bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased circulating CC chemokine levels in the metabolic syndrome are reduced by low‐dose atorvastatin treatment: evidence from a randomized controlled trial
Authors: Loughrey Brona V. , McGinty Ann , Young Ian S. , McCance David R. , Powell Lesley A.
Published: November 2012

Objective

Central obesity and insulin resistance are key components of the metabolic syndrome, which is associated with an increased risk of cardiovascular disease. In obesity, CC chemokines, such as monocyte chemotactic protein‐1 (MCP‐1), macrophage inhibitory protein‐1β (MIP‐1β) and eotaxin‐1 and their respective receptors, are critically involved in peripheral monocyte activation and adipose tissue infiltration. The aim of the current study was to examine whether low‐dose atorvastatin (10 mg/d) treatment modulated serum levels of CC chemokines in metabolic syndrome subjects.

Materials and Methods

Serum levels of MCP‐1, eotaxin‐1, MIP‐1β, C reactive protein (CRP) and interleukin‐6 (IL‐6) were measured in lean control and metabolic syndrome subjects at baseline, and following a 6‐week randomized placebo‐controlled clinical trial of atorvastatin (10 mg/d). Peripheral CD14+ monocytes were isolated and mRNA levels of MCP‐1, MIP‐1 β and CCR5 determined.

Results

Serum MCP‐1 (P = 0·02), eotaxin‐1 (P = 0·02) and MIP‐1β (P = 0·03), CRP (P < 0·001) and IL‐6 (P = 0·006) were significantly increased in metabolic syndrome in comparison with lean controls. Furthermore, CD14+ peripheral monocyte mRNA expression of the chemokine receptor, CCR5, of which MIP‐1β and eotaxin‐1 are ligands, was increased two‐fold in the metabolic syndrome group (P = 0·03). In addition to the expected improvements in lipid profile, atorvastatin treatment significantly reduced circulating eotaxin‐1 (P < 0·05), MIP‐1β (P < 0·05) levels and CD14+ peripheral monocyte CCR5 mRNA expression (P = 0·02).

Conclusion

These results support a model whereby atorvastatin treatment, by inhibiting CD14+ monocyte CCR5 expression, may inhibit monocyte trafficking, reduce chronic inflammation and, thus, lower circulating levels of CC chemokines.
A UNIFIED FRAMEWORK OF TARGETED MARKETING USING CUSTOMER PREFERENCES
Authors: Huang Jiajin , Zhong Ning , Yao Yiyu
Published: November 2012

One of the fundamental tasks of targeted marketing is to elicit associations between customers and products. Based on the results from information retrieval and utility theory, this article proposes a unified framework of targeted marketing. The customer judgments of products are formally described by preference relations and the connections of customers and products are quantitatively measured by market value functions. Two marketing strategies, known as the customer‐oriented and product‐oriented marketing strategies, are investigated. Four marketing models are introduced and examined. They represent, respectively, the relationships between a group of customers and a group of products, between a group of customers and a single product, between a single customer and a group of products, and between a single customer and a single product. Linear and bilinear market value functions are suggested and studied. The required parameters of a market value function can be estimated by exploring three types of information, namely, customer profiles, product profiles, and transaction data. Experiments on a real‐world data set are performed to demonstrate the effectiveness of the proposed framework.
Ethical Considerations in Clinical Trials: A Critique of theICH‐GCP Guideline
Authors: Kaur Sharon , Choy Choong Yeow
Published: November 2012

This article examines issues relating to ethics decision‐making in clinical trials. The overriding concern is to ensure that the well being and the interests of human subjects are adequately safeguarded. In this respect, this article will embark on a critical analysis of theICH‐GCP Guideline. The purpose of such an undertaking is to highlight areas of concern and the shortcomings of the existingICH‐GCP Guideline. Particular emphasis is made on how ethics committees perform their duties and responsibilities in line with the principles outlined in theICH‐GCP Guideline. This article will draw attention to the need for a new approach to addressing the weaknesses of theICH‐GCP Guideline in its present form.
Why Restrictions on the Immigration of Health Workers Are Unjust
Authors: Hidalgo Javier
Published: November 2012

Some bioethicists and political philosophers argue that rich states should restrict the immigration of health workers from poor countries in order to prevent harm to people in these countries. In this essay, I argue that restrictions on the immigration of health workers are unjust, even if this immigration results in bad health outcomes for people in poor countries. I contend that negative duties to refrain from interfering with the occupational liberties of health workers outweighs rich states' positive duties to prevent harm to people in sending countries. Furthermore, I defend this claim against the objection that health workers in poor countries acquire special duties to their compatriots that render them liable to coercive interference.
Association between radiographic Wallerian degeneration and neuropathological changes post childhood stroke
Authors: JONES KEVIN C , HAWKINS CYNTHIA , ARMSTRONG DEREK , DEVEBER GABRIELLE , MACGREGOR DAUNE , MOHARIR MAHENDRANATH , ASKALAN RAND
Published: November 2012

Aim  Wallerian degeneration is a radiological finding thought to reflect corticospinal tract degeneration. This finding on magnetic resonance imaging (MRI) is routinely used as a predictor of poor prognosis in childhood stroke. However, its validity has never been established. Our objective was to correlate Wallerian degeneration seen on MRI with histopathology.

Method  We searched the databases of the Department of Pathology and Children’s Stroke registry at the Hospital for Sick Children, Toronto for autopsy specimens exhibiting focal infarcts from children born at term who underwent MRI after a stroke. The specimens were examined for Wallerian degeneration and then correlated with the pre‐mortem MRI findings.

Results  Seven children (four females, three males) with a median age of 11 years (1–17y) at the time of stroke met the inclusion criteria for this study. Of the seven children included in the study with ischaemic or haemorrhagic infarcts, six had concordant Wallerian degeneration findings on both MRI and post‐mortem histopathological examination. The median time between stroke and death was 20 days (3–1825d).

Interpretation  Our results show for the first time that the radiographic finding of Wallerian degeneration is a valid biomarker of corticospinal tract degeneration in children who have had ischaemic or haemorrhagic stroke.
Early Wallerian degeneration on magnetic resonance imaging: underappreciated but highly relevant
Authors: KLEINMAN JONATHAN T
Published: November 2012

This commentary is on the original article by Jones et al. on pages 173–177 of this issue
Habitat use, home range, movements and interactions of introducedLepomis gibbosusand nativeSalmo truttain a small stream of Southern England
Authors: Stakėnas Saulius , Vilizzi Lorenzo , Copp Gordon H.
Published: November 2012

Radio telemetry data were analysed to assess the microhabitat use, movement patterns, home range overlap and interspecific interactions of non‐native pumpkinseedLepomis gibbosus(L.) and native brown troutSalmo trutta(L.) in a small English stream located immediately below a commercial angling lake from which pumpkinseed escaped. Although both species favoured pool habitats, brown trout preferred higher velocities and coarser substrata compared with pumpkinseed. Also, some individual brown trout preferred deeper waters than did pumpkinseed. Home range area of brown trout was substantially larger than that of pumpkinseed in spring and summer, and for both species, home range area in autumn was significantly smaller than in the other seasons. Range centre distribution analysis revealed that both species were distributed significantly nonrandomly within the stream during all seasons. There was substantial home range overlap between the two species in all seasons, the greatest being in spring. Overall distances moved were greatest during spring for both species, with brown trout moving greater distances relative to pumpkinseed. However, the absence of mutual attraction or avoidance between the species, as well as the lack of cohesion in preferred habitats and strong territorial fidelity, suggests little or no impact of introduced pumpkinseed on resident brown trout.
Post‐stroke subjective cognitive impairment is associated with acute lacunar infarcts in the basal ganglia
Authors: Narasimhalu K. , Wiryasaputra L. , Sitoh Y.‐Y. , Kandiah N.
Published: November 2012

Background and purpose

While recent studies have examined neuroimaging correlates of post‐stroke mild cognitive impairment (MCI), no studies have examined neuroimaging correlates of post‐stroke subjective cognitive impairment (SCI).

Methods

Consecutive patients with magnetic resonance imaging‐confirmed acute lacunar strokes at a tertiary institute were recruited for this cross‐sectional study. All patients underwent cognitive testing, and those with MCI were excluded from these analyses. Two independent neuroradiologists ascertained data on the number and location of any infarcts, as well as the degree of white matter hyperintensities. Multivariate logistic regression analyses were performed to study the association between neuroimaging markers and SCI. Only variables that were significant in the univariate stage and clinically relevant potential confounders were included in multivariable analyses.

Results

Of 145 patients evaluated, 48 patients with MCI were excluded from the study. Of the remaining 97 patients, 30 patients had SCI. In multivariable analyses, only mini‐mental state examination (OR 0.61; CI 0.38–0.98) and basal ganglia infarcts (OR 8.19; CI 1.18–56.6) were significant predictors of SCI.

Conclusion

In patients with acute lacunar strokes, we find that basal ganglia infarcts are associated with SCI. As the basal ganglia have been previously shown to be involved with learning of tasks, we hypothesize that infarcts in basal ganglia may affect learning speeds thereby contributing to the development of SCI. Larger studies are needed to confirm these results.
Reconciliation in Male Stump‐tailed Macaques (Macaca arctoides): Intolerant Males Care for Their Social Relationships
Authors: de la O Claudio , Mevis Lieke , Richter Christin , Malaivijitnond Suchinda , Ostner Julia , Schülke Oliver
Published: November 2012

Recent research has shown that social relationships may exert positive effects on fitness. Therefore, it is expected that animals make efforts to develop and preserve close social bonds. Reconciliation is a conflict resolution mechanism, which allows buffering the negative effects of aggressive conflict on social relationships. As socioecological theories claim that intrasexual competition and conflict‐shaped social interactions among macaque males, postconflict behaviour should reflect the effects of these evolutionary forces. Here, we present the results of a study on a provisioned group ofMacaca arctoidesinThailand focusing exclusively on male postconflict behaviour. Through an Information Theory–Model Selection approach, we evaluated the relative support for three predictions about the occurrence of reconciliation and the quality of the opponents' social relationships. The strength of the opponents' affiliative relationship was the only variable predicting reconciliation occurrence. This agrees with the main prediction of the valuable relationship hypothesis for the function and distribution of reconciliation, which states that the opponents sharing high‐quality relationships are more likely to reconcile, and this interaction is aimed to repair the disturbing effects of previous aggression on their relationship. The conciliatory tendency found among these wild males is much lower than reported previously for this species from captive conditions, matching more closely the rates reported for species with an intolerant‐despotic dominance style. The results offer strong support for the importance of developing and preserving valuable relationships, even among rather intolerant males.
Identification of transcription factor binding sites usingGaussian mixture models
Authors: Karabulut Mustafa , Ibrikci Turgay
Published: November 2012

Identification of transcription factor binding sites still remains a challenging problem even though many computational tools have been proposed in the literature for this specific task. In this study, a method to discover such DNA subsequences, that is, motifs, is proposed. The method usesGaussian mixture models with expectation‐maximization algorithm. In order to show the potential of the proposed method, experiments are conducted by use of data sets extracted from theDNAsequences of various organisms. The proposed method is also compared with four other methods:MEME,MDScan,SOMBREROand the fuzzyC‐means based motif finder. As a result, the proposed method proves itself as a promising tool in identifying over‐representedDNAmotifs.
Unified characterisation of in‐plane and out‐of‐plane constraint based on crack‐tip equivalent plastic strain
Authors: YANG J. , WANG G. Z. , XUAN F. Z. , TU S. T.
Published: November 2012

Constraint can be divided into two conditions of in‐plane and out‐of‐plane, and each of them has its own parameter to characterize. However, in most cases, there exists a compound change of both in‐plane and out‐of‐plane constraint in structures, a unified measure that can reflect both of them is needed. In this paper, the finite element method (FEM) was used to calculate the equivalent plastic strain (ɛp) distribution ahead of crack tips for specimens with different in‐plane and out‐of‐plane constraints, and the FEM simulations based on Gurson–Tvergaard–Needleman (GTN) damage model and a small number of tests were used to obtain fracture toughness for the specimens with different constraints. Unified measure and characterisation parameter of in‐plane and out‐of‐plane constraints based on crack‐tip equivalent plastic strain has been investigated. The results show that the area APEEQ surrounded by the ɛp isoline ahead of crack tips can characterize both in‐plane and out‐of‐plane constraints. Based on the area APEEQ, a unified constraint characterisation parameter Ap was defined. It was found that there exists a sole linear relation between the normalised fracture toughness JIC/Jref and regardless of the in‐plane constraint, out‐of‐plane constraint and the selection of the ɛp isolines. The unified JIC/Jref−reference line can be used to determine constraint‐dependent fracture toughness of materials. The FEM simulations with the GTN damage model (local approach) can be used in obtaining the unified JIC/Jref−reference line for materials with ductile fracture.
Gravel dredging alters diversity and structure of riverine fish assemblages
Authors: FREEDMAN JONATHAN A. , CARLINE ROBERT F. , STAUFFER JAY R.
Published: November 2012

1. Human activities affect fish assemblages in a variety of ways. Large‐scale and long‐term disturbances such as in‐stream dredging and mining alter habitat and hydrodynamic characteristics within rivers which can, in turn, alter fish distribution. Habitat heterogeneity is decreased as the natural riffle–pool–run sequences are lost to continuous pools and, as a consequence, lotic species are displaced by lentic species, while generalist and invasive species displace native habitat specialists. Sediment and organic detritus accumulate in deep, dredged reaches and behind dams, disrupting nutrient flow and destroying critical habitat for habitat specialist species.

2. We used standard ecological metrics such as species richness and diversity, as well as stable isotope analysis of δ13C and δ15N, to quantify the differences in fish assemblages sampled by benthic trawls among dredged and undredged sites in the Allegheny River, Pennsylvania, U.S.A.

3. Using mixed‐effects models, we found that total catch, species richness and diversity were negatively correlated with depth (P < 0.05), while species richness, diversity and proportion of species in lithophilic (‘rock‐loving’) reproductive guilds were lower at dredged than at undredged sites (P < 0.05).

4. Principal components analysis and manova revealed that taxa such as darters in brood hider and substratum chooser reproductive guilds were predominantly associated with undredged sites along principal component axis 1 (PC1 and manovaP < 0.05), while nest spawners such as catfish and open substratum spawners including suckers were more associated with dredged sites along PC2 (P < 0.05).

5. Stable isotope analysis of δ13C and δ15N revealed shifts from reliance on shallow water and benthic‐derived nutrients at undredged sites to reliance on phytoplankton and terrestrial detritus at deep‐water dredged sites. Relative trophic positions were also lower at dredged sites for many species; loss of benthic nutrient pathways associated with depth and dredging history is hypothesised.

6. The combination of ecological metrics and stable isotope analysis thus shows how anthropogenic habitat loss caused by gravel dredging can decrease benthic fish abundance and diversity, and that species in substratum‐specific reproductive guilds are at particular risk. The effects of dredging also manifest by altering resource use and nutrient pathways within food webs. Management and conservation decisions should therefore consider the protection of relatively shallow areas with suitable substratum for spawning for the protection of native fishes.
Congenital von Willebrand's disease and clinical hypothyroidism
Authors: Hassan S. , Qureshi W. , Donthireddy V. , Kuriakose P.
Published: November 2012

Data from case reports and systematic reviews suggest an association of Hypothyroidism and Acquired von Willebrand's syndrome. It is not known if congenital von Willebrand's disease is associated with hypothyroidism in a similar way. The aim of this study was to identify the association of congenital von Willebrand's disease (VWD) with clinical hypothyroidism. A total of 350 cases of congenital VWD were initially screened from our institution database from 1985 to 2010. A careful review of patient records was carried out to see if patients truly had congenital VWD and coexisting clinical hypothyroidism. Patients with uncertain diagnoses or other bleeding disorders were excluded, leading to 197 patients remaining in the final sample. A random age‐ and sex‐matched parallel control group was also obtained from the hospital database. Of 197 patients (mean age 43.8 ± 17.5 years, women 72%) of congenital VWD, 32/197 (16%) were diagnosed with clinical hypothyroidism, while only 11/197 (5.6%) of the matched controls were clinically hypothyroid. Univariate and multivariate analysis demonstrated that VWD was an independent predictor of developing clinical hypothyroidism (OR 3.45; 95% CI 1.65–7.22, P = 0.001). The proportion of patients diagnosed with clinical hypothyroidism was more in the VWD group (P < 0.0001). Our analysis shows a strong association of clinical hypothyroidism in patients with congenital VWD, but future studies will be required to delineate a pathological mechanism. In our opinion, clinicians should consider checking thyroid function in the newly diagnosed and established cases of congenital VWD.
Impact of baseline HIV‐1 RNA levels on initial highly active antiretroviral therapy outcome: a meta‐analysis of 12,370 patients in 21 clinical trials*
Authors: Stephan C , Hill A , Sawyer W , van Delft Y , Moecklinghoff C
Published: November 2012

Background

Individual randomized trials of first‐line antiretroviral treatment do not consistently show an association between higher baseline HIV‐1 RNA and lower efficacy.

Methods

A MEDLINE search identified 21 HIV clinical trials with published analyses of antiretroviral efficacy by baseline HIV‐1 RNA, using a standardized efficacy endpoint of HIV‐1 RNA suppression <50 copies/mL at week 48.

Results

Among 21 clinical trials identified, eight evaluated only nonnucleoside reverse transcriptase inhibitor (NNRTI)‐based combinations, eight evaluated only protease inhibitor‐based regimens and five compared different treatment classes. Ten of the trials included tenofovir (TDF)/emtricitabine (FTC) as only nucleoside reverse transcriptase inhibitor (NRTI) backbone, in addition but not restricted to abacavir (ABC)/lamivudine (3TC) (n = 7), zidovudine (ZDV)/3TC (n = 4) and stavudine (d4T)/3TC (n = 1). Across trials, the mean percentage of patients achieving HIV‐1 RNA < 50 copies/mL at week 48 was 81.5% (5322 of 6814) for patients with baseline HIV‐1 RNA < 100 000, vs. 72.6% (3949 of 5556) for patients with HIV‐1 RNA > 100 000 copies/mL. In the meta‐analysis, the absolute difference in efficacy between low and high HIV‐1 RNA subgroups was 7.4% [95% confidence interval (CI) 5.9–8.9%; P < 0.001]. This difference was consistent in trials of NNRTI‐based treatments (difference = 6.9%; 95% CI 4.3–9.6%), protease inhibitor‐based treatments (difference = 8.4%; 95% CI 6.0–10.8%) and integrase or chemokine (C‐C motif) receptor 5 (CCR5)‐based treatments (difference = 6.0%; 95% CI 2.1–9.9%) and for trials using TDF/FTC (difference = 8.4%; 95% CI 6.0–10.8%); there was no evidence for heterogeneity of this difference between trials (Cochran's Q test; not significant).

Conclusions

In this meta‐analysis of 21 first‐line clinical trials, rates of HIV‐1 RNA suppression at week 48 were significantly lower for patients w ith baseline HIV‐1 RNA > 100 000 copies/mL (P < 0.001). This difference in efficacy was consistent across trials of different treatment classes and NRTI backbones.
The molecular characterization of a catalase from Chinese mitten crab Eriocheir sinensis
Authors: Wang M. , Wang L. , Zhou Z. , Gao Y. , Wang L. , Shi X. , Gai Y. , Mu C. , Song L.
Published: November 2012

Catalase (CAT) is an antioxidant enzyme and plays a significant role in the protection against oxidative stress by reducing hydrogen peroxide. The CAT cDNA of Eriocheir sinensis (EsCAT) was cloned via RACE technique. The complete sequence of EsCAT cDNA consisted of a 5′ untranslated regions (UTR) of 224 bp, a 3′ UTR of 1287 bp with a poly (A) tail and an open reading frame (ORF) of 1542 bp, which encoded a polypeptide of 513 amino acid residues with a calculated molecular mass of approximately 58.86 kDa and a theoretical isoelectric point of 6.880. The deduced amino acid sequence of EsCAT contained a highly conserved proximal active‐site signature motif (60FDRERIPERVVHAKGAL76) and a proximal heme–ligand signature motif (350RLFSYNDTH358) and exhibited high similarity with other reported CATs. In the phylogenetic tree, EsCAT was clustered with the CATs from Scylla serrata and Portunus trituberculatus. The EsCAT transcripts were constitutively expressed in haepatopancreas, haemocytes, gill, gonad, muscle and heart, with highest expression level in haepatopancreas. The relative expression level of EsCAT mRNA in haemocytes was continuously up‐regulated and reached the peak level at 48 h post‐Vibrio anguillarum challenge. The purified recombinant EsCAT protein displayed antioxidant activity against hydrogen peroxide with high thermal stability and broad spectrum of pH values. All these results demonstrated that EsCAT was an efficient antioxidant enzyme and potentially involved in the regulation of redox and innate immune response of crabs.
Laser‐assisted pulpotomy in primary teeth: a systematic review
Authors: De Coster Peter , Rajasekharan Sivaprakash , Martens Luc
Published: November 2012

Objective

The purpose of this systematic review was to identify high‐quality articles comparing laser with conventional pulpotomy procedures, and to assess whether laser treatment may offer an appreciable benefit over conventional approaches.

Methods

A systematic search was implemented for MEDLINE, WEB of SCIENCE and Cochrane's CENTRAL databases (1980–2012) to identify eligible studies. Two reviewers independently assessed the methodological quality of the articles (Κ = 0.89) using specific study design‐related quality assessment forms (Dutch Cochrane Collaboration).

Results

Seven articles met the inclusion criteria, of which five randomized control trials (RCT) and two case series (CS), involving Nd:YAG, Er:YAG, CO2 and 632/980 nm diode lasers. Although heterogeneity between pulpotomy studies was high, odds ratios (OR) were generally <1, indicating that laser is less successful than conventional pulpotomy techniques.

Conclusion

Given the paucity and high heterogeneity of high‐quality articles, general recommendations for the clinical use of laser in pulpotomy in primary teeth can yet not be formulated.
Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country
Authors: Nag Falguni , De Abhishek , Hazra Avijit , Chatterjee Gobinda , Ghosh Arghyaprasun , Surana Trupti V
Published: November 2012

Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle‐Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non‐invasive outpatient department (OPD)‐based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries.
Marital power process of Korean men married to foreign women: A qualitative study
Authors: Kim Miyoung , Park Gyeong Sook , Windsor Carol
Published: November 2012

This study explored how Korean men married to migrant women construct meaning around married life. Data were collected through in‐depth interviews with 10 men who had had been married to migrant women for ≥ 2 years. Data collection and analysis were performed concurrently using a grounded theory approach. The core category generated was the process of sustaining a family unit. The men came to understand the importance of a distribution of power within the family in sustaining the family unit. Constituting this process were four stages: recognizing an imbalance of power, relinquishing power, empowering, and fine‐tuning the balance of power. This study provides important insight into the dynamics of marital power from men's point of view by demonstrating a link between the way people adjust to married life and the process by which married couples adjust through the distribution and redistribution of power.
Is social movement unionism still relevant? The case of the South African federation COSATU
Authors: Dibben Pauline , Wood Geoffrey , Mellahi Kamel
Published: November 2012

Is adopting a social movement role the most effective organisational strategy for organised labour or is it little more than an ideal, in an age of austerity and union defensiveness? This article draws on a national survey of Congress of South African Trade Union (COSATU) members to test perceptions of union activities and finds that COSATU unions largely embrace a social movement role. However, in the context of insecurity, unions need to address the central challenge of declining formal sector employment and precarious jobs.
Union‐division: on the paradoxes of purpose and membership scope in union mergers
Authors: Bednarek Rebecca , Blumenfeld Stephen , Riad Sally
Published: November 2012

Union mergers raise central questions about a union's raison d'être and the range of constituents it can serve effectively. Whereas the challenges posed by union purpose and scope of membership have long engaged researchers, few studies have fleshed out the contradictory issues that engage committed members and leaders during a merger. We argue that in mergers, fundamental themes in unionism intersect in paradoxical ways. We analyse a merger of tertiary education unions in New Zealand and situate its debates within a changing context for industrial relations. The case provides insight into the tensions inherent in union mergers by addressing the drivers for integration and differentiation as well as the role of leaders in shaping these. The findings elucidate paradoxical dynamics inherent in mergers: the paradox of purpose confronts the tension between industrial and craft unionism and the paradox of membership scope considers critical mass and communities of interest. The conclusion reflects on identity, leadership and context during mergers and poses contributions to research and practice.
Convergence of the Economic Sentiment Cycles in the Eurozone: A Time‐Frequency Analysis
Authors: Aguiar‐Conraria Luís , Martins Manuel M.F. , Soares Maria Joana
Published: November 2012

In this article, wavelet tools and economic sentiment indicators are used to study the similarity and synchronization of economic cycles in the eurozone. The time‐varying and frequency‐varying patterns of business cycles synchronization are assessed and the impact of the creation of the European monetary union (EMU) in 1999 is tested. Among several results, it is found that: the EMU is associated with a significant increase in the similarity and synchronization of the economic sentiment in the eurozone; and the hard‐peg of its currency to the euro led to a comparable effect on Denmark's economic sentiment after 1999, different from what happened in the United Kingdom.
Determining intensive care unit nurses' perceptions and practice levels of spiritual care in Turkey
Authors: Turan Türkan , Yavuz Karamanoğlu Ayla
Published: November 2012

Purpose: The purpose of this study is to determine the validity and reliability of the Turkish version of the Spiritual Care Perceptions and Practices Scale and to evaluate factors that may be effective in providing spiritual care by general intensive care unit (ICU) nurses.

Background: Spiritual needs are necessary to offset spiritual deficiencies or support moral strength. During hospitalization, patients with critical conditions and their families tend to become anxious because of fear of the unknown and an uncertain future. Spiritual issues become prominent concerns for these patients and their families.

Method: The data of the study were collected from a university hospital, two public hospitals and two private hospitals. A total of 170 nurses were in the ICU of these hospitals, and 123 nurses (79·4%), agreed to participate and, were included in this study. Prior to the study, an information sheet was provided to all nurses to explain the purpose and procedures of the survey. The demographic data form of ICU nurses and the Nurses' Spiritual Care Perceptions and Practices Scale were used for data collection.

Results: A statistically significant difference was found between the marital status of the nurses and the total scale mean score. It was also determined that ICU nurses are in a better position regarding their perception levels of spiritual care compared to their practice levels of spiritual care, and nurses with a higher perception of spiritual care also have higher scores in the practice of spiritual care.

Conclusions: ICU nurses were found to be inadequate in spiritual care practices. Study findings may be used to improve the support of nurses, to ensure sensitive spiritual care in their daily practices.

Relevance to clinical practice:: ICU nurses should be aware of the importance of spiritual care and develop tools for assessing the spiritual needs of patients.
Unplanned extubation in critically ill adults: clinical review
Authors: Kiekkas Panagiotis , Aretha Diamanto , Panteli Eleftheria , Baltopoulos George I , Filos Kriton S
Published: November 2012

Aims and objectives: To investigate and synthesize the evidence on the incidence and consequences of unplanned extubation (UE) in intensive care unit (ICU) patients, and on risk factors for UE.

Background: ICU patients generally spend considerable time being intubated via the endotracheal route. Non‐planned endotracheal tube removal, either deliberate or accidental, may pose significant safety risks for them. As UE is among the most studied critical incidents in the ICU, evaluation and summary of existing findings could provide important implications for clinical practice.

Search strategies, inclusion and exclusion criteria: Observational studies published between 1990 and 2012 in English‐language journals indexed by Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science and the Cochrane Library were searched for studies on UE of critically ill adults. Thirty‐three articles were considered eligible for inclusion.

Conclusions: UE incidence varies considerably among reports, with self‐extubation representing the majority of cases. Agitation, especially when combined with inadequate sedation, and decreased patient surveillance are the major risk factors for UE. Inexperienced personnel and improper tube fixation may also be important, while physical restraint use remains controversial. UE can be followed by serious complications, mainly aspiration, laryngeal oedema and increased risk for pneumonia. Need for re‐intubation is a major determinant of patient outcomes. Implementation of educational or quality improvement programs is expected to advance personnel's knowledge about risk factors for UE, promote skills on safe, standardized procedures for patient care and increase compliance with them.

Relevance to clinical practice: Identifying risk factors for UE and minimizing UE incidence through appropriate preventive strategies are prerequisites for improving nursing care quality and patient safety in the ICU.
Integrated Economic Equilibrium and Life Cycle Assessment Modeling for Policy‐based Consequential LCA
Authors: Earles J. Mason , Halog Anthony , Ince Peter , Skog Kenneth
Published: November 2012

Consequential life cycle assessment (CLCA) has emerged as a tool for estimating environmental impacts of changes in product systems that go beyond physical relationships accounted for in attributional LCA (ALCA). This study builds on recent efforts to use more complex economic models for policy‐based CLCA. A partial market equilibrium (PME) model, called the U.S. Forest Products Module (USFPM), is combined with LCA to analyze an energy demand scenario in which wood use increases 400 million cubic meters in the United States for ethanol production. Several types of indirect economic and environmental impacts are identified and estimated using USFPM‐LCA. A key finding is that if wood use for biofuels increases to high levels and mill residue is used for biofuels and replaced by natural gas for heat and power in forest products mills, then the increased greenhouse gas emissions from natural gas could offset reductions obtained by substituting biofuels for gasoline. Such high levels of biofuel demand, however, appear to have relatively low environmental impacts across related forest product sectors.
HLA‐DPB POLYMORPHISMS: Glu 69 ASSOCIATION WITH SARCOIDOSIS
Authors: Lympany P. A. , Petrek M. , Southcott A. M. , Taylor A. J. Newman , Welsh K. I. , Bois R. M. du
Published: November 2012

Sarcoidosis is a chronic granulomatous disorder, which is characterized by the accumulation of activated CD4+ T lymphocytes (T cells) at disease sites. There is up‐regulation of cell surface expression of MHC molecules in sarcoidosis, and it has been suggested that specific MHC class II alleles are associated with the disease. A study of chronic beryllium disease (CBD), a granulomatous disorder which is pathologically similar to sarcoidosis, has identified an association between this disease and the presence of a glutamine residue at position 69 (Glu 69+) of the B1 chain of the HLA‐DPB molecule. A further study also suggested the importance of Glu at position 55 of the same chain. The aims of the present study were to attempt to define MHC class II alleles associated with sarcoidosis by comparison of their frequency in two groups of subjects and to compare the frequency of HLA‐DPB1 Glu 69+/– and Glu 55+/– alleles in the same subjects. Forty‐one subjects with sarcoidosis and 76 normal subjects were studied. The polymorphic regions of the class II MHC were identified by PCR in association with sequence‐specific oligonucleotide probes. There were no significant differences in the phenotype frequencies of MHC class II or Glu 55+ alleles between the two groups of subjects. However, there was a significant increase (P = 0.02) in the frequency of HLA‐DPB1* Glu 69+ alleles compared with the control population. We therefore suggest that the presence of a Glu residue at position 69 on the DPB1 chain may play an important role in antigen presentation and recognition in chronic granulomatous diseases.
Reflections on Design Education in a Changing World
Authors: Trummer Juliane , Lleras Silvia
Published: November 2012

An overview of design education across the world: how it has evolved, where it is going, and the pressures and issues it faces
How Knowmads Are Changing the Face of Education
Authors: Spinder Pieter
Published: November 2012

In Amsterdam, an idea, a dream, a learning adventure.
Bridging Languages: New Challenges for Future Designers
Authors: Mortati Marzia , Villari Beatrice
Published: November 2012

Students in a master class on service design took the city of Milan as their starting point, and they came up with a whole crop of business plans.
Learning to Practice: Nurturing Client Business in Design Education
Authors: Murphy Emma , Baldwin Jonathan
Published: November 2012

“Mad Men” is a television show. The real world of professional design is more complicated, and a lot harder to teach.
Hypoxia‐inducible factor‐1 as a therapeutic target in cancer
Authors: Tang Ceen‐Ming , Yu Jun
Published: November 2012

Hypoxia‐inducible factor‐1 (HIF‐1) is a transcription factor that immortalizes tumors by inducing key genes in cancer biology, including angiogenesis, glycolysis, invasion, and metastasis. Overexpression of HIF‐1α is thus associated with resistance to cancer chemotherapy and increased patient mortality in several cancer phenotypes. In the present review, we summarize the role of intratumoral hypoxia and bioactive lipids in enhancing HIF‐1 activity, critically discussing the potential for HIF‐1α inhibitors in cancer chemotherapy. Considering preclinical studies, HIF‐1 inhibitors appear to have antitumor effects and thus represent a novel therapeutic strategy.
Assessing the cost‐effectiveness of treating chronic hepatitis C virus in people who inject drugs in Australia
Authors: Visconti Adam J , Doyle Joseph S , Weir Amanda , Shiell Alan M , Hellard Margaret E
Published: November 2012

Background and Aim

To assess the cost‐effectiveness of hepatitis C virus treatment with pegylated interferon alfa‐2a and ribavirin in current and former people who inject drugs (PWID).

Methods

A decision analytic model simulated the lifetime costs and outcomes of four treatment options: early treatment with mild fibrosis, standard treatment with moderate fibrosis, late treatment with compensated cirrhosis, and no treatment. Treatment modalities were simulated across current, former, and never‐injector cohorts of 1000 hypothetical patients with chronic hepatitis C virus. The main outcome measures were incremental costs ($AUD) per quality‐adjusted life years (QALYs) gained, and incremental cost‐effectiveness ratios (ICERs) were calculated for each cohort.

Results

Treatment of current PWID during mild fibrosis resulted in a discounted average gain of 1.60 QALYs (95% confidence interval 0.93–2.26) for an added cost of $12 723 ($11 153–$14 396) compared with no treatment, yielding an ICER of $7941 per QALY gained ($6347–$12 017). Former PWID gained 1.80 QALYs (1.29–2.33) for $10 441 ($8843–$12 074) for early treatment compared with no treatment, resulting in an ICER of $5808 per QALY gained ($5189–$6849). Never‐injectors gained 2.33 QALYs (1.87–2.80) for $9290 ($7642–$10 912) compared with no treatment—an ICER of $3985 per QALY gained ($3896–$4080). Early treatment was more cost‐effective than late treatment in all cohorts.

Conclusions

Despite comorbidities, increased mortality, and reduced adherence, treatment of both current and former PWID is cost‐effective. Our estimates fall below the unofficial Australian cost‐effectiveness threshold of $AUD 50 000 per QALY for public subsidies. Scaling up treatment for PWID can be justified on purely economic grounds.
Advanced glycation end products augment experimental hepatic fibrosis
Authors: Goodwin Michelle , Herath Chandana , Jia Zhiyuan , Leung Chris , Coughlan Melinda T , Forbes Josephine , Angus Peter
Published: November 2012

Background and Aims

Advanced glycation end products (AGEs) are nonenzymatic modifications of proteins by reducing sugars. These compounds accumulate in a number of chronic disease states, contributing to tissue injury via several mechanisms, including activation of the receptor for advanced glycation end products (RAGE). We aimed to investigate whether AGEs can exacerbate chronic liver injury and contribute to hepatic fibrosis.

Methods

We initially studied the effects of chronic hepatic exposure to high levels of AGEs given intraperitoneally as AGE‐rat serum albumin. In a separate experiment, we examined the impact of high AGE exposure in rats following bile duct ligation (BDL).

Results

In normal rats, chronic AGE‐rat serum albumin administration induced significant increases in α‐smooth muscle actin gene and protein expression but did not induce fibrosis or biochemical evidence of liver injury. However, in BDL animals, AGE‐bovine serum albumin administration significantly increased hepatic fibrosis as evidenced by increased collagen content and α‐smooth muscle actin expression, compared with BDL alone. Furthermore, AGEs increased hepatic oxidative stress and receptor for advanced glycation end products gene expression.

Conclusions

These findings suggest that AGEs may contribute to the pathogenesis of chronic liver injury and fibrosis.
Evaluation of the odour of Aminoleban® EN, taste-masked with flavoured powders, by human and electronic noses
Authors: Haraguchi Tamami , Yoshida Miyako , Uchida Takahiro
Published: November 2012

Objectives

Aminoleban® EN is a bitter total enteral nutrient product with an unpleasant odour. The purpose of this study was to evaluate the odour of Aminoleban® EN, taste-masked with various flavoured powders, by human testing and by using an electronic nose system (Alpha M.O.S.).

Methods

Initially, the odour of Aminoleban® EN alone at various concentrations was evaluated. Secondly, the odour of Aminoleban® EN with the addition of various flavoured powders was evaluated; the evaluation included data on odour intensity, preference levels and evoked taste image.

Key findings

With the human nose, a concentration of 0.43 g/100 ml seemed to be the taste threshold for Aminoleban® EN. In the electronic nose system, principal component analysis revealed that concentrations over 0.39 g/100 ml Aminoleban® EN could be distinguished from water. It was clear from both human testing and using the electronic nose system that the unpleasant odour of Aminoleban® EN could be masked by pineapple- and plum-flavoured powders, both of which contain not only sweet but also sour components.

Conclusions

The electronic nose system may be useful for detecting odours at or below the level detectable by the human olfactory system and for classifying the quality of different odours, thus reducing the amount of human testing required.
Minimally invasive monitoring of skeletal muscle hypermetabolism induced by the phosphodiesterase-III-inhibitor milrinone and sodium fluoride
Authors: Schuster Frank , Johannsen Stephan , Roewer Norbert , Anetseder Martin
Published: November 2012

Objectives

We hypothesized that the phosphodiesterase-III-inhibitor milrinone and the non-specific G-protein activator sodium fluoride increase the skeletal muscular lactate levels as a sign of a hypermetabolic response.

Methods

With approval of the local animal care committee Sprague–Dawley rats were killed and artificially perfused either with Ringer's solution or sodium fluoride 110 mm, while milrinone 1.32 mm or Ringer's solution at 1 μl/min was applied via microdialysis probes in both hind limbs. Lactate was measured spectrophotometrically in the dialysate.

Key findings

Baseline lactate levels before drug application did not differ between hind limbs. Local infusion of milrinone via microdialysis did not significantly increase intramuscular lactate concentrations compared with the Ringer control group. Muscular perfusion with sodium fluoride resulted in a significant increase of lactate and was potentiated by combination with local milrinone.

Conclusions

Phosphodiesterase-III-inhibition alone does not significantly influence the lactate levels in skeletal muscle of sacrificed rats. Sodium fluoride infusion leads to an intramuscular lactate increase, which was further potentiated by local inhibition of phosphodiesterase-III. The fluoride-mediated hypermetabolic response following sodium fluoride could be a possible explanation for the observed myotoxic adverse effects in individuals treated by fluoride-containing agents.
Review: Membrane‐associated misfolded protein propagation in natural transmissible spongiform encephalopathies (TSEs), synthetic prion diseases and Alzheimer's disease
Authors: Jeffrey M.
Published: November 2012

Protein misfolding has long been recognized as a primary cause of systemic amyloidosis and, increasingly, template‐mediated misfolding of native host proteins is now also considered to be central pathogenetic events in some neurodegenerative diseases. Alzheimer's disease, naturally occurring transmissible spongiform encephalopathies (TSEs) and experimental disorders caused by misfolded prion protein (PrP) generated in vitro all share an imbalance of protein synthesis, aggregation and clearance that leads to protein aggregation, prompting some to suggest that Alzheimer's disease is caused by a prion‐like mechanism. In TSEs, the host‐coded, glycosyl‐phosphoinositol (GPI) membrane‐anchored prion protein (PrPc) is misfolded into disease‐associated, putatively infectious aggregates known as prions. In Alzheimer's disease the membrane‐spanning Alzheimer's precursor protein (APP) is progressively cleaved within the plasmalemma to form Aβ peptide fragments that can form pathogenic extracellular aggregates while microtubule‐associated tau proteins may also aggregate within neurones. Oligomeric Aβ peptides and full‐length misfolded PrP show a common potential to convert native protein and aggregate on plasma membranes before subsequent release to form amyloid fibrils in the extracellular space. However, the nature, membrane topography and processing of the precursor and propagated proteins in prion and Alzheimer's disease all differ, and each group of diseases has distinctive spectra of additional pathological changes and clinical signs suggesting that fundamentally different disease mechanisms are involved.