bluuebunny/crossref_metadata_2025 huggingface dataset:
Paradoxical tolerance to cocaine after initial supersensitivity in drug‐use‐prone animals
Authors: Ferris Mark J. , Calipari Erin S. , Melchior James R. , Roberts David C. S. , España Rodrigo A. , Jones Sara R.
Published: June 2013

There is great interest in outlining biological factors and behavioral characteristics that either predispose or predict vulnerability to substance use disorders. Response to an inescapable novel environment has been shown to predict a “drug‐use‐prone” phenotype that is defined by rapid acquisition of cocaine self‐administration. Here, we showed that response to novelty can also predict the neurochemical and behavioral effects of acute and repeated cocaine in rats. We used cocaine self‐administration under a fixed‐ratio 1 schedule followed by fast‐scan cyclic voltammetry in brain slices to measure subsecond dopamine (DA) release and uptake parameters in drug‐use‐prone and ‐resistant phenotypes. Despite no significant differences in stimulated release and uptake, animals with high responses to a novel environment had DA transporters that were more sensitive to cocaine‐induced uptake inhibition, which corresponded to greater locomotor activating effects of cocaine. These animals also acquired cocaine self‐administration more rapidly and, after 5 days of extended access cocaine self‐administration, high‐responding animals showed robust tolerance to DA uptake inhibition by cocaine. The effects of cocaine remained unchanged in animals with low novelty responses. Similarly, the rate of acquisition was negatively correlated with DA uptake inhibition by cocaine after self‐administration. Thus, we showed that tolerance to the cocaine‐induced inhibition of DA uptake coexists with a behavioral phenotype that is defined by increased preoccupation with cocaine as measured by rapid acquisition and early high intake.
Are Government‐Supported Healthy Marriage Initiatives Affecting Family Demographics? A State‐Level Analysis
Authors: Hawkins Alan J. , Amato Paul R. , Kinghorn Andrea
Published: June 2013

This study assesses whether government‐supported Healthy Marriage Initiatives (HMIs)—educational programs to help couples form and sustain healthy marriages and relationships—have had a measurable impact on population‐level family outcomes. We compiled data on funding for these initiatives between 2000 and 2010 and aggregated these data to the state level for each year. We employed pooled time‐series regression with fixed state and year effects to estimate the effects of funding on population‐level outcomes taken from the American Community Survey. Cumulative per capita funding for HMIs between 2005 and 2010 was positively associated with small changes in the percentage of married adults in the population and children living with two parents, and it was negatively associated with the percentage of children living with one parent, nonmarital births, and children living in poverty. These results were diminished, however, when an influential outlier—Washington, DC—was removed from the analysis. Interpretations and implications of these findings are discussed.
When Family Members Are Also Business Owners: Is Entrepreneurship Good for Families?
Authors: Jennings Jennifer E. , Breitkreuz Rhonda S. , James Albert E.
Published: June 2013

This article represents a call to family scholars for help in examining the effects of business ownership on families. To demonstrate the importance of this call, we illustrate the extent to which new venture creation is encouraged by policymakers and estimate the number of families engaged in entrepreneurial activity around the globe. We then summarize emergent critiques questioning the glorification of entrepreneurship in general and review the limited body of scholarly work examining the effects on families in particular. We conclude by outlining potential research agendas for several domains of family scholarship, providing examples of the provocative questions that arise when business ownership is explicitly acknowledged as a factor likely to impact family dynamics and well‐being.
The mechanism of competition between two bloom‐forming Microcystis species
Authors: Zhai Chunmei , Song Shuang , Zou Shaohua , Liu Changhong , Xue Yarong
Published: June 2013

Cyanobacteria, a phylum of bacteria that obtains energy by oxygenic photosynthesis, can be found in almost every terrestrial and aquatic habitat on Earth and play an important role in global carbon and oxygen cycles and as food sources for fish. However, common bloom‐forming cyanobacteria in the genus Microcystis produce microcystins that are toxic to human beings and aquatic animals and can have disastrous effects in aquatic ecosystems.

Algal species follow seasonal successions of bloom formation and Microcystis spp. have been reported to be more competitive than other algal species in lakes. However, so far there has been no clear demonstration of competition among Microcystis species.

By means of growth experiments, we demonstrate that two common cyanobacterial species Microcystis aeruginosa FACHB‐905 and Microcystis flos‐aquae FACHB‐1028, which are the dominant toxigenic species in Lake Taihu, exhibit a competitive relationship under coculture condition, the former outcompeting the latter.

We show that M. aeruginosa is a superior competitor to M. flos‐aquae regardless of temperature, nutrients and initial abundance ratios. Moreover, both unicultured filtrates of M. aeruginosa and cocultured filtrates of both species strongly inhibit the growth of M. flos‐aquae.

An analysis using gas chromatography mass spectrometry of extracts of filtrates from unicultures and cocultures indicates that some extracellular allelopathic compounds produced by M. aeruginosa, such as D‐limonene and 1‐chlorine heptacosane, might play important roles in competition among the species.
Climate‐related variation in mortality and recruitment determine regional forest‐type distributions
Authors: Vanderwel Mark C. , Lyutsarev Vassily S. , Purves Drew W.
Published: June 2013

Aim

The geographic distributions of different forest types are expected to shift in the future under altered climatic conditions. At present, the nature, magnitude and timing of these shifts are uncertain because we lack a quantitative understanding of how forest distributions emerge from climate‐ and competition‐related variation in underlying demographic processes. Forest dynamics result primarily from the manner in which the physical environment and competition for limiting resources affect tree growth, mortality and recruitment. We sought to uncover the relative importance of these processes in controlling the geographic limits of different forest types.

Location

Eastern USA.

Methods

We parameterized a climate‐dependent forest dynamics model with extensive observations of tree growth, mortality and recruitment from forest inventory data. We then implemented the resulting demographic models in simulations of joint population dynamics for seven plant functional types (PFTs) across the region. By removing various climate effects in a series of simulation experiments, we assessed the importance of climate‐dependent demography and competition in limiting forest distributions.

Results

Distributions that emerged from simulated population dynamics approximated the current distributions for all seven PFTs well and captured several known patterns of succession. Temperature‐related increases in mortality determined the southern boundaries of three out of four boreal and northern temperate PFTs, whereas temperature‐related decreases in recruitment controlled the northern limit of all three southern temperate PFTs. Changes in growth rates and competitor performance had only minor effects on the distribution limits of most PFTs.

Main conclusions

Our results imply that dynamic global vegetation models, which are widely used to predict future vegetation distributions under climate change, should seek to more appropriately capture the observed climate sensitivity of mortality and recruitment. Understanding the mechanisms controlling forest distributions will enable better predictions of their future responses to climate change.
Disordering network theory: an introduction
Authors: MARSHALL JONATHAN PAUL , GOODMAN JAMES
Published: June 2013

Whereas theories of the information society/network society tend to regard networks as generally resilient and adaptable, the articles in this special issue treat disorder as inherently important in social theory and in the analysis of networks. By taking disorder seriously, the contributors recognize that it is something more than a correctable failure or a symptom of decay. This introduction makes five main claims about disorder. First, ordering networks can contain and generate their oppositions and produce what some of those within those networks call disorder. Second, networks of commodification, survival and the making of culture come into conflict. Third, information is necessarily distorted, or blocked, in information capitalism. Fourth, networks are sometimes functional precisely because they are unstable and ambiguous. And, fifth, disorder can be creative and indeed may offer hope of an escape from fatal ordering, but perhaps not into a new order.
The tangled hydra: developments in transglobal peer‐to‐peer culture
Authors: DA RIMINI FRANCESCA
Published: June 2013

Internet‐enabled file sharing via peer‐to‐peer (P2P) systems is a transglobal activity involving millions of people circulating vast amounts of information. ‘Anonymous peers’ exchange data via autonomous networks that are simultaneously external to, and embedded within, market structures. A transnational alliance of technology and media industries and governments employs technological barriers, legal instruments and, belatedly, commercial alternatives to constrain the phenomenon. Such ‘digital enclosures’ trigger productive rebellious acts by programmers, intellectual property activists and file sharers inhabiting overlapping informal networks. Escalating cycles of retaliation and resistance spawn further disorder in the informational domain. The period 2009–12 has been a watershed for technological trends, landmark legal battles and supranational treaties. However, scant attention is paid to how ‘digital piracy’ disturbs the logic of capital by instituting material practices that tolerate contradictory positions on free culture and electronic freedom, creating new contexts for social experimentation and recomposition.
‘Disorderly conduct’: on the unruly rules of public communication in social network sites
Authors: WAGNER ELKE , STEMPFHUBER MARTIN
Published: June 2013

In this article, we examine typical styles and practices of public communication on social network sites (SNSs) in order to confront the traditional concept of publics as machines for creating order. Through an ethnographic case study of the SNS Facebook, we show how indeterminacy, ambiguity and constant irritation, rather than arguments or reason, produce the communicative order. A decidedly disorderly style of communication and connectivity emerges. Indeterminacy, from our point of view, is a solution to the problem of speaking privately in public and to an indefinite audience. We use these findings to problematize the insights of network theory and Niklas Luhmann's systems theory that only out of noise can we generate order – we can also generate it through noise. Since order undermines itself through the creation of ambiguous communicative possibilities, a new kind of public sphere is created.
Gender Norms and Women's Political Representation: A Global Analysis of Cabinets, 1979–2009
Authors: Jacob Suraj , Scherpereel John A. , Adams Melinda
Published: June 2013

What role does the international diffusion of gender norms play in determining recent increases in women's political representation? We argue that norm diffusion has larger positive effects on women's cabinet representation than on women's legislative representation. We also show that within cabinets, norm diffusion affects low‐prestige appointments more than high‐prestige appointments. We test these arguments using an original database of ministers from 1979 to 2009 and find that the association of women's representation with three separate indicators of international diffusion—levels of women's representation among neighboring states, levels of women's representation among intergovernmental organization partners, and time since ratification of the Convention on the Elimination of All Forms of Discrimination against Women—is consistent with our arguments.
Laser in caries treatment – patients' experiences and opinions
Authors: Sarmadi R , Hedman E , Gabre P
Published: June 2013

Objectives

The aim of this study was to obtain a deeper understanding of patient's experiences and perspectives after dental caries treatment with Er:YAG laser technology.

Methods

Twelve patients aged 15–30 years who had undergone at least one laser caries excavation agreed to participate in an interview study. All the interviews were tape recorded and transcribed by a transcription agency. The transcribed texts were analysed using manifest and latent qualitative content analysis.

Results

The categories in this study were identified as choosing laser, understanding laser, encouraging dental care and my oral health. The motivation for laser treatment was described as dental fear in general, specific fear of needles or discomfort with the drill. The informants described the dentist's role as initiators of treatment and willing or unwilling facilitators. Laser treatment was described as safer and more carefully considered treatment. They felt generally safe with laser and were able to relax during the treatment. All interviewers described a positive impression of the laser, and words like ‘up to date’ and ‘future‐oriented’ were used to describe laser. Laser treatment was considered less painful.

Conclusions

The results indicate that patients find laser a feasible and convenient treatment option.
A new indicator of the oral hygiene habits of disabled persons: relevance of the carer's personal appearance and interest in oral health
Authors: Limeres J , Martínez F , Feijoo JF , Ramos I , Liñares A , Diz P
Published: June 2013

Objective

To investigate whether there is a relationship between the oral hygiene habits of individuals with severe disability the carer's personal appearance and interest in oral health.

Patients and methods

The study group was formed of 60 disabled persons and their respective carers who came for the first time to consultation in the Special‐Needs Dentistry Unit of the University of Santiago de Compostela, Spain. All the carers answered a standardised questionnaire of 28 questions divided into four sections: disabled individual's demographic data, disabled individual's general medical details, social aspects of the carer (personal appearance of the carer and interest in oral health), and disabled individual's oral hygiene habits. The personal appearance of the carers and their interest in the disabled individual's oral health were evaluated using independent scales designed specifically for the study, with five binary items in each scale.

Results

The carer's personal appearance and interest in the disabled individual's oral health showed a statistically significant relationship with the individual's oral hygiene habits, particularly with respect to the frequency and duration of toothbrushing, need for physical restraint during toothbrushing, use of a manual toothbrush and use of toothpaste.

Conclusions

The carer's personal appearance and interest in the disabled individual's oral health are good indicators of the oral hygiene habits of an individual with severe disability. Consideration should be given to the inclusion of these aspects as a complementary element of the dental record.
Patients' satisfaction with the care offered by advanced practice nurses: A new role in Swedish primary care
Authors: Bergman Karin , Perhed Ulla , Eriksson Irene , Lindblad Ulf , Fagerström Lisbeth
Published: June 2013

The aim of this study is to describe patients' satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi‐squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN‐led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents' comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.
Comparison of health‐related quality of life and emotional distress among Chinese cancer survivors
Authors: So Winnie KW , Ling Gigi CC , Choi Kai‐chow , Chan Carman WH , Wan Rayman WM , Mak Suzanne SS , Sit Janet WH
Published: June 2013

The purpose of this study is to compare health‐related quality of life (HRQoL) and emotional distress among diverse cancer survivors who had completed all treatment within the previous year. A convenience sample of 353 cancers survivors (lung, head and neck, breast and prostate cancers) were recruited to complete a survey, which consisted of (i) Hospital Anxiety and Depression Scales; (ii) Chinese version of the Functional Assessment of Cancer Therapy—General version; and (iii) demographic and clinical data. The HRQoL scores were similar among the four types of survivors. Mild anxiety and depression levels were reported, but no significant difference was noted. Younger females with financial burdens and uncertain prognosis were particularly associated with HRQoL and emotional distress. Further studies are essential to identify specific problems that cancer patients experience after cancer diagnosis that might lead to the early detection of those most at risk of ongoing problems.
House dust mite and cat allergen in different indoor environments
Authors: CUSTOVIC A. , TAGGART S. C. O. , WOODCOCK A.
Published: June 2013

Allergy to house dust mites (HDM) and domestic pets is a major cause of asthma. People in developed countries spend more than 90% of their time indoors. We have measured levels of HDM allergen Der p I and cat allergen Fel d I in public buildings and public transport. Dust samples were collected by vacuuming a 1 m2 area for 2 min from five schools, six hotels, four cinemas, six pubs, three buses, two trains and 12 domestic households without a cat. Der p I and Fel d I were assayed with monoclonal antibodies in a two‐site immunometric ELISA. Der p I concentration was significantly higher in the private homes than in comparable sites in public places except for cinema seats (where high values were found) compared with domestic sofas. Der p I >2000 ng/g of fine dust was found in 30% of the upholstered seats, 9% having a concentration > 10000 ng/g. Fel d I levels were significantly higher in the dust from upholstered seats (geometric mean 14±88 μg/g) than in carpeted floors (geometric mean 0±73 μg/g), and in public places than in private homes. Fel d I >8 μg/g was found in 79% of the upholstered seats or furniture sampled in public buildings or public transport. In conclusion, upholstered seats from public buildings and public transport constitute an allergen reservoir for continuous contamination of the indoor environment which could compromise the effects of allergen avoidance employed at home.
Corporate Governance, Affirmative Action and Firm Value in Post‐apartheid South Africa: A Simultaneous Equation Approach
Authors: Ntim Collins G.
Published: June 2013

The post‐apartheid South African corporate governance (CG) model is a unique hybridization of the traditional Anglo‐American and Continental European‐Asian CG models, distinctively requiring firms to explicitly comply with a number of affirmative action and stakeholder CG provisions, such as black economic empowerment, employment equity, environment, HIV/Aids, and health and safety. This paper examines the association between a composite CG index and firm value in this distinct corporate setting within a simultaneous equation framework. Using a sample of post‐apartheid South African listed corporations, and controlling for potential interdependencies among block ownership, board size, leverage, institutional ownership, firm value and a broad CG index, we find a significant positive association between a composite CG index and firm value. Further, our two‐stage least squares results show that there is also a reverse association between our broad CG index and firm value, emphasizing the need for future research to adequately control for potential interrelationships between possible alternative CG mechanisms and firm value. Distinct from prior studies, we find that compliance with affirmative action CG provisions impacts positively on firm value. Our results are consistent with agency, legitimacy, political cost, and resource dependent theoretical predictions. Our findings are robust across a number of econometric models that adequately control for different types of endogeneity problems, and alternative accounting, and market‐based firm valuation proxies.
Playing the Game: Strategies of Resistance and Co‐optation in Diversity Work
Authors: Swan Elaine , Fox Steve
Published: June 2013

The article addresses diversity work as a specific form of management work that involves complex micro‐political strategies of resistance. Diversity work stems from an activist agenda that has been adopted by mainstream management practice, especially new public sector management. But in being adopted, it has been critiqued for also being co‐opted, and as a result de‐radicalized. The article seeks to examine this critique. First, we examine the politics of diversity, discussing critiques of diversity work from political theory and referencing femocrats, an earlier movement affecting women in management. Secondly, we recognize that the ambivalence of diversity work can be understood in terms of co‐optation and resistance. Here our central contribution is to understand these two processes in a much more nuanced way, drawing on our own and other organizational studies of diversity work in practice. We locate this more nuanced analysis of diversity work in the emergent context of new public sector management. We draw attention to three micro‐practices that help to exhibit a complex understanding of co‐optation and resistance: (a) discursive resources, (b) embodied resources and (c) management technologies as resources. Finally, we conclude by outlining the article's contribution: extending Meyerson and Scully's notion of the tempered radical in four key ways. We do this by emphasizing the importance of the specificities of occupational resources of resistance, arguing that resources of resistance move beyond the discursive, emphasizing the gendered, classed and racialized variegated nature of insider/outsider dynamics and finally, stressing that co‐optation and resistance are temporal, dynamic, intermingled processes in diversity work.
Making a difference: ethical consumption and the everyday
Authors: Adams Matthew , Raisborough Jayne
Published: June 2013

Our everyday shopping practices are increasingly marketed as opportunities to ‘make a difference’ via our ethical consumption choices. In response to a growing body of work detailing the ways in which specific alignments of ‘ethics’ and ‘consumption’ are mediated, we explore how ‘ethical’ opportunities such as the consumption of Fairtrade products are recognized, experienced and taken‐up in the everyday. The ‘everyday’ is approached here via a specially commissioned Mass Observation directive, a volunteer panel of correspondents in the UK. Our on‐going thematic analysis of their autobiographical accounts aims to explore a complex unevenness in the ways ‘ordinary’ people experience and negotiate calls to enact their ethical agency through consumption. Situating ethical consumption, moral obligation and choice in the everyday is, we argue, important if we are to avoid both over‐exaggerating the reflexive and self‐conscious sensibilities involved in ethical consumption, and, adhering to a reductive understanding of ethical self‐expression.
The HIV global pandemic: The development and emerging implications
Authors: Scully C
Published: June 2013

AIDS was first observed in 1981. The World Health Organisation has estimated that over 6 million AIDS cases had occurred by late 1995 but that only one‐third had been reported. There is an annual increase worldwide of 20%, but in Asia it is in excess of 150% each year. HIV‐1 can be classified into two major groups: M which contains 10 subtypes and O which contains several heterogenous viruses. HIV‐2, found mainly in Africa, contains at least five subtypes. Combination therapies with nucleoside analogues are now recommended.
Neutrophil phagocytosis in AIDS patients with azole resistant candidiasis
Authors: Dios P Diz , Iglesias I , Valcarcel JP , Ocampo A , Vazquez E , Castro M
Published: June 2013

OBJECTIVE AND SUBJECTS: This study aimed to evaluate phagocytosis of C. albicans by neutrophils in 10 AIDS patients and 50 control subjects. Five of the AIDS patients were colonised with azole‐resistant C. albicans isolates and five with azole‐sensitive isolates.

RESULTS AND CONCLUSIONS: Percentage phagocytosis was within normal limits for seven of the 10 AIDS patients and was reduced in the remaining three patients. Phagocytosis was unaffected by the carriage of azole resistant C. albicans, and the patients' own strains were phagocytosed as readily as a standard strain of C. albicans. This study suggests that azole resistance is not related to impaired phagocytosis in AIDS patients.
Epstein‐Barr virus: Biology and disease
Authors: Cruchley AT , Williams DM , Niedobitek G , Young LS
Published: June 2013

Epstein—Barr virus is a human herpes virus which, whilst found as a widespread asymptomatic infection, is also associated with certain tumours of lymphoid and epithelial origin including Burkitt's lymphoma (BL), immunoblastic lymphoma (IBL), Hodgkin's Disease (HD) and nasopharyngeal carcinoma (NPC). A unique characteristic of EBV is its ability to infect and transform primary resting B lymphocytes in vitro into permanently growing lymphoblastoid cell lines (LCLs); this effect is associated with constitutive expression of a limited set of viral genes. Interestingly, the pattern of EBV gene expression observed in LCLs in vitro is also a feature of IBLs, a tumour associated with immunosuppression. The other EBV associated tumours display a more restricted pattern of EBV latent protein expression. B cell lines can be activated in vitro into the virus replicative cycle, where a large number of viral genes associated with EBV DNA replication and virus assembly are synthesised. Whilst EBV can be detected in throat washings from seropositive individuals, the only in vivo situation where full virus replication can be reliably observed is hairy leukoplakia (HL), a benign lesion of lingual epithelium frequently found in AIDS patients. Thus, the relative contribution of lymphoid cells and epithelial cells to latent EBV infection/persistence vs replication in vivo remains controversial. Recent studies suggest that HL represents a focus of EBV replication in the absence of a truly latent infection and this supports the contention that EBV persistence resides in the lymphoid compartment. These aspects together with the role of EBV in oral diseases and the effect of certain EBV genes on the control of epithelial cell growth and differentiation will be discussed.
The deep mycoses in HIV infection
Authors: Scully C , de Almeida OP , Sposto MR
Published: June 2013

The deep mycoses are uncommon infections, usually acquired from the inhalation or ingestion of fungal spores, sometimes from the soil in areas of endemicity, such as in the Americas and south‐east Asia, or from decaying vegetable matter. They are also seen in immunocompromised persons and, increasingly, in HIV‐infected persons.

Respiratory involvement is frequent, with granuloma formation, and mucocutaneous involvement may be seen. Oral lesions of the deep mycoses are typically chronic but non‐specific, though nodular or ulcerative appearances are common. Person‐to‐person transmission is rare. In HIV disease, the most common orofacial involvement of deep mycoses has been in histoplasmosis, cryptococcosis, aspergillosis and zygomycosis. Diagnosis is usually confirmed by lesional biopsy although culture may also be valuable. Treatment is with amphotericin or an azole.
The professional responsibility for care
Authors: Glick M , Burris S
Published: June 2013

Access to dental care is an essential need for all patients, particularly for individuals with complex medical conditions. Consequently, dentists have a moral and professional obligation to provide care for all individuals within the dentist's realm of expertise. However, throughout the HIV epidemic dental professionals have demonstrated an unwillingness to treat infected patients. This article addresses common objections raised by dentists unwilling to provide care, and discusses the professional obligation to treat and the importance of professionalism in reducing discrimination.
Psychological aspects of infection control and the care of the patient with HIV in dentistry
Authors: Green J
Published: June 2013

HIV presents a number of challenges to the dentist. There is a need to control infection risks and, in spite of all the information available, a minority of dentists still have incomplete infection control procedures. The reasons for this and the implications for dental education are explored. There is also a need to ensure that the patient is optimally managed by the dentist and the importance of linkages to other services and the likely demands of patients on the dentist are reviewed. Finally the impact of treating the patient with HIV disease on the dentist and ways of minimising stress associated with the work are considered.
Management of the oral mucosal lesions seen in association with HIV infection
Authors: Greenspan D , Shirlaw PJ
Published: June 2013

Oral lesions cause considerable morbidity in association with HIV infection. Their successful management depends upon accurate diagnosis and the use of appropriate therapy. Various treatment approaches are described for some of the common oral lesions including Kaposi's sarcoma, oral candidiasis, hairy leukoplakia and recurrent oral ulcers associated with HIV disease. This paper will discuss the therapies available in the USA and UK. In other countries some of the drugs discussed will be available in different doses and preparations. In addition other drugs may be available in other parts of the world that are not licensed for use in the USA or UK, and their availability may vary.
Oral lesions of HIV and AIDS in Asia: An overview
Authors: Anil S , Challacombe SJ
Published: June 2013

The magnitude of HIV infection in the Asian region is increasing dramatically. Oral disease represents an important health problem for HIV‐infected individuals, because of its diagnostic, prognostic and therapeutic implications. The documentation and reporting of HIV infection and AIDS in most of the Asian countries has been superficial. Though the epidemiology of HIV infection in Asia has been studied by many investigators, few attempts have been made to summarise the data and assess the magnitude of the problem, the mode of transmission, the spread of infection and clinical pattern of illness. A review of the literature shows that there is hardly any published data on oral manifestations of HIV infection or AIDS from the Asian region. However, some preliminary information is available on the type of lesion presenting in patients from India and Thailand. These observations suggest that oral manifestations are common in HIV‐infected and AIDS patients. The pattern of occurrence of various lesions reported appears to show variation from those reports from other parts of the world, but no definitive conclusion can be drawn from these preliminary observations. Further epidemiological studies are necessary to substantiate the present understanding of the nature of oral lesions found in Asian countries.
HIV‐associated oral lesions: Prevalence in Zambia
Authors: Hodgson TA
Published: June 2013

OBJECTIVES: To describe the prevalence of HIV‐associated oral lesions in known HIV* subjects in Zambia and assess the predictive value of these lesions to identify individuals with CD4 cell counts less than 200 times 106 L−1.

SETTING: St Francis Hospital, situated in the rural Katete District, Eastern Province, Zambia. SUBJECTS: 107 newly diagnosed heterosexual HIV positive individuals included 42% males and 58% females (mean age 34.5, range 16–62).

METHODS: Following a medical history and detailed oral examination, blood and whole saliva were collected in each subject.

RESULTS: A total of 47.7% from this sample had an AIDS diagnosis. The mean CD4 count was 252.2 cells mm−3(s.d. ± 160.5, range 44–810); 40.2% of the study group demonstrated oral lesions associated with HIV seropositivity. Candidiasis was most commonly seen (25% prevalence). In this population erythematous candidiasis was the only oral lesion significantly associated with CD4 counts of less than 200 times 106L−1 (P < 0.05, Two‐tailed Fisher's Exact Test).

CONCLUSION: In resource poor countries a thorough oral examination may suggest HIV infection and predict disease progression. Health care professional education regarding the orofacial manifestations of HIV infection needs urgent reinforcement in these areas.
Orofacial manifestations and seroprevalence of HIV infection in Namibian dental patients
Authors: Itula PFB , Mackenzie SBP , Lewis K , Mortimer PP
Published: June 2013

SUBJECTS AND METHODS: In an anonymous study of HIV‐1 sero‐reactivity in dental patients in a Government clinic in Namibia, 29 (7%) out of 405 patients (10 female and 19 male) were confirmed as HIV‐infected. HIV‐anti‐body testing was done cheaply and conveniently by collecting and storing finger‐prick blood on absorbent paper, and eluting the samples 7 weeks later. Testing was done by GACPAT, a simple, inexpensive temperature independent assay which requires no specialised equipment.

RESULTS AND CONCLUSIONS: Six patients had orofacial lesions, including Kaposi's sarcoma, leukoplakia (bilateral on buccal mucosa), cervical lymphadenopathy, hairy leukoplakia, circum‐oral herpes simplex, HIV‐gingivitis and necrotising ulcerative gingivitis. This sampling and testing system is well suited for use in epidemiological surveys in developing countries.
The social, economic and political impact of the global HIV/AIDS epidemic
Authors: Kleinman DV
Published: June 2013

OBJECTIVES: This paper reviews the themes emerging from reports of the many social, economic and political effects of the HIV/AIDS epidemic on individuals, nations and the world. The impact of the global HIV/AIDS epidemic has been felt in every facet of society.

APPROACH: The impact of the epidemic is described in five areas: (1) challenges and changes to traditional public health approaches to infectious diseases and sexually transmitted diseases; (2) adjustments to ‘standard’ clinical research and drug regulatory practices; (3) emphasis on the importance of personal behaviors and behavioral approaches in controlling the epidemic; (4) revealing the complexity of and recognizing the need to monitor the impacts of HIV/AIDS; and (5) highlighting the difficulties of, and need for, the international responsiveness to address HIV/AIDS. The oral health community's response to the epidemic is briefly described.

CONCLUSIONS: Although in its second decade, the epidemic is still in its early stages of evolution. The challenges lie in the development and perpetual evolution of strategies to respond to the epidemic locally while thinking and acting globally. The international oral health community is one of many that has played and must continue to play an active role in a multi‐disciplinary effort needed to curb this epidemic.
Salivary and mucosal immune responses to HIV and its co‐pathogens
Authors: Challacombe SJ , Sweet SP
Published: June 2013

The profound effects that HIV induces in systemic immunity have been well characterised, but the situation with regard to mucosal immune responses is less clear. Oral cavity fluids have been used as a marker of the mucosal immune system. Whole and parotid saliva IgA, IgA1 and IgA2 concentrations have been found to be lower in both HIV infection and AIDS subjects, whereas serum IgA and IgA subclasses are markedly raised, suggesting a dichotomy between systemic and secretory immunity. Salivary antibodies to HIV can be readily detected and secretory IgA antibody can be neutralising to some strains of HIV. HIV vaccines can also induce antibody responses in saliva, but vaccination routes other than parenteral immunisation are needed. Antibody responses to oral microbes have also been studied and it has been shown that IgA, IgA1 and IgA2 subclass antibody titres to Candida albicans and to Streptococcus mut‐ans are increased in whole or parotid saliva from HIV patients, but reduced in AIDS patients, suggesting a compensatory response which is overcome with progressive immunodeficiency. The avidity of salivary IgA antibodies to Candida in HIV seems unimpaired, whereas relative avidities of serum antibodies in HIV patients with candidiasis are lowered. Non‐specific factors which may inhibit Candida and other opportunist pathogens are also found in saliva. The candidacidal, myelomonocytic protein calprotectin is present in saliva at levels which are biologically active, although levels are lowered in HIV infection. Overall, HIV infection appears to be associated with disregulation of a number of immune factors at the mucosal surface, but the ability of patients with HIV infection to mount specific antibody secretory responses seems to be relatively intact until late in infection.
Molecular and phenotypic analysis of Candida dubliniensis: A recently identified species linked with oral candidosis in HIV‐infected and AIDS patients
Authors: Coleman D , Sullivan D , Harrington B , Haynes K , Henman M , Shanley D , Bennett D , Moran G , McCreary C , O'Neill L
Published: June 2013

The discovery and characterisation of a novel species of Candida, termed Candida dubliniensis, associated with oral candidosis in HIV‐infected individuals is described. These organisms share several phenotypic characteristics in common with Candida albicans and Candida stellatoidea, including the ability to produce germ tubes and chlamydospores. However, in contrast to these latter two species, C. dubliniensis isolates produce abundant chlamydospores, which are often arranged in contiguous pairs, triplets and other multiples suspended from a single suspensor cell. They belong to C. albicans serotype A and exhibit atypical substrate assimilation profiles. Genomic DNA fingerprinting analysis with the C. albicons‐specific probe 27A and five different oligonucleotide probes consisting of short repeat sequence‐containing motifs, demonstrated that C. dubliniensis has a distinct genomic organisation relative to C. albicans and C. stellatoidea. This was confirmed by karyotype analysis and random amplified polymorphic DNA (RAPD) analysis. Comparison of 500 bp of the V3 variable region of the large ribosomal subunit genes from 14 separate C. dubliniensis isolates and the corresponding sequences from C. albicans, C. stellatoidea, C. tropicalis, C. glabrata, C. parapsilosis, C. kefyr and C. krusei demonstrated that the C. dubliniensis isolates formed a homogenous cluster (100% similarity), representing a discrete taxon within the genus Candida that was significantly different from the other species analysed.
Oxaliplatin‐related sinusoidal obstruction syndrome mimicking metastatic liver tumors
Authors: Arakawa Yusuke , Shimada Mitsuo , Utsunomya Tohru , Imura Satoru , Morine Yuji , Ikemoto Testuya , Hanaoka Jun , Sugimoto Koji , Bando Yoshimi
Published: June 2013

A 40‐year‐old woman who had undergone a curative low anterior resection for advanced rectal cancer was admitted to our hospital. She had been administrated oxaliplatin‐based chemotherapy as postoperative adjuvant chemotherapy. The contrast‐enhanced computed tomography revealed three hypovascular tumors, 3.0, 1.5 and 1.0 cm in diameter, located in the right hepatic lobe. The hepatocyte phase of the gadoxetic acid‐enhanced magnetic resonance imaging demonstrated these lesions as hypointense tumors relative to the surrounding hepatic parenchyma. All these findings of the preoperative imaging modalities were compatible to metastatic liver tumors from the rectal cancer, and right hepatic lobectomy was successfully performed. Histopathologically, the tumors revealed sinusoidal dilation and severe congestion outlined by atrophic hepatocyte trabeculae, which was known as peliosis hepatis. The perisinusoidal space of Disse was extensively dilated and contained many erythrocytes. Taking these findings into account, the hepatic tumors were considered to be the space‐occupying lesions resulting from the sinusoidal obstruction syndrome. We herein report the first case of focal sinusoidal obstruction syndrome mimicking metastatic liver tumors.
Timing of motor milestones achievement and development of overweight in childhood: a study within the Danish National Birth Cohort
Authors: Schmidt Morgen C. , Andersen A.‐M. N. , Due P. , Neelon S. B. , Gamborg M. , Sørensen T. I. A.
Published: June 2013

What is already known about this subject

The risk of childhood obesity is influenced by a number of pre‐ and post‐natal factors.

The risk of childhood obesity is correlated with body weight during infancy, which might be related to the psychomotor development of the child.

The previous literature on motor milestones and childhood overweight is limited and results are inconsistent.

What this study adds

Weight status in early life and timing of achievement of gross motor milestones (the ability to sit and walk) are largely independent of each other.

Timing of achievement of motor milestones in early life does not predict overweight or increased BMI later in childhood.

Background

Overweight may hinder achievement of gross motor milestones and delayed achievement of milestones may increase the risk of later overweight for reasons involving physical activity and the building of lean body mass.

Objective

To investigate whether increased birth weight and body mass index (BMI) at 5 months is associated with the achievement of the ability to sit up and walk and whether delayed achievement of these milestones is associated with overweight at age 7 years.

Methods

We used data from the Danish National Birth Cohort on 25 148 children born between 1998 and 2003. Follow‐up took place from 2003 to 2010. Mean age at follow‐up was 7.04 years. We used logistic and linear regression analyses.

Results

Birth weight and BMI at 5 months were marginally associated with earlier achievement of the ability to sit up and walk (regression coefficients between −0.027 months; [CI −0.042; −0.013] and −0.092 months [CI −0.118; −0.066]). Age in months of sitting and walking were not associated with overweight at age 7 years (ORs between 0.97 [CI 0.95–1.00] and 1.00 [CI 0.96–1.04]). Later achievement of sitting and walking predicted lower BMI at age 7 years (ln‐BMI –z‐scores between −0.023 [CI −0.029; −0.017] and −0.005 [CI −0.015; 0.005)).

Conclusions

All observed associations were of negligible magnitude and we conclude that birth weight or BMI at age 5 months and motor milestones appear largely independent of each other and that timing of achievement of motor milestones seems not to be associated with later overweight or increased BMI.
Is It Possible to Shorten Ambulatory Blood Pressure Monitoring?
Authors: Wolak Talya , Wilk Lior , Paran Esther , Wolak Arik , Gutmacher Bella , Shleyfer Elena , Friger Michael
Published: June 2013

The aim of this investigation was to find a time segment in which average blood pressure (BP) has the best correlation with 24‐hour BP control. A total of 240 patients with full ambulatory BP monitoring (ABPM) were included; 120 had controlled BP (systolic BP [SBP] ≤135 mm Hg and diastolic BP [DBP] ≤85 mm Hg) and 120 had uncontrolled BP (SBP >135 mm Hg and/or DBP >85 mm Hg). Each ABPM was divided into 6‐ and 8‐hour segments. Evaluation for correlation between mean BP for each time segment and 24‐hour BP control was performed using receiver operating characteristic curve analysis and Youden's index for threshold with the best sensitivity and specificity. The mean BP in the following segments showed the highest area under the curve (AUC) compared with average controlled 24‐hour BP: SBP 2 am to 8 am (AUC, 0.918; threshold value of 133.5 mm Hg, sensitivity−0.752 and specificity−0.904); SBP 2 pm to 10 pm (AUC, 0.911; threshold value of 138.5 mm Hg, sensitivity−0.803 and specificity−0.878); and SBP 6 am to 2 pm (AUC, 0.903; threshold value of 140.5 mm Hg, sensitivity−0.778 and specificity−0.888). The time segment 2 pm to 10 pm was shown to have good correlation with 24‐hour BP control (AUC >0.9; sensitivity and specificity >80%). This time segment might replace full ABPM as a screening measure for BP control or as abbreviated ABPM for patients with difficulty in performing full ABPM.
Asthma and attention‐deficit/hyperactivity disorder: a nationwide population‐based prospective cohort study
Authors: Chen Mu‐Hong , Su Tung‐Ping , Chen Ying‐Sheue , Hsu Ju‐Wei , Huang Kai‐Lin , Chang Wen‐Han , Chen Tzeng‐Ji , Bai Ya‐Mei
Published: June 2013

Background

Previous cross‐sectional studies have suggested an association between asthma and attention‐deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population‐based prospective case–control cohort study (1:4, age‐/gender‐matched), we hypothesized that asthma in infanthood or early childhood would increase the risk of ADHD in later life.

Methods

In all, 2,294 children with asthma and 9,176 controls aged between 0 and 3 years in 2000 were included in our study. Cases of ADHD that occurred to the end of follow‐up (31 December 2010) were identified.

Results

Children with asthma had a higher incidence of developing ADHD (7% vs. 4.6%, p < .001) than control cohort during the follow‐up period. After adjusting for age at enrollment, gender, level of urbanization, and comorbid allergic diseases (allergic rhinitis and atopic dermatitis), children with asthma had an elevated risk (HR: 1.31, 95% CI: 1.07–1.59) of developing ADHD compared with control group.

Discussion

Our prospective study supported a temporal relationship between asthma and ADHD. Asthma in very early life increased the risk of developing ADHD during the school years. Further studies are required to investigate whether the prompt treatment of asthma and comorbid allergic diseases could prevent the development of ADHD or decrease ADHD symptoms.