bluuebunny/crossref_metadata_2025 huggingface dataset:
Addiction Research Centres and the Nurturing of Creativity. National Institute on Alcohol and Drugs Policies, Brazil
Authors: Laranjeira Ronaldo , Mitsuhiro Sandro Sendin
Published: March 2011

The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population.
Characterization of haematological parameters with bortezomib–melphalan–prednisone versus melphalan–prednisone in newly diagnosed myeloma, with evaluation of long‐term outcomes and risk of thromboembolic events with use of erythropoiesis‐stimulating agents: analysis of the VISTA trial
Authors: Richardson Paul , Schlag Rudolf , Khuageva Nuriet , Dimopoulos Meletios , Shpilberg Ofer , Kropff Martin , Vekemans Marie‐Christiane , Petrucci Maria Teresa , Rossiev Viktor , Hou Jian , Robak Tadeusz , Mateos Maria‐Victoria , Anderson Kenneth , Esseltine Dixie‐Lee , Cakana Andrew , Liu Kevin , Deraedt William , van de Velde Helgi , San Miguel Jesús F.
Published: March 2011

Although haematological toxicities, such as anaemia, are common in multiple myeloma (MM), no clear consensus exists on the use and impact of erythropoiesis‐stimulating agents (ESA) on outcomes in MM. This analysis characterizes haematological toxicities and associated interventions in the phase III VISTA (Velcade® as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) study of bortezomib plus melphalan/prednisone (VMP, n = 344) versus MP (n = 338) in previously untreated MM patients ineligible for high‐dose therapy, and evaluates the impact of ESA use or red‐blood‐cell (RBC) transfusions on outcomes and thromboembolic risk. Incidence of haematological toxicities was similar with VMP and MP; similar rates of interventions and associated complications (e.g. bleeding, febrile neutropenia) were observed. Two hundred thirty three patients received ESA; 204 had RBC transfusions. Frequency of thromboembolic events was low and not affected by ESA use. Median time‐to progression (TTP) was similar between ESA/non‐ESA [hazard ratio: 1·03 (95% confidence interval 0·76–1·39); P = 0·8478] in both arms (VMP: 19·9/not reached; MP: 15·0/17·5 months). Three‐year overall survival (OS) rates were similar between ESA/non‐ESA in each arm. Patients receiving RBC transfusions had significantly shorter OS (P < 0·0001) versus non‐RBC‐transfusion patients. In conclusion, bortezomib did not add to melphalan haematological toxicity. Concomitant ESA use with VMP/MP in previously untreated MM patients did not adversely affect TTP or OS, or increase thromboembolic risk. However, RBC transfusion was associated with significantly shorter survival.
Modelling everything everywhere: a new approach to decision‐making for water management under uncertainty
Authors: BEVEN KEITH J. , ALCOCK RUTH E.
Published: March 2011

1. There are increasing demands to predict ecohydrological responses to future changes in catchments but such predictions will be inevitably uncertain because of natural variability and different sources of knowledge (epistemic) uncertainty.

2. Policy setting and decision‐making should therefore reflect these inherent uncertainties in both model predictions and potential consequences.

3. This is the focus of a U.K. Natural Environment Research Council knowledge exchange project called the Catchment Change Network (CCN). The aim is to bring academics and practitioners together to define Guidelines for Good Practice in incorporating risk and uncertainty into assessments of the impacts of change.

4. Here, we assess the development of such Guidelines in the context of having catchment models of everywhere.
Nurse‐delivered and doctor‐delivered care in an attention deficit hyperactivity disorder follow‐up clinic: a comparative study using propensity score matching
Authors: Foreman David M. , Morton Stephanie
Published: March 2011

foreman d.m. & morton s. (2011) Nurse‐delivered and doctor‐delivered care in an attention deficit hyperactivity disorder follow‐up clinic: a comparative study using propensity score matching. Journal of Advanced Nursing67(6), 1341–1348.

Background.  Nurse prescribers may be a cost‐effective alternative to doctors in managing attention deficit hyperactivity disorder, but to date there has been no study of their relative effectiveness, and there are concerns about their usage. We therefore undertook a direct comparison of nurse‐delivered and doctor‐delivered attention deficit hyperactivity disorder care in an attention deficit hyperactivity disorder follow‐up clinic.

Method.  Seventy patients were identified between February 2005 and September 2006, 36 managed by an attention deficit hyperactivity disorder specialist nurse, 34 by doctors. Average age at referral was 7·1 years; their duration in the service was 5·5 years. Outcomes included changes since admission in the predicted diagnostic category from Strengths and Difficulties Questionnaire scores, the Commission for Health Improvement patient satisfaction questionnaire and a clinic‐developed side‐effect questionnaire. Propensity score matching and multiple imputation were used to manage selection bias and missing data. The impact of nurse management was estimated using the Average Treatment effect on the Treated statistic with 95% confidence intervals.

Results.  All the Average Treatment effects on the Treated approximated zero. Inspecting the confidence intervals suggested that there was, at worst, 2·5% risk of nurses underidentifying emotional disorders with respect to doctors.

Conclusions.  There seems little to distinguish the quality of doctor‐ or nurse‐delivered care in ordinary attention deficit hyperactivity disorder follow‐up clinics. There seems no clinical impediment to using nurse prescribers to increase clinic capacity. It may be useful to add structured assessment of mood difficulties at follow‐up if nurse prescribers are used.
Effects of an osteoarthritis self‐management programme
Authors: Wu Shu‐Fang Vivienne , Kao Mu‐Jung , Wu Meng‐Ping , Tsai Mei‐Wun , Chang Wan‐Wen
Published: March 2011

wu s.‐f.v., kao m.‐j., wu m.‐p., tsai m.‐w. & chang w.‐w. (2011) Effects of an osteoarthritis self‐management programme. Journal of Advanced Nursing67(7), 1491–1501.

Aim. The aim of this study was to assess the effectiveness of a self‐management programme among osteoarthritis knee sufferers.

Background. Osteoarthritis of the knee is a major cause of loss of function and is common in the older people. A self‐management programme is an effective way to increase arthritis self‐efficacy, and helps with mastering self‐management practices.

Method. This study was carried out from January 2008 to December 2008 and included 205 participants, with 114 in the intervention group and 91 in the control group. The 4‐week trial was followed by an 8‐week follow‐up assessment. The outcome measures included assessments of arthritis self‐efficacy, pain beliefs, unplanned medical consultations, pain days and disability days using the Mann–Whitney U‐test and Friedman test.

Findings. At post‐intervention, significant differences were found in pain beliefs (P < 0·001) and pain days (P < 0·004). At 8‐week follow‐up, there was a significant improvement in arthritis self‐efficacy: pain and other symptoms subscales (P < 0·001 and 0·049, respectively), pain beliefs (P < 0·001) and number of unplanned medical consultations (P < 0·010).

Conclusion. The study supports the hypothesis that a self‐management programme enhances arthritis‐related self‐efficacy and pain beliefs. A decrease in the number of unplanned medical consultations, pain days and disability days suggests that the programme might help reduce healthcare costs. This programme has introduced a significant result about self‐efficacy and self‐management to a chronic disease population in Taiwan. In short, there were great beneficial effects on self‐management among persons who are affected by knee osteoarthritis.
Modernization and future care preferences: a cross‐sectional survey of Arab Israeli caregivers
Authors: Khalaila Rabia , Litwin Howard
Published: March 2011

khalaila r. & litwin h. (2011) Modernization and future care preferences: a cross‐sectional survey of Arab Israeli caregivers. Journal of Advanced Nursing67(7), 1614–1624.

Aims.  This paper is a report of a study designed to examine the association between modernization and future care preferences among adult children caregivers of older Arab parents in Israel and to identify factors that may mediate the association.

Method.  Cross‐sectional data were collected in 2006–2007 by a structured interview from 250 randomly sampled Arab‐Israeli adult children caregivers (response rate = 94%). Respondents’ preference for formal and/or informal future care for themselves was regressed on selected predictor variables.

Results.  The vast majority of family caregivers would ‘prefer’ to be cared for by family members (76·4%). Urbanization level was a negative correlate of preference for future family care and a positive correlate of preference for future formal care. However, these associations were mediated by the extent of filial piety and caregiving burden. Filial piety was a positive predictor of preference for future family care (OR = 3·6, P < 0·01), and a negative predictor of preference for formal care (OR = 0·09, P < 0·01). Caregiving burden was a positive predictor of preferences for future formal care (OR = 5·15, P < 0·01).

Conclusion.  Modernization has an impact on future care preferences in traditional cultures. In order to maintain informal family care, community nurses should examine ways to lessen the burden of care among family caregivers. They should also develop culturally sensitive services that will meet the evolving expectations and preferences that are held by the next generations of family caregivers.
Surviving the wait: defining support while awaiting breast cancer surgery
Authors: Dickerson Suzanne S. , Alqaissi Nesreen , Underhill Meghan , Lally Robin M.
Published: March 2011

dickerson s.s., alqaissi n., underhill m. & lally r.m. (2011) Surviving the wait: defining support while awaiting breast cancer surgery. Journal of Advanced Nursing67(7), 1468–1479.

Aim.  This paper is a report of a descriptive study of the common meanings, shared experiences and practices of social support of women within the days between breast cancer diagnosis and treatment initiation.

Background.  Support needs, types of social support and support outcomes during and after breast cancer treatment have been explored worldwide. However, to promote women’s psychological wellbeing it is essential to understand how women define support in the highly stressful period initially following diagnosis.

Methods.  Secondary analysis of narrative texts using interpretive phenomenology from 18 women in the Midwestern United States newly diagnosed with breast cancer who were interviewed in 2005 for a study of women’s pretreatment thought processes.

Findings.  ‘Surviving the wait for surgery by balancing support needs to maintain a hopeful outlook’ was the overarching pattern linking six other related themes: (1) controlling access to information for self and to others, (2) knowing which supportive network members to access, (3) controlling anxiety through distraction to maintain hope while waiting, (4) being in good hands and comfortable with decision (provider support), (5) protecting others through concealment and being strong to maintain hope and (6) accepting care from others vs. maintaining a nurturing role.

Conclusion.  Implications for nurses working with women in the days following breast cancer diagnosis include assessing women’s definitions and availability of support; respecting varied needs for informational support; providing a supportive clinical environment; educating clinicians, family and friends regarding unsupportive responses within the cultural context and validating women’s control and balancing of support needs.
Competition may explain the fine‐scale spatial patterns and genetic structure of two co‐occurring plant congeners
Authors: Matesanz Silvia , Gimeno Teresa E. , de la Cruz Marcelino , Escudero Adrián , Valladares Fernando
Published: March 2011

1. The spatial distribution of individual plants within a population and the population’s genetic structure are determined by several factors, like dispersal, reproduction mode or biotic interactions. The role of interspecific interactions in shaping the spatial genetic structure of plant populations remains largely unknown.

2. Species with a common evolutionary history are known to interact more closely with each other than unrelated species due to the greater number of traits they share. We hypothesize that plant interactions may shape the fine genetic structure of closely related congeners.

3. We used spatial statistics (georeferenced design) and molecular techniques (ISSR markers) to understand how two closely related congeners, Thymus vulgaris (widespread species) and T. loscosii (narrow endemic) interact at the local scale. Specific cover, number of individuals of both study species and several community attributes were measured in a 10 × 10 m plot.

4. Both species showed similar levels of genetic variation, but differed in their spatial genetic structure. Thymus vulgaris showed spatial aggregation but no spatial genetic structure, while T. loscosii showed spatial genetic structure (positive genetic autocorrelation) at short distances. The spatial pattern of T. vulgaris’ cover showed significant dissociation with that of T. loscosii. The same was true between the spatial patterns of the cover of T. vulgaris and the abundance of T. loscosii and between the abundance of each species. Most importantly, we found a correlation between the genetic structure of T. loscosii and the abundance of T. vulgaris: T. loscosii plants were genetically more similar when they were surrounded by a similar number of T. vulgaris plants.

5. Synthesis. Our results reveal spatially complex genetic structures of both congeners at small spatial scales. The negative association among the spatial patterns of the two species and the genetic structure found for T. loscosii in relation to the abundance of T. vulgaris indicate that competition between the two species may account for the presence of adapted ecotypes of T. loscosii to the abundance of a competing congeneric species. This suggests that the presence and abundance of close congeners can influence the genetic spatial structure of plant species at fine scales.
The activities and participation of adolescents with autism spectrum disorders in Singapore: findings from an ICF‐based instrument
Authors: Poon K. K.
Published: March 2011

Background This study sought to describe the activities and participation of adolescents with autism spectrum disorders (ASD) in Singapore and to examine the suitability of the Activity and Participation component of the International Classification of Functioning, Disability and Health for achieving this purpose. This information may guide the development of intervention programmes for adolescents and adults as well as the provision of a means to document meaningful outcomes.

Methods Parents of 20 adolescents with ASD attending special schools in Singapore were interviewed using the Vineland Adaptive Behavioural Scales – Second Edition and the Activities and Participation Rating Scale (APRS), which was developed for this study.

Results The adolescents with ASD were rated to have more difficulties with participation than with the engagement of activities. Individual domain analyses indicate no difficulties with mobility and mild difficulties with self‐care. The performance of general tasks and demands were rated as less problematic than domestic, major life areas, communication and interpersonal interactions. The adolescents with ASD were rated to have more difficulties in communication and community environments than in at home. In addition, analysis of associations between the APRS and Vineland Adaptive Behavioural Scales – Second Edition reveal a pattern of strong relationships between sub‐tests.

Conclusion This study highlights the imperative for researchers and practitioners alike to develop a focus on strengths, generalisation and the quality of life of adolescents with ASD. The APRS also shows promise in helping document outcomes for adolescents with ASD in Asia and further development of this instrument is needed.
Two hydrophobins are involved in fungal spore coat rodlet layer assembly and each play distinct roles in surface interactions, development and pathogenesis in the entomopathogenic fungus,Beauveria bassiana
Authors: Zhang Shizhu , Xia Yu Xian , Kim Byong , Keyhani Nemat O.
Published: March 2011

The entomogenous filamentous fungus,Beauveria bassianaexpresses two hydrophobin genes,hyd1andhyd2, hypothesized to be involved in cell surface hydrophobicity, adhesion, virulence, and to constitute the protective spore coat structure known as the rodlet layer. Targeted gene inactivation ofhyd1resulted in seemingly ‘bald’ conidia that contained significantly altered surface fascicles or bundles. These cells displayed decreased spore hydrophobicity, loss of water mediated dispersal, changes in surface carbohydrate epitopes and β‐1,3‐glucan distribution, lowered virulence in insect bioassays, but no effect on adhesion. In contrast,Δhyd2mutants retained distorted surface bundles, but truncated/incomplete rodlets could be seen within the bundles.Δhyd2conidia displayed both decreased cell surface hydrophobicity and adhesion, but the mutant was unaffected in virulence. The doubleΔhyd1Δhyd2mutant was distinct from the single mutants, lacking both bundles and rodlets, and displaying additively decreased cell surface hydrophobicity, reduced cell attachment and lowered virulence than theΔhyd1mutant. Epitope tagged constructs of the proteins were used to examine the expression and distribution of the proteins and to demonstrate the continued presence of Hyd2 in theΔhyd1strain and vice versa. The implications of our results with respect to fascicle and rodlet assembly on the spore surface are discussed.
DsbA2 (27 kDa Com1‐like protein) of Legionella pneumophila catalyses extracytoplasmic disulphide‐bond formation in proteins including the Dot/Icm type IV secretion system
Authors: Jameson‐Lee Max , Garduño Rafael A. , Hoffman Paul S.
Published: March 2011

In Gram‐negative bacteria, thiol oxidoreductases catalyse the formation of disulphide bonds (DSB) in extracytoplasmic proteins. In this study, we sought to identify DSB‐forming proteins required for assembly of macromolecular structures in Legionella pneumophila. Here we describe two DSB‐forming proteins, one annotated as dsbA1 and the other annotated as a 27 kDa outer membrane protein similar to Com1 of Coxiella burnetii, which we designate as dsbA2. Both proteins are predicted to be periplasmic, and while dsbA1 mutants were readily isolated and without phenotype, dsbA2 mutants were not obtained. To advance studies of DsbA2, a cis‐proline residue at position 198 was replaced with threonine that enables formation of stable disulphide‐bond complexes with substrate proteins. Expression of DsbA2 P198T mutant protein from an inducible promoter produced dominant‐negative effects on DsbA2 function that resulted in loss of infectivity for amoeba and HeLa cells and loss of Dot/Icm T4SS‐mediated contact haemolysis of erythrocytes. Analysis of captured DsbA2 P198T–substrate complexes from L. pneumophila by mass spectrometry identified periplasmic and outer membrane proteins that included components of the Dot/Icm T4SS. More broadly, our studies establish a DSB oxidoreductase function for the Com1 lineage of DsbA2‐like proteins which appear to be conserved among those bacteria also expressing T4SS.
A Mycobacterium marinum TesA mutant defective for major cell wall‐associated lipids is highly attenuated in Dictyostelium discoideum and zebrafish embryos
Authors: Alibaud Laeticia , Rombouts Yoann , Trivelli Xavier , Burguière Adeline , Cirillo Suat L. G. , Cirillo Jeffrey D. , Dubremetz Jean‐François , Guérardel Yann , Lutfalla Georges , Kremer Laurent
Published: March 2011

Infection of the zebrafish with Mycobacterium marinum is regarded as a well‐established experimental model to study the pathogenicity of Mycobacterium tuberculosis. Herein, a M. marinum transposon mutant library was screened for attenuated M. marinum phenotypes using a Dictyostelium discoideum assay. In one attenuated mutant, the transposon was located within tesA, encoding a putative type II thioesterase. Thin‐layer chromatography analyses indicated that the tesA::Tn mutant failed to produce two major cell wall‐associated lipids. Mass spectrometry and nuclear magnetic resonance clearly established the nature of missing lipids as phthioglycol diphthioceranates and phenolic glycolipids, respectively, indicating that TesA is required for the synthesis of both lipids. When injected into the zebrafish embryo bloodstream, the mutant was found to be highly attenuated, thus validating the performance and relevance of the Dictyostelium screen. Consistent with these in vivo findings, tesA::Tn exhibited increased permeability defects in vitro, which may explain its failure to survive in host macrophages. Unexpectedly, virulence was retained when bacteria were injected into the notochord. Histological and ultrastructural studies of the infected notochord revealed the presence of actively proliferating mycobacteria, leading to larval death. This work presents for the first time the notochord as a compartment highly susceptible to mycobacterial infection.
Estimated Pregnancy Length from Ovulation to Parturition in the Bitch and its Influencing Factors: A Retrospective Study in 162 Pregnancies
Authors: Mir F , Billault C , Fontaine E , Sendra J , Fontbonne A
Published: March 2011

Contents

An accurate timing of parturition is very useful for managing canine parturition. It is generally accepted that parturition in bitches occurs between 64 and 66 days after the luteinizing hormone peak. In this retrospective study, we determined pregnancy length in different breeds and its influencing factors dating it from the estimated day of ovulation (EDO), defined as the day when peripheral plasma level of progesterone (P4) reaches 6 ng/ml. From January 2001 to December 2006, 162 pregnancies in 151 bitches of 53 different breeds were followed. Different parameters concerning the bitch, the litter, the type of semen and the type of reproduction were studied. The mean estimated pregnancy length in the bitch from EDO to parturition was 63.1 ± 2.1 days. The main influencing factors for the pregnancies studied were the breed, the size of the bitch and the number of puppies within the litter.
X‐linked recessive polyfibromatosis manifesting with spontaneous keloid scars and Dupuytren's contracture
Authors: Ly Lena , Winship Ingrid
Published: March 2011

We present a patient with keloid scars and Dupuytren's contracture comprising the polyfibromatosis syndrome; four members over three generations of his family are also affected. To our knowledge this is the first familial case reported of polyfibromatosis with this specific phenotypic presentation and probable X‐linked recessive inheritance.
Presence of SPINK‐1 variant alters the course of chronic pancreatitis
Authors: Sandhu Bimaljit , Vitazka Patrik , Ferreira‐Gonzalez Andrea , Pandya Arti , Vachhani Ravi , Bouhaidar Doumit , Zfass Alvin , Sanyal Arun
Published: March 2011

Background and Aims:  There is growing evidence that genetic mutations/variants increase susceptibility to the development and progression of chronic pancreatitis (CP). Several mutations have been identified that have a direct and indirect role in events leading to CP. Mutations in the serine protease inhibitor, Kazal type‐1 (SPINK‐1) gene have been reported to lower the threshold for pancreatitis in the presence of other genetic or environmental factors. The prevalence and impact of SPINK‐1 mutations on the clinical course and outcomes of CP remains unclear. This study was conducted to assess the prevalence of the SPINK‐1/N34S variant in patients with CP, and to understand the impact of the SPINK‐1 mutation on the natural history of CP.

Methods:  A retrospective‐prospective analysis of 239 patients with CP was performed. A detailed history, including duration of symptoms, type of pain (intermittent flares or chronic continuous pain), number of flares requiring hospital admission, alcohol and smoking history, and family history was obtained. The baseline morphological stage of CP was categorized by Cambridge classification. Clinical outcome variables included frequency and severity of pain episodes, presence of exocrine failure (defined by presence of steatorrhea and/or fecal elastase < 200 ug/g), and diabetes. The genetic tests included the cationic trypsinogen gene‐1 mutation, cystic fibrosis gene mutations (Genzyme assay), and the SPINK‐1/N34S mutation.

Results:  Of the 239 patients with CP, 13 (5.4%) were positive for the SPINK‐1/N34S mutation. There were 35 (14.6%) patients with idiopathic pancreatitis (IP) in this cohort. Most of the patients who were positive for the SPINK‐1/N34S mutation had IP and were Caucasian (69.2%). The patients with the SPINK‐1/N34S mutation had a younger age of onset (32.9 ± 10.2 vs 40.1 ± 13.6 years; P = 0.108) than those with IP and no mutation. Over a median follow up of 9.6 years, the patients with the SPINK‐1/N34S mutation had a significantly greater number of acute flares each year, as compared to those without the mutation (11.8 ± 1.5 vs 4 ± 0.98; P = 0.0001).

Conclusions:  The prevalence of the SPINK‐1/N34S mutation in patients with CP is 5.4%, and is approximately 37.1% in patients with IP. These mutations are more prevalent in Caucasian patients with CP. The SPINK‐1/N34S mutation predisposes to early onset IP and more frequent acute flares of pancreatitis that might ultimately lead to pancreatic insufficiency. The patients with IP and borderline alcohol history should be considered for testing for genetic analysis, including SPINK‐1 mutations, initially restricted to clinical trials.
Ghrelin inhibits 5‐fluorouracil‐induced apoptosis in colonic cancer cells
Authors: He Xiao‐Tong , Fan Xiao‐Ming , Zha Xi‐Liang
Published: March 2011

Background and Aim:  The aim of the present study was to investigate if ghrelin inhibits apoptosis in colonic cancer cells.

Methods:  Cell viability in HT‐29 cells was measured using 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assay. Apoptosis was measured using 4′,6‐diamidino‐2‐phenylindole staining and flow cytometry. The protein expression of Bcl‐2, Bax, and caspase‐3 activation was examined using Western blotting.

Results:  Ghrelin dose dependently decreased the growth inhibition of HT‐29 cells induced by 5‐fluorouracil (5‐FU). Cells treated with 5‐FU displayed chromatin condensation and nuclear fragmentation, which are typical changes of apoptosis. However, co‐treatment with ghrelin reduced these changes. Flow cytometry after staining with Annexin V and propidium iodide showed that ghrelin decreased the apoptotic rate of HT‐29 cells induced by 5‐FU. Caspase‐3 activation was significantly lower in the co‐treated group than in the group treated with 5‐FU alone. In addition, ghrelin reversed the 5‐FU‐induced Bcl‐2/Bax protein ratio.

Conclusion:  Ghrelin inhibits 5‐FU‐induced apoptosis in colon cancer cells through the regulation of the Bcl‐2/Bax protein ratio.
Pleural infection: Changing bacteriology and its implications
Authors: LISBOA THIAGO , WATERER GRANT W. , LEE Y.C. GARY
Published: March 2011

The incidence of pleural infection continues to rise worldwide. Identifying the causative organism(s) is important to guide antimicrobial therapy. The bacteriology of pleural infection is complex and has changed over time. Recent data suggest that the bacterial causes of empyema are significantly different between adult and paediatric patients, between community‐acquired and nosocomial empyemas and can vary among geographical regions of the world. Since the introduction of pneumococcal vaccines, a change has been observed in the distribution of the serotypes of Streptococcus pneumoniae in empyema. These observations have implications on therapy and vaccine strategies. Clinicians need to be aware of the local bacteriology of empyema in order to guide antibiotic treatment.
Community‐acquired methicillin‐resistant Staphylococcus aureus pneumonia: A clinical audit
Authors: THOMAS RAJESH , FERGUSON JOHN , COOMBS GEOFFREY , GIBSON PETER G
Published: March 2011

Background and objective:  Community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) strains are primarily associated with skin and soft tissue infections; however, they are increasingly causing more invasive infections including severe community‐acquired pneumonia. The objective of this study was to describe the clinico‐pathological characteristics of community‐acquired MRSA pneumonia.

Methods:  A retrospective analysis of case records from January 2002 to August 2008 was performed on patients admitted with community‐acquired MRSA pneumonia to two large teaching hospitals.

Results:  Sixteen patients with community‐acquired MRSA pneumonia were identified. Their age ranged from 11 months to 86 years (median age; 30 years). Duration of symptoms before hospital presentation ranged from one to 21 days. Most patients had productive cough, fever and dyspnoea. The most common radiological presentation included multilobar consolidation (8/16), necrotizing consolidation (7/16) and empyema (5/16).

Seven patients required intensive care support; four required ionotropic support and five required mechanical ventilation for a mean duration of 53 h and 6.6 days, respectively. Six patients underwent surgery (VATS or open thoracotomy). There was a mean delay of approximately 69 h (range; 18 h to 11 days) after presentation before appropriate MRSA antimicrobial treatment was initiated. Three patients died of complications from pneumonia, all within 72 h of presentation. Among survivors, the average length of hospital stay was 23.8 days (range; 10–49 days). Majority of survivors were left with mild residual radiological changes.

Conclusions:  Community‐acquired MRSA pneumonia is increasing and should be suspected in patients with severe community‐acquired pneumonia. There was a delay in initiation of appropriate antimicrobial treatment that could have lead to increased morbidity.
Atypical metastatic carcinoid of the uterine cervix and review of the literature
Authors: Yoshida Yoshio , Sato Kumiko , Katayama Kanji , Yamaguchi Akio , Imamura Yoshiaki , Kotsuji Fumikazu
Published: March 2011

Atypical carcinoid tumors of the uterine cervix represent rare neuroendocrine tumors and are highly aggressive, showing early lymphatic invasion and hematogenous distant metastases. Because of the small number of cases, there are currently no recommendations regarding treatment, and little is known about the response to chemotherapeutic agents. A 39‐year‐old woman was diagnosed with a primary atypical carcinoid of the uterine cervix with numerous metastases to the liver. After radical hysterectomy, she underwent hepatic arterial chemoembolization with streptozotocin and 5‐fluorouracil. Complete response was achieved in numerous liver metastases. At the 2‐year follow up of chemotherapy, the patient remains alive. Treatment for atypical carcinoid tumors remains elusive, however hepatic arterial chemoembolization with streptozotocin and 5‐fluorouracil was effective in the present primary atypical carcinoid with liver metastases. A review of the previous reports is also presented.
Biodiversity and geochemistry of an extremely acidic, low‐temperature subterranean environment sustained by chemolithotrophy
Authors: Kimura Sakurako , Bryan Christopher G. , Hallberg Kevin B. , Johnson D. Barrie
Published: March 2011

The geochemical dynamics and composition of microbial communities within a low‐temperature (∼8.5°C), long‐abandoned (> 90 years) underground pyrite mine (Cae Coch, located in north Wales) were investigated. Surface water percolating through fractures in the residual pyrite ore body that forms the roof of the mine becomes extremely acidic and iron‐enriched due to microbially accelerated oxidative dissolution of the sulfide mineral. Water droplets on the mine roof were found to host a very limited diversity of exclusively autotrophic microorganisms, dominated by the recently described psychrotolerant iron/sulfur‐oxidizing acidophile Acidithiobacillus ferrivorans, and smaller numbers of iron‐oxidizing Leptospirillum ferrooxidans. In contrast, flowing water within the mine chamber was colonized with vast macroscopic microbial growths, in the form of acid streamers and microbial stalactites, where the dominant microorganisms were Betaproteobacteria (autotrophic iron oxidizers such as ‘Ferrovum myxofaciens’ and a bacterium related to Gallionella ferruginea). An isolated pool within the mine showed some similarity (although greater biodiversity) to the roof droplets, and was the only site where archaea were relatively abundant. Bacteria not previously associated with extremely acidic, metal‐rich environments (a Sphingomonas sp. and Ralstonia pickettii) were found within the abandoned mine. Data supported the hypothesis that the Cae Coch ecosystem is underpinned by acidophilic, mostly autotrophic, bacteria that use ferrous iron present in the pyrite ore body as their source of energy, with a limited role for sulfur‐based autotrophy. Results of this study highlight the importance of novel bacterial species (At. ferrivorans and acidophilic iron‐oxidizing Betaproteobacteria) in mediating mineral oxidation and redox transformations of iron in acidic, low‐temperature environments.
Current and emerging treatment modalities for metastatic castration‐resistant prostate cancer
Authors: Bracarda Sergio , Logothetis Christopher , Sternberg Cora N. , Oudard Stéphane
Published: March 2011

Docetaxel‐based therapy is established as the standard first‐line chemotherapy in patients with metastatic castration‐resistant prostate cancer (mCRPC), based on results from two landmark Phase III studies. However, prognosis remains poor, with a median survival of less than 2 years. There is no standard of care for patients who progress during or after docetaxel treatment, which represents a real unmet medical need. Several small retrospective studies suggest that patients with mCRPC who responded to first‐line docetaxel‐based therapy are sensitive to re‐treatment, but a survival benefit in prospective randomized trials has not been demonstrated. Epithelial–stromal interactions in the tumour microenvironment appear to play a central role in prostate cancer progression and response to therapy. Recent insights into the molecular mechanisms that underpin prostate cancer progression have allowed the identification of potential therapeutic targets. New agents, including angiogenesis inhibitors, hormone therapies, chemotherapies, bone targeting agents, vaccines and immunotherapies are currently undergoing clinical development in advanced prostate cancer using docetaxel as a backbone. Several Phase III studies have now been completed. Sipuleucel‐T prolonged survival compared with placebo in asymptomatic or minimally symptomatic patients with mCRPC. Cabazitaxel plus prednisone prolonged survival in patients with mCRPC who progressed during or after docetaxel‐based therapy compared with the active agent mitoxantrone, plus prednisone. Multidisciplinary management and optimization of the role and timing of new agents in this evolving treatment continuum will be critical to maximizing patient outcomes. Identification of predictive markers and better gene expression profiling will be critical to tailoring therapies to individual patients and disease states, whereas validated surrogate markers of overall survival will help accelerate drug approval.
Can we measure daily tobacco consumption in remote Indigenous communities? Comparing self‐reported tobacco consumption with community‐level estimates in an Arnhem Land study
Authors: CLOUGH ALAN R. , MACLAREN DAVID J. , ROBERTSON JAN A. , IVERS ROWENA G. , CONIGRAVE KATHERINE M.
Published: March 2011

Introduction and Aims. In remote Indigenous Australian communities measuring individual tobacco use can be confounded by cultural expectations, including sharing. We compared self‐reported tobacco consumption with community‐level estimates in Arnhem Land (Northern Territory). Design and Methods. In a cross‐sectional survey in three communities (population 2319 Indigenous residents, aged≥16 years), 400 Indigenous residents were interviewed (206 men, 194 women). Eight community stores provided information about tobacco sold during the survey. To gauge the impact of 255 non‐Indigenous residents on tobacco turnover, 10 were interviewed (five men, five women). Breath carbon monoxide levels confirmed self‐reported smoking. Self‐reported number of cigarettes smoked per day was compared with daily tobacco consumption per user estimated using amounts of tobacco sold during 12 months before the survey (2007–2008). ‘Lighter smokers’ (<10 cigarettes per day) and ‘heavier smokers’ (≥10 cigarettes per day) in men and women were compared. Results. Of 400 Indigenous study participants, 305 (76%) used tobacco; four chewed tobacco. Of 301 Indigenous smokers, 177 (58%) provided self‐reported consumption information; a median of 11–11.5 cigarettes per day in men and 5.5–10 cigarettes per day in women. Men were three times (odds ratio = 2.9) more likely to be ‘heavier smokers’. Store turnover data indicated that Indigenous tobacco users consumed the equivalent of 9.2–13.1 cigarettes per day; very similar to self‐reported levels. Sixty per cent (= 6/10) of non‐Indigenous residents interviewed were smokers, but with little impact on tobacco turnover overall (2–6%). Discussion and Conclusions. Smoking levels reported by Indigenous Australians in this study, when sharing tobacco was considered, closely reflected quantities of tobacco sold in community stores. [Clough AR, MacLaren DJ, Robertson JA, Ivers RG, Conigrave KM. Can we measure daily tobacco consumption in remote Indigenous communities? Comparing self‐reported tobacco consumption with community‐level estimates in an Arnhem Land study. Drug Alcohol Rev 2010]
Heroin maintenance treatment: From idea to research to practice
Authors: UCHTENHAGEN AMBROS A.
Published: March 2011

Maintaining opiate addicts on opiates has a long history. The idea to prescribe pharmaceutical morphine as a substitute for street heroin started in USA and was abolished on the basis of prohibitionist legislation. A new approach to maintain opiate addicts on substitution therapy was initiated in USA in 1963, with the prescription of methadone. This approach found, although slowly, increasing acceptance, and is nowadays considered to be a cornerstone in the management of opiate dependence and for the prevention of HIV/AIDS in opiate injectors. Since 1975, the concept of heroin maintenance treatment was re‐activated in order to reach out to treatment‐resistant heroin addicts. Research projects were performed in Switzerland, the Netherlands, Germany, Spain, Canada and in England, another one is planned in Belgium. Based on the unanimously positive outcomes, heroin maintenance has become routine treatment for otherwise untreatable heroin addicts in Switzerland, the Netherlands, Germany and England, and Denmark has set up heroin maintenance without new research trials.[Uchtenhagen AA. Heroin maintenance treatment: From idea to research to practice.Drug Alcohol Rev2011;30:130–137]
Developing, evaluating and implementing alcohol brief interventions in Europe
Authors: HEATHER NICK
Published: March 2011

Issues. This article traces the history of research on the development, evaluation and implementation of alcohol brief intervention (BI) in Europe.

Approach. Narrative and historical review.

Key Findings. BI originated in Europe and, following a definition of opportunistic BI, early pioneering studies are summarised. The role of European scientists in the series of studies making up the WHO Collaborative Project on Detection and Management of Alcohol‐related Problems in Primary Health Care (1982–2006) is then described, followed by a short account of a current EU‐funded project (Primary Health European Project on Alcohol) with the aim of achieving a widespread, routine and enduring implementation of BI in EU member states. In addition to involvement in these two major projects, a great deal of research on BI has been carried out in a range of European countries and some of this research is noted.

Implications. Several European governments are now taking the rolling out of BI in routine services very seriously as a policy measure. There is no necessary conflict between widely available BI and alcohol control measures.

Conclusion. While much remains to be done regarding practical implementation, the mood of those interested in the promotion of BI as a means of reducing alcohol‐related harm, in Europe as elsewhere, is cautiously optimistic.[Heather N. Developing, evaluating and implementing alcohol brief interventions in Europe. Drug Alcohol Rev 2011;30:138–147]
Inter‐ and Intra‐Household Earnings Differentials among Homosexual and Heterosexual Couples
Authors: Ahmed Ali M. , Andersson Lina , Hammarstedt Mats
Published: March 2011

We present earnings differentials between homosexuals and heterosexuals. In line with previous research, we find that gay males earn less than heterosexual males, and that lesbians earn more than heterosexual females. However, when combining the individuals into households, our results are strikingly different: very small earnings differentials between gay households and heterosexual households are found. Lesbian households earn considerably less. The largest earnings inequalities between spouses are found among gay males followed by heterosexuals. Studying sexual orientation and earnings is complex, and household earnings have to be taken into consideration when conclusions are drawn.
TECHNICAL EFFICIENCY IN THE INDIAN TEXTILES INDUSTRY: A NON‐PARAMETRIC ANALYSIS OF FIRM‐LEVEL DATA
Authors: Bhandari Anup Kumar , Ray Subhash C.
Published: March 2011

The Indian textiles industry is now at the crossroads with the phasing out of the quota regime that prevailed under the Multi‐Fiber Agreement until the end of 2004. In the face of a full integration of the textiles sector in the WTO, maintaining and enhancing productive efficiency is a precondition for competitiveness of the Indian firms in the new liberalized world market. In this paper, we use data obtained from the Annual Survey of Industries for a number of years to measure the levels of technical efficiency in the Indian textiles industry at the firm level. We use both a grand frontier applicable to all firms and a group frontier specific to firms from any individual state, ownership or organization type in order to evaluate their efficiencies. This permits us to separately identify how locational, proprietary and organizational characteristics of a firm affect its performance.
PUBLIC PRIVATE PARTNERSHIPS: ADDED VALUE BY ORGANIZATIONAL FORM OR MANAGEMENT?
Authors: STEIJN BRAM , KLIJN ERIK‐HANS , EDELENBOS JURIAN
Published: March 2011

The central idea of public private partnerships (PPPs) is that added value can be achieved from greater co‐operation between public and private actors. In general, the literature speaks of PPPs in which public and private actors develop a more or less sustainable co‐operation through which they realize products, services, or policies together, share risks, and develop an organizational form to arrange this. The assumption is that a higher degree of PPP leads to more and better outcomes because public and private actors combine their knowledge and resources. One can find a wide array of organizational forms in which this co‐operation is organized and the literature pays a great deal of attention to these forms. But is this organizational form really so important, or are the intensity and type of managerial strategies more important for the outcomes? Based on a large survey of individuals involved in Dutch environmental projects, we show that although the degree of PPP correlates positively with the outcomes of projects, this correlation disappears when we include in the analysis the number of managerial strategies employed. The organizational form does not have significant impact on outcomes and the conclusion we draw is that scholars and practitioners of public private partnerships should pay greater attention to the managerial efforts necessary to develop and implement PPPs.
DIVERSITY AND DOMINANCE IN THE ARCTIC. ETHNIC RELATIONS IN THE GREENLANDIC BUREAUCRACY
Authors: BINDERKRANTZ ANNE SKORKJÆR
Published: March 2011

Public bureaucracies are increasingly characterized by employee diversity in terms of ethnicity. Investigating relations between ethnic groups in bureaucracies is therefore important. This article focuses on the particularly interesting case of the Greenlandic administration. Being a former Danish colony, Greenland still recruits bureaucrats from mainland Denmark. These work alongside locally hired employees resulting in an administration with different ethnicities, cultures and languages. The analysis of ethnic relations is based on 28 interviews with bureaucrats of Danish and Greenlandic origin. Even though overall relations are found to be largely harmonious, ethnicity makes a difference. Interviewees describe differences in ethnic traits and behaviour and processes of social categorization. Particularly among Greenlanders, Danes are described as dominant and this dominance is reinforced by co‐variation between ethnicity, language skills and education. Finally, inter‐group relations are found to vary with the numerical balance of ethnic groups in different parts of the bureaucracy.
Social Capital in the Field of Power: The Case of Norway
Authors: Denord François , Hjellbrekke Johs. , Korsnes Olav , Lebaron Frédéric , Le Roux Brigitte
Published: March 2011

This paper analyses social capital structures in the field of power, based on data from the Norwegian Power and Democracy Survey on elites. Separating between objectified, institutionalised, embodied, and inherited social capital, and inspired by Bourdieu's approach, we analyse the relations between social capital and the other forms of capital by way of specific multiple correspondence analysis and ascending hierarchical cluster analysis. First, we find that the level of institutionalised social capital varies from one fraction of the Norwegian elite to another. Secondly, the range of networks established through previous work experiences is related to field seniority. Thirdly, the positions of highest endogamy are situated in the religious field, and to a lesser extent, in the scientific field, and in the juridical field. Finally, the ‘core of the core’ is defined by actors who are strongly interconnected inside what is called ‘the tripartite system’, with a high level of multipositionality and intersectorial connections.