photography, and to refigure light as an agent of excess in the medium. The photographic phenomena of lens flare, over-exposure and solarization embody points at which these ambivalent inscriptions of light converge, and will offer a means of developing an alternative approach to photographic theory.
Cruising the Archive
Authors: Ofield Simon
Published: November 2005

Beginning with the work of David Hockney and a personal selection of popular fictional texts of the 1950s, 1960s and 1970s, this article explores the expressive connection between visual culture and sexual identity that a range of disciplines have established around the practices and pleasures that in the 20th century became known as ‘homosexual’. As an alternative to these disciplinary protocols of identification, ‘cruising’ is proposed as a model that can undermine the commitment to ‘detection’ and revelation evident in a broad range of projects within and beyond gay studies and queer theory. Although often somewhat informal, ‘cruising’ is not represented as the alternative to more professional forms of investigation, but understood as a form of practice always already caught up in the disciplines that it attempts to dodge and the understandings that it seeks to displace.
From Structure to Enigma and Back, Perhaps
Authors: Rifkin Adrian
Published: November 2005

This article is concerned with reviewing the histories of structuralism and poststructuralism in their moment of redundancy as theoretical terms in order to unearth and instate some of the missing relations of writing and figure that we can read out of the work of the French writer Jean-Louis Schefer. Little read in the Anglo-Saxon university, his thinking on art, cinema and literature represents a unique intervention that, in its poetic denial of its own structuralist origins, offers a form of critical text that escapes the categories and methodologies of critical theory while remaining rooted in a series of different forms of profound scholarship. Schefer’s work invites us to configure images and to map out the surfaces that make them visible as the invention of an equal and amorous or sometimes unequal relation with them. He invites us to invent.
The University and the New Humanities
Authors: Peters Michael A.
Published: November 2005

Recently, Derrida has pointed to the university to come and the future of the professions within a place of resistance, and yet maintained the historical link to two ideas that mediate and condition both the humanities and the performative structure of acts of profession: human rights and crimes against humanity. Derrida (2001a) maintains that the ‘modern university should be unconditional’, by which he means that it should have the ‘freedom’ to assert, to question, to profess, and to ‘say everything’ in the manner of a literary fiction. This article reviews what Derrida calls ‘the future of the profession or the university without conditions’. Second, it focuses on a series of criticisms raised by Richard Rorty against Derrida’s concept of literature and on Derrida’s status as a ‘private ironist’. Third, the article examines Derrida in relation to the ends of literature and the university, under the impact of globalization and new technologies of communication. Finally, in a postscript the article returns to the concept of the university and its postcolonial possibilities.
Do Actions Speak Louder Than Words?
Authors: Rae Jan
Published: November 2005

It is argued that a primary goal of a theatrical production is the making of meaning by the audience through the vehicle of multiple media (i.e. staging, design, sound and lighting effects and so on). Effective rehearsal of these elements affords the greatest opportunity for a coherent interpretation of the text. Although individual rehearsals will by their very nature be unique, it does not follow that the characteristics of the rehearsal process cannot be identified, modelled, and applied in a range of contexts.Theatrical rehearsal practices, so often compartmentalized in the academic literature and reduced in the craft literature, are theorized in this article by reference to the rich literatures of pedagogy, educational multiple media development, and group communication. This iterative analysis will serve as a first step towards constructing a better understanding of the heuristic nature, the purposes and effective uses of rehearsal.
Delta-like1-induced Notch1 signaling regulates the human plasmacytoid dendritic cell versus T-cell lineage decision through control of GATA-3 and Spi-B
Authors: Dontje Wendy , Schotte Remko , Cupedo Tom , Nagasawa Maho , Scheeren Ferenc , Gimeno Ramon , Spits Hergen , Blom Bianca
Published: November 2005

Human early thymic precursors have the potential to differentiate into multiple cell lineages, including T cells and plasmacytoid dendritic cells (pDCs). This decision is guided by the induction or silencing of lineage-specific transcription factors. The ETS family member Spi-B is a key regulator of pDC development, whereas T-cell development is critically dependent on GATA-3. Here we show that triggering of the Notch1 signaling pathway by Delta-like1 controls the T/pDC lineage decision by regulating the balance between these factors. CD34+CD1a- thymic progenitor cells express Notch1, but down-regulate this receptor when differentiating into pDCs. On coculture with stromal cell lines expressing either human Delta-like1 (DL1) or Jagged1 (Jag1) Notch ligands, thymic precursors express GATA-3 and develop into CD4+CD8+TCRαβ+ T cells. On the other hand, DL1, but not Jag1, down-regulates Spi-B expression, resulting in impaired development of pDCs. The Notch1-induced block in pDC development can be relieved through the ectopic expression of Spi-B. These data indicate that DL1-induced activation of the Notch1 pathway controls the lineage commitment of early thymic precursors by altering the levels between Spi-B and GATA-3. (Blood. 2006;107:2446-2452)
Mast cells and neutrophils proteolytically activate chemokine precursor CTAP-III and are subject to counterregulation by PF-4 through inhibition of chymase and cathepsin G
Authors: Schiemann Florian , Grimm Tobias Alexander , Hoch Josef , Gross Roland , Lindner Buko , Petersen Frank , Bulfone-Paus Silvia , Brandt Ernst
Published: November 2005

The CXC chemokines platelet factor 4 (PF-4/CXCL4) and connective tissue-activating peptide III (CTAP-III) are released by activated human platelets in micromolar concentrations. So far, neutrophils have been recognized to cleave the precursor CTAP-III to form the active chemokine neutrophil-activating peptide 2 (NAP-2/CXCL7) through limited proteolysis by membrane-associated cathepsin G. Here we show for the first time that activated human skin mast cells (MCs) convert CTAP-III into biologically active NAP-2 through proteolytic cleavage by released chymase. A direct comparison on a cell number basis revealed that unstimulated MCs exceed the CTAP-III–processing potency of neutrophils about 30-fold, whereas MCs activated by IgE cross-linking exhibit even 1000-fold higher CTAP-III–processing capacity than fMLP-stimulated neutrophils. Intriguingly, PF-4 counteracted MC- as well as neutrophil-mediated NAP-2 generation at physiologically relevant concentrations. Addressing the underlying mechanism, we obtained evidence that PF-4 acts as an inhibitor of the CTAP-III–processing enzymes cathepsin G and chymase without becoming cleaved itself as a competitive substrate. Because cleavage of the CTAP-III–unrelated substrate substance P was also affected by PF-4, our results suggest a regulatory role for PF-4 not only in NAP-2 generation but also in neutrophil- and MC-mediated processing of other physiologically relevant inflammatory mediators.
De novo synthesis of early growth response factor-1 is required for the full responsiveness of mast cells to produce TNF and IL-13 by IgE and antigen stimulation
Authors: Li Bo , Power Melanie R. , Lin Tong-Jun
Published: November 2005

Early growth-response factor 1 (Egr-1) is a zinc-finger transcription factor that plays a regulatory role in the expression of many genes important for inflammation. Whether Egr-1 is involved in IgE-dependent mast-cell activation was investigated. We demonstrated that IgE and antigen (TNP) stimulation induced a rapid expression of Egr-1 mRNA in mouse bone marrow–derived mast cells (BMMCs). As early as 15 to 20 minutes after IgE + TNP stimulation, Egr-1 protein was detectable in the nucleus of BMMCs by immunofluorescence or electrophoretic mobility shift assay. To examine a role for Egr-1 in IgE-dependent cytokine production by mast cells, Egr-1–deficient (Egr-1–/–) BMMCs were developed from the bone marrow cells of Egr-1 knockout mice. Egr-1–/– BMMCs express similar levels of surface c-kit and IgE receptor as compared with those on Egr-1+/+ BMMCs. Importantly, IgE + TNP-induced TNF and IL-13 expression was significantly reduced at both mRNA and protein levels in Egr-1–/– BMMCs as compared with those in Egr-1+/+ BMMCs. Thus, our results suggest that de novo synthesis of Egr-1 represents a novel mechanism in FcϵRI signaling and is required for the full responsiveness of IgE-dependent TNF and IL-13 production by mast cells.
Impaired class switch recombination (CSR) in Waldenström macroglobulinemia (WM) despite apparently normal CSR machinery
Authors: Kriangkum Jitra , Taylor Brian J. , Strachan Erin , Mant Michael J. , Reiman Tony , Belch Andrew R. , Pilarski Linda M.
Published: November 2005

Analysis of clonotypic isotype class switching (CSR) in Waldenström macroglobulinemia (WM) and IgM monoclonal gammopathy of undetermined significance (MGUS) reveals a normal initial phase of B-cell activation as determined by constitutive and inducible expression of activation-induced cytidine deaminase (AID). Switch μ (Sμ) analysis shows that large deletions are not common in WM or IgM MGUS. In CD40L/IL-4-stimulated WM cultures from 2 patients, we observed clonotypic IgG exhibiting intraclonal homogeneity associated with multiple hybrid Sμ/Sγ junctions. This suggests CSR had occurred within WM cells. Nevertheless, the estimated IgG/IgM-cell frequency was relatively low (1/1600 cells). Thus, for the majority of WM B cells, CSR does not occur even when stimulated in vitro, suggesting that the WM cell is constitutively unable to or being prevented from carrying out CSR. In contrast to WM, the majority of IgM MGUS clones exhibit intraclonal heterogeneity of IgH VDJ. Furthermore, most IgM MGUS accumulate more mutations in the upstream Sμ region than do WM, making them unlikely WM progenitors. These observations suggest that switch sequence analysis may identify the subset of patients with IgM MGUS who are at risk of progression to WM.
N-acetylcysteine increases manganese superoxide dismutase activity in septic rat diaphragms
Authors: Barreiro E. , Sánchez D. , Gáldiz J. B. , Hussain S. N. A. , Gea J.
Published: November 2005

The antioxidantN-acetylcysteine (NAC) prevented sepsis-induced diaphragmatic dysfunction. As an indirect antioxidant NAC was shown to induce superoxide dismutase (SOD) activity in immune cells from endotoxaemic mice. The aim of this study was to assess whether NAC acts as an indirect antioxidant by inducing manganese (Mn)-SOD activity in the diaphragms of endotoxaemic rats, while preventing muscle dysfunction.

A controlled study was conducted, in which protein carbonylation, Mn-SOD, catalase, and 3-nitrotyrosine immunoreactivity were detected using immunoblotting and immunohistochemistry in rat diaphragms. Six groups were studied for 24 h after a saline (control) or lipopolysaccharide (LPS; 20 mg·kg−1)i.p.injection in the absence and presence of NAC pre-treatment (either 1.5 or 3 mmol·kg−1·24 h−1for 7 days, oral administration). Diaphragm mitochondrial Mn-SOD activity and respiratory muscle function were also determined.

Within 24 h, LPS induced maximal inspiratory pressure reduction, increasing diaphragmatic protein carbonylation and nitration. Pre-treatment with 3 mmol·kg−1NAC clearly increased muscle Mn-SOD protein content and activity in both LPS- and saline-injected animals, while reducing protein carbonylation and nitration, and partially preventing the LPS-induced respiratory muscle dysfunction.

Data produced from this study indicate that high doses ofN-acetylcysteine induces manganese superoxide dismutase, as well as preserves its activity, possibly by preventing nitration of critical tyrosine residues of the enzyme.
Respiratory insufficiency and limb muscle weakness in adults with Pompe’s disease
Authors: Pellegrini N. , Laforet P. , Orlikowski D. , Pellegrini M. , Caillaud C. , Eymard B. , Raphael J-C. , Lofaso F.
Published: November 2005

The objective of the present study was to prospectively evaluate relationships linking age, respiratory function and locomotor function in 29 outpatients with late-onset Pompe’s disease and to retrospectively determine clinical outcomes.

Using univariate regression analysis, vital capacity (VC) was weakly, but significantly, correlated to shoulder motility, Walton score and lower-limb Modified Medical Research Council score. Six patients were able to walk without a walking aid and with only the help of a handrail on the stairs (Walton score = 3), although VC was <50%. No parameters were significantly correlated with age.

As assessed retrospectively, VC and locomotion deteriorated over time in most patients. In contrast, among the 16 patients started on invasive or noninvasive ventilation with VC monitoring, eight had a VC increase at the first measurement time-point.

The absence of correlation with age and the presence, in some patients, of severe respiratory insufficiency without severe limb girdle muscle weakness indicate that respiratory function should be monitored independently from the degree of peripheral muscle weakness. Mechanical ventilation and tracheostomy may improve vital capacity and should, therefore, be taken into account when evaluating treatments for the adult form of Pompe’s disease.
Social class in asthma and allergic rhinitis: a national cohort study over three decades
Authors: Bråbäck L. , Hjern A. , Rasmussen F.
Published: November 2005

The aim of this study was to assess whether the association with social class differed between allergic rhinitis and asthma and whether these associations have changed over time.

The Swedish Military Service Conscription Register was linked to two other national registers for 1,247,038 male conscripts in successive cohorts born between 1952 and 1977.

The percentage of asthma cases associated with allergic rhinitis was 15% in the oldest cohort and 44% in the youngest cohort. Low socio-economic status (SES) was associated with an increased risk (assessed as odds ratio) of asthma without allergic rhinitis (1.14, 95% confidence interval (CI) 1.11–1.17) but a slightly reduced risk of asthma with allergic rhinitis (0.96, 95% CI 0.93–1.00). The risk of allergic rhinitis was 0.84, 95% CI 0.82–0.85. A positive interaction between SES and year of birth occurred in all three conditions. Low SES was related to a reduced risk of asthma with allergic rhinitis in the earliest cohort (0.72, 95% CI 0.53–0.82) but a slightly increased risk in the most recent cohort (1.07, 95% CI 1.01–1.14).

In conclusion, the role of social class has changed over time. The steepest increase in asthma and allergic rhinitis occurred in conscripts with a low socio-economic status.
Protective effect of pneumococcal vaccine against death by pneumonia in elderly subjects
Authors: Vila-Córcoles A. , Ochoa-Gondar O. , Llor C. , Hospital I. , Rodríguez T. , Gómez A.
Published: November 2005

The present study assessed the effectiveness of the 23-valent pneumococcal polysaccharide vaccine to prevent pneumonia and death in older adults in a first-time report between January and December 2002.

A prospective cohort study was conducted including all individuals ≥65 yrs of age assigned to one of eight primary care centres in Tarragona, Spain (n = 11,241). The primary outcomes were community-acquired pneumonia (hospitalised or outpatient) and death from pneumonia. All pneumonias were validated by checking clinical records. The association between the pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional-hazard models, adjusted by age, sex, influenza vaccination status, comorbidity and immunological status.

Pneumococcal vaccination did not alter the risk of hospitalisation from pneumonia (hazard ratio (HR): 0.80; 95% confidence interval (CI): 0.50–1.28) or overall pneumonia (HR: 0.86; 95% CI: 0.56–1.31), but the vaccine was associated with considerable reductions of death risk from pneumonia (HR: 0.28; 95% CI: 0.09–0.83).

In conclusion, these results suggest that pneumococcal polysaccharide vaccine may not be effective in reducing the incidence of pneumonia, but may be able to diminish the severity of the infection. These findings support the effectiveness of the pneumococcal polysaccharide vaccine to prevent mortality caused by pneumonia in older adults, providing a new argument to recommend systematic vaccination in the elderly.
Changes in the use of anti-asthmatic medication in an international cohort
Authors: Janson C. , de Marco R. , Accordini S. , Almar E. , Bugiani M. , Carolei A. , Cazzoletti L. , Cerveri I. , Corsico A. , Duran-Tauleria E. , Gislason D. , Gulsvik A. , Jõgi R. , Marinoni A. , Martínez-Moratalla J. , Pin I. , Vermeire P. , Jarvis D.
Published: November 2005

The aim of this study was to describe changes in pharmacotherapy for asthma since the early 1990s in an international cohort of young and middle-aged adults.

A total of 28 centres from 14 countries participated in a longitudinal study. The study included 8,829 subjects with a mean follow-up time of 8.7 yrs. Change in the prevalence of use for medication was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period.

The use of anti-asthmatics was found to have increased by 3.1% (2.4–3.7%) and the prevalence of symptomatic asthma by 4.0% (3.5–4.5%). In the sample with asthma in both surveys (n = 423), the use of inhaled corticosteroids increased by 12.2% (6.6–17.8%). Despite this, only 17.2% were using inhaled corticosteroids on a daily basis at follow-up. Females with continuous asthma were more likely, compared with males, and smokers with asthma, to have started using inhaled corticosteroids since the first survey.

The use of anti-asthmatics has increased in a pattern consistent with current consensus on treatment. However, despite increased use of inhaled corticosteroids, a large majority of subjects with symptomatic asthma do not use this treatment on a daily basis, particularly males and smokers with asthma.
Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD
Authors: Díaz O. , Bégin P. , Andresen M. , Prieto M. E. , Castillo C. , Jorquera J. , Lisboa C.
Published: November 2005

To assess the clinical impact of noninvasive mechanical ventilation (NIMV) on stable hypercapnic chronic obstructive pulmonary disease, changes in exercise capacity, dyspnoea and simple physiological parameters were evaluated. The time course of these effects during treatment and recovery was also assessed.

Patients were randomly allocated to NIMV (n = 27) or sham-NIMV (n = 15), applied 3 h·day−1, 5 days a week, for 3 weeks. A 6-min walking distance (6MWD), arterial blood gases, spirometry, pattern of breathing, mouth occlusion pressure (P0.1), and respiratory system impedance (P0.1/tidal volume (VT)/inspiratory time (tI)) were measured weekly during treatment and 2 weekly during follow-up. Transition dyspnoea index (TDI) was also measured.

During NIMV, carbon dioxide arterial tension decreased progressively, concomitantly with a slow deep pattern of breathing, a proportional increase in the forced expiratory volume in one second (FEV1), the forced vital capacity and significant reductions of P0.1and P0.1/VT/tI. The 6MWD improved by a mean of 76 m after NIMV, and by 73 m and 61 m 1 and 2 weeks, respectively, after treatment. Dyspnoea improved with a mean TDI of three points. Changes in 6MWD were highly related to TDI and to a lesser extent to changes in FEV1(r = 0.60).

The current authors conclude that noninvasive mechanical ventilation has significant and sustained clinical impact in stable hypercapnic chronic obstructive pulmonary disease.
Autoimmunity and pulmonary hypertension: a perspective
Authors: Nicolls M. R. , Taraseviciene-Stewart L. , Rai P. R. , Badesch D. B. , Voelkel N. F.
Published: November 2005

The association between autoimmunity and pulmonary arterial hypertension (PAH) has been appreciated for >40 yrs, but how autoimmune injury might contribute to the pathogenesis of this disease has only been examined in a case-specific manner.

It is becoming increasingly clear that a variety of diverse clinical diseases, ranging from viral infections to connective tissue disorders, can culminate in pulmonary vascular pathology that is indistinguishable. Is there a hitherto unappreciated biology that unites these seemingly unrelated conditions?

The answer to this question may come from the increasing body of evidence concerned with the central importance of regulatory T-cells in preventing inappropriate B-cell activity. Two striking similarities between conditions associated with severe angioproliferative pulmonary hypertension are a defect in the CD4 T-cell compartment and auto-antibody production. Pathogenic auto-antibodies targeting endothelial cells are capable of inducing vascular endothelial apoptosis and may initiate the development of PAH.

The present review will focus on what is known about autoimmune phenomena in pulmonary arterial hypertension patients, in order to better consider whether an early loss of self-tolerance followed by autoimmune injury could influence the early development of severe angioproliferative pulmonary hypertension.
Effects of exacerbations and seasonality on exhaled nitric oxide in COPD
Authors: Bhowmik A. , Seemungal T. A. R. , Donaldson G. C. , Wedzicha J. A.
Published: November 2005

Exhaled nitric oxide (eNO) appears to be associated with airway inflammation seen in chronic obstructive pulmonary disease (COPD). The present authors studied the effects of exacerbation, season, temperature and pollution on eNO.

eNO was measured seasonally and at exacerbations in 79 outpatients suffering from COPD (mean forced expiratory volume in one second = 42%). The effects of exacerbation symptoms, physiological and environmental parameters were analysed.

Stable eNO levels were correlated positively with arterial oxygen tension. Median levels were found to be lower in smokers (5.3 ppb) than in ex- or nonsmokers (6.8 ppb). Levels were higher during October to December (6.9 ppb) than in April to June (4.6 ppb). Levels were also higher during 68 exacerbations in 38 patients (7.4 ppb) than in stable conditions (5.4 ppb), independent of the effects of smoking. The rise in eNO was greater in exacerbations that were associated with colds, a sore throat or dyspnoea combined with a cold.

In conclusion, exhaled nitric oxide levels were higher in colder weather and in the autumn, perhaps related to the increased prevalence of viral infection at this time of year. The levels were lower in more severe chronic obstructive pulmonary disease. Exhaled nitric oxide levels were raised at the onset of exacerbation, particularly in the presence of a cold.
Choice of endogenous control for gene expression in nonsmall cell lung cancer
Authors: Liu D. W. , Chen S. T. , Liu H. P.
Published: November 2005

This study attempts to identify a suitable endogenous control gene for real-time RT-PCR in nonsmall cell lung cancer (NSCLC) tissues.

Expression of seven common endogenous control genes (glyceraldehyde-3-phosphate dehydrogenase (GAPDH), v-abl Abelson murine leukaemia viral oncogene homologue 1, beta-2-microglobulin, hypoxanthin phosphoribosyltransferase 1 (HPRT1), phosphoglycerate kinase 1, peptidylprolyl isomerase A, and ribosomal protein, large, P0) in 18 heterogenous NSCLC tumour specimens, 10 normal lung tissues and six NSCLC cell lines were analysed by quantitative RT-PCR. The variances and correlation coefficients of cycle threshold (Ct) value of each control gene in three tissue groups and subgroups were compared. The difference and correlation coefficients between the Ct value for each control gene and the mean Ct value of the remaining control genes were calculated.

The GAPDH gene transcript showed the least variance and linear regression analysis demonstrated that GAPDH and HPRT had the strongest correlation in pooled tumour and normal lung tissues. Furthermore, GAPDH expression value showed stringent correlation and had the lowest difference with the mean expression value of the remaining endogenous control genes.

Among the seven common endogenous control genes, glyceraldehyde-3-phosphate dehydrogenase is the most suitable for quantitative RT-PCR reaction in nonsmall cell lung cancer tissue samples.
Macrophages induce an allergen-specific and long-term suppression in a mouse asthma model
Authors: Vissers J. L. M. , van Esch B. C. A. M. , Hofman G. A. , van Oosterhout A. J. M.
Published: November 2005

Increasing evidence suggests that macrophages (Mφ) play a crucial downregulatory role in the initiation and progression of allergic asthma. Recently, the current authors demonstrated that ovalbumin (OVA)-loaded Mφ (OVA-Mφ) suppress subsequent OVA-induced airway manifestations of asthma and that this effect could be potentiated upon selective activation. In the present study, the authors further delineated the underlying pathway by which Mφ exert this immunosuppressive effect.

To examine the migration of OVA-Mφ, cells were labelled with 5′chloromethylfluorescein diacetate (CMFDA) and were administered (i.v.) into OVA-sensitised BALB/c mice. After 20 h, the relevant organs were dissected and analysed using fluorescent microscopy. Allergen-specificity was investigated by treating OVA-sensitised mice with keyhole limpet haemocyanin (KLH)-Mφ activated with immunostimulatory sequence oligodeoxynucleotide (ISS-ODN). By lengthening the period between treatment and challenge to 4 weeks it was examined whether OVA-Mφ exerted an immunosuppressive memory response.

Strikingly, CMFDA-labelled Mφ were not trapped in the lungs, but migrated to the spleen. ISS-ODN-stimulated KLH-Mφ failed to suppress OVA-induced airway manifestations of asthma. Moreover, treatment with ISS-ODN-stimulated OVA-Mφ was still effective after lengthening the period between treatment and challenge.

These data demonstrate that allergen-loaded macrophages can induce an indirect immunosuppressive response that is allergen-specific and long lasting, which are both hallmarks of a memory lymphocyte response.