bluuebunny/crossref_metadata_2025 huggingface dataset:
FieldML: concepts and implementation
Authors: Christie G. Richard , Nielsen Poul M.F. , Blackett Shane A. , Bradley Chris P. , Hunter Peter J.
Published: April 2009

The field modelling language FieldML is being developed as a standard for modelling and interchanging field descriptions in software, suitable for a wide range of computation techniques. It comprises a rich set of operators for defining generalized fields as functions of other fields, starting with basic
domain fields
including sets of discrete objects and coordinate systems. It is extensible by adding new operators and by their arbitrary combination in expressions, making it well suited for describing the inherent complexity of biological materials and organ systems. This paper describes the concepts behind FieldML, including a simple example of a spatially varying finite-element field. It outlines current implementations in established, open source computation and visualization software, both drawing on decades of bioengineering modelling software development experience.
Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients
Authors: HAHM Bong Jin , MIN Seong Uk , YOON Mi Young , SHIN Yong Wook , KIM Jin Sook , JUNG Jae Yoon , SUH Dae Hun
Published: April 2009

Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne‐related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Beck's depression inventory [BDI]), anxiety (Beck's anxiety inventory [BAI]) and psychopathology (Symptomchecklist‐90‐revised [SCL‐90‐R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne‐related life quality improvements rather than to improvement in acne grade.
Ocular alterations in patients of alopecia areata
Authors: PANDHI Deepika , SINGAL Archana , GUPTA Ritika , DAS Gopal
Published: April 2009

There is paucity of published work on ocular alterations in patients of alopecia areata (AA), especially from the Asian continent. We studied the clinical profile of 83 patients of AA and 80 sex‐ and age‐matched controls to assess and compare the ocular changes, namely punctate opacities, cataract, intraocular tension and retinal changes. The outcome was analyzed with respect to prevalence of atopy, concomitant personal or family history of autoimmune diseases and nail changes in both the groups. The prevalence of atopy and family history of autoimmune diseases was significantly higher in the patient group. Lenticular changes were observed in 40.9% patients (including cataract in 16.9%) and 11.2% controls (P < 0.005). Within the patient group, lenticular involvement occurred with increased frequency in atopics (P = 0.034) and in the presence of family history of autoimmune diseases (P < 0.05). Retinal changes in the form of degenerative changes, pigmentary clumping and abnormal vascular changes were more prevalent (P < 0.001) in the study group. As the ocular changes were not found to correlate with the age, severity or extent of the disease, an initial ophthalmological screening of all patients is suggested.
Evaluation of polymerase chain reaction‐based detection of Mycobacterium leprae for the diagnosis of leprosy
Authors: BANG Pham Dang , SUZUKI Koichi , PHUONG Le Thi , CHU Tran Man , ISHII Norihisa , KHANG Tran Hau
Published: April 2009

Because Mycobacterium leprae cannot be cultivated in vitro, laboratory diagnosis of leprosy is generally made by microscopic and histopathological examination. The objective of the present study was to evaluate the sensitivity and utility of polymerase chain reaction (PCR) to detect M. leprae in comparison with other conventional methods for diagnosis such as split skin smears, histopathology and serodiagnosis. PCR amplification of the M. leprae‐specific 16S ribosomal RNA was compared to other methods. Samples included 37 multibacillary (MB) patients with a positive bacteriological index (BI), 32 newly diagnosed paucibacillary (PB) patients whose BI were negative and 30 plaque psoriasis patients not residing in leprosy endemic areas as controls. The sensitivity of PCR was 30 fg of M. leprae DNA, which is equivalent to the DNA from 8.3 bacilli. The detection rate in MB and PB were 100% and 50%, respectively; the specificity was 100%. Semiquantitative evaluation of PCR correlated well with BI, but not with the morphological index (MI) nor with the serum antibody against phenolic glycolipid‐1 (PGL‐1). PCR detection of M. leprae targeting 16S ribosomal RNA was specific and more sensitive than conventional methods, and can contribute to early and accurate diagnosis of leprosy.
Severity factors of Mamushi (Agkistrodon blomhoffii) bite
Authors: OKAMOTO Osamu , OISHI Masaki , HATANO Yutaka , KAI Yoshitaka , GOTO Mizuki , KATO Aiko , SHIMIZU Fumiaki , KATAGIRI Kazumoto , FUJIWARA Sakuhei
Published: April 2009

The factors determining the severity of a Mamushi (Agkistrodon blomhoffii) bite were analyzed based on the findings of our 34 cases and those appearing in the published work. It was not possible to forecast the final severity at the time of the patient's arrival and by the initial blood examination data. The maximal creatinine kinase (CK) values elevated proportionally with the time from the bite, and the relation approximated the equation of y = 300χ, where y represents the maximal CK value and χ indicates the time from the bite to the peak of CK level. In the severe cases which required intensive care, the level of the CK deviated remarkably from this line, and could be grossly distinguished from the non‐severe cases. The maximal white blood cell (WBC) count also gradually increased in concordance with the time from the bite, and in addition, the WBC count of most of the severe cases exceeded 20 000/µL. This evidence suggests that the rate of the CK value elevation in relation to the time from the bite can be a useful indicator of the severity of a Mamushi bite, and the WBC count also reflects the severity.
Rituximab‐induced vasculitis: A case report and review of the medical published work
Authors: KIM Min Joo , KIM Hyung Ok , KIM Ho Yeon , PARK Young Min
Published: April 2009

Rituximab is an anti‐CD20 chimeric murine/human monoclonal antibody mainly used in the treatment of patients with a cutaneous lymphoid malignancy. Among the side‐effects associated with rituximab administration, vasculitis has been rarely reported. There are two reported cases in the English language medical published work. We describe a 38‐year‐old Korean man with cutaneous vasculitis occurring 1 day after rituximab administration.
Neurofibromatosis type 1 associated with Charcot–Marie–Tooth type 1A
Authors: KOC Filiz , GUZEL A. Irfan
Published: April 2009

Neurofibromatosis and Charcot–Marie‐Tooth are genetic disorders of the nervous system affecting the development and growth of nerve cells and demyelination of peripheral neurons, respectively. We report a 22‐year‐old man who presented clinical manifestations of both neurofibromatosis type 1 (NF1) and Charcot–Marie–Tooth type 1A. The simultaneous occurrence of neurofibromatosis and Charcot–Marie–Tooth disease has rarely been reported. More extensive reports and further investigations of this combination will certainly provide a better understanding of this linkage in the near future.
Very low prevalence of XPD K751Q polymorphism and its association with XPD expression and outcomes of FOLFOX‐4 treatment in Asian patients with colorectal carcinoma
Authors: Lai Jiun‐I. , Tzeng Cheng‐Hwai , Chen Po‐Min , Lin Jen‐Kou , Lin Tzu‐Chen , Chen Wei‐Shone , Jiang Jeng‐Kae , Wang Huann‐Sheng , Wang Wei‐Shu
Published: April 2009

Xeroderma pigmentosum group D (XPD) participates in DNA unwinding during nucleotide excision repair, which may alter the efficacy of platinum‐based chemotherapy. We analyzed the influence of codon 751 Lys→Gln polymorphism of XPD on its protein expression levels, clinico‐pathological features, and outcome of 188 Chinese patients with metastatic colorectal carcinoma (CRC) that had been treated with first‐line Oxaliplatin + Leucovorin + 5‐Fluorouracil (FOLFOX‐4) chemotherapy. The results showed that in comparison with Caucasian populations, a remarkably lower prevalence of Lys/Gln genotype was noted (16%, n = 30). No between‐group difference in XPD protein expression of patients with or without this polymorphism was noted (56.5%vs 59.7%; P = 0.783). Patients with Gln751 allele have a significantly lower response to FOLFOX‐4 treatment (36.7%vs 58.2%, P = 0.03), and shorter progression‐free (7 vs 11 months; P < 0.01) and overall (14 vs 22 months; P < 0.01) survivals. The incidence of grade 3/4 oxaliplatin‐neuropathies was very similar in both groups (13.3%vs 16.5%; P = 0.67). By adjusted analysis, this polymorphism was further identified as an independent prognostic factor (P = 0.03). These data suggest that Asian populations have a significantly lower prevalence of codon 751 Lys/Gln polymorphism in XPD, which could be a key determinant for good response to oxaliplatin‐based treatment and favorable outcomes. (Cancer Sci 2009; 100: 1261–1266)
Novel spliced form of a lens protein as a novel lung cancer antigen, Lengsin splicing variant 4
Authors: Nakatsugawa Munehide , Hirohashi Yoshihiko , Torigoe Toshihiko , Asanuma Hiroko , Takahashi Akari , Inoda Satoko , Kiriyama Kenji , Nakazawa Emiri , Harada Kenji , Takasu Hideo , Tamura Yasuaki , Kamiguchi Kenjiro , Shijubo Noriharu , Honda Ryoichi , Nomura Naohiro , Hasegawa Tadashi , Takahashi Hiroki , Sato Noriyuki
Published: April 2009

A glutamine synthetase I family protein, Lengsin, was previously identified as a novel lens‐specific transcript in the vertebrate eye. In this report, we show for the first time that Lengsin is a novel tumor‐associated antigen expressed ectopically in lung cancer. Interestingly, a novel spliced form of human Lengsin termed ‘splicing variant 4’, gaining exon 3 that codes extra 63 amino acids, is the dominant transcript form in lung cancer cells. Lengsin mRNA could be detected in 7 of 12 (58%) lung cancer cell lines and 7 of 7 (100%) surgically resected lung cancer tissues. On the other hand, Lengsin transcripts could not be detected in normal major tissues or in other cancer cell lines, including melanoma, colorectal carcinoma, breast carcinoma and hepatocellular carcinoma. In addition, knockdown of Lengsin mRNA with RNAi caused cell death and a decrease of cell viability, suggesting that Lengsin has some essential role in cell survival. Since the lens is an immune‐privileged site, we regard Lengsin as a highly immunogenic cancer antigen. Anti‐Lengsin autoantibodies were detectable in sera of lung cancer patients, although these patients did not show any lens‐related disturbances. Hence, Lengsin splicing variant 4 might be an immunogenic lung cancer‐specific antigen that is suitable as a diagnostic marker and for molecular targeting therapy, including immunotherapy. (Cancer Sci 2009)
Enhancement of antitumor natural killer cell activation by orally administered Spirulina extract in mice
Authors: Akao Yuusuke , Ebihara Takashi , Masuda Hisayo , Saeki Yoshiko , Akazawa Takashi , Hazeki Kaoru , Hazeki Osamu , Matsumoto Misako , Seya Tsukasa
Published: April 2009

Oral administration of hot‐water extract of Spirulina, cyanobacterium Spirulina platensis, leads to augmentation of NK cytotoxicity in humans. Here, we applied to syngeneic tumor‐implant mice (C57BL/6 versus B16 melanoma) Spirulina to elucidate the mechanism of raising antitumor NK activation. A B16D8 subcell line barely expressed MHC class I but about 50% expressed Rae‐1, a ligand for NK activation receptor NKG2D. The Rae‐1‐positive population of implant B16 melanoma was effectively eliminated in the tumor mass progressed in mice. This antitumor activity was induced in parallel with IFN‐γ and abolished in mice by treatment with asialoGM‐1 but not CD8β Ab, suggesting the effector is NK cell. NK cell activation occurred in the spleen of wild‐type mice medicated with Spirulina. This Spirulina‐mediated enhanced NK activation was abrogated in MyD88 –/– mice but not in TICAM‐1 –/– mice. The NK activating properties of Spirulina depending on MyD88 were confirmed with in vitro bone marrow‐derived dendritic cells expressing TLR2/4. In D16D8 tumor challenge studies, the antitumor effect of Spirulina was abolished in MyD88 –/– mice. Hence, orally administered Spirulina enhances tumoricidal NK activation through the MyD88 pathway. Spirulina exerted a synergistic antitumor activity with BCG–cell wall skeleton, which is known to activate the MyD88 pathway via TLR2/4 with no NK enhancing activity. Spirulina and BCG–cell wall skeleton synergistically augmented IFN‐γ production and antitumor potential in the B16D8 versus C57BL/6 system. We infer from these results that NK activation by Spirulina has some advantage in combinational use with BCG–cell wall skeleton for developing adjuvant‐based antitumor immunotherapy. (Cancer Sci 2009)
Radiosensitizing effects of gefitinib at different administration times in vitro
Authors: Zhuang Hong‐Qing , Sun Jian , Yuan Zhi‐Yong , Wang Jun , Zhao Lu‐Jun , Wang Ping , Ren Xiu‐Bao , Wang Chang‐Li
Published: April 2009

The optimal administration time for applying epidermal growth factor receptor inhibitors combined with radiotherapy has been unclear. We investigated the efficacy of combining gefitinib with radiation in different treatment schedules. We demonstrated that gefitinib was administered to A549 lung cancer cells in three ways (administration before irradiation, administration upon irradiation, administration after irradiation) to establish the radiosensitizing effect. Cell‐survival rates were evaluated by colony‐forming assays. Cell apoptosis and cell‐cycle distribution were investigated using flow cytometry; meanwhile, the expression of P21, Cdc25c, Bcl‐2, Bax, Rad51 and phosphorylated DNA‐PKcs (phospho‐DNA‐PK) after 6 Gy irradiation and/or gefitinib were determined by Western blot analysis. The sensitizer enhancement ratios of the gefitinib administration before irradiation, administration upon irradiation, and administration after irradiation groups were 2.23, 1.51 and 1.30, respectively. A higher apoptosis rate and G2/M phase arrest were observed in cells at 48 h after exposure to 6 Gy irradiation when gefitinib was administrated before irradiation. Increased cell apoptosis and cell cycle arrest were further supported by the expression changes of Bcl‐2, Bax, P21, Cdc25c, Rad51 and phospho‐DNA‐PK at the same time. The best radiosensitizing effect was obtained when gefitinib was delivered before irradiation. Apoptosis might be an important way of cell killing and G2/M phase arrest might be an important mechanism of apoptosis. The expression proportion changes of P21/Cdc25c proteins may play an important role in G2/M cell cycle arrest. Moreover, the pro‐apoptotic/antiapoptotic and DNA repair factors may be important modulators taking part in the molecular events of the radiosensitizing effect of gefitinib combined with irradiation. (Cancer Sci 2009)
Factor VIII mutations in 42 Moldovan haemophilia A families, including 12 that are novel
Authors: SIROCOVA N. , TSOUREA V. , VICOL M. , BARBACAR N. , NAKAYA S. M. , THOMPSON A. R. , PRATT K. P.
Published: April 2009

Summary.  Haemophilia A (HA) is a bleeding disorder caused by mutations within the X‐linked F8 gene. A series of 42 unrelated Moldovan patients with HA had their disease‐causative mutation determined to provide clinically valuable genotyping information for a historically underserved population and to utilize factor VIII (FVIII) structural information to analyse the effects of haemophilic missense substitutions. DNA samples were analysed to detect intron 22 and intron 1 inversions followed by heteroduplex analysis of PCR‐amplified fragments containing all exonic sequences. Missense sites identified by DNA sequencing were visualized in the recently described crystal structures of human FVIII. Of the 26 different point mutations, 12 were novel. Gel electrophoresis identified samples with a second major DNA band that migrated abnormally; these amplified products were sequenced. Thirteen intron 22 inversions and one intron 1 inversion were found. Two patients had large, partial gene deletions and there were six frameshift, two non‐sense, two splicing and 16 missense genotypes. Two subjects with an intron 22 inversion and one with a large, partial gene deletion developed an alloimmune inhibitor. Their localization suggests intra‐ and possibly inter‐molecular interactions that are important for the structural integrity and/or procoagulant function of FVIII.
Do women change their health behaviours in pregnancy? Findings from the Southampton Women's Survey
Authors: Crozier Sarah R. , Robinson Siân M. , Borland Sharon E. , Godfrey Keith M. , Cooper Cyrus , Inskip Hazel M. ,   the SWS Study Group
Published: April 2009

A woman's life style choices before and during pregnancy have important implications for her unborn child, but information on behaviour can be unreliable when data are collected retrospectively. In particular there are no large longitudinal datasets that include information collected prospectively before pregnancy to allow accurate description of changes in behaviour into pregnancy. The Southampton Women's Survey is a longitudinal study of women in Southampton, UK, characterised when they were not pregnant and again during pregnancy. The objective of the analyses presented here is to describe the degree to which women comply with diet and life style recommendations before and during pregnancy, and changes between these time points. The analyses are based on 1490 women who delivered between 1998 and 2003 and who provided information before pregnancy and at 11 and 34 weeks' gestation. At each time point a trained research nurse ascertained smoking status and assessed food and drink consumption using a food frequency questionnaire. We derived the proportions of women who complied with recommendations not to smoke, to eat five portions of fruit and vegetables per day and to drink no more than four units of alcohol per week and 300 mg of caffeine per day.

There was a notable reduction in smoking when women became pregnant: before pregnancy 27% of women smoked, whereas in early pregnancy 15% smoked. Similarly there were significant reductions in alcohol consumption and intake of caffeinated drinks: before pregnancy 54% of women drank more than four units of alcohol per week and 39% had estimated intakes of caffeine in drinks of >300 mg per day, whereas comparable figures for early pregnancy were 10% and 16% respectively. However, there was little change in fruit and vegetable intake; the percentages of women who did not achieve the recommendation to eat at least five portions of fruit and vegetables per week were 47% before pregnancy and 46% in early pregnancy. Younger women and those with fewer educational qualifications were less likely to comply with public health recommendations. Overall, 81% of women in early pregnancy complied with at least three of the recommendations. Although there is encouraging evidence of changed health behaviours in pregnancy, young women and those with few educational qualifications may particularly benefit from targeted health initiatives.
The EASTR study: a new approach to determine the reasons for transfusion in epidemiological studies
Authors: Llewelyn C. A. , Wells A. W. , Amin M. , Casbard A. , Johnson A. J. , Ballard S. , Buck J. , Malfroy M. , Murphy M. F. , Williamson L. M.
Published: April 2009

summary Previous studies of blood use have used different methods to obtain and classify transfusion indications. Before undertaking a national study of transfusion recipients, a pilot study was performed over 2 months at two teaching and two district general hospitals to match information from hospital transfusion laboratories with clinical coding data from the hospital’s Patients Administration System to determine the indication for transfusion in 2468 recipients. Data analysis revealed major limitations in the conventional use of primary diagnostic International Statistical Classification of Disease and Related Health Problems 10th Revision (ICD‐10) or procedure Office of Population, Censuses and Surveys – Classification of Surgical Operations and Procedures – 4th Revision (OPCS‐4) codes alone in allocating transfusion indications. A novel algorithm was developed, using both types of code, to select the probable indication for transfusion for each patient. A primary OPCS‐4 code was selected for recipients transfused in relation to surgery (43%) and either the primary (36%) or the secondary (12%) ICD‐10 code was chosen for recipients transfused for medical reasons. The remaining patients were unclassified. Selected codes were then collated into Epidemiology and Survival of Transfusion Recipients (EASTR) casemix groups (E‐CMGs). The most frequent E‐CMGs were haematology (15% of recipients), musculoskeletal (14%), digestive system (12%) and cardiac (10%). The haematology E‐CMG includes patients with malignant and non‐malignant blood disorders and recipients transfused for anaemia where no cause was listed. Recipients undergoing hip and knee replacement and coronary artery bypass grafting are within the musculoskeletal and cardiac E‐CMGs. The digestive E‐CMG includes recipients transfused for gastrointestinal (GI) bleeds and those undergoing GI surgery. This methodology provides a more useful means of establishing the probable indication for transfusion and arranging recipients into clinically relevant groups.
Hospital Blood Inventory Practice: the factors affecting stock level and wastage
Authors: Perera G. , Hyam C. , Taylor C. , Chapman J. F.
Published: April 2009

summary To analyse the Issuable Stock Index (days worth of stock) and wastage in relation to data continuously collected by the Blood Stocks Management Scheme (BSMS) with aspects of blood inventory management practice determined by the 2006 hospital inventory practice survey (IPS). The BSMS collects blood inventory data from hospitals and blood services in England, Wales and Northern Ireland. Data sets were constructed from information obtained from the 2006 IPS, which included questions on the crossmatch reservation period, methods for calculating the blood order and stock share relationships between hospitals. Two of the Scheme’s measures that can indicate a hospital’s blood inventory management performance were used to present blood stock and wastage data in a comparable format. Data were analysed using the Student’s t‐test. The results showed significantly lower inventory and wastage in hospitals which used a 24‐h reservation period compared with 48 h (P = 0·02 and P = 0·04, respectively), and for hospitals that used their computer for calculating the blood order compared with those that used a ‘visual review’ (P = 0·02 and P ≤ 0·001, respectively). A strong correlation co‐efficient (0·61) was found for a relationship between a hospital’s stock level and wastage. The study showed that differences in stock management practice between hospitals are associated with significant differences in stock levels and wastage of blood. The paper identifies examples of best practice.
Association between socio economic status and schistosomiasis infection in Jinja District, Uganda
Authors: Muhumuza Simon , Kitimbo George , Oryema‐Lalobo Michael , Nuwaha Fred
Published: April 2009

Objective  To examine the role of socioeconomic situation in influencing the risk and intensity of infection with Schistosomiasis mansoni.

Methods  Cross‐sectional study in Walukuba Division bordering Lake Victoria, Jinja District. We assessed a random sample of 463 individuals aged 10–20 years for Schistosoma mansoni infection, water contact behaviour and treatment status with praziquantel as of the last mass treatment. Socioeconomic conditions of the participants’ households were assessed by calculating a wealth index (based on type of housing and ownership of assets). Households were classified in four classes; multivariate logistic regression analysis was used to identify independent predictors of being infected with schistosomiasis. Intensities of infection with S. mansoni were compared across the classes of wealth index.

Results  Wealth index emerged a risk factor for infection with S. mansoni after controlling for water contact and treatment with praziquantel. The adjusted odds ratio of being infected for the lowest level of wealth index compared to the highest was 10.42 (95% CI 3.38–32.36 P < 0.001). The intensity of infection decreased with wealth index Linearity F‐ratio 13.91, 1 df, P < 0.001). The geometric egg count for those in the lowest wealth index was 230 (95% CI 199–279) compared to 114 (95% CI 80–162) for the highest wealth index.

Conclusions  In addition to mass treatment with praziquantel, improving the socio‐economic conditions of the population should be given priority.
Simple and inexpensive point‐of‐care tests improve diagnosis of vaginal infections in resource constrained settings
Authors: Madhivanan Purnima , Krupp Karl , Hardin Jill , Karat Chitra , Klausner Jeffrey D. , Reingold Arthur L.
Published: April 2009

Objective  Bacterial vaginosis (BV) and Trichomonas vaginalis infection (TV) have been associated with adverse birth outcomes and increased risk for HIV. We compare the performance of simple inexpensive point‐of‐care (POC) tests to laboratory diagnosis and syndromic management of BV and TV in poor settings.

Methods  Between November 2005 and March 2006, 898 sexually active women attending two reproductive health clinics in Mysore, India were recruited into a cohort study investigating the relationship between vaginal flora and HSV‐2 infection. Participants were interviewed and screened for reproductive tract infections. Laboratory tests included serology for HSV‐2; cultures for TV, Candida sp., and Neisseria gonorrhoeae; Gram stains; and two POC tests: vaginal pH; and Whiff test.

Results  Of the 898 participants, 411 [45.7%, 95% confidence interval (95% CI): 42.4–49.0%] had any laboratory diagnosed vaginal infection. BV was detected in 165 women (19.1%, 95%CI: 16.5–21.9%) using Nugent score. TV was detected in 76 women (8.5%, 95%CI: 6.7–10.4%) using culture. Among the entire study population, POC correctly detected 82% of laboratory diagnosed BV cases, and 83% of laboratory diagnosed TV infections. Among women with complaints of vulval itching, burning, abnormal vaginal discharge, and/or sores (445/898), POC correctly detected 83% (60 of 72 cases) of laboratory diagnosed BV cases vs. 40% (29 of 72 cases) correctly managed using the syndromic approach (P < 0.001). Similarly, POC would have detected 82% (37 of 45 cases) of TV cases vs. 51% (23 of 45 cases) correctly managed using the syndromic approach (P = 0.001).

Conclusions  In the absence of laboratory diagnostics, POC is not only inexpensive and practical, but also significantly more sensitive than the syndromic management approach, resulting in less overtreatment.
Progress towards the Millennium Development Goals in a community of extreme poverty: local vs. national disparities in Peru
Authors: Gyorkos Theresa W. , Joseph Serene A. , Casapía Martin
Published: April 2009

Objectives  Standard indicators are being used worldwide to track progress towards achieving the Millennium Development Goals (MDGs). These are usually at country level and do not accurately reflect within‐country variability of progress towards the targets. This may lead to lack of attention and under‐resourcing of the most vulnerable populations. Therefore, the objective of this study was to compare selected standard MDG indicators at country level and community level in Peru.

Methods  As MDG indicators we selected: (i) moderate to severe and severe underweight in children under 5 years old; (ii) immunization against measles in 1‐year olds; (iii) births attended by skilled health professionals and (iv) youth unemployment. Country‐level data for Peru were obtained from United Nations published sources. Community‐level data were obtained from a household survey conducted in 2005–2006 in Belén, a community of extreme poverty in the Amazon region.

Results  Belén indicators were consistently less favourable than country‐level indicators, and indicators even differed between zones of high and low socioeconomic status within Belén itself.

Conclusions  Compared to MDG indicators at the national level in Peru, the population of Belén experiences intra‐country regional disparities in important health and social outcomes. Improving the coverage and quality of interventions and services in this community is essential. Other vulnerable populations in Peru should also be identified and targeted so that they can benefit from, and ultimately contribute to, progress in achieving the MDGs.
Turning points, reproduction number, and impact of climatological events for multi‐wave dengue outbreaks
Authors: Hsieh Y.‐H. , Chen C. W. S.
Published: April 2009

Objectives  To study climatological and public health events which might have affected the 2007 two‐wave dengue outbreak in Taiwan, an island with both tropical and subtropical regions, where the 2007 dengue incidence exceeded the combined total of the previous four years.

Methods  A multi‐phase Richards model was fitted to weekly cumulative dengue data to pinpoint the turning points of the outbreak. We obtained the ‘initial’ reproduction numbers for the two waves of the outbreak. By means of correlation analysis we explored the possible impact of climatological events on the occurrence of turning points.

Results  Three turning points occurred around early August, late August/early September, and late October/early November. The ‘initial’ reproduction number for the first wave was Ri = 4.67 (95% CI: 0*–10.92), where 0* = max{0, lower bound}, and Ri = 3.93 (95% CI: 1.74–6.13) for the second wave. The highest correlation was between dengue incidence and two climatological variables: maximum temperature at a lag of 5 weeks (r = 0.66 and 0.71) and total precipitation at a lag of seven weeks (r = 0.53).

Conclusions  The first two turning points were partially attributable to two typhoons around early to mid‐August that brought a sharp drop in temperature and substantial rainfall. The drop in temperature first drove the dengue incidence down, then the rainfall drove it up at the beginning of fall. In recent years, Taiwan has witnessed increasingly frequent large summer dengue outbreaks that persisted into early winter, perhaps due to warmer autumns. This highlights the possible impact of global warming on the spread of infectious diseases.
The female sex work typology in India in the context of HIV/AIDS
Authors: Buzdugan Raluca , Halli Shiva S. , Cowan Frances M.
Published: April 2009

Objective To conduct a critical review of the typology of female sex work in India.

Method Published and unpublished studies (1986–2008) were identified through electronic databases, hand searching and contacting experts.

Results The review assesses the appropriateness of the existing typologies from a programmatic perspective and identifies their strengths and limitations. It indicates there is conceptual confusion around the typology and that none of the existing typologies are exhaustive, in that none includes all types of sex work documented in India. The typology developed by the National AIDS Control Organization (NACO) is the most comprehensive. The typology is based on the primary place of solicitation and categorizes female sex workers (FSWs) as brothel‐based, street‐based, home‐based, lodge‐based, dhaba‐based and highway‐based FSWs. However, this typology has its limitations. First, it does not include all categories of FSWs documented in the literature, such as indirect‐primary (primarily solicit clients at their places of work, which are venues where facilitating sex work is their main purpose e.g. massage parlours, bars), indirect‐secondary (primarily solicit clients at their places of work, which are in non‐sex work related industries e.g. agriculture, construction) and phone‐based FSWs (primarily solicit clients through phones). Second, the methodology used to develop the typology proposed by NACO or by any other researchers is not explicit. In addition, the extent to which the typology captures the HIV risk variability between FSWs types is not explored.

Conclusion There is a need to develop an evidence‐based, inclusive typology which takes account of HIV risk for researchers and programmers.
The epidemiology of malaria among pregnant women attending antenatal clinics in an area with intense and highly seasonal malaria transmission in northern Ghana
Authors: Clerk Christine Alexandra , Bruce Jane , Greenwood Brian , Chandramohan Daniel
Published: April 2009

Objective  To describe the factors associated with malaria infection and anaemia in pregnancy in northern Ghana.

Method  We studied 3642 pregnant women of all gravidities and gestational age of 18–32 weeks who attended an antenatal clinic in the Kassena‐Nankana district of Ghana between June 2004 and July 2006. Blood samples were examined for haemoglobin concentrations and parasitaemia, and we obtained socio‐demographic data, an obstetric history, information on their past and current state of health and bed net use.

Results  The overall prevalence of malaria parasitaemia during pregnancy was 47%. Older age [adjusted odds ratio (AOR) 0.65, 95% CI 0.54–0.78], multigravidity (AOR 0.51, 95% CI 0.42–0.61) and third trimester of pregnancy (AOR 0.85, 95% CI 0.73–0.99) were associated with a decreased risk of parasitaemia. Enrolment during the rainy or post‐rainy season was associated with an increased risk of parasitaemia (AOR 2.59, 95% CI 2.20–3.04 and AOR 3.12, 95% CI, 2.60–3.74 respectively). Malaria infection was associated with an increased risk of anaemia among young women. The prevalences of anaemia (Hb<11.0 g/dl) and severe anaemia (Hb<7.0 g/dl) during pregnancy were 72% and 2% respectively. The risk of anaemia was lower in older women (AOR 0.79, 95% CI, 0.64–0.97), multigravidae (AOR 0.67, 95% CI 0.55–0.83) and in educated women (AOR 0.81, 0.68–0.98).

Conclusion  The prevalence of malaria parasitaemia and anaemia among pregnant women in Kassena‐Nankana district is high with marked seasonal variation. Targeting of interventions to the high transmission season and to paucigravidae may be appropriate in this setting.
Risk factors for typhoid in Darjeeling, West Bengal, India: evidence for practical action
Authors: Sharma Puran K. , Ramakrishnan R. , Hutin Y. , Manickam P. , Gupte M. D.
Published: April 2009

Objective  To identify risk factors for typhoid and propose prevention measures.

Methods  Case–control study; we compared hospital‐based typhoid cases defined as fever>38°C for ≥3 days with four‐fold rise in ‘O’ antibodies on paired sera (Widal) with community, age and neighbourhood matched controls. We obtained information on drinking water, fruits, vegetables, milk products and sanitation; and calculated matched odds ratios (MOR) and attributable fractions in the population (AFP) for the risk factors or failure to use prevention measures.

Results  The 123 typhoid cases (median age: 25 years, 47% female) and 123 controls did not differ with respect to baseline characteristics. Cases were less likely to store drinking water in narrow‐mouthed containers (MOR: 0.4, 95% CI: 0.2–0.7, AFP 29%), tip containers to draw water (MOR: 0.4, 95% CI: 0.2–0.7, AFP 33%) and have home latrines (MOR: 0.5, 95% CI: 0.3–0.8, AFP 23%). Cases were more likely to consume butter (OR: 2.3, 95% CI: 1.3–4.1, AFP 28%), yoghurt (OR: 2.3, 95% CI: 1.4–3.7, AFP 34%) and raw fruits and vegetables, including onions (MOR: 2.1, 95% CI: 1.2–3.9, AFP 34%), cabbages (OR: 2.8, 95% CI: 1.7–4.8, AFP 44%) and unwashed guavas (OR: 1.9, 95% CI: 1.2–3, AFP 25%).

Conclusion  Typhoid was associated with unsafe water and sanitation practices as well as with consumption of milk products, fruits and vegetables. We propose to chlorinate drinking water at the point of use, wash/cook raw fruits and vegetables and ensure safer preparation/storage of local milk products.
Staphylococcal colonization of mucosal and lesional skin sites in atopic and healthy dogs
Authors: Fazakerley Jennifer , Nuttall Tim , Sales Debby , Schmidt Vanessa , Carter Stuart D. , Hart C. Anthony , McEwan Neil A.
Published: April 2009

Staphylococcal colonization was compared in healthy dogs and in dogs with atopic dermatitis. Bacterial swabs were collected from the nasal mucosa, ear and perineum of 43 healthy and 24 atopic dogs and also from potentially infected skin lesions of the atopic dogs. Coagulase positive staphylococcal isolates were identified to the species level. At the time of this studyStaphylococcus intermediuswas considered a single species but has since been recognized as comprising at least three species with canine isolates believed to belong toStaphylococcus pseudintermedius. Of atopic dogs, 87.5% were colonized withS. intermediuscompared to only 37.2% of healthy dogs. The ear was the only carriage site that showed any significant difference inS. intermediusisolation between healthy and atopic dogs. The perineum represented the most frequently colonized mucosal site for both groups. Sampling the nasal mucosa alone identified 71.4% of atopic and 37.5% of healthyS. intermediuscarriers. Inclusion of a perineal swab identified 100% of atopic and 93.8% of healthy carriers.S. intermediuswas isolated from all the lesional sites sampled from atopic dogs. Significantly fewer dogs were colonized byStaphylococcus aureusthanS. intermedius, and there was no significant difference betweenS. aureuscolonization of atopic and healthy dogs.S. aureuswas not recovered from any lesions in atopic dogs. The results show thatS. intermediuscarriage is more prevalent in atopic dogs compared to healthy dogs and that to identify staphylococcal carriers both the nasal mucosa and the perineum should be sampled.
Pseudopapilledema in a pediatric kidney transplant recipient
Authors: Bilginer Yelda , Haliloglu Göknur , Kadayıfçılar Sibel , Bakkaloglu Aysin , Besbas Nesrin
Published: April 2009

Bilginer Y, Haliloglu G, Kadayıfçılar S, Bakkaloglu A, Besbas N. Pseudopapilledema in a pediatric kidney transplant recipient. Pediatr Transplantation 2010: 14:E83–E85. © 2009 John Wiley & Sons A/S.

Abstract:  IIH is a syndrome of increased intracranial pressure characterized by headache, visual disturbance, papilledema with normal cranial neuroimaging. It is associated with many factors in childhood. From the renal perspective renal insufficiency, chronic dialysis, steroid treatment, and recombinant human growth hormone have been associated with IIH. It has also been described in pediatric recipients several months to years following kidney transplantation. In this study, we present a pediatric kidney transplant recipient receiving CyA, prednisone, and mycophenolate mofetil who was discovered to have pseudopapilledema during routine ophthalmological examination. He had no additional signs of increased intracranial pressure. Awareness of possible side effects in the follow‐up of these patients may improve management of these children.
The use of drotrecogin alfa (activated) in solid organ transplant patients: a case series
Authors: Berkman S. , Weimert N.A. , Taber D.J. , Baillie G.M. , Lin A. , Baliga P. , Chavin K.D.
Published: April 2009

Background. Drotrecogin alfa (activated) (DAA), a recombinant human activated protein C, is indicated for the reduction of mortality in patients with severe sepsis who have a high risk of death. In the initial trial, DAA demonstrated a significant reduction in mortality at 28 days for patients treated with DAA in comparison with standard supportive treatment (placebo). However, solid organ transplant recipients were excluded from the study. Transplant recipients are at an increased risk for sepsis and there is minimal literature describing the safety and efficacy of DAA in the transplant population.

Methods. Thirteen solid organ transplant recipients who received DAA between November 2001 and January 2004 were included in this case series. Patients were prospectively identified and data collection occurred concurrently and by retrospective chart review. All patients met the DAA use criteria based on the institutional standard protocol.

Results. We report the outcomes of the 13 adult transplant patients who received a total of 14 courses of DAA for severe sepsis. At the time of DAA initiation, all patients required mechanical ventilation, 86% necessitated vasopressor support, and had a median of 3 dysfunctional organs. The median Acute Physiology and Chronic Health Evaluation (APACHE) II score at initiation was 30. Overall, hemodynamic stability and APACHE II score improved at the end of DAA infusion. Causes of early discontinuation were bleeding (57%), scheduled procedure (14%), increased international normalized ratio (14%), and death (14%). In‐hospital, 28‐day, and 1‐year mortality was 69%, 62%, and 83%, respectively.

Conclusion. DAA appears to be safe with appropriate monitoring. However, transplant recipients had a higher incidence of bleeding events leading to early discontinuation of DAA. Efficacy is difficult to assess without an appropriate control group for comparison.
New developments in the antiviral treatment of hepatitis C
Authors: De Bruijne J. , Weegink C. J. , Jansen P. L. M. , Reesink H. W.
Published: April 2009

Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. HCV is endemic in most parts of the world, with an estimated 170 million people infected worldwide and 3–4 million new cases each year. HCV‐related end‐stage liver disease is now the main indication for liver transplantation in the USA and Western Europe. Unfortunately, no vaccine or immunoglobulin is available to prevent HCV infection. Currently, HCV treatment consists of the combined administration of pegylated interferon and ribavirin for a period of 24–48 weeks, resulting in complete viral eradication in 40–80% of patients, depending on genotype, viral load and patient characteristics. This therapy is often accompanied with side‐effects that affect compliance and reduce treatment outcomes.

Recently, reliablein vitroculture systems have been developed which accelerated antiviral therapy research. Many new specifically targeted antiviral therapies for hepatitis C (STAT‐C) and treatment strategies are evaluated in clinical trials. These new antiviral agents are expected to improve treatment significantly with potentially shorter treatment duration. The most promising antiviral agents will be reviewed.
FUZZY TRUST AGGREGATION AND PERSONALIZED TRUST INFERENCE IN VIRTUAL SOCIAL NETWORKS
Authors: Lesani Mohsen , Montazeri Niloufar
Published: April 2009

Virtual marketplaces on the Web provide people with great facilities to buy and sell goods similar to conventional markets. In traditional business, reputation is subjectively built for known persons and companies as the deals are made in the course of time. As it is important to do business with trustful individuals and companies, there is a need to survive the reputation concept in virtual markets. Auction sites generally employ reputation systems based on feedbacks that provide a global view to a cyber dealer. In contrast to global trust, people usually infer their personal trust about someone whose reputation is completely or partially unknown by asking their trusted friends. Personal reputation is what makes a person trusted for some people and untrusted for others. There should be a facility for users in a virtual market to specify how much they trust a friend and also a mechanism that infers the trust of a user to another user who is not directly a friend of her. There are two main issues that should be addressed in trust inference. First, the trust modeling and aggregation problem needs to be challenged. Second, algorithms should be introduced to find and select the best paths among the existing trust paths from a source to a sink. First, as trust to a person can be stated more naturally using linguistic expressions, this work suggests employing linguistic terms for trust specification. To this end, corresponding fuzzy sets are defined for trust linguistic terms and a fuzzy trust aggregation method is also proposed. Comparing the fuzzy aggregation method to the existing aggregation methods shows superiority of fuzzy approach especially at aggregating contradictory information. Second, this paper proposes an incremental trust inference algorithm. The results show improvement in preciseness of inference for the proposed inference algorithm over the existing and recently proposed algorithm named TidalTrust.
Testing for a break in persistence under long‐range dependencies
Authors: Sibbertsen Philipp , Kruse Robinson
Published: April 2009

Abstract.  We show that tests for a break in the persistence of a time series in the classical I(0)/I(1) framework have serious size distortions when the actual data‐generating process (DGP) exhibits long‐range dependencies. We prove that the limiting distribution of a CUSUM of squares‐based test depends on the true memory parameter if the DGP exhibits long memory. We propose adjusted critical values for the test and give finite sample response curves that allow easy implementation of the test by the practitioner and also ease in computing the relevant critical values. We furthermore prove the consistency of the test for a simple breakpoint estimator also under long memory. We show that the test has satisfying power properties when the correct critical values are used.
Bootstrapping a weighted linear estimator  of the ARCH parameters
Authors: Bose Arup , Mukherjee Kanchan
Published: April 2009

Abstract.  A standard assumption while deriving the asymptotic distribution of the quasi maximum likelihood estimator in ARCH models is that all ARCH parameters must be strictly positive. This assumption is also crucial in deriving the limit distribution of appropriate linear estimators (LE). We propose a weighted linear estimator (WLE) of the ARCH parameters in the classical ARCH model and show that its limit distribution is multivariate normal even when some of the ARCH coefficients are zero. The asymptotic dispersion matrix involves unknown quantities. We consider appropriate bootstrapped version of this WLE and prove that it is asymptotically valid in the sense that the bootstrapped distribution (given the data) is a consistent estimate (in probability) of the distribution of the WLE. Although we do not show theoretically that the bootstrap outperforms the normal approximation, our simulations demonstrate that it yields better approximations than the limiting normal.