bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel sequence variation of AIRE and detection of interferon‐ω antibodies in early infancy
Authors: Tóth Beáta , Wolff Anette S. B. , Halász Zita , Tar Attila , Szüts Péter , Ilyés István , Erdős Melinda , Szegedi Gyula , Husebye Eystein S. , Zeher Margit , Maródi László
Published: October 2009

Objective  Autoimmune polyendocrine syndrome type I (APS I) is a rare primary immunodeficiency disorder characterized by chronic mucocutaneous candidiasis, multi‐organ autoimmunity and ectodermal dysplasia. Autoantibodies to parathyroid and adrenal glands and type I interferons (IFN) are hallmarks of APS I, which results from mutations in the autoimmune regulator (AIRE) gene. We wished to study clinical, immunological and genetic features of APS I in Hungarian patients, and to correlate anti‐IFN‐ω serum concentration with APS I and other multi‐organ autoimmune diseases.

Design  Detailed analysis of patients with APS I and multi‐organ autoimmune diseases.

Patients  Seven patients with APS I and 11 patients with multi‐organ autoimmune diseases were studied.

Measurements  Mutational analysis was performed by bidirectional sequencing of AIRE. Antibodies against IFN‐ω and endocrine organ‐specific autoantigens were studied with radioimmunoassay. RFLP was performed by digestion of DNA with Hin6I restriction enzyme.

Results  AIRE sequence analysis revealed homozygous c.769C>T mutations in three patients and compound heterozygous sequence variants (c.769C>T/c.44_66dup26bp; c.769C>T/c.965_977del13bp; c.769C>T/c.1344delC) in four patients with APS I. All the six live patients tested had markedly elevated IFN‐ω antibodies, which were not found in heterozygous siblings or parents. One of the identified patients was negative for antibodies against IFN‐ω at 6 weeks of age, but became positive at 7 months. At age 1, he is still without symptoms of the disease. In contrast to patients with APS I, no AIRE mutation or elevation of IFN‐ω antibodies were detected in patients with multi‐organ autoimmune diseases.

Conclusion  This is the first overview of patients diagnosed with APS I in Hungary. A novel c.1344delC mutation in AIRE was detected. Anti‐IFN‐ω antibodies seem to appear very early in life and are helpful to differentiate APS I from other multi‐organ autoimmune diseases.
The evaluation of self‐care and self‐efficacy in patients undergoing hemodialysis
Authors: Bağ Eylem , Mollaoğlu Mukadder
Published: October 2009

Purpose  The purpose of this study is to assess patients' self‐care ability and self‐efficacy, to examine the relationship between them and to determine the factors affecting self‐care ability and self‐efficacy in people undergoing hemodialysis (HD).

Methods  This research was conducted as a descriptive survey study by 138 people with ESRD who were patients of HD units service in Sivas. The data were collected with a Personal Information Form, Exercise of Self‐Care Agency (ESCA) Scale and Self‐Efficacy Assessment Form. Data collected from the study were analysed using percent, mean, Tukey test, significance test of two means, one‐way variant analysis and Kruskal–Wallis test.

Results  The study results demonstrate that while there is a correlation between self‐care ability and education level, work status, income level and frequency of HD application, factors such as age, gender, education level, work status, income level and frequency of HD application determine self‐efficacy. Furthermore, a positive correlation was found between patients' self‐care ability and self‐efficacy. It was determined that as the level of self‐care ability increases self‐efficacy level also increases.

Conclusions  Hemodialysis application affects patients' self‐care ability and self‐efficacy levels. There is a positive correlation between self‐care ability and self‐efficacy. In view of this study's results, it is recommended to organize education programmes to increase self‐care ability and self‐efficacy levels of HD patients and prepare comprehensive plans including patients' families.
Plant chemical defence allocation constrains evolution of local range
Authors: SIEMENS DAVID H. , HAUGEN RISTON , MATZNER STEVEN , VANASMA NICHOLAS
Published: October 2009

Many species of plants in the wild are distributed spatially in patches, the boundaries of which may occur and change because of a complicated interplay between myriad environmental stressors and limitations of, or constraints on, plant coping mechanisms. By examining genetic variation and co‐variation among marker‐inferred inbred lines and sib‐families of an upland wild mustard species within and just a few meters across a natural patch boundary, we show that the evolution of tolerance to the stressful environment outside the patch may be constrained by allocation to glucosinolate compounds (GS) that are defensive against generalist insect herbivores. Several potential stressors were associated with the patch boundary, but carbon isotope ratios indicated that sib‐families with smaller stomatal apertures maintained performance better in response to late season dry conditions, suggesting that drought was an important stressor. The presence of GS may help explain the characteristic patchy distribution of mustards, a relatively diverse and important plant family. This result challenges one end of the continuum of the long‐standing Plant Apparency hypothesis, which essentially states the opposite causation, that low molecular weight toxins like GS are evolutionary responses of patchy distributions and correlated life‐history traits.
Sex ratio and the role of mild relative humidity in mating behaviour of red date palm weevil Rhynchophorus ferrugineus Oliv. (Coleoptera: Curculionidae) gamma‐irradiated adults
Authors: Al‐Ayedh H. Y. , Rasool K. G.
Published: October 2009

The influence of gamma radiation on the mating behaviour of the red date palm weevil (RDPW), Rhynchophorus ferrugineus (Olivier), and the efficacy of sterile insect technique (SIT) under different levels of relative humidity (RH) were studied. No adverse effects of gamma radiation were observed on the mating behaviour parameters of the RDPW, such as mate recognition time, mating duration, mating frequency within a 30‐min period and duration between consecutive matings. However, the weevils were sexually stimulated during aggregation. RH significantly affected egg laying as well as egg hatching. Significantly lower egg laying and hatching were recorded at 25% RH than at higher humidity levels, suggesting that low humidity conditions are better for successful SIT manipulations in the field. Lifespan of irradiated RDPW males was significantly shorter than that of un‐irradiated controls, irrespective of RH level.
Humour as experienced by patients and nurses in aged nursing in Finland
Authors: Isola Arja , Åstedt‐Kurki Päivi
Published: October 2009

Isola A & Åstedt‐Kurki P. International Journal of Nursing Practice 1997; 3: 29–33

Humour as experienced by patients and nurses in geriatric nursing in Finland

Humour is an integral part of everyday life and therefore a component of the care and treatment of elderly patients in the modern health care. This article deals with the role of humour in aged nursing from the perspective of the nursing home residents. It also describes some preliminary results of our study on the meaning of humour to professional nurses. The chief motivation for the study is to provide a deeper understanding of humour as a part of aged nursing and as a ‘phenomenon’, which should also help us in the continuing challenge to improve the quality of nursing care. In this study the qualitative approach was used because the focus of interest was on an issue that has received only little attention in earlier research. The research material consists of data from patients and nurses. The data were collected via interviews and essay‐type responses. The data obtained were analysed using the qualitative method of content analysis. In the light of our findings here, humour can be described as a joie de vivre which manifests itself in human interaction in the form of fun, jocularity and laughter. The assumption is supported by earlier research results which indicated that humour is an individual and personal matter and, in aged nursing care it is also very much a context‐bound phenomenon. Humour makes it easier for some of the elderly patients to experience a positive, human relationship with the nurse. According to the results it seems to us that research should be continued and intensified into the role and use of humour in elderly people’s everyday life and particularly in gerontological nursing care.
Nursing and researching
Authors: Fitzgerald Mary
Published: October 2009

Fitzgerald M. International Journal of Nursing Practice 1997; 3: 53–56

Nursing and Researching

An example from an interpretive phenomenological study of the experience of chronic illness in rural Australia is used to describe aspects of the nursing researcher relationship with study participants and to draw some comparisons between this relationship and the nurse and client relationship. Nurses are bound to serve their clients; however, the researcher’s principal purpose is to come to know and understand. These different principal purposes do not necessarily mean that the two relationships are completely different processes. There is a case for making the most of some overlapping skills and to see the results as positive ‘by‐products’. The question as to whether, or to what extent it is possible for the researcher to help participants intentionally is an issue worthy of discussion.
Oral buffered esomeprazole is superior to i.v. pantoprazole for rapid rise of intragastric pH: A wireless pH metry analysis
Authors: Banerjee Rupa , Reddy D Nageshwar , Guda Nalini M , Kalpala Rakesh , Mahurkar Swapna , Darisetty Santosh , Rao G Venkat
Published: October 2009

Background and Aims:  A pH of more than 6 is required for clot stability and hemostasis. Intravenous proton pump inhibitors have a rapid onset of action compared to oral and have been preferred for management of non‐variceal bleeding. Intravenous pantoprazole has been used extensively. Buffered esomeprazole (BE) is an oral preparation consisting of an inner core of non‐enteric‐coated esomeprazole with a shell of sodium bicarbonate. The buffer protects against acid degradation of esomeprazole in addition to immediate antacid action. The aim of this study was to assess the efficacy of BE for raising and maintaining an intragastric pH of more than 6 in comparison to i.v. pantoprazole in equivalent dosing.

Methods:  A randomized two‐way cross‐over study was conducted. Ten healthy volunteers were randomized to twice daily BE 40 mg or pantoprazole 40 mg i.v. bolus. Intragastric pH was measured with a wireless pH radiotelemetry capsule (Bravo, Medtronic). A 2‐week washout period was given between doses.

Results:  BE achieved a steady pH of more than 6 in a median time of 2 min (range 1–5 min) after the first dose. The mean % time that intragastric pH was more than 6.0 for BE was 96%, and 90% of the 24‐h period compared to pantoprazole (47% and 18%), P = 0.000. A median pH (interquartile range) for the BE group was 6.2 (6.175–6.2) which was higher than i.v. pantoprazole 4.60 (4.5–5.0) (P = 0.005).

Conclusion:  BE achieves and maintains a pH of more than 6 within minutes of administration. It was significantly superior to i.v. pantoprazole in equivalent dosing. This finding could have implications in the management of non‐variceal bleed where a rapid and sustained pH of more than 6 is desirable.
Eukaryotic expression of extracellular ligand binding domains of murine Tie‐2 and its anti‐angiogenesis effect in SGC‐7901 cell lines
Authors: Yang Hua , Yang Kun , Hu Jian‐Kun , Tang Hong , Zhang Bo , Chen Zhi‐Xin , Wang You‐Juan , Chen Jia‐Ping
Published: October 2009

Background and Aims:  Researches about blocking angiogenesis to treat tumor have become one of the most promising and active fields in anticancer research. This study aimed to investigate the eukaryotic expression of extracellular ligand binding domains of murine Tie‐2 and its anti‐angiogenesis effect.

Methods:  A eukaryotic expression vector pcDNA3.1+ integrating with a DNA fragment which encode extracellular ligand binding domains of murine Tie‐2 was transfected into SGC‐7901 gastric cancer cell line. The protein expression was detected by western blot analysis and immunocytochemistry staining. Following the construction of nude mouse tumor xenograft model with and without transfected cells, tumor microvessel density was determined by counting per high power field in the sections stained with an antibody to CD31 to test its inhibition of angiogenesis.

Results:  The extracellular ligand binding domains of murine Tie‐2 receptor was highly expressed in SGC‐7901 gastric cancer cells with plasmid transfection. The mean tumor sizes of groups with and without transfection were 1.27 ± 0.35 and 1.75 ± 0.17 cm3, respectively (P = 0.025). The mean inhibitory rate of tumor was 27.18 ± 19.93%. The comparison between highest microvessel density of group with transfection (14.00 ± 3.80) and that of group without transfection (22.30 ± 5.91) was statistically significant at P = 0.030.

Conclusion:  The protein of extracellular ligand binding domains of murine Tie‐2 can be expressed at high level in the eukaryotic expression system, and the expressed protein may have the anti‐angiogenesis effect.
Major adverse events, pretransplant assessment and outcome prediction
Authors: Huang Hui‐Chun , Lee Fa‐Yauh , Huo Teh‐Ia
Published: October 2009

Liver cirrhosis and portal hypertension pose enormous loss of lives and resources throughout the world, especially in endemic areas of chronic viral hepatitis. Although the pathophysiology of cirrhosis is not completely understood, the accumulating evidence has paved the way for better control of the complications, including gastroesophageal variceal bleeding, hepatic encephalopathy, ascites, hepatorenal syndrome, hepatopulmonary syndrome and portopulmonary hypertension. Modern pharmacological and interventional therapies have been designed to treat these complications. However, liver transplantation (LT) is the only definite treatment for patients with preterminal end‐stage liver disease. To pursue successful LT, the meticulous evaluation of potential recipients and donors is pivotal, especially for living donor transplantation. The critical shortage of cadaveric donor livers is another concern. In many Asian countries, cultural and religious concerns further limit the number of the donors, which lags far behind that of the recipients. The model for end‐stage liver disease (MELD) scoring system has recently become the prevailing criterion for organ allocation. Initial results showed clear benefits of moving from the Child–Turcotte–Pugh‐based system toward the MELD‐based organ allocation system. In addition to the MELD, serum sodium is another important prognostic predictor in patients with advanced cirrhosis. The incorporation of serum sodium into the MELD could enhance the performance of the MELD and could become an indispensable strategy in refining the priority for LT. However, the feasibility of the MELD in combination with sodium in predicting the outcome for patients on transplant waiting list awaits actual outcome data before this becomes standard practice in the Asia–Pacific region.
Malignant peritoneal mesothelioma: Quantitative analysis of asbestos burden
Authors: Kurimoto Ryota , Kishimoto Takashi , Nagai Yuichiro , Takazawa Hiroshi , Sakaue Nobuyuki , Shinohara Yasushi , Hiroshima Kenzo
Published: October 2009

Malignant mesotheliomas develop commonly in the pleural cavity and rarely arise in the peritoneal cavity. It is well established that asbestos exposure is related to malignant pleural mesothelioma, but the asbestos burden in the abdominal cavity in patients with malignant peritoneal mesothelioma has not been well studied. The purpose of the present study was therefore to report on an autopsy case of malignant peritoneal mesothelioma with quantitative analysis of the asbestos burden in tissues from the pleura and organs in the abdominal cavity. The patient was a 67‐year‐old man with a history of asbestos exposure. The peritoneum was thickened with diffuse tumor proliferation. This patient was diagnosed as having malignant peritoneal epithelioid mesothelioma. The number of asbestos fibers was >10 000/g dry tissue in all samples examined except in the small intestine. The number of asbestos fibers in the stomach was 53 000/g, which was higher than that in a control asbestosis subject. The existence of numerous asbestos fibers found in the abdominal cavity suggests that asbestos stimuli are related to the tumorigenesis of malignant peritoneal mesothelioma.
Disaster response: The University of Texas School of Nursing experience
Authors: Pattillo Marilyn M. , O'Day Trish M.
Published: October 2009

Nurses comprise the largest group of health‐care providers and should be key partners for any disaster response in their community. An often untapped resource in many communities is the contingent of nurse faculty, staff and students in schools of nursing across the country. In an effort to provide guidance on how schools and colleges of nursing link with their community and provide real‐world experience for students, the present paper: (i) outlines how a Memorandum of Cooperation between the City of Austin and the University of Texas at Austin was created; and (ii) describes an example of how a school of nursing could become organized to respond to a community's call for help.
Management of idiopathic anal fistula using cross‐linked collagen: a prospective phase 1 study
Authors: Hammond T. M. , Porrett T. R. , Scott S. M. , Williams N. S. , Lunniss P. J.
Published: October 2009

Aim  Fibrin glue and porcine intestinal submucosa are used in novel sphincter‐preserving techniques to heal anal fistulae. However, their success is highly variable and decreases with the length of follow up. The aim of this study was to assess the safety, feasibility and potential efficacy of another novel agent, cross‐linked collagen, in two different physical formats, to heal anal fistulae.

Method  Prospectively recruited patients underwent symptom, continence and anal physiology assessments and magnetic resonance imaging. Patients with secondary tracts or acute sepsis were excluded. At operation, participants were randomized to receiving a solid collagen implant or collagen fibres suspended in fibrin glue. Follow up included repeat symptom, continence and physiological assessments at 3 months, and regular clinical review thereafter.

Results  Twenty‐nine of 43 entrants were eligible for inclusion. Thirteen patients received the collagen implant, and 16 collagen–fibrin glue. Three months postoperation, no patient experienced acute sepsis or continence disturbance, and sphincter function and integrity were unchanged. At 29 months, 12 of 15 (one lost to follow up) patients treated with collagen–fibrin glue were healed, compared with seven of 13 who received the implant.

Conclusion  In the short‐to‐medium term, both techniques are safe and equally effective. The results justify continued research into the use of biomaterials to heal anal fistulae.
How active are American adolescents and have they become less active?
Authors: Li S. , Treuth M. S. , Wang Y.
Published: October 2009

The aim of this study was to systematically examine patterns and time trends in US adolescents' physical activity (PA) and sedentary behaviours. We examined findings from the nationally representative Youth Risk Behavior Surveillance Surveys during 1991–2007, and fit regression models estimating average annual changes and tested time trends, and age, gender and ethnic differences. US adolescents had less PA but more sedentary behaviours than recommended, but showed no clear evidence of becoming less active. In 2007, 24.9% reported on average spending ≥3 h of screen time per day for non‐school work; only 34.7% met the current PA recommendations, and it (25.6%) was even lower in girls. The prevalence of having sufficient vigorous PA changed little between 1993 and 2005 (from 65.8% to 64.1%). Encouraging changes regarding TV viewing time and physical education (PE) were detected. PE daily attendance rate and exercising >20 min during an average PE class increased significantly, while watching TV ≥3 h d−1 decreased significantly in recent years. Considerable sex, age and ethnic differences existed in the patterns and trends. These national data show no clear evidence of declining PA among US adolescents in recent years. Reduced PA is not likely the major explanation of the recent increase in obesity among US adolescents.
Combine harvesting
Authors: Birkinshaw Julian , Crainer Stuart
Published: October 2009

Mix the wisdom of internal and external networks and you might just come up with brilliant and unexpected solutions to apparently intractable problems. Julian Birkinshaw and Stuart Crainer report on how Roche Diagnostics is exploring an experimental approach to harvesting bright ideas.
Challenging Solidarity? An Analysis of Exit Options in Social Policies
Authors: Fenger Menno
Published: October 2009

Processes of adverse selection are generally considered as challenges to the viability of the solidarity that has been institutionalized in insurance schemes in the social domain. This article analyses to what extent the introduction of free choice in social policies might trigger processes of adverse selection in modern welfare states. Free choice not only concerns the choice between different providers or different types of services, but also creates possibilities to exit or partially exit social policies that previously were mandatory. Free choice in social policies might contribute to increasing responsiveness in service delivery. However, when the decisions to exit social policies are not distributed equally among the participants in social policy schemes but are related to participants' risk profiles, adverse selection might occur. The common response to the challenge of adverse selection is obligatory and universal participation in health insurance schemes, pension schemes and other social policies. The introduction of exit options as part of free choice strategies thus might threaten solidarity. Although the issue of free choice in social policies has received considerable scholarly attention, the introduction of exit options and its consequences have been analysed less extensively. This article sets out to fill this gap by exploring to what extent the introduction of free choice in modern welfare states has created exit options, and to what extent this triggers processes of adverse selection in health policies, unemployment policies and pension schemes in four European countries: the Netherlands, Spain, Sweden and the UK.
ACCOUNTING FOR (A) PUBLIC GOOD: PUBLIC HEALTHCARE IN ENGLAND
Authors: Ellwood Sheila
Published: October 2009

This paper reviews accounting technologies used over recent decades in the National Health Service: a public service (good) and the accounting for public interest (good) therein. The trends in NHS accounting are considered in the context of the defining characteristics of a modern public service. The accounting technologies, collectively known as New Public Financial Management (NPFM), are integral to wider public service reform. The overview of accounting technologies in context attempts to draw out some of the deficiencies or apparent mismatches in accounting technologies and public service reform.
Are All Professional Investors Sophisticated?
Authors: Menkhoff Lukas , Schmeling Maik , Schmidt Ulrich
Published: October 2009

Existing empirical evidence is inconclusive as to whether professional investors show more sophisticated behavior than individual investors. Therefore, we study two important groups of professional investors and compare them with laymen by means of a survey covering about 500 investors.We find that some professionals, i.e. institutional investors, behave in a more sophisticated manner than laymen, whereas the less researched investment advisors seem to do even worse. Our survey approach complements available evidence due to its design: it compares professionals with (qualified) interested laymen, it covers six measures of sophisticated behavior, uses several control variables and strictly compares investment decisions in the private domain.
Sickness and disability benefit programmes: What is driving policy convergence?
Authors: Prinz Christopher , Tompson William
Published: October 2009

In this paper we explore the reasons for the apparent convergence in sickness and disability policies across the OECD, asking whether and to what extent policy convergence should be seen as a product of policy learning. We conclude that convergence is the result of policy imitation more than policy learning and that learning (from past mistakes) is more likely within countries than across borders. Given limited evidence on what really “works”, when it comes to designing policies that both provide adequate income security and still encourage labour‐force participation, governments look abroad or to bodies like the OECD for possible models and ideas to underlie a reform. However, translating those ideas into workable policies requires great sensitivity to the institutional and political‐economic context — especially the role of the social partners and the nature of policies in existence. When it comes to policy implementation, such contextual learning may be crucial.
Old growth and secondary forest site occupancy by nocturnal birds in a neotropical landscape
Authors: Sberze M. , Cohn‐Haft M. , Ferraz G.
Published: October 2009

High rates of old growth (OG) forest destruction and difficult farming conditions result in increasing cover of secondary forests (SF) in the Amazon. In this setting, it is opportune to ask which animals use newly available SF and which stay restricted to OG. This study presents a comparison of SF and OG site occupancy by nocturnal birds in terra firme forests of the Amazon Guianan shield, north of Manaus, Brazil. We tested species‐specific occupancy predictions for two owls (Lophostrix cristata/Glaucidium hardyi), two potoos (Nyctibius leucopterus/Nyctibius griseus) and two nightjars (Caprimulgus nigrescens/Nyctidromus albicollis). For each pair, we predicted that one species would have higher occupancy in OG while the other would either be indifferent to forest type or favor SF sites. Data were collected in 30 OG and 24 SF sites with monthly samples from December 2007 to December 2008. Our analytic approach accounts for the possibility of detection failure and for spatial autocorrelation in occupancy, thus leading to strong inferences about changes in occupancy between forest types and between species. Nocturnal bird richness and community composition were indistinguishable between OG and SF sites. Owls were relatively indifferent to forest type. Potoos followed the a priori predictions, and one of the nightjars (C. nigrescens) favored SF instead of OG as predicted. Only one species, Nyctib. leucopterus, clearly favored OG. The landscape context of our SF study sites, surrounded by a vast expanse of continuous OG forest, partially explains the resemblance between SF and OG fauna but leaves unexplained the higher occupancy for SF than OG sites for several study species. The causal explanation of high SF occupancy remains an open question, but the result itself motivates further comparisons for other groups, as well as recognition of the conservation potential of SF.
Structural and functional characterization of a novel FE65 protein product up‐regulated in cognitively impaired FE65 knockout mice
Authors: Cool Bethany H. , Zitnik Galynn , Martin George M. , Hu Qubai
Published: October 2009

FE65 is a multi‐modular adaptor protein that binds the cytoplasmic tail of the β‐amyloid precursor protein (APP). Genetic evidence suggests that APP is intimately involved in the pathogenesis of dementias of the Alzheimer type, neurodegenerative disorders that affect multiple cognitive domains, including learning and memory. Evidence from p97FE65‐specific knockout mice (lacking the 97 kDa full‐length FE65 protein, p97FE65) suggests an important role for FE65 in learning and memory. Interpretation of the learning and memory phenotype, however, is complicated by the up‐regulation (compared with wild‐type mice) of a novel 60 kDa FE65 isoform (p60FE65). Here, we report an evidence that p60FE65 is translated from an alternative methionine, M261, on the p97FE65 transcript. Thus, p60FE65 has a shortened N‐terminus, lacking part of the WW domain that is considered important for nuclear translocation and transactivation of gene expression. Consistently, p60FE65 exhibits an attenuated ability for APP‐Gal4‐mediated transcription as compared with p97FE65. Similar to p97FE65, however, both transfected and endogenous p60FE65 are able to translocate to the nucleus in cultured cells and in neurons. These results are consistent with earlier evidence from our laboratory that reduced FE65 nuclear signaling may contribute, in part, to the phenotypes observed in p97FE65 knockout mice.
Treatment‐resistant Obsessive‐compulsive Disorder in Young People: Assessment and Treatment Strategies
Authors: Krebs Georgina , Heyman Isobel
Published: October 2009

Cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitors have both been established as effective interventions for paediatric obsessive‐compulsive disorder (OCD), with CBT being the recommended first‐line treatment in most cases. While the majority of young people respond well to these treatments, a significant proportion remain symptomatic. Although the research on treatment‐resistant OCD remains limited, increasing empirical attention is being paid to predictors of treatment outcome in young people with OCD, and efforts are being made to identify the factors that hinder recovery. This article outlines potential barriers in treatment and highlights strategies for optimising outcome, with particular focus on cognitive behavioural techniques.
Carisbamate as adjunctive treatment of partial onset seizures in adults in two randomized, placebo‐controlled trials
Authors: Sperling Michael R. , Greenspan Andrew , Cramer Joyce A. , Kwan Patrick , Kälviäinen Reetta , Halford Jonathan J. , Schmitt Jennifer , Yuen Eric , Cook Thomas , Haas Magali , Novak Gerald
Published: October 2009

Purpose:  To assess the efficacy, safety, and tolerability of the investigational drug carisbamate as adjunctive treatment for partial‐onset seizures (POS).

Methods:  Two identical, randomized, placebo‐controlled, double‐blind studies were conducted in adults with POS uncontrolled for ≥1 year. Therapy‐refractory epilepsy patients (≥16 years) remained on stable doses of prescribed antiepileptic drugs (≤2) for an 8‐week prospective baseline phase and were then randomized (1:1:1) to carisbamate 200 mg/day, carisbamate 400 mg/day, or placebo, for a 12‐week double‐blind phase. Primary efficacy end points were percent reduction in seizure frequency and responder rate (patients with ≥50% reduction in POS frequency) during the double‐blind phase compared with the prospective baseline phase.

Results:  Of the 565 patients randomized in study 1, 93% completed the study; of the 562 randomized in study 2, 94% completed the study. Patient characteristics were similar across both studies and treatment arms: mean age, 35 years (study 1, range 16–75 years) and 36 years (study 2, range 16–74 years); approximately 50% were men. Treatment with carisbamate 400 mg/day resulted in significant improvement (p < 0.01) in both efficacy measures compared with placebo in study 1 but not in study 2. Carisbamate 200 mg/day did not differ statistically from placebo in either study. Among the most common treatment‐emergent adverse events (≥5% in any group), those with an incidence exceeding placebo (≥3%) were dizziness (400 mg/day group) and somnolence.

Conclusions:  Carisbamate 400 mg/day was effective in patients with refractory partial‐onset seizures in one of these global studies. More than 200 mg/day of carisbamate is required for efficacy. Carisbamate was well‐tolerated in both studies.
Empirical Derivation and Validation of a Wandering Typology
Authors: Algase Donna L. , Antonakos Cathy , Beattie Elizabeth R. A. , Beel‐Bates Cynthia A. , Yao Lan
Published: October 2009

OBJECTIVES: To develop and validate a wandering typology.

DESIGN: Cross‐sectional, correlational descriptive design.

SETTING:: Twenty‐two nursing homes and six assisted living facilities.

PARTICIPANTS: One hundred forty‐two residents with dementia who spoke English, met Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for dementia, scored less than 24 on the Mini‐Mental State Examination (MMSE), were ambulatory (with or without assistive device), and maintained a stable regime of psychotropic medications were studied.

MEASUREMENTS: Data on wandering were collected using direct observations, plotted serially according to rate and duration to yield 21 parameters, and reduced through factor analysis to four components: high rate, high duration, low to moderate rate and duration, and time of day. Other measures included the MMSE, Minimum Data Set 2.0 mobility items, Cumulative Illness Rating Scale—Geriatric, and tympanic body temperature readings.

RESULTS: Three groups of wanderers were identified through cluster analysis: classic, moderate, and subclinical. MMSE, mobility, and cardiac and upper and lower gastrointestinal problems differed between groups of wanderers and in comparison with nonwanderers.

CONCLUSION: Results have implications for improving identification of wanderers and treatment of possible contributing factors.
Endurance Exercise Training in Older Patients with Heart Failure: Results from a Randomized, Controlled, Single‐Blind Trial
Authors: Brubaker Peter H. , Moore J. Brian , Stewart Kathryn P. , Wesley Debra J. , Kitzman Dalane W.
Published: October 2009

OBJECTIVES: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF).

DESIGN: Randomized, controlled, single‐blind trial.

SETTING: Outpatient cardiac rehabilitation program.

PARTICIPANTS: Fifty‐nine patients aged 60 and older with HFrEF recruited from hospital records and referring physicians were randomly assigned to a 16‐week supervised ET program (n=30) or an attention‐control, nonexercise, usual care control group (n=29).

INTERVENTION: Sixteen‐week supervised ET program of endurance exercise (walking and stationary cycling) three times per week for 30 to 40 minutes at moderate intensity regulated according to heart rate and perceived exertion.

MEASUREMENTS: Individuals blinded to group assignment assessed four domains pivotal to HFrEF pathophysiology: exercise performance, left ventricular (LV) function, neuroendocrine activation, and health‐related quality of life (QOL).

RESULTS: At follow‐up, the ET group had significantly greater exercise time and workload than the control group, but there were no significant differences between the groups for the primary outcomes: peak exercise oxygen consumption (VO2 peak), ventilatory anaerobic threshold (VAT), 6‐minute walk distance, QOL, LV volumes, EF, or diastolic filling. Other than serum aldosterone, there were no significant differences after ET in other neuroendocrine measurements. Despite a lack of a group “training” effect, a subset (26%) of individuals increased VO2 peak by 10% or more and improved other clinical variables as well.

CONCLUSION: In older patients with HFrEF, ET failed to produce consistent benefits in any of the four pivotal domains of HF that were examined, although the heterogeneous response of older patients with HFrEF to ET requires further investigation to better determine which patients with HFrEF will respond favorably to ET.
2. Cluster Headache
Authors: Van Kleef Maarten , Lataster Arno , Narouze Samer , Mekhail Nagy , Geurts José W. , Van Zundert Jan
Published: October 2009

Cluster headache is a strictly unilateral headache that is associated with ipsilateral cranial autonomic symptoms and usually has a circadian and circannual pattern. Prevalence is estimated at 0.5 to 1.0/1,000. The diagnosis of cluster headache is made based on the patient's case history. There are two main clinical patterns of cluster headache: the episodic and the chronic. Episodic is the most common pattern of cluster headache. It occurs in periods lasting 7 days to 1 year and is separated by at least a 1‐month pain‐free interval. The attacks in the chronic form occur for more than 1 year without remission periods or with remission periods lasting less than 1 month.

Conservative therapy consists of abortive and preventative remedies. Ergotamines and sumatriptan injections, sublingual ergotamine tartrate administration, and oxygen inhalation are effective abortive therapies. Verapamil is an effective and the safest prophylactic remedy. When pharmacological and oxygen therapies fail, interventional pain treatment may be considered. The effectiveness of radiofrequency treatment of the ganglion pterygopalatinum and of occipital nerve stimulation is only evaluated in observational studies, resulting in a 2 C+ recommendation.

In conclusion, the primary treatment is medication. Radiofrequency treatment of the ganglion pterygopalatinum should be considered in patients who are resistant to conservative pain therapy. In patients with cluster headache refractory to all other treatments, occipital nerve stimulation may be considered, preferably within the context of a clinical study.
China's booming livestock industry: household income, specialization, and exit
Authors: Rae Allan N. , Zhang Xiaohui
Published: October 2009

China's production of livestock products has generally kept pace with her rapidly increasing demand. Over‐supply and market corrections for various livestock products took place over the latter part of the 1990s and large numbers of householders exited this type of production. Using household survey data, we estimate the relationship between a household's specialization in livestock production and household net income in 1995, and use a logit model to explore some predictors of household exit from livestock production over the following decade of market instability. We conclude that specialist livestock households with access to necessary skills, technologies, and markets increase their incomes from further livestock specialization in the base year, whereas those to whom livestock production is relatively unimportant can increase household incomes by diverting their resources away from animal husbandry. It was specialist rather than diversified livestock households that tended to bear the brunt of the adjustment to unfavorable price movements over the decade post‐1995. Policy concerns include the exit of larger‐scale specialized producers who tended to earn relatively high household incomes in 1995, barriers to the effective formation and operation of horizontal and vertical integration options to help mitigate market instability, the further development of insurance programs and markets for livestock producers, and development assistance to livestock households that for various reasons cannot increase scale and specialization.
Multinational supermarket chains in developing countries: does local agriculture benefit?
Authors: Stokke Hildegunn E.
Published: October 2009

There is no consensus in the empirical literature on how entry of multinational supermarket chains affects farmers in developing countries. Econometric analyses struggle with causality issues and are unclear about the channel of effects. We quantify the dynamic effects of supermarket expansion on agriculture within a structural framework that clarifies the adjustment mechanisms involved. The model specification allows for endogenous interaction between agricultural productivity and supermarkets’ choice of suppliers. Based on numerical simulations, two results emerge. First, we offer a possible interpretation of the conflicting evidence in the empirical literature. Whether farmers benefit from supermarkets or get stuck in a low productivity trap depends on the extent of local constraints related to production capacity and market access. Second, supply chain development initiated by supermarkets can help farmers escape the low productivity trap. While supermarkets face a short‐run cost to supplier upgrading, they gradually gain from more productive local suppliers.
C3d immunohistochemistry on formalin‐fixed tissue is a valuable tool in the diagnosis of bullous pemphigoid of the skin
Authors: Pfaltz Katrin , Mertz Kirsten , Rose Christian , Scheidegger Paul , Pfaltz Madeleine , Kempf Werner
Published: October 2009

Background: Direct immunofluorescence (DIF) testing is an important procedure in the diagnosis of autoimmune bullous dermatoses. We investigated the expression of C3d in formalin‐fixed, paraffin‐embedded tissue of autoimmune bullous dermatoses.

Methods: The immunohistochemical expression of C3d in bullous pemphigoid (BP) (n = 32), pemphigoid gestationis (PG) (n = 3), pemphigus (n = 14), dermatitis herpetiformis Duhring (DHD) (n = 10), linear immunoglobulin A (IgA) dermatosis (n = 4), mixed forms of BP and linear IgA dermatosis (n = 2), and 44 controls was analyzed on formalin‐fixed tissue.

Results: Thirty‐one of 32 cases (97%) of BP and 3 out of 3 cases (100%) of PG showed a linear positivity of C3d along the basement membrane. Only 3 out of 14 (21%) cases of pemphigus showed an intraepidermal intercellular expression of C3d. The two mixed forms of linear IgA dermatosis and BP showed a linear positivity of C3d along the basement membrane. All cases of DHD, linear IgA dermatosis and all of the controls were negative for C3d.

Conclusions: C3d immunohistochemistry is a valuable tool in the diagnosis of BP and PG of the skin with a sensitivity of at least 97%. Mixed forms of linear IgA dermatosis, and BP, DHD and linear IgA dermatosis can only be identified by DIF. A positive result may prompt serologic confirmation of BP without further need for DIF.

Pfaltz K, Mertz K, Rose C, Scheidegger P, Pfaltz M, Kempf W. C3d immunohistochemistry on formalin‐fixed tissue is a valuable tool in the diagnosis of bullous pemphigoid of the skin.
Fatty aldehyde dehydrogenase is up‐regulated by polyunsaturated fatty acid via peroxisome proliferator‐activated receptor α and suppresses polyunsaturated fatty acid‐induced endoplasmic reticulum stress
Authors: Ashibe Bunichiro , Motojima Kiyoto
Published: October 2009

Fatty aldehyde dehydrogenase (FALDH; also known as ALDH3A2 or ALDH10) oxidizes medium‐ or long‐chain aliphatic aldehydes. FALDH deficiency in humans is known to be the cause of Sjögren–Larsson syndrome, in which individuals display neurological symptoms and cutaneous abnormality. FALDH‐V, a splice isoform of FALDH, is localized in the peroxisome and contributes to the oxidization of pristanal, an intermediate of the α‐oxidation pathway. FALDH‐N, another splice isoform of FALDH, is induced by peroxisomal proliferator‐activated receptor α ligands, although its activation mechanism has not been clarified. In the present study, we show that transcriptional activation of FALDH is directly regulated by peroxisomal proliferator‐activated receptor α through a direct repeat‐1 site located in the FALDH promoter. In addition, FALDH is efficiently induced by linoleic acid in rat hepatoma Fao cells through transcriptional activation by peroxisomal proliferator‐activated receptor α. Furthermore, ectopic expression of endoplasmic reticulum‐localizing FALDH‐N, but not peroxisome‐localizing FALDH‐V, suppresses endoplasmic reticulum stress caused by linoleic acid in HEK293 cells. These results suggest the autocatalytic nature of the FALDH‐N system against endoplasmic reticulum stress that is induced by polyunsaturated fatty acid; polyunsaturated fatty acid binds to peroxisomal proliferator‐activated receptor α to activate the expression of FALDH‐N, which then detoxifies polyunsaturated fatty acid‐derived fatty aldehydes and protects cells from endoplasmic reticulum stress.
Alternative splicing produces an H‐protein with better substrate properties for the P‐protein of glycine decarboxylase
Authors: Hasse Dirk , Mikkat Stefan , Hagemann Martin , Bauwe Hermann
Published: October 2009

Several thousand plant genes are known to produce multiple transcripts, but the precise function of most of the alternatively encoded proteins is not known. Alternative splicing has been reported for the H‐protein subunit of glycine decarboxylase in the genus Flaveria. H‐protein has no catalytic activity itself but is a substrate of the three enzymatically active subunits, P‐, T‐ and L‐protein. In C4 species of Flaveria, two H‐proteins originate from single genes in an organ‐dependent manner. Here, we report on differences between the two alternative H‐protein variants with respect to their interaction with the glycine‐decarboxylating subunit, P‐protein. Steady‐state kinetic analyses of the alternative Flaveria H‐proteins and artificially produced ‘alternative’ Arabidopsis H‐proteins, using either pea mitochondrial matrix extracts or recombinant cyanobacterial P‐protein, consistently demonstrate that the alternative insertion of two alanine residues at the N‐terminus of the H‐protein elevates the activity of P‐protein by 20%in vitro, and could promote glycine decarboxylase activity in vivo.
The origin of magnetism on the upper main sequence
Authors: Ferrario Lilia , Pringle J. E. , Tout Christopher A. , Wickramasinghe D. T.
Published: October 2009

We consider the incidence of magnetism in main-sequence stars with mainly radiative envelopes. We propose that the small fraction, which increases with mass, of stars which are magnetic can be explained if towards the end of the formation process, after the stars have developed a substantial radiative envelope, a correspondingly small fraction of stars merge. Such late mergers would produce a brief period of strong differential rotation and give rise to large-scale fields in the radiative envelopes. Such late mergers can also account for the lack of close binaries among these stars.
The origin of the Guitar pulsar
Authors: Tetzlaff N. , Neuhäuser R. , Hohle M. M.
Published: October 2009

Among a sample of 140 OB associations and clusters, we want to identify probable parent associations for the Guitar pulsar (PSR B2224+65), which would then also constrain its age. For this purpose, we are using an Euler–Cauchy technique, treating the vertical component of the Galactic potential to calculate the trajectories of the pulsar and each association into the past. To include errors, we use Monte Carlo simulations varying the initial parameters within their error intervals. The whole range of possible pulsar radial velocities is taken into account during the simulations.

We find that the Guitar pulsar most probably originated from the Cygnus OB3 association ≈0.8Myr ago, inferring a current radial velocity of vr≈−30kms−1, consistent with the inclination of its bow shock.