bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic risk of hepatocellular carcinoma in patients with hepatitis C virus: A case control study
Authors: Tomoda Takeshi , Nouso Kazuhiro , Sakai Akiko , Ouchida Mamoru , Kobayashi Sayo , Miyahara Koji , Onishi Hideki , Nakamura Shinichiro , Yamamoto Kazuhide , Shimizu Kenji
Published: October 2011

Backgroud and Aim:  Chronic hepatitis C virus (HCV) infection is a well known risk factor for hepatocellular carcinoma (HCC). The aim of this study is to elucidate the genetic risk of development and recurrence of HCC in patients with HCV.

Methods:  A total of 468 patients with HCV, including 265 with HCC were enrolled. We genotyped 88 single nucleotide polymorphisms (SNPs) in 81 genes expected to influence hepatocarcinogenesis using the iPLEX assay. Risk of HCC was clarified by stratifying patients into risk groups based on the multiplied odds ratio (MOR) for SNPs associated with HCC, and the cumulative effects on the development and recurrence of HCC were analyzed.

Results:  Six SNPs associated with risk of HCC were identified (OR range: 0.29–1.76). These included novel SNPs for hepatocarcinogenesis with HCV CCND2 rs1049606, RAD23B rs1805329, CEP164 rs573455, and GRP78rs430397 in addition to the known SNPs MDM2 rs2279744 and ALDH2 rs671. MOR analysis revealed that the highest risk group exerted about a 19‐fold higher relative OR compared with the lowest risk group (P = 1.08 × 10−5). Predicted 10‐year HCC risk ranged from 1.7% to 96% depending on the risk group and the extent of fibrosis. Recurrence‐free survival of radiofrequency ablation‐treated HCC in the high risk group (n = 53) was lower than that of low risk group (n = 58, P = 0.038).

Conclusion:  Single nucleotide polymorphisms of CCND2, RAD23B, GRP78, CEP164, MDM2, and ALDH2 genes were significantly associated with development and recurrence of HCC in Japanese patients with HCV.
Trends in childhood asthma hospitalisation in three Asia Pacific countries
Authors: Chua Kun Lin , Ma Stefan , Prescott Susan , Ho Marco HK , Ng Daniel K , Lee Bee Wah
Published: October 2011

Aim:  The study aims to examine recent childhood asthma hospitalisation rates in the Asia Pacific countries of Australia, Hong Kong and Singapore. On the background of reported decline in many countries with high asthma prevalence during late 1990s.

Methods:  Annual asthma hospitalisation (ICD9‐CM: 493 or ICD10‐AM: J45‐46)* and population data from 1994 to 2008, of children aged 0–14 years old, were obtained from the Australian National Hospital Morbidity Database, from the Hospital Authority in Hong Kong and from the Ministry of Health in Singapore. Data were stratified in two age groups: 0–4 and 5–14 years old, and also in different periods of calendar years. Time‐series regression analyses were used to examine temporal trends. Diagnostic transfer was addressed by examining bronchitis hospitalisations.

Results:  Significant decreases of up to 6.5% per annum in childhood asthma hospitalisation rates were found over the study period. However, the latter half of the study period showed increases in hospitalisation rates in all countries studied. No evidence of diagnostic transfer was found.

Conclusion:  Although there has been a decrease in childhood asthma hospitalisation rates since the 1990s, a modest increase was observed from 2003 to 2008. Ongoing monitoring is required.
Long‐term efficacy of plasma exchange treatment for refractory Kawasaki disease
Authors: Hokosaki Tatsunori , Mori Masaaki , Nishizawa Takashi , Nakamura Tomoko , Imagawa Tomoyuki , Iwamoto Mari , Yokota Shumpei
Published: October 2011

Background:  The treatment of Kawasaki disease patients who fail to respond to initial i.v. immunoglobulin (IVIG) therapy is controversial. The aim of the present study was to investigate the long‐term efficacy of plasma exchange (PE) treatment for refractory Kawasaki disease.

Methods:  A total of 125 Kawasaki disease patients refractory to IVIG were treated with PE. Coronary artery lesions (CAL) before PE, in the acute period, and during the late period were examined retrospectively.

Results:  Residual sequelae requiring medical treatment occurred in six cases in the late period. The outcomes of treatment tended to be better when PE was begun in the early stage. Sequelae remained in 2.8% of patients in whom PE was initiated prior to day 9 after onset, and were present in 15% of patients in whom PE was started on or after day 10. The 105 patients whose coronary arteries were normal before PE had no sequelae (residual sequelae: 0%). Dilatation was present before PE in 14 patients, but remained in only two patients in the late period (residual sequelae, 14.3%). In four of the six patients in whom aneurysms had already formed before PE, the lesions had advanced into giant aneurysms, but in the other two patients they returned to the normal range (residual sequelae, 66.6%).

Conclusions:  The outcomes of PE for Kawasaki disease refractory to IVIG are favorable, and the effectiveness of this treatment is excellent, particularly if it is initiated before CAL arise.
Ranibizumab therapy for choroidal neovascularization secondary to non‐age‐related macular degeneration causes
Authors: Troutbeck Robyn , Bunting Roland , van Heerdon Anton , Cain Melinda , Guymer Robyn
Published: October 2011

Abstract

Background:  To investigate the efficacy of ranibizumab therapy for choroidal neovascular (CNV) membranes secondary to conditions other than macular degeneration.

Design:  Prospective case series conducted at the Royal Victorian Eye and Ear Hospital.

Participants:  Twelve‐month follow‐up data for 41 patients with CNV recruited from the outpatient clinic from May 2008 to April 2010 is presented. Fifteen patients had myopia, seven had multifocal choroiditis, and eight had other primary causes.

Methods:  All patients had visual acuity, fluorescein angiogram and optical coherence tomography performed at the initial visit (baseline). Ranibizumab was injected with a standard sterile technique. Patients were reviewed after 1 month, and further injections were given at the treating doctors' discretion.

Main Outcome Measures:  Change in visual acuity and central macular thickness at 12 months was compared with baseline for each of the groups. Local and systemic adverse outcomes were recorded.

Results:  Analysis was stratified by primary pathology. On average, 40%, 43% and 25% of patients with myopia, multifocal choroiditis and ‘other’ pathologies, respectively, experienced a three or more line improvement in vision. The average number of injections in 12 months was 4.2 for the entire group. Central macular thickness significantly decreased in the 12‐month period for the combined group (P = 0.03). No patient had an adverse systemic side‐effect; however, there was one case of endophthalmitis.

Conclusions:  Ranibizumab is an effective treatment for CNV secondary to non‐age‐related macular degeneration causes, with most patients gaining an improvement in the first 2 months following injection.
The male sling for post‐prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes
Authors: Welk Blayne K. , Herschorn Sender
Published: October 2011

What's known on the subject? and What does the study add?

Long‐term cure and improved rates for the bone anchored sling range from 40–88%. Midterm cure and improved rates for the retrourethral transobturator sling rage from 76–91%. Midterm cure and improved rates for the adjustable retropubic sling rage from 72–79%.

Potential complications common to all urethral slings include postoperative urinary retention, perineal pain, and urethral erosion/device infection. All male urethral slings have primarily been studied in post radical prostatectomy patients, with inconsistent success among patients with prior pelvic radiation.

OBJECTIVE

To examine the outcomes and adverse events associated with novel male sling designs described in the last decade.

METHODS

A literature review was carried out using Medline, EmBase, Cochrane Registered Trials Database and the Center for Reviews and Dissemination Database.

RESULTS

Three principal slings are described in the literature. The bone‐anchored sling has success rates of 40–88%, with some series having a mean follow‐up of 36–48 months. It is associated with a mesh infection rate of 2–12%, which usually requires sling explantation.

The retrourethral transobturator sling has a success rate of 76–91% among three large case series with follow‐ups of 12–27 months. There is a low reported explantation rate.

The adjustable retropubic sling has a success rate of 72–79% with follow‐ups of 26–45 months. Erosion (3–13%) and infection (3–11%) can lead to explantation.

CONCLUSIONS

Most male slings have a similar reported efficacy. Most case series define success as either dry or improved. True cure rates are lower. Mid‐ and long‐term data are now available that indicate the male sling is a viable option for PPI.

The use of male slings in severe UI, radiated patients, and non‐radical prostatectomy patients is still unclear. Further study is needed to try and define criteria for the use of male slings, and to directly compare different procedures.
Prescribed medicines for elderly frail people with diabetes resident in nursing homes—issues of polypharmacy and medication costs
Authors: Gadsby R. , Galloway M. , Barker P. , Sinclair A.
Published: October 2011

Diabet. Med. 29, 136–139 (2012)

Aims  To describe the numbers and costs of medications prescribed to people living with diabetes resident in nursing homes in one primary care trust in the UK.

Methods  A retrospective case notes review of 75 people with known diabetes who were resident in the 11 nursing homes in the Coventry teaching primary care trust.

Results  Sixty‐three residents (84%) were being prescribed four or more medications. Forty‐four residents (59%) were prescribed anti‐platelet drugs for prevention of cardiovascular disease, including aspirin, clopidogrel and dipyridamole, and 31 residents (41%) were on statin therapy. Eighteen (24%) residents had a monthly medication cost that was above £101 per month. On detailed review, these were largely residents who were being prescribed special order liquid preparations, usually for secondary cardiovascular disease prevention.

Conclusion  Polypharmacy, defined as taking four or more drugs per day per resident, is highly prevalent within this population of care home residents with diabetes. A high proportion of residents are prescribed drugs for cardiovascular disease prevention, which may be entirely inappropriate in this population with limited life expectancy. Regular medication review of care home residents with diabetes should be undertaken as it has the potential to reduce costs, minimize adverse drug reactions and increase health gain.
THE IMPACT OF THE AFFILIATION OF VENTURE CAPITAL FIRMS: A SURVEY
Authors: Andrieu Guillaume
Published: October 2011

The aim of this paper is to review the theoretical and empirical literature on the impact of the affiliation of venture capital (VC) firms with a particular focus on the differences between Europe and the US. A main characteristic of VC firms is their high level of involvement in the management of funded firms. However, the VC industry is composed of heterogeneous actors. The literature has studied to a great degree the independent funds that dominate the US market. Yet, there also exist VC funds affiliated with banks or with industrial firm, which can benefit from synergies with their parent corporation. Several studies have highlighted significant differences between these types of VC firms.
ARE ALL ECONOMIC FACTS GREATLY EXAGGERATED? THEORY COMPETITION AND SELECTIVITY
Authors: Doucouliagos Chris , Stanley T.D.
Published: October 2011

Abstract..There is growing concern and mounting evidence of selectivity in empirical economics. Most empirical economic literatures have a truncated distribution of results. The aim of this paper is to explore the link between publication selectivity and theory contests. This link is confirmed through the analysis of 87 distinct empirical economics literatures, involving more than three and a half thousand separate empirical studies, using objective measures of both selectivity and contests. Our meta–meta‐analysis shows that publication selection is widespread, but not universal. It distorts scientific inference with potentially adverse effects on policy making, but competition and debate between rival theories reduces this selectivity and thereby improves economic inference.
Bulimic Beckett: food for thought and the archive of analysis
Authors: Salisbury Laura
Published: October 2011

Critics have noted a mode in Samuel Beckett's writing that can be characterised as the urge to purge. Obsessed with figuring language as both vomit and shit in the guts of an oral/anal textual system, many of his texts are constructed by an oscillation between force‐feeding and the compulsive evacuations of emetic and enema. This article suggests that Beckett's persistent textual questioning of what it means to take in and process material from outside the self can usefully be understood in relation to psychoanalytic interpretations of eating disorders; it also suggests that it can be read alongside Beckett's desperate turn to psychoanalytic psychotherapy in the 1930s. Plagued by difficulties with ingestion and digestion (among other symptoms), Beckett sought treatment from Wilfred Bion – the man who would later become one of the most famous British psychoanalysts. Beckett spat out and abandoned the therapy relatively quickly; nevertheless, after his time with Bion there is a sense that the textual evacuations enacted in an uncontrolled fashion in the earlier writing could now be ruminated on, raised to the level of form, and consequently contained. Perhaps coincidentally, the later Bion insisted that what analysis offered, in the face of the patient's frantic desire to ingest and master the world by splitting off and evacuating parts of themselves, was a container – a container for thinking. He insisted that this capacity for thinking should be understood as a form of ‘digestion’ that might bear external material long enough for it to be used rather than purged. Quite properly, Bion never gave details of his therapeutic work with Beckett and there is no accessible archive of clinical material on Beckett's case. This article suggests, however, that an archive of Beckett's analysis can be found in his corpus – in the words and writing he used as food for thought.
COMBINING HIERARCHICAL AND NETWORK STRATEGIES: SUCCESSFUL CHANGES IN DUTCH SOCIAL HOUSING
Authors: KOFFIJBERG JOS , DE BRUIJN HANS , PRIEMUS HUGO
Published: October 2011

In the current times of economic turmoil, many sectors are thought to be in need of structural reform or system overhauls, which call for political leadership, decisiveness and vision. These kinds of challenges present governments with a dilemma. On the one hand, there is a call for radical change while, on the other hand, the options available for such radical change are limited by the many interdependencies of a network society. In this article, we analyse three fundamental and structural reforms in Dutch housing. These reforms were all implemented in a world of interdependencies. The strategies applied appear to be a mixture of unilateral, hierarchical strategies and multilateral, network strategies. These hybrid strategies come in three forms: (1) a combination of hierarchical and network strategies; (2) variations/alternations over time between network strategies and hierarchical strategies; and (3) the use of one strategy in the frontstage while the other strategy is being used backstage. Greater understanding of these types of hybrids can help governments in dealing with the tension between interdependencies and the need for change.
THE NEW GOVERNANCE ARRANGEMENTS FOR NHS FOUNDATION TRUST HOSPITALS: REFRAMING GOVERNORS AS META‐REGULATORS
Authors: WRIGHT JOHN S.F. , DEMPSTER PAUL G. , KEEN JUSTIN , ALLEN PAULINE , HUTCHINGS ANDREW
Published: October 2011

New governance arrangements for NHS Foundation Trusts (FTs) aimed to replace centralized state ownership of acute English hospitals with a new form of social ownership. Under this, trusts would exist as independent public interest organizations on the model of mutuals and co‐operative societies. Assessing the impact of the new arrangements on the management structure of four acute hospitals, we demonstrate that FTs have failed to deliver social ownership and local accountability on this model. We suggest that policy‐makers should re‐frame the governance apparatus associated with mutualism and social ownership in terms of the concept of meta‐regulation. By re‐framing governors as meta‐regulators, regulatory institutions would acquire new powers to steer FTs towards sustainable forms of compliance via non‐coercive, non‐intrusive means.
NEW PUBLIC MANAGEMENT IN PUBLIC EDUCATION: A CATALYST FOR THE PROFESSIONALIZATION OF SWEDISH SCHOOL PRINCIPALS
Authors: JARL MARIA , FREDRIKSSON ANDERS , PERSSON SOFIA
Published: October 2011

New Public Management (NPM) is one of the most significant reforms in public welfare in recent times. Making individual civil servants more dependent on the directions of the local manager than on common professional standards, previous sociological research argues that NPM results in a ‘deprofessionalization’ of civil servants. Taking a somewhat different approach, recent public administration research indicates that NPM may, at the same time, enhance the professional status of welfare managers. By integrating the literature on the sociology of professions and public administration, this article develops a theoretical framework for understanding the influence of NPM using the example of a professional project for school principals in Sweden. Taking a process‐oriented methodological approach, the result shows that Swedish school principals gained increased support for their professional project by the introduction of NPM. The article argues that NPM can function as a catalyst for welfare managers' professional projects.
The Impact of Input and Output Tariffs on Firms' Productivity: Theory and Evidence
Authors: Luong Tuan Anh
Published: October 2011

This paper studies the impact of trade liberalization on productivity. It shows that when intermediate inputs are not highly differentiated, lowering input tariffs leads to a rise in within‐firm productivity and wages, and lowering output tariffs has the opposite effect. When intermediate inputs are highly differentiated, the conclusions reverse. These predictions are supported by the data, given by the industrial survey from INEGI (Mexico's Insitituto Nacional de Estadistica Geografia e Informacion) in the period 1984–90. The paper yields estimates for the elasticity of substitution among intermediate inputs, which are useful in determining the direction of the impact of trade liberalization. These estimates can be used to assess the gains from trade liberalization.
The Immigration Policy Puzzle
Authors: Giordani Paolo E. , Ruta Michele
Published: October 2011

This paper revisits the puzzle of immigration policy: standard economic theory predicts that free immigration improves natives' welfare, but (with few historical exceptions) an open door policy is never implemented in practice. What rationalizes the puzzle? We first review the model of immigration policy where the policy maker maximizes national income of natives net of the tax burden of immigration. We show that this model fails to provide realistic policy outcomes when the receiving region's technology is described by a standard Cobb–Douglas or CES function. Then we describe three extensions of this basic model that reconcile theory with evidence. The first introduces a cost of integration of the immigrant community in the destination country; the second takes into account the policy maker's redistributive concern across different social groups; the last extension considers positive spillover effects of (skilled) migrants on the receiving economy.
Distant Peers
Authors: Vorobej Mark
Published: October 2011

What is the nature of rational disagreement? A number of philosophers have recently addressed this question by examining how we should respond to epistemic conflict with a so‐called epistemic peer—that is, someone over whom you enjoy no epistemic advantage. Some say that you're rationally required to suspend judgment in these cases—thereby denying the very possibility of a certain kind of rational disagreement. Others say that it's permissible to retain your beliefs even in the face of epistemic conflict. By distinguishing between close peers and distant peers, I argue that it's rational to respond to different types of peers in different ways. I also argue that remote peers—a particularly distant kind of distant peer—provide us with an important lesson in epistemic humility.
Toward a New Pragmatist Politics
Authors: Talisse Robert B.
Published: October 2011

In A Pragmatist Philosophy of Democracy, I launched a pragmatist critique of Deweyan democracy and a pragmatist defense of an alternative view of democracy, one based in C. S. Peirce's social epistemology. In this article, I develop a more precise version of the criticism of Deweyan democracy I proposed in A Pragmatist Philosophy of Democracy, and provide further details of the Peircean alternative. Along the way, some recent critics are addressed.
Libel: Its Purpose and Reform
Authors: Howarth David
Published: October 2011

Discussion of libel often fails to define defamation law's purpose and thus properly to assess its value. This article argues that defamation's purpose relates to fundamental human interests in sociality, directly linked to important aspects of human health and well‐being. Protecting such interests is arguably required by the right to private life underECHRarticle 8 and should not count as a violation of the right to freedom of speech. Some current reform proposals are criticised as failing to appreciate the importance of protecting sociality. ‘Business’ libel, however, often protects not sociality but purely economic interests. The article therefore argues that the protection of libel law, as opposed to that offered by malicious falsehood and the economic torts, should be withdrawn from purely economic reputation, starting with removing the rights of corporations to sue in defamation, a position compatible with theECtHR's decision inKarakovHungary.
Are Children's Best Interests Really Best? ZH (Tanzania) (FC) v Secretary of State for the Home Department
Authors: Fortin Jane
Published: October 2011

Although the Supreme Court's decision in ZH (Tanzania) is an important one, as this note explains, it is less novel than many suppose – and is in some ways disappointing. By stressing the importance of immigrant children's best interests, it fails to use this opportunity to promote their Convention rights effectively.
Phosphorylation of LRRK2 serines 955 and 973 is disrupted by Parkinson’s disease mutations and LRRK2 pharmacological inhibition
Authors: Doggett Elizabeth A. , Zhao Jing , Mork Christina N. , Hu Dongmei , Nichols R. Jeremy
Published: October 2011

J. Neurochem. (2012) 120, 37–45.

Mutations in leucine‐rich repeat kinase 2 (LRRK2) are the most common cause of familial Parkinson’s disease. An amino terminal cluster of constitutively phosphorylated residues, serines 860, 910, 935, 955, and 973, appears to be biologically relevant. Phosphorylation of serines 910 and 935 is regulated in response to LRRK2 kinase activity and is responsible for interaction with 14‐3‐3 and maintaining LRRK2 in a non‐aggregated state. We examined the phosphorylation status of two other constitutive phosphorylation sites, serines 955 and 973. Treatment of LRRK2 expressing cells with the selective LRRK2 inhibitor LRRK2‐IN1 revealed that, like Ser910/Ser935, phosphorylation of Ser955 and Ser973 is disrupted by acute inhibition of LRRK2 kinase activity. Additionally, phosphorylation of Ser955 and 973 is disrupted in the context of several Parkinson’s disease associated mutations [R1441G/C, Y1699C, and I2020T]. We observed that modification of Ser973 is dependent on the modification of Ser910/Ser935. Ser955Ala and Ser973Ala mutations do not induce relocalization of LRRK2; however, all phosphomutants exhibited similar localization patterns when exposed to LRRK2‐IN1. We conclude that the mechanisms of regulation of Ser910/935/955/973 phosphorylation are similar and physiologically relevant. These sites can be utilized as biomarkers for LRRK2 activity as well as starting points for the elucidation of upstream and downstream enzymes that regulate LRRK2.
Biliverdin reductase‐A: a novel drug target for atorvastatin in a dog pre‐clinical model of Alzheimer disease
Authors: Barone Eugenio , Mancuso Cesare , Di Domenico Fabio , Sultana Rukhsana , Murphy M. Paul , Head Elizabeth , Butterfield D. Allan
Published: October 2011

J. Neurochem. (2012) 120, 135–146.

Biliverdin reductase‐A (BVR‐A) is a pleiotropic enzyme involved in cellular stress responses. It not only transforms biliverdin‐IX alpha into the antioxidant bilirubin‐IX alpha but through its serine/threonine/tyrosine kinase activity is able to modulate cell signaling networks. BVR‐A’s involvement in neurodegenerative disorders such as Alzheimer disease (AD) and amnestic mild cognitive impairment was previously described. Statins have been proposed to reduce risk of AD. In this study we evaluated the effect of atorvastatin treatment (80 mg/day for 14.5 months) on BVR‐A in the parietal cortex, cerebellum and liver of a well characterized pre‐clinical model of AD, the aged beagle. We found that atorvastatin significantly increased BVR‐A protein levels, phosphorylation and activity only in parietal cortex. Additionally, we found significant negative correlations between BVR‐A and oxidative stress indices, as well as discrimination learning error scores. Furthermore, BVR‐A up‐regulation and post‐translational modifications significantly correlated with β‐secretase protein levels in the brain, suggesting a possible role for BVR‐A in Aβ formation.
Art and gentrification: pursuing the urban pastoral in Hoxton, London
Authors: Harris Andrew
Published: October 2011

The role of artists as precursors and agents of gentrification processes has been widely acknowledged and studied. Yet there has been limited consideration of the particular aesthetic practices and attitudes deployed by these artists, and the related urban landscapes they have helped shape and re‐imagine. This paper uses the notion drawn from art history of the ‘urban pastoral’ to highlight largely disregarded socio‐cultural and political relations of power accompanying gentrification. It focuses on a district of inner London called Hoxton where a deindustrialised location and a legacy of forms and practices of British working‐class popular culture offered artists a rich resource and socio‐spatial environment to work and operate during the 1990s. By indulging in fantasies and performances of the urban pastoral, these artists fashioned a new cultural landscape that not only catered to many of the lifestyle tastes and investment priorities within postindustrial London, but manipulated and downplayed the complex and potentially conflictual histories of the area. The paper argues that this capture of urban space through the pastoral is indicative of new forms of gentrification where class‐based and race‐related neighbourhood change occurs without direct displacement.
Iron metabolism and the role of HFE gene polymorphisms in Wilson disease
Authors: Pfeiffenberger Jan , Gotthardt Daniel N. , Herrmann Thomas , Seeßle Jessica , Merle Uta , Schirmacher Peter , Stremmel Wolfgang , Weiss Karl Heinz
Published: October 2011

Wilson disease (WD) is a rare inherited disorder of copper metabolism, which can lead to severe liver failure and to a variety of neuropsychiatric symptoms. Previous animal studies and case reports suggest that hepatic iron overload and alterations in iron processing are associated with WD. The aim of this study was the assessment of iron metabolism and of the frequency of the most common HFE gene polymorphisms in WD patients.

Patients and methods

Data from 143 patients with WD were analysed. Clinical presentation, liver function and iron metabolism parameters were recorded. Blood samples of the patients were analysed for HFE gene alterations (H63D; C282Y). Twenty‐seven liver biopsies of these patients were studied with regard to iron content and fibrosis score.

Results

Contrary to previous reports of HFE gene polymorphisms in WD patients, in our cohort the allele frequencies (C282Y: 2.1%; H63D: 7.3%) were in line with frequencies obtained for general population. Male WD patients with decreased serum ceruloplasmin (Cp), showed increased serum ferritin levels. Hepatic iron content was normal in most cases.

Discussion

Male patients with very low Cp serum concentrations showed slightly elevated median serum ferritin concentrations, probably related to lack of ferroxidase acitivity. However, in consideration of absolute numbers of ferritin concentrations, these changes seem to be of minor clinical relevance.
Research of influences of surface structure of coloured textiles: applying fuzzy logic
Authors: Glogar Martinia Ira , Parac‐Osterman Djurdjica , Grundler Darko , Rolich Tomislav
Published: October 2011

The fuzzy logic‐based approach was applied in studying the influence of a different textile surface structure on colour appearance and similarity. The fuzzy‐based approach has been chosen because fuzzy logic provides the computerising of human reasoning. For the analyses, 100% cotton samples with certain characteristics were chosen. First, the computer match prediction was performed to determine the concentrations of dyestuff to be used in the experimental work. A yellow‐shaded direct dyestuff suitable for cotton dyeing was used. In the next step, the fuzzy logic system was created based on terms that would define the surface characteristics of the samples. The most important part was a proper definition of the rules and linguistic variables that use words for assigning the values of properties and that influence the experience of an observer (gloss, smoothness, roughness, etc.) and connect input space with output space. Finally, the performances of both systems were compared and analysed. In this work, the approach was based solely on the surface–structural characteristics of textile samples. The main aim was to examine the approach using the fuzzy logic‐based technique in order to provide the method that would include surface parameters of textile samples that are of importance in applying colour to different structured textile surfaces. It was confirmed that the fuzzy logic reasoning would have its application in the control of the influence of the surface structure of coloured textiles, especially for lighter shades where the influence of structure parameters on the colour experience of an observer is more emphasised.
Introduction to Pharmatech
Authors: Diaz‐Buxo Jose A. , Kotanko Peter
Published: October 2011

The collection of papers published in this issue of Seminars in Dialysis describes our approach to Pharmatech, which is the integration of services, medical devices, and pharmacologic agents, into specific prescription processes. Pharmatech is developed to systematically facilitate an individual's prescription according to each patient's specific needs. This includes evidence‐based algorithms for control, anemia management and isonatremic dialysis, devices to deliver precise doses of injectable drugs, and future developments to simplify loading new applications into the system.
Application of Kinetic Modeling to Mineral Metabolism Management
Authors: Stennett Amanda K. , Ofsthun Norma J. , Gotch Frank A.
Published: October 2011

Patients with CKD face many consequences of renal failure, including disorders of bone and mineral metabolism. The current approach to management of these mineral metabolism issues lacks comprehensive quantitative assessment, so a kinetic modeling program has been designed to quantify intake and removal of phosphorus and calcium, as well as provide recommendations for treatment and prescriptions based on total mass balance and serum concentrations. This program is known as phosphorus kinetic modeling or PKM. The modeling program and associated graphical reports have been developed as a tool for clinicians in the management of mineral metabolism in CKD patients.
Improving the Delivery of Coordinated and Individualized Care
Authors: Sands Jeffrey J. , Diaz‐Buxo Jose A.
Published: October 2011

Pharmatech comprises systems for the automated use and coordination of clinical information, medical devices, care paths, and pharmacologic agents into specific prescription and care‐delivery processes tailored to meet individual patient needs. In ESRD, future suites of applications to run on hemodialysis, peritoneal dialysis machines, external computers and devices both in‐center and in the home setting offer the potential to further automate billing and inventory, improve documentation, reduce medical errors, and decrease costs. On a clinical basis, these systems will aid nurses, physician assistants, nurse practitioners, and physicians in performing and overseeing a wide range of clinical activities that constitute 21st‐century medicine. Future innovations may allow Pharmatech systems to learn by achieving defined outcomes. These developments offer the potential to provide customized ESRD care by integrating standard practices with individual patient characteristics and patient‐specific needs. The development of Pharmatech represents one of the next advances in healthcare technology and will become an important component in the delivery of 21st‐century medicine. Adoption of information technology (IT) has been prioritized by the federal government, and is a key component of US healthcare policy. The United States Agency for Healthcare Research and Quality is currently funding the development and implementation of a wide array of health IT applications. This extensive funding combined with rapid technologic advances will continue to drive Pharmatech development and the widespread implementation of medical IT in the coming decade.
Anemia Management in Patients Receiving Chronic Hemodialysis
Authors: Thakuria Mayuri , Ofsthun Norma J. , Mullon Claudy , Diaz‐Buxo Jose A.
Published: October 2011

Anemia treatment in hemodialysis‐dependent (HDD) CKD patients involves adequate supply of iron and an erythropoiesis‐stimulating agent (ESA). Despite widespread usage of these agents, there is no generally accepted “standard dosing algorithm” for treating anemia in HDD‐CKD patients. The new anemia Quality Incentive Program (QIP) introduced by the Centers for Medicare & Medicaid Services represents a motivation to standardize and harmonize iron and ESA regimens with interactive electronic algorithms and novel modes of deliveries for IV iron and ESA doses. In addition, quality assessment and performance improvement programs at dialysis facilities include achieving measurable improvement in health outcomes, healthcare cost, and reductions in medical errors. Thus, the Corporate Medical Advisory Board for Fresenius Medical Services (FMS) is evaluating an anemia algorithm that will be incorporated into the automated workflow of a new clinical system at FMS clinics. In the future, such systems might communicate with medication pumps incorporated into state‐of‐the‐art HD machines, thereby eliminating manual data entry of medication orders and other potential errors related to data entry or administration of medications such as ESA and IV iron. In addition, the CritLine III TQA Monitor, which allows real‐time blood volume, oxygen, and anemia monitoring during HD in acute and chronic settings, may become an integrated diagnostic tool to improve volume and anemia management through better fluid management and ESA dose adjustment algorithms. These novel interactive electronic algorithms, delivery and monitoring methods, and data transfer may be integrated in the Pharmatech process to meet patient‐specific anemia therapy.
In vivo confocal microscopy of Meissner corpuscles as a novel sensory measure in CMT1A
Authors: Almodovar Jorge L. , Ferguson Michele , McDermott Michael P. , Lewis Richard A. , Shy Michael E. , Herrmann David N.
Published: October 2011

Reliable, valid, and responsive outcomes for different aspects of Charcot‐Marie‐Tooth (CMT) neuropathy have become increasingly important in an emerging era of therapy development. Measures of the sensory component of CMT in particular are limited. One novel approach with potential applicability to CMT is non‐invasive in vivo reflectance confocal microscopy (RCM) of Meissner corpuscles (MCs). In this prospective study, we evaluated MC densities using RCM, and touch‐pressure and vibration sensation thresholds in a cohort of Charcot‐Marie‐Tooth type 1A (CMT1A) subjects with comparison to healthy controls. MC density was lower in CMT1A subjects than in controls at the fingertip (digit V) (2.59 ± 2.73 MCs/mm2 vs. 6.77 ± 3.68 MCs/mm2, p = 0.001), but not more proximally at the thenar eminence. Touch‐pressure thresholds were higher in CMT1A than in controls at digit V (p = 0.002) and at the thenar eminence (p = 0.0001). Vibration thresholds in CMT1A at digit V were also higher than in controls (p = 0.0001). A lower MC density at digit V was associated with greater global CMT severity as reflected by the Charcot‐Marie‐Tooth neuropathy score (CMTNS) (r = −0.76, p = 0.004) and the Neuropathy impairment score (NIS) (r = −0.73, p = 0.007). Similarly, worse touch‐pressure thresholds at the fingertip (digit V) were associated with more severe CMT1A on the CMTNS (r = 0.71, p = 0.009) and NIS (r = 0.70, p = 0.011). Vibration thresholds at digit V were not associated with either the CMTNS (r = 0.11, p = 0.74) or NIS (r = 0.21, p = 0.52). Non‐invasive in vivo RCM of MC density at the hand and the evaluation of touch‐pressure thresholds show promise as measures of sensory structure and function in CMT1A.
Long‐term response to rituximab and fludarabine combination in IgM anti‐myelin‐associated glycoprotein neuropathy
Authors: Gruson Berengere , Ghomari Kamel , Beaumont Marie , Garidi Reda , Just Alain , Merle Philippe , Merlusca Lavinia , Marolleau Jean P. , Royer Bruno
Published: October 2011

We report the clinical response and biological effects of treatment with rituximab and fludarabine (RF) in five patients with IgM anti‐myelin‐associated glycoprotein (MAG) demyelinating neuropathy. Between November 2006 and October 2009, four men and one woman aged 52–85 years received intravenous rituximab at 375 mg/m2 on day 1 and oral fludarabine at 40 mg/m2/day from days 1 to 5, in a treatment cycle that was repeated every month for up to 6 months. Two patients had IgM monoclonal gammopathy of undetermined significance and three low tumor mass Waldenstrom's macroglobulinemia. Four patients showed a major hematological response with a decrease in anti‐MAG titer in three and clearing in one. One patient did not respond. For the responding patients, symptoms and electrophysiological parameters improved significantly. No patient relapsed at post‐RF treatment follow‐up (12–45 months), and no toxicity was reported. The combination of RF induced significant responses in IgM anti‐MAG demyelinating neuropathies, without toxicity. Clinical improvements were correlated to hematological and immunological results.
Reliability of the CMT neuropathy score (second version) in Charcot‐Marie‐Tooth disease
Authors: Murphy Sinéad M. , Herrmann David N. , McDermott Michael P. , Scherer Steven S. , Shy Michael E. , Reilly Mary M. , Pareyson Davide
Published: October 2011

The Charcot‐Marie‐Tooth neuropathy score (CMTNS) is a reliable and valid composite score comprising symptoms, signs, and neurophysiological tests, which has been used in natural history studies of CMT1A and CMT1X and as an outcome measure in treatment trials of CMT1A. Following an international workshop on outcome measures in Charcot‐Marie‐Tooth disease (CMT), the CMTNS was modified to attempt to reduce floor and ceiling effects and to standardize patient assessment, aiming to improve its sensitivity for detecting change over time and the effect of an intervention. After agreeing on the modifications made to the CMTNS (CMTNS2), three examiners evaluated 16 patients to determine inter‐rater reliability; one examiner evaluated 18 patients twice within 8 weeks to determine intra‐rater reliability. Three examiners evaluated 63 patients using the CMTNS and the CMTNS2 to determine how the modifications altered scoring. For inter‐ and intra‐rater reliability, intra‐class correlation coefficients (ICCs) were ≥0.96 for the CMT symptom score and the CMT examination score. There were small but significant differences in some of the individual components of the CMTNS compared with the CMTNS2, mainly in the components that had been modified the most. A longitudinal study is in progress to determine whether the CMTNS2 is more sensitive than the CMTNS for detecting change over time.
Chemotherapy‐induced peripheral neurotoxicity can be misdiagnosed by the National Cancer Institute Common Toxicity scale
Authors: Frigeni Barbara , Piatti Marialuisa , Lanzani Francesca , Alberti Paola , Villa Patrizia , Zanna Claudio , Ceracchi Maurizio , Ildebrando Massimo , Cavaletti Guido
Published: October 2011

The assessment of chemotherapy‐induced peripheral neurotoxicity (CIPN) is still uncertain as several of the most frequently used scales do not rely on a formal neurological evaluation and depend on patients' reports and examiners' interpretations. The aim of this study was to compare the assessment of CIPN using the National Cancer Institute Common Toxicity Criteria (NCI‐CTC) scale and a formal neurological assessment scored with the Total Neuropathy Score (TNS, i.e., a composite scale designed to grade the impairment in neuropathy patients) to identify possible discrepancies in the diagnosis. In this prospective study, 155 patients treated with cisplatin/carboplatin or with paclitaxel/docetaxel and CIPN were examined in a collaborative oncological/neurological multi‐center trial using the NCI‐CTC scale and the TNS; the results were then extensively compared. We evidenced that the TNS allows possible misdiagnosed neuropathies to be revealed. In fact, the NCI‐CTC evaluation performed by experienced examiners overestimated the occurrence of motor neuropathy, possibly because of the presence of confounding factors (e.g., fatigue, depression, cachexia), which might be difficult to be ruled out without a formal neurological examination. This study strongly indicates that a more formal neurological assessment of patients with CIPN than that achievable with the common toxicity scales (e.g., NCI‐CTC) is advisable.
Outcome measures for Charcot‐Marie‐Tooth disease: clinical and neurofunctional assessment in children
Authors: Pagliano Emanuela , Moroni Isabella , Baranello Giovanni , Magro Anita , Marchi Alessia , Bulgheroni Sara , Ferrarin Maurizio , Pareyson Davide
Published: October 2011

Charcot‐Marie‐Tooth (CMT) disease is the most common inherited neuromuscular disorder, presenting with symptoms often occurring since childhood, and showing a progressive course. At present, there are no valid and reliable measures for evaluation of impairment and disability in the pediatric population. The aim of this study was to determine the usefulness of outcome measures, commonly used in adult patients, in CMT children. We report the results of a comprehensive evaluation of 21 children affected with CMT type 1A, including clinical examinations, measure of hand and foot muscle strength with a hand‐held dynamometer, and the following scales: CMT Neuropathy Score or its clinical component CMT Examination Score, Overall Neuropathy Limitations Scale (ONLS), Walk‐12 questionnaire, and nine‐hole peg test (9‐HPT). Hand grip, three‐point pinch, and foot dorsiflexion strength were significantly lower than age/sex equivalent in almost all cases. 9‐HPT was significantly abnormal in 62% of patients and CMT Examination Score was <10 points in all cases. ONLS showed presence of minor disability in the upper limbs in 57% and mild abnormalities of gait in 71% of patients. Overall, these scales demonstrated limited potential to measure disability and severity of the disease confirming that it is necessary to identify specific scales for children with CMT.
Solitary Versus Social Drinking: An Experimental Study on Effects of Social Exposures on In Situ Alcohol Consumption
Authors: Kuendig Hervé , Kuntsche Emmanuel
Published: October 2011

Background:  Whereas the effects of modeling and of drinking contexts on alcohol use are documented, studies are lacking regarding the effect of given social exposures on actual alcohol consumption during drinking episodes (i.e., in situ alcohol consumption, the quantity of alcohol actually ingested in given occasion, e.g., in grams).

Methods:  Applying the experimental paradigms, our study investigates the impact of social condition (alone vs. with others) on in situ alcohol consumption (analog measurements) of 123 young adults who participated in 2 wine‐tasting sessions (one together with others, i.e., group condition; 1 solitary, i.e., individual condition: the sequence of participation was assigned at random). Bivariate and multivariate analyses, that is, paired‐ and independent‐samples t‐tests and repeated measure analysis of variance, were applied to investigate the effects through both transversal and longitudinal perspectives.

Results:  In the first session, higher average amounts of alcohol were consumed in the group condition compared with the individual one. Conversely, higher average consumption was recorded in the individual compared with the group condition in the second session. Considering simultaneously data from the 2 experimental sessions demonstrated that subjects consumed higher amounts of alcohol in individual condition when this condition was organized subsequent and not prior to the group condition. Yet, alcohol consumption in group condition appeared to not vary between the 2 sessions.

Conclusions:  Results first highlight the effects of social condition on in situ alcohol consumption. However, they also suggest that in situ exposition to others drinking is possibly involved in shaping the perception of context‐related drinking norms, which might further influence subsequent drinking behaviors in an analogous context. Beyond the issues of imitation effects, these findings raise the issues of the development of preventive initiatives aiming to induce changes in individuals’ perception of context‐specific drinking norms.