bluuebunny/crossref_metadata_2025 huggingface dataset:
Trust, Strangeness and Hospitality
Authors: Cornu Laurence
Published: October 2008

This paper presents a way of building social cohesion open to diversity, assuming that democracy is alive only when it is reinvented. It challenges social trust to welcome diversity, thus allowing for a continual reinvention of democratic cohesion. Articulating cultural diversity and trust represents a major challenge for democratic coexistence. Philosophy is called to take into account the existing models of social cohesion and trust, and to reinvent democracy by defining a new paradigm of trust integrating social and cultural diversity.
The Non- and Anti-Democratic in Post-Modernity
Authors: Hamashita Masahiro
Published: October 2008

Is, or has, democracy a universal value? This is the main question raised by this paper, which distinguishes between two aspects of democracy: political institution in opposition to despotism, and political belief against any kind of slavery and subordination. The role played by intellectuals in the development of contemporary democracy, and the relation of democracy to mass culture and the influence of mass media on a true democratic attitude, are studied within the frame of an overall ‘mass aesthetization' which characterizes contemporary societies.
International Law and Democracy
Authors: Martin-Chenut Kathia
Published: October 2008

This contribution intends to examine the role of democracy in the evolution of international law, and equally the role of the latter in the advancement of democracy, or, one might say, in its ‘reinvention'. Two aspects of this broad theme are addressed: the influence of processes of democratization at the level of the individual nation on the evolution of international law, and the extent of penetration of democracy and democratic mechanisms within the processes of creation and application of international law. A rich record of examples drawn by international jurisprudence is used to illustrate these complementary processes.
Democracy versus Republic: Inclusion and Desire in Social Struggles
Authors: Ribeiro Renato Janine
Published: October 2008

This paper argues that the idea of inclusion is linked to the democratic tradition rather than to the republican one. By analyzing the origins and meaning of these two concepts, the author holds that democracy is rather linked to desire and republic to will (and to the expression of desire), and concludes that, since North Atlantic political tradition has not given a key role to desire, democracy, in order to overcome the difficulties it has been encountering in all parts of the world, should take more account of desire and of the social struggles it brings to the fore.
Equality and Democracy
Authors: Vermeren Patrice
Published: October 2008

This paper analyzes the relations between public space, language, and democracy. It describes how dissensus, democratic citizenship, domination, and political speech are linked together in contemporary French political philosophy, referring in particular to Jacques Rancière, Miguel Abensour, Alain Badiou and Claude Lefort. Hannah Arendt's political thought represents a theoretical frame or reference for most of these authors, who relate to her work in different, and often discrepant, ways.
Tocqueville Reinvented or ‘Democracy in Brazil’
Authors: Freitag Barbara
Published: October 2008

This paper compares Tocqueville's concept of democracy to the social and political evolution of Brazil. It draws attention to the different points of departure which marked the establishment of American and Brazilian societies, through the works of authors such as Laura de Mello e Souza, Gilberto Freyre, Florestan Fernandes, Celso Furtado, and Sérgio Buarque de Holanda. It notes that, despite conditions being more favourable for the formation of a democratic society in the United States than in Brazil, subsequent to the founding periods a certain coming together occurred in the process of formation of the two societies. The ‘similarity of differences' between American and Brazilian societies becomes clear as soon as one brings together the roles played by the three constituent ethnic groups of these societies, which, by their simple existence, link difference to inequality.
Republic, Nation and Democracy: The Challenge of Diversity
Authors: Villavicencio Susana
Published: October 2008

This paper analyzes how cultural diversity in Argentina is calling into question modern political concepts like republic, nation or democracy. The phenomenon of population movements, the demand for recognition of indigenous people's rights, or the conflicts arising from claims to regions' right to life and identity - as in the case of the town of Gualeguaychú in Argentina - challenge the logic of the nation-state and its sovereignty as well as the republican principles of liberty, equality and fraternity. The author examines how far the representation of the Argentinean republic at the time of its foundation included a standardizing vision of diversity, and how the legacy of this representation brought about an ambivalence between a universalist wish to take part in the progress of humanity and the reality of an exclusive democracy that valued one culture over others. It studies the narrative of national identity and attempts to describe how, proceeding from this narrative, the opposition between civilization and barbarity affects the way Latin Americans see the great challenges presented by the future of democracy, and by the recognition of the plurality of cultural allegiances.
Discrepancy Score Reliabilities in the WISC-IV Standardization Sample
Authors: Glass Laura A. , Ryan Joseph J. , Charter Richard A. , Bartels Jared M.
Published: October 2008

This investigation provides internal consistency reliabilities for Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) subtest and index discrepancy scores using the standardization sample as the data source. Reliabilities range from .50 to .82 for subtest discrepancy scores and from .78 to .88 for index discrepancy scores. Thus, the reliabilities of the WISC-IV subtest and index discrepancy scores do not reach the ≥.90 criterion recommended for clinical decision making. However, 5 of the 66 subtest and 33 of the 36 index discrepancy score reliabilities are ≥.80, which is regarded as adequate when hypothesis generation is the goal instead of decision making.
Bioactivity of a Novel Nano— composite of Hydroxyapatite and Chitosan—Phosphorylated Chitosan Polyelectrolyte Complex
Authors: Li Quan-Li , Wu Ming-Yue , Tang Li-Li , Jian Zhou  , Yong Jiang  , Darvell Brian W.
Published: October 2008

The bioactivity of a novel composite of carbonate-containing low-crystallinity nanoparticle hydroxyapatite (HA) and a chitosan—phosphorylated chitosan polyelectrolyte complex (PEC) was evaluated in vitro and in vivo. The HA—PEC nanocomposite with complicated porous structure was prepared by a biomimetic method. An acidic chitosan (polycation) solution containing calcium and phosphate ions (6 mM Ca2+, Ca/P: 1.67) was added into phosphorylated chitosan (polyanion) solution; the formation of PEC and the controlled HA crystal growth were co-organized in alkaline solution. The material was co-cultured with rat osteoblasts in vitro, and implanted into rabbit femur marrow cavities. The results indicate that the PEC—HA composite promoted osteoblast adhesion, morphology, proliferation, and differentiation in vitro; the bone tissue response to the material histologically showed that it was bioactive, as well as biodegradable. The HA—PEC composite shows promise as a bone-repair material.
Synthesis of Novel Chitosan Derivatives for Micellar Solubilization of Cyclosporine A
Authors: Xiaolei Chen  , Song Ding  , Guowei Qu  , Can Zhang
Published: October 2008

In this study, the solubilization of poor water-soluble drugs using N-acyl, O-acyl-N-trimethyl chitosan chloride (ATMC) micelles as a carrier system was investigated. Three series ofATMCs were synthesized by N-trimethyl chitosan chloride (TMC) with substitutions of 21.3, 44.8, and 45.2% as start material grafting five different long-chain saturated fatty acids (C10—C 18), and characterized by 1H-NMR, 13C-NMR, and FT-IR spectra, respectively. The degree of long-chain acyl group of ATMC was ~8.1%. These ATMC micelles self-assemble and were used to encapsulate the poorly soluble drug, Cyclosporine A. These assemblies were prepared by a dialysis, wherein the drug loading capacity of the ATMC micelles ranged from 9.6% to 17.1% and encapsulation capacity ranged from 35.8% to 69.8%, with the mean micellar particle size of 288 nm. The critical micellar concentrations of the 70,000 Mw ATMC2 were 0.028—0.038 mg/mL. Nanoscale near-spherical ATMC micelles were observed by transmission electron microscopy. Additionally, the chitosan derivatives with a high methylation degree, medium-sized long-chain acyl groups (C14) and large molecular weight had the most effective capacity for loading Cyclosporine A. These ATMC micelles are being investigated as carriers to improve oral administration absorption of poorly permeable drugs.
Pitch Perception and Auditory Stream Segregation: Implications for Hearing Loss and Cochlear Implants
Authors: Oxenham Andrew J.
Published: October 2008

Pitch is important for speech and music perception, and may also play a crucial role in our ability to segregate sounds that arrive from different sources. This article reviews some basic aspects of pitch coding in the normal auditory system and explores the implications for pitch perception in people with hearing impairments and cochlear implants. Data from normal-hearing listeners suggest that the low-frequency, low-numbered harmonics within complex tones are of prime importance in pitch perception and in the perceptual segregation of competing sounds. The poorer frequency selectivity experienced by many hearing-impaired listeners leads to less access to individual harmonics, and the coding schemes currently employed in cochlear implants provide little or no representation of individual harmonics. These deficits in the coding of harmonic sounds may underlie some of the difficulties experienced by people with hearing loss and cochlear implants, and may point to future areas where sound representation in auditory prostheses could be improved.
Time-Frequency Masking for Speech Separation and Its Potential for Hearing Aid Design
Authors: Wang DeLiang
Published: October 2008

A new approach to the separation of speech from speech-in-noise mixtures is the use of time-frequency (T-F) masking. Originated in the field of computational auditory scene analysis, T-F masking performs separation in the time-frequency domain. This article introduces the T-F masking concept and reviews T-F masking algorithms that separate target speech from either monaural or binaural mixtures, as well as microphone-array recordings. The review emphasizes techniques that are promising for hearing aid design. This article also surveys recent studies that evaluate the perceptual effects of T-F masking techniques, particularly their effectiveness in improving human speech recognition in noise. An assessment is made of the potential benefits of T-F masking methods for the hearing impaired in light of the processing constraints of hearing aids. Finally, several issues pertinent to T-F masking are discussed.
Bending the school rules to re-engage students: implications for improving teaching practice
Authors: Deed Craig G.
Published: October 2008

What scope is there for teachers to purposefully deviate from their routine classroom practice in order to respond to disengaging students? A case study of a small provincial school in Australia shows an example of alternative pedagogy used in response to a disengaged group of young adolescents. The students temporarily engaged with a different version of school although they continued to resist and even sabotage established school routines. The main implication drawn from the case study is that school staff members need to consider the purpose of alternative pedagogy in terms of school engagement.
Understanding friendship between critical friends
Authors: Gibbs Paul , Angelides Panayiotis
Published: October 2008

This conceptual article discusses the issue of friendship implied by the term `critical friends'. Our argument relates to the generalized use of the term `friendship' and the assumptions that it may carry compared with the actuality of the roles played by critical friends. We attempt to build a more precise definition of friendship which we believe can clarify what critical friends might be which is different from the utilitarian notion between critical friends. The article draws on Aristotle's work to develop a contemporary taxonomy of forms of friendly relationships and discusses this in the context of school improvement.
External change agents in developed and developing countries
Authors: Mir Afzal Tajik
Published: October 2008

During the last four decades, educational researchers and practitioners have intensively engaged in bringing about positive changes in schools. Therefore, the kinds of changes introduced to schools have become complex in nature and overwhelming in number — from improving teacher professional knowledge base and teaching repertoires to developing innovative curricula to changing the organizational structures and cultures in schools. The skills required by schools and teachers to implement these changes have also become more complex. Consequently, a large number of external agents — variously referred to as consultants, linking agents, education officers, or supervisors — have mobilized themselves for building schools' capacity and knowledge utilization at the local level. This article intends to analyse the existing stock of knowledge and understanding about external agents' roles and practices in school change, focusing on the significance, limitations, diversity and magnitude, and the challenges and tensions attached to this role in both developed and developing nations. The comparative analysis of the external change agents' roles and practices in the developed and developing country contexts provides useful insights into how context influences the change agents' roles and practices in school change.
Layer upon Layer: Public Authorities and Airport Ownership and Management in St. Louis, 1947-1980
Authors: Daly Bednarek Janet R.
Published: October 2008

Although the ownership and management of the nation's air carrier airports continues under a variety of models, the public authority became a popular option following World War II. Beginning in 1947, the St. Louis region witnessed repeated attempts to place the area's air carrier and general aviation airports under a single metropolitan airport authority, one that would operate not only in Missouri but Illinois as well. A number of potential models for action existed. After many attempts, however, the ownership and management of the airports in the St. Louis region remained fragmented, with many overlapping layers.
Schwann Cell Strip for Peripheral Nerve Repair
Authors: KALBERMATTEN D. F. , ERBA P. , MAHAY D. , WIBERG M. , PIERER G. , TERENGHI G.
Published: October 2008

Many strategies have been investigated to provide an ideal substitute to treat a nerve gap injury. Initially, silicone conduits were used and more recently conduits fabricated from natural materials such as poly-3-hydroxybutyrate (PHB) showed good results but still have their limitations. Surgically, a new concept optimising harvested autologous nerve graft has been introduced as the single fascicle method. It has been shown that a single fascicle repair of nerve grafting is successful. We investigated a new approach using a PHB strip seeded with Schwann cells to mimic a small nerve fascicle. Schwann cells were attached to the PHB strip using diluted fibrin glue and used to bridge a 10-mm sciatic nerve gap in rats. Comparison was made with a group using conventional PHB conduit tubes filled with Schwann cells and fibrin glue. After 2 weeks, the nerve samples were harvested and investigated for axonal and Schwann cell markers. PGP9.5 immunohistochemistry showed a superior nerve regeneration distance in the PHB strip group versus the PHB tube group (> 10 mm, crossed versus 3.17± 0.32 mm respectively, P<0.05) as well as superior Schwann cell intrusion (S100 staining) from proximal (> 10 mm, crossed versus 3.40± 0.36 mm, P<0.01) and distal (> 10 mm, crossed versus 2.91± 0.31 mm, P<0.001) ends. These findings suggest a significant advantage of a strip in rapidly connecting a nerve gap lesion and imply that single fascicle nerve grafting is advantageous for nerve repair in rats.
Carpal Tunnel Volume Changes of the Wrist Under Distraction
Authors: CHO M. S. , MEANS K. R. , SHROUT J. A. , SEGALMAN K. A.
Published: October 2008

This study attempts to determine changes in carpal canal volume with distraction across the wrist. Uniform longitudinal distraction was maintained with two external fixators on the radial and ulnar aspects of the forearm axis of five cadaver specimens. After CT scanning, volume determinations were made at 5 mm increments beginning at the lunocapitate joint to a point 1.5 cm distal to the middle finger carpometacarpal joint. There was a statistically significant decrease of the mean total carpal canal volume from 0 to 4.54 kg of distraction, with no statistically significant decrease from 0 to 2.27 kg or 2.27 to 4.54 kg. The largest decrease occurred at 15 and 20 mm distal to the proximal edge of the transverse carpal ligament corresponding to the level of the hamate hook. Reduction in mean carpal canal volume was 10.2% and 7.5% at these distances, respectively, from 0 to 4.54 kg of distraction. Progressive distraction across the wrist causes a decrease in total carpal canal volume.
Validation of a Modern Activity Hand Survey with Respect to Reliability, Construct and Criterion Validity
Authors: ALEXANDER M. , FRANKO O. I. , MAKHNI E. C. , ZURAKOWSKI D. , DAY C. S.
Published: October 2008

This study validates a novel, modern wrist and hand functional assessment: the Modern Activity Subjective Survey of 2007 (MASS07). In total, 326 patients visiting an academic tertiary-care orthopaedic hand clinic (April 2006–April 2007) were recruited to complete the MASS07 questionnaire, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and Patient-Rated Wrist Evaluation (PRWE) to assess construct validity, criterion validity and test–retest reliability of the MASS07. MASS07 correlated strongly with both PRWE (0.81) and DASH (0.85) even when adjusted for age, sex and history of hand problems ( P<0.001). MASS07 scores compared for 42 patients with repeated visits indicated no statistically significant difference between MASS07 scores at the patients’ first and second clinic visit. We conclude that the newly constructed MASS07 instrument is valid and reliable with respect to the outpatient population with a wide spectrum of hand and wrist pathologies for fast and effective assessment of patient-reported hand function during modern daily activities.
Interfacial phenomena of cold metal transfer (CMT) welding of zinc coated steel and wrought aluminium
Authors: Zhang H. T. , Feng J. C. , He P.
Published: October 2008

The interfacial microstructures and intermetallic compounds produced by cold metal transfer (CMT) welding of wrought aluminium to zinc coated steel have been investigated. The results showed that the reaction layer mainly consists of FeAl3 phase and the thickness of the layer was decreased to 7–8 μm owing to the low heat input of the CMT method. And the thin reaction layer guarantees the tensile property of the joint. At last, according to the interface characteristic of the dissimilar metal joint, the interfacial reaction process was described in detail.
Gene expression profiling of pulmonary mucosa-associated lymphoid tissue lymphoma identifies new biologic insights with potential diagnostic and therapeutic applications
Authors: Chng Wee J. , Remstein Ellen D. , Fonseca Rafael , Bergsagel P. Leif , Vrana Julie A. , Kurtin Paul J. , Dogan Ahmet
Published: October 2008

We conducted comprehensive gene expression profiling (GEP) of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma (n = 33) and compared the results to GEP of other B- and T-cell lymphomas and normal lymphocytes to identify novel markers and deregulated pathways. MALT has a prominent T-cell signature and a marginal zone/memory B-cell profile. Four novel transcripts were specifically overexpressed in MALT, and 2 of these, MMP7 and SIGLEC6, were validated at the protein level. GEP also revealed distinct molecular subsets in MALT. One subset, characterized by MALT1 translocations, showed overexpression of nuclear factor-κB (NF-KB) pathway genes but also was enriched for chemokine signaling pathways. Another subset showed increased plasma cells and a prominent plasma cell gene signature. By analyzing several genes with very high (“spiked”) expression in individual cases, we identified clusters with different biologic characteristics, such as samples with MALT1 translocations having high expression of MALT1 and RARA, samples with plasmacytic differentiation having high FKBP11 expression, and samples with high RGS13 expression tending to have trisomy 3 and reactive follicles. In conclusion, MALT subgroups with distinct pathologic features defined by distinct groups of deregulated genes were identified. These genes could represent novel diagnostic and therapeutic targets.
Improvement in survival in younger patients with acute lymphoblastic leukemia from the 1980s to the early 21st century
Authors: Pulte Dianne , Gondos Adam , Brenner Hermann
Published: October 2008

Acute lymphoblastic leukemia (ALL) is an uncommon but highly fatal disease in adults. We used period analysis to data from the Surveillance, Epidemiology, and End Results (SEER) database to disclose changes in outcomes for patients diagnosed with ALL in the United States in the 2 decades between 1980–1984 and 2000–2004. Major improvement in survival was observed for patients less than 60 years of age. Improvement in survival was greater for women than for men, but was significant for both genders. The greatest improvement was seen in patients aged 15 to 19, in whom 5-year relative survival improved from 41.0% to 61.1%, and 10-year survival improved from 33.0% to 60.4%. Lesser but significant improvements were seen for age groups 20–29, 30–44, and 45–59. Survival for patients aged 60 and over remained essentially unchanged at levels around or below 10%, respectively. Survival has improved for patients with ALL over the time period studied, but treatment of older patients remains a difficult issue.
CTLA4 blockade with ipilimumab to treat relapse of malignancy after allogeneic hematopoietic cell transplantation
Authors: Bashey Asad , Medina Bridget , Corringham Sue , Pasek Mildred , Carrier Ewa , Vrooman Linda , Lowy Israel , Solomon Scott R. , Morris Lawrence E. , Holland H. Kent , Mason James R. , Alyea Edwin P. , Soiffer Robert J. , Ball Edward D.
Published: October 2008

Relapse of malignancy after allogeneic hematopoietic cell transplantation (allo-HCT) remains a therapeutic challenge. Blockade of the CTLA4 molecule can effectively augment antitumor immunity mediated by autologous effector T cells. We have assessed the safety and preliminary efficacy of a neutralizing, human anti-CTLA4 monoclonal antibody, ipilimumab, in stimulating the graft-versus-malignancy (GVM) effect after allo-HCT. Twenty-nine patients with malignancies that were recurrent or progressive after allo-HCT, received ipilimumab as a single infusion at dose cohorts between 0.1 and 3.0 mg/kg. Dose-limiting toxicity was not encountered, and ipilimumab did not induce graft-versus-host disease (GVHD) or graft rejection. Organ-specific immune adverse events (IAE) were seen in 4 patients (grade 3 arthritis, grade 2 hyperthyroidism, recurrent grade 4 pneumonitis). Three patients with lymphoid malignancy developed objective disease responses following ipilimumab: complete remission (CR) in 2 patients with Hodgkin disease and partial remission (PR) in a patient with refractory mantle cell lymphoma. At the 3.0 mg/kg dose, active serum concentrations of ipilimumab were maintained for more than 30 days after a single infusion. Ipilimumab, as administered in this clinical trial, does not induce or exacerbate clinical GVHD, but may cause organ-specific IAE and regression of malignancy. This study is registered at http://clinicaltrials.gov under NCI protocol ID P6082.
Protozoa in respiratory pathology: a review
Authors: Martínez-Girón R. , Esteban J. G. , Ribas A. , Doganci L.
Published: October 2008

Among the micro-organisms that may affect the respiratory apparatus are the protozoa. The diseases they may give rise to constitute a relatively uncommon group of respiratory ailments with, in the majority of cases, an underlying clinical situation corresponding to states of suppressed immunity (AIDS, transplants, malign haemopathies, corticotherapy,etc.). Other factors, such as visits to endemic areas and immigration, also have to be taken into account.

In view of the probable increase in the number of cases and the appearance of new emerging diseases, it is the intention of the present work to review the publications available, in different fields of medicine, that refer to the principal kinds of protozoa (Entamoeba, Acanthamoeba, Balamuthia, Leishmania, Trypanosoma, Trichomonas, Lophomonas, Cryptosporidium, Cyclospora, Toxoplasma, Plasmodium, Babesia, Encephalitozoon, Enterocytozoon and Balantidium) and, at the same time, detail and comment on the latest findings on this subject.
Pathomechanisms of cyst formation in pulmonary light chain deposition disease
Authors: Colombat M. , Caudroy S. , Lagonotte E. , Mal H. , Danel C. , Stern M. , Fournier M. , Birembaut P.
Published: October 2008

Cystic lung light chain deposition disease (CL-LCDD) is a recently described rare disorder characterised by numerous cysts and diffuse monoclonal nonamyloid light chain deposits surrounded by macrophagic giant cells. The mechanisms responsible for cyst development remain unknown.

The objectives of the present study were to analyse the major components of the pulmonary extracellular matrix in CL-LCDD and to determine the influence of metalloproteinases (MMPs) by comparison with other cystic lung disorders.

A virtually complete degradation of the elastic network was found in CL-LCDD. To a lesser degree, loss of fibrillar and basement membrane collagens was also observed. Macrophagic giant cells expressed MMP-1, MMP-2, MMP-9, MMP-12 and MMP-14 andin situzymography highlighted a strong gelatinolytic activity. As in CL-LCDD, cystic lesions in Langerhans' cell histiocytosis (LCH) and lymphangioleiomyomatosis (LAM) were characterised by the lack of elastic fibres. Similarly, MMP were expressed in CL-LCDD and LCH but the labelled cells were different. In contrast, few MMPs were detected in LAM.

In conclusion, elastolysis is common to cystic lung light chain deposition disease and other cystic lung disorders, suggesting its implication in cyst formation. Moreover, in cystic lung light chain deposition disease, a role of metalloproteinases in elastolysis is strongly indicated by the metalloproteinase expression and activity pattern.
Using written information in clinical work with patients and carers
Authors: Timms Philip , Ramsay Rosalind , Byfield Roslyn
Published: October 2008

In all areas of medicine there is increasing awareness that patients need information that is clear, relevant and appropriately timed. This is obviously connected with ethical concerns of patient dignity and autonomy, but it also underpins the principle of informed choice. It is not possible to make an informed choice about how you want a problem to be managed, if you do not have the relevant information. Doctors have, historically, been poor communicators of such information. Although, on the face of it, this seems a straightforward issue to rectify, there are a surprising number of practical problems to be addressed before such communication can become a reality in daily practice.
Medically unexplained symptoms in primary care
Authors: Guthrie Else
Published: October 2008

Adult patients with medically unexplained symptoms (somatisation) in primary care are numerous and make disproportionately high demands on health services. Most of these individuals are open to the suggestion that their illness reflects psychological needs. Empowering explanations from doctors can enable patient and doctor to work collaboratively in managing the problem and can reduce healthcare contacts. Parental medically unexplained symptoms, sexual and physical abuse in childhood and childhood neglect are associated with a greater risk of medically unexplained symptoms in adulthood. The overall prognosis for the majority of primary care patients with medically unexplained symptoms is very good. The two most common approaches to dealing with medically unexplained symptoms in primary care are stepped-care approaches and teaching general practitioners new skills to manage consultations more effectively.
Gulf War syndrome – has it gone away?
Authors: Tarn Mark , Greenberg Neil , Wessely Simon
Published: October 2008

‘Gulf War syndrome’ was a phrase coined after the 1991 Gulf War. This article looks at the variety of hypotheses that have been put forward about the origins of the concept and the studies attempting to characterise the health manifestations of Gulf service and the lasting effects on veterans. It also serves to bring readers up to date with research on the present deployment in Iraq. Finally, consideration is given to how Gulf War syndrome compares with the rich historical literature of post-conflict medical syndromes and how sociological factors may interact with symptom attribution in veterans.
Mental healthcare of asylum-seekers and refugees
Authors: McColl Helen , McKenzie Kwame , Bhui Kamaldeep
Published: October 2008

Many health professionals feel ill-equipped to deal with the complex needs of asylum-seekers and refugees. This article offers an overview of the literature, and reviews the demography, epidemiology and causes of mental illness in refugee and asylum-seeker groups. It discusses the types of service configurations and service response that would be appropriate. It highlights the findings of the Royal College of Psychiatrists' consensus team and their position statement on the treatment of refugees and asylum-seekers. It finishes with some thoughts about what clinicians can do to improve their treatment. Clearly, there is a need for more training, education and service development.
Learning from critical incidents
Authors: Clarke Ian
Published: October 2008

Critical incident reviews are an integral part of modern psychiatric practice. The issue is central to the clinical governance agenda in the UK, yet there is widespread debate about their usefulness. There is a lack of systematic research into their impact on clinical outcomes, with most authors commenting on their form, their political implications, and whether they should exist at all. This article explores the historical basis to incident investigation, outlines an ‘ideal’ method of review and discusses the concepts of the learning organisation and root cause analysis. Further discussion focuses on what the objectives of critical incident review might be and whether organisations as a whole can learn from them.
Case–control study of suicide in Karachi, Pakistan
Authors: Khan Murad Moosa , Mahmud Sadia , Karim Mehtab S. , Zaman Mohammad , Prince Martin
Published: October 2008

Background

In recent years suicide has become a major public health problem in Pakistan.

Aims

To identify major risk factors associated with suicides in Karachi, Pakistan.

Method

A matched case–control psychological autopsy study. Interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls.

Results

Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. Only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide.

Conclusions

Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated. The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan.
Mood changes after delivery: role of the serotonin transporter gene
Authors: Sanjuan J. , Martin-Santos R. , Garcia-Esteve L. , Carot J. M. , Guillamat R. , Gutierrez-Zotes A. , Gornemann I. , Canellas F. , Baca-Garcia E. , Jover M. , Navines R. , Valles V. , Vilella E. , de Diego Y. , Castro J. A. , Ivorra J. L. , Gelabert E. , Guitart M. , Labad A. , Mayoral F. , Roca M. , Gratacos M. , Costas J. , van Os J. , de Frutos R.
Published: October 2008

Background

Polymorphic variations in the serotonin transporter gene (5-HTT) moderate the depressogenic effects of tryptophan depletion. After childbirth there is a sharp reduction in brain tryptophan availability, thus polymorphic variations in5-HTTmay play a similar role in the post-partum period.

Aims

To study the role of5-HTTpolymorphic variations in mood changes after delivery.

Method

One thousand, eight hundred and four depression-free Spanish women were studied post-partum. We evaluated depressive symptoms at 2–3 days, 8 weeks and 32 weeks post-partum. We used diagnostic interview to confirm major depression for all probable cases. Based on two polymorphisms of5-HTT(5-HTTLPR and STin2 VNTR), three genotype combinations were created to reflect different levels of5-HTTexpression.

Results

One hundred and seventy-three women (12.7%) experienced major depression during the 32-week post-partum period. Depressive symptoms were associated with the high-expression5-HTTgenotypes in a dose–response fashion at 8 weeks post-partum, but not at 32 weeks.

Conclusions

High-expression5-HTTgenotypes may render women more vulnerable to depressive symptoms after childbirth.
A measure of perceived stigma in people with intellectual disability
Authors: Ali Afia , Strydom Andre , Hassiotis Angela , Williams Rachael , King Michael
Published: October 2008

Background

There is a lack of validated instruments measuring perceived stigma in people with intellectual disability.

Aims

To develop a valid and reliable self-rated instrument to measure perceived stigma that can be completed by people with mild to moderate intellectual disability.

Method

A literature search was used to generate a list of statements. Professionals, individuals with intellectual disability and carers were consulted about the suitability of statements. An instrument was developed containing statements about stigma with accompanying photographs. Test–retest reliability, internal consistency and the factor structure of the instrument were evaluated.

Results

The instrument was completed by 109 people once and 88 people twice. Items with limited variability in responses and kappa coefficients lower than 0.4 were dropped. Exploratory factor analysis revealed two factors: ‘perceived discrimination’ (seven items) and ‘reaction to discrimination’ (four items). One item loaded onto both factors. Cronbach's alpha for the ten-item instrument was 0.84.

Conclusions

This instrument will further our understanding of the impact of stigma in people with intellectual disability in clinical and research settings.
Services for ethnic minorities: a question of trust
Authors: Appleby Louis
Published: October 2008

Mental healthcare for ethnic minorities is a government policy priority. However, debate about how services should develop has been overshadowed by public criticism over high rates of admission and sectioning in some ethnic groups, the implication being that racism is rife in mental healthcare. These criticisms are headline-seeking, scientifically crude and unfair to mental health professionals. However, it is true that some minority communities are mistrustful of the services available. We need to overcome this mistrust with a positive message – and a promise of fair treatment.
Autocrine Human Growth Hormone Promotes Tumor Angiogenesis in Mammary Carcinoma
Authors: Brunet-Dunand Severine E. , Vouyovitch Cecile , Araneda Silvia , Pandey Vijay , Vidal Laurent J.-P. , Print Cristin , Mertani Hichem C. , Lobie Peter E. , Perry Jo K.
Published: October 2008

Accumulating literature implicates pathological angiogenesis and lymphangiogenesis as playing key roles in tumor progression. Autocrine human growth hormone (hGH) is a wild-type orthotopically expressed oncogene for the human mammary epithelial cell. Herein we demonstrate that autocrine hGH expression in the human mammary carcinoma cell line MCF-7 stimulated the survival, proliferation, migration, and invasion of a human microvascular endothelial cell line (HMEC-1). Autocrine/paracrine hGH secreted from mammary carcinoma cells also promoted HMEC-1 in vitro tube formation as a consequence of increased vascular endothelial growth factor-A (VEGF-A) expression. Semiquantitative RT-PCR analysis demonstrated that HMEC-1 cells express both hGH and the hGH receptor (hGHR). Functional antagonism of HMEC-1-derived hGH reduced HMEC-1 survival, proliferation, migration/invasion, and tube formation in vitro. Autocrine/paracrine hGH secreted by mammary carcinoma cells increased tumor blood and lymphatic microvessel density in a xenograft model of human mammary carcinoma. Autocrine hGH is therefore a potential master regulator of tumor neovascularization, coordinating two critical processes in mammary neoplastic progression, angiogenesis and lymphangiogenesis. Consideration of hGH antagonism to inhibit angiogenic processes in mammary carcinoma is therefore warranted.

Autocrine/paracrine human growth hormone secreted by mammary carcinoma cells increases in vitro and in vivo indices of angiogenesis and lymphangiogenesis.
Thioredoxin Binding Protein-2/Thioredoxin-Interacting Protein Is a Critical Regulator of Insulin Secretion and Peroxisome Proliferator-Activated Receptor Function
Authors: Oka Shin-ichi , Yoshihara Eiji , Bizen-Abe Akiko , Liu Wenrui , Watanabe Mutsumi , Yodoi Junji , Masutani Hiroshi
Published: October 2008

The feeding-fasting nutritional transition triggers a dynamic change in metabolic pathways and is a model for understanding how these pathways are mutually organized. The targeted disruption of the thioredoxin binding protein-2 (TBP-2)/thioredoxin-interacting protein (Txnip)/VDUP1 gene in mice results in lethality with hypertriglyceridemia and hypoglycemia during fasting. To investigate the molecular mechanism of the nutritional transition and the role of TBP-2, microarray analyses were performed using the liver of TBP-2−/− mice in the fed and fasted states. We found that the fasting-induced reduction in the expression of lipogenic genes targeted by insulin (SREBP-1), such as FASN and THRSP, was abolished in TBP-2−/− mice, and the expression of lipoprotein lipase is down-regulated, which was consistent with the lipoprotein profile. TBP-2−/− mice also exhibited enhanced glucose-induced insulin secretion and sensitivity. Another feature of the hepatic gene expression in fed TBP-2−/− mice was the augmented expression of peroxisome proliferator activated receptor (PPAR) target genes, such as CD36, FABP2, ACOT1, and FGF21, to regulate fatty acid consumption. In TBP-2−/− mice, PPARα expression was elevated in the fed state, whereas the fasting-induced up-regulation of PPARα was attenuated. We also detected an increased expression of PPARγ coactivator-1α protein in fed TBP-2−/− mice. TBP-2 overexpression significantly inhibited PPARα-mediated transcriptional activity induced by a specific PPARα ligand in vitro. These results suggest that TBP-2 is a key regulator of PPARα expression and signaling, and coordinated regulation of PPARα and insulin secretion by TBP-2 is crucial in the feeding-fasting nutritional transition.

TBP-2/Txnip is a key regulator of PPARα expression and signaling, and coordinated regulation of PPARα and insulin secretion by TBP-2/Txnip is crucial in fasting response.
Regulation of Pigmentation in Human Epidermal Melanocytes by Functional High-Affinity β-Melanocyte-Stimulating Hormone/Melanocortin-4 Receptor Signaling
Authors: Spencer J. D. , Schallreuter K. U.
Published: October 2008

To date, the principal receptor considered to regulate human pigmentation is the melanocortin-1 receptor (MC1-R) via induction of the cAMP/protein kinase A pathway by the melanocortins α-MSH and ACTH. In this context, it is noteworthy that β-MSH can also induce melanogenesis, although it has a low affinity for the MC1-R, whereas the preferred receptor for this melanocortin is the MC4-R. Because β-MSH is present in the epidermal compartment, it was of interest to ascertain whether functioning MC4-Rs are present in human epidermal keratinocytes and melanocytes. Our results provide evidence that the MC4-R is expressed in situ and in vitro throughout the human epidermis at the mRNA and protein level using RT-PCR, Western blotting, and double immunofluorescence staining. Moreover, radioligand binding studies yielded high-affinity receptors for β-MSH on epidermal melanocytes (3600 receptors per cell), undifferentiated keratinocytes (7200 receptors per cell), and differentiated keratinocytes (72,700 receptors per cell), indicating that MC4-R expression correlates with epidermal differentiation. Importantly, increased melanogenesis after stimulation of the β-MSH/cAMP/microphthalmia-associated transcription factor/tyrosinase cascade proved the functionality of this signal in melanocytes, which was attenuated in the presence of the specific MC4-R antagonist HS014. In summary, our results imply an important role for the β-MSH/MC4-R cascade in human melanocyte biology, although the function and purpose of this signal in keratinocytes needs further elucidation.

Although a high affinity MC4-R signal in human epidermal melanocytes (3,600 receptors/cell) stimulates melanogenesis via the β-MSH /cAMP/MITF/tyrosinase cascade, the purpose of this signal in keratinocytes remains unclear.
Developmental Programming: Excess Weight Gain Amplifies the Effects of Prenatal Testosterone Excess On Reproductive Cyclicity—Implication for Polycystic Ovary Syndrome
Authors: Steckler Teresa L. , Herkimer Carol , Dumesic Daniel A. , Padmanabhan Vasantha
Published: October 2008

Sheep exposed to testosterone (T) during early to midgestation exhibit reproductive defects that include hypergonadotropism, functional hyperandrogenism, polycystic ovaries, and anovulatory infertility, perturbations similar to those observed in women with polycystic ovary syndrome. Obesity increases the severity of the phenotype in women with polycystic ovary syndrome. To determine whether prepubertal weight gain would exaggerate the reproductive disruptions in prenatal T-treated sheep, pregnant sheep were injected with 100 mg T propionate (∼1.2 mg/kg) im twice weekly, from d 30–90 of gestation. Beginning about 14 wk after birth, a subset of control and prenatal T-treated females were overfed to increase body weight to 25% above that of controls. Twice-weekly progesterone measurements found no differences in timing of puberty, but overfed prenatal T-treated females stopped cycling earlier. Detailed characterization of periovulatory hormonal dynamics after estrous synchronization with prostaglandin F2α found 100% of controls, 71% of overfed controls, 43% of prenatal T-treated, and 14% of overfed prenatal T-treated females had definable LH surges. Only one of seven overfed prenatal T-treated female vs. 100% of control, 100% of overfed control, and seven of eight prenatal T-treated females exhibited a luteal progesterone increase. Assessment of LH pulse characteristics during the anestrous season found both overfeeding and prenatal T excess increased LH pulse frequency without an interaction between these two variables. These findings agree with the increased prevalence of anovulation observed in obese women with polycystic ovary syndrome and indicate that excess postnatal weight gain amplifies reproductive disruptions caused by prenatal T excess.

Exposure of sheep to excess testosterone in utero disrupts reproductive cyclicity, with postpubertal excess weight gain amplifying the severity of this adult reproductive phenotype.
Censorship, Surveillance, and Protest Theater in Zimbabwe
Authors: Zenenga Praise
Published: October 2008

Praise Zenenga's article navigates the long and troubled history between Zimbabwe's theater artists, and national government and local police strongmen. Zenenga uses the Zimbabwean Censorship and Entertainment Control Act of 1967 as his departure point and compartmentalizes censorship of theater arts into three eras: 1) Zimbabwe's liberation struggle from the late 1960s through the 1970s, 2) the newly won independence of 1980s, with hope of economic and social progress giving way to frustration, and 3) the contemporary clash of President Mugabe's strong response against theater's critique of broken government promises. Even though the Censorship Board demands scripts be registered, Zimbabwean theater artists have found creative ways around censorship throughout these three eras, implementing underground performances and “hit and run” political guerilla theater. Zenenga disturbingly uncovers that, while official government censorship may be decreasing, partly to evade international scrutiny, shadowy interrogation, harassment, and even physical assault of artists are becoming more common.
The REwind Cantata
Authors: Cole Catherine M.
Published: October 2008

In this excerpt from her forthcoming study Stages of Transition: Performing South Africa's Truth Commission, Cole examines the creation and reception of REwind: A Cantata, a musical performance incorporating recorded testimony from South Africa's Truth and Reconciliation Commission, along with the performativity of that ongoing process itself.
Homo Profanus: Giorgio Agamben's Profane Philosophy
Authors: de la Durantaye Leland
Published: October 2008

Giorgio Agamben's work first achieved international recognition—and notoriety—through his study of the sacred in Homo Sacer. This recognition and notoriety grew with the subsequent installments in this still ongoing series, Remnants of Auschwitz (Homo Sacer III), State of Exception (Homo Sacer II.1), and The Kingdom and the Glory (Homo Sacer II.2). Agamben's recent work, Profanations, is, however, not a part of that series. As its title indicates, it turns from the sacred to the profane, and in so doing reveals the most profound intentions of Agamben's philosophy. Agamben's naming the profane rather than the sacred in the title of this work does not, however, represent a turn to a new topic. Beginning with his first books in the 1970s, he has shown himself deeply interested in the idea of the profane, in significant part through terms and concepts employed by Walter Benjamin such as “profane illumination” and “the order of the profane.” In his Homo Sacer project, this idea of the profane has followed Agamben's studies of the sacred like a shadow. With this new work, however, it has moved to the center of his reflections and in doing offers his reader a glimpse of hitherto unseen elements in his personal trajectory, his philosophical vocation, and his political project. The works in the Homo Sacer series have compellingly and persuasively argued that the creating of sacred and sovereign states of exception has often been responsible for the dire states of political affairs we find ourselves in. Profanations seeks to offer a solution.