bluuebunny/crossref_metadata_2025 huggingface dataset:
Kazakhstan: modernizing government in the context of political inertia
Authors: Knox Colin
Published: September 2008

Kazakhstan declared its independence from the Soviet Union in 1991 and joined the Commonwealth of Independent States. Since then it has witnessed a remarkable economic transformation under the leadership of President Nursultan Nazarbayev. Pursuing a policy of `economy first and then politics', Kazakhstan is under growing pressure to engage in political reforms which include a modernization agenda to improve public service provision. Recent constitutional reforms have received a lukewarm reaction from the international community that Kazakhstan is keen to become part of. At the same time a progressive agenda of public services reform is well under way rooted in new public management and a desire to become much more customer focussed in their orientation. This article examines the parallel themes of political reforms and public services modernization in Kazakhstan.

Points for practitioners This article offers two key points for practitioners. First, it describes the detail of public sector reforms taking place in a developing country which secured its independence approximately 16 years ago, and the significant progress since then. Second, it poses questions about the political context in which administrative reform can take place. Has the existence of a highly centralized and autocratic form of presidential leadership resulted in a top-down imperative which has helped the pace of public services modernization in Kazakhstan?
The common good as an invisible hand: Machiavelli's legacy to public management
Authors: Rochet Claude
Published: September 2008

Public management has been dominated by the quest for efficiency and has left us with fundamental ethical questions that remain unresolved. It is argued that Machiavellian thought may provide us with concepts and tools applicable to ruling societies confronted with uncertainties and change that are (1) in line with the most recent insights into institutional evolution and (2) appropriate to solve complex decision-making problems. The common good — a central concept of Machiavelli's thought — appears to be an invisible hand that lowers the transaction costs and acts as the keystone of complex public affairs thinking. This analysis is illustrated by a comparative case study of the two management projects of infrastructure crossing the Alps, the AlpTransit in Switzerland, and the Lyon Torino Link. It concludes with a proposal to upgrade the research program in public management that allows effectiveness (legitimacy of the ends) and effectiveness in its implementation.

Points for practitioners The mainstream of public management theories and reform has been dominated by the quest of efficiency as a Holy Grail. I argue that theses reforms didn't deliver with their promises and left us with fundamental ethical questions unresolved: doing things right do not answer to the question of doing the right things. The main reason is a profound misunderstanding of the very nature of the ongoing change process that makes any kind one size fits all recipes inappropriate. Such a sea change occurred in the Renaissance era and Machiavelli bequeathed us a comprehensive understanding of how to rule a public body in a changing and uncertain world. I explain Machiavelli's misunderstood legacy and apply his teaching to analyzing two huge management projects of public infrastructures. I conclude on what has to be upgrade in the research programmes in public management to confront with the challenges of our era that call for a back to basics of classical political philosophy
Aortic valve replacement with patent bilateral internal thoracic artery grafts using cross-clamp fibrillation
Authors: Dimarakis I , Stefanou DC , Mulholland JW , Anderson JR
Published: September 2008

Aortic valve replacement in patients with patent coronary grafts poses many challenges. Intraoperative myocardial protection remains one of the key technical issues in these redo cases. We present a case of aortic valve replacement with patent bilateral internal thoracic artery grafts, using cross-clamp fibrillation.
Monumental Library Buildings in the Internet Era: the future of public libraries
Authors: Shoham Snunith , Yablonka Israela
Published: September 2008

This research examines the phenomena of building monumental library buildings, which began in the 1990s, parallel to the development of computer technology, digital storage, telecommunications, Internet and sophisticated search engines. The research included interviews with futurists, sociologists, architects, urban planners and experts from the fields of information and library science. Also, 24 directors of new and large libraries in Israel and the Western world completed a questionnaire. This research is a wide, interdisciplinary study that considers social aspects, architectural structures, the human need to monumentalize, personal and political interests, organizational survival and futurism. Primarily, this research focuses on the future of public libraries in a world that is changing rapidly.
The Changing Role of Religion in Iranian Books
Authors: Kokabi Mortaza
Published: September 2008

Some recent statistics in Iran illustrate the fact that religious books have the highest rank compared to books on other disciplines, but the trend was not the same in pre-1979 Revolution periods. The paper aims to show the growing number and the domination of religious books in the book publishing industry in some pre- and post-Revolution periods in Iran. The geographical distribution of Iranian publishers, the provinces that have the highest ranks after Tehran in the Iranian book publishing industry, the languages and subject distribution of Iranian books are among the issues discussed. Some comparisons are also made between religion and two other disciplines: literature and technology, that are the closest rivals of religion. The paper observes a balance between the three subjects: religion, literature, and technology as the Revolution settles down, and predicts that the three subjects probably will continue to be the three highest subjects among other disciplines.
Modernization of Library and Information Services in Technical Higher Education Institutions in North India: state-of-the-art report
Authors: Vasishta Seema
Published: September 2008

Developments in the technical literature of engineering and technology have posed problems of collecting, storing and disseminating information. To overcome these problems and render improved and efficient information services, libraries are adopting the concept of modernization. The goal of the article is to assess the impact of modernization on the ambience, collection development, services rendered and human resources in the six Technical Deemed University libraries of North India. The survey findings conclude that most of the libraries are in transition from traditional to modern libraries and that, although these libraries have started the process of modernization of services, a lot can be done to improve the current situation and provide modernized services to the user community.
Concurrent Design of a Computer Network for x-abilities using MADM Approach
Authors: Naga Balaji Kiran G. , Agrawal V.P.
Published: September 2008

Organizations are deploying well-designed computer networks supporting converged applications of data, audio, and video. Use of different applications demands computer network to have various abilities — performance, resilience, security, maintainability, etc. called x-abilities — in varying degree of importance depending on application requirements of an organization. To facilitate design of computer network simultaneously for all x-abilities in an integrated way, a concurrent design methodology using multi attribute decision making (MADM) approach is proposed. This concurrent design methodology is aimed at reducing design time considerably and makes use of expertise of experts from different specialized fields in a single design team. MADM approach provides technique for selection of best computer network for the application under consideration.
Globalization, nationality and commodification: the politics of the social construction of the internet
Authors: Hrynyshyn Derek
Published: September 2008

Theories of the social construction of technology help to identify ways in which social forces can influence the development of communication media such as the internet, but often fail to pay sufficient attention to the ways that social structures constrain the agency of those who are most central to the social construction processes. This article examines some decisions concerning the domain name system of the internet and finds that such structural concerns add a needed dimension and can illuminate the power relations that help to shape the role of the internet in the tension between national and global structures of communications.
The young and techless? Investigating internet use and problem-solving behaviors of young adults in Singapore
Authors: Hope Cheong Pauline
Published: September 2008

This article critically examines the technologically-savvy image of young adults by investigating the digital divide issues underlying youth internet use, including their daily computer and internet problem-solving behaviors. The study draws on data from a web-based questionnaire and face-to-face interviews with young adults in Singapore, a country where internet adoption is pervasive. Contrary to popular conceptualizations of youths as a cohort of technically-savvy experts, the findings showed considerable variance in their internet expertise and problem-solving behaviors, with some demonstrating limited knowledge of internet use and awareness of troubleshooting strategies. The analyses also showed that internet skills and self-efficacy in internet-related problem-solving behaviors were significantly related to the internet practices of young adults. The findings suggest that in wired contexts, variations in post-adoption patterns may reflect more accurately the extent and presence of social stratification, extending the meaning and scope of the digital divide.
Availability and Use of Palliative Care and End-of-Life Services for Pediatric Oncology Patients
Authors: Johnston Donna L. , Nagel Kim , Friedman Debra L. , Meza Jane L. , Hurwitz Craig A. , Friebert Sarah
Published: September 2008

Purpose

Palliative care prevents or relieves the symptoms caused by life-threatening medical conditions. Previous surveys have shown both underuse and lack of availability of these services for children with cancer throughout North America. We sought to investigate the current practices and resources surrounding palliative and end-of-life care among participating institutions of the Children's Oncology Group (COG).

Methods

A survey regarding practices and resources was developed by the COG palliative care subcommittee and was sent to all 232 institutions to complete for the calendar year 2005.

Results

The survey was completed by 81% of the institutions. Per institution, there were a mean of 64.6 newly diagnosed patients and 17.7 patients experiencing relapse. A palliative care team was available in 58% of institutions, a pain service in 90%, a hospice in 60%, a psychosocial support team in 80%, and a bereavement program in 59%. Complementary and alternative medicine was available in 39% of institutions and in 95% of the COG institution's community. Most services, even when available, were not well used by patients.

Conclusion

Despite the well-established benefit of pediatric palliative care, it is only offered in 58% of COG institutions caring for children with cancer. In an era where the benefit of palliative care has been clearly established, this number should approach 100%. Efforts should be directed toward understanding barriers to provision of such services, so that they are available and well used at all childhood cancer centers.
Longitudinal Changes in Obesity and Body Mass Index Among Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study
Authors: Garmey Edward G. , Liu Qi , Sklar Charles A. , Meacham Lillian R. , Mertens Ann C. , Stovall Marilyn A. , Yasui Yutaka , Robison Leslie L. , Oeffinger Kevin C.
Published: September 2008

Purpose

We examined the rate of increase in the body mass index (BMI; kg/m2) after final height attainment in survivors of acute lymphoblastic leukemia (ALL) and a noncancer comparison group.

Methods

Childhood Cancer Survivor Study (CCSS) is a retrospectively ascertained cohort study that prospectively tracks the health status of adults who were diagnosed with childhood cancer between 1970 and 1986 and a comparison group of siblings. Changes in BMI from baseline enrollment to time of completion of follow-up (mean interval, 7.8 years) were calculated for 1,451 ALL survivors (mean age, 32.3 years at follow-up) and 2,167 siblings of childhood cancer survivors (mean age, 35.9 years).

Results

The mean BMI of the CCSS sibling comparison group increased with age (women, 0.25 units/yr, 95% CI, 0.22 to 0.28 units; men, 0.23 units/yr, 95% CI, 0.20 to 0.25 units). Compared with CCSS siblings, ALL survivors who were treated with cranial radiation therapy (CRT) had a significantly greater increase in BMI (women, 0.41 units/yr, 95% CI, 0.37 to 0.45 units; men, 0.29 units/yr; 95% CI, 0.26 to 0.32 units). The rate of BMI increase was not significantly increased for ALL survivors who were treated with chemotherapy alone. Younger age at CRT exposure significantly modified risk.

Conclusion

CRT used in the treatment of childhood ALL is associated with a greater rate of increasing BMI, particularly among women treated with CRT during the first decade of life. Health care professionals should be aware of this risk and interventions to reduce or manage weight gain are essential in this high-risk population.
Computed Tomography Response, But Not Positron Emission Tomography Scan Response, Predicts Survival After Neoadjuvant Chemotherapy for Resectable Non–Small-Cell Lung Cancer
Authors: Tanvetyanon Tawee , Eikman Edward A. , Sommers Eric , Robinson Lary , Boulware David , Bepler Gerold
Published: September 2008

Purpose

Tumor response is considered a surrogate marker of survival. We investigated whether tumor response based on computed tomography (CT) scan or whole-body [18F]fluorodeoxyglucose positron emission tomography (PET) scan after neoadjuvant chemotherapy for resectable non–small-cell lung cancer (NSCLC) is prognostic of survival.

Patients and Methods

Two consecutive phase II clinical trials were jointly analyzed. Patients underwent CT and PET scans before and after completion of neoadjuvant chemotherapy, followed by surgery.

Results

Eighty-nine patients were included. Patients with a partial or complete response based on Response Evaluation Criteria in Solid Tumors categories (n = 33) had a better overall survival than those with stable or progressive disease (n = 56; median survival time, not reached v 36 months, respectively; P = .04). Of all patients, those with response in the highest quartile had 1- and 2-year survival rates of 100% and 81%, respectively, compared with 77% and 61%, respectively, among patients in the lowest quartile. However, on the basis of visual analysis of PET scan, patients with a metabolic response (n = 28) had no significant difference in survival compared with patients without response (n = 61; median survival time, 35.6 months v not reached, respectively; P = .94). In addition, on the basis of a semiquantitative analysis of PET scan, using at least 30% reduction in tumor metabolism as a response (n = 59), we also found no significant difference in survival among those with or without response.

Conclusion

Among patients with resectable NSCLC treated with neoadjuvant chemotherapy, we found no evidence that tumor response by PET scan after chemotherapy is prognostic of survival; however, response by CT scan was associated with better survival.
Oxaliplatin Plus Irinotecan Compared With Irinotecan Alone as Second-Line Treatment After Single-Agent Fluoropyrimidine Therapy for Metastatic Colorectal Carcinoma
Authors: Haller Daniel G. , Rothenberg Mace L. , Wong Alfred O. , Koralewski Piotr M. , Miller Wilson H. , Bodoky Gyorgy , Habboubi Nassir , Garay Carlos , Olivatto Luis O.
Published: September 2008

Purpose

To determine whether irinotecan plus oxaliplatin (IROX) is superior to irinotecan alone in patients with metastatic colorectal cancer (CRC) previously treated with single-agent fluoropyrimidines.

Patients and Methods

A phase III, randomized, open-label, multicenter study of patients with metastatic or recurrent CRC that had progressed or recurred during or after adjuvant or first-line fluoropyrimidines (fluorouracil/leucovorin or capecitabine, the latter only for metastatic CRC). Patients received IROX (irinotecan 200 mg/m2 plus oxaliplatin 85 mg/m2) or irinotecan alone (350 mg/m2) every 3 weeks.

Results

At the data cutoff (when 447 of 628 randomly assigned patients had died), median overall survival was 13.4 months (95% CI, 12.4 to 14.7 months) and 11.1 month (95% CI, 10.0 to 12.7 months) in the IROX and irinotecan groups, respectively (hazard ratio = 0.78; 95% CI, 0.65 to 0.94; P = .0072). Overall response rate (22% v 7%, respectively; P < .0001), median time to progression (5.3 v 2.8 months, respectively; P < .0001), and improvement in tumor-related symptoms (32% v 19%, respectively; P = .0072) were also improved with IROX as compared with irinotecan. With the exception of granulocytopenia (25% v 13%), diarrhea (28% v 23%), and sensory disturbances (5% v 0%), grade 3 to 4 toxicities were comparable between the IROX and irinotecan groups, respectively.

Conclusion

IROX is an effective treatment for metastatic CRC that has progressed after first-line fluoropyrimidine therapy. IROX improves efficacy compared with irinotecan alone, providing an additional option in the postadjuvant or second-line treatment setting for patients who experience treatment failure with single-agent fluoropyrimidine therapy.
Formation of C–C Bonds via Ruthenium-catalyzed Transfer Hydrogenation: Carbonyl Addition from the Alcohol or Aldehyde Oxidation Level
Authors: Shibahara Fumitoshi , Krische Michael J
Published: September 2008

Under the conditions of ruthenium-catalyzed transfer hydrogenation employing isopropyl alcohol as terminal reductant, π-unsaturated compounds (1,3-dienes, allenes, 1,3-enynes, and alkynes) reductively couple to aldehydes to furnish products of carbonyl addition. In the absence of isopropyl alcohol, π-unsaturated compounds couple directly from the alcohol oxidation level to form identical products of carbonyl addition. Such “alcohol-unsaturate C–C couplings” enable carbonyl allylation, propargylation and vinylation from the alcohol oxidation level in the absence of stoichiometric organometallic reagents or metallic reductants. Thus, direct catalytic C–H functionalization of alcohols at the carbinol carbon is achieved.
A Convenient Procedure for the Acidic Activation of Mineral Bentonite: An Environmentally Friendly Method for the Preparation of Bleaching Earths
Authors: Kótai László , Sajó István E , Jakab Emma , Keresztury Gábor , Pfeifer Éva , Kocsis László , Papp Katalin , Gács István , Valyon József , Lippart József
Published: September 2008

Refluxing montmorillonite-containing raw bentonite ((Na,Ca)0.33(Al,Mg)2Si4O10(OH)2) in aq HNO3, then neutralizing it with NH3 produces NH4NO3-containing NH4–bentonite. The NH4NO3 intercalated can be eliminated as a gaseous product (N2O and H2O) by heating at 400 °C, and the deammoniation and dehydroxylation process of the preactivated bentonite leads to formation of bleaching earth (Hx(Al,Mg)2−ySi4O10(OH)2).
Laser-enhanced Dispersion of Multiwalled Carbon Nanotubes in Acetonitrile
Authors: Tanaka Nobuaki , Nishikiori Hiromasa , Kubota Satoshi , Iinuma Atsushi , Endo Morinobu , Fujii Tsuneo
Published: September 2008

Laser irradiation effect on the dispersibility of multiwalled carbon nanotubes (MWCNTs) has been investigated by UV–vis spectroscopy. Absorbance growth indicated increased dispersion in acetonitrile. Dispersibility depended on the irradiation time and power density. Even under high fluence irradiation the morphology scarcely changed under SEM observation, while the Raman spectrum measurement was indicative of the surface change.
Focus-on-Teens, sexual risk-reduction intervention for high-school adolescents: impact on knowledge, change of risk-behaviours, and prevalence of sexually transmitted diseases
Authors: Gaydos C A , Hsieh Y-H , Galbraith J S , Barnes M , Waterfield G , Stanton B
Published: September 2008

A community-based intervention, Focus-on-Kids (FOK) has demonstrated risk-behaviour reduction of urban youth. We modified FOK to Focus-on-Teens (FOT) for high schools. High school adolescents ( n = 1190) were enrolled over successive school semesters. The small-group sessions were presented during the school-lunch hours. Confidential surveys were conducted at baseline, immediate, six-, and 12-month postintervention for demographics, parental communication/monitoring, sexual risk behaviours and sexually transmitted diseases (STDs)/HIV/condom-usage knowledge. Sexually active participants were encouraged to volunteer for urine-based STDs testing at the School-Based Health Centres. Many (47.4%) students reported having had sexual intercourse at baseline. Overall behaviours changed towards ‘safer’ sex behaviours (intent-to-use and using condoms, communicating with partner/parents about sex/condoms/STDs) with time ( P < 0.05). Proportion of students with complete correct knowledge of STDs/HIV increased to 88% at time 4 from 80% at baseline after adjusting for age, gender and sexual activity ( P < 0.05). High prevalence of STDs was detected in 875 participants who reported for urine testing at time 1: trichomonas, 11.8%; chlamydia, 10.1% and gonorrhoea, 4.1%. Prevalence decreased significantly for 310 participants who re-tested; chlamydia: 27.4% to 6.1% and gonorrhoea: 11.3% to 3.2%. FOT was successfully implemented as an STDs/HIV risk-reduction intervention. Sustained improvements of knowledge about STDs/HIV/condom usage, decreases in sexual risk behaviours supported the effectiveness of this intervention.
Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil
Authors: Filho L F B , Nogueira S A , Machado E S , Abreu T F , De Oliveira R H , Evangelista L , Hofer C B
Published: September 2008

The objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10–19 years) followed at Instituto de Puericultura e Pediatria Martagão Gesteira and Hospital Universitário Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking ≥95% of the ARTs (adherent), or <95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value ≤0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) = 3.47 (95% confidence interval [CI] = 1.13–10.68); if they do not carry an extra dose of ART, OR = 6.63 (95% CI = 1.73–25.47); if a healthcare worker taught them how to take ART, OR = 0.27 (95% CI = 0.08–0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.
Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study
Authors: Jernberg E , Moghaddam A , Moi H
Published: September 2008

There are no evidence-based guidelines for the treatment of Mycoplasma genitalium-positive genital infection. In a retrospective survey, we analysed the treatment results of patients tested for M. genitalium at Olafia, Unit for Sexual Transmitted Diseases in Oslo. Out of 10,109 patients, 452 had a positive polymerase chain reaction. Between 72% and 100% of patients in the different treatment groups returned for test of cure after four to five weeks. First-line treatment with 1 g single dose azithromycin had a recovery rate of 79%. It was as effective as an extended five-days’ course of azithromycin. Ofloxacin 200 mg b.i.d for 10 days cured 56% and moxifloxacin 400 mg o.d. for seven days as either second-, third- or fourth-line treatment after azithromycin or ofloxacin failure cured 100%. Azithromycin 1 g as a single dose seems to be the best choice of treatment for M. genitalium, with moxifloxacin 400 mg × 1 for seven days if treatment fails.
Human papillomavirus type-distribution in condylomata acuminata of mainland China: a meta-analysis
Authors: Wang H , Qiao Y L
Published: September 2008

The aim of this work was to study the human papillomavirus (HPV) type-distribution in condylomata acuminata (CA) of mainland China and to estimate the potential role of HPV prophylactic vaccines for CA in mainland China. Forty-three studies using polymerase chain reaction to detect HPV were included in this meta-analysis, and totally 5247 CA cases and 436 controls were included. The overall and type-specific prevalence of HPV 6, 11, 40, 42, 43, 44 were estimated using non-conditional logistic regression model. Overall HPV prevalence was 84.2% and 4.6% for CA and controls, respectively. Estimated HPV types 6, 11, 40, 42 positive fractions in CA were 54.9%, 41.1%, 2.7% and 2.0%, respectively, and exactly 0% for HPV types 43 and 44. HPV 6 and/or 11-positive fractions were 83.0% in mainland China. Thus, prophylactic HPV vaccine has the potential to protect up to 83% of CA cases in mainland China.
Herpes simplex virus type 2 infection among commercial sex workers in Kunming, Yunnan Province, China
Authors: Ngo T D , Laeyendecker O , Li C , Tai H , Cui M , Lai S , Quinn T C
Published: September 2008

A cross-sectional survey was conducted to determine the sociodemographic correlates of herpes simplex virus type 2 (HSV-2) infection among male and female commercial sex workers in Kunming, Yunnan Province of China. HSV-2 prevalence was 33.0%, human immunodeficiency virus (HIV) infection was 2.4% and hepatitis C virus (HCV) infection was 6.8%. Subjects who were positive for HSV-2 had a significantly higher prevalence of HIV infection (5.5% versus 0.9%, P = 0.002; odds ratio [OR]: 6.4, P = 0.006) and HCV infection (18.7% versus 2.4%, P < 0.001; OR: 7.6, P < 0.001) compared with HSV-2-negative individuals. Risk factors that increased the odds of HSV-2 infection were HIV infection, HCV infection, being female, and having a steady sex partner within the last six months ( P ≤ 0.01). In a multivariate analysis, being female (OR: 6.6, P < 0.001), having HCV infection (OR: 5.9, P < 0.001) and having a sex partner within the last six months (OR: 2.2, P < 0.05) showed greater odds of being infected with HSV-2. A strong relationship was found between HSV-2, HIV and HCV infections.
Cost-effectiveness estimates for antenatal HIV testing in the Netherlands
Authors: Rozenbaum M H , Verweel G , Folkerts D K F , Dronkers F , Van Den Hoek J A R , Hartwig N G , De Groot R , Postma M J
Published: September 2008

This paper provides an estimation of the lifetime healthcare cost of HIV-infected children and an update of the cost-effectiveness of universal HIV-screening of pregnant women in Amsterdam (The Netherlands). During 2003–2005, we collected data concerning the prevalence of newly diagnosed HIV-infected pregnant women in Amsterdam. Also, data on resource utilization and HAART regimen for HIV-infected children was gathered from a national registry. Using Kaplan-Meier survival analysis, we estimated the life-expectancy of a vertically HIV-infected child at 19 years, with the corresponding lifetime healthcare costs of €179,974. HIV-screening of pregnant women could prevent 2.4 HIV transmissions annually in Amsterdam, based on an estimated prevalence of nine yet undiagnosed HIV-positive pregnant women per 10,000 pregnancies. We show that universal HIV screening during pregnancy generates significant net cost savings and health benefits in most situations. Universal antenatal HIV screening is justified in Amsterdam from a health-economic point of view.
Cholangiocarcinoma presenting in an adolescent with vertically acquired HIV infection
Authors: Mangeya N , Mafukidze A T , Pascoe M , Mbuwayesango B , Madziva D , Ndlovu N , Corbett E L , Miller R F , Ferrand R A
Published: September 2008

An adolescent with longstanding HIV infection who was severely immunosuppressed during HIV diagnosis developed cholangiocarcinoma 1.5 years after starting antiretroviral therapy.
Reactivity in the Venereal Diseases Research Laboratory test and the Mercia® IgM enzyme immunoassay after treatment of early syphilis
Authors: Mcmillan A , Young H
Published: September 2008

The aim of the study was to compare reactivity in the Mercia immunoglobulin M enzyme immunoassay (IgM EIA) and the Venereal Disease Research Laboratory (VDRL) after treatment of 229 previously untreated patients with early syphilis. At three months, the VDRL and the IgM EIA were negative in 41 (38%) and 71 (62%) cases, respectively; a four-fold or greater decrease in VDRL titre occurred in 106 (99%). At six months, the VDRL and the IgM EIA were negative in 45 (48%) and 69 (71%) patients, respectively; a four-fold or greater decrease in VDRL titre occurred in 88 (95%) and an eight-fold or greater decrease in 80 (86%). At 12 months, the VDRL and the IgM EIA were negative in 35 (70%) and 55 (92%) patients, respectively; a four-fold or greater decrease in VDRL titre occurred in 49 (98%) and an eight-fold or greater decrease in 47 (94%). The Mercia IgM EIA is as sensitive as the VDRL in monitoring treatment of primary syphilis but not as sensitive as the finding of a four-fold or eight-fold decrease in VDRL titre in patients treated for secondary or early latent infection.
An evaluation of the performance of OraQuick® ADVANCE Rapid HIV-1/2 Test in a high-risk population attending genitourinary medicine clinics in East London, UK
Authors: Zelin J , Garrett N , Saunders J , Warburton F , Anderson J , Moir K , Symonds M , Estcourt C
Published: September 2008

To date, no data have been published on the use of OraQuick® ADVANCE Rapid HIV-1/2 Test (OraQuick) in the UK. We report preliminary findings of an ongoing evaluation of OraQuick in UK genitourinary (GU) medicine clinics. A total of 820 samples from patients in high-risk groups for HIV were tested with OraQuick and results were compared with standard HIV antibody testing. HIV prevalence (enzyme immunoassay [EIA]) was 5.73%, sensitivity of OraQuick was 93.64% (95% CI 82.46–98.66%), specificity 99.87% (99.28–100%), positive predictive value 97.78% (88.27–99.94%) and negative predictive value 99.61% (98.87–99.92%). This includes three false-negatives considered to be due to observer error and now rectified by further training. This has increased test sensitivity to 100%. Our observed test performance of OraQuick compares well with EIA and with other rapid tests. We believe that simple, non-invasive antibody detection tests such as OraQuick can increase HIV testing and diagnosis in UK GU medicine and community settings.
Attendance rates during working-hours versus out-of-hours otolaryngology clinics
Authors: Donne AJ , Siau D , Swindell R , Homer JJ
Published: September 2008

In the foreword to Choice matters: Increasing choice improves patients' experiences, the minister of state for delivery and quality states that patients want and expect convenient services tailored to accommodate their increasingly busy lives. The British Social Attitudes Survey 22nd Report indicated that patients with semi-routine and routine occupations were more interested in choice compared to patients with managerial and professional occupations. However, almost 60% of the latter group were still interested. Clearly a major proportion of the general public are keen to be empowered with greater choice.
Get SSET: Speciality Skills in Emergency Surgery and Trauma
Authors: Hammond JS , Watts E , Simpson A , Brooks A
Published: September 2008

The education department at the Royal College of Surgeons has recently launched a package of speciality skills courses that offer practical, hands-on workshops for trainees in general surgery. The first of these, Speciality Skills in Emergency Surgery and Trauma (SSET) convened by Adam Brooks, was piloted at the College in February 2008. Its aim is to provide seamless training in the core principles of emergency surgery and trauma, bridging the gap between the cornerstones of early general surgical training (ATLS®, CCrISP®, see page 308) and courses traditionally undertaken towards the end of higher surgical training (Definitive Surgical Trauma Skills).
Safer patients in surgery
Authors: Russell Joan
Published: September 2008

Earlier in 2008 the World Health Organisation (WHO) launched its second global campaign, Safe Surgery Saves Lives, to reduce the number of errors occurring in surgery on a worldwide basis. The focus of the campaign is a surgical safety checklist, which addresses issues such as haemorrhage risk, antibiotic prophylaxis, airway management, allergy and correct site surgery. The Royal College of Surgeons of England endorsed the principles of the WHO global campaign.
Latitudinal Variation in Physiological and Behavioral Responses of Nest‐Guarding Smallmouth Bass to Common Recreational Angling Practices
Authors: Hanson Kyle C. , Gravel Marie‐Ange , Redpath Tara , Cooke Steven J. , Siepker Michael J.
Published: September 2008

Management policies related to catch‐and‐release (CR) angling of smallmouth bass Micropterus dolomieu vary widely across the geographic distribution of the species. Some jurisdictions, principally in the northern latitudes, prohibit or limit angling efforts that target nesting male smallmouth bass, whereas angling during the nesting period is generally unregulated in southern jurisdictions. Existing studies of individual‐level angling impacts on nesting smallmouth bass have primarily been conducted in the north; thus, the extent to which these findings are relevant to other regions is unknown. In the current study, we sought to systematically evaluate the rates of nest abandonment by nesting smallmouth bass subjected to common angling practices (CR treatment: Brief angling and no exposure to air; air exposure [AE] treatment: Exhaustive angling and 3 min of AE) and tournament practices (simulated tournament [ST] treatment: Exhaustive angling, 2 h of live‐well retention, and 3 min of AE prior to release) across a latitudinal gradient encompassing virtually the entire south‐north range of smallmouth bass (i.e., southern Missouri [MO], southern Ontario [SON], and northern Ontario [NON]) and compared these treatment groups with nonangled controls. We also quantified the extent to which physiological disturbance associated with angling varied across latitudes (peripheral populations [MO and NON] versus the intermediate‐latitude population [SON]). Whole‐blood lactate and glucose levels were highest in fish subjected to ST conditions, indicating increased stress; this pattern was conserved across all latitudes (although there was some evidence of intraspecific variation in stress response). Additionally, the pattern of brood abandonment was similar among fish at all three latitudes; ST fish exhibited the highest rates of nest abandonment (MO: Control = 9.1%, CR = 0%, AE = 9.1%, ST = 100%; SON: control = 10%, CR = 10%, AE = 10%, ST = 50%; NON: control = 7.7%, CR = 0%, AE = 9.1%, ST = 50%). Interestingly, fish from the most southerly latitude, where regulations are the most liberal, abandoned nests at higher rates than did fish from the other latitudes. Collectively, these data reveal that the reproductive success of individual smallmouth bass can suffer from interaction with anglers, particularly in a tournament context, regardless of the region. Further study is needed to determine the extent to which individual nest success is relevant to recruitment and how this relationship varies across latitudes.
On the other law of the iterated logarithm for self-normalized sums
Authors: Cai Guang-Hui
Published: September 2008

Inthisnote, we obtain a Chung's integral test for self-normalized sums of i.i.d. random variables. Furthermore, we obtain a convergence rate of Chung law of the iterated logarithm for self-normalized sums.
Two fast screening methods (GC-MS and TLC-ChEI assay) for rapid evaluation of potential anticholinesterasic indole alkaloids in complex mixtures
Authors: Vieira Ivo J.C. , Medeiros Walter L.B. , Monnerat Cecilia S. , Souza Jucimar J. , Mathias Leda , Braz-Filho Raimundo , Pinto Angelo C. , Sousa Priscila M. , Rezende Claudia M. , Epifanio Rosângela De A.
Published: September 2008

The pharmacotherapyfor Alzheimer's disease (AD) includes the use of acetylcholinesterase inhibitors (AChEI). Recent investigations for novel AD therapeutic agents from plants suggested that Tabernaemontana genus is a promising source of novel anticholinesterasic indole alkaloids. In this work two fast screening techniques were combined in order to easily identify novel cholinesterase inhibitors (ChEI). Gas chromatography-mass spectrometry (GC-MS) of the less polar alkaloidic fractions obtained from the acid-base extraction of the stalk of T. laeta revealed thirteen monoindole alkaloids, four of them confirmed by co-injection with previously isolated alkaloids. The others were tentatively identified by mass fragmentation analysis. By gas chromatography with flame ionization detection (GC-FID) and using isatin as internal standard, affinisine and voachalotine were determined as major compounds. These fractions and fourteen previously isolated alkaloids, obtained from root bark of T. laeta and T. hystrix were investigated for acetyl (AChE) and butyrylcholinesterase (BuChE) inhibitory activities by the modified Ellman's method in thin layer chromatography(TLC-ChEI). Results showed selective inhibition of the alkaloids heyneanine and Nb-methylvoachalotine for BuChE, and 19-epi-isovoacristine for AChE, whereas olivacine, affinisine, ibogamine, affinine, conodurine and hystrixnineinhibited both enzymes. In addition to confirming that monoterpenoid indole alkaloids can be novel therapeutic agents for AD, this is the first report of the ChEI activity of olivacine, a pyridocarbazole alkaloid.
Anatomy and ontogeny of the pericarp of Pterodon emarginatus Vogel (Fabaceae, Faboideae), with emphasis on secretory ducts
Authors: Paiva Élder A.S. , Oliveira Denise M.T. , Machado Silvia R.
Published: September 2008

Discrepant and incomplete interpretations of fruits of Pterodon have been published, especially on the structural interpretation of the pericarp portion that remain attached to the seed upon dispersal. The present work clarified these doubts and analyzed ultrastructural aspects of the Pterodon emarginatus diaspores using light and transmission electron microscopes. Cell divisions are prevalent among the initial phases of development, and the subadaxial and adaxial meristems form the fibrous inner mesocarp and the endocarp composed of multi-seriate epidermis, respectively. At the median mesocarp, numerous secretory ducts differentiate between the lateral bundles, by lytic process. After lysis of the central cells and the formation of the lumen, the ducts show unistratified secretory epithelium with dense cells; oil droplets are observed on the secretory epithelium and the subadjacent tissues. At maturity, the uniseriate exocarp and the outer mesocarp slough off in an irregular fashion, leaving the diaspore composed of a papery and brittle wing linked to a seed chamber that includes the median mesocarp composed of lignified cells, bordering vascular bundles and many secretory ducts whose epithelial cells develop large vacuoles that accumulate oleoresins. The Pterodon emarginatus fruit is a cryptosamara.
Influence of Palythoa caribaeorum (Anthozoa, Cnidaria) zonation on site-attached reef fishes
Authors: Mendonça-Neto José P. , Ferreira Carlos E.L. , Chaves Laís C.T. , Pereira Renato C.
Published: September 2008

This work aimed to test the influence of Palythoa caribeorum, a widely distributed zoanthid in the Atlantic, on site-attached reef fish in a subtropical rocky shore. Density, richness and vertical distribution of reef fish inside (ID) and outside (OD) previously chosen P. caribaeorum dominance patches were compared through stationary visual censuses along three different periods. Fishes were grouped in different trophic guilds to evidence differences in resources uses in both treatments. A complexity index was estimated by the chain link method and percentage covering of benthic organisms was obtained analyzing random points from replicated photo-quadrats. We observed thirty-eight species of fishes, belonging to twenty-five families. Reef fish communities between studied patches were similar,both in terms of species composition and vertical distribution. Considering only the most site-attached fishes, which were the most frequent and abundant species, data showed that ID sustains higher diversity and abundance than OD. Results showed that benthic composition differ significantly among patches whereas complexity remained without differences. Otherwise, results indicated that these areas might play an important role in space limitation, structuring neighboring benthic community and consequently reef fish assemblages.
Global environmental change research: empowering developing countries
Authors: Nobre Carlos A. , Lahsen Myanna , Ometto Jean P.H.B.
Published: September 2008

This paper discusses ways to reconcile the United Nations Millennium Development Goals with environmental sustainability at the national and international levels. The authors argue that development and better use of sustainability relevant knowledge is key, and that this requires capacity building globally, and especially in the less developed regions of the world. Also essential is stronger integration of high-quality knowledge creation and technology-and policy-development, including, importantly, the creation of centers of excellence in developing regions which effectively use and produce applications-directed high quality research and bring it to bear on decision making and practices related to environmental change and sustainable management of natural resources. The authors argue that Southern centers of excellence are a necessary first step for bottom-up societal transformation towards sustainability, and that such centers must help design innovative ways to assess and place value on ecosystem services.
Transpressive dextral shear in the Italva-Itaperuna section, Northern State of Rio de Janeiro, Brazil
Authors: Karniol Tiago R. , Machado Rômulo , Dehler Nolan M.
Published: September 2008

Structural analysis carried out on a segment of the Neoproterozoic Ribeira Belt, southeastern Brazil, show that it represents part of the transpressive dextral orogen related to the Central Mantiqueira Province. NNE-trending and steeply dipping regional mylonitic belts form anastomosed geometry, and describe a map-scale, S-C-like structure that is characterized by their deflection towards NE near the Além Paraíba Lineament. Lithological and structural control related to deformation partition were responsible for the formation of felsic mylonitic granulites with S-type granites lenses developed in ductile shear zones, alternated with less deformed intermediate to basic granulites associated with charnockites. The dextral shear sense indicators are consistent with transpressive deformation in the region and are common especially at the border of the main shear zones. The presence of S-type leucogranite may lead to variations of linear and planar relationships, which result in local extension zones. These elements are consistent with oblique continental collision considering the São Francisco Craton as a stable block.
Fisiologia do eixo GH-sistema IGF
Authors: Martinelli Jr Carlos Eduardo , Custódio Rodrigo José , Aguiar-Oliveira Manuel Hermínio
Published: September 2008

O crescimento, principal característica da infância e da adolescência, apresenta padrão semelhante na maioria dos indivíduos. A herança genética e os componentes do eixo GH-IGF são os fatores que diretamente influenciam esse processo. O GH, produzido na hipófise, exerce sua ação sobre o crescimento mediante regulação do sistema IGF. Os IGFs (IGF-1 e IGF-2) são fatores de crescimento produzidos na maioria dos órgãos e tecidos do organismo, possuindo ações autócrinas, parácrinas e endócrinas sobre o metabolismo intermediário, proliferação, crescimento e diferenciação celular. Associam-se com elevado grau de especificidade e de afinidade à família de seis proteínas carreadoras, denominadas IGFBPs (IGFBP-1 a -6), as quais modulam suas bioati-vidades. A maioria das ações conhecidas dos IGFs é exercida mediante sua ligação com o receptor tipo 1 (IGF-1R). Neste artigo será revisada a composição e a regulação do eixo GH-sistema IGF, assim como a participação de cada um dos seus diferentes componentes no processo de regulação do crescimento humano.
Ghrelina e secretagogos do hormônio de crescimento (GHS): modulação da secreção do hormônio de crescimento e perspectivas terapêuticas
Authors: Correa-Silva Silvia R. , Sá Larissa Bianca Paiva Cunha de , Lengyel Ana-Maria J.
Published: September 2008

A secreção do hormônio de crescimento (GH) é modulada pelo hormônio liberador de hormônio de crescimento (GHRH) e pela somatostatina. Na última década foi descoberto um terceiro mecanismo de controle, envolvendo os secretagogos de GH (GHS). A ghrelina, o ligante endógeno do receptor dos GHS, é um peptídeo acilado produzido no estômago, que também é sintetizado no hipotálamo. Este peptídeo é capaz de liberar GH, além de aumentar a ingesta alimentar. A ghrelina endógena parece amplificar o padrão básico de secreção de GH, ampliando a resposta do somatotrofo ao GHRH, estimulando múltiplas vias intracelulares interdependentes. Entretanto, seu local de atuação predominante é o hipotálamo. Neste trabalho, será apresentada revisão sobre a descoberta da ghrelina, os mecanismos de ação e o possível papel fisiológico dos GHS e da ghrelina na secreção de GH e, finalmente, as possíveis aplicações terapêuticas destes compostos.
Conseqüências em longo prazo da deficiência do hormônio de crescimento
Authors: Oliveira Carla R. P. , Pereira Rossana M. C. , Barreto-Filho José A. S. , Aguiar-Oliveira Manuel H.
Published: September 2008

Este artigo descreve as conseqüências puras, em longo prazo, da deficiência isolada e vitalícia do hormônio de crescimento (GH) porque usa um modelo único de resistência ao hormônio liberador do GH (GHRH), em virtude da mutação homozigótica no gene do receptor do GHRH, em uma centena de indivíduos acometidos. Elas incluem baixa estatura grave com estatura final entre -9,6 a -5,2 desvios-padrão abaixo da média, com redução proporcional das dimensões ósseas, redução do volume da adenohipófise corrigido para o volume craniano e da tireóide, do útero, do baço e da massa ventricular esquerda, todos corrigidos para a superfície corporal, em contraste com o tamanho de pâncreas e fígado, maior que o de controles, quando igualmente corrigidos. As alterações características da composição corporal incluem redução acentuada da quantidade de massa magra (kg) e aumento do percentual de gordura com depósito predominante no abdome. Nos aspectos metabólicos são encontrados aumento de colesterol total e LDL, redução de insulina e do índice de resistência à insulina homeostasis model assessment, acompanhados de aumento da proteína C reativa de alta sensibilidade e da elevação da pressão arterial sistólica nos adultos, embora sem evidências de aterosclerose precoce. Outros achados incluem resistência óssea menor, embora acima do limiar de fraturas, puberdade atrasada, fertilidade normal, paridade diminuída, climatério antecipado e qualidade de vida normal.