bluuebunny/crossref_metadata_2025 huggingface dataset:
A Profile of HIV-Risk Behaviours Among Travellers
Authors: Melbye Mads , Biggar Robert J.
Published: February 2016

The population of Greenland has behavioural characteristics that indicate a high risk of HIV spread once HIV is introduced into the population. Much depends, however, on the degree of exposure from visitors, particularly in an initial phase. We used a national questionnaire survey of 4 680 randomly selected Danes between 18–59 years to study HIV risk behaviours among Danes with (+travellers) and without (-travellers) travel experience to Greenland. Median number of lifetime sexual partners was more than twice as high among male +travellers (median = 12 partners) compared to -travellers (median = 5; p < 0.0001) and also slightly higher among women ( p = 0.03). Furthermore, a significantly higher percentage of male +travellers than -travellers reported prostitute contact (OR = 2.3 (95% CI: 1.4–3.9)), with a peak of 32.0% among men aged 40–49 years. A history of a sexually transmitted disease was three times (95% CI: 2.0–4.5) as common among +travellers as in -travellers. +Travellers were also significantly more likely to have visited other places outside Europe and Greenland, including HIV endemic areas (OR = 2.9 (2.0–4.1)). Overall, sexual contact with someone considered at high risk of HIV infection (a homo/bisexual man, intravenous drug user, prostitute, or previous or present resident of Sub-Saharan Africa) was reported by 33.5% of male +travellers compared to 15.6% of -travellers and among women by 9.7% and 5.0%, respectively. In conclusion, travellers tend to have more sexual partners and more sexual interaction with high HIV-risk group members than non-travellers. A national intervention programme to prevent HIV spread in Greenland should not only consider campaigns to educate safe sex procedures among the Inuits but also establish an intervention programme for visitors to the island.
Cigarette Smoking and Drinking of Alcohol are not Associated with Rapid Progression to Acquired Immunodeficiency Syndrome among Homosexual Men in Norway
Authors: Eskild Anne , Petersen Georg
Published: February 2016

In order to study the influence of cigarette smoking and drinking of alcohol on the progression to acquired immunodeficiency syndrome (AIDS), eighty HIV infected homosexual men were included in a prospective study from the date of diagnosed HIV seropositivity. Two men were lost to follow-up. The mean follow-up time was 62 months.

By the end of the follow-up period 26 out of 78 subjects (33%) were diagnosed with AIDS. When controlling for age, year of HIV diagnosis, number of male lifetime partners and frequency of receptive anal intercourse, the adjusted relative risk of being diagnosed with AIDS for the group smoking 1–20 cigarettes daily was 0.4 (0.2–1.2, 95% confidence interval) and 1.1 (0.4–2.7, 95% confidence interval) for the group smoking more than 20 cigarettes daily, as opposed to the non-smoking group. The adjusted relative risk of progression to AIDS for daily alcohol drinkers as opposed to less frequent drinkers was 0.8 (0.3–2.2, 95% confidence interval). The adjusted relative risks of receptive anal intercourse often or usually and more than 500 lifetime male partners were 2.2 and 2.0, respectively. These estimates, however, were not significantly above 1.0.

The lack of positive association between cigarette smoking, drinking of alcohol and progression to AIDS found in this study as well as in other studies, may have implication for the understanding of the pathogenesis of the HIV disease and for counselling HIV infected subjects.
Case Report on a Sick Building: Analysis and Interpretation in the Context of Its Disease History
Authors: Thörn Åke
Published: February 2016

The sick building syndrome is a widespread, modern health problem with a probably very multifactorial causation. Studies of the syndrome have shown associations between its occurrence and a wide variety of factors related to the buildings, work environments and the individual occupants. The associations are often inconsistent and contradictory. The presented case report indicates that this might depend on the subjective nature of most of the symptoms of the syndrome, which makes it difficult to study and interpret. The case consists of a municipal office building where the personnel experienced two very protracted episodes of sick building syndrome. The study of it suggests that psychogenic mechanisms sometimes might be a stronger partial causative factor in the etiology of the sick building syndrome than is generally considered, and that quantitative information should be supplemented by qualitative in the study of sick buildings.
Issue-oriented hackathons as material participation
Authors: Lodato Thomas James , DiSalvo Carl
Published: February 2016

In recent years, intensive design and development events known as hackathons have become increasingly common. Issue-oriented hackathons are a subset of this trend that bring together ad hoc groups under the auspices of conceiving and prototyping technologies to address social conditions and concerns. In this article, we present ethnographic accounts of a set of issue-oriented hackathons that took place in the United States between 2012 and 2013, in order to explore how these events structure and express emerging forms of participation. Specifically, we propose that issue-oriented hackathons are sites of experimental material participation.
Feminist participatory methodologies in geography: creating spaces of inclusion
Authors: Caretta Martina Angela , Riaño Yvonne
Published: February 2016

This introduction prefaces a special issue on the topic of feminist participatory methodologies in geography. Drawing upon the experiences of the contributors in developing new tools and methods to facilitate interaction with participants and working with groups that tend to be forgotten, subordinated and/or alienated, we argue for the methodological significance of instating a feminist perspective to participatory research. Although much theoretical debate has taken place among feminist and post-colonial scholars on unequal research relationships between ‘researchers’ and ‘research subjects’, the literature on how to operationalize greater equality remains quite limited. We attempt to fill this research gap by bringing together scholars working in both the Northern and Southern hemispheres in order to illuminate the multifaceted ways in which these methods can be used not only to debunk hierarchical research relationships, but also to produce new scientific insights with greater validity.
A simulation model for ship response in flooding scenario
Authors: Acanfora Maria , Cirillo Antonio
Published: February 2016

Recent ship damages underline the importance of an accurate intact and damage stability analysis. The stability of ships is presently determined by applying quasi-static methods, neglecting dynamic effects; for flooding scenarios, flow calculations are not carried out either. In general, for damage cases, water dynamics inside the compartment affect ship motions. It has been observed that some kind of vessels could experience large roll motions due to the sudden water ingress after damage. In this article, a non-linear tool for damage stability evaluation is presented, including water dynamics in a flooded compartment. In particular the transient stage of flooding is investigated. The flooded water has been treated using the lumped mass approach. A new method has been developed and applied in this article in order to model the water motions: the freesurface is assumed to be no more horizontal but dependent on ship and flooded water accelerations. The developed method is intended to be an intermediate approach between the quasi-static method (uncoupled) and fully coupled method. In coupling the flooded water motions with ship motions, no more unknowns are introduced: only ship lateral acceleration is used to determine the freesurface inclination of the flooded water. A valuation is carried out, comparing the numerical result from the simulations with the experimental studies on a barge model. Additional applications are carried out on the free roll motion of the TNK tanker model.
Divide and conquer, or the disintegration of strategic management: It’s time to celebrate
Authors: Arend Richard J.
Published: February 2016

Every so often it is useful for a field of study to take the time to self-reflect and consider its existence from a high level in order to re-evaluate and possibly re-direct its resource allocations moving forward (where such reflection has become a wonderful and valuable standard in Strategic Organization!). In this essay, we counter Hambrick’s call to consolidate with a radical suggestion to separate the field of strategic organization into at least two camps. We offer a sound logic for that split and detail its hypothetical positive implications for the field in terms of the possibilities for improved research resource allocation and improved practical impact.
The Uses of ‘New Exodus’ in New Testament Scholarship: Preparing a Way through the Wilderness
Authors: Smith Daniel Lynwood
Published: February 2016

Nineteenth-century Isaiah scholarship appears to be responsible for popularizing the term ‘new exodus’, a phrase that underscores how Isaiah’s prophecies of a return from exile link this new saving act of God with the Israelite exodus from Egypt. In the twentieth century, New Testament scholars adopted the term, and in recent years, ‘new exodus’ has been applied to a wide array of biblical and extra-biblical texts. The burgeoning popularity of the phrase ‘new exodus’ has not been matched with equal interest in reflecting on its diverse applications to a variety of ancient texts. This free-wheeling usage has diluted the value of the phrase, and a descriptive term runs the risk of becoming a simple buzzword.
The Seventh-Century Prophets in Twenty-first Century Research
Authors: Jones Barry A.
Published: February 2016

This article surveys major issues addressed in scholarship on Nahum, Habakkuk, and Zephaniah since 2000. Researchers have continued attempts to locate these books more precisely within the historical context of the late seventh century bce. Efforts to trace the literary growth of the books have increased following a decrease in diachronic approaches in the 1990s. Redactional analyses have sought new methodological strategies to supplement the limited historical evidence available for tracking literary growth. Several redactional studies overlap with efforts to describe the editorial history of the Book of the Twelve, although resistance to reading the prophets in this context has also emerged in recent studies. Studies employing literary theory and ideological criticism have sought to balance historically oriented interpretation with attention to more existential concerns. A growing pluralism of methods, aims, and results characterizes the study of the seventh-century prophets in the early twenty-first century.
Unruly Pluralism and Inclusive Tolerance: The Normative Contribution of Jamesian Pragmatism to Non-ideal Theory
Authors: Koopman Colin
Published: February 2016

Much attention is focussed on recent debates in contemporary political philosophy concerning the relative merits of ideal theory and non-ideal theory. In one of their many forms, these debates take shape as a realist challenge to idealistic or utopian approaches to normative political theory. This article shows that the philosophical tradition of pragmatism both instructively anticipates and also, more importantly, can today contribute to contemporary realism. It is shown how a political pragmatism, particularly one centred in William James’ work, helps frame two key contributions that would be resources for the realist challenge to ideal theory. First is an orientation towards unruly pluralism as a feasibility condition that should constrain political theorising. Second is a procedural norm of inclusive tolerance that can help enact the motion of a liberal political vision under the constraints of unruly pluralism.
Changing Minds: Pragmatism and Feminism
Authors: Gascoigne Neil
Published: February 2016

Since the 1990s Sally Haslanger has argued that part of the work of philosophers is not to describe a concept like women but to change it in order to help bring about a fairer society. Since, she argues, the definitions of such concepts should be formulated in accordance with an epistemological framework that foregrounds their normative role, the work of feminists is crucial in identifying the legitimate values that such concepts ought to serve and thus what their meanings should be. This article evaluates Haslanger’s proposal that our values are best served by reducing the concept woman to a ‘person subordinated on the grounds of her sex’ by contrasting it with an alternative that draws on Richard Rorty’s early work on the mind–body problem. According to this, the concept women should be subject not to reduction but to elimination, the consequence being that there never were any women.
Pragmatism and the Naturalist Project in Ethics and Politics: Lessons from Peirce, Lewis and Ramsey
Authors: Misak Cheryl
Published: February 2016

It is argued here that the pragmatism of C.S. Peirce, C.I. Lewis and Frank Ramsey can deliver a cognitivist, naturalist account of ethical and political inquiry. The ensuing position escapes relativism and delivers a conception of ethical and political beliefs on which they are evaluable.
Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System
Authors: Fan Qiyong , Yeung Anamaria R. , Amdur Robert , Helmig Richard , Park Justin , Li Jonathan , Kahler Darren , Liu Chihray , Lu Bo
Published: February 2016

Purpose:

The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively.

Methods:

The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system.

Results:

In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are <3 mm and <1.5°, respectively, in all directions.

Conclusions:

The rectal balloon provides significant dose reduction to the rectum and it may potentially minimize patient discomfort. The immobilization system permits almost no movement of the applicator during treatment. This work has the potential to be promoted as a standardized solution for high-dose rate treatment of cervical cancer.
Field Evaluations of Tracking/Locating Technologies for Prevention of Missing Incidents
Authors: Bulat Tatjana , Kerrigan Michael V. , Rowe Meredeth , Kearns William , Craighead Jeffrey D. , Ramaiah Padmaja
Published: February 2016

Background:

Persons with dementia are at risk of a missing incident, which is defined as an instance in which a demented person’s whereabouts are unknown to the caregiver and the individual is not in an expected location. Since it is critical to determine the missing person’s location as quickly as possible, we evaluated whether commercially available tracking technologies can assist in a rapid recovery.

Methods:

This study examined 7 commercially available tracking devices: 3 radio frequency (RF) based and 4 global positioning system (GPS) based, employing realistic tracking scenarios. Outcome measures were time to discovery and degree of deviation from a straight intercept course.

Results/Conclusion:

Across all scenarios tested, GPS devices were found to be approximately twice as efficient as the RF devices in locating a “missing person.” While the RF devices showed reasonable performance at close proximity, the GPS devices were found to be more appropriate overall for tracking/locating missing persons over unknown and larger distances.
The Effects of Physiological and Methodological Determinants on 18F-FDG Mouse Brain Imaging Exemplified in a Double Transgenic Alzheimer Model
Authors: Deleye Steven , Waldron Ann-Marie , Richardson Jill C. , Schmidt Mark , Langlois Xavier , Stroobants Sigrid , Staelens Steven
Published: February 2016

Introduction:

In this study, the influence of physiological determinants on 18F-fluoro-d-glucose (18F-FDG) brain uptake was evaluated in a mouse model of Alzheimer disease.

Materials and Methods:

TASTPM (Tg) and age-matched C57BL/6 J (WT) mice were fasted for 10 hours, while another group was fasted for 20 hours to evaluate the effect of fasting duration. The effect of repeatedly scanning was evaluated by scanning Tg and WT mice at days 1, 4, and 7. Brain 18F-FDG uptake was evaluated in the thalamus being the most indicative region. Finally, the cerebellum was tested as a reference region for the relative standard uptake value (rSUV).

Results:

When correcting the brain uptake for glucose, the effect of different fasting durations was attenuated and the anticipated hypometabolism in Tg mice was demonstrated. Also, with repeated scanning, the brain uptake values within a group and the hypometabolism of the Tg mice only remained stable over time when glucose correction was applied. Finally, hypometabolism was also observed in the cerebellum, yielding artificially higher rSUV values for Tg mice.

Conclusion:

Corrections for blood glucose levels have to be applied when semiquantifying 18F-FDG brain uptake in mouse models for AD. Potential reference regions for normalization should be thoroughly investigated to ensure that they are not pathologically affected also by afferent connections.
A cluster randomized controlled trial comparing relative effectiveness of two licensed influenza vaccines in US nursing homes: Design and rationale
Authors: Gravenstein Stefan , Dahal Roshani , Gozalo Pedro L , Davidson H Edward , Han Lisa F , Taljaard Monica , Mor Vincent
Published: February 2016

Background:

Influenza, the most important viral infection affecting older adults, produces a substantial burden in health care costs, morbidity, and mortality. Influenza vaccination remains the mainstay in prevention and is associated with reduced rates of hospitalization, stroke, heart attack, and death in non-institutional older adult populations. Influenza vaccination produces considerably lower antibody response in the elderly compared to young adults. Four-fold higher vaccine antigen (high-dose) than in the standard adult vaccine (standard-dose) elicits higher serum antibody levels and antibody response in ambulatory elderly.

Purpose:

To describe the design considerations of a large clinical trial of high-dose compared to standard-dose influenza vaccine in nursing homes and baseline characteristics of participating nursing homes and long-stay (more than 90 days) residents over 65 years of age.

Methods:

The high-dose influenza vaccine intervention trial is multifacility, cluster randomized controlled trial with a 2×2 factorial design that compares hospitalization rates, mortality, and functional decline among long-stay nursing home residents in facilities randomized to receive high-dose versus standard-dose influenza vaccine and also randomized with or without free staff vaccines provided by study organizers. Enrollment focused on nursing homes with a large long-stay resident population over 65 years of age. The primary outcome is the resident-level incidence of hospitalization with a primary diagnosis of pulmonary and influenza-like illness, based upon Medicare inpatient hospitalization claims. Secondary outcomes are all-cause mortality based upon the vital status indicator in the Medicare Vital Status file, all-cause hospitalization directly from the nursing home Minimum Data Set discharge records, and the probability of declining at least 4 points on the 28-point Activities of Daily Living Scale.

Results:

Between February and September 2013, the high-dose influenza vaccine trial recruited and randomized 823 nursing homes. The analysis sample includes 53,035 long-stay nursing home residents over 65 years of age, representing 57.7% of the participating facilities’ population. Residents are mainly women (72.2%), white (75.5%), with a mean age of 83 years. Common conditions include hypertension (79.2%), depression (55.1%), and diabetes mellitus (34.4%). The prevalence of circulatory and pulmonary disorders includes heart failure (20.5%), stroke (20.1%), and asthma/chronic obstructive pulmonary disease (20.2%).

Conclusions:

This high-dose influenza vaccine trial uniquely offers a paradigm for future studies of clinical and programmatic interventions within the framework of efforts designed to test the impact of changes in usual treatment practices adopted by health care systems.

Trial registration:

NCT01815268
“Ah … the power of mothers”: Bereaved mothers as victim-heroes in media enacted crusades for justice
Authors: Wright Sarah
Published: February 2016

The display of maternal suffering is powerful, as the bereaved mother’s experience represents any parent’s deepest fear. When her pain is enmeshed with calls to support changes in our justice systems, it has the potential to bring about unconstitutional effects, for a mother’s love has no end and so her life sentence can only be addressed with equal amounts of endless suffering for the said offender (Valier and Lippens, 2004). This paper explores the construction of the bereaved mother figure as a victim-hero within contemporary media enacted crime narratives. It examines two murder cases in the New Zealand context where a bereaved mother’s displays of grief can be linked to changes made to the legal code. It will be argued that the character of the bereaved mother as a victim-hero has become a powerful agent of change that has implications for criminal justice system modification. It is argued that critical attention is required of criminology to the role of the good mother in criminal justice discourses, and in particular to the ways in which the good mother is characterised in mediated public discourses.
A Postcolonial Perspective: Law and the Literary World
Authors: Lagji Amanda Ruth Waugh
Published: February 2016

This commentary shows the advantages of a postcolonial approach to law and literature, using Nuruddin Farah’s novel Maps as a suggestive case study to examine Somalia’s laws and literature and the colonial context embedded in both. Whereas Western and European juridical systems are often silent referents in law and literature scholarship, my reading of Maps also places it in dialogue with Somali customary laws and culture. I conclude my commentary by bringing together the history of Somali customary law and my reading of Maps to offer methodological suggestions for law and literature given this particular postcolonial perspective.
Managing inclusion in competitive school systems: The cases of Sweden and England
Authors: Alexiadou Nafsika , Dovemark Marianne , Erixon-Arreman Inger , Holm Ann-Sofie , Lundahl Lisbeth , Lundström Ulf
Published: February 2016

The last 40 years have seen great political attention paid to issues of inclusion in education, both from international organisations and also individual nations. This flexible concept has been adopted enthusiastically in education reforms concerned with increased standardisation of teaching and learning, decentralisation of education management, reduced teacher autonomy and marketisation of school systems. This paper draws from a research project that explores inclusion as part of the education transformations in England and Sweden. These two countries have been very different in their state governance and welfare regimes, but have been following similar directions of reform in their education systems. The paper evaluates the changing policy assumptions and values in relation to inclusion in the schooling changes of the last few decades, through an analysis of policy contexts and processes, and a presentation of selected empirical material from research in the two countries. We argue that, despite the similar dominant discourses of competition and marketisation, the two education systems draw on significantly different paradigms of operationalising inclusion, with distinct outcomes regarding equality.
Applying principles from the game theory to acute stroke care: Learning from the prisoner’s dilemma, stag-hunt, and other strategies
Authors: Saposnik Gustavo , Johnston S Claiborne
Published: February 2016

Background

Acute stroke care represents a challenge for decision makers. Decisions based on erroneous assessments may generate false expectations of patients and their family members, and potentially inappropriate medical advice. Game theory is the analysis of interactions between individuals to study how conflict and cooperation affect our decisions.

Aims

We reviewed principles of game theory that could be applied to medical decisions under uncertainty.

Medical decisions in acute stroke care are usually made under constrains: short period of time, with imperfect clinical information, limit understanding about patients and families’ values and beliefs. Game theory brings some strategies to help us manage complex medical situations under uncertainty. For example, it offers a different perspective by encouraging the consideration of different alternatives through the understanding of patients’ preferences and the careful evaluation of cognitive distortions when applying ‘real-world’ data. The stag-hunt game teaches us the importance of trust to strength cooperation for a successful patient–physician interaction that is beyond a good or poor clinical outcome.

Conclusions

The application of game theory to stroke care may improve our understanding of complex medical situations and help clinicians make practical decisions under uncertainty.
Edaravone, a potent free radical scavenger and a calcium channel blocker attenuate isoproterenol induced myocardial infarction by suppressing oxidative stress, apoptotic signaling and ultrastructural damage
Authors: Hassan Md. Quamrul , Akhtar Md. Sayeed , Akhtar Mohd. , Ali Javed , Haque Syed Ehtaishamul , Najmi Abul Kalam
Published: February 2016

Objectives:

In the present study, we investigated whether combination therapy of low-dose benidipine with the potent free radical scavenger edaravone has a cardioprotective effect against isoproterenol (ISO)-induced myocardial infarction (MI) in Wistar rats.

Methods:

Rats were pretreated with concurrent doses of benidipine and edaravone (1 μg/kg/day + 1 mg/kg/day and 3 μg/kg/day + 3 mg/kg/day) by intravenous (i.v.) and intraperitoneal (i.p.) routes respectively for 28 days, followed by MI induction using ISO (85 mg/kg) by subcutaneous route for two days at 24 h intervals. After the treatment period, blood was withdrawn and the heart was preserved for biochemical estimations.

Results:

The activities of the cardiac biomarkers (lactate dehydrogenase and creatine kinase-MB), and the level of malondialdehyde (MDA) significantly increased, while antioxidant markers (reduced glutathione, catalase, superoxidase dismutase, glutathione peroxidase, glutathione reductase) were significantly decreased in the ISO intoxicated group compared with the control group. Moreover, the level of C-reactive protein (CRP) and Caspase-3 activity significantly increased in ISO-intoxicated group. An ultrastructure study was also carried out. Pretreatment with a combination of benidipine and edaravone significantly attenuated the activities of the cardiac biomarkers and the level of MDA, and significantly increased the antioxidant markers compared with the ISO-intoxicated group. Furthermore, pretreatment with the combination of benidipine and edaravone significantly decreased the level of CRP and Caspase-3 activity as compared to the ISO-treated group. The ultrastructure study of myocardium revealed that pretreated groups preserved the mitochondrial shape, the membrane and its internal structures.

Conclusion:

Taken together these results suggest that the combination of benidipine and edaravone showed significant protective effect in ISO-induced MI.
Breast cancer and other breast lumps
Authors: Ferguson Douglas James
Published: February 2016

Each year, breast lumps are the feature of concern for many thousands of patients presenting to primary care. Due to the major publicity regarding breast cancer, many patients present promptly, concerned that the lump is cancerous. However, a few women present late, resulting in delayed diagnosis of cancer and poorer outcomes. It can be difficult to evaluate symptoms and clinical findings to distinguish between potentially malignant and benign conditions, however, by using the information in this article GPs should be able to improve their ability to manage patients locally and judge when a referral to secondary care is required.
Psychosexual medicine: Why me?
Authors: Stainer-Smith Andrew Martin , Shiner Alice
Published: February 2016

This article describes how a particular approach to sexual difficulties allows a useful therapeutic relationship with patients to be developed. Combined with an understanding of the dynamics encountered in the genital examination, it is possible for any interested GP to engage in psychosexual work. The Institute of Psychosexual Medicine has been training GPs and other doctors for over 40 years.
Heavy menstrual bleeding
Authors: Clark T Justin
Published: February 2016

Heavy menstrual bleeding (HMB) is one of the most common reasons for primary care consultations by women of reproductive age. The condition is associated with a reduction in health-related quality of life and substantial utilisation of health service resources. There are several underlying causes of HMB, which are generally benign in nature and can exist in isolation or in combination. The majority of women presenting with HMB can be managed in primary care, either expectantly or using effective medical treatments. Referral to secondary care should be restricted to refractory cases, where surgical or radiological interventions may be indicated and where pre-malignant or malignant uterine disease is suspected. This article will explore the nature of HMB, the terminology that should be used to describe menstrual disorders and the aetiology of HMB. Diagnostic work-up and clinical management, encompassing treatment in primary care and indications for referral to secondary care based on national clinical guidance, will also be discussed.
EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence
Authors: Onda Saori , Ogura Takeshi , Kurisu Yoshitaka , Masuda Daisuke , Sano Tatsushi , Takagi Wataru , Fukunishi Shinya , Higuchi Kazuhide
Published: February 2016

Background:

Few reports have described endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for biliary lesions. In addition, adverse events were not completely examined in previous reports, due to the inclusion of cases in which biliary stents had already been placed. The present study aimed to investigate the diagnostic yield and adverse events of EUS-FNA for biliary lesions as the first-line diagnostic modality for consecutive prospectively registered patients.

Methods:

Inclusion criteria were as follows: (1) patients with suspected cholangiocarcinoma (CCA) based on computed tomography or other imaging modalities; (2) patients who had not previously undergone endoscopic retrograde cholangiopancreatography or EUS-FNA; (3) absence of surgically altered anatomy, such as Roux-en-Y anastomosis or duodenal obstruction caused by tumor invasion, through which an endoscope could not pass; and (4) provision of written informed consent to all procedures associated with the study.

Results:

A total of 47 consecutive patients with suspected CCA were registered to this study. Sensitivity and accuracy were 89% and 87%, respectively. On multivariate analysis, puncture site was the only factor associated with reduced diagnostic yield (hazard ration, 6.879; 95% confidence interval, 1.172–40.374; P = 0.033). Remarkably, no adverse events such as bleeding or bile leakage were associated with EUS-FNA in any of the 47 patients.

Conclusions:

Our results suggest that EUS-FNA can be safely performed for biliary disease without biliary stenting. Furthermore, this procedure may warrant use as the first-line diagnostic method, although our results need to be validated in future prospective studies.
Best practice in the prevention and management of paediatric respiratory syncytial virus infection
Authors: Drysdale Simon B. , Green Christopher A. , Sande Charles J.
Published: February 2016

Respiratory syncytial virus (RSV) infection is ubiquitous with almost all infants having been infected by 2 years of age and lifelong repeated infections common. It is the second largest cause of mortality, after malaria, in infants outside the neonatal period and causes up to 200,000 deaths per year worldwide. RSV results in clinical syndromes that include upper respiratory tract infections, otitis media, bronchiolitis (up to 80% of cases) and lower respiratory tract disease including pneumonia and exacerbations of asthma or viral-induced wheeze. For the purposes of this review we will focus on RSV bronchiolitis in infants in whom the greatest disease burden lies. For infants requiring hospital admission, the identification of the causative respiratory virus is used to direct cohorting or isolation and infection control procedures to minimize nosocomial transmission. Nosocomial RSV infections are associated with poorer clinical outcomes, including increased mortality, the need for mechanical ventilation and longer length of hospital stay. Numerous clinical guidelines for the management of infants with bronchiolitis have been published, although none are specific for RSV bronchiolitis. Ribavirin is the only licensed drug for the specific treatment of RSV infection but due to drug toxicity and minimal clinical benefit it has not been recommended for routine clinical use. There is currently no licensed vaccine to prevent RSV infection but passive immunoprophylaxis using a monoclonal antibody, palivizumab, reduces the risk of hospitalization due to RSV infection by 39–78% in various high-risk infants predisposed to developing severe RSV disease. The current management of RSV bronchiolitis is purely supportive, with feeding support and oxygen supplementation until the infant immune system mounts a response capable of controlling the disease. The development of a successful treatment or prophylactic agent has the potential to revolutionize the care and outcome for severe RSV infections in the world’s most vulnerable infants.
Trends in Literature About Emerging Adulthood
Authors: Swanson Joan Ann
Published: February 2016

The body of knowledge related to emerging adulthood has grown in the past decade. This study surveyed published empirical research studies on emerging adulthood, from 2000 to April 2015, using Academic Search Complete and PsycINFO databases and references from The Society for the Study of Emerging Adulthood website resources. These studies ( N = 1,334) consisted of peer-reviewed journal articles reporting on empirical research. This study adds to the current knowledge base for the field of emerging adulthood by providing a critical examination of the main topics, the methods, current research trends, and the most prolific authors and publishing outlets in the field. Implications from these results support emerging adulthood as a global and cross-cultural developmental period and field of study. Additionally, results reveal current research trends and expose the need for significant future research to further expand the emerging adulthood knowledge base.
Testing a Hierarchical Model of Neuroticism and Its Cognitive Facets
Authors: Zinbarg Richard E. , Mineka Susan , Bobova Lyuba , Craske Michelle G. , Vrshek-Schallhorn Suzanne , Griffith James W. , Wolitzky-Taylor Kate , Waters Allison M. , Sumner Jennifer A. , Anand Deepika
Published: February 2016

Neuroticism and several other traits have been proposed to confer vulnerability for unipolar mood disorders (UMDs) and anxiety disorders (ADs). However, it is unclear whether the associations of these vulnerabilities with these disorders are attributable to a latent variable common to all vulnerabilities, more narrow latent variables, or both. In addition, some researchers have suggested that neuroticism predicts UMDs, ADs, and substance use disorders (SUDs) with comparable strength, whereas other researchers have hypothesized that neuroticism is more strongly related to UMDs and ADs. We tested hypotheses about the factor structure of several vulnerabilities and the prospective associations of these latent variables with initial onsets of UMDs, ADs, and SUDs during a 3-year period in 547 participants recruited as high school juniors. Although a general neuroticism factor predicted SUDs, it predicted UMDs and ADs more strongly and especially predicted comorbid UMDs and ADs. There was also mixed support for specific associations involving more narrow latent vulnerabilities.
Dynamic Range Across Music Genres and the Perception of Dynamic Compression in Hearing-Impaired Listeners
Authors: Kirchberger Martin , Russo Frank A.
Published: February 2016

Dynamic range compression serves different purposes in the music and hearing-aid industries. In the music industry, it is used to make music louder and more attractive to normal-hearing listeners. In the hearing-aid industry, it is used to map the variable dynamic range of acoustic signals to the reduced dynamic range of hearing-impaired listeners. Hence, hearing-aided listeners will typically receive a dual dose of compression when listening to recorded music. The present study involved an acoustic analysis of dynamic range across a cross section of recorded music as well as a perceptual study comparing the efficacy of different compression schemes. The acoustic analysis revealed that the dynamic range of samples from popular genres, such as rock or rap, was generally smaller than the dynamic range of samples from classical genres, such as opera and orchestra. By comparison, the dynamic range of speech, based on recordings of monologues in quiet, was larger than the dynamic range of all music genres tested. The perceptual study compared the effect of the prescription rule NAL-NL2 with a semicompressive and a linear scheme. Music subjected to linear processing had the highest ratings for dynamics and quality, followed by the semicompressive and the NAL-NL2 setting. These findings advise against NAL-NL2 as a prescription rule for recorded music and recommend linear settings.
Evaluating Distributional Differences in Income Inequality
Authors: Liao Tim Futing
Published: February 2016

Income and wage inequality between gender and other social groups is commonly evaluated by the difference in average income or the decomposition of the total amount of inequality into between-group and within-group components using an inequality measure such as the Theil index. Either approach ignores the dispersional difference between social groups, often manifested in glass-ceiling and glass-floor effects. The author introduces a refined Theil decomposition that offers two ways of capturing such between-group distributional differences. An analysis of income data from 10 European countries illustrates the usefulness of the proposed evaluation and decomposition methods.
Why Do Young, Unmarried Women Who Do Not Want to Get Pregnant Contracept Inconsistently? Mixed-method Evidence for the Role of Efficacy
Authors: England Paula , Caudillo Mónica L. , Littlejohn Krystale , Bass Brooke Conroy , Reed Joanna
Published: February 2016

Many sexually active single women do not want to get pregnant but use contraception inconsistently. To explore why, the authors conducted in-depth interviews with 99 unmarried women in their 20s, asking about contraception with each of their sexual partners. The authors present quantitative and qualitative evidence that contraceptive inconsistency sometimes results from having too little efficacy, a concept that includes the subconcepts of planfulness, self-regulation, assertiveness, and believing that one can affect one’s goals. The authors discuss how sociologists should think about personal characteristics such as low efficacy that may stem from disadvantaged origins and affect desired outcomes.
Inhibition of Pim1 kinase, new therapeutic approach in virus-induced asthma exacerbations
Authors: Vries Maaike de , Bedke Nicole , Smithers Natalie P. , Loxham Matthew , Howarth Peter H. , Nawijn Martijn C. , Davies Donna E.
Published: February 2016

Therapeutic options to treat virus-induced asthma exacerbations are limited and urgently needed. Therefore, we tested Pim1 kinase as potential therapeutic target in human rhinovirus (HRV) infections. We hypothesised that inhibition of Pim1 kinase reduces HRV replication by augmenting the interferon-induced anti-viral response due to increased activity of the janus kinase–signal transducer and activator of transcription (JAK-STAT) pathway.

Air–liquid interface (ALI) cultures of primary bronchial epithelial cells (PBECs) from healthy individuals and moderate-to-severe asthmatic volunteers were infected with HRV-16 with or without a specific Pim1 inhibitor; viral replication and induction of anti-viral responses were measured using RT-qPCR. Viral titres were measured by 50% tissue culture infective dose and release of interferon-γ-induced protein 10 (IP-10) and RANTES protein assessed by ELISA. Phosphorylation of STAT-1 was determined using western blotting.

Viral replication was reduced in ALI cultures of healthy and asthmatic PBECs treated with the Pim1 inhibitor. Using cultures from healthy donors, enhanced STAT-1 phosphorylation upon inhibition of Pim1 kinase activity resulted in increased mRNA expression of interferon-β, interleukin-29, IP-10 and RANTES 12 h after infection and increased protein levels of IP-10 and RANTES 24 h after infection.

We have identified Pim1 kinase as novel target to reduce viral replication in ALI cultures of PBECs. This may open new avenues for therapeutic interventions in virus-induced asthma exacerbations.
Activin-A is overexpressed in severe asthma and is implicated in angiogenic processes
Authors: Samitas Konstantinos , Poulos Nikolaos , Semitekolou Maria , Morianos Ioannis , Tousa Sofia , Economidou Erasmia , Robinson Douglas S. , Kariyawasam Harsha H. , Zervas Eleftherios , Corrigan Christopher J. , Ying Sun , Xanthou Georgina , Gaga Mina
Published: February 2016

Activin-A is a pleiotropic cytokine that regulates allergic inflammation. Its role in the regulation of angiogenesis, a key feature of airways remodelling in asthma, remains unexplored. Our objective was to investigate the expression of activin-A in asthma and its effects on angiogenesisin vitro.

Expression of soluble/immunoreactive activin-A and its receptors was measured in serum, bronchoalveolar lavage fluid (BALF) and endobronchial biopsies from 16 healthy controls, 19 patients with mild/moderate asthma and 22 severely asthmatic patients.In vitroeffects of activin-A on baseline and vascular endothelial growth factor (VEGF)-induced human endothelial cell angiogenesis, signalling and cytokine release were compared with BALF concentrations of these cytokinesin vivo.

Activin-A expression was significantly elevated in serum, BALF and bronchial tissue of the asthmatics, while expression of its protein receptors was reduced.In vitro, activin-A suppressed VEGF-induced endothelial cell proliferation and angiogenesis, inducing autocrine production of anti-angiogenic soluble VEGF receptor (R)1 and interleukin (IL)-18, while reducing production of pro-angiogenic VEGFR2 and IL-17. In parallel, BALF concentrations of soluble VEGFR1 and IL-18 were significantly reduced in severe asthmaticsin vivoand inversely correlated with angiogenesis.

Activin-A is overexpressed and has anti-angiogenic effectsin vitrothat are not propagatedin vivo, where reduced basal expression of its receptors is observed particularly in severe asthma.
Recombinant human pentraxin-2 therapy in patients with idiopathic pulmonary fibrosis: safety, pharmacokinetics and exploratory efficacy
Authors: van den Blink Bernt , Dillingh Marlous R. , Ginns Leo C. , Morrison Lake D. , Moerland Matthijs , Wijsenbeek Marlies , Trehu Elizabeth G. , Bartholmai Brian J. , Burggraaf Jacobus
Published: February 2016

Abnormal fibrogenic repair response upon alveolar injury is believed to play an important role in the pathogenesis of idiopathic pulmonary fibrosis (IPF). PRM-151 (recombinant human pentraxin-2, also known as serum amyloid P), has been shown to reduce fibrosis in preclinical lung fibrosis models, and was well tolerated with a favourable pharmacokinetic profile in an earlier single-dose phase I study.

A randomised, double-blind, placebo-controlled, multiple ascending dose trial was performed to assess the tolerability and pharmacokinetic and pharmacodynamic characteristics of multiple doses of PRM-151 in IPF patients. Subjects in three successive cohorts (1, 5, or 10 mg·kg−1versusplacebo) received intravenous study drug on days 1, 3, 5, 8 and 15, and were followed-up to day 57.

PRM-151 was well tolerated at all dose levels, with no serious adverse reactions. Administration of PRM-151 resulted in two- to eight-fold dose-dependent increases in circulating pentraxin-2 levels. Forced vital capacity and 6-min walk test showed trends towards improvement in the combined PRM-151 dose groups. On high-resolution computed tomography scans, stable or improved lung volume unoccupied by interstitial lung abnormality was noted in some PRM-151 subjects compared to placebo subjects on day 57.

The efficacy of PRM-151 in IPF remains to be investigated in dedicated future trials.