bluuebunny/crossref_metadata_2025 huggingface dataset:
Consuming the Planet to Excess
Authors: Urry John
Published: May 2010

This article examines some major changes relating to the contemporary conditions of life upon Earth. It deals especially with emergent contradictions that stem from shifts within capitalism in the rich North over the course of the last century or so. These shifts involve moving from low-carbon to high-carbon economies/societies, from societies of discipline to societies of control, and more recently from specialized and differentiated zones of consumption to mobile, de-differentiated consumptions of excess. Societies become centres of conspicuous, wasteful consumption. The implications of such forms of ‘excess’ consumption are examined for clues as to the nature and characteristics of various futures. Special attention is paid to the interdependent system effects of climate change, the peaking of oil and exceptional growth of urban populations. It is argued that the 20th century has left a bleak legacy for the new century, with a very limited range of possible future scenarios which are briefly described.
Anti-reflexivity
Authors: McCright Aaron M. , Dunlap Riley E.
Published: May 2010

The American conservative movement is a force of anti-reflexivity insofar as it attacks two key elements of reflexive modernization: the environmental movement and environmental impact science. Learning from its mistakes in overtly attacking environmental regulations in the early 1980s, this counter-movement has subsequently exercised a more subtle form of power characterized by non-decision-making. We examine the conservative movement’s efforts to undermine climate science and policy in the USA over the last two decades by using this second dimension of power. The conservative movement has employed four non-decision-making techniques to challenge the legitimacy of climate science and prevent progress in policy-making. We argue that reflexive modernization scholars should focus more attention on similar forces of anti-reflexivity that continue to shape the overall direction of our social, political and economic order, and the life chances of many citizens. Indeed, better understanding of the forces and effectiveness of anti-reflexivity may very well be crucial for societal resilience and adaptation, especially in the face of global environmental problems like climate change.
Climate for Change, or How to Create a Green Modernity?
Authors: Beck Ulrich
Published: May 2010

The discourse on climate politics so far is an expert and elitist discourse in which peoples, societies, citizens, workers, voters and their interests, views and voices are very much neglected. So, in order to turn climate change politics from its head onto its feet you have to take sociology into account. There is an important background assumption which shares in the general ignorance concerning environmental issues and, paradoxically, this is in corporated in the specialism of environmental sociology itself — this is the category of ‘the environment’. If ‘the environment’ only includes everything which is not human, not social, then the concept is sociologically empty. If the concept includes human action and society, then it is scientifically mistaken and politically suicidal.
Cosmopolitan Climates
Authors: Hulme Mike
Published: May 2010

This essay argues for the fruitfulness of Beck’s idea of cosmopolitanism for understanding the changing political, sociological and psychological attributes of climate change. This argument is illustrated through brief examinations of how climate change is contributing to the dissolution of three modern dualisms: nature-culture (ontology), present-future (epistemology) and global-local (geography). Not only does the cosmopolitan perspective help to understand the ways in which science and society are mutually constructing the phenomenon of climate change, it also offers us a way of asking ‘what can climate change do for us?’ rather than ‘what can we do for climate change?’ Sociologists are needed for answering this question.
Climate Change, Social Theory and Justice
Authors: Parks Bradley C. , Roberts J. Timmons
Published: May 2010

This article seeks to answer why North—South climate negotiations have gone on for decades without producing any substantial results. To address this question, we revisit and seek to integrate insights from several disparate theories, including structuralism (new and old), world systems theory, rational choice institutionalism, and social constructivism. We argue that the lack of convergence on climate grew almost inevitably from our starkly unequal world, which has created and perpetuated highly divergent ways of thinking (worldviews and causal beliefs) and promoted particularistic notions of fairness (principled beliefs). We attempt to integrate structural insights about global inequality with the micro-motives of rational choice institutionalism. The structuralist insight that ‘unchecked inequality undermines cooperation’ suggests climate negotiations must be broadened to include a range of seemingly unrelated development issues such as trade, investment, debt, and intellectual property rights agreements. We conclude by reviewing the work of some ‘norm entrepreneurs’ bringing justice issues into climate negotiations and explore how these insights might influence ‘burden sharing’ discussions in the post-Kyoto world, where development is constrained by climate change.
A New Climate for Society
Authors: Jasanoff Sheila
Published: May 2010

This article argues that climate change produces discordances in established ways of understanding the human place in nature, and so offers unique challenges and opportunities for the interpretive social sciences. Scientific assessments such as those of the Intergovernmental Panel on Climate Change helped establish climate change as a global phenomenon, but in the process they detached knowledge from meaning. Climate facts arise from impersonal observation whereas meanings emerge from embedded experience. Climate science thus cuts against the grain of common sense and undermines existing social institutions and ethical commitments at four levels: communal, political, spatial and temporal. The article explores the tensions that arise when the impersonal, apolitical and universal imaginary of climate change projected by science comes into conflict with the subjective, situated and normative imaginations of human actors engaging with nature. It points to current environmental debates in which a reintegration of scientific representations of the climate with social responses to those representations is taking place. It suggests how the interpretive social sciences can foster a more complex understanding of humanity’s climate predicament. An important aim of this analysis is to offer a framework in which to think about the human and the social in a climate that seems to render obsolete important prior categories of solidarity and experience.
Reading and Writing the Weather
Authors: Szerszynski Bronislaw
Published: May 2010

In this article I argue that an adequate response to climate change requires an overcoming of the metaphysics of presence that is structuring our relationship with the weather. I trace the links between this metaphysics and the dominant way that the topic of climate change is being narrated, which is structured around the transition from diagnosis to cure, from the scientific reading to the technological writing of the weather. Against this narrative I develop a rather different account of the current ecopolitical moment. I first argue that an understanding of anthropogenic climate change must be grounded in a biosemiotic analysis of the evolving metabolism between society and nature, one that is alert to the way that metabolism involves a folded relation between inside and outside, and that recognizes the constant deferral of biosemiotic meaning in ecological systems. I then use a deconstructive reading of climate technics to problematize the distinction between the diagnosis and solution of climate change, and expose modern scientific practices of reading the climate as already containing within themselves a notion of weather’s technological writability. Exploring the notion that previous transformations of the metabolic regime of society have always involved transformations of notions of the human, I conclude by sketching out a different way of reading and writing the weather, one that takes place in the ‘opening’ of climate change, that problematizes the idea of the human as the end of nature, and that thereby implies a more radical version of climate responsibility.
Social Theory and Climate Change
Authors: Shove Elizabeth
Published: May 2010

Social theorists have been dealing with issues of environment and climate change for quite some years, but on which topics have they focused and with whom have they been talking? Many of the articles included in this special issue exemplify a tendency to frame problems of climate change in terms of existing concerns, including the character of capitalism, the relation between nature and culture, or the social process of problem definition. Other forms of conceptual development are much more obviously driven by the challenge of understanding and perhaps fostering societal transformation in response to climate change. Meanwhile, policy proceeds on the basis of a characteristically thin account of the social world. In this short article I highlight differences in how these agendas unfold and comment on what this means for types of questions that social theorists have often, sometimes and not yet asked about climate change. I conclude that social theory — broadly defined — has much to offer but that realizing this potential will require concerted effort and active engagement with new and unfamiliar audiences.
Strange Weather, Again
Authors: Wynne Brian
Published: May 2010

For a long time before the ‘climategate’ emails scandal of late 2009 which cast doubt on the propriety of science underpinning the Intergovernmental Panel on Climate Change (IPCC), attention to climate change science and policy has focused solely upon the truth or falsity of the proposition that human behaviour is responsible for serious global risks from anthropogenic climate change. This article places such propositional concerns in the perspective of a different understanding of the relationships between scientific knowledge and public policy issues from the conventional ‘translation’ model, in which prior scientific research and understanding is communicated and translated into corresponding policies — or not, if it remains disputed and overly uncertain. Explaining some of the key contingencies and bases for uncertainty in IPCC climate projections and human influences, I show how social and technical analysis of climate science is not about denial of the scientific propositional claims at issue, but about understanding the conditional and essentially ambiguous epistemic character of any such knowledge, however technically sophisticated and robust it may be. Contrary to conventional wisdom, it is entirely plausible that existing scientific representations of climate change and its human causes may understate the risks induced by prevailing social-economic processes rather than exaggerate them. As the article shows, the public meanings given to climate science, and to ‘the climate problem’, and thus also the public culture which that knowledge is supposed to inform, are themselves already in key respects presumed and (attemptedly) imposed by the science and its framing. This gives rise to perverse effects on public readiness to take informed democratic responsibility for ‘the global climate problem’, and associated cross-cutting issues which existing scientific framings of public policy erase from view.
Biopolitical Economies and the Political Aesthetics of Climate Change
Authors: Yusoff Kathryn
Published: May 2010

As environments and their inhabitants undergo a multitude of abrupt changes due to climate, in the aesthetic field there has been a hardening of a few representational figures that stand in for those contested political ecologies. Biodiversity loss and habitat change can be seen to be forcing an acceleration of archival practices that mobilize various images of the ‘play of the world’, including the making of star species to represent planetary loss, and the consolidation of other species into archives implicitly organized around the category of their destruction. The first section of this article looks at Jacques Rancière’s concept of political aesthetics in order to extend an argument about the importance of aesthetics in multispecies living beyond a concentration on practices per se and into a more excessive engagement articulated by Georges Bataille. I argue that aesthetics must be considered as part of the practice of politics and a space that configures the realm of what is possible in that politics. This is to suggest aesthetics as a form of ethics or an ‘aesthetics of existence’, as Foucault put it. The conclusion considers how a biopolitical aesthetic comes into being through such archival practices, and asks what aesthetic shifts would make the ‘play of the world’ more present in its absences.
The associations of migraines and other headaches with work performance: Results from the National Comorbidity Survey Replication (NCS-R)
Authors: Kessler RC , Shahly V , Stang PE , Lane MC
Published: May 2010

It is unknown if comorbid conditions account for the association between migraines and work performance. This issue was investigated in the National Comorbidity Survey Replication ( n = 9282). Twelve-month severe or persistent migraines and other headaches were assessed with comorbid 12-month mental and physical disorders using the WHO Composite International Diagnostic Interview. Work performance was assessed using the WHO Health and Work Performance Questionnaire. Significant associations of these conditions with work disability disappeared with controls for comorbid disorders, but severe or persistent migraines continued to predict work loss days even with controls. Individual-level and societal-level annual human capital values were $1165 and $9.3 billion for this subset of migraines. Roughly 20% of these associations were due to comorbidity, 60% to direct effects and 20% to indirect effects through temporally secondary comorbidities. These strong associations suggest that workplace interventions for severe or persistent migraines might have a positive return-on-investment for employers.
Indian Perspectives on International Financial Institution (IFI) Reforms with Special Emphasis on the International Monetary Fund
Authors: Bhattacharya A.K.
Published: May 2010

The approach of India’s political establishment toward economic reforms and economic policy-making may have undergone major changes in the last few decades, but its terms of engagement with international financial institutions, particularly with the International Monetary Fund (IMF), continue to be influenced to a large extent by the mindset that prevailed in the 1980s. More recently, some changes have been discernible in the Indian government’s official positions on issues pertaining to reforms in the governance structure of international financial institutions. This paper seeks to bring out the basic dichotomy in the way the political establishment in India continues to engage with international financial institutions and how the Indian government’s official views on reforms in the governance structure of these bodies have made a big difference to the way India has begun to see itself and its role in the global financial community.
The Financial Crisis
Authors: Claessens Stijn
Published: May 2010

The ongoing global financial crisis is rooted in a combination of factors common to previous financial crises and some new factors. The crisis has called for revisiting monetary and fiscal policy and has brought to light a number of deficiencies in financial regulation and architecture. The global nature of the financial crisis has made clear that financially integrated markets, while offering many benefits, can also pose significant risks, with large real economic consequences. Deep reforms are therefore needed to the international financial architecture to safeguard the stability of an increasingly financial integrated world. Emerging markets and developing countries face some specific policy issues as they address institutional and development challenges.
Synchronisation of Recessions in Major Developed and Emerging Economies
Authors: Banerji Anirvan , Dua Pami
Published: May 2010

This paper examines various measures of synchronisation of recessions, including clustering of the onset of recession across economies, proportion of economies in expansion and the diffusion index of international coincident indexes, and shows that the recent global recession is possibly the most concerted in the post-world-war period. Factors that contributed to the synchronisation and severity of the recession, such as trade and financial linkages and timing of policy actions, are analysed.
Global Financial Architecture
Authors: Goyal Ashima
Published: May 2010

In the context of the formation of G-20, the paper points out the absence of reform in the Global Financial Architecture (GFA) after the East Asian crisis, and assesses factors that can improve the chances of real reform this time. A factual assessment of various causes advanced for the global crisis, puts the main responsibility on lax regulation. Liquidity created by current account imbalances was tiny compared to endogenous amplification of liquidity in the financial sector. Emerging markets needed reserves as self-insurance in the face of volatile cross border flows. Even so global imbalances increase risk. The paper summarises the Chimerica debate and the blocks that have stalled progress in resolving the issue. It argues that symmetric and balanced reform, at individual country and international level, is required to remove the blocks. Deeper governance reforms will make it feasible. Potential contributions of the G-20 are outlined. It is argued that India is a useful example of flexible but managed exchange rates that allowed market deepening and export growth.
Microstructure modelling and prediction of effective elastic properties of 3D multiphase and multilayer braided composite
Authors: Xu Y J , Zhang W H , Domaszewski M
Published: May 2010

This paper is focused on the microstructure modelling and evaluation of effective elastic properties of three-dimensional multiphase and multilayer braided composite. Regarding the multiscale characteristics of the composite, the microstructure modelling is carried out sequentially from fibre to tow scale. The geometrical configuration of the microstructure is first analysed, and mathematical relations among different geometrical parameters are derived on each scale. Second, effective elastic properties are obtained based on the sequential homogenisation from fibre to tow scale. A strain energy based method is proposed to evaluate effective elastic properties with specific boundary conditions imposed on the microstructure. Numerical results obtained by the proposed method and the microstructure model show a good agreement with the results measured experimentally.
Microstructure and mechanical properties of TiC/Ti–6Al–4V composites processed by in situ casting route
Authors: Wei Z J , Cao L , Wang H W , Zou C M
Published: May 2010

TiC/Ti–6Al–4V composites containing various volume fractions of TiC were produced by induction skull melting and common casting utilising in situ reaction between titanium and carbon powder. The microstructure and room tensile properties of as cast and heat treated TiC/Ti–6Al–4V composites were investigated. Bar-like or small globular eutectic TiC were found in 5 vol.-TiC/Ti–6Al–4V composite, whereas the equiaxed or dendritic primary TiC particles were found to be the main reinforcements in 10 and 15 vol.-TiC/Ti–6Al–4V composites. The as cast TiC/Ti–6Al–4V composites have shown higher strength but lower ductility than those of monolithic Ti–6Al–4V alloy. The shape and fracture of TiC particles can strongly influence the fracture and failure of the composites, and so the ultimate tensile strengths and elongations of as cast composites reduce with the increase in volume fraction of TiC. TiC particles appear to be spheroidised, and titanium precipitation can be found within large TiC particles after heat treatment at 1050°C for 8 h, which can promote the resistance to fracture of composites. Therefore, the elongations of the composites increase significantly, and the ultimate tensile strengths also have marginal increase especially for the 10 and 15 vol.-TiC/Ti–6Al–4V composites after heat treatment.
On R ratio dependence of threshold stress intensity factor range for fatigue crack growth in type 316(N) stainless steel weld
Authors: Samuel K. G. , Sasikala G. , Ray S. K.
Published: May 2010

The influence of R ratio in the range 0·05–0·4 on the ambient temperature fatigue crack growth behaviour of an austenitic stainless steel weld, SS 316(N), has been studied. Results indicate that the cyclic threshold stress intensity factor Δ Kth increases with decreasing R ratio. The data are compared with those for SS 316, SS 316L and SS 316L(N) base materials from the literature, and various approaches dealing with the R ratio effects are examined. Zhang's model considering the contribution of the crack tip plasticity to the fundamental fatigue crack propagation process does provide a consistent interpretation for the data.
Profiling of histone H3 lysine 9 trimethylation levels predicts transcription factor activity and survival in acute myeloid leukemia
Authors: Müller-Tidow Carsten , Klein Hans-Ulrich , Hascher Antje , Isken Fabienne , Tickenbrock Lara , Thoennissen Nils , Agrawal-Singh Shuchi , Tschanter Petra , Disselhoff Christine , Wang Yipeng , Becker Anke , Thiede Christian , Ehninger Gerhard , zur Stadt Udo , Koschmieder Steffen , Seidl Matthias , Müller Frank U. , Schmitz Wilhelm , Schlenke Peter , McClelland Michael , Berdel Wolfgang E. , Dugas Martin , Serve Hubert ,   on behalf of the Study Alliance Leukemia
Published: May 2010

Acute myeloid leukemia (AML) is commonly associated with alterations in transcription factors because of altered expression or gene mutations. These changes might induce leukemia-specific patterns of histone modifications. We used chromatin-immunoprecipitation on microarray to analyze histone 3 lysine 9 trimethylation (H3K9me3) patterns in primary AML (n = 108), acute lymphoid leukemia (n = 28), CD34+ cells (n = 21) and white blood cells (n = 15) specimens. Hundreds of promoter regions in AML showed significant alterations in H3K9me3 levels. H3K9me3 deregulation in AML occurred preferentially as a decrease in H3K9me3 levels at core promoter regions. The altered genomic regions showed an overrepresentation of cis-binding sites for ETS and cyclic adenosine monophosphate response elements (CREs) for transcription factors of the CREB/CREM/ATF1 family. The decrease in H3K9me3 levels at CREs was associated with increased CRE-driven promoter activity in AML blasts in vivo. AML-specific H3K9me3 patterns were not associated with known cytogenetic abnormalities. But a signature derived from H3K9me3 patterns predicted event-free survival in AML patients. When the H3K9me3 signature was combined with established clinical prognostic markers, it outperformed prognosis prediction based on clinical parameters alone. These findings demonstrate widespread changes of H3K9me3 levels at gene promoters in AML. Signatures of histone modification patterns are associated with patient prognosis in AML.
Targeting Breast Cancer Stem Cells
Authors: Liu Suling , Wicha Max S.
Published: May 2010

There is increasing evidence that many cancers, including breast cancer, contain populations of cells that display stem-cell properties. These breast cancer stem cells, by virtue of their relative resistance to radiation and cytotoxic chemotherapy, may contribute to treatment resistance and relapse. The elucidation of pathways that regulate these cells has led to the identification of potential therapeutic targets. A number of agents capable of targeting breast cancer stem cells in preclinical models are currently entering clinical trials. Assessment of the efficacy of the agents will require development of innovative clinical trial designs with appropriate biologic and clinical end points. The effective targeting of breast cancer stem cells has the potential to significantly improve outcome for women with both early-stage and advanced breast cancer.
The French Health Care System: Liberal Universalism
Authors: Steffen Monika
Published: May 2010

This article analyzes the reforms introduced over the last quarter century into the French health care system. A particular public-private combination, rooted in French history and institutionalized through a specific division of the policy field between private doctors and public hospitals, explains the system's core characteristics: universal access, free choice, high quality, and a weak capacity for regulation. The dual architecture of this unique system leads to different reform strategies and outcomes in its two main parts. While the state has leverage in the hospital sector, it has failed repeatedly in attempts to regulate the ambulatory care sector. The first section of this article sets out the main characteristics and historical landmarks that continue to affect policy framing and implementation. Section 2 focuses on the evolution in financing and access, section 3 on management and governance in the (private) ambulatory care sector, and section 4 on the (mainly public) hospital sector. The conclusion compares the French model with those developed in the comparative literature and sets out the terms of the dilemma: a state-run social health insurance that lacks both the legitimacy of Bismarckian systems and the leverages of state-run systems. The French system therefore pursues contradictory policy goals, simultaneously developing universalism and liberalism, which explains both the direct state intervention and its limits.
Stewardship in Mental Health Policy: Inspiration, Influence, Institution?
Authors: Brown Lawrence D. , Isett Kimberley R. , Hogan Michael
Published: May 2010

The venerable but amorphous concept of stewardship has lately gained prominence in discussions of public policy and management and is sometimes offered as a “strategy” with a distinctive potential to mobilize effective public leadership in the service of broad social missions. In this article we explore how stewardship may be useful to the theory and practice of mental health policy, and, reciprocally, how examples from mental health policy may elucidate the dynamics of stewardship. After examining its key political ingredients — authority, advocacy, and analysis — we discuss the practical challenges in moving stewardship from moral inspiration to institutional reality.
Triptycene Derivatives: Synthesis and Applications
Authors: Zhao Liwei , Li Zhong , Wirth Thomas
Published: May 2010

The family of triptycene derivatives have special structures, unique electrochemical and photochemical properties and have been found versatile for materials chemistry, in host–guest interactions and as molecular rotors. This present review summarizes the synthesis of triptycene and derivatives and their use in synthesis and as ligands.
A Size-controlled Synthesis of Hollow Apatite Nanospheres at Water–Oil Interfaces
Authors: He Wenhui , Tao Jinhui , Pan Haihua , Xu Xurong , Tang Ruikang
Published: May 2010

A size-controllable synthesis of hollow structures of apatite in the hexane–water–bis(2-ethylhexyl) sulfosuccinate is presented, and the hollow sphere sizes can be easily regulated within a range of 50–1000 nm. The isotherm curves of the size controls and the roles of different experimental parameters are discussed. This feasible pathway may offer an ideal strategy of the size-controlled synthesis of hollow nanomaterials.
Effect of Surfactant on the Physical Properties of Hierarchically Macro–Mesoporous Metal Oxides
Authors: Zeng Tianying , Zhou Zhiming , Cheng Zhenmin , Yuan Weikang
Published: May 2010

Hierarchically macro–mesoporous titania and alumina were prepared by simply dropwise addition of titanium and aluminum alkoxides to an ammonia solution in the presence or absence of surfactant molecules, cetyltrimethylammonium bromide (CTAB). The textural, morphological, and crystalline phase features of the prepared and calcined samples were characterized by N2 adsorption–desorption, SEM, and XRD analysis. It was found that the surfactant molecules had a significant effect on the physical properties of the hierarchically porous metal oxides.
Controllable Synthesis of TiO2 Submicrospheres with Smooth or Rough Surface
Authors: Wu Wei , Xiao Xiangheng , Zhang Shaofeng , Zhou Juan , Ren Feng , Jiang Changzhong
Published: May 2010

Titanium dioxide (TiO2) submicrospheres (SMs) have been successfully synthesized via a solvothermal method by hydrolysis of tetrabutyl titanate in ethanol solution with the cetyltrimethylammonium bromide (CTAB) presented. The SMs are composed of closely packed rod or tetragonal nanoparticles (NPs), and the inner structure of SMs depends on whether the hexamethylenetetramine (HMTA) was introduced in the reaction or not. The surface and inner morphologies, structure, and optical properties of the SMs were investigated.
Elution Behavior of Proteins in Capillary Chromatography Using an Untreated Fused-silica Capillary Tube and a Water–Hydrophilic–Hydrophobic Organic Mixture Carrier Solvent
Authors: Masuhara Yuji , Jinno Naoya , Hashimoto Masahiko , Tsukagoshi Kazuhiko
Published: May 2010

We examined the elution behavior of isoluminol isothiocyanate (ILITC)-labeled proteins (alcohol dehydrogenase (ADH) and bovine serum albumin (BSA)) in a capillary chromatography system using an untreated fused-silica capillary tube and a water–acetonitrile–ethyl acetate mixture carrier solution. The mixture of ILITC and ILITC-labeled protein (ADH or BSA) was analyzed using this system with a chemiluminescence detector; the ILITC and the labeled protein were separated in this order with an organic solvent-rich carrier solution, while they were eluted in the reverse order with a water-rich carrier solution. In addition, the mixture of ILITC, ILITC-labeled ADH, and ILITC-labeled BSA was added to this system, and the analytes of the mixture were separated and confirmed with the individual peaks on the chromatograms.
Variations in CD4 cell counts among HIV-uninfected and infected women in Uganda and Zimbabwe
Authors: Lovvorn A E , Patnaik P , Walker C J , Kwok C , Van Der Pol B , Chipato T , Byamugisha J K , Salata R A , Morrison C S
Published: May 2010

We conducted a cross-sectional study with 208 HIV-uninfected and 188 HIV-infected women in Uganda and Zimbabwe to investigate differences in median CD4 counts. Absolute CD4 counts were determined by flow cytometry. Multivariate analyses were used to examine the association of country and HIV-infection status on CD4 counts. Median CD4 counts were significantly lower in Zimbabwe than in Uganda overall (649 and 783 cells/mm3, P = 0.009) and among HIV-infected women (470 and 614 cells/mm3, P = 0.003). In separate multivariable models, CD4 counts were significantly lower in Zimbabwe in HIV-uninfected ( P = 0.014) and infected ( P < 0.001) women, controlling for age, contraceptive method, education and living with partner status. In a model combining HIV-uninfected and infected women, there was no significant interaction between country and HIV infection status ( P = 0.344), suggesting that the relationship between country and CD4 count was not significantly modified by HIV infection status. This study reinforces the importance of establishing country-specific reference CD4 levels as CD4 count continues to be used as a key biomarker in clinical decision-making for HIV-infected individuals in sub-Saharan Africa.
Self-reported HIV testing practice among physicians treating tuberculosis in Australia and New Zealand
Authors: Emerson C R , Goldberg H , Vollmer-Conna U , Post J J
Published: May 2010

Not all people with tuberculosis have their HIV status ascertained despite the interaction between these infections. We investigated the self-reported HIV testing practice among physicians treating tuberculosis in Australia and New Zealand and used logistic regression to assess factors associated with a routine offer of HIV testing in cases of tuberculosis. Of 290 subjects, 61% always recommended an HIV test for a 38-year-old married man with smear-positive pulmonary tuberculosis. A lower proportion (40%) always tested a 78-year-old man or a female patient (58%), and more always HIV tested a South African case (85%), a patient with oral candidiasis (87%) or an unmarried male patient (66%). No scenario was associated with a universal offer of HIV testing. Clinician factors such as specialty (odds ratio [OR] 3.09), jurisdiction of practice (OR 4.09) and number of HIV tests requested in the past five years (OR 0.29) predicted the self-reported frequency of always HIV testing tuberculosis patients. At least 48% of respondents reported that epidemiological or clinical factors influenced their decision to offer testing. Strategies to increase HIV testing in cases of tuberculosis need to consider clinician factors.
HIV-1 vertical transmission in Rio Grande, Southern Brazil
Authors: Tornatore M , Gonçalves C V , Mendoza-Sassi R A , Silveira J M , D'ávila N E , Maas C G , Bianchi M S , Pinheiro E M , Machado E S , Soares M A , Martinez A M B
Published: May 2010

The aim of this study was to determine the rate and risk factors of HIV-1 mother-to-child transmission (MTCT), the timing of transmission and the transmitted subtype in a population where subtypes B and C co-circulate. One hundred and forty-four babies born to HIV-1-infected mothers were studied. Subtype and timing of transmission were determined by a nested polymerase chain reaction of the gp41 gene. Seven children were infected (4.9%): four were infected intrautero and one intrapartum. The higher frequency of intrautero transmission was statistically significant ( P = 0.001). Use of antiretrovirals (ARVs) in the three stages of gestation was a protective risk factor for MTCT (PR = 0.42; CI: 0.21–0.83; P = 0.013). A higher HIV viral load at delivery was the only independent risk factor for MTCT. Early and universal access to ARVs during pregnancy are the most important measures to decrease vertical HIV-1 transmission even in areas where HIV clade distribution differs.
Developing quality indicators for sexually transmitted infection services with patient and public involvement
Authors: Challenor R , FitzGerald M , Warwick Z
Published: May 2010

The views of genitourinary (GU) medicine clinic populations in two locations (university teaching hospital and district general hospital) were sought regarding service quality measures. In Plymouth, patients were invited to participate in a qualitative interview. Twenty GU medicine patients (10 men, 10 women; age range 17–63 years) were interviewed and consistent themes emerged. In Taunton, patients were invited to complete a quantitative survey. Twenty patients (10 men, 10 women; age range 17–48 years) were asked to rank the importance of suggested quality measures. The qualitative and quantitative approaches produced different results but were complementary. Service quality indicators were finalized at a multidisciplinary team meeting with three public members. Quality indicators need to be challenging yet achievable and it is difficult to judge precisely where standards should be set. We hope other services may wish audit performance against these proposed local measures. If such data were to be pooled, it would provide valuable evidence for ‘SMART’ (Specific, Measurable, Attainable, Relevant, Time-based) service quality indicators that are challenging yet achievable for the majority of clinics. This paper demonstrates that it is possible to obtain GU medicine patient views despite problems with confidentiality and ‘one-stop’ clinic visits.
Do ‘do not attends’ at a genitourinary medicine service matter?
Authors: Swarbrick C , Foley E , Sanmani L , Patel R
Published: May 2010

Patients who do not attend (DNA) clinic appointments are wasteful of resources and may also pose a potential public health risk through the onward transmission of untreated sexually transmitted infections (STIs). This service evaluation was performed to assess the demographics of DNAs, patient reasons for non-attendance and follows up data to determine the health outcomes of non-attendance. The genitourinary (GU) medicine clinic DNA rate between October 2008 and March 2009 was 6% (383/6961). Of the 383 patients who DNA'd their appointment successful telephone contact was made in 182 (48%) of them. Of these 40% of patients reported that they had forgotten they held an appointment; no patients reported that clinic opening hours prevented their attendance. Telephone contact increased GU medicine clinic attendance by 9% (35/383), but led to a greater number of subsequent DNAs; 43/75 (63%) of patients who accepted a further appointment DNA'd that appointment. Sending a SMS text message to patients who DNA notifying them of the time of walk-in services might be the most effective way of recapturing these patients without compromising future clinic appointment slots.
Ureaplasma urealyticum is significantly associated with non-gonococcal urethritis in heterosexual Sydney men
Authors: Couldwell D L , Gidding H F , Freedman E V , McKechnie M L , Biggs K , Sintchenko V , Gilbert G L
Published: May 2010

We investigated the prevalence of various genital organisms in 268 men with (cases) and 237 men without (controls) urethral symptoms/signs (urethral discharge, dysuria and/or urethral irritation) from two sexual health clinics in Sydney between April 2006 and November 2007. The presence of urethral symptoms/signs was defined as non-gonococcal urethritis (NGU) for this study. Specific aims were to investigate the role of Ureaplasma urealyticum in NGU and the prevalence of Mycoplasma genitalium in our population. Multiplex polymerase chain reaction-based reverse line blot (mPCR/RLB) assay was performed to detect 14 recognized or putative genital pathogens, including Chlamydia trachomatis, M. genitalium, U. urealyticum and U. parvum. U. urealyticum was associated with NGU in men without another urethral pathogen (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.1–3.8; P = 0.04); this association remained after controlling for potential confounding by age and history of unprotected vaginal sex in the last four weeks (OR 2.0, 95% CI: 1.1–3.9; P = 0.03). C. trachomatis (OR 7.5, P < 0.001) and M. genitalium (OR 5.5, P = 0.027) were significantly associated with NGU. The prevalence of M. genitalium was low (4.5% cases, 0.8% controls). U. urealyticum is independently associated with NGU in men without other recognized urethral pathogens. Further research should investigate the role of U. urealyticum subtypes among heterosexual men with NGU.
Availability of services for subjects of sexual assault in genitourinary medicine clinics
Authors: Mandal D , Maw R D , Carne C A , Opaneye A , Thirunavukarasu T
Published: May 2010

The aim of this study is to gain an understanding of the services available to subjects of sexual assault at genitourinary medicine (GU medicine) clinics throughout the United Kingdom, and to determine whether these services are adequate. By means of a questionnaire, consultants in 106 clinics provided information on the number of patients who reported sexual assault and the services available to them. The study found a marked regional variation in attendances by subjects of sexual assault. However, only a minority of clinics kept accurate data (36.7% regarding female victims and 37.75% regarding male victims). The number of subjects who were aged under 16 years was disproportionately high (under 16s: 6.9% of female victims and 1.2% male victims; 16 and over: 1.3% of female victims and 0.14% of male victims). This survey highlights deficiencies in services that need to be addressed by clinics, management and the speciality.
High prevalence of suspected HIV-associated dementia in adult Malawian HIV patients
Authors: Patel V N , Mungwira R G , Tarumbiswa T F , Heikinheimo T , van Oosterhout J J
Published: May 2010

HIV-associated dementia (HAD) has received little attention in sub-Saharan Africa, and there are no data available from Malawi. We used the International HIV Dementia Scale (IHDS), a cross-cultural, simple and validated screening tool to study the prevalence of suspected HAD, defined as an IHDS score ≤10, in adult patients of a large urban antiretroviral (ART) clinic in Blantyre, Malawi. Use of the IHDS was feasible in our setting. The overall prevalence of suspected HAD was 14.0% (95% confidence interval 8.9–19.1%); there was no significant difference in prevalence between 134 patients on ART for at least six months and 45 patients not on ART (13.4% versus 15.6%; P = 0.722). Male gender and low education level were independent risk factors of suspected HAD. More knowledge of the value of the IHDS to predict ART outcomes is required.
Risk of Chlamydia trachomatis infection during pregnancy: effectiveness of guidelines-based screening in identifying cases
Authors: Silveira M F , Erbelding E J , Ghanem K G , Johnson H L , Burke A E , Zenilman J M
Published: May 2010

Our goal was to define the risk factors for Chlamydia trachomatis (CT) infection among pregnant women at a large urban medical centre. In a retrospective study, clinical records at a US maternity unit from July 2005 through February 2008 were reviewed. The study population included all pregnant women with a singleton newborn of at least 20 weeks gestation and antenatal care information. Logistic regression was used to analyse the association between a positive CT test and demographic, behavioural and prenatal care variables. A total of 2127 women were included in this analysis. The prevalence of CT infection was 4.7%. Cases were more likely to be younger, black and single. Other risk factors included tobacco use and Neisseria gonorrhoeae infection. Our findings suggest that factors other than age may impact upon the diagnosis of CT in pregnant women and that a more comprehensive testing strategy should be considered.
Role of penile biopsy in the diagnosis of penile dermatoses
Authors: Samuel M , Brady M , Tenant-Flowers M , Taylor C
Published: May 2010

The aim of this study was to review the utility of penile biopsy in genitourinary (GU) medicine clinics, its acceptability and the range of penile dermatoses diagnosed histologically. A retrospective case-notes review of 401 cases attending a dedicated penile dermatoses clinic from 1 June 2001 to 30 November 2007 was carried out. In 115/401 (28.7%) of cases a biopsy was invoked to resolve ambiguities of diagnosis. In 60/401 (15%) of those cases differential diagnosis was resolved, in 26/401 (6.5%) clinically suspected diagnoses were confirmed and in 22/401 (5.5%) clinically unsuspected diagnoses were identified. In 7/401 (1.7%) of cases the biopsy was also the treatment. Targeted penile biopsy has an important role in the diagnosis of penile dermatoses, particularly where there is clinical uncertainty. As a diagnostic tool in GU medicine departments it should be readily available even if not for routine use. There were indications that circumcision may reduce the incidence of penile dermatoses. There was also some indication of a possible ethnic factor in the relative incidences of penile lichen sclerosus and lichen planus in biopsied patients.
Nodular herpes simplex virus-1-positive oral lesions as a manifestation of immune reconstitution inflammatory syndrome
Authors: Briggs A , Kinghorn G R
Published: May 2010

We describe a case of nodular oral herpes simplex virus-1-positive lesions consistent with immune reconstitution inflammatory syndrome in a patient recently commenced on treatment for tuberculosis and HIV co-infection.
Population-based study of asymptomatic infection with Chlamydia trachomatis among female and male students
Authors: Imai H , Nakao H , Shinohara H , Fujii Y , Tsukino H , Hamasuna R , Osada Y , Fukushima K , Inamori M , Ikenoue T , Katoh T
Published: May 2010

There are few epidemiological studies of asymptomatic chlamydial infection among students in non-medical settings with minimal bias and improved accuracy; thus, useful data from screening among students are limited. We aimed to obtain accurate epidemiological information about asymptomatic chlamydial infection among students in non-medical settings. A population-based cross-sectional survey of 10,440 ≥18-year-old asymptomatic students who volunteered for a urine screening test for chlamydia was conducted. The prevalences of asymptomatic infection were 9.5% for women and 6.7% for men. Multivariate analysis revealed the risk factors to be a lifetime history of ≥4 sexual partners for women (odds ratio [OR] 3.17) and inconsistent condom use for men (OR 4.18). For both sexes, younger age at first intercourse was associated with a higher rate of inconsistent condom use. This study produced accurate epidemiological information on asymptomatic chlamydial infection. These results may contribute to the establishment of preventive countermeasures against such infection.
Three cases of Lipschütz vulval ulceration
Authors: Alés-Fernández M , Rodríguez-Pichardo A , García-Bravo B , Ferrándiz-Pulido L , Camacho-Martínez F M
Published: May 2010

A Lipschütz ulcer or ‘ulcus vulvae acutum’ is an acute simple ulceration of the vulva or vagina of non-venereal origin which can be associated with lymphadenopathy. Three cases are described with accompanying clinical photographs. Two cases refer to adolescents, one an infant, all without any history of sexual contact. The cases serve to illustrate a little known but potentially important differential diagnosis of vulval ulceration.
Integrated diagnostics: a conceptual framework with examples
Authors: Madabhushi Anant , Doyle Scott , Lee George , Basavanhally Ajay , Monaco James , Masters Steve , Tomaszewski John , Feldman Michael
Published: May 2010

With the advent of digital pathology, imaging scientists have begun to develop computerized image analysis algorithms for making diagnostic (disease presence), prognostic (outcome prediction), and theragnostic (choice of therapy) predictions from high resolution images of digitized histopathology. One of the caveats to developing image analysis algorithms for digitized histopathology is the ability to deal with highly dense, information rich datasets; datasets that would overwhelm most computer vision and image processing algorithms. Over the last decade, manifold learning and non-linear dimensionality reduction schemes have emerged as popular and powerful machine learning tools for pattern recognition problems. However, these techniques have thus far been applied primarily to classification and analysis of computer vision problems (e.g., face detection). In this paper, we discuss recent work by a few groups in the application of manifold learning methods to problems in computer aided diagnosis, prognosis, and theragnosis of digitized histopathology. In addition, we discuss some exciting recent developments in the application of these methods for multi-modal data fusion and classification; specifically the building of meta-classifiers by fusion of histological image and proteomic signatures for prostate cancer outcome prediction.

Clin Chem Lab Med 2010;48:989–98.