bluuebunny/crossref_metadata_2025 huggingface dataset:
A discussion paper on valuations for mortgage and the level of house prices
Authors: Bowcock Philip
Published: February 2015

Purpose

– The aim of the present paper is to consider the effect of the current approach to valuations for mortgage on the level of house prices during the housing bubble of 2000-2008 which has been a major contributor to the following recession followed previous smaller bubbles in 1972 and 1990. Despite a warning from the International Monetary Fund in 2004 that prices were too high and home buyers should “exercise particular caution”, no fundamental research appears to have been done into the contribution to this of those responsible for valuation for mortgage.

Design/methodology/approach

– Data from the Nationwide Quarterly Index were used as a basis and compared with the writer’s professional experience in carrying out valuations for mortgage.

Findings

– Instructions to valuers advising on the properties offered as security for a mortgage loan have requested only a valuation based on the market as it existed at the time of the valuation without regard to the possibility that a change in economic circumstances could cause a fall in the value of the security. Many mortgagors have found on sale or repossession that their liability to repay their mortgage is greater than the value of the property.

Originality/value

– Valuations for mortgage should include an indication of the possible risks involved, including the results of changes in the global economic environment.
Impressions in action: the socially situated construction of expertise in the workplace
Authors: Johri Aditya
Published: February 2015

Purpose

– The impressions of others’ expertise are fundamental to workplace dynamics. Identifying expertise is essential for workplace functions such as task assignment, task completion, and knowledge generation. Although prior work has examined both the nature of expertise and its importance for work, formation of expertise impressions in the workplace has not received much attention. The paper aims to discuss these issues.

Design/methodology/approach

– In this paper the author addresses the question – how do we form expertise impressions in the workplace – using data from an ethnographic study of a workplace setting. The author employs a case study of project team formation to synthesize a process framework of impression formation.

Findings

– The author proposes a framework that integrates sociocultural and interactional accounts to argue that actors utilize situational and institutional frames to socially construct their expertise impressions of others. These frames emerge as actors engage in activities within a community of practice.

Originality/value

– This practice-based explication of expertise construction moves beyond narrow conceptions of personality-based traits or credentials as signals of expertise. It explains why sharing of expertise within organizations through the use of information technology continues to be problematic – expertise is an enactment and therefore it defies reification through knowledge management.
Narratives of enterprise revisited: methodological appendices in ethnographic books
Authors: Down Simon
Published: February 2015

Purpose

– This paper is the first in a series that reprints methodological appendices or methods chapters found in workplace and organisational ethnographic books, and provides an opportunity for reflection by the author through an introductory commentary. Simon Down, the author of Narratives of Enterprise (Down, 2006) reflects on the writing and the research underpinning his ethnography. The paper aims to discuss these issues.

Design/methodology/approach

– The reprinting of such chapters will enhance access to key ethnographic texts, and facilitate reflection on methodological choices authors made. In so doing this paper will provide insights into methodological ethnographic writing, and show how sensibilities and fashions change over time.

Findings

– Narratives of Enterprise (Down, 2006) examined how two small business managers in a single firm construct an entrepreneurial self-identity, and what this process of self-creation means for the individuals and how the firm is managed. The key topics explored in the book, self-identity as a conceptual tool and enterprise as a social and economic reality, have both grown in relevance and importance since the research was conducted. Down also reflects on that nature and dynamism of friendship in research practice.

Originality/value

– Reflection on choices made at some distance can provide particular and valuable insights into the development of research practice.
The Crc/CrcZ‐CrcY global regulatory system helps the integration of gluconeogenic and glycolytic metabolism in Pseudomonas putida
Authors: La Rosa Ruggero , Nogales Juan , Rojo Fernando
Published: February 2015

In metabolically versatile bacteria, carbon catabolite repression (CCR) facilitates the preferential assimilation of the most efficient carbon sources, improving growth rates and fitness. In Pseudomonas putida, the Crc and Hfq proteins and the CrcZ and CrcY small RNAs, which are believed to antagonize Crc/Hfq, are key players in CCR. Unlike that seen in other bacterial species, succinate and glucose elicit weak CCR in this bacterium. In the present work, metabolic, transcriptomic and constraint‐based metabolic flux analyses were combined to clarify whether P. putida prefers succinate or glucose, and to identify the role of the Crc protein in the metabolism of these compounds. When provided simultaneously, succinate was consumed faster than glucose, although both compounds were metabolized. CrcZ and CrcY levels were lower when both substrates were present than when only one was provided, suggesting a role for Crc in coordinating metabolism of these compounds. Flux distribution analysis suggested that, when both substrates are present, Crc works to organize a metabolism in which carbon compounds flow in opposite directions: from glucose to pyruvate, and from succinate to pyruvate. Thus, our results support that Crc not only favours the assimilation of preferred compounds, but balances carbon fluxes, optimizing metabolism and growth.
Microbial community dynamics during the early stages of plant polymer breakdown in paddy soil
Authors: Wegner Carl‐Eric , Liesack Werner
Published: February 2015

We used paddy soil slurries amended with rice straw to identify the microbial populations involved in the methanogenic breakdown of plant polymers. Rice straw greatly stimulated microbial activity over the 28‐day incubation period. On day 7, the transient peak concentration of acetate (24 mM) coincided with the onset of increased methane production. Microbial 16S rRNA transcript numbers increased by one to two orders of magnitude, but not the 16S rRNA gene copy numbers. Using metatranscriptomic rRNA, Clostridiaceae, Lachnospiraceae, Ruminococcaceae, Veillonellaceae and Pseudomonadaceae were identified to be the most abundant and the most dynamic bacterial groups. Changes in methanogen rRNA and mRNA abundances corresponded well with methanogenic activity. Acetate determined the abundance ratio between Methanosarcinaceae and Methanosaetaceae. Methanocellaceae dominated hydrogenotrophic methanogenesis. Transcript levels of mRNA families involved in plant polymer breakdown increased slightly with time. Glycosyl hydrolase (GH) transcripts involved in cellulose and chitin breakdown were predominantly expressed by the Firmicutes, whereas those involved in hemicellulose breakdown exhibited more diverse taxonomic sources, including Acidobacteria, Bacteriodetes and Chloroflexi. Taken together, we observed strong population dynamics and the expression of taxonomically diverse GH families, suggesting that not only Firmicutes, but also less abundant groups play a major functional role in the decomposition of rice straw.
Ice cover extent drives phytoplankton and bacterial community structure in a large north‐temperate lake: implications for a warming climate
Authors: Beall B. F. N. , Twiss M. R. , Smith D. E. , Oyserman B. O. , Rozmarynowycz M. J. , Binding C. E. , Bourbonniere R. A. , Bullerjahn G. S. , Palmer M. E. , Reavie E. D. , Waters LCDR M. K. , Woityra LCDR W. C. , McKay R. M. L.
Published: February 2015

Mid‐winter limnological surveys of Lake Erie captured extremes in ice extent ranging from expansive ice cover in 2010 and 2011 to nearly ice‐free waters in 2012. Consistent with a warming climate, ice cover on the Great Lakes is in decline, thus the ice‐free condition encountered may foreshadow the lakes future winter state. Here, we show that pronounced changes in annual ice cover are accompanied by equally important shifts in phytoplankton and bacterial community structure. Expansive ice cover supported phytoplankton blooms of filamentous diatoms. By comparison, ice free conditions promoted the growth of smaller sized cells that attained lower total biomass. We propose that isothermal mixing and elevated turbidity in the absence of ice cover resulted in light limitation of the phytoplankton during winter. Additional insights into microbial community dynamics were gleaned from short 16S rRNA tag (Itag) Illumina sequencing. UniFrac analysis of Itag sequences showed clear separation of microbial communities related to presence or absence of ice cover. Whereas the ecological implications of the changing bacterial community are unclear at this time, it is likely that the observed shift from a phytoplankton community dominated by filamentous diatoms to smaller cells will have far reaching ecosystem effects including food web disruptions.
Mapping diversity indices: not a trivial issue
Authors: Granger Victoria , Bez Nicolas , Fromentin Jean‐Marc , Meynard Christine , Jadaud Angélique , Mérigot Bastien
Published: February 2015

Mapping diversity indices, that is estimating values in all locations of a given area from some sampled locations, is central to numerous research and applied fields in ecology.

Two approaches are used to map diversity indices without including abiotic or biotic variables: (i) the indirect approach, which consists in estimating each individual species distribution over the area, then stacking the distributions of all species to estimate and map a posteriori the diversity index, (ii) the direct approach, which relies on computing a diversity index in each sampled locations and then to interpolate these values to all locations of the studied area for mapping.

For both approaches, we document drawbacks from theoretical and practical viewpoints and argue about the need for adequate interpolation methods. First, we point out that the indirect approach is problematic because of the high proportion of rare species in natural communities. This leads to zero‐inflated distributions, which cannot be interpolated using standard statistical approaches. Secondly, the direct approach is inaccurate because diversity indices are not spatially additive, that is the diversity of a studied area (e.g. region) is not the sum of the local diversities. Therefore, the arithmetic variance and some of its derivatives, such as the variogram, are not appropriate to ecologically measure variation in diversity indices. For the direct approach, we propose to consider the β‐diversity, which quantifies diversity variations between locations, by the mean of a β‐gram within the interpolation procedure. We applied this method, as well as the traditional interpolation methods for comparison purposes on different faunistic and floristic data sets collected from scientific surveys. We considered two common diversity indices, the species richness and the Rao's quadratic entropy, knowing that the above issues are true for complementary species diversity indices as well as those dealing with other biodiversity levels such as genetic diversity.

We conclude that none of the approaches provided an accurate mapping of diversity indices and that further methodological developments are still needed. We finally discuss lines of research that may resolve this key issue, dealing with conditional simulations and models taking into account biotic and abiotic explanatory variables.
Emergency Department Quality Improvement Activity: An Inventory From the American Board of Emergency Medicine Maintenance of Certification Program
Authors: Kowalenko Terry , Carius Michael L. , Korte Robert C. , Miller Michele C. , Reisdorff Earl J.
Published: February 2015

Objectives

The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program requires every ABEM‐certified physician to attest to participating in a quality improvement (QI) activity every 5 years. Understanding the type and frequency of these QI activities could inform the emergency medicine community about the variety of QI activities in which emergency physicians (EPs) are involved. These QI activities could provide ideas for the development of additional quality measures.

Methods

This was a retrospective descriptive study of self‐reported QI activity attestations from the ABEM MOC program during 2013. Attestations were provided by ABEM‐certified EPs using the ABEM MOC website. The type, number, and cumulative frequency of activities are reported.

Results

ABEM received 9,380 attestations for QI activities in 91 different categories. The three most commonly reported activities were acute myocardial infarction‐percutaneous coronary intervention within 90 minutes of arrival (includes door‐to‐balloon time), door‐to‐doctor times, and throughput time measures. These three activities comprised 36.4% of attestations. More than half (54.4%) of the attestations were captured by the five most frequently attested activities, 67.1% by the top seven categories, and 89.9% by the top 21 categories. Of these 21 categories, 10 involved clinical protocols, nine were time‐centered measures, and two were patient‐centered activities.

Conclusions

This report demonstrates that diverse QI activities occur in emergency departments (EDs) across the United States. The majority of reported projects are nested in a few categories, following recognized areas of emphasis in emergency care, particularly in areas using time‐sensitive metrics.
Accountability of Children's Services Organizations in China
Authors: Fisher Karen R. , Shang Xiaoyuan , Li Jing
Published: February 2015

The accountability of children's services organizations is a current challenge in China as its social service system expands. The government is beginning to fund children's services organizations directly; however, the accountability practices remain weak. This has created a credibility crisis with the public about the use of donations and quality of services. Some organizations are starting to engage with their service users to address this problem. User participation is an important approach for China, since government regulation of nongovernment organizations is limited. This qualitative case study applies a multidimensional accountability framework (managerial and democratic) to examine participation practices in a child disability organization founded by parents. We found that the governance and operational structures attempted to provide accountability to all stakeholders, but top‐down accountability to government and donors was prioritized over accountability to children and families. Accountability for professional and technical quality was supported by international professional organizations, which is an option only available to some NGOs. Government support for multidimensional aspects of accountability needs to extend beyond funding, to training and technical support to achieve quality service provision by NGOs.
Social Insurance Participation of Rural Migrant Workers Based on Gender Dimension: Evidence from Four Chinese Cities
Authors: Yao Jianping , Kim Byung‐Cheol
Published: February 2015

The aim of this article is to investigate the gender differences of rural migrant workers participating in social insurance involving three social protection models in four Chinese cities. The results show that, of the three models, the inclusive model has the highest participation rate and the independent model has the lowest. In general there are few gender differences in social insurance coverage. For both male and female participants, the factors which influence the participation of rural migrant workers in social insurance systems are age, income, education, enterprise ownership, labor contract, occupational mobility, and location. However, the relative importance of these factors in participation in social insurance is differentiated by gender.
Phase I study of tivantinib in Japanese patients with advanced hepatocellular carcinoma: Distinctive pharmacokinetic profiles from other solid tumors
Authors: Okusaka Takuji , Aramaki Takeshi , Inaba Yoshitaka , Nakamura Shinichiro , Morimoto Manabu , Moriguchi Michihisa , Sato Takashi , Ikawa Yuta , Ikeda Masafumi , Furuse Junji
Published: February 2015

A c‐Met inhibitor tivantinib is a candidate anticancer agent for patients with hepatocellular carcinoma (HCC), and CYP2C19 is the key metabolic enzyme for tivantinib. Previous Japanese phase I studies in patients with solid tumors (except HCC) recommend 360 mg twice daily (BID) and 240 mg BID for CYP2C19 extensive metabolizers (EM) and poor metabolizers (PM), respectively. In this study, Japanese patients with HCC in whom sorafenib treatment has failed were enrolled to evaluate the safety, tolerability and pharmacokinetics of oral tivantinib as a single agent. The dose was escalated separately in EM and PM, from 120 mg BID to 240 mg BID, in both capsule and tablet formulations. A total of 28 patients (EM: 21, PM: 7) received tivantinib. At a dose of 120 mg BID, dose‐limiting toxicities (DLT) did not develop in 12 EM (capsule: 6, tablet: 6) and 7 PM (capsule: 4, tablet: 3) during the DLT‐observation period (for 29 days after first dosing). At this dose, the pharmacokinetic profiles of tivantinib (AUC0–12 and Cmax) did not remarkably differ between EM and PM. When treated with 240 mg BID, 5 of 9 EM (capsule: 4 of 6, tablet: 1 of 3) developed neutropenia‐related DLT accompanying plasma tivantinib concentration higher than expected from the previous studies. Consequently, PM did not receive 240 mg BID. In conclusion, 120 mg BID of tivantinib is recommended among Japanese patients with HCC regardless of CYP2C19 phenotype.
Intrinsic membrane plasticity via increased persistent sodium conductance of cholinergic neurons in the rat laterodorsal tegmental nucleus contributes to cocaine‐induced addictive behavior
Authors: Kamii Hironori , Kurosawa Ryo , Taoka Naofumi , Shinohara Fumiya , Minami Masabumi , Kaneda Katsuyuki
Published: February 2015

The laterodorsal tegmental nucleus (LDT) is a brainstem nucleus implicated in reward processing and is one of the main sources of cholinergic afferents to the ventral tegmental area (VTA). Neuroplasticity in this structure may affect the excitability ofVTAdopamine neurons and mesocorticolimbic circuitry. Here, we provide evidence that cocaine‐induced intrinsic membrane plasticity inLDTcholinergic neurons is involved in addictive behaviors. After repeated experimenter‐delivered cocaine exposure,ex vivowhole‐cell recordings obtained fromLDTcholinergic neurons revealed an induction of intrinsic membrane plasticity in regular‐ but not burst‐type neurons, resulting in increased firing activity. Pharmacological examinations showed that increased riluzole‐sensitive persistent sodium currents, but not changes in Ca2+‐activatedBK,SKor voltage‐dependent A‐type potassium conductance, mediated this plasticity. In addition, bilateral microinjection of riluzole into theLDTimmediately before the test session in a cocaine‐induced conditioned place preference (CPP) paradigm inhibited the expression of cocaine‐inducedCPP. These findings suggest that intrinsic membrane plasticity inLDTcholinergic neurons is causally involved in the development of cocaine‐induced addictive behaviors.
Hijab (Headscarf) Headache
Authors: Ansari Huma N. , Solomon Glen D.
Published: February 2015

Hijab (headscarf) headache is well known among wearers and is a common topic of discussion. It has never previously been reported in the medical literature. Five women described bilateral headache either prompted by or worsened by donning the hijab, or headscarf. The headache always resolved soon after removal of the headscarf. Hijab headache may also be alleviated by minimal modifications in style while allowing women to maintain their moral conviction. It likely represents an extracranial etiology of headache, and recognition may prevent unnecessary evaluation and suffering in hijab wearers.
Community perspective on the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Geffen N , Aagaard P , Corbelli GM , Meulbroek M , Peavy D , Rappoport C , Schwarze S , Collins S ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) Community Advisory Board
Published: February 2015

Determining when to start antiretroviral treatment (ART) is vitally important for people living with HIV. Yet the optimal point at which to start to maximize clinical benefit remains unknown. In the absence of randomized studies, current guidelines rely on conflicting observational data and expert opinion, and consequently diverge on this point. In the USA, ART is recommended irrespective of CD4 cell count. The World Health Organization now recommends starting ART at a CD4 cell count of 500 cells/μL, while the threshold for the UK and South Africa remains at 350 cells/μL.

The Strategic Timing of AntiRetroviral Treatment (START) study, one of the largest clinical trials on the treatment of HIV infection, will answer this question. START compares two treatment strategies: immediate treatment at a CD4 cell count of 500 cells/μL or higher versus deferring treatment until the CD4 cell count decreases to 350 cells/μL or until AIDS develops. START includes seven substudies, five of which will clarify the relative contributions of HIV and ART in common comorbidities. START is fully enrolled and expected to be completed in 2016. HIV advocates support the study's design and have been involved from inception to enrolment. The trial will produce rigorous data on the benefits and risks of earlier treatment. It will inform policy and treatment advocacy globally, benefitting the health of HIV‐positive people.
Demographic and HIV‐specific characteristics of participants enrolled in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Sharma S , Babiker AG , Emery S , Gordin FM , Lundgren JD , Neaton JN , Bakowska E , Schechter M , Wiselka MJ , Wolff MJ ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

Objectives

The risks and benefits of initiating antiretroviral treatment (ART) at high CD4 cell counts have not been reliably quantified. The Strategic Timing of AntiRetroviral Treatment (START) study is a randomized international clinical trial that compares immediate with deferred initiation of ART for HIV‐positive individuals with CD4 cell counts above 500 cells/μL. We describe the demographics, HIV‐specific characteristics and medical history of this cohort.

Methods

Data collected at baseline include demographics, HIV‐specific laboratory values, prior medical diagnoses and concomitant medications. Baseline characteristics were compared by geographical region, gender and age.

Results

START enrolled 4685 HIV‐positive participants from 215 sites in 35 countries. The median age is 36 years [interquartile range (IQR) 29–44 years], 27% are female, and 45% self‐identify as white, 30% as black, 14% as Latino/Hispanic, 8% as Asian and 3% as other. The route of HIV acquisition is reported as men who have sex with men in 55% of participants, heterosexual sex in 38%, injecting drug use in 1% and other/unknown in 5%. Median time since HIV diagnosis is 1.0 year (IQR 0.4–3.0 years) and the median CD4 cell count and HIV RNA values at study entry are 651 cells/μL (IQR 584–765 cells/μL) and 12 754 HIV RNA copies/mL (IQR 3014–43 607 copies/mL), respectively.

Conclusions

START has enrolled a diverse group of ART‐naïve individuals with high CD4 cell counts who are comparable to the HIV‐positive population from the regions in which they were enrolled. The information collected with this robust study design will provide a database with which to evaluate the risks and benefits of early ART use for many important outcomes.
Baseline cardiovascular risk in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Soliman EZ , Sharma S , Arastéh K , Wohl D , Achhra A , Tambussi G , O'Connor J , Stein JH , Duprez DA , Neaton JD , Phillips A ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

Objectives

The Strategic Timing of AntiRetroviral Treatment (START) trial has recruited antiretroviral‐naïve individuals with high CD4 cell counts from all regions of the world. We describe the distribution of cardiovascular disease (CVD) risk factors, overall and by geographical region, at study baseline.

Methods

The distribution of CVD risk factors was assessed and compared by geographical region among START participants who had a baseline electrocardiogram (n = 4019; North America, 11%; Europe/Australia/Israel, 36%; South America, 26%; Asia, 4%; Africa, 23%; median age 36 years; 26% female).

Results

About 58.3% (n = 2344) of the participants had at least one CVD risk factor and 18.9% (n = 761) had two or more. The most common CVD risk factors were current smoking (32%), hypertension (19.3%) and obesity (16.5%). There were significant differences in the prevalence of CVD risk factors among geographical regions. The prevalence of at least one risk factor across regions was as follows: North America, 70.0%; Europe/Australia/Israel, 65.1%; South America, 49.4%; Asia, 37.0%; Africa, 55.8% (P‐value < 0.001). Significant regional differences were also observed when risk factors were used as part of the Framingham and Data Collection on Adverse events of Anti‐HIV Drugs (D:A:D) risk scores or used to define a favourable risk profile.

Conclusions

CVD risk factors are common among START participants, and their distribution varies by geographical region. Better understanding of how and why CVD risk factors develop in people with HIV infection and their geographical distributions could shed light on appropriate strategies for CVD prevention and may inform the interpretation of the results of START, as CVD is expected to be a major fraction of the primary endpoints observed.
Quality of life assessment among HIV‐positive persons entering the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Lifson AR , Grandits GA , Gardner EM , Wolff MJ , Pulik P , Williams I , Burman WJ ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

Objectives

With HIV treatment prolonging survival and HIV infection now managed as a chronic illness, quality of life (QOL) is important to evaluate in persons living with HIV (PLWH). We assessed at study entry the QOL of antiretroviral‐naïve PLWH with CD4 counts > 500 cells/μL in the Strategic Timing of AntiRetroviral Treatment (START) clinical trial.

Methods

QOL was assessed with: (1) a visual analogue scale (VAS) for self‐assessment of overall current health; (2) the Short‐Form 12‐Item Version 2 Health Survey® (SF‐12V2), for which responses are summarized into eight individual QOL domains plus component summary scores for physical health [the Physical Health Component Summary (PCS)] and mental health [the Mental Health Component Summary (MCS)]. The VAS and eight domain scores were scaled from 0 to 100. Mean QOL measures were calculated overall and by demographic, clinical and behavioural factors.

Results

A total of 4631 participants completed the VAS and 4119 the SF‐12. The mean VAS score (with standard deviation) was 80.9 ± 15.7. Mean SF‐12 domain scores were lowest for vitality (66.3 ± 26.4) and mental health (68.6 ± 21.4), and highest for physical functioning (89.3 ± 23.0) and bodily pain (88.0 ± 21.4). Using multiple linear regression, PCS scores were lower (P < 0.001) for Asians, North Americans, female participants, older participants, and those with less education, longer duration of known HIV infection, alcoholism/substance dependence and body mass index ≥ 30 kg/m2. MCS scores were highest (P < 0.001) for Africans, South Americans and older participants, and lowest for female participants, current smokers and those with alcoholism/substance dependence.

Conclusions

In this primarily healthy population, QOL was mostly favourable, emphasizing that it is important that HIV treatments do not negatively impact QOL. Self‐assessed physical health summary scores were higher than mental health scores. Factors such as older age and geographical region had different effects on perceived physical and mental health.
Pulmonary function in an international sample of HIV‐positive, treatment‐naïve adults with CD4 counts > 500 cells/μL: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Kunisaki KM , Niewoehner DE , Collins G , Nixon DE , Tedaldi E , Akolo C , Kityo C , Klinker H , La Rosa A , Connett JE ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

Objectives

The aim of the study was to describe the prevalence and correlates of chronic obstructive pulmonary disease (COPD) in a multicentre international cohort of persons living with HIV (PLWH).

Methods

We performed a cross‐sectional analysis of adult PLWH, naïve to HIV treatment, with baseline CD4 cell count > 500 cells/μL enrolled in the Pulmonary Substudy of the Strategic Timing of AntiRetroviral Treatment (START) trial. We collected standardized, quality‐controlled spirometry. COPD was defined as forced expiratory volume in 1 s:forced vital capacity (FEV1:FVC) ratio less than the lower limit of normal.

Results

Among 1026 participants from 80 sites and 20 countries, the median age was 36 [interquartile range (IQR) 30, 44] years, 29% were female, and the median time since HIV diagnosis was 1.2 (IQR 0.4, 3.5) years. Baseline median CD4 cell count was 648 (IQR 583, 767) cells/μL, median viral load was 4.2 (IQR 3.5, 4.7) log10 HIV‐1 RNA copies/mL, and 10% had a viral load ≤ 400 copies/mL despite lack of HIV treatment. Current/former/never smokers comprised 28%/11%/61% of the cohort, respectively. COPD was present in 6.8% of participants, and varied by age, smoking status and region. Forty‐eight per cent of those with COPD reported lifelong nonsmoking. In multivariable regression, age and pack‐years of smoking had the strongest associations with FEV1:FVC ratio (P < 0.0001). There was a significant effect of region on FEV1:FVC ratio (P = 0.010).

Conclusions

Our data suggest that, among PLWH who were naïve to HIV treatment and had CD4 cell counts > 500 cells/μL, smoking and age were important factors related to COPD. Smoking cessation should remain a high global priority for clinical care and research in PLWH.
Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Carr A , Grund B , Neuhaus J , Schwartz A , Bernardino JI , White D , Badel‐Faesen S , Avihingsanon A , Ensrud K , Hoy J ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

Objectives

HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV‐positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreated HIV infection to bone loss.

Methods

The primary objective of the Strategic Timing of AntiRetroviral Treatment (START) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV‐related and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual‐energy X‐ray absorptiometry, using multiple regression.

Results

A total of 424 ART‐naïve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) < 20 kg/m2. Mean (SD) Z‐scores were −0.41 (0.94) at the spine and −0.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD (hip or spine T‐score < −1.0). Factors independently associated with lower BMD at the hip and spine were female sex, Latino/Hispanic ethnicity, lower BMI and higher estimated glomerular filtration rate. Longer time since HIV diagnosis was associated with lower hip BMD. Current or nadir CD4 cell count and HIV viral load were not associated with BMD.

Conclusions

In this geographically and racially diverse population of ART‐naïve adults with normal CD4 cell counts, low BMD was common, but osteoporosis was rare. Lower BMD was significantly associated with traditional risk factors but not with CD4 cell count or viral load.
β‐cyclodextrin in personal care formulations: role on the complexation of malodours causing molecules
Authors: Lopedota A. , Cutrignelli A. , Laquintana V. , Franco M. , Donelli D. , Ragni L. , Tongiani S. , Denora N.
Published: February 2015

Synopsis

Objective

The aim of this study was to prove the capability of β‐cyclodextrin (β‐CD) to interact with some representative molecules responsible to cause body malodour, such as carboxylic acids, thiols and steroids, present in sweat and body secretions.

Methods

The association constants in guest‐CD were determined by 1H‐NMR spectroscopy for thiols and steroids such as 3‐mercapto‐1‐hexanol, androstenone, androstenol and androsterone, and pH‐potentiometric titration for acetic acid, l(+) lactic acid, isobutyric acid, isovaleric acid and 3‐hydroxy‐3‐methyl‐hexanoic acid.

Results

All considered systems are able to interact with relatively weak association constants with β‐cyclodextrin, in a 1 : 1 host–guest ratio.

Conclusion

From these findings, it is possible to conclude that β‐CD is capable to interact with different components present in the sweat and body secretion, forming inclusion complexes. For this reason, β‐CD could be a component of body care formulations, such as deodorants.
Proposal of a classification system for opportunities to innovate in skin care products
Authors: Souza I. D. da S. , Almeida T. L. , Takahashi V. P.
Published: February 2015

Synopsis

Objectives

What are the opportunities to innovate in a skin care product? There are certainly many opportunities and many technologies involved. In this work, we assumed the role of identifying and categorizing these opportunities to develop a comprehensive and intelligible classification system, which could be used as a tool to support decision‐making in different professional contexts.

Methods

Initially, we employed the Delphi method to identify, discuss and standardize the opportunities to innovate in a skin care product. Finally, we used the classification system obtained in the previous phase to label patent applications, therefore, testing the suitability and utility of the system.

Results

At the end of the process, we achieved a 10‐category classification system for opportunities to innovate in skin care products, and we also illustrated how this system could be used.

Conclusion

The resultant classification system offers a normalized terminology for cosmetic scientists interested in dealing with the particularities of incremental and radical innovations in skin care products.
Effect on energy and macronutrient intake with partial replacement of external food supply by in‐house cooking at a nursing home for older people inSweden
Authors: Tieva Åse , Persson Evelina , Rhodin Anders , Sköldunger Anders , Pettersén Sigrid , Jonsäll Anette , Hörnell Agneta
Published: February 2015

An increased awareness of the importance of nutrition for older people's health and quality of life has underpinned projects and quality improvements for the meal situation in care establishments. The present study took place in a nursing home in a village outside an average‐sized town situated in mid‐Sweden. Care staff had initiated a change from external catered meals to purchase the food and cook the main meals themselves. The intention was to increase flexibility in accommodating the requests and needs of the elderly and, in doing so, to achieve increased professional pride and satisfaction.

To ensure that no negative effects resulted for the residents in the nursing home, outcomes were evaluated through the present intervention study. The objective was to investigate whether and, if so, how their energy and nutrient intake and weight were affected. At the start, only one main hot meal was exchanged for home cooking to avoid work load problems as no increased costs were allowed and no extra staff were to be recruited.

The study population consisted of 21 residents, aged 69–97 years. Weight, energy and nutrient intake were recorded before and during the intervention by 3‐day food records validated by Goldberg's cutoff method. The same 3 days of the week—Sunday to Tuesday—and the same menus were used for both measurement periods.

At group level, the energy intake corresponded to the estimated energy requirements, both at baseline and at follow‐up, although the intervention resulted in a significantly higher energy intake from the meals cooked in the ward kitchens. Two‐thirds of the residents (n = 13) slightly increased in weight from baseline to follow‐up, while two participants (with body mass index 27.5 kg/m2and 33.5 kg/m2, respectively) lost 5.0 kg and 6.9 kg, respectively. The total protein intake was insufficient both at baseline and follow‐up and only met the participants' needs to 81 ± 22% and 83 ± 26%, respectively.

In conclusion, the intervention resulted in no adverse consequences for participants in terms of energy and nutrient intake. Most participants were weight stable or had small increases in weight, and the greatest weight gain was observed in the lighter clients. The low protein intake at both time points causes concern and suggests the need for further nutritional interventions to optimize older people's protein intake.
The Hawke’s Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms
Authors: Ryder Hollie , Aspden Trudi , Sheridan Janie
Published: February 2015

Objectives

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke’s Bay District Health Board, New Zealand, set up a pilot condom card scheme (‘the Scheme’) to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme.

Methods

Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013.

Key findings

Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme’s criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme.

Conclusions

The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people’s suggestions for improving the Scheme is also essential.
Tadalafil 5 mg once daily for the treatment of Asian men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: Analyses of data pooled from three randomized, double‐blind, placebo‐controlled studies
Authors: Nishizawa Osamu , Yoshida Masaki , Takeda Masayuki , Yokoyama Osamu , Morisaki Yoji , Murakami Masahiro , Viktrup Lars
Published: February 2015

Objectives

Assess the efficacy and safety of tadalafil 5 mg once‐daily in Asian men with lower urinary tract symptoms by pooling data from three clinical studies.

Methods

Data on 1199 Japanese, Korean, and Taiwanese men given tadalafil 5 mg (n = 601) or placebo (n = 598) were pooled from three double‐blind, placebo‐controlled, 12‐week studies. Efficacy measures included International Prostate Symptom Score, and Patient and Clinician Global Impressions of Improvement. These measures were also assessed for patient subgroups (age categories, baseline disease severity and/or prostate volume, prior alpha‐blocker treatment). Safety measures included adverse events, including those in selected body systems. Efficacy measure changes throughout treatment were assessed by mixed‐effect model repeated‐measures analysis; baseline to end‐point changes for the total population and subgroups were evaluated by analysis of covariance.

Results

Tadalafil 5 mg led to significant improvement (vs placebo) in all International Prostate Symptom Scores at all time‐points (week 4 P ≤ 0.013 for all measures; week 8 P ≤ 0.005, week 12 P < 0.001). End‐point results for both global impressions scales also favored tadalafil (both P < 0.001 vs placebo). Tadalafil efficacy was similar between patient subgroups of varied disease severity (interaction P = 0.097), prior alpha‐blocker use (P = 0.580), and prostate volume (P = 0.921). The drug was slightly less effective in older men (interaction P = 0.042). No unexpected adverse events were reported, and no meaningful adverse effects were observed in visual, auditory, or cardiovascular systems.

Conclusions

Tadalafil 5 mg once‐daily for 12 weeks is efficacious and safe in Asian men with lower urinary tract symptoms. Tadalafil is also effective in men of different ages, disease severity, prior alpha‐blocker exposure, and prostate volumes.
Commentary: Developmental origins of autism and ADHD – a commentary on Johnson et al. (2015)
Authors: Nelson Charles A.
Published: February 2015

Autism (autistic spectrum disorder, ASD) and attention deficit hyperactivity disorder (ADHD) are two highly prevalent neurodevelopmental disorders. Current estimates for autism exceed 1% For ADHD, the 2013 US‐based life time prevalence figure is 11%. Both disorders are also highly heritable. Intriguingly, approximately 50% of children with ASD also meet criteria for ADHD. Between their high heritability and comorbidity, some have wondered whether these two seemingly different disorders might in fact be related at some deep neurobiological level. The notion that these two disorders may be related is surprising when one considers the fact that autism generally appears in the first 1–2 years of life, whereas it is virtually impossible to identify ADHD during this time frame; indeed, inattentiveness and hyperactivity tend to be traits that are shared by nearly all toddlers, making a stable diagnosis of ADHD virtually impossible until early childhood (although a reliable diagnosis can generally be made during the preschool period). Like many neurodevelopmental disorders, early identification and early treatment are essential to easing the life time burden of these disorders. Of course, early treatment is predicated on early identification and it is for this reason that the review article by Johnson and colleagues is so intriguing, as it sets out to determine whether these disorders can be identified in the infancy period. It also raises a number of puzzling issues that remain undiscussed.
Commentary: Seeing the forest of knowledge for the trees of associations – a commentary on Costello and Maughan (2015)
Authors: Oldehinkel Albertine J.
Published: February 2015

Costello and Maughan have written an excellent and highly informative review on outcomes of child and adolescent emotional, attention‐deficit/hyperactivity, disruptive and substance use disorders, which is very much worth a read. The review confirms the notion that child and adolescent mental illnesses have a highly heterogeneous course. The majority of the children and adolescents with mental illnesses will keep having (residual) problems later in their lives but this developmental trajectory is by no means deterministic; adult mental health and functioning within the normal range is prevalent as well, particularly among adolescent substance abusers. This is hopeful since it suggests that there is room for improvement, and calls for identification of good early‐life predictors of long‐term outcomes to make optimally informed decisions about who will probably end up in a favorable trajectory spontaneously and who will need treatment to achieve that. The current state of knowledge with regard to these long‐tern predictions still shows many gaps, and Costello and Maughan hence conclude that ‘there is a need for further research on optimal outcomes both within specific diagnostic groups and across child psychopathology as a whole’ There is a need for further knowledge on this issue indeed, but how should we proceed to gain that knowledge? Are there lessons to be learnt from the past?
Simple risk score to detect rural Asian Indian (Bangladeshi) adults at high risk for type 2 diabetes
Authors: Bhowmik Bishwajit , Akhter Afroza , Ali Liaquat , Ahmed Tofail , Pathan Faruque , Mahtab Hajera , Khan Abul Kalam Azad , Hussain Akhtar
Published: February 2015

Aims/Introduction

To develop and evaluate a simple, non‐invasive, diabetes risk score for detecting individuals at high risk for type 2 diabetes in rural Bangladesh.

Materials and Methods

Data from 2,293 randomly selected individuals aged ≥20 years from a cross‐sectional study in a rural community of Bangladesh (2009 Chandra Rural Study) was used for model development. The validity of the model was assessed in another rural cross‐sectional study (2009 Thakurgaon Rural Study). The logistic regression model used included age, sex, body mass index, waist‐to‐hip ratio and hypertension status to predict individuals who were at high risk for type 2 diabetes.

Results

On applying the developed model to both cohorts, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval 0.68–0.72) for the Chandra cohort and 0.71 (95% confidence interval 0.68–0.74) for the Thakurgaon cohort. The risk score of >9 was shown to have the optimal cut‐point to detect diabetes. This score had a sensitivity of 62.4 and 75.7%, and specificity of 67.4 and 61.6% in the two cohorts, respectively. This risk score was shown to have improved sensitivity and specificity to detect type 2 diabetes cases compared with the Thai, Indian, Omani, UK, Dutch, Portuguese and Pakistani diabetes risk scores.

Conclusions

This simple, non‐invasive risk score can be used to detect individuals at high risk for type 2 diabetes in rural Bangladesh. Subjects with a score of 9 or above (out of 15) should undergo an oral glucose tolerance test for definitive diagnosis of diabetes.