bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific Collaborative Group Intervention for Patients with Medically Unexplained Symptoms in General Practice: A Cluster Randomized Controlled Trial
Authors: Schaefert R. , Kaufmann C. , Wild B. , Schellberg D. , Boelter R. , Faber R. , Szecsenyi J. , Sauer N. , Guthrie E. , Herzog W.
Published: December 2012

Background: Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. Methods: We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). Results: At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. Conclusions: Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care.
Increased Somatic Morbidity in the First Year after Leaving Opioid Maintenance Treatment: Results from a Norwegian Cohort Study
Authors: Skeie I. , Brekke M. , Clausen T. , Gossop M. , Lindbaek M. , Reinertsen E. , Thoresen M. , Waal H.
Published: December 2012

Background/Aims: Some patients on opioid maintenance treatment (OMT) leave treatment temporarily or permanently. This study investigated whether patients interrupting their OMT differed from non-interrupters in sociodemographic and drug-use characteristics and examined acute/sub-acute somatic morbidity among the interrupters, prior to, during, and after OMT. Methods: Cohort design. Observation Period: 5 years prior to, up to first 5 years during, and up to 5 years after interruption of OMT. Participants: The sample (n = 200) comprised 51 OMT interrupters and 149 non-interrupters. Data on patient characteristics were obtained from interviews and OMT register information. Data on somatic morbidity were gathered from hospital records. Measurements: Key patient characteristics among OMT interrupters and non-interrupters. Incidence rates of acute and sub-acute somatic disease incidents leading to hospital treatment (drug-related/non-drug-related/injuries) prior to/during/after OMT. Results: Interrupters and non-interrupters did not differ in sociodemographic characteristics, while longer duration of amphetamine and benzodiazepine dependence predicted OMT interruption. Interrupters scored significantly higher on drug-taking and overdose during OMT but still had a significant 41% reduction in drug-related treatment, episodes. After interruption of treatment, such episodes increased markedly and were 3.6 times more frequent during the first post-OMT year compared to the pre-OMT period (p < 0.001). This increase was highest during the first months after OMT interruption. 2–5 years after interruption there was no significant increase. Conclusions: Increased somatic morbidity was found among OMT interrupters during the first year after OMT, and especially during the immediate post-treatment period.
The Effect of Chronic Smoking on the Pupil and Photostress Recovery Time
Authors: Sobacı Güngör , Erdem Üzeyir , Gundogan Fatih Ç. , Musayev Samir
Published: December 2012

Purpose: To determine the effect of chronic smoking on the pupil and photostress recovery time. Methods: Macular adaptation to photostress condition, and mesopic and photopic pupillary responses were measured using automated perimetry (Humprey®), and an OPD device (Nidek), respectively. Forty heavy smokers (smoking ≥1 box/day for the past 5 years at least), and 40 age- and sex-matched nonsmokers were enrolled. All the subjects had full vision and no ocular problems. Results: The baseline foveal threshold value (FTV) before photostress was similar in both groups (p = 0.75). Although photostress recovery times (7.1 ± 1.1 and 7.4 ± 1.3 min) were similar in smokers and nonsmokers (p = 0.30), FTV measured at the first minute after photostress was statistically higher in smokers (36.05 ± 0.98 dB) than nonsmokers (34.7 ± 1.03 dB; p = 0.018). Scotopic pupil sizes in smokers (6.73 ± 0.82 mm) and nonsmokers (6.55 ± 0.62 mm) were similar (p = 0.28); however, photopic pupil size in smokers (5.36 ± 0.73 mm) was different from nonsmokers (4.73 ± 0.58 mm; p = 0.001). Conclusions: Chronic smoking may dilate the pupil, and increases macular FTV immediately after photostress.
Spinal Cord Compression in Maroteaux-Lamy Syndrome: Case Report and Review of the Literature with Effects of Enzyme Replacement Therapy
Authors: Jurecka Agnieszka , Opoka-Winiarska Violetta , Jurkiewicz Elżbieta , Marucha Jolanta , Tylki-Szymańska Anna
Published: December 2012

The purpose of this report is to review the literature regarding spinal cord compression in mucopolysaccharidosis type VI (MPS VI), to discuss the possible impact of enzyme replacement therapy (ERT) and to stress the necessity of timely surgical intervention. A 9.5-year-old female patient with severe MPS VI had been receiving ERT since the age of 7. After 2.5 years of treatment, she developed craniovertebral canal stenosis with spinal cord compression and cervical myelopathy. Conclusions: (1) baseline cervical spine evaluation and regular neurological assessment should be performed in all MPS VI patients, (2) detailed neurological observation should be conducted in patients treated with ERT, especially in the period of improvement in the osteoarticular system, as ERT fails to prevent cervical myelopathy and (3) surgical decompression is required and in order to achieve a satisfying outcome it might be crucial to perform surgery at an early age.
Evaluation of the Performances of Two Rapid Diagnostic Tests (Cyscope®mini and Paracheck-Pf®) in the Diagnosis of Malaria among Febrile Children in Southwest Nigeria
Authors: Rabiu Olawunmi R. , Kosoko Ayokulehin M. , Falade Catherine O. , Ademowo Olusegun G.
Published: December 2012

Objective: The aim of this study was to test the diagnostic performances of Cyscope®mini and Paracheck-Pf® for Plasmodium falciparum relative to microscopy. Subjects and Methods: 209 children aged 6 months to 12 years presenting with symptoms suggestive of malaria were enrolled at the University College Hospital, Ibadan, Nigeria, within a period of 6 months. Malaria parasites were identified in capillary blood samples using Cyscope®mini (parasite DNA-based fluorescence microscope) and Paracheck-Pf® (an HRP-II-based test) with microscopy of Giemsa-stained thick blood films as reference gold standard. The overall performances were calculated using OpenEpi version 2.3 statistical package. 209 samples were performed for Cyscope®mini and light microscopy while 140 samples were done by Paracheck-Pf®. Results: The prevalence of malaria parasitaemia by light microscopy was 22.0% (46/209), while those of Cyscope®mini and Paracheck-Pf® were 85.2% (178/209) and 32.1% (45/140), respectively. Parasite density ranged from 40 to 203,883/µl. Cyscope®mini and Paracheck-Pf® had sensitivities of 91.3 and 86.21%, respectively. The respective specificities were 16.56 and 81.98% for Cyscope®mini and Paracheck-Pf® with diagnostic accuracies of 33.01 and 82.86%. The diagnostic performances of the two rapid diagnostic tests were significantly different. Conclusion: Paracheck-Pf® performed better than Cyscope®mini for diagnosis of falciparum malaria and will be a good diagnostic tool for field studies.
Novel Actions of Oxazolidinones: In vitro Screening of a Triazolyloxazolidinone for Anticonvulsant Activity
Authors: Kombian Samuel B. , Phillips Oludotun A.
Published: December 2012

Objective: To test the hypothesis that a triazolyloxazolidinone (PH084) has anticonvulsant activity by examining its effects on in vitro seizure models in the rat hippocampus. Materials and Methods: Whole-cell synaptic currents, action potentials and extracellular population spikes (PS) were recorded in the cell body area of rat hippocampal CA1 region in acutely prepared slices. Chemical [picrotoxin (100 µM) and zero magnesium] and electrical seizures were induced and the effect of PH084 (10 µM) was tested on cellular responses, multiple spikes and spontaneous bursting frequencies. Results: PH084 depressed evoked excitatory postsynaptic currents, action potential firing frequency and PS amplitude. All of these responses did not recover to baseline after 15-20 min washout of PH084. Perfusion with zero magnesium ion (Mg2+)-containing buffer converted a single PS to multiple PS (mPS) accompanied by spontaneous burst. PH084 suppressed the mPS and the spontaneous burst frequency and it also suppressed the picrotoxin-induced mPS number. However, it did not affect the frequency of stimulus train-induced after discharge or bursts. Furthermore, 8-10 min pretreatment with PH084 did not affect the ability of zero Mg2+ buffer, picrotoxin or stimulus train to induce epileptiform activity. Conclusions: Thus, while PH084 may have potential for anticonvulsant activity against chemically induced seizures, it has little or no potential against electrically induced seizures or in preventing epileptiform discharge.
Aristotle’s Model of Animal Motion
Authors: Corcilius Klaus , Gregoric Pavel
Published: December 2012

Abstract

In this paper we argue that Aristotle operates with a particular theoretical model in his explanation of animal locomotion, what we call the ‘centralized incoming and outgoing motions’ (CIOM) model. We show how the model accommodates more complex cases of animal motion and how it allows Aristotle to preserve the intuition that animals are self-movers, without jeopardizing his arguments for the eternity of motion and the necessary existence of one eternal unmoved mover in Physics VIII. The CIOM model helps to elucidate Aristotle’s two central yet problematic claims, namely that the soul is the efficient cause of animal motion and that it is the internal supporting-point necessary for animal motion. Moreover, the CIOM model helps us to explain the difference between voluntary, involuntary and non-voluntary motions, and to square Aristotle’s cardiocentrism with his hylomorphism, but also, more generally, it provides an interesting way of thinking about the place of intentionality in the causal structure of the world.
Differential investment in acoustic communication during social interactions in two closely-related sand goby species
Authors: Bolgan Marta , Pedroso Silvia S. , Picciulin Marta , Fonseca Paulo J. , Amorim M. Clara P.
Published: December 2012

Communication signals provide key information for conspecific recognition, mate choice and rival assessment. The painted goby Pomatoschistus pictus and the common goby P. microps are two closely-related sand goby species, often sympatric and with an overlapping breeding season. In this study we staged male–male and male–female interactions and compared visual, tactile and acoustic behaviour in both species. Sound production in the common goby is here accounted for the first time. We observed some differences in visual behaviour and a striking divergence in the use of tactile and acoustic communication during courtship and agonistic interactions. We further describe differences in drumming signals with social context in the painted goby. This study suggests a divergence in communication in two closely-related sand goby species and emphasizes the importance of further research concerning the role of multimodal communication in closely-related species.
Anti-poverty and progressive social change in Brazil: lessons for other emerging economies
Authors: Kiggundu Moses N
Published: December 2012

This article examines Brazil’s experiences with anti-poverty and progressive social change, and spells out possible lessons for emerging economies with similar challenges. It draws on the Bolsa Familia conditional cash transfers (CCT) and the continuous cash benefits programmes and discusses important aspects of programme leadership, management and coordination. After a brief discussion of poverty, it presents a framework synthesizing key success factors for effective and sustaining programme implementation. Brazil does not offer a ‘blueprint’ for other countries to copy; only lessons from experience. Therefore the article concludes by discussing key ongoing challenges and suggests areas for future research, focusing on comparative studies across countries.

Points for practitioners

Progress has been made against global poverty, notably in countries experiencing sustained economic growth like Brazil. In spite of these remarkable efforts, challenges remain especially for countries which focus only on macroeconomic growth but not equity or inclusive development. Growth without equity does not eradicate poverty. Accordingly, emerging economies are being urged to pursue multipronged strategies: crafting innovative public policies, reshaping institutions for macroeconomic management, reaching out and engaging target communities, democratization, legislated and constitutionally mandated progressive social change. This article provides practical lessons from experience from Brazil, which practitioners from other emerging economies can adapt to their own circumstances for the effective and sustaining implementation of anti-poverty and progressive social change. It also provides a holistic framework for better understanding the institutional context, leadership, management, inter-government and cross-sectoral coordination and private sector participation. Finally, it identifies some of the key ongoing challenges in Brazil, and suggests areas for applied comparative research.
Asian American Parents’ Experiences of Raising Children with Autism: Multicultural Family Perspective
Authors: Wang Hui-Ting , Casillas Nicole
Published: December 2012

This article describes the experiences of Mandarin-speaking immigrant parents – an understudied population – raising a child with autism in the United States. Using purposive sampling, semi-structured interviews were conducted with four sets of parents and two mothers of children with autism. The interviews were transcribed and translated verbatim and analyzed using content analysis. Three main themes regarding parents’ experiences were derived from the data: immigration and cultural accommodation; impact of autism and cognitive response; and outlook for the future. Implications for developing cultural competency to serve culturally and linguistically diverse populations were discussed. It is suggested that more cultural studies involving participants of diverse backgrounds should be conducted in further studies.
Energy methods for modelling damage in laminates
Authors: McCartney LN
Published: December 2012

The paper represents the author’s contribution to the Third World-Wide Failure Exercise, which is aimed at benchmarking current models of damage, matrix cracking, initiation of delamination and their interaction with fibre failure. The approach used for the development of damage in laminates is based on an energy methodology that requires knowledge of the dependence of thermo-elastic constants on damage. The various models, developed by the author, are applied to the majority of the Third World-Wide Failure Exercise Test Cases, which included thin and thick cross ply and quasi-isotropic laminates, loading and unloading of an angle ply laminate, bending of a general laminate, and cracking under thermal loadings. Methods used to predict ply properties from those of the fibres and matrix are also described. Crack density in the 90 degree plies was modelled using a ply refinement technique. Detailed discussion is made on a number of relevant issues (initiating defect size and shape, fibre strength, ply saturation, off-axis ply cracking, delamination, mixed mode ply cracking) and their likely effects on design.
Modelling mechanical performance of damaged laminates
Authors: Varna Janis
Published: December 2012

This article is the author’s contribution to the third World-Wide Failure Exercise which aims at benchmarking current damage models for composites. Reduction of thermo-elastic constants of laminates and their nonlinear behaviour due to intralaminar cracking and nonlinear shear response of the composite are analysed using global–local approach. The macroscopic properties of damaged laminates are expressed in simple forms containing density of intralaminar cracks and their surface displacement features obtained from local solutions. The initiation and evolution of the intralaminar damage is analysed using strength-based approach for laminates with thick layers and fracture mechanics approach for thin layers. Due to a lack of information, certain characteristics, such as statistical failure properties distribution parameters and transition point (thickness) from strength to fracture mechanics applicability, were assumed. All calculations are based on analytical expressions, some of which were developed previously through numerical analysis. The present method was applied to solve 9 out of the 13 test cases of the third World-Wide Failure Exercise and that was sufficient to illustrate the capability of the damage model.
The Effect of Transport Costs on Housing-related Financial Stress in Australia
Authors: Vidyattama Yogi , Tanton Robert , Nepal Binod
Published: December 2012

Housing-related financial stress or housing stress is usually measured on the basis of income and direct housing costs such as mortgage repayments and rents. One cost that is not included in calculations of housing stress, but which may be important, is the difference made by transport costs. This paper shows how a measure of housing stress that incorporates transport costs can give a different picture of housing stress from a measure that ignores transport costs. The result shows that, in capital cities, bringing transport costs into a housing stress measure particularly affects households with children. It is also found that the impact of transport costs is even greater outside capital cities and that access to public transport may play a role in determining the spatial pattern of housing stress and hence the impact of transport cost on housing stress.
An Institutional Economic Analysis of the Decision to Do-it-yourself in Housing Renovation
Authors: Peng Ti-Ching
Published: December 2012

This paper examines home renovators’ decision in choosing do-it-yourself (DIY) or hiring contractors. DIY may reduce financial pressure but may lead to potential domestic discord and perils of incompetence; hiring contractors may alleviate time pressures but may require more financial resource. This choice is modelled as analogous to Williamson’s corporate strategic decision between ‘outsourcing’ and ‘internalisation’ in the context of vertical integration, and extended via Richardson’s capabilities-based theory, with social reputation effect taken into account. Based on a survey of Brisbane home renovators, it is found that the Richardson’s thesis seems stronger than the Williamson’s when applied to housing renovation and that ‘trust’ issues in respect of contractors are paramount.
Biomedical Research in India: Law and Ethics at Crossroads
Authors: Shenoi Anjali
Published: December 2012

This article tries to lay out these inter-sectional linkages through the means of recent advocacy initiatives against the unethical conduct of trials on marginalised communities along with the broader scope of regulation of the biomedical research industry in India. A special case can also be made for legal clinics for students seeking to explore the intersectionality between law and ethics in the field of biomedical research in India. This is particularly important given the dynamic pace and scope of the industry that creates complex legal and ethical issues, questions and controversies, which often seem to fall through the gaps.
Renewal of the Rights Discourse
Authors: Rai Dhananjay
Published: December 2012

Rights are vital for the arrival of equal beings. Of late, rights are marginalised in the context of capitalism-led pauperisation and heightening ascriptive discrimination. In social sciences, rights discourse has been replaced by citizenship discourse wherein the state becomes the decider of rights. In this context, rekindling of rights discourse becomes immensely significant in the backdrop of creative theory. Rights are political affirmations and delinked from duties. There have to be interdependence and interconnection of varied rights. Besides, the new direction of rights emphasises on theorisation of world or critical knowledge production domain on four accounts (production of collective epistemic, arrival of critical theory, treatment of critical knowledge as counteraction of post-ideologies/ism /philosophies and delinking abstract and concrete rights). Reconceptualisation of rights in creative society brings back the domain of normative political theory while highlighting the deficiency of prevalent system along with the urge for an alternative system by struggling equals.
Teaching the Truth About Lies to Psychology Students
Authors: Pearson Matthew R. , Richardson Thomas A.
Published: December 2012

To teach the importance of deception in everyday social life, an in-class activity called the Speed Lying Task was given in an introductory social psychology class. In class, two major research findings were replicated: Individuals detected deception at levels no better than expected by chance and lie detection confidence was unrelated to lie detection accuracy. Using a pretest–posttest design, the activity led to significant increases in deception knowledge, and the activity was seen as helpful, engaging, and interesting to the students. This study supports using students as both research subjects and research consumers in the classroom to teach classical concepts in social psychology.
The story of a ‘boss man’, his community and the 1984 miners’ strike
Authors: Bolton Sharon C , Ditchburn Jack
Published: December 2012

The aim of this particular ‘on the frontline’ account is to allow the voice of a pit overman, Jack Ditchburn, to tell his own story of being a miner, a trade unionist and a ‘boss man’ – a man who saw himself as miner first and foremost and as manager second. Jack worked as a miner in the Blackhall and Horden pits, part of the Durham coalfields, which were some of the most deeply affected by the 1984–5 strike. Jack’s narrative adds rich biographical detail to current understandings of the work of a miner, the 1984 strike, the characters involved and the relationships made and broken by it.
A late-Holocene vegetation history from the Maya lowlands, Lamanai, Northern Belize
Authors: Rushton Elizabeth AC , Metcalfe Sarah E , Whitney Bronwen S
Published: December 2012

A 3 m core from the New River Lagoon, adjacent to the Maya city of Lamanai, Northern Belize, contains a continuous record of vegetation change between c. 1500 bc and ad 1500. Inferred changes in forest abundance and plant community assemblage build on previous palaeolimnological analysis of the same core reported by Metcalfe et al. (2009). A near-complete, abundant record of Zea mays grains provides a detailed account of field-based agriculture local to Lamanai, in the context of a regional record obtained from a large lake (13.5 km2) with a substantial catchment. Three periods ( c. 170 bc–ad 150, c. ad 600–980 and c. ad 1500) of extraction of Pinus from pine savannas adjacent to the east of the New River Lagoon, can be distinguished from clearance of seasonal broadleaf forest for agriculture. An increased palm signal is observed during c. 1630–1150 bc and 100 bc–ad 1100 and may be indicative of Maya cultivation. This record shows that during the late Classic period the Maya actively managed the vegetation resources using a combination of field-based agriculture, arboreal resources and perhaps, palm cultivation. There is no evidence from the vegetation history of drying during the late Classic coincident with the Maya ‘collapse’ and this is consistent with the palaeolimnological and archaeological records of continuous occupation of the Maya at Lamanai. Both the decline in palms c. ad 1400 and the increase in Pinus extraction c. ad 1500 are consistent with changes in vegetation associated with European arrival, however further analysis of material from the last 1000 years will enable a better understanding of vegetation change pre- and post-European encounter.
Effect of belimumab treatment on renal outcomes: results from the phase 3 belimumab clinical trials in patients with SLE
Authors: Dooley MA , Houssiau F , Aranow C , D’Cruz DP , Askanase A , Roth DA , Zhong ZJ , Cooper S , Freimuth WW , Ginzler EM
Published: December 2012

A pooled post-hoc analysis of the phase 3, randomized, placebo-controlled BLISS trials (1684 patients with active systemic lupus erythematosus (SLE)) was performed to evaluate the effect of belimumab on renal parameters in patients with renal involvement at baseline, and to explore whether belimumab offered additional renal benefit to patients receiving mycophenolate mofetil at baseline. In addition to belimumab or placebo, all patients received standard SLE therapy. Patients with severe active lupus nephritis were excluded from the trials. Over 52 weeks, rates of renal flare, renal remission, renal organ disease improvement (assessed by Safety of Estrogens in Lupus Erythematosus National Assessment–Systemic Lupus Erythematosus Disease Activity Index and British Isles Lupus Assessment Group), proteinuria reduction, grade 3/4 proteinuria, and serologic activity favored belimumab, although the between-group differences in most renal outcomes were not significant. Among the 267 patients with renal involvement at baseline, those receiving mycophenolate mofetil or with serologic activity at baseline had greater renal organ disease improvement with belimumab than with placebo. Limitations of this analysis included the small patient numbers and the post-hoc nature of this pooled analysis. The results suggest that belimumab may offer renal benefit in patients with SLE. Further study is warranted in patients with severe active lupus nephritis.
Lupus nephritis and non-Hodgkin lymphoma simultaneously diagnosed in a patient on methimazole
Authors: Lionaki S , Vlachopanos G , Georgalis A , Ziakas P , Gakiopoulou H , Petra C , Boletis J
Published: December 2012

A 78 year old white male on methimazole due to Grave’s thyroiditis presented with acute renal failure after a short term history of progressive shortness of breath, malaise, myalgias, arthralgias, and bilateral lower limb swelling. The abdomen was remarkable for splenomegaly and lower extremities for erythema nodosum. No peripheral lymphadenopathy was detected. Serum albumin was 1.7 g/dl and very high erythrocyte sedimentation rate. Urine sediment was very active with dysmorphic red blood cells and casts and significant proteinuria (6.6 grams/day). Serum complements were abnormally low and antinuclear and anti-DNA antibodies were positive. Renal histopathology revealed membranoproliferative glomerulonephritis, along with a full house pattern on IFF consistent with lupus nephritis. Bone marrow aspiration revealed a 40% infiltration by a lymphocyte population of small cells consistent with a B cell non-Hodgkin lymphoma.

The patient was treated with methylprednisolone, cyclophosphamide and rituximab and acute dialysis. Over the following weeks the patient became dialysis independent and returned to his baseline GFR.
Mycophenolate mofetil-induced erythroid hypoplasia in a patient with systemic lupus erythematosus
Authors: Doherty T , Austin SK , Newell B , Kiely PDW
Published: December 2012

Anaemia is prevalent in patients with systemic lupus erythematosus (SLE). The anaemia is often a consequence of the disease itself but may also be secondary to drug treatments. Mycophenolate mofetil (MMF) is increasingly used in the management of patients with SLE and its associated anaemia. We describe the case of a 19-year-old girl, who presented acutely with SLE and renal involvement. Her disease was controlled with immunosuppression but she later developed severe transfusion-dependent anaemia. Several causes were considered before a bone marrow biopsy led to the diagnosis of erythroid hypoplasia. In the absence of clinical or laboratory markers of active lupus, MMF was implicated as the cause. Its discontinuation led to a rapid and sustained correction of the anaemia. Red cell aplasia linked to the use of MMF is uncommon and the manufacturers are aware of fewer than 50 cases. This is the first case report of evolving red cell aplasia induced by MMF in SLE.
Analysis of JC virus DNA in NPSLE patients treated with different immunomodulatory agents
Authors: Iacobaeus E , Hopia L , Khademi M , Lundén M , Hammarin A-L , Svenungsson E , Andersson M
Published: December 2012

Objective

The objective of this report is to assess the presence and viral load of JC polyomavirus (JCV) DNA in cerebrospinal fluid (CSF) and plasma from neuropsychiatric systemic lupus erythematosus (NPSLE) patients in comparison to controls and to investigate if different types of immunosuppressive treatments were correlated to detection and viral load of JCV DNA in SLE.

Background

Reactivation of a latent JCV infection with subsequent development of the fatal disease progressive multifocal leukoencephalopathy (PML) has become an increasing problem in patients with autoimmune diseases treated with newer immunosuppressants. Accumulating data point out that SLE patients are at particular risk for PML compared to patients with other rheumatic diseases.

Methods

CSF samples ( n = 69) and plasma samples ( n = 51) from 71 SLE patients and 58 controls (53 CSF samples and 50 plasma samples) with other non-inflammatory neurological disease (OND) were analyzed for JCV DNA with a quantitative PCR method.

Results

All CSF and plasma samples from NPSLE patients and controls were negative for JCV DNA.

Conclusion

JCV DNA was absent in CSF and plasma in NPSLE patients and controls and consequently we were not able to identify any correlation between the occurrence of JCV DNA and type of immunosuppressive medication.
Variation in and Correlates of Body Mass Status of Older Singaporean Men and Women
Authors: Østbye Truls , Malhotra Rahul , Chan Angelique
Published: December 2012

This study describes the body mass status of older (≥60 years) Singaporeans, using the international and Asian body mass index (BMI) classifications, assesses sociodemographic correlates of BMI, underweight, obesity, and “high-risk” BMI (≥27.5 kg/m2), and ascertains the relationship between body mass and important health outcomes. Prevalence of underweight, obesity, and high-risk BMI among 4371 older Singaporeans was 6.8%, 7.4%, and 18.6%, respectively. Women (vs men) and Malays and Indians (vs Chinese) were more likely to have obesity or high-risk BMI. Increasing education decreased the odds of obesity and high-risk BMI only among women. Prevalence and odds of various health conditions was similar in corresponding categories of the two BMI classifications. Whereas the prevalence of obesity is lower among elderly in Singapore than in many other countries, the prevalence of high-risk BMI is considerable. It is important to address high-risk BMI among them, with elderly of minority ethnic groups, especially females, being a priority.
Changes in Active Life Expectancy Among Older Thais
Authors: Jiawiwatkul Uthaithip , Aekplakorn Wichai , Vapattanawong Patama , Prasartkul Pramote , Porapakkham Yawarat
Published: December 2012

This study aims to determine the disability prevalence and changes in active life expectancy of the Thai older people between 1997 and 2004. Data on disability of older people aged ≥60 years were obtained from the National Health Examination Surveys. Disability refers to one or more restrictions on the activities of daily living. The Sullivan method was used to calculate active life expectancy. A total of 4048 older people in 1997 and 19 372 older people in 2004 were included in the analysis. Active life expectancy at age 60 of men was 16.5 years in 1997 and 17.6 years in 2004, whereas that of women was 17.9 and 19.9 years, respectively. Women spent a greater proportion of the remaining life with disability. The proportion of active life for both genders also increased during the 7-year period suggesting an evidence of the compression of morbidity in Thai older people.
Is Empathy Effective for Customer Service? Evidence From Call Center Interactions
Authors: Clark Colin Mackinnon , Murfett Ulrike Marianne , Rogers Priscilla S. , Ang Soon
Published: December 2012

This study examines the nature and value of empathic communication in call center dyads. Our research site was a multinational financial services call center that we came to know through grounded study techniques, including analyses of 289 stressful calls. Examining calls as communication genre revealed that agents and customers have conflicting organizational, service, and efficiency needs that undermine communication. But three types of empathic expression can mitigate these conflicts in some interactions. Affective expressions, such as “I’m sorry,” were less effectual, but attentive and cognitive responses could engender highly positive responses although customers’ need for them varied tremendously. Thus, customer service agents must use both diagnostic and enactment skills to perform empathic communication effectively, a coupling that we call empathy work.
Persisting myelin oligodendrocyte glycoprotein antibodies in aquaporin-4 antibody negative pediatric neuromyelitis optica
Authors: Rostásy K , Mader S , Hennes EM , Schanda K , Gredler V , Guenther A , Blaschek A , Korenke C , Pritsch M , Pohl D , Maier O , Kuchukhidze G , Brunner-Krainz M , Berger T , Reindl M
Published: December 2012

Background:

Recently we showed that antibodies to myelin oligodendrocyte glycoprotein (MOG) can be found in aquaporin-4 (AQP4)-immunoglobulin (IgG) seronegative pediatric and adult patients with definite and high-risk neuromyelitis optica (NMO).

Objective:

The purpose of this study was to describe the clinical characteristics and temporal dynamics of MOG-IgG in AQP4-IgG seronegative pediatric patients presenting with definite NMO.

Methods:

Children with definite NMO who were referred for further testing of serum antibodies for AQP4 and MOG with a cell-based assay were included in this study. Clinical disease course, cerebrospinal fluid and magnetic resonance imaging (MRI) studies of these patients were reviewed.

Results:

Between 2008 and 2012 eight children who fulfilled the diagnostic criteria of definite NMO were recruited. Two children with definite NMO tested positive for AQP4-IgG but were negative for MOG-IgG antibodies. Three children had an absence of AQP4-IgG and MOG-IgG antibodies. Three children with definite NMO had high titers of serum MOG-IgG antibodies (≥1: 160), but no AQP4-directed humoral immune response. Longitudinal analysis of serum samples of the latter three children showed persisting high MOG-IgG titers over time.

Conclusion:

Pediatric patients presenting with clinical symptoms and MRI findings highly suggestive of NMO but with high and persisting MOG-IgG antibody titers are most likely to represent a distinct subgroup of acute demyelinating diseases with important clinical and therapeutic implications.
Methods and measures: what’s new for MS?
Authors: Mayo Nancy E , Hum Stanley , Kuspinar Ayse
Published: December 2012

At no other time in the history of multiple sclerosis (MS) has the accurate measurement of health outcomes been so important. There are now many kinds of interventions of proven or potential efficacy available for people with MS and many other methods are under investigation. Not all outcomes that matter can be measured with a biological parameter. Many important outcomes of treatment can be assessed only by asking the patient directly. For clinical decision making, asking one good question, asking it consistently, and writing down the answer will produce historically accurate data to judge MS progression on life-altering constructs like fatigue, depression and pain. To get a total score from items in a questionnaire, Rasch Measurement Theory provides a way of estimating the extent to which the items form a linear continuum with mathematical properties. Preference-based measures, when the preferences are derived from patients, permit the impact of the multiple health dimensions associated with MS to be valued. The bottom line is, ask a good question and you will likely get a good answer, ask a poor question and assuredly, you will not.
Listening to the views of children with learning disabilities
Authors: Boyden Paul , Muniz Michelle , Laxton-Kane Martha
Published: December 2012

In line with Valuing People Now: A New Three-year Strategy for People With Learning Disabilities ( Department of Health, 2009 ), this article details a service evaluation for a learning disability-child and adolescent mental health service (LD-CAMHS) in Chesterfield, North Derbyshire. The aim of the project was to produce a set of quality standards in order to ensure service users’ needs are met. Semi-structured interviews were conducted with seven children between the ages of 11 and 17 years, with moderate to severe learning disabilities. Four themes were derived from a thematic analysis; the experience of the service, communication, impact of the work carried out, and difficulties encountered. It was recommended that staff working within the service should ensure communication is at a level appropriate for the client; offer a welcoming approach; provide an open approach; and offer a reasonable choice of location. This article provides suggestions for how other LD-CAMHS teams could use these standards for their own purposes.
Jordanian parental needs of critically ill infants in neonatal intensive care units
Authors: Obeisat Salwa M. , Hweidi Issa M.
Published: December 2012

This descriptive correlational study was conducted to identify perceived parental needs of critically ill infants in Neonatal Intensive Care Units (NICUs). Jordanian parents who were visiting their infants admitted in NICU ( N = 170) composed the study sample. Participants completed the demographic data sheet and the NICU Family Needs Inventory. Findings showed that parents ranked assurance, information and proximity as the most important needs, while comfort and support were ranked the lowest. The primary concern of parents was to be assured and informed about the progress of their infant. In addition, the results indicated that the mother’s perceived needs for support, information and proximity were significantly more important than the father's. Accordingly, nurses should establish a rapport with family members and provide them with understandable and honest information. Furthermore, the provision of quality, holistic, family-centered nursing care that relies primarily on early and comprehensive needs assessment, which correlates with infants’ outcomes, is imperative.
Bronchoscopic staging of lung cancer
Authors: Hanna Waël C. , Yasufuku Kazuhiro
Published: December 2012

Advances in bronchoscopy have contributed valuable tools to the diagnosis and staging of lung cancer. Detection of lesions at the premalignant microscopic stage has become possible with autofluorescence bronchoscopy and narrow band imaging. Bronchoscopy also allows for sampling of visible intra-bronchial lesions and for transbronchial needle aspiration of lesions in pulmonary parenchyma. With endobronchial ultrasound guidance, real-time evaluation and biopsy of mediastinal and pulmonary lesions can be achieved, enabling accurate clinical and pathological T-staging and N-staging without the need for surgery. In combination with advanced imaging techniques, Navigational bronchoscopy allows for the targeting and biopsy of the most peripheral lesions that are located in the smallest airways. For patients in whom tumor genetics are important, bronchoscopic-guided transbronchial biopsy can provide sufficient material for molecular analysis. As minimally invasive technology continues to evolve and improve, bronchoscopic techniques are poised to continue to be essential for the diagnosis and staging of lung cancer.
Pulmonary hypertension complicated by pericardial effusion: a single center experience
Authors: Honeycutt Gregory R. , Safdar Zeenat
Published: December 2012

Background:

Pericardial effusion is an independent predictor of mortality in patients with pulmonary arterial hypertension (PAH). However, the management and outcomes of patients with pulmonary hypertension (PH) and pericardial effusion are not well described.

Methods:

A retrospective, observational study was conducted at Baylor College of Medicine and The Methodist Hospital by screening all patients admitted between 1 June 2005 and 1 June 2010 with the International Classification of Diseases, ninth revision codes for PH and pericardial effusion. A total of 138 patients were identified, and 103 patients were excluded on the basis of valvular heart disease, recent surgery or end-stage renal disease. Thirty-five patients with PH diagnosed by a historical right heart catheterization or echocardiography and with documented pericardial effusion were included in this analysis. Demographic, hemodynamic, laboratory and survival data were collected.

Results:

The mean age was 49.5±36 years (mean ± standard deviation), 31 of 35 patients were women (93%) and pulmonary artery systolic pressure was 77 ± 19 mmHg. Mean follow-up period was 20.5 ± 12.9 months. Fifteen patients had PAH associated with connective tissue disease (50%). The majority of the patients (87%) with pericardial effusion were managed conservatively. Four patients (13%) who were hemodynamically unstable underwent pericardial window placement. One of them was started on epoprostenol, and two patients had the doses of PAH-specific medications uptitrated. Three of four pericardial window patients survived to the conclusion of the follow-up period. The overall survival in our cohort was 60%, with three patients lost to follow-up.

Conclusions:

Connective tissue disease associated PAH and female sex were predominant in our cohort of patients with pericardial effusion. Seventy-five percent of patients who were treated with pericardial window for hemodynamically unstable pericardial effusion survived until the end of the study period. Pericardial window may be a therapeutic option in patients with unstable PH with pericardial effusion. Further studies are needed to determine the optimal treatment strategy for such patients.
Best practice in the use of natalizumab in multiple sclerosis
Authors: Fernández Óscar
Published: December 2012

Natalizumab is approved for the treatment of patients with relapsing–remitting multiple sclerosis who have failed first-line treatment with traditional disease-modifying therapies or who have highly active disease. The drug has proved highly effective, both in a clinical trial setting and in clinical practice, with marked reductions in the rate of clinical relapses and slowed disease progression. These clinical outcomes are mirrored by a marked reduction in disease activity as evidenced by magnetic resonance imaging of the brain. However, natalizumab treatment has been associated with a risk of progressive multifocal leukoencephalopathy (PML), a potentially fatal condition caused by JC virus (JCV) activation. When this condition was detected in a clinical trial shortly after approval, the drug was immediately and voluntarily withdrawn from the market. As a condition of its reinstatement, stringent pharmacovigilance measures and a risk management plan were enforced. The recent availability of a two-step enzyme-linked immunosorbent assay (ELISA) test for the presence of anti-JCV antibodies (free testing is available in a central laboratory for registered centers), along with an ever-improving understanding of other risk factors such as prior immunosuppressant use and duration of treatment, allow an increasingly refined stratification of the risk of PML. This improved stratification of risk can help guide decisions about treatment. This review will also deal with other topics of relevance to clinical practice such as the development of antinatalizumab antibodies and their negative implications in terms of hypersensitivity reactions and loss of efficacy, withdrawal of treatment, and compassionate pediatric use.
Quantitatively integrating molecular structure and bioactivity profile evidence into drug-target relationship analysis
Authors: Xu Tianlei , Zhu Ruixin , Liu Qi , Cao Zhiwei
Published: December 2012

Background

Public resources of chemical compound are in a rapid growth both in quantity and the types of data-representation. To comprehensively understand the relationship between the intrinsic features of chemical compounds and protein targets is an essential task to evaluate potential protein-binding function for virtual drug screening. In previous studies, correlations were proposed between bioactivity profiles and target networks, especially when chemical structures were similar. With the lack of effective quantitative methods to uncover such correlation, it is demanding and necessary for us to integrate the information from multiple data sources to produce an comprehensive assessment of the similarity between small molecules, as well as quantitatively uncover the relationship between compounds and their targets by such integrated schema.

Results

In this study a multi-view based clustering algorithm was introduced to quantitatively integrate compound similarity from both bioactivity profiles and structural fingerprints. Firstly, a hierarchy clustering was performed with the fused similarity on 37 compounds curated from PubChem. Compared to clustering in a single view, the overall common target number within fused classes has been improved by using the integrated similarity, which indicated that the present multi-view based clustering is more efficient by successfully identifying clusters with its members sharing more number of common targets. Analysis in certain classes reveals that mutual complement of the two views for compound description helps to discover missing similar compound when only single view was applied. Then, a large-scale drug virtual screen was performed on 1267 compounds curated from Connectivity Map (CMap) dataset based on the fused similarity, which obtained a better ranking result compared to that of single-view. These comprehensive tests indicated that by combining different data representations; an improved assessment of target-specific compound similarity can be achieved.

Conclusions

Our study presented an efficient, extendable and quantitative computational model for integration of different compound representations, and expected to provide new clues to improve the virtual drug screening from various pharmacological properties. Scripts, supplementary materials and data used in this study are publicly available at http://lifecenter.sgst.cn/fusion/.