bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects for social dialogue in the public sector - European confederations, sectoral federations and forms of interest intermediation
Authors: Keller Berndt , Henneberger Fred
Published: January 2010

The article represents - in the form of a case study of the public services - an empirical contribution on the opportunities for and constraints upon interest intermediation at the sectoral level in the European Union. On the one hand, our results show that the transnational organisation of interests has made more progress on the employees' than on the employers' side. On the other hand, none of the corporate protagonists have any serious intention of transferring national authority to transnational associations.

Different strategies of interest representation will have different time horizons. In the short run, lobbying will remain the most efficient strategy for exerting influence. In the medium term, highly decentralised social dialogues in those parts of the public sector performing transnational tasks might become more important. Only in the long term, if at all, can collective bargaining - first of all on qualitative issues - be envisaged.

Pragmatically oriented steps towards reconciliation between different employees' organisations contribute to a striking reduction in the interest differences which, at the national level, have long been considered impossible to eradicate.
Trade unions and interest representation in the context of globalisation
Authors: Hyman Richard
Published: January 2010

This article begins by offering a framework for the analysis of the future of interest representation. Trade unions, explicitly or implicitly, have to answer three fundamental questions: whose interests they represent, which issues they embrace as relevant for the task of representation, and what methods and procedures they adopt in undertaking this task. Traditional answers to these questions have been challenged by the erosion of former models of solidarity, the increasing weight of competitive market forces, and the exhaustion of norms of egalitarianism. The author suggests new strategies for reviving trade unions' effectiveness as representative organisations.
Single currency, multiple budgets?
Authors: Le Cacheux Jacques
Published: January 2010

The painful process of convergence of national macroeconomic performances in order to comply with the Maastricht treaty criteria is coming to an end and the creation in time of the European single currency, probably with eleven members in the initial stage, is now taken for granted by most analysts and financial market participants. It is thus high time to think about how best to organise economic policy-making within the new euro zone. Although monetary unification will bring benefits for European consumers, there will also be costs, in particular due to increased competition within the single European monetary area. The combination of a single central bank and tax and fiscal competences retained, for the most part, by national governments necessitates an explicit coordination of fiscal policies for at least three reasons: macroeconomic stabilisation in Europe, especially in cases of asymmetric shocks; the "policy mix", i.e. the combination of monetary and fiscal policies at the European, aggregate level, and its influence on the external exchange rate of the euro; and the potential dangers of tax competition and "social dumping" , as national governments, deprived of their power over the exchange rate, may be tempted to gain a competitive advantage by other means. In the wake of monetary unification, the European Union will thus have to invent its own brand of "economic and fiscal federalism" , the recent creation of a "Council of the euro" being but one step in this direction.
Trade union proposals towards EMU
Authors: Foden David
Published: January 2010

This article provides an overview of the debate within the trade union movement on Europe's forthcoming economic and monetary union. It reviews the reasoning behind the ETUC's critical support for EMU and outlines the main issues in the trade union debate in ten European countries. It finds that the general political debate at national level has a significant influence on the discussion within the trade unions, and that the sector of the economy within which individual unions organise is also of relevance. Nevertheless, these specific concerns are placed within the framework of policy defined by the ETUC.
Changing work organisation in America : what has happened and who has benefited?
Authors: Osterman Paul
Published: January 2010

In the USA, with a strong economy and falling unemployment, a large number of firms are still restructuring the workplace, including laying off workers. Coupled with this is a change in the employment relationship, giving some workers opportunities to use their knowledge and skills, while other workers are experiencing a deterioration in their working conditions. This paper, resulting from a survey carried out by the Sloan School of Management, MIT, in 1997, examines the spread of High Performance Work Systems and shows that managers accept that these innovations lead to higher productivity and quality. The survey also shows that workers welcome the higher levels of responsibility these work systems give. However, it also indicates that the balance of power within these firms is shifting away from employees to managers, resulting in higher possibilities of layoff and higher levels of income inequality.
From "collective" to "individual" reductions in working time ?
Authors: Lehndorff Steffen
Published: January 2010

A survey of working time trends in the countries of the European Union over the past twenty years reveals the diminishing role of general collectively agreed working time reductions. The increasing importance of part-time work is interpreted less as a shift in emphasis from "collective" to "individual" working time reductions than as a concomitant of increasing, female labour market participation which may represent a transition to equal status of men and women in working life. On the basis of the European experiences reported in the other articles contained in this issue, the author discusses possible paths to a revival of collective bargaining and statutory policy in the working time field.
The implementation of EU directives in national systems - lessons from the Danish case
Authors: Knudsen Herman , Lind Jens
Published: January 2010

Labour market regulation in Denmark is traditionally considered as characterised by bipartite voluntarism dominated by centralised organisations of labour and capital interests supplemented and supported by state legislation. This system is undergoing some changes and, especially in relation to the implementation of EU-directives, it seems that it might come under severe pressure. In the Danish debate it is usually assumed that the answer to this pressure is to “defend the Danish model”. In this paper we challenge this strategy and argue that state regulation should not be considered as hostile to trade union interests. The defence of the present voluntarism in Denmark has problematic consequences for Danish workers as well as the Danish trade unions’ influence on European trade unionism.

Au Danemark, la réglementation du marché du travail est caractérisée traditionnellement par un volontarisme bipartite dominé par les organisations centralisées du travail et les intérêts du capital complétés et appuyés par la législation de l'Etat. Ce système est en train de subir des changements et, tout particulièrement en ce qui concerne la mise en oeuvre des directives européennes, il semble qu'il pourrait subir une pression énorme. Les discussions portant sur ce thème au Danemark admettent généralement que la réponse à cette pression est de « défendre le modèle danois ». Dans cet article, nous remettons en question cette stratégie et mettons en avant que la réglementation légale ne devrait pas être considérée comme hostile aux intérêts des syndicats. Actuellement la défense du volontarisme au Danemark a des conséquences problématiques à la fois pour les travailleurs danois et l'influence des syndicats danois sur le syndicalisme européen.

Die dänische Form der Arbeitsmarktregulierung wurde traditionell charakterisiert als System, das auf freiwilligen Vereinbarungen basiert und in dem die Spitzenorganisationen von Arbeitgebern und Gewerkschaften den Ton angeben. Die Gesetzgebung wirkt dabei ergänzend und unterstützend. Dieses Modell macht nun Veränderungen durch, wobei es aussieht, als könnte es vor allem im Zusammenhang mit der Umsetzung von EU-Richtlinien, unter starken Druck geraten. Gemeinhin wird in Dänemark davon gesprochen, dass man als Antwort auf diesen Druck das dänische Modell verteidigen müsse. Die Autoren wenden sich gegen diese Betrachtungsweise und argumentieren, dass staatliche Intervention sich nicht von vornherein gegen Gewerkschaftsinteressen richte. Das starre Festhalten am dänischen System, so ihre These, habe dagegen problematische Folgen für die dänischen Arbeitnehmer und den Einfluss der dänischen Gewerkschaften in der europäischen Gewerkschaftsbewegung.
The Affect and Arousal Scales: Psychometric Properties of the Dutch Version and Multigroup Confirmatory Factor Analyses
Authors: De Bolle Marleen , De Fruyt Filip , Decuyper Mieke
Published: January 2010

Psychometric properties of the Dutch version of the Affect and Arousal Scales (AFARS) were inspected in a combined clinical and population sample ( N = 1,215). The validity of the tripartite structure and the relations between Negative Affect, Positive Affect, and Physiological Hyperarousal (PH) were investigated for boys and girls, younger (8-11 years) and older (12-14 years) children, and for children with high versus low levels of emotional/behavioral problems separately. Results demonstrated an adequate fit of the tripartite structure in each of the subgroups. Multigroup confirmatory factor analysis demonstrated parameter equivalence across sex, age, and psychopathology status. Furthermore, the assumption of invariant error variances of the indicator variables was tenable across sex, age, and psychopathology status. Invariant variances and covariances of the latent constructs (i.e., the tripartite factors) were supported across sex and psychopathology status but not across age. Finally, adequate item and scale properties and good convergent and moderate divergent validity of the Dutch AFARS subscales were demonstrated, except for the divergent validity of the PH subscale.
Very long-term eradication of minimal residual disease in patients with hairy cell leukemia after a single course of cladribine
Authors: Sigal Darren S. , Sharpe Robert , Burian Carol , Saven Alan
Published: January 2010

Cladribine induces protracted remissions in patients with hairy cell leukemia (HCL). However, many long-term responders ultimately relapse. We sought to determine whether long-term complete responders subsequent to a single 7-day course of cladribine were without minimal residual disease (MRD) and potentially cured of HCL. From the 358-person Scripps Clinic cladribine database, we identified 19 patients in continuous and complete hematologic response (median age, 75 years; median time from diagnosis, 18 years; and median time from cladribine, 16 years). Nine of 19 (47%) patient samples had no evidence of residual disease; 7 of 19 (37%) samples had MRD; and 3 of 19 (16%) had morphologic evidence of HCL in hematoxylin and eosin–stained bone marrow sections. These results indicate that HCL is potentially curable after cladribine treatment. In addition, patients with MRD and even gross morphologic disease can live many years without manifesting hematologic relapses.
Influenza virus infection among pediatric patients reporting diarrhea and influenza-like illness
Authors: Dilantika Charisma , Sedyaningsih Endang R , Kasper Matthew R , Agtini Magdarina , Listiyaningsih Erlin , Uyeki Timothy M , Burgess Timothy H , Blair Patrick J , Putnam Shannon D
Published: January 2010

Background

Influenza is a major cause of morbidity and hospitalization among children. While less often reported in adults, gastrointestinal symptoms have been associated with influenza in children, including abdominal pain, nausea, vomiting, and diarrhea.

Methods

From September 2005 and April 2008, pediatric patients in Indonesia presenting with concurrent diarrhea and influenza-like illness were enrolled in a study to determine the frequency of influenza virus infection in young patients presenting with symptoms less commonly associated with an upper respiratory tract infection (URTI). Stool specimens and upper respiratory swabs were assayed for the presence of influenza virus.

Results

Seasonal influenza A or influenza B viral RNA was detected in 85 (11.6%) upper respiratory specimens and 21 (2.9%) of stool specimens. Viable influenza B virus was isolated from the stool specimen of one case. During the time of this study, human infections with highly pathogenic avian influenza A (H5N1) virus were common in the survey area. However, among 733 enrolled subjects, none had evidence of H5N1 virus infection.

Conclusions

The detection of influenza viral RNA and viable influenza virus from stool suggests that influenza virus may be localized in the gastrointestinal tract of children, may be associated with pediatric diarrhea and may serve as a potential mode of transmission during seasonal and epidemic influenza outbreaks.
Plasmodium falciparum resistance to anti-malarial drugs in Papua New Guinea: evaluation of a community-based approach for the molecular monitoring of resistance
Authors: Marfurt Jutta , Smith Thomas A , Hastings Ian M , Müller Ivo , Sie Albert , Oa Olive , Baisor Moses , Reeder John C , Beck Hans-Peter , Genton Blaise
Published: January 2010

Background

Molecular monitoring of parasite resistance has become an important complementary tool in establishing rational anti-malarial drug policies. Community surveys provide a representative sample of the parasite population and can be carried out more rapidly than accrual of samples from clinical cases, but it is not known whether the frequencies of genetic resistance markers in clinical cases differ from those in the overall population, or whether such community surveys can provide good predictions of treatment failure rates.

Methods

Between 2003 and 2005, in vivo drug efficacy of amodiaquine or chloroquine plus sulphadoxine-pyrimethamine was determined at three sites in Papua New Guinea. The genetic drug resistance profile (i.e., 33 single nucleotide polymorphisms in Plasmodium falciparum crt, mdr1, dhfr, dhps, and ATPase6) was concurrently assessed in 639 community samples collected in the catchment areas of the respective health facilities by using a DNA microarray-based method. Mutant allele and haplotype frequencies were determined and their relationship with treatment failure rates at each site in each year was investigated.

Results

PCR-corrected in vivo treatment failure rates were between 12% and 28% and varied by site and year with variable longitudinal trends. In the community samples, the frequencies of mutations in pfcrt and pfmdr1 were high and did not show significant changes over time. Mutant allele frequencies in pfdhfr were moderate and those in pfdhps were low. No mutations were detected in pfATPase6. There was much more variation between sites than temporal, within-site, variation in allele and haplotype frequencies. This variation did not correlate well with treatment failure rates. Allele and haplotype frequencies were very similar in clinical and community samples from the same site.

Conclusions

The relationship between parasite genetics and in vivo treatment failure rate is not straightforward. The frequencies of genetic anti-malarial resistance markers appear to be very similar in community and clinical samples, but cannot be used to make precise predictions of clinical outcome. Thus, indicators based on molecular data have to be considered with caution and interpreted in the local context, especially with regard to prior drug usage and level of pre-existing immunity. Testing community samples for molecular drug resistance markers is a complementary tool that should help decision-making for the best treatment options and appropriate potential alternatives.
A randomized phase II study of carboplatin plus pegylated liposomal doxorubicin versus carboplatin plus paclitaxel in platinum sensitive ovarian cancer patients: a Hellenic Cooperative Oncology Group study
Authors: Bafaloukos Dimitrios , Linardou Helena , Aravantinos Gerasimos , Papadimitriou Christos , Bamias Aristotelis , Fountzilas George , Kalofonos Haralabos P , Kosmidis Paris , Timotheadou Eleni , Makatsoris Thomas , Samantas Epaminondas , Briasoulis Evangelos , Christodoulou Christos , Papakostas Pavlos , Pectasides Dimitrios , Dimopoulos Athanasios M
Published: January 2010

Background

Platinum-based combinations are the standard second-line treatment for platinum-sensitive ovarian cancer (OC). This randomized phase II study was undertaken in order to compare the combination of carboplatin and pegylated liposomal doxorubicin (LD) with carboplatin and paclitaxel (CP) in this setting.

Methods

Patients with histologically confirmed recurrent OC, at the time of or more than 6 months after platinum-based chemotherapy, were randomized to six cycles of CP (carboplatin AUC5 + paclitaxel 175 mg/m2, d1q21) or CLD (carboplatin AUC5 + pegylated LD 45 mg/m2, d1q28).

Results

A total of 189 eligible patients (CP 96, CLD 93), with a median age of 63 years, median Performance Status (PS) 0 and a median platinum free interval (PFI) of 16.5 months, entered the study. Discontinuation due to toxicity was higher in the CP patients (13.5% versus 3%, P = 0.016). The overall response rate was similar: CP 58% versus CLD 51%, P = 0.309 (Complete Response; CR 34% versus 23%) and there was no statistical difference in time-to-progression (TTP) or overall survival (OS; TTP 10.8 months CP versus 11.8 CLD, P = 0.904; OS 29.4 months CP versus 24.7 CLD, P = 0.454). No toxic deaths were recorded. Neutropenia was the most commonly seen severe toxicity (CP 30% versus CLD 35%). More frequent in CLD were severe thrombocytopenia (11% versus 2%, P = 0.016), skin toxicity and Palmar-plantar erythrodysesthesia (PPE) grade 1-2 (38% versus 9%, P< 0.001), while grade 3 neurotoxicity and alopecia were higher in CP (7% versus 0%, P = 0.029, 20% versus 5%, P = 0.003). PS and PFI were independent prognostic factors for TTP and OS.

Conclusions

The combination of pegylated LD with carboplatin is effective, showing less neurotoxicity and alopecia than paclitaxel-carboplatin. It thus warrants a further phase III evaluation as an alternative treatment option for platinum-sensitive OC patients.

Trial Registration

Australian New Zealand Clinical Trials Registry: ACTRN12609000436279
The trend in mental health-related mortality rates in Australia 1916-2004: implications for policy
Authors: Doessel Darrel P , Williams Ruth FG , Whiteford Harvey
Published: January 2010

Background

This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as "mental/behavioural disorders"), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods.

Results

This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.

Conclusions

There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.
Being Black There: Racial Subjectivity and Temporality in Walter Mosley's Detective Novels
Authors: English Daylanne K.
Published: January 2010

In this essay I offer a temporal-philosophical and literary-political reading of Walter Mosley's Easy Rawlins detective novel series. African American literature has conventionally been understood as following its own timeline; however, ascribing a distinct temporality to black people has been far more controversial, and rightly so. Because to the degree that they have been perceived to be in or of another time, black people have also been excluded from dominant constructions of Western modernity, such as those of Hegel and Jefferson. Yet the idea that African Americans inhabit a distinct temporality, albeit an imposed one, has also been advanced by black intellectuals, at least since Frederick Douglass's 1845 declaration that slaves “seldom come nearer” their birthdays than “planting-time, harvest-time, cherry-time, spring-time, or fall-time.” To adapt Heidegger in this context, dasein (being there) does not describe slave subjectivity as much as would a term such as arbeitsein (being in work). But contemporary scholars have raised concerns about positing black alterity. Madhu Dubey, for one, cautions against situating African American cultural production in “residual zones” outside the socioeconomic or temporal structures of postmodernism. But the Easy Rawlins novels reinforce Douglass's notion that African American people occupy an alternate temporality; at the same time, it is precisely through their distinctive temporalities at levels of form and content that the novels achieve much of their political force. Via a hard-boiled form born of 1930s cynicism, Mosley's Easy Rawlins novels insist on the still-lived experience of “being black there.”
“No Such Thing as Action”: William Godwin, the Decision, and the Secret
Authors: Fielding Penny
Published: January 2010

This essay address the problem of action in William Godwin's writing, comparing his characterization of the ethical decision in An Enquiry concerning Political Justice with his much more uneasy rendering of it in Caleb Williams. The novel, coming between the two editions of Political Justice, seems to change Godwin's mind about the possibility of a clear-cut definition of action. Whereas the work of political philosophy allows the description of moral ideas leading to ethical action, the form of the novel as narrative, which requires examples of enacted decisions, stresses the necessity of the radically unknowable in the decision.
Symptomatology and the Novel
Authors: Fleissner Jennifer L.
Published: January 2010

Jonathan Lethem, discussing Ian McEwan's work, argued in 2007 that “neurology” has replaced “psychoanalysis” as today's great “rival to the novel's authority.” This essay explores Lethem's proposition via attention to these discourses' differing notions of the symptom. While Freud states in Studies on Hysteria that “it is difficult to attribute too much sense” to what may seem minor details (such as tics), neurology tends to grant them no meaning whatsoever. Where does this leave a literary-critical hermeneutics that has tended to take the Freudian view here as its default model? In place of either of these poles, I extended Gilles Deleuze's notion of fiction as a form of “symptomatology” by focusing not on the revelation of the symptom's “latent content” or its lack thereof but instead on what Slavoj Žižek has described as its elaboration of that content as a consequence of investing it with a libidinal charge. Lethem's novel Motherless Brooklyn (1999) offers a case study in which the narrator Lionel's Tourettic tics gain significance not for some psycho-biographical cause they reveal but for their effects, on the reader as much as on the world of the text itself. In both cases, the tic or repeated, jarring detail reorganizes the realist space momentarily in the mode of perversity, reopening its narrative frame to discordant echoes from the literary past (satire) and future (modernism). The symptom is thus mobilized in its specificity to refuse the etiological model that psychoanalysis and neurology often share, which emphasizes a linear progression from cause to resolution.
Narratives of Survival
Authors: Ginsburg Michal Peled
Published: January 2010

Discussions of closure, which played an important role in the analysis of novels in the heyday of narratology, associated the open text with a subversive resistance to containment and the failure or inability to fix meaning. Such a description fails to account for narratives in which “process” or movement in time is not goal oriented, where the goal is immanent to the process and where the notion of closure is irrelevant rather than subverted or unattainable. I propose to call such plots “narratives of survival” because they tend to foreground the continuous, in principle endless, process of creation anew (production and reproduction) necessary for the maintenance of life, self, social group, family bonds, affect. In doing so they diverge from the norms that characterize the English novel in its hegemonic form, where survival is merely the taken-for-granted precondition for “higher” pursuits—a transparent means to other ends. But the sway the concept of “progress” exerts over images of forward movement, specifically the movement of stories that shape cultural notions of what makes a life worthwhile, is such that these narratives are seldom read on their own terms. Conversely, as I show through an analysis of Oliver Goldsmith's Vicar of Wakefield, Elizabeth Gaskell's Cranford, and Charles Dickens's Old Curiosity Shop, reading them on their own terms allows us to perceive an alternative view of family and home to that produced by the novel in its hegemonic form.
Arrow of Godand the World on Paper
Authors: Kortenaar Neil Ten
Published: January 2010

A great project of the first two generations of African writers was to establish continuities with the precolonial and ongoing oral tradition. This essay, however, asks what African writers thought of the act of writing itself. A key scene in Chinua Achebe's novel Arrow of God juxtaposes a mother's oral storytelling with a son reading the first page in his Igbo primer, the first book ever to enter the family compound. The novel narrates the coming of literacy to Igboland by focusing on three quite different images: the python in a box as an image for the book (and the Domestication of the Savage Mind); the road through the forest as a symbol of writing and its power; and the solitary man, shut up in a closet, who attends to a disembodied voice but is distracted by noises from outside as a metonym for the experience of reading. While Achebe expresses a deep ambivalence about literacy, he does establish that the nonliterate world has the same potential for meaning and artistic creation and knows the same dangers of solipsism and literal reading as literacy does. I also consider several related themes: the trope of the talking book and the orthography that missionaries invented to write down the Igbo language.
The Sociology of the Novel: George Eliot's Strangers
Authors: McWeeny Gage
Published: January 2010

The oblique interrelations of characters through complex social networks—the Empire of the Little which so much occupies mid-nineteenth-century realism—constituted for fiction a “new social continent,” as Fredric Jameson has suggested. But this continent has more than one discoverer, and George Eliot's Middlemarch stakes its claim as a novel not only alongside, but also beyond, sensibilities and modes sociological, that other explorer of the “new social continent.” This essay shows that the novel's desire to secure its difference from sociological practices is strong enough to write itself into Middlemarch's plot, registering its effects in the novel's depiction of the debased or merely sociological outlooks of some within its pages. Those characters (like Rosamond Vincy) whom Eliot represents as too allied with sociological “ways of seeing” become casualties of a border contest between literature and science, their fates bearing the mark of Middlemarch's concern to maintain the specificity of the novelistic even in its proximity to the sociological. With this in mind, we will see how the realist novel's project of self-differentiation—its claims to offer forms of insight distinct from those of the emergent human sciences—is served by Middlemarch's unlikely investment in “noisiness” over intelligibility in apprehensions of the social world, inverting the social scientific clarity promised in the book's subtitle, A Study of Provincial Life. The novel's realism is achieved, I argue, in part through its demotions of sociological insight, even at the level of character, as if sociological acuity were after all not quite what one wanted from reading, or even within, a realist novel like Middlemarch. Eliot's brief for the realist novel is mixed: both sociological enough to apprehend the social landscape of modernity and novelistic enough to make the failures of sociological knowledge and sensibilities one of its central dramas.
Dynamic regulation of ROCK in tumor cells controls CXCR4-driven adhesion events
Authors: Struckhoff Amanda P. , Vitko Jason R. , Rana Manish K. , Davis Carter T. , Foderingham Kamau E. , Liu Chi-Hsin , Vanhoy-Rhodes Lyndsay , Elliot Steven , Zhu Yun , Burow Matt , Worthylake Rebecca A.
Published: January 2010

CXCR4 is a chemokine receptor often found aberrantly expressed on metastatic tumor cells. To investigate CXCR4 signaling in tumor cell adhesion, we stably overexpressed CXCR4 in MCF7 breast tumor cells. Cell attachment assays demonstrate that stimulation of the receptor with its ligand, CXCL12, promotes adhesion of MCF7-CXCR4 cells to both extracellular matrix and endothelial ligands. To more closely mimic the conditions experienced by a circulating tumor cell, we performed the attachment assays under shear stress conditions. We found that CXCL12-induced tumor cell attachment is much more pronounced under flow. ROCK is a serine/threonine kinase associated with adhesion and metastasis, which is regulated by CXCR4 signaling. Thus, we investigated the contribution of ROCK activity during CXC12-induced adhesion events. Our results demonstrate a biphasic regulation of ROCK in response to adhesion. During the initial attachment, inhibition of ROCK activity is required. Subsequently, re-activation of ROCK activity is required for maturation of adhesion complexes and enhanced tumor cell migration. Interestingly, CXCL12 partially reduces the level of ROCK activity generated by attachment, which supports a model in which stimulation with CXCL12 regulates tumor cell adhesion events by providing an optimal level of ROCK activity for effective migration.
Evaluation of the PAX8/PPARG Translocation in Follicular Thyroid Cancer with a 4-Color Reverse-Transcription PCR Assay and Automated High-Resolution Fragment Analysis
Authors: Algeciras-Schimnich Alicia , Milosevic Dragana , McIver Bryan , Flynn Heather , Reddi Honey V , Eberhardt Norman L , Grebe Stefan KG
Published: January 2010

Background: Molecular testing of thyroid malignancies, in combination with cytologic and histologic examination, is becoming increasingly attractive as a tool for refining traditional morphologic diagnosis. The molecular changes associated with follicular thyroid carcinoma (FTC) are point mutations in RAS oncogenes or the presence of PAX8/PPARG (paired box 8/peroxisome proliferator-activated receptor gamma) rearrangement.

Methods: We developed and validated a clinical assay for the detection of PAX8/PPARG rearrangements that uses a 4-color reverse-transcription PCR (RT-PCR) assay and high-resolution fragment analysis.

Results: The RT-PCR assay is applicable for detecting the various described fusion transcripts of PAX8/PPARG in formalin-fixed, paraffin-embedded thyroid tissue and in fine-needle aspirate biopsy washes from thyroid nodules. The analytical sensitivity of the assay is 1 abnormal cell in a background of 100–10 000 translocation-negative cells. A comparison of the RT-PCR assay with dual-fusion fluorescence in situ hybridization showed an overall concordance of 95%. With this assay, we obtained a prevalence for the PAX8/PPARG rearrangement in FTC of 62% (13 of 21 cases), compared with a 5% prevalence (3 of 55) for other follicular cell–derived neoplasms.

Conclusions: The introduction of this assay into clinical practice could provide useful information for the diagnosis and possibly for the prognosis and treatment of thyroid cancer in the future.
Characteristics of precession electron diffraction intensities from dynamical simulations
Authors: Sinkler Wharton , Marks Laurence D.
Published: January 2010

Precession Electron Diffraction (PED) offers a number of advantages for crystal structure analysis and solving unknown structures using electron diffraction. The current article uses many-beam simulations of PED intensities, in combination with model structures, to arrive at a better understanding of how PED differs from standard unprecessed electron diffraction. It is shown that precession reduces the chaotic oscillatory behavior of electron diffraction intensities as a function of thickness. An additional characteristic of PED which is revealed by simulations is reduced sensitivity to structure factor phases. This is shown to be a general feature of dynamical intensities collected under conditions in which patterns with multiple incident beam orientations are averaged together. A new and significantly faster method is demonstrated for dynamical calculations of PED intensities, based on using information contained in off-central columns of the scattering matrix.
Hypothalamic regulation of food intake and clinical therapeutic applications
Authors: Simpson Katherine Anne , Martin Niamh M. , R. Bloom Stephen
Published: January 2010

Current estimates suggest that over 1 billion people are overweight and over 300 million people are obese. Weight gain is due to an imbalance between energy expenditure and dietary intake. This review discusses the hypothalamic control of appetite and highlights key developments in research that have furthered our understanding of the complex pathways involved. Nuclei within the hypothalamus integrate peripheral signals such as adiposity and caloric intake to regulate important pathways within the central nervous system controlling food intake and energy expenditure. Firmly established pathways involve the orexigenic NPY/AgRP and the anorexigenic POMC/CART neurons in the arcuate nucleus (ARC) of the hypothalamus. These project from the ARC to other important hypothalamic nuclei, including the paraventricular, dorsomedial, ventromedial and lateral hypothalamic nuclei. In addition there are many projections to and from the brainstem, cortical areas and reward pathways, which modulate food intake.
Interação entre gene e nutriente e sua associação à obesidade e ao diabetes melito
Authors: Steemburgo Thais , Azevedo Mirela J.de , Martínez José Alfredo
Published: January 2010

A genômica nutricional avalia o efeito da variação genética na interação entre dieta e doenças crônicas. O objetivo deste manuscrito foi revisar os principais polimorfismos associados à obesidade, ao diabetes melito e também aos fatores da dieta. As principais interações entre polimorfismos genéticos e dieta foram: para obesidade: interleucina-6 (IL-6) com consumo energético; receptor ativado por proliferador de peroxissoma gama 2 (PPAR-gama2) e fat mass and obesity associated (FTO) com consumo de gorduras; receptor β-adrenérgico 2 (ADRB2) e receptor da melanocortina-4 (MCR4) com consumo de carboidratos; para perda de peso: proteínas desacopladoras (UCPs) com restrição calórica; para leptinemia: receptor da leptina (LEPR) com restrição calórica; para diabetes melito: PPAR-gama2 com consumo de gordura; para hipertrigliceridemia: proteína transportadora de ácidos graxos 2 (FABP2) com consumo de gordura. Os dados apresentados sugerem que a genômica nutricional é importante ao desenvolvimento da obesidade e do diabetes melito.
Hiper-homocisteinemia e risco cardiometabólico
Authors: Vannucchi Helio , Melo Sandra Soares
Published: January 2010

A hiper-homocisteinemia, quando considerada como fator causal de doenças vasculares, tem suscitado muitas discussões. Estudos caso-controle, retrospectivos e prospectivos têm identificado relação entre concentrações plasmáticas elevadas de homocisteína e doenças vasculares. Na presente revisão, objetivou-se compreender melhor a inter-relação entre as concentrações plasmáticas de homocisteína e doenças vasculares, além do envolvimento de fatores de risco clássicos para a doença: os genéticos, como as mutações em genes que codificam as enzimas envolvidas no metabolismo da homocisteína, e os nutricionais, como a deficiência de vitaminas do complexo B. Foram consultadas as publicações das principais bases de dados em saúde, no período de 1962 a 2009. O mecanismo pelo qual a hiper-homocisteinemia atua como fator de risco para doenças vasculares ainda não está totalmente esclarecido; entretanto, sugere-se o envolvimento da disfunção endotelial e da peroxidação lipídica. O tratamento da hiper-homocisteinemia fundamenta-se na suplementação alimentar e medicamentosa, com ácido fólico e vitaminas B6 e B12.
Experiência inicial no tratamento endoscópico de fístulas gastrocutâneas pós-gastroplastia vertical redutora através da aplicação de matriz acelular fibrogênica
Authors: Maluf-Filho Fauze , Lima Marcelo Simas de , Hondo Fabio , Giordano-Nappi José Humberto , Garrido Teresa , Sakai Paulo
Published: January 2010

RACIONAL: A gastroplastia redutora à Capella, que combina técnicas restritiva e disabsortiva, é o procedimento bariátrico mais realizado no Brasil. Uma das complicações mais temidas desta operação é a fístula gastrocutânea que ocorre na linha de grampeamento vertical da neocâmara. O tratamento inicial consiste em drenagem adequada, suporte nutricional, bloqueio da produção de ácido e antibioticoterapia. Em 20% a 30% dos casos, a fístula tomará curso crônico. Nestes casos, vários tratamentos endoscópicos têm sido sugeridos. OBJETIVO: Descrever a técnica e os resultados do tratamento endoscópico das fístulas gastrocutâneas decorrentes de operações bariátricas através da aplicação de matriz acelular fibrogênica. MÉTODOS: Nesta série de casos, descrevem-se 25 pacientes com esta complicação tratados de maneira pioneira através da aplicação endoscópica de matriz acelular fibrogênica. O tempo entre o diagnóstico da fístula e a primeira sessão do tratamento endoscópico variou de 4 a 25 semanas, mediana: 7 semanas). RESULTADOS: Dos 25 pacientes, 20 (80%) tiveram a fístula fechada pelo método. Seis deles com uma única sessão (30,0%), 11 necessitaram de duas aplicações (55,0%) e 3 pacientes, de uma terceira sessão (15,0%) para a obliteração do trajeto fistuloso. Não houve complicações relacionadas ao procedimento. CONCLUSÃO: O uso de matriz fibrogênica para o tratamento endoscópico da fístula gástrica após operação de Capella é método seguro e eficaz, sendo sua principal limitação o número de sessões necessárias.
Association of Helicobacter pylori restriction endonuclease-replacing gene, hrgA with overt gastrointestinal diseases
Authors: G Manoj , Tiwari Santosh K. , Sharma Vishwas , Habeeb Mohammed Aejaz , Khan Aleem A. , Cm Habibullah
Published: January 2010

BACKGROUND and AIM: Helicobacter pylori has been proven to be responsible for causing various gastrointestinal disorders including gastric adenocarcinoma. Several genes of pathogen (the genes of the cag-PAI, vacA, iceA, and babA) either in combination or independently have been reported to significantly increase the risk of ulceration/gastric carcinoma, with the cagA gene having the strongest predictive value. Pursuit to identify new genes which could serve as a marker of overt disease progression, lead to the discovery of hrgA gene. METHODS: Fifty-six indigenous strains of H. pylori from subjects with various gastric disorder were screened to assess the status of hrgA gene along with the cagA gene using simple polymerase chain reaction using specific oligonucleotide primers. Post-amplification, amplicons were subjected for sequencing to identify any strain specific variations in sequences from the H. pylori isolated from different disease manifestations. Histopathological analysis was done to ascertain any significant change in the histological scores of subjects infected with cagA+/hrgA+ and cagA-/hrg+ strains. RESULTS: All the 56 (100%) subjects amplified with the oligonucleotide primers specific to hrgA gene, whereas 81.71% subjects showed the presence of cagA gene. Sequencing of the amplimers showed 99% homology. Histology of the cagA+/hrgA+ and cagA-/hrg+ subjects did not show any significant difference. CONCLUSION: hrgA gene of Helicobacter pylori is not a ideal surrogate marker for identifying individuals with higher risk of developing overt gastro-duodenal diseases such as neoplasia of the stomach.
Estenoses benignas de esôfago: abordagem endoscópica com velas de Savary-Gilliard
Authors: Novais Paula , Lemme Eponina , Equi Claudia , Medeiros Claudia , Lopes Camila , Vargas Cleber
Published: January 2010

RACIONAL: As estenoses benignas de esôfago são complicações decorrentes de diversas causas. Possuem tratamentos similares, na maioria dos casos necessitando de dilatação endoscópica, no entanto a resposta terapêutica, tempo ideal de tratamento, assim como intervalo entre as sessões podem ser variáveis. OBJETIVO: Analisar, do ponto de vista endoscópico, as estenoses benignas de esôfago em 14 anos de experiência no Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, RJ, avaliando etiologia, a extensão da estenose, o número de dilatações necessário para atingir resposta terapêutica satisfatória, assim como a relação entre a extensão da estenose e a resposta terapêutica. MÉTODO: Foram analisadas 2.568 dilatações endoscópicas com uso de velas de Savary-Gilliard em 236 pacientes, durante um período de 14 anos e 10 meses, até junho de 2007. RESULTADOS: A estenose péptica foi a causa mais freqüentemente encontrada, seguida pela estenose cáustica. As estenoses longas e cáusticas necessitaram de maior número de sessões para ausência de disfagia. Estenoses pépticas e curtas responderam melhor a número menor de sessões de dilatação. CONCLUSÃO: A estenose péptica foi a causa mais comum e respondeu bem à terapia endoscópica, em concordância com a literatura. As estenoses cáusticas foram as mais refratárias, principalmente as longas. Quanto maior foi a extensão da estenose, também maior foi o número de sessões necessárias. Estenoses curtas apresentaram boa evolução na maioria dos casos. O número de dilatações necessárias dependeu diretamente da causa e da extensão da estenose.
Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis
Authors: Vasconcellos Luiz Felipe Rocha , Novis Sergio A. Pereira , Moreira Denise Madeira , Rosso Ana Lucia Z. , Leite Ana Claudia C.B.
Published: January 2010

The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism.
Sleep patterns and symptoms of anxiety and depression in patients with chronic pain
Authors: Castro Martha M.C. , Daltro Carla
Published: January 2010

BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.