bluuebunny/crossref_metadata_2025 huggingface dataset:
NONPARAMETRIC QUANTILE ESTIMATION FROM RECORD‐BREAKING DATA
Authors: Gulati1 Sneh , Padgett W.J.
Published: August 2010

Sometimes, in industrial quality control experiments and destructive stress testing, only values smaller than all previous ones are observed. Here we consider nonparametric quantile estimation, both the ‘sample quantile function’ and kernel‐type estimators, from such record‐breaking data. For a single record‐breaking sample, consistent estimation is not possible except in the extreme tails of the distribution. Hence replication is required, and form.such independent record‐breaking samples the quantile estimators are shown to be strongly consistent and asymptotically normal as m‐→∞. Also, for smallm, the mean‐squared errors, biases and smoothing parameters (for the smoothed estimators) are investigated through computer simulations.
AN ALGORITHM FOR CHOOSING THE SAMPLING TIMES FOR AN EXPERIMENT ON A CONTINUOUS PROCESS
Authors: Saunders Ian W.
Published: August 2010

Saunders & Eccleston (1992) and Saunders, Eccleston & Spessa (1992) developed an approach to the design of factorial experiments on continuous processes that allows for the correlation present in such processes. Their methods concentrated on identifying the order of application of treatments in such experiments, assuming that the spacing between experiments is constant. On a continuous process, there is no necessity to maintain equally spaced sampling times. This paper gives an algorithm for choosing the optimal sampling times for a factorial experiment aimed at estimating a particular parameter or set of parameters. It is shown that in practical situations the optimal sampling times give considerable improvements in the accuracy of the parameter estimates.
ON THE POWER BREAKDOWN OF THE NEGATIVE EXPONENTIAL DISPARITY TESTS
Authors: Sarathi Dey Partha , Basu Ayanendranath
Published: August 2010

The generalized negative exponential disparity, discussed in Bhandari et al. (Robust inference in parametric models using the family of generalized negative exponential disparities, 2006, ANZJS, 48, 95–114), represents an important class of disparity measures that generates efficient estimators and tests with strong robustness properties. In their paper, however, Bhandari et al. failed to provide a sharp lower bound for the power breakdown point of the corresponding tests. This was acknowledged by the authors, who indicated the possible existence of a sharper bound, but noted that they did not “have a proof at this point”. In this paper we provide an improved bound for this power breakdown point, and show with an example how this can enhance the existing results.
IDENTIFYING TREATMENT EFFECTS IN MULTI‐CHANNEL MEASUREMENTS IN ELECTROENCEPHALOGRAPHIC STUDIES: MULTIVARIATE PERMUTATION TESTS AND MULTIPLE COMPARISONS
Authors: Wheldon M. C. , Anderson M. J. , Johnson B. W.
Published: August 2010

A versatile procedure is described comprising an application of statistical techniques to the analysis of the large, multi‐dimensional data arrays produced by electroencephalographic (EEG) measurements of human brain function. Previous analytical methods have been unable to identify objectively the precise times at which statistically significant experimental effects occur, owing to the large number of variables (electrodes) and small number of subjects, or have been restricted to two‐treatment experimental designs. Many time‐points are sampled in each experimental trial, making adjustment for multiple comparisons mandatory. Given the typically large number of comparisons and the clear dependence structure among time‐points, simple Bonferroni‐type adjustments are far too conservative. A three‐step approach is proposed: (i) summing univariate statistics across variables; (ii) using permutation tests for treatment effects at each time‐point; and (iii) adjusting for multiple comparisons using permutation distributions to control family‐wise error across the whole set of time‐points. Our approach provides an exact test of the individual hypotheses while asymptotically controlling family‐wise error in the strong sense, and can provide tests of interaction and main effects in factorial designs. An application to two experimental data sets from EEG studies is described, but the approach has application to the analysis of spatio‐temporal multivariate data gathered in many other contexts.
BAYESIAN ESTIMATION OF RUIN PROBABILITIES WITH A HETEROGENEOUS AND HEAVY‐TAILED INSURANCE CLAIM‐SIZE DISTRIBUTION
Authors: Ausin M. Concepcion , Lopes Hedibert F.
Published: August 2010

This paper describes a Bayesian approach to make inference for risk reserve processes with an unknown claim‐size distribution. A flexible model based on mixtures of Erlang distributions is proposed to approximate the special features frequently observed in insurance claim sizes, such as long tails and heterogeneity. A Bayesian density estimation approach for the claim sizes is implemented using reversible jump Markov chain Monte Carlo methods. An advantage of the considered mixture model is that it belongs to the class of phase‐type distributions, and thus explicit evaluations of the ruin probabilities are possible. Furthermore, from a statistical point of view, the parametric structure of the mixtures of the Erlang distribution offers some advantages compared with the whole over‐parametrized family of phase‐type distributions. Given the observed claim arrivals and claim sizes, we show how to estimate the ruin probabilities, as a function of the initial capital, and predictive intervals that give a measure of the uncertainty in the estimations.
SHRINKAGE, PRETEST AND ABSOLUTE PENALTY ESTIMATORS IN PARTIALLY LINEAR MODELS
Authors: Ahmed S. Ejaz , Doksum Kjell A. , Hossain S. , You Jinhong
Published: August 2010

We consider a partially linear model in which the vector of coefficientsβin the linear part can be partitioned as(β1,β2), whereβ1is the coefficient vector for main effects (e.g. treatment effect, genetic effects) andβ2is a vector for ‘nuisance’ effects (e.g. age, laboratory). In this situation, inference aboutβ1may benefit from moving the least squares estimate for the full model in the direction of the least squares estimate without the nuisance variables (Steinian shrinkage), or from dropping the nuisance variables if there is evidence that they do not provide useful information (pretesting). We investigate the asymptotic properties of Stein‐type and pretest semiparametric estimators under quadratic loss and show that, under general conditions, a Stein‐type semiparametric estimator improves on the full model conventional semiparametric least squares estimator. The relative performance of the estimators is examined using asymptotic analysis of quadratic risk functions and it is found that the Stein‐type estimator outperforms the full model estimator uniformly. By contrast, the pretest estimator dominates the least squares estimator only in a small part of the parameter space, which is consistent with the theory. We also consider an absolute penalty‐type estimator for partially linear models and give a Monte Carlo simulation comparison of shrinkage, pretest and the absolute penalty‐type estimators. The comparison shows that the shrinkage method performs better than the absolute penalty‐type estimation method when the dimension of theβ2parameter space is large.
THE J‐CURVE AT THE INDUSTRY LEVEL: EVIDENCE FROM TRADE BETWEEN THE US AND AUSTRALIA*
Authors: BAHMANI‐OSKOOEE MOHSEN , WANG YOMGQING
Published: August 2010

Previous studies that tested the J‐curve phenomenon for Australia used trade data either between Australia and the rest of the world or between Australia and its trading partners on a bilateral basis. They were unable to find support for the J‐curve in the short run nor any significant relation between the trade balance and the exchange rate in the long run. In this paper we disaggregate the data between Australia and its second largest trading partner, the US, and consider the trade between 108 industries. Using annual data over the 1962–2003 period and bounds testing approach to cointegration and error‐correction modelling, we are able to discover short‐run effects of currency depreciation on the trade balance in 64 industries. The long‐run and positive effects were only evidenced in 35 cases, supporting the J‐curve.
PREDICTING FINANCIAL DISTRESS IN THE AUSTRALIAN FINANCIAL SERVICE INDUSTRY
Authors: YIM JULIANA , MITCHELL HEATHER
Published: August 2010

This paper looks at the ability of a relatively new technique, a non‐linear extension of the Granger thick model concept, hybrid ANN's, to predict failure of financial service firms in Australia. These models are compared with traditional statistical techniques and conventional ANN models. The results suggest that hybrid neural networks outperform all other models in predicting failure for up to two years prior to the event. This suggests that for researchers, policymakers and others interested in early warning systems, hybrid network may be a useful tool for predicting firm failure.
SLAVERY AND DOMINATION AS POLITICAL IDEAS IN AUGUSTINE'S CITY OF GOD
Authors: CHAMBERS KATHERINE
Published: August 2010

The purpose of this article is to explore the meaning of domination and slavery in the political philosophy of Augustine of Hippo (354–430), particularly in the major work of his later years, the City of God. It offers an exploration of this aspect of Augustine's thought in the light of relatively recent scholarship on the meaning of these terms for political philosophy (in particular, the work of Quentin Skinner and Philip Pettit). It finds that, in Augustine's eyes, the nature of domination or slavery in the political sphere differed from its nature in the domestic sphere.
Early predictors of dyslexia in Chinese children: familial history of dyslexia, language delay, and cognitive profiles
Authors: McBride‐Chang Catherine , Lam Fanny , Lam Catherine , Chan Becky , Fong Cathy Y.‐C. , Wong Terry T.‐Y. , Wong Simpson W.‐L.
Published: August 2010

Background:  This work tested the rates at which Chinese children with either language delay or familial history of dyslexia at age 5 manifested dyslexia at age 7, identified which cognitive skills at age 5 best distinguished children with and without dyslexia at age 7, and examined how these early abilities predicted subsequent literacy skills.

Method:  Forty‐seven at‐risk children (21 who were initially language delayed and 26 with familial risk) and 47 control children matched on age, IQ, and mothers’ education were tested on syllable awareness, tone detection, rapid automatized naming, visual skill, morphological awareness, and word reading at age 5 and subsequently tested for dyslexia on a standard Hong Kong measure at age 7.

Results:  Of those with an early language delay, 62% subsequently manifested dyslexia; for those with familial risk, the rate of dyslexia was 50%. Those with dyslexia were best distinguished from those without dyslexia by the age‐5 measures of morphological awareness, rapid automatized naming, and word reading itself; other measures did not distinguish the groups. In a combined regression analysis across all participants, morphological awareness uniquely explained word reading accuracy and rapid automatized naming uniquely explained timed word reading at age 7, with all other measures statistically controlled. Separate stepwise regression analyses by group indicated that visual skill uniquely explained subsequent literacy skills in the at‐risk group only, whereas tone and syllable awareness were unique predictors of literacy skills in the control group only.

Conclusions:  Both early language delay and familial risk strongly overlap with subsequent dyslexia in Chinese children. Overall, rapid automatized naming and morphological awareness are relatively strong correlates of developmental dyslexia in Chinese; visual skill and phonological awareness may also be uniquely associated with subsequent literacy development in at‐risk and typically developing children, respectively.
Contextual risk factors as predictors of disruptive behavior disorder trajectories in girls: the moderating effect of callous‐unemotional features
Authors: Kroneman Leoniek M. , Hipwell Alison E. , Loeber Rolf , Koot Hans M. , Pardini Dustin A.
Published: August 2010

Background:  The presence of callous‐unemotional (CU) features may delineate a severe and persistent form of conduct problems in children with unique developmental origins. Contextual risk factors such as poor parenting, delinquent peers, or neighborhood risk are believed to influence the development of conduct problems primarily in children with low levels of CU features. However, longitudinal studies examining the moderating effect of CU features on the relation between contextual risk factors and conduct problems trajectories in girls are rare.

Methods:  Growth curve analysis was conducted using five annual measurements of oppositional defiant disorder/conduct disorder (ODD/CD) behaviors in a community sample of 1,233 girls aged 7–8 at study onset. The relation between contextual risk factors in multiple domains (i.e., family, peer, community) and trajectories of ODD/CD behaviors across time were examined for girls with differing levels of CU features.

Results:  Growth curve analysis indicated that CU features were associated with chronically high levels of ODD/CD symptoms over time. Low levels of parental warmth were also associated with chronically high levels of ODD/CD, and this effect was particularly pronounced for girls with high CU features. Exposure to harsh parenting was associated with higher ODD/CD behaviors for girls in childhood regardless of their level of CU features, but this effect dissipated over time.

Conclusions:  Girls with elevated CU features who are exposed to low levels of parental warmth seem to exhibit particularly severe ODD/CD symptoms and should be targeted for intensive intervention in childhood.
Borderline personality symptoms differentiate non‐suicidal and suicidal self‐injury in ethnically diverse adolescent outpatients
Authors: Muehlenkamp Jennifer J. , Ertelt Troy W. , Miller Alec L. , Claes Laurence
Published: August 2010

Background:  There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non‐suicidal self‐injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI from suicide attempts or differentiate single from repeated acts of either suicide or NSSI.

Method:  Archival, de‐identified outpatient clinical charts from 441 ethnically diverse (4.3% Caucasian; 70.9% female) adolescents (mean age = 14.9, SD = 1.61) were reviewed. Data pertaining to NSSI, suicide attempt history, BPD symptoms, and psychiatric diagnoses were obtained from self‐report measures and semi‐structured interviews administered at intake.

Results:  MANOVA and logistic regression analyses revealed significant differences across groups, with the BPD symptoms of ‘confusion about self’ and ‘unstable interpersonal relationships’ significantly predicting NSSI and NSSI+Suicide group status. The number of BPD criteria met plus high levels of confusion about self significantly predicted single vs. repeat self‐harm group membership.

Conclusions:  Two BPD symptoms exhibit distinct relationships to NSSI and suicide attempts, but there is not strong variation in their relationship to BPD. Treatment addressing BPD symptoms may be useful to reducing both NSSI and suicide in ethnically diverse adolescents.
Needs for food security from the standpoint of Canadian households participating and not participating in community food programmes
Authors: Hamelin Anne‐Marie , Mercier Céline , Bédard Annie
Published: August 2010

In a context where food assistance continues to dominate talks on food security, this study was undertaken to refocus the debate on households' needs. Our objective was to examine the food security experience and needs of food‐insecure households from the standpoint of those participating in community programmes for food security as well as those not doing so. Semi‐structured individual interviews were conducted with a purposive sample of 55 food‐insecure households in Quebec City, Canada. Transcriptions were subjected to content analysis. The results revealed distinct food insecurity situations. The interviewees' accounts show that households participating in community food security programmes and non‐participating households did not have the same profile of food insecurity risks and capacity to cope with those risks. Nevertheless, three main categories of needs emerged from all the households: needs specific to food security (particularly good quality diet), needs regarding the conditions necessary for achieving food security (especially financial access to food) and related needs. Food insecurity was seen as involving a cluster of problems. The results reinforce the necessity for responses that are not uniform but rather situation‐specific. Clearly, households are demanding more than food for survival: they need a set of conditions that will ensure them regular and sustainable access to a good quality diet.
THE VINLAND MAP: A CRITICAL REVIEW OF ARCHAEOMETRIC RESEARCH ON ITS AUTHENTICITY*
Authors: HARBOTTLE G.
Published: August 2010

The authenticity of the ‘Vinland Map’ (Beinecke Library of Rare Books and Manuscripts at Yale University) has been challenged on both codicological and scientific grounds, the latter resulting from a microscopic study of the ink employed. McCrone Associates of Chicago examined, between 1972 and 1974, a total of 29 microparticles, including 16 of ink from the Vinland Map, and in 1974 reported to Yale that it contained a pigment, anatase, only available after 1920. In 1974, Yale announced that the map was ‘probably a modern forgery’. This review critically examines archaeometric research leading to, and testing, this conclusion.
CHARACTERIZING THE DIET OF INDIVIDUALS AT THE NEOLITHIC CHAMBERED TOMB OF HAZLETON NORTH, GLOUCESTERSHIRE, ENGLAND, USING STABLE ISOTOPIC ANALYSIS*
Authors: HEDGES R. , SAVILLE A. , O’CONNELL T.
Published: August 2010

Stable carbon and nitrogen isotope compositions were measured on human and faunal bones, sampled from the Neolithic chambered tomb of Hazleton North, Gloucestershire, UK. The values were used to characterize the diet of the burial community as a whole. Humans were higher in δ15N by 4.5–5.0‰ relative to animal δ15N, from which we conclude that, based on currently accepted interpretations of isotopic data, the humans consumed a diet that was very high in meat or animal products (75% by weight of protein). Comparison was also possible between cortical and cancellous femoral collagen, with the results showing no significant difference for the adult humans. The sample of human isotopic values showed little variability, in contrast to that found in the domestic and wild animals from the site (including cattle, pigs, sheep and deer). We suggest that this is due to local environmental differences, rather than to environmental change over time or physiological differences between individual animals, and that this pattern is likely to hold for many other archaeological sites when analysed with sufficient statistical weight.
Role of connexin 43 in the maintenance of spontaneous activity in the guinea pig prostate gland
Authors: Dey Anupa , Kusljic Snezana , Lang Richard J , Exintaris Betty
Published: August 2010

BACKGROUND AND PURPOSETo investigate the role of connexin 43 in the maintenance of spontaneous activity in prostate tissue from young and old guinea pigs.

EXPERIMENTAL APPROACHConventional intracellular microelectrode and tension recording techniques, coupled with Western blot analysis and immunohistochemistry for connexin 43 (CX43) were used. The effects of three gap junction uncouplers, 18β glycyrrhetinic acid (10 µM, 40 µM), carbenoxolone (10 µM, 50 µM) and octanol (0.5 mM, 1 mM), were studied in cells displaying slow wave activity and on spontaneously contracting tissue from prostate glands of young (2–5 months) and old (9–16 months) guinea pigs.

KEY RESULTS18β Glycyrrhetinic acid (40 µM), carbenoxolone (50 µM) or octanol (0.5 mM) abolished slow wave activity in prostate tissue from young and old guinea pigs and depolarized membrane potential by approximately 5 mV. These treatments also abolished all contractions in both sets of prostate tissue. These effects were reversed upon washout. Western blot analysis and CX43 immunohistochemistry showed that there was no age‐related difference in the expression and distribution of CX43 in prostate tissues.

CONCLUSION AND IMPLICATIONSWhen gap junctional communication via CX43 was disrupted, spontaneous activity was abolished at a cellular and whole tissue level; CX43 is therefore essential for the maintenance of spontaneous slow wave activity and subsequent contractile activity in the guinea pig prostate gland.
Are there functional β3‐adrenoceptors in the human heart?
Authors: Michel Martin C , Harding Sian E , Bond Richard A
Published: August 2010

β3‐Adrenoceptor mRNA is expressed in the human heart, but corresponding receptor protein has not yet consistently been demonstrated. Furthermore, their physiological role remains highly controversial. For example, in human atria these receptors apparently do not promote cAMP formation. Evidence presented in this issue of theBJPsuggests that a previously reported β3‐adrenoceptor‐mediated stimulation of Ca2+channels at room temperature is absent at physiological temperatures, and that β3‐adrenoceptors have no effect on atrial contraction. Drugs classified as β3‐adrenoceptor agonists cause contraction in human atria but in most cases this involves β1‐ and/or β2‐adrenoceptors. In contrast, in human ventricles β3‐adrenoceptor agonists can exhibit negative inotropic effects, potentially involvingPertussistoxin‐sensitive G‐proteins and activation of a NO synthase. However, firmer pharmacological evidence is required that these effects indeed occur via β3‐adrenoceptors. Whether the expected future use of β3‐adrenoceptor agonists in the treatment of urinary bladder dysfunction is associated with adverse events related to cardiac function remains to be determined from clinical studies.

LINKED ARTICLEThis article is a commentary on Christet al., pp. 823–839 of this issue. To view this paper visithttp://dx.doi.org/10.1111/j.1476‐5381.2010.00996.x
Structural determinants in the second intracellular loop of the human cannabinoid CB1receptor mediate selective coupling to Gsand Gi
Authors: Chen XP , Yang W , Fan Y , Luo JS , Hong K , Wang Z , Yan JF , Chen X , Lu JX , Benovic JL , Zhou NM
Published: August 2010

BACKGROUND AND PURPOSEThe cannabinoid CB1receptor is primarily thought to be functionally coupled to the Giform of G proteins, through which it negatively regulates cAMP accumulation. Here, we investigated the dual coupling properties of CB1receptors and characterized the structural determinants that mediate selective coupling to Gsand Gi.

EXPERIMENTAL APPROACHA cAMP‐response element reporter gene system was employed to quantitatively analyze cAMP change. CB1/CB2receptor chimeras and site‐directed mutagenesis combined with functional assays and computer modelling were used to determine the structural determinants mediating selective coupling to Gsand Gi.

KEY RESULTSCB1receptors could couple to both Gs‐mediated cAMP accumulation and Gi‐induced activation of ERK1/2 and Ca2+mobilization, whereas CB2receptors selectively coupled to Giand inhibited cAMP production. Using CB1/CB2chimeric receptors, the second intracellular loop (ICL2) of the CB1receptor was identified as primarily responsible for mediating Gsand Gicoupling specificity. Furthermore, mutation of Leu‐222 in ICL2 to either Ala or Pro switched G protein coupling from Gsto Gi, while to Ile or Val led to balanced coupling of the mutant receptor with Gsand Gi.

CONCLUSIONS AND IMPLICATIONSThe ICL2 of CB1receptors and in particular Leu‐222, which resides within a highly conserved DRY(X)5PL motif, played a critical role in Gsand Giprotein coupling and specificity. Our studies provide new insight into the mechanisms governing the coupling of CB1receptors to G proteins and cannabinoid‐induced tolerance.
Apsoriatic psoriatic arthritis
Authors: LEUNG Y. Y. , LIM K. K. T.
Published: August 2010

Numerous features distinguish psoriatic arthritis (PsA) from other arthropathies, including the presence of psoriasis, distal interphalangeal (DIP) joint involvement, nail dystrophy, enthesitis, dactylitis and spinal involvement. Two decades ago, the presence of psoriasis was mandatory in the diagnosis of PsA. Up to 15% of patients had joint disease preceding psoriasis. In this group of patients, it may have been years after the onset of arthritis before the definitive diagnosis of PsA could be made. With advancements in treatment modalities, an accurate and proper diagnosis is relevant to the management of PsA. In their case report appearing in this issue, Taniguchi and Kamatani present a case with classical PsA without skin and nail lesions for 21 years. It may not be that unusual to encounter this in clinical practice, but we think it an opportune time to review the classification criteria and illustrate how the diagnosis of PsA can be made earlier.
Role of tumor necrosis factor‐alpha in rheumatoid arthritis: a review
Authors: VASANTHI Pallinti , NALINI Ganesan , RAJASEKHAR G.
Published: August 2010

Tumor necrosis factor‐alpha (TNF‐α) is a proinflammatory cytokine that plays a pivotal role in regulating the inflammatory response in rheumatoid arthritis (RA). Although it is controversial whether TNF‐α genes are associated with RA susceptibility, they are well known to mediate RA pathogenesis. We review in depth the history, formation and biological action, TNF receptor, role in mediating pathogenesis in RA and mode of action, of anti‐TNF‐α drugs.
Glomerulonephropathy in ankylosing spondylitis
Authors: CHAO Yin‐Cih , TSAI Shih‐Tzu , HUANG De‐Feng
Published: August 2010

Aim:  Renal abnormalities have been reported in ankylosing spondylitis (AS). The purpose of this study was to elucidate the nature of glomerulonephropathy in AS.

Methods:  Two hundred and sixty‐six patients with definite AS diagnosed at Taipei Veterans General Hospital, Taiwan, were enrolled. Urinary analysis and renal biopsy were performed in this study. The nature of glomerulonephropathy in AS was analyzed.

Results:  Twelve out of 266 (4.5%) patients had AS‐associated nephropathy manifesting as haematuria alone (11 patients) or haematuria and proteinuria (1 patient). Renal biopsy in seven patients showed IgA nephropathy in two cases, mesangial nephropathy with isolated C3 deposits in three cases, and IgM nephropathy in two cases, one of which had accompanied infectious endocarditis.

Conclusion:  AS‐associated nephropathy is not uncommon and mesangial nephropathy is the most common form. Microscopic haematuria and proteinuria are the most common manifestations of renal involvement.
Pattern of psoriatic arthritis in an Asian population (Malaysia)
Authors: VEERAPEN Kiran Kapoor
Published: August 2010

Objective: To profile the pattern of psoriatic arthritis (PsA) and its relationship to disease duration.

Methods: Forty‐six consecutive patients with PsA were entered into a cross‐sectional study. Demographic data, disease duration and disability were recorded. Joint involvement was documented at 6 months from onset and at presentation. X‐rays of the sacroiliac (SI) joints, thoracolumbar spine, and hands were taken. HLA B27 typing was done.

Results: The male : female ratio was 2.3 : 1, mean age at onset of arthritis was 35.8 years and mean duration of PsA was 4.2 years. Oligoarticular involvement predominated (63%) at onset. Progression from oligoarthritis to polyarthritis occurred largely in the second year; 65.2% reported asymmetrical disease at onset while 50% had asymmetrical disease when disease duration was > 1 year. The frequency of involvement at onset was as follows: sausage toes, metatarsophalangeals (MTPs) and interphalangeals (IPs) in 50% (each), proximal interphelangeals (PIPs) in 47.8%, sausage fingers 34.7% and knees 30%. With mean duration of 4.2 years it was: sausage toe 71.1%, IP 69.5%, PIP and MTP 63%, knees 60.8%, distal interphalangeals (DIPs) 54.3%, sausage finger 52.1%, wrist 47.8%, followed by neck and back pain. Disability related to lower limb functions predominated and occurred early. Forty‐one percent had radiological sacroiliatis/spondylitis and 46% had erosive arthritis in the hands; 10.2% were HLA B27 positive.

Conclusion: PsA was progressive, starting predominantly as an asymmetrical oligoarthritis and becoming largely polyarticular within 2 years from onset. Lower limb disability was evident early and erosive changes in hand X‐rays were seen in more than half the patients after 1 year.
Clinical significance of elevated serum levels of matrix metalloproteinase‐3 and C‐reactive protein in patients with rheumatoid arthritis
Authors: NAGASAWA Hayato , KAMEDA Hideto , AMANO Koichi , TAKEUCHI Tsutomu
Published: August 2010

Aim:  Serum levels of C‐reactive protein (CRP) and matrix metalloproteinase‐3 (MMP‐3) are used as indicators of the activity of rheumatoid arthritis (RA). The aim of this study was to characterize the clinical features of patients showing exclusive elevation of either serum CRP or MMP‐3, and the differences in the time‐course of changes between the serum levels of MMP‐3 and CRP after initiation of therapy.

Methods:  A total of 129 RA patients were classified into four groups according to the serum levels of CRP and MMP‐3 at the time of enrolment: negative for both CRP and MMP‐3 levels; positive for both; positive for CRP alone (CRP‐positive group); and positive for MMP‐3 alone (MMP‐3‐positive group). The analysis included evaluation of the serum CRP and MMP‐3 levels, and the Lansbury Articular Index at enrolment and at final observation.

Results:  In the CRP‐positive group (19%), 21% of the patients remained CRP‐positive at the final observation; 42% became double‐negative, and 31% became double‐positive. In contrast, in the MMP‐3‐positive group (9%), about two‐thirds of the patients remained MMP‐3‐positive at the final observation. The disease duration in the MMP‐3‐positive group was significantly longer, and the ratio of the number of large swollen joints to the total number of swollen joints was higher as compared with that in the other groups. Furthermore, elevated serum CRP responded faster to disease‐modifying antirheumatic drug therapy than elevated serum MMP‐3.

Conclusions:  Serum CRP is a better predictor of the response to treatment than serum MMP‐3, which is associated to a greater extent with large joint involvement.
Ultrasonographic detection of spontaneous rupture in the Biceps tendon of a patient with rheumatoid arthritis
Authors: KIM Hyun‐Sook , JU Ji Hyeon , YOON Chong‐Hyeon , PARK Sung‐Hwan , KIM Ho‐Youn
Published: August 2010

Ultrasonography is a useful imaging modality for the diagnosis of pathologic conditions in the biceps tendon. We describe a 64‐year old man with rheumatoid arthritis (RA) who suddenly developed a painless lump in the antecubital region of the right arm. The bulging was prominent when he flexed his forearm. Proximal loss of the long head in biceps tendon could be demonstrated by ultrasonography. The ultrasonographic features of spontaneous isolated biceps tendon rupture occurring in a patient with RA are described.
Long‐standing ulcerative colitis complicated by right subclavian artery occlusion and upper limbs arteriolitis with digital ischemia
Authors: EMAD Yasser , RAGAB Yasser , EL‐MARAKBI Ahmed , MOHAMED HANFI Salama
Published: August 2010

A 48‐year‐old male patient with long‐standing ulcerative colitis since February 2001 which was diagnosed by endoscopy, developed acute digital ischemia affecting both hands with fixed colour changes in the left index finger which was followed shortly by digital ulceration. Magnetic resonance angiography (MRA) of both upper limbs showed evidence of vasculitis affecting digital arterioles on both sided and right subclavian occlusion. The patient received pulse methylprednisolone followed by cyclophosphamide pulse therapy, the latter continuing on a monthly basis for 6 months with appreciable improvement and remission of the vasculitic process; follow‐up MRA showed reperfusion of the previously occluded subcalvian artery. To the authors’ knowledge vasculitis complicating the course of ulcerative colitis is a rare association and is only sporadically reported in the literature. This rare entity should be diagnosed early and aggressively treated; MRA is a very promising diagnostic tool that is suitable for both diagnosis and follow‐up of patients with this rare entity.
An unusual cause of calf hypertrophy: severe lumbar canal stenosis with S1 nerve root radiculopathy
Authors: ONG V. , JONES J. , STEUER A.
Published: August 2010

We report an unusual case of calf hypertrophy in a 62‐year‐old woman who developed progressive enlargement of the left calf in association with chronic lower back pain. Magnetic resonance imaging (MRI) of the affected calf confirmed enlargement of the soleus muscle. MRI of the lumbar spine showed multilevel degenerative changes. Electromyography revealed neurogenic features consistent with S1 radiculopathy. Our case illustrates that muscular hypertrophy may follow chronic denervation as a consequence of spinal neural compressive disease. The various mechanisms postulated for this distinct condition and therapeutic strategies are outlined.
Alveolar hemorrhage in systemic lupus erythematosus
Authors: GOGIA Atul , KAKAR Atul , SUREKA Rohit , BYOTRA S. , PRAKASH Ved
Published: August 2010

Alveolar haemorrhage is a catastrophic though rare complication of systemic lupus erythematosus (SLE) and is associated with a high mortality rate with most studies showing a mortality of 23–92%. The treatment modalities available for such complications are pulse cyclophosphamide therapy with steroids and plasmapheresis in patients who do no respond to the above treatment. We report here a case of SLE with alveolar haemorrhage that despite being on immunomodulatory therapy developed alveolar haemorrhage and did not respond to plasmapheresis.
Pathergy test in Behcet's disease: change in incidence over the time
Authors: DAVATCHI Fereydoun , CHAMS‐DAVATCHI Cheyda , SHAHRAM Farhad , NADJI Abdolhadi , SHAMS Hormoz , GHODSI Zahra , AKHLAGHI Massoomeh , NADERI Nasim , SADEGHI‐ABDOLAHI Bahar
Published: August 2010

Introduction:  Pathergy phenomenon (PP) is used as a criterion in many diagnostic criteria for Behcet's disease (BD): Curth, Japan, Hubault and Hamza, Cheng and Zhang, Dilsen, International Study Group, Iran criteria (traditional format and the Classification Tree), Korea criteria, and the new International Criteria. PP is rather specific to BD. It has been reported with high frequency from most countries along the Silk Road, but with much lower frequency from other countries (UK, US). The incidence of PP has been reported from some countries (Japan, Turkey) to decrease gradually. The aim of this study was to test the above hypothesis in a large cohort of patients in Iran.

Materials:  Patients (6057) were divided into several groups by two methods. Method 1: patients were divided into six groups according to the time of their first visit. Method 2: patients were divided into four groups according to the date of the beginning of their first manifestation.

Results:  In method 1, the percentage of PP was 71.8% from patients 1–1000. The percentage became 55.9% from patients 1001–2000, 57.6% from patients 2001–3000, 58.8% from patients 3001–4000, 45.3% from patients 4001–5000, and 33.9% from patients 5001–6000. In method 2, the percentage of PP was 61.5% for patients with their disease onset before 1977. The percentage was 59.9% for patients with their disease starting between 1978 and 1987. The percentage dropped to 52.1% for patients with disease onset between 1988 and 1997. The percentage finally dropped to 41% for patients having their disease onset between 1998 and 2007.

Conclusion:  The incidence of PP is decreasing gradually. It is now 34%, which is rather low for a criterion used in many diagnosis criteria. It is important to find a surrogate for it because with the decrease in the incidence of PP the sensitivity of the diagnosis criteria will drop significantly.
Prenatal Diagnosis of Fetal Polycystic Kidney by Ultrasound
Authors: Garrett W. J. , Grunwald G. , Robinson D. E.
Published: August 2010

Summary: By two‐dimensional ultrasonography the presence of a polycystic kidney has been demonstrated in a fetus at the 31st week of pregnancy. The diagnosis was made by observing gross enlargement of the kidney together with fetal ascites, extreme oligohydramnios and cystic spaces in the kidney in the echograms.
Surgical Conditions Complicating Pregnancy
Authors: O'Neill James P.
Published: August 2010

Summary:In this last part of these papers on coincident surgical conditions seen during 91,500 confinements, intestinal obstruction and carcinoma of the large bowel are discussed as are the rarer surgical conditions. The maternal and fetal outcome are discussed in detail and conclusions made.
Urinary Oestriol Excretion in Retarded Intrauterine Fetal Growth
Authors: Elliott Peter M.
Published: August 2010

Summary: Retarded intrauterine fetal growth is associated with a high perinatal mortality.

Serial urinary oestriol excretion estimations were performed in the third trimester of 22 pregnancies associated with small babies and the amniotic fluid volume was measured in 16.

Low oestriol excretion was observed in 18 pregnancies and in 10 of these it was very low. Low amniotic fluid volumes were found in 10 and were associated with reduced oestriol and clinically very small fetuses. When all 3 co‐existed placental failure appeared imminent.

It is suggested that serial urinary oestriol estimations are a useful aid in assessing fetal prognosis and that judicious interpretation of the results with more widespread use of Caesarean section will result in improved fetal salvage.
Prolonged Labour in Primigravid Patients with Special Reference to The Use of Caudal Block and the Vacuum Extractor
Authors: Dudgeon Grahame I.
Published: August 2010

Summary:A conservative form of management of prolonged labour in primigravid patients is presented, advocating the use of caudal or other epidural block, oxytocic stimulation in the event of secondary uterine inertia (providedthat bonydisproportion has been excluded by pelvic X‐ray) and delivery with the aid of the vacuum extractor if the cervix fails to reach full dilatation at the cessation of progress. No morbidity has been found in the mothers or babies which could be attributed to the method.

Five case reports are given together with a summary of the author's previous experience with the procedure.
Perinatal Mortality by Birth Order in Multiple Pregnancy
Authors: Patten P. T.
Published: August 2010

Summary: A series of 1001 multiple pregnancies was studied to ascertain perinatal mortality according to birth order. The result indicated a greatly increased hazard for later‐born infants, their mortality being 50% higher than for first borns. Prematurity and birth asphyxia or injury were the chief causes of this. The results support the view that once the presence of more than one infant is known, delivery of the later‐born ones should be expedited.
Birth Weight of Infants with Rhesus Incompatibility
Authors: Kitchen W. H.
Published: August 2010

Summary: Despite suggestions to the contrary, there is no statistically significant increase in birth weight in 1,149 erythroblastotic infants of 32 to 40 weeks gestational age, when contrasted with 1,480 normal infants drawn from a similar population. When severely affected infants are contrasted with mildly affected infants, there is again no difference in birth weight demonstrated.
Cyclophosphamide in Pregnancy*
Authors: Coates Alan
Published: August 2010

Summary: Cyclophosphamide was given to a young woman with nephrotic syndrome, and was inadvertently continued until the eighth week of her pregnancy. The baby had only two minor malformations; an umbilical hernia and a cutaneous haemangioma, which were probably not due to the cyclophosphamide.
Cervical Carcinoma in Situ
Authors: Green G. H.
Published: August 2010

Summary: Two series of cases, one of 576 patients with cervical carcinoma in situ, and one of 1,235 patients with invasive carcinoma, both diagnosed and managed in the years 1946 to 1967 at National Women's Hospital, are presented; follow‐up of both series is 100%. Except for a special series of 27 patients diagnosed and treated by punch biopsy alone, all those with carcinoma in situ have had at least a cone‐type biopsy for diagnosis. The following conclusions have been drawn. (a) The incidence of, mortality from, and 5‐year survival rates of invasive cervical cancer have not been influenced by cytology screening, (b) Hysterectomy is an unnecessarily radical treatment for cervical carcinoma in situ, (c) Providing invasive cancer is excluded initially the patient with in situ cancer has only the normal chance of developing future invasive cancer, (d) The only way to settle finally the problem of what happens to in situ cancer is to follow indefinitely patients with diagnosed but untreated lesions. This is being attempted
A history of caesarean section: From ancient world to the modern era
Authors: TODMAN Donald
Published: August 2010

Caesarean section has been recorded in history since ancient times in both Western and non‐Western literature. Although the first use of the term in obstetrics was from the seventeenth century, its early history is obscured by mythology. The origin of the term caesarean is believed to be from the birth of Julius Caesar; however, this is unlikely considering his mother Aurelia Cotta lived for many years afterwards. In ancient times, it was performed only when the woman was dead or dying as an attempt to rescue the fetus. With few exceptions, this was the pattern until the era of anaesthesia in the nineteenth century. Developments in surgical technique from the later nineteenth century and through the twentieth century have refined the procedure, with resulting low morbidity and mortality. As a consequence, the objectives of caesarean section have evolved from rescuing the fetus or for cultural or religious reasons towards concerns for the safety of mother and child as well as considering the mother's preferences.
Perinatal HIV transmission and pregnancy outcomes in indigenous women in Western Australia
Authors: GILLES Marisa T. , DICKINSON Jan E. , CAIN Alison , TURNER Kate A. , MCGUCKIN Rosemary , LOH Richard , PRESCOTT Susan L. , FRENCH Martyn A.
Published: August 2010

Background:  Implementation of obstetric and neonatal interventions has reduced mother to child transmission of HIV. Health outcomes for Aboriginal people are often worse than for non‐Aboriginal people; was this the case for HIV infection in pregnancy?

Aims:  To compare the management and outcomes of pregnancy in Aboriginal and non‐Aboriginal HIV‐positive women in Western Australia (WA).

Methods:  A retrospective study of all pregnancies delivered in WA to HIV‐infected women from 1991 until 2005. Managed pregnancies were compared in Aboriginal and non‐Aboriginal women. Outcome measures were HIV status of the babies, birthweight, rates of caesarean delivery and perinatal mortality.

Results:  Fifty‐six pregnancies occurred in 41 HIV‐infected women resulting in 54 live births. Of the 41 women, 16 (39%) were Aboriginal. In regard to birthweight, perinatal mortality, rates of caesarean section and rates of HIV perinatal transmission, there was no significant difference between babies born to Aboriginal and those born to non‐Aboriginal mothers. In contrast, of the eight pregnancies, with no contact with the multidisciplinary team, five babies (63%) were infected with HIV (2% vs 63%P = 0.001). There was no case of perinatal HIV infection in 22 pregnancies of the Aboriginal women that received care through the multidisciplinary team; perinatally acquired HIV occurred in the first pregnancy of one of these women before she was aware of her status when she was not managed by the team.

Conclusions:  Similar outcomes can be achieved in both HIV‐positive Aboriginal and non‐Aboriginal women, through intensive, culturally appropriate, multidisciplinary care and without elective caesarean delivery.
Prophylactic antibiotics for the prevention of preterm birth in women at risk: A meta‐analysis
Authors: SIMCOX Rachael , SIN Wing‐To A. , SEED Paul T. , BRILEY Annette , SHENNAN Andrew H.
Published: August 2010

Background:  Preterm birth (PTB) is the major determinant of perinatal morbidity and mortality. Infection is implicated in a large proportion of preterm deliveries, but there is no consensus regarding the efficacy of antibiotic prophylaxis for women at risk.

Aim:  To determine whether antibiotic treatment reduces the risk of preterm delivery in asymptomatic pregnant women at risk of PTB.

Method:  Relevant publications were identified via electronic searches of MEDLINE (1966 to August 2005), The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Central Register of Controlled Trials (the Cochrane Library, Issue 3, 2005) and PubMed using multiple search terms related to PTB and antibiotics. Publications were limited to randomised controlled trials comparing antibiotics with placebo given to asymptomatic non‐labouring women. A random effect model was used, and combined risk ratios calculated for the various risk groups. Associations between treatment effect and the rate of PTB were analysed by meta‐regression.

Results:  Seventeen trials were included, 12 identifying women at risk by abnormal vaginal flora, three on women at high risk from a previous PTB and two recruiting women based on positive fetal fibronectin status. There was no significant association between antibiotic treatment and reduction in PTB irrespective of criteria used to assess risk, the antimicrobial agent administered, or gestational age at time of treatment (overall combined random effect for delivery at less than 37 weeks RR 1.03 (95% CI 0.86–1.24)).

Conclusions:  Treating women at risk of PTB with antibiotics does not reduce the risk of subsequent PTB.
Institution of universal screening for Group B streptococcus (GBS) from a risk management protocol results in reduction of early‐onset GBS disease in a tertiary obstetric unit
Authors: ANGSTETRA Donald , FERGUSON John , GILES Warwick B.
Published: August 2010

Aim:  To determine the effect of institution of a universal screening protocol as per CDC 2002 guidelines had on the incidence of early‐onset Group B streptococcal (GBS) and non‐GBS disease in a tertiary obstetric unit.

Methods:  A prospective study with historical control data reporting the incidence of early‐onset GBS and non‐GBS disease following institution of a universal screening strategy at John Hunter Hospital, Newcastle, Australia. We compared the incidence of early‐onset GBS and non‐GBS disease during prescreening (1994–2002) with screening period (2004 to June 2006). The outcome measure was the incidence of early‐onset GBS disease. We specifically reported the number of women needed to treat (NNT) with antibiotics and the number of women needed to screen.

Results:  The incidence of early‐onset GBS and non‐GBS during the prescreening period was 0.84/1000 and 0.94/1000 live births, respectively. After institution of universal screening, the incidence was 0.00/1000 and 0.72/1000 live births, respectively. This is a statistically significant reduction in early‐onset GBS disease by 84% (χ2 = 5.75; P = 0.016). There was no difference in non‐GBS disease (χ2 = 0.14; P = 0.71). The NNT is 1191 and we needed to screen 5704 women to prevent one case of early‐onset GBS disease.

Conclusion:  Screening for GBS rather than by assessing risk factors has significantly reduced the incidence of early‐onset GBS disease in our unit. Despite low incidence of early‐onset GBS prior to screening period, we still found a significant decrease in early‐onset GBS disease after institution of universal screening protocol. These results support the screening‐based approach at 34–37 weeks gestation.