bluuebunny/crossref_metadata_2025 huggingface dataset:
Education for sustainable development in the UK: Making the connections between the environment and development agendas
Authors: Bourn Douglas
Published: June 2008

Education for Sustainable Development (ESD) is an initiative that dates back to the early 1990s. Whilst policy statements at this time referred to ESD as a bringing together of environmental and development education, in the UK, as in most other industrialized countries, it has been the environmental agenda that has tended to dominate. In the UK, policy-makers have since 1997 played an increasingly leading role in promoting ESD, particularly within schools. However, the drive behind these initiatives poses wider questions about their ultimate purpose: a learning agenda or one based on seeking behavioural change?

Development education has always been the junior partner in the ESD debates in the UK, in part because of its low academic profile but also because of the policy separation by governments.This has, however, begun to change through the merging of policy initiatives around ESD and global citizenship which, by their very nature, are again posing the wider questions about the purpose and goal of these agendas.
Geographic Proximity Versus Institutions
Authors: Tam Cho Wendy K. , Nicley Erinn P.
Published: June 2008

Scholars have recently begun to connect political phenomena with geographic proximity, noting that in addition to one's personal characteristics, individuals are strongly affected by their social context. We push this literature further by examining how institutions such as state borders mediate and condition the effects of geographic proximity. Our findings expand our understanding of geography by demonstrating that the geographic landscape has interesting facets beyond proximity and distance. Rather, geography is the product of political relationships that intersect in particular places.
A Mentor-Based Targeted Intervention for High-Risk Latino College Freshmen
Authors: Torres Campos Cidhinnia M. , Phinney Jean S. , Perez-Brena Norma , Kim Chami , Ornelas Beatriz , Nemanim Liron , Padilla Kallemeyn Delia M. , Mihecoby Anita , Ramirez Cinthya
Published: June 2008

This article describes the implementation and evaluation of a pilot mentoring program that provided support for Latino college freshmen at risk for poor academic outcomes. Latino is a term used in the United States to identify persons of Spanish-speaking origin or descent who designate themselves as Mexican American, Chicano, Puerto Rican, Cuban, or of some other Hispanic Origin. The study illustrates specific ways in which a mentoring program can promote positive academic outcomes by targeting students at high psychosocial risk.
The Many Faces of Internationalization in Japanese Anime
Authors: Lu Amy Shirong
Published: June 2008

This article explores the internationalization of Japanese anime (animation) in an effort to help explain the cultural politics behind this popular cultural product. The internationalization of anime includes the incorporation of de-Japanized elements into anime's background, context, character design, and narrative organization. A theoretical framework for understanding anime's internationalization is developed, proposing that there are at least three kinds of cultural politics working behind anime's international success: one, de-politicized internationalization, which primarily serves as a commercial tactic to attract international audiences; two, Occidentalized internationalization, which satiates a nationalistic sentiment; three, self-Orientalized internationalization, which reveals a cultural desire to establish Japan as an ersatz Western country in Asia.
The Balinese Cockfight Decoded: Reflections on Geertz, the Strong Program and Structuralism
Authors: Smith Philip
Published: June 2008

The essay by Geertz on the Balinese cockfight is by far his most famous and influential piece of work. Why? Using resources from the Russian formalism of the early 20th century, the article uncovers the textual and structural foundations that gave it a competitive advantage over his other writings. In so doing the analysis seeks to reconcile Geertz with the structuralism that he famously and perhaps unwisely dismissed as irrelevant for interpretative sociology. The reception trajectory of Geertz points to the need for a more robust theory of culture than his hermeneutics could offer. The Yale strong program is understood as a solution to this malaise, one that combines structuralist analysis with Geertzian sensibilities.
Maximal Interpretation in Clifford Geertz and the Strong Program in Cultural Sociology: Towards a New Epistemology
Authors: Reed Isaac
Published: June 2008

The strong program in cultural sociology faces — and creates for sociology generally — an epistemic dilemma: does an interpretation of culture constitute an explanation of social action? The work of Clifford Geertz suggests the two are not mutually exclusive. In his empirical studies he artfully produced `maximal interpretations' that went beyond both extant theories and the immediate data given by participant observation. Maximal interpretations, I argue, claim the epistemic status of sociological explanations. Indeed, the core problems of the philosophy of social science and social theory can be reframed in terms of the difference between relatively uncontroversial `minimal interpretation' and relatively tendentious (but powerful)`maximal interpretation'.The implications of this distinction for research can be made clear by considering, as an example, what is required to explain witch hunts in Early Modern Europe and Colonial America, and the Salem witch trials in particular.
`To Locate in the Tenor of Their Setting the Sources of Their Spell': Clifford Geertz and the `Strong Program' in Cultural Sociology
Authors: Trondman Mats
Published: June 2008

In their formulation of a `strong program' in cultural sociology, Jeffrey C.Alexander and Philip Smith argue that sociology is suffering from a `numbness toward meaning' due to `cultural unmusical scholars'. Clifford Geertz embodied this demanded musicality on, in Geertz's own words, `particular ways of being in the world'. He knew how to do a cultural sociology of symbolic structures, meaning making and performances, but did not found a school and had no party line. He even came to reject theory, which in the mid-1980s forced Alexander to conclude that `we must reluctantly turn away from Geertz'.The aim of this article is to reconcile Geertz with Alexander and the`strong program'. While Alexander rightly criticized Geertz from his turn away from theory, Alexander, at the very same time, missed out on the multidimensional cultural analysis that Geertz kept on doing so well. This is what is being demonstrated.
The 2007 General Election in Kenya and Its Aftermath: The Role of Local Language Media
Authors: Ismail Jamal Abdi , Deane James
Published: June 2008

Political parties in Kenya reached a fragile but potentially historic agreement in March 2008 paving the way for an end to the violence that has wracked the country. The Kenyan government and international observers accused some media organizations, particularly local language radio stations, of fanning the violence. Based on a series of 20 semistructured interviews with senior media figures in Kenya, this article analyzes the role of the media in the lead up to and during the recent crisis.
Peripheral deletional tolerance of alloreactive CD8 but not CD4 T cells is dependent on the PD-1/PD-L1 pathway
Authors: Haspot Fabienne , Fehr Thomas , Gibbons Carrie , Zhao Guiling , Hogan Timothy , Honjo Tasuku , Freeman Gordon J. , Sykes Megan
Published: June 2008

Although interaction between programmed death-1 (PD-1) and the ligand PD-L1 has been shown to mediate CD8 cell exhaustion in the setting of chronic infection or the absence of CD4 help, a role for this pathway in attenuating early alloreactive CD8 cell responses has not been identified. We demonstrate that the PD-1/PD-L1 pathway is needed to rapidly tolerize alloreactive CD8 cells in a model that requires CD4 cells and culminates in CD8 cell deletion. This protocol involves allogeneic bone marrow transplantation (BMT) following conditioning with low-dose total body irradiation and anti-CD154 antibody. Tolerized donor-reactive T-cell receptor transgenic CD8 cells are shown to be in an abortive activation state prior to their deletion, showing early and prolonged expression of activation markers (compared with rejecting CD8 cells) while being functionally silenced by day 4 after transplantation. Although both tolerized and rejecting alloreactive CD8 cells up-regulate PD-1, CD8 cell tolerance is dependent on the PD-1/PD-L1 pathway. In contrast, CD4 cells are tolerized independently of this pathway following BMT with anti-CD154. These studies demonstrate a dichotomy between the requirements for CD4 and CD8 tolerance and identify a role for PD-1 in the rapid tolerization of an alloreactive T-cell population via a deletional mechanism.
Transient blockade of the inducible costimulator pathway generates long-term tolerance to factor VIII after nonviral gene transfer into hemophilia A mice
Authors: Peng Baowei , Ye Peiqing , Blazar Bruce R. , Freeman Gordon J. , Rawlings David J. , Ochs Hans D. , Miao Carol H.
Published: June 2008

Formation of inhibitory antibodies is a common problem encountered in clinical treatment for hemophilia. Human factor VIII (hFVIII) plasmid gene therapy in hemophilia A mice also leads to strong humoral responses. We demonstrate that short-term therapy with an anti-ICOS monoclonal antibody to transiently block the inducible costimulator/inducible costimulator ligand (ICOS/ICOSL) signaling pathway led to sustained tolerance to hFVIII in hFVIII plasmid–treated hemophilia A mice and allowed persistent, high-level FVIII functional activity (100%-300% of normal). Anti-ICOS treatment resulted in depletion of ICOS+CD4+ T cells and activation of CD25+Foxp3+ Tregs in the peripheral blood, spleen, and lymph nodes. CD4+ T cells from anti-ICOS–treated mice did not proliferate in response to hFVIII stimulation and produced high levels of regulatory cytokines, including interleukin-10 and transforming growth factor-β. Moreover, CD4+CD25+ Tregs from tolerized mice adoptively transferred dominant tolerance in syngeneic hFVIII plasmid-treated hemophilia A mice and reduced the production of antibodies against FVIII. Anti-ICOS–treated mice tolerized to hFVIII generated normal primary and secondary antibody responses after immunization with the T-dependent antigen, bacteriophage Φx 174, indicating maintenance of immune competency. Our data indicate that transient anti-ICOS monoclonal antibody treatment represents a novel single-agent immunomodulatory strategy to overcome the immune responses against transgene product after gene therapy.
Analysis of clonotypic switch junctions reveals multiple myeloma originates from a single class switch event with ongoing mutation in the isotype-switched progeny
Authors: Taylor Brian J. , Kriangkum Jitra , Pittman Julie A. , Mant Michael J. , Reiman Tony , Belch Andrew R. , Pilarski Linda M.
Published: June 2008

Multiple myeloma (MM) is a cancer of plasma cells (PCs) expressing immunoglobulin heavy chain (IgH) postswitch isotypes. The discovery of earlier stage cells related to postswitch PCs, called preswitch clonotypic IgM (cIgM) cells led to the hypothesis that cIgM cells may be MM progenitors, replenishing the tumor throughout malignancy. cIgM cells may do this by undergoing class switch recombination (CSR), a process detectable in postswitch PCs as multiple IgH switch junctions associated with a single clonotypic IgH V/D/J. We addressed this with a specific clonotypic-switch polymerase chain reaction (PCR), informative for 32 of 41 cases. Here we made 2 significant discoveries: (1) in all cases, we detected only a single clonotypic switch fragment that persists over time (1-7.6 years), and (2) we detected ongoing mutation upstream of the switch junction in 5 of 6 patients, often targeting the intronic enhancer, a key control region in IgH expression. The presence of a single, unchanging clonotypic switch junction suggests that cIgM cells are not MM-PC progenitors; rather, postswitch PCs arise from a single cIgM cell, and MM-PC progenitors reside in the postswitch population. Furthermore, mutations revealed here provide a new marker to identify MM-PC progenitors and aggressive clones that evolve throughout malignancy.
Effective elimination of fludarabine-resistant CLL cells by PEITC through a redox-mediated mechanism
Authors: Trachootham Dunyaporn , Zhang Hui , Zhang Wan , Feng Li , Du Min , Zhou Yan , Chen Zhao , Pelicano Helene , Plunkett William , Wierda William G. , Keating Michael J. , Huang Peng
Published: June 2008

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia, and resistance to fludarabine-based therapies is a major challenge in CLL treatment. Because CLL cells are known to have elevated levels of reactive oxygen species (ROS), we aimed to test a novel ROS-mediated strategy to eliminate fludarabine-resistant CLL cells based on this redox alteration. Using primary CLL cells and normal lymphocytes from patients (n = 58) and healthy subjects (n = 12), we showed that both fludarabine-resistant and -sensitive CLL cells were highly sensitive to β-phenylethyl isothiocyanate (PEITC) with mean IC50 values of 5.4 μM and 5.1 μM, respectively. Normal lymphocytes were significantly less sensitive to PEITC (IC50 = 27 μM, P < .001). CLL cells exhibited intrinsically higher ROS level and lower cellular glutathione, which were shown to be the critical determinants of CLL sensitivity to PEITC. Exposure of CLL cells to PEITC induced severe glutathione depletion, ROS accumulation, and oxidation of mitochondrial cardiolipin leading to massive cell death. Such ROS stress also caused deglutathionylation of MCL1, followed by a rapid degradation of this cell survival molecule. Our study demonstrated that the natural compound PEITC is effective in eliminating fludarabine-resistant CLL cells through a redox-mediated mechanism with low toxicity to normal lymphocytes, and warrants further clinical evaluation.
Literature-aided meta-analysis of microarray data: a compendium study on muscle development and disease
Authors: Jelier Rob , 't Hoen Peter AC , Sterrenburg Ellen , den Dunnen Johan T , van Ommen Gert-Jan B , Kors Jan A , Mons Barend
Published: June 2008

Background

Comparative analysis of expression microarray studies is difficult due to the large influence of technical factors on experimental outcome. Still, the identified differentially expressed genes may hint at the same biological processes. However, manually curated assignment of genes to biological processes, such as pursued by the Gene Ontology (GO) consortium, is incomplete and limited. We hypothesised that automatic association of genes with biological processes through thesaurus-controlled mining of Medline abstracts would be more effective. Therefore, we developed a novel algorithm (LAMA: Literature-Aided Meta-Analysis) to quantify the similarity between transcriptomics studies. We evaluated our algorithm on a large compendium of 102 microarray studies published in the field of muscle development and disease, and compared it to similarity measures based on gene overlap and over-representation of biological processes assigned by GO.

Results

While the overlap in both genes and overrepresented GO-terms was poor, LAMA retrieved many more biologically meaningful links between studies, with substantially lower influence of technical factors. LAMA correctly grouped muscular dystrophy, regeneration and myositis studies, and linked patient and corresponding mouse model studies. LAMA also retrieves the connecting biological concepts. Among other new discoveries, we associated cullin proteins, a class of ubiquitinylation proteins, with genes down-regulated during muscle regeneration, whereas ubiquitinylation was previously reported to be activated during the inverse process: muscle atrophy.

Conclusion

Our literature-based association analysis is capable of finding hidden common biological denominators in microarray studies, and circumvents the need for raw data analysis or curated gene annotation databases.
Identification of genes associated with regenerative success of Xenopus laevishindlimbs
Authors: Pearl Esther J , Barker Donna , Day Robert C , Beck Caroline W
Published: June 2008

Background

Epimorphic regeneration is the process by which complete regeneration of a complex structure such as a limb occurs through production of a proliferating blastema. This type of regeneration is rare among vertebrates but does occur in the African clawed frog Xenopus laevis, traditionally a model organism for the study of early development. Xenopus tadpoles can regenerate their tails, limb buds and the lens of the eye, although the ability of the latter two organs to regenerate diminishes with advancing developmental stage. Using a heat shock inducible transgene that remains silent unless activated, we have established a stable line of transgenic Xenopus (strain N1) in which the BMP inhibitor Noggin can be over-expressed at any time during development. Activation of this transgene blocks regeneration of the tail and limb of Xenopus tadpoles.

Results

In the current study, we have taken advantage of the N1 transgenic line to directly compare morphology and gene expression in same stage regenerating vs. BMP signalling deficient non-regenerating hindlimb buds. The wound epithelium of N1 transgenic hindlimb buds, which forms over the cut surface of the limb bud after amputation, does not transition normally into the distal thickened apical epithelial cap. Instead, a basement membrane and dermis form, indicative of mature skin. Furthermore, the underlying mesenchyme remains rounded and does not expand to form a cone shaped blastema, a normal feature of successful regeneration.

Using Affymetrix Gene Chip analysis, we have identified genes linked to regenerative success downstream of BMP signalling, including the BMP inhibitor Gremlin and the stress protein Hsp60 (no blastema in zebrafish). Gene Ontology analysis showed that genes involved in embryonic development and growth are significantly over-represented in regenerating early hindlimb buds and that successful regeneration in the Xenopus hindlimb correlates with the induction of stress response pathways.

Conclusion

N1 transgenic hindlimbs, which do not regenerate, do not form an apical epithelial cap or cone shaped blastema following amputation. Comparison of gene expression in stage matched N1 vs. wild type hindlimb buds has revealed several new targets for regeneration research.
Identification of geographically distributed sub-populations of Leishmania (Leishmania) majorby microsatellite analysis
Authors: Al-Jawabreh Amer , Diezmann Stephanie , Müller Michaela , Wirth Thierry , Schnur Lionel F , Strelkova Margarita V , Kovalenko Dmitri A , Razakov Shavkat A , Schwenkenbecher Jan , Kuhls Katrin , Schönian Gabriele
Published: June 2008

Background

Leishmania (Leishmania) major, one of the agents causing cutaneous leishmaniasis (CL) in humans, is widely distributed in the Old World where different species of wild rodent and phlebotomine sand fly serve as animal reservoir hosts and vectors, respectively. Despite this, strains of L. (L.) major isolated from many different sources over many years have proved to be relatively uniform. To investigate the population structure of the species highly polymorphic microsatellite markers were employed for greater discrimination among it's otherwise closely related strains, an approach applied successfully to other species of Leishmania.

Results

Multilocus Microsatellite Typing (MLMT) based on 10 different microsatellite markers was applied to 106 strains of L. (L.) major from different regions where it is endemic. On applying a Bayesian model-based approach, three main populations were identified, corresponding to three separate geographical regions: Central Asia (CA); the Middle East (ME); and Africa (AF). This was congruent with phylogenetic reconstructions based on genetic distances. Re-analysis separated each of the populations into two sub-populations. The two African sub-populations did not correlate well with strains' geographical origin. Strains falling into the sub-populations CA and ME did mostly group according to their place of isolation although some anomalies were seen, probably, owing to human migration.

Conclusion

The model- and distance-based analyses of the microsatellite data exposed three main populations of L. (L.) major, Central Asia, the Middle East and Africa, each of which separated into two sub-populations. This probably correlates with the different species of rodent host.
Transcriptome profiling of developmental and xenobiotic responses in a keystone soil animal, the oligochaete annelid Lumbricus rubellus
Authors: Owen Jennifer , Hedley B Ann , Svendsen Claus , Wren Jodie , Jonker Martijs J , Hankard Peter K , Lister Linsey J , Stürzenbaum Stephen R , Morgan A John , Spurgeon David J , Blaxter Mark L , Kille Peter
Published: June 2008

Background

Natural contamination and anthropogenic pollution of soils are likely to be major determinants of functioning and survival of keystone invertebrate taxa. Soil animals will have both evolutionary adaptation and genetically programmed responses to these toxic chemicals, but mechanistic understanding of such is sparse. The clitellate annelidLumbricus rubellusis a model organism for soil health testing, but genetic data have been lacking.

Results

We generated a 17,000 sequence expressed sequence tag dataset, defining ~8,100 different putative genes, and built an 8,000-element transcriptome microarray forL. rubellus. Strikingly, less than half the putative genes (43%) were assigned annotations from the gene ontology (GO) system; this reflects the phylogenetic uniqueness of earthworms compared to the well-annotated model animals. The microarray was used to identify adult- and juvenile-specific transcript profiles in untreated animals and to determine dose-response transcription profiles following exposure to three xenobiotics from different chemical classes: inorganic (the metal cadmium), organic (the polycyclic aromatic hydrocarbon fluoranthene), and agrochemical (the herbicide atrazine). Analysis of these profiles revealed compound-specific fingerprints which identify the molecular responses of this annelid to each contaminant. The data and analyses are available in an integrated database, LumbriBASE.

Conclusion

L. rubellushas a complex response to contaminant exposure, but this can be efficiently analysed using molecular methods, revealing unique response profiles for different classes of effector. These profiles may assist in the development of novel monitoring or bioremediation protocols, as well as in understanding the ecosystem effects of exposure.
Apoptosis of supraoptic AVP neurons is involved in the development of central diabetes insipidus after hypophysectomy in rats
Authors: Wang Yihua , Zhao Cuiping , Wang Zhigang , Wang Chengwei , Feng Wenfeng , Huang Lijin , Zhang Jialin , Qi Songtao
Published: June 2008

Background

It has been reported that various types of axonal injury of hypothalamo-neurohypophyseal tract can result in degeneration of the magnocellular neurons (MCNs) in hypothalamus and development of central diabetes insipidus (CDI). However, the mechanism of the degeneration and death of MCNs after hypophysectomy in vivo is still unclear. This present study was aimed to disclose it and to figure out the dynamic change of central diabetes insipidus after hypophysectomy.

Results

The analysis on the dynamic change of daily water consumption (DWC), daily urine volume(DUV), specific gravity of urine(USG) and plasma vasopressin concentration showed that the change pattern of them was triphasic and neuron counting showed that the degeneration of vasopressin neurons began at 10 d, aggravated at 20 d and then stabilized at 30 d after hypophysectomy. There was marked upregulation of cleaved Caspase-3 expression of vasopressin neurons in hypophysectomy rats. A "ladder" pattern of migration of DNA internucleosomal fragments was detected and apoptotic ultrastructure was found in these neurons. There was time correlation among the occurrence of diabetes insipidus, the changes of plasma vasopressin concentration and the degeneration of vasopressin neurons after hypophysectomy.

Conclusion

This study firstly demonstrated that apoptosis was involved in degeneration of supraoptic vasopressin neurons after hypophysectomy in vivo and development of CDI. Our study on time course and correlations among water metabolism, degeneration and apoptosis of vasopressin neurons suggested that there should be an efficient therapeutic window in which irreversible CDI might be prevented by anti-apoptosis.
Age-specific seroprevalence of hepatitis A in Antananarivo (Madagascar)
Authors: Raharimanga Vaomalala , Carod Jean-François , Ramarokoto Charles-Emile , Chrétien Jean-Baptiste , Rakotomanana Fanjasoa , Talarmin Antoine , Richard Vincent
Published: June 2008

Background

Hepatitis A virus (HAV) is an enteric, viral, infectious disease endemic in many developing countries such as Madagascar. Infection is often subclinical or asymptomatic in children; however, symptomatic acute infections become more common with increasing age. In some developing countries, improvements in living conditions have led to changes in the epidemiological pattern of HAV infection. There are very few reports on the prevalence of HAV in Madagascar.

This study was to determine the seroprevalence of hepatitis A virus antibodies in relation to age in the city of Antananarivo, Madagascar.

Methods

Serum samples collected in 2004 during a cross-sectional survey of individuals aged between two and 24 years from Antananarivo were tested for anti-HAV antibody using a commercial enzyme immunoassay kit. Subjects were investigated using a standardized social and medical history questionnaire.

Results

926 subjects were enrolled including 406 males and 520 females. There were 251 children under 10 years old and 675 subjects between 10 and 24 years old. Of the 926 serum samples tested, 854 (92.2%) were positive for anti-HAV antibodies. The number of seropositive samples was similar for males and females. The overall seroprevalence was 83.7% (210/251) for children under 10 years old and 95.5% (644/675) for subjects aged between 10 and 24 years (p < 0.001).

Conclusion

Despite improvements in sanitary conditions and hygiene over the last few years, the prevalence of HAV in Antananarivo is high. Only children under five years old remain susceptible to HAV infection. Immunization against HAV is not needed at the present time in the Madagascan population, but should be recommended for travellers.
Cognitive-behaviour therapy for patients with Abridged Somatization Disorder (SSI 4,6) in primary care: a randomized, controlled study
Authors: Magallón Rosa , Gili Margalida , Moreno Sergio , Bauzá Natalia , García-Campayo Javier , Roca Miquel , Ruiz Yolanda , Andrés Eva
Published: June 2008

Background

Somatoform disorders are characterized by the presence of multiple somatic symptoms without an organic cause that completely explains their symptoms.

These patients generate a high cost in health services. We aim to evaluate the effectiveness and feasibility of a cognitive-behaviour therapy (CBT) programme, administered in group and individual formats in primary care for patients who are diagnosed with abridged somatization disorder.

Method/design

Design:Multicentre, randomized, controlled trial involving 3 groups, one of which is the control group consisting of standardized recommended treatment for somatization disorder in primary care (Smith's norms) and the 2 others, the intervention groups, consisting of cognitive-behavioural therapy (10 sessions) administered in individual format (intervention group 1) or in group format (intervention group 2).

Setting:29 primary care health centres in the province of Zaragoza and 3 primary care health centres in the province of Mallorca, Spain.

Sample:N = 204 patients, (68 in each of the three groups), aged 18–65 years, able to understand and read Spanish, who fulfil Escobar's criteria of Abridgged Somatization Disorder (SSI 4,6), stable with pharmacotherapy over the previous month, and who will remain stable for the next 3 months in the doctor's opinion, having signed informed consent.

Intervention:Control group: Standardized recommended treatment for somatization disorder in primary care (Smith's norms). Intervention group: 10 weekly sessions of CBT, following a protocol designed by Prof. Escobar's group at UMDNJ, USA. There are 2 different treatment conditions: individual and group format.

Measurements:Survey on the use of health services, number and severity of somatic symptoms, anxiety, depression, quality of life and clinical global impression. The interviewers will not know which group the patient belongs to (blind). The assessments will be carried out at baseline, post-treatment, 6 months and 12 post-treatment.

Main variables:Utilization of health services, number and severity of somatic symptoms.

Analysis: The analysis will be per intent to treat. We will use the general linear models of the SPSS v.15 statistical package, to analyse the effect of treatment on the result variable (utilization of health services, number and severity of somatic symptoms).

Discussion

It is necessary to develop more effective psychological treatments for somatoform disorders. This randomised clinical trial will determine whether cognitive behaviour therapy, both in group or in individual format, is effective for the treatment of these patients.

Trial registration

Current controlled trials ISRCTN69944771
Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): Study rationale and design
Authors:   The SPRINT Investigators
Published: June 2008

Background

Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing controversy regarding which is better.

Methods/Design

The objective of this trial was to assess the impact of reamed versus non-reamed intramedullary nailing on rates of re-operation in patients with open and closed fractures of the tibial shaft. The study to prospectively evaluate reamed intramedullary nails in tibial fractures (S.P.R.I.N.T) was a multi-center, randomized trial including 29 clinical sites in Canada, the United States and the Netherlands which enrolled 1200 skeletally mature patients with open (Gustilo Types I-IIIB) or closed (Tscherne Types 0–3) fractures of the tibial shaft amenable to surgical treatment with an intramedullary nail. Patients received a statically locked intramedullary nail with either reamed or non-reamed insertion. The first strategy involved fixation of the fracture with an intramedullary nail following reaming to enlarge the intramedullary canal (Reamed Group). The second treatment strategy involved fixation of the fracture with an intramedullary nail without prior reaming of the intramedullary canal (Non-Reamed Group). Patients, outcome assessors, and data analysts were blinded to treatment allocation. Peri-operative care was standardized, and re-operations before 6 months were proscribed. Patients were followed at discharge, 2 weeks post-discharge, and at 6 weeks, 3, 6, 9, and 12 months post surgery. A committee, blinded to allocation, adjudicated all outcomes.

Discussion

The primary outcome was re-operation to promote healing, treat infection, or preserve the limb (fasciotomy for compartment syndrome after nailing). The primary outcome was a composite comprising the following re-operations: bone grafts, implant exchanges, and dynamizations, in patients with fracture gaps less than 1 cm post intramedullary nail insertion. Infections and fasciotomies were considered events irrespective of the fracture gap. We planneda priorito conduct a subgroup analysis of outcomes in patients with open and closed fractures. S.P.R.I.N.T is the largest collaborative trial evaluating alternative orthopaedic surgical interventions in patients with tibial shaft fractures. The methodological rigor will set new benchmarks for future trials in the field and its results will have important impact on patient care. The S.P.R.I.N.T trial was registered [ID NCT00038129] and received research ethics approval (REB#99-077).
Patient satisfaction of primary care for musculoskeletal diseases: A comparison between Neural Therapy and conventional medicine
Authors: Mermod Joelle , Fischer Lorenz , Staub Lukas , Busato André
Published: June 2008

Background

The main objective of this study was to assess and compare patient satisfaction with Neural Therapy (NT) and conventional medicine (COM) in primary care for musculoskeletal diseases.

Methods

A cross-sectional study in primary care for musculoskeletal disorders covering 77 conventional primary care providers and 18 physicians certified in NT with 241 and 164 patients respectively. Patients and physicians documented consultations and patients completed questionnaires at a one-month follow-up. Physicians documented duration and severity of symptoms, diagnosis, and procedures. The main outcomes in the evaluation of patients were: fulfillment of expectations, perceived treatment effects, and patient satisfaction.

Results

The most frequent diagnoses belonged to the group of dorsopathies (39% in COM, 46% in NT). We found significant differences between NT and COM with regard to patient evaluations. NT patients documented better fulfilment of treatment expectations and higher overall treatment satisfaction. More patients in NT reported positive side effects and less frequent negative effects than patients in COM. Also, significant differences between NT and COM patients were seen in the quality of the patient-physician interaction (relation and communication, medical care, information and support, continuity and cooperation, facilities availability, and accessibility), where NT patients showed higher satisfaction. Differences were also found with regard to the physicians' management of disease, with fewer work incapacity attestations issued and longer consultation times in NT.

Conclusion

Our findings show a significantly higher treatment and care-related patient satisfaction with primary care for musculoskeletal diseases provided by physicians practising Neural Therapy.
Spatially-explicit risk profiling of Plasmodium falciparum infections at a small scale: a geostatistical modelling approach
Authors: Silué Kigbafori D , Raso Giovanna , Yapi Ahoua , Vounatsou Penelope , Tanner Marcel , N'Goran Eliézer K , Utzinger Jürg
Published: June 2008

Background

There is a renewed political will and financial support to eradicate malaria. Spatially-explicit risk profiling will play an important role in this endeavour. Patterns ofPlasmodium falciparuminfection prevalence were examined among schoolchildren in a highly malaria-endemic area.

Methods

A questionnaire was administered and finger prick blood samples collected from 3,962 children, aged six to 16 years, attending 55 schools in a rural part of western Côte d'Ivoire. Information was gathered from the questionnaire on children's socioeconomic status and the use of bed nets for the prevention of malaria. Blood samples were processed with standardized, quality-controlled methods for diagnosis ofPlasmodiumspp. infections. Environmental data were obtained from satellite images and digitized maps. Bayesian variogram models for spatially-explicit risk modelling ofP. falciparuminfection prevalence were employed, assuming for stationary and non-stationary spatial processes.

Findings

The overall prevalence ofP. falciparuminfection was 64.9%, ranging between 34.0% and 91.9% at the unit of the school. Risk factors for aP. falciparuminfection included age, socioeconomic status, not sleeping under a bed net, distance to health care facilities and a number of environmental features (i.e. normalized difference vegetation index, rainfall and distance to rivers). After taking into account spatial correlation only age remained significant. Non-stationary models performed better than stationary models.

Conclusion

Spatial risk profiling ofP. falciparumprevalence data provides a useful tool for targeting malaria control intervention, and hence will play a role in the quest of local elimination and ultimate eradication of the disease.
Successful treatment of perineal necrotising fasciitis and associated pubic bone osteomyelitis with the vacuum assisted closure system
Authors: Kumar Susim , O'Donnell Mark E , Khan Khalid , Dunne Gillian , Carey P Declan , Lee Jack
Published: June 2008

Background

Acute necrotising fasciitis is a life-threatening condition, which requires urgent surgical intervention. Surgical debridement is invariably associated with large areas of tissue loss.

Case presentation

We present a 58-year old woman with a past history of cervical carcinoma who presented with necrotising fasciitis of the perineum and upper thighs with associated pubic bone osteomyelitis. Following extensive debridement, a Vacuum Assisted Closure (VAC) system was applied to the large residual defect to facilitate skin graft application and optimise wound healing.

Conclusion

This case demonstrates the successful management of a complex and potentially lethal wound of the perineum with debridement, skin grafting and the VAC system.
The association between disease activity and NT-proBNP in 238 patients with rheumatoid arthritis: a 10-year longitudinal study
Authors: Provan Sella A , Angel Kristin , Ødegård Sigrid , Mowinckel Petter , Atar Dan , Kvien Tore K
Published: June 2008

Introduction

Disease activity in patients with rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, of which N-terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor. Our objective was to examine the cross-sectional and longitudinal associations between markers of inflammation, measures of RA disease activity, medication used in the treatment of RA, and NT-proBNP levels (dependent variable).

Methods

Two hundred thirty-eight patients with RA of less than 4 years in duration were followed longitudinally with three comprehensive assessments of clinical and radiographic data over a 10-year period. Serum samples were frozen and later batch-analyzed for NT-proBNP levels and other biomarkers. Bivariate, multivariate, and repeated analyses were performed.

Results

C-reactive protein (CRP) levels at baseline were cross-sectionally associated with NT-proBNP levels after adjustment for age and gender (r2 adjusted = 0.23; P < 0.05). At the 10-year follow-up, risk factors for cardiovascular disease were recorded. Duration of RA and CRP levels were independently associated with NT-proBNP in the final model that was adjusted for gender, age, and creatinine levels (r2 adjusted = 0.38; P < 0.001). In the longitudinal analyses, which adjusted for age, gender, and time of follow-up, we found that repeated measures of CRP predicted NT-proBNP levels (P < 0.001).

Conclusion

CRP levels are linearly associated with levels of NT-proBNP in cross-sectional and longitudinal analyses of patients with RA. The independent associations of NT-proBNP levels and markers of disease activity with clinical cardiovascular endpoints need to be further investigated.
Application of seismic interferometry to extract P- and S-wave propagation and observation of shear-wave splitting from noise data at Cold Lake, Alberta, Canada
Authors: Miyazawa Masatoshi , Snieder Roel , Venkataraman Anupama
Published: June 2008

We extract downward-propagating P- and S-waves from industrial noise generated by human and/or machine activity at the surface propagating down a borehole at Cold Lake, Alberta, Canada, and measure shear-wave splitting from these data. The continuous seismic data are recorded at eight sensors along a downhole well during steam injection into a 420–470-m-deep oil reservoir. We crosscorrelate the waveforms observed at the top sensor and other sensors to extract estimates of the direct P- and S-wave components of the Green’s function that account for wave propagation between sensors. Fast high-frequency and slow low-frequency signals propagating vertically from the surface to the bottom are found for the vertical and horizontal components of the wave motion, which are identified with P- and S-waves, respectively. The fastest S-wave polarized in the east-northeast–west-southwest direction is about 1.9% faster than the slowest S-wave polarized in the northwest-southeast direction. The direction of polarization of the fast S-wave is rotated clockwise by [Formula: see text] from the maximum principal stress axis as estimated from the regional stress field. This study demonstrates the useful application of seismic interferometry to field data to determine structural parameters, which are P- and S-wave velocities and a shear-wave-splitting coefficient, with high accuracy.
New insights into one-norm solvers from the Pareto curve
Authors: Hennenfent Gilles , Berg Ewout van den , Friedlander Michael P. , Herrmann Felix J.
Published: June 2008

Geophysical inverse problems typically involve a trade-off between data misfit and some prior model. Pareto curves trace the optimal trade-off between these two competing aims. These curves are used commonly in problems with two-norm priors in which they are plotted on a log-log scale and are known as L-curves. For other priors, such as the sparsity-promoting one-norm prior, Pareto curves remain relatively unexplored. We show how these curves lead to new insights into one-norm regularization. First, we confirm theoretical properties of smoothness and convexity of these curves from a stylized and a geophysical example. Second, we exploit these crucial properties to approximate the Pareto curve for a large-scale problem. Third, we show how Pareto curves provide an objective criterion to gauge how different one-norm solvers advance toward the solution.
Directing Surgical Quality Improvement Initiatives: Comparison of Perioperative Mortality and Long-Term Survival for Cancer Surgery
Authors: Bilimoria Karl Y. , Bentrem David J. , Feinglass Joseph M. , Stewart Andrew K. , Winchester David P. , Talamonti Mark S. , Ko Clifford Y.
Published: June 2008

Purpose

Quality-improvement initiatives are being developed to decrease volume-based variability in surgical outcomes. Resources for national and hospital quality-improvement initiatives are limited. It is unclear whether quality initiatives in surgical oncology should focus on factors affecting perioperative mortality or long-term survival. Our objective was to determine whether differences in hospital surgical volume have a larger effect on perioperative mortality or long-term survival using two methods.

Patients and Methods

From the National Cancer Data Base, 243,103 patients who underwent surgery for nonmetastatic colon, esophageal, gastric, liver, lung, pancreatic, or rectal cancer were identified. Multivariable modeling was used to evaluate 60-day mortality and 5-year conditional survival (excluding perioperative deaths) across hospital volume strata. The number of potentially avoidable perioperative and long-term deaths were calculated if outcomes at low-volume hospitals were improved to those of the highest-volume hospitals.

Results

Risk-adjusted perioperative mortality and long-term conditional survival worsened as hospital surgical volume decreased for all cancer sites, except for liver resections where there was no difference in survival. When comparing low- with high-volume hospitals, the hazard ratios for perioperative mortality were substantially larger than for long-term survival. However, the number of potentially avoidable deaths each year in the United States, if outcomes at low-volume hospitals were improved to the level of highest-volume centers, was significantly larger for long-term survival.

Conclusion

Although the magnitude of the hazard ratios implies that quality-improvement efforts should focus on perioperative mortality, a larger number of deaths could be avoided by focusing quality initiatives on factors associated with long-term survival.
Due Process and Lethal Confinement
Authors: Dayan Colin
Published: June 2008

No concept has been as central to constitutional law as due process. In the current war on terror and the Bush administration's treatment of suspected terrorists, no protection is more threatened. The cases that pertain to due process—when it is due and how much—are crucial to the lives of those restrained in their liberty. Among those labeled the “worst of the worst,” especially offshore at Guantánamo Bay, the innocent fare far worse than those who have been charged with terrorist acts. How can they prove that they are not “illegal enemy combatants,” a category invented by White House lawyers but unknown to international law? How can the innocent prove their innocence? Yet this categorical reconstruction of identity is not unprecedented. To claim a history for these conditions of disfigured personhood and civil incapacity, I summon the cautionary haunt of due process in slave and prison law.
The role of intermediaries in getting evidence into policy and practice: some useful lessons from examining consultancy–client relationships
Authors: Sin Chih Hoong
Published: June 2008

The evidence-based policy and practice movement increasingly recognises the potential role of intermediaries. Unfortunately, there is little systematic attempt at defining who intermediaries may be, what they can potentially do and how they do what they do. There has also been bias in the relevant literature, with the private sector conspicuously missing. This article acknowledges the growing importance of consultancies in the knowledge industry and examines consultancy–client relationships in order to derive useful lessons for the evidencebased movement. Five consultancy approaches are identified, relating to potential intermediary roles as cross-pollinators, matchmakers, translators and processors, multiple dissemination routes, and articulators of user perspectives.
The policy implications of economic reasoning: what we do not know about moral hazard in health policy
Authors: Whitford Andrew B.
Published: June 2008

Over the past three decades the economic reasoning embodied in the term ‘moral hazard’ has entered the lexicon of public health policy. What has been its impact? This commentary sketches three core points where we lack information about the impact of economic reasoning on the current and future direction of health policy.
Building research capacity in the allied health professions
Authors: Pickstone Caroline , Nancarrow Susan , Cooke Jo , Vernon Wesley , Mountain Gail , Boyce Rosalie A. , Campbell Jackie
Published: June 2008

This article discusses research capacity building and its relevance for health practitioners using allied health professionals (AHPs) as a case example. Allied health professionals is a term used to represent a diverse group of health workers, each with a discrete clinical focus, whose needs for research capacity building are likely to be similar to one another and to other medical and nursing professionals. The work of AHPs challenges many current research paradigms being complex and multidisciplinary in nature, often delivered in community settings and focusing on holistic outcomes. This article examines some of the current drivers in the healthcare context and highlights tensions for AHPs in developing their research base in basic science and applied health research. The authors argue for a strategic approach to research capacity building and examine the implications of current policy initiatives for AHP roles and activity in research. The importance of a sustained approach to capacity building is underscored.