bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful treatment of nephrotic syndrome caused by recurrent IgA nephropathy with chronic active antibody‐mediated rejection three years after kidney transplantation
Authors: Yaginuma Tatsuhiro , Yamamoto Hiroyasu , Mitome Jun , Kobayashi Akimitsu , Yamamoto Izumi , Tanno Yudo , Hayakawa Hiroshi , Miyazaki Youichi , Yokoyama Keitaro , Utsunomiya Yasunori , Miki Jun , Yamada Hiroki , Furuta Nozomu , Yamaguchi Yutaka , Hosoya Tatsuo
Published: June 2011

Yaginuma T, Yamamoto H, Mitome J, Kobayashi A, Yamamoto I, Tanno Y, Hayakawa H, Miyazaki Y, Yokoyama K, Utsunomiya Y, Miki J, Yamada H, Furuta N, Yamaguchi Y, Hosoya T. Successful treatment of nephrotic syndrome caused by recurrent IgA nephropathy with chronic active antibody‐mediated rejection three years after kidney transplantation. Clin Transplant 2011: 25 (Suppl. 23): 28–33. © 2011 John Wiley & Sons A/S.

Abstract:  Here, we report the successful treatment of a 38‐yr‐old Japanese man diagnosed with recurrent immunoglobulin A nephropathy (IgAN) with chronic active antibody‐mediated rejection (CAAMR), three yr after undergoing living‐related donor kidney transplantation. Immediately after transplantation, the allograft function was well maintained with a serum creatinine (S‐Cr) level of <1.8 mg/dL. About three yr after transplantation, urine protein excretion had reached 4.59 g/d, and the S‐Cr level had increased to more than 2.0 mg/dL. Based on the allograft biopsy, we diagnosed nephrotic syndrome because of recurrence of IgAN with CAAMR. Subsequently, we performed a tonsillectomy, administered three sessions of steroid pulse therapy, and added losartan for the recurrence of IgAN. We also changed his immunosuppressant from mizoribine to mycophenolate mofetil to treat the CAAMR. The nephrotic syndrome improved with the multiple therapeutic approaches; however, the S‐Cr level did not decrease below 2.0 mg/dL. We possibly could have performed additional treatments such as rituximab and intravenous immunoglobulin for the CAAMR, but therapeutic strategies for CAAMR have not yet been established.
Overlapped glomerular lesions of chronic rejection and recurrent lupus nephritis in transplanted kidney: a case report
Authors: Masuzawa Naoko , Urasaki Koji , Okamoto Masahiko , Nobori Shuji , Ushigome Hidetaka , Yoshimura Norio , Yanagisawa Akio
Published: June 2011

Masuzawa N, Urasaki K, Okamoto M, Nobori S, Ushigome H, Yoshimura N, Yanagisawa A. Overlapped glomerular lesions of chronic rejection and recurrent lupus nephritis in transplanted kidney: a case report. Clin Transplant 2011: 25 (Suppl. 23): 49–52. © 2011 John Wiley & Sons A/S.

Abstract:  We describe a renal transplant recipient with systemic lupus erythematosus (SLE) who showed continuous proteinuria and low complement levels without clinical evidence of active SLE. Her first renal allograft biopsy, performed nine yr and eight months after transplantation, revealed unusual histological change of glomeruli, and it initially led us to make a contradictory diagnosis based on light and electron microscopic examinations. Diffuse global double‐ or multi‐contour glomerular basement membrane was caused by chronic endothelial injury owing to chronic rejection, and mesangial proliferation associated with mesangial electron‐dense deposit was a histological change characteristic of recurrent lupus nephritis (RLN). Immunofluorescence study displayed weak mesangial staining of IgM and C1q. We concluded that this case presented overlapped chronic rejection and RLN. Because both transplant nephropathy and lupus nephritis present constellations of various histologies, it is difficult to diagnose their overlap. Complete morphologic studies with both immunofluorescence and electron microscopic evaluations in addition to microscopic examination should be performed to elucidate complex histological findings.
BK polyomavirus nephropathy complicated with acute T‐cell‐mediated rejection in a kidney transplant recipient: a case report
Authors: Tanabe Tatsu , Shimizu Tomokazu , Sai Keiko , Miyauchi Yuki , Shirakawa Hiroki , Ishida Hideki , Honda Kazuho , Koike Junki , Yamaguchi Yutaka , Tanabe Kazunari
Published: June 2011

Tanabe T, Shimizu T, Sai K, Miyauchi Y, Shirakawa H, Ishida H, Honda K, Koike J, Yamaguchi Y, Tanabe K. BK polyomavirus nephropathy complicated with acute T‐cell‐mediated rejection in a kidney transplant recipient: a case report. Clin Transplant 2011: 25 (Suppl. 23): 39–43. © 2011 John Wiley & Sons A/S.

Abstract:  We present a case of severe BK polyomavirus nephropathy (BKVN) complicated with persistent acute T‐cell‐mediated rejection (ATMR) that progressed to allograft failure. A 54‐yr‐old man received a living donor kidney transplant from his wife. Approximately four months after transplantation, the patient’s serum creatinine (SCr) increased from a baseline value of 1.5–2.4 mg/dL. A histological analysis showed BKVN, and the SV40 antigen was detected in the tubular nuclei. The doses of immunosuppressants were reduced, and immunoglobulin was administered intravenously. The SCr increased further, to 5.3 mg/dL, and a second renal biopsy revealed the presence of severe ATMR. Antirejection treatment was performed, and low‐dose cidofovir was started. The SCr decreased, to 3 mg/dL, and BK virus antigen in the serum and urine samples became negative at the time of hospital discharge. However, the histological findings subsequently showed gradually progressive interstitial fibrosis and tubular atrophy, and the SCr increased gradually. Two years after the transplantation, the patient resumed hemodialysis. BK polyomavirus nephropathy is usually treated with a reduction in immunosuppressant therapy, although in some patients, the reduction in immunosuppressants induces a subsequent exacerbation of acute rejection and results in progressive graft failure, which suggests difficulty in treating BKVN after kidney transplantation.
The case of BK virus infection in which it was difficult to differentiate from acute rejection
Authors: Ito Yumi , Nishi Shinichi , Imai Naofumi , Yoshita Kazuhiro , Saito Kazuhide , Nakagawa Yuki , Takahashi Kota , Narita Ichiei
Published: June 2011

Ito Y, Nishi S, Imai N, Yoshita K, Saito K, Nakagawa Y, Takahashi K, Narita I. The case of BK virus infection in which it was difficult to differentiate from acute rejection. Clin Transplant 2011: 25 (Suppl. 23): 44–48. © 2011 John Wiley & Sons A/S.

Abstract:  BK virus (BKV) nephropathy is one of the major causes of allograft dysfunction or graft loss in kidney transplant recipients. Early diagnosis and timely reduction in immunosuppressant is important for proper treatment. We report a 35‐yr‐old male case of cadaveric renal transplantation with BK viral related tubulointerstitial nephritis complicated by acute rejection. The diagnostic biopsy showed severe inflammatory infiltrates, tubulitis, and peritubular capillaritis. Discontinuation of mycophenolate mofetil, prednisone pulse therapy, and r‐globulin was successful in relieving allograft dysfunction.
A case of transplant glomerulopathy early after kidney transplantation
Authors: Shimizu Tomokazu , Ishida Hideki , Tanabe Tatsu , Shirakawa Hiroki , Tanabe Kazunari , Honda Kazuho , Koike Junki
Published: June 2011

Shimizu T, Ishida H, Tanabe T, Shirakawa H, Tanabe K, Honda K, Koike J. A case of transplant glomerulopathy early after kidney transplantation. Clin Transplant 2011: 25 (Suppl. 23): 34–38. © 2011 John Wiley & Sons A/S.

Abstract:  Transplant glomerulopathy (TG) has commonly been described as a late manifestation of allograft injury, occurring years after renal transplantation. We describe herein a patient who developed TG early (49 days) after kidney transplantation (KTx).

Case report:  A 44‐yr‐old woman received a second living‐related KTx from her younger brother in October 2009. Pre‐transplant donor‐specific anti‐human leukocyte antigen antibodies (DSA) were positive for both class I and class II. During the renal transplant operation, she suffered from hyperacute antibody‐mediated rejection (AMR) and intravenous immune globulin therapy was immediately performed. Once hyperacute AMR was resolved, accelerated acute AMR occurred on the first post‐transplant day (PTD). The renal allograft biopsy performed on PTD 19 diagnosed acute AMR type II. The renal allograft biopsy performed on PTD 49 showed focal lesions of double contours of glomerular basement membranes in some glomeruli. Interstitial fibrosis showed a strong, diffuse staining of C4d in peritubular capillaries (PTCs). The DSA examined on PTD 39 were still positive for both class I and class II. From these histopathological findings of TG, C4d deposition in PTC and presence of circulating DSA, we diagnosed this case to have c‐AMR.

Conclusions:  TG might be recognized in early after KTx.
Parental attitudes to digital recording: A paediatric hospital survey
Authors: Taylor Katherine , VanDenberg Stephanie , le Huquet Ariel , Blanchard Nadeene , Parshuram Christopher S
Published: June 2011

Aim:  Digital recording is ubiquitous in the community. Its objectivity, permanence and utility in medical education have led to increasing use in health‐care settings. As participants in this process, the perspectives of families are important to inform practice. We surveyed family members of hospitalized children to evaluate their opinions.

Methods:  A survey was administered to adults in emergency, operating room or ICU waiting areas at a university‐affiliated paediatric hospital in Toronto. Respondents rated the frequency of digital recording in the community and hospital environments, the acceptability of five clinical indications and of consent discussions.

Results:  Participants completed 154 surveys (response rate 83%) with median (interquartile range) of 2 (1–2) children. Community use of recording >4 times in the week prior was reported by 47 (31%); 42 (28%) reported no recording. The respondents rated the following indications for digital recording acceptable in the health care research 142 (94%), medical education 140 (93%), quality improvement 140 (92%), patient safety 147 (97%), and clinical care (96%). Within healthcare, consent discussions at different times were rated as acceptable before recording by 99%; after recording by 41%; and with no consent by 17%.

Conclusion:  We performed the first post‐privacy legislation survey of digital recording in Canadian health care. There is widespread acceptance of digital recording in public spaces and health care; however, respondents preferred to provide consent before recording. Balancing these preferences with the demonstrated advantages of video recording in health care presents challenges for optimal health policy creation. This study provides contemporary data to inform discussions.
Intrapleural therapy
Authors: HUGGINS J. TERRILL , DOELKEN PETER , SAHN STEVEN A.
Published: June 2011

Numerous intrapleural therapies have been adopted to treat a vast array of pleural diseases. The first intrapleural therapies proposed focused on the use of fibrinolytics and DNase to promote fluid drainage in empyema. Numerous case series and five randomized controlled trials have been published to determine the outcomes of fibrinolytics in empyema treatment. In the largest randomized trial, the use of streptokinase had no reduction in mortality, decortication rates or hospital days compared with placebo in the treatment of empyema. Criticism over study design and patient selection may have potentially affected the outcomes in this study. The development of dyspnoea is common in the setting of malignant pleural effusions. Pleural fluid evacuation followed by pleurodesis is often attempted. Numerous sclerosing agents have been studied, with talc emerging as the most effective agent. Small particle size of talc should be avoided because of increased systemic absorption potentiating toxicity, such as acute lung injury. Over the past several years, the use of chronic indwelling pleural catheters have emerged as the preferred modality in the treating a symptomatic malignant pleural effusion. For patients with malignant‐related lung entrapment, pleurodesis often fails due to the presence of visceral pleural restriction; however, chronic indwelling pleural catheters are effective in palliation of dyspnoea. Finally, the use of staphylococcal superantigens has been proposed as a therapeutic model for the treatment of non‐small lung cancer. Intrapleural instillation of staphylococcal superantigens increased median survival by 5 months in patients with non‐small cell lung cancer with a malignant pleural effusion.
The ‘well‐run’ system and its antimonies
Authors: Rudge Trudy
Published: June 2011

An aim of all of the management of healthcare systems is the smooth provision of services. A great deal of effort is put into ensuring processes will obtain this ideal – the well‐run system. The central argument in this paper is that these processes result in a system that perpetrates violence and coercion on its clients and workers. This violence is structural and personalizing in its effects. Moreover, time and effort is taken away from the actual work of the system for its management. Under such managerialist control, the idea of chaos and the need to ensure order are used to fuel an apparatus that takes the focus from other aspects of the system such as the power relations that keep the system as it is. In such an ordering, the clinical audit is promoted as a method to ensure order by keeping ahead of, or removing the potential for chaos. In using Žižek's ideas about violence it is possible to identify how efforts and attempts to correct the system are doomed to fail just as they hide how nurses' enrolment in the service of the system leads to alienation and subjectification. A central aim of this paper is to rethink how power and implicit violence are practised in such processes. To overcome the inherent violence of the audit culture, this paper suggests an interruption of audit cultures with a promotion of more radical positions for nursing practice and clinically based research. The hope is to recalculate and interrupt how nurses are to operate in the management structures that organize healthcare.
Pharmaceutical Industry discursives and the marketization of nursing work: a case example
Authors: Springer Rusla Anne
Published: June 2011

Increasing pharmaceutical industry presence in health care research and practice has evoked critical social, political, economic, and ethical questions and concern among health care providers, ethicists, economists, and the general citizenry. The case example presented of the ‘marketization’ of nursing practice not only reveals the magnitude of the purview of the pharmaceutical industry, it demonstrates how that industry imparts effect upon the organization of nursing work, an area of health care professional practice where the ethical polemic of pharmaceutical industry involvement and influence has been largely ignored, and the profession of nursing conspicuously silent. Drawing on a Foucauldian dispositive analysis that troubled the complex apparatus responsible for the production of knowledge and action in the neurology subspecialty of multiple sclerosis (MS), the case discloses how the pharmaceutical industry has created compliance and adherence as clinical imperatives in the practice of MS nursing. The case makes explicit the conscious transformative self‐action undertaken by MS nurses as a result of their subjectivation (marketization) and demonstrates how MS nurses have become pawns in pharmaceutical industry strategic games of power, truth, identity, and wealth creation by turning their clinical practice settings into heterodiscursive spaces of surveillance and persuasion. MS nurses have become instruments of the pharmaceutical industry, and their clinical practices ordered, organized, limited, constrained, and marketized as a result.
COMBINING MULTIPLE MARKERS FOR MULTI‐CATEGORY CLASSIFICATION: AN ROC SURFACE APPROACH
Authors: Zhang Yanyu , Li Jialiang
Published: June 2011

The Receiver Operating Characteristic (ROC) curve and the Area Under the ROC Curve (AUC) are effective statistical tools for evaluating the accuracy of diagnostic tests for binary‐class medical data. However, many real‐world biomedical problems involve more than two categories. The Volume Under the ROC Surface (VUS) and Hypervolume Under the ROC Manifold (HUM) measures are extensions for the AUC under three‐class and multiple‐class models. Inference methods for such measures have been proposed recently. We develop a method of constructing a linear combination of markers for which the VUS or HUM of the combined markers is maximized. Asymptotic validity of the estimator is justified by extending the results for maximum rank correlation estimation that are well known in econometrics. A bootstrap resampling method is then applied to estimate the sampling variability. Simulations and examples are provided to demonstrate our methods.
MULTILEVEL DISCRETE‐TIME EVENT HISTORY MODELS WITH APPLICATIONS TO THE ANALYSIS OF RECURRENT EMPLOYMENT TRANSITIONS
Authors: Steele Fiona
Published: June 2011

Data on the timing of events such as births, residential moves and changes in employment status are collected in many longitudinal surveys. These data often have a highly complex structure, with events of several types occurring repeatedly over time to an individual and interdependences between different event processes (e.g. births and employment transitions). The aim of this paper is to review a general class of multilevel discrete‐time event history models for handling recurrent events and transitions between multiple states. It is also shown how standard methods can be extended to allow for time‐varying covariates that are outcomes of an event process that is jointly determined with the process of interest. The considerable potential of these methods for studying transitions through the life course is illustrated in analyses of the effect of the presence and age of children on women's employment transitions, using data from the British Household Panel Survey.
Imagine There Is a War and No One Turns Up! A Response to the Commentaries
Authors: Reicher Stephen , Doise Willem , Elcheroth Guy
Published: June 2011

In this response to the commentaries, we make one concession and try to clarify two critical points raised by the commentators. The concession is about the common stock of knowledge on which social representations approaches draw in general, and the model outlined in our article in particular. The two points we attempt to clarify concern the importance of both an intergroup perspective and of the structural components of power to our model of social representations.
Coalition and Minority Government in Scotland: Lessons for the United Kingdom?
Authors: CAIRNEY PAUL
Published: June 2011

The United Kingdom general election result in 2010 produced a hung or balanced parliament for the first time in over three decades. Since the United Kingdom has limited postwar experience of this outcome, it is natural that commentators have begun to look elsewhere for lessons on the practicalities of minority and coalition government. This article considers the lessons we can learn from the Scottish parliamentary experience since 1999. It outlines two main points of comparison: strength and stability. One might assume that coalition provides more of both than minority government. Indeed, for that reason, it is rare for central or devolved governments in the United Kingdom to operate as minorities through choice. Yet, the Scottish experience shows that the differences between coalition and minority government are not completely straightforward. Much depends on the institutional context and, in many cases, idiosyncratic elements of particular systems. Consequently, one can identify a trade‐off in comparative analysis: as the identification of elements specific to one system increases, the ability to draw clear meaningful lessons decreases.
Coalition and Minority Government in Wales: Lessons for the United Kingdom?
Authors: PALMER ROSANNE
Published: June 2011

Post‐devolution Wales has had experience of a variety of different types of government and a variety of different parties in government; single party rule with one party gaining an overall majority of the seats (Labour, 2003–05), minority administrations (Labour, 1999–2000, 2005–07) and coalitions between Labour and the Liberal Democrats (2000–03) and Labour and Plaid Cymru (2007 to date). This article explores the experiences of both minority and coalition government in Wales, focusing most notably on the convoluted process of coalition formation in 2007, before proceeding to draw lessons for the United Kingdom coalition government based upon developments in Wales.
On Joining the Constitution
Authors: HENNESSY PETER
Published: June 2011

A new independent crossbench peer takes stock of the institution he has just joined, examines the arguments for reform and ponders what might await.
Biases of Parameter Estimates in Misspecified Structural Equation Models
Authors: Kolenikov Stanislav
Published: June 2011

We deal with the problem of quantifying the degree to which parameter estimates in a structural equation model can be biased when structural relationships were not specified correctly by the researcher. We propose a framework to relate moment residuals to biases of parameter estimates and the overall noncentrality of the model. For each parameter in the model, an impact of either particular moment residual or the overall model noncentrality can be evaluated, although the latter tends to give error bounds that are rather conservative. We provide illustrative analytical and empirical examples to demonstrate the steps in application of the proposed procedures. The first example is a mildly misspecified model with causal indicators mistaken to be effect indicators. The resulting biases can be approximated very accurately by accounting for the effect of a single misfitted residual moment. The second example is a grossly misspecified model in which a mediating latent variable was erroneously omitted. In this case, the misspecification spreads to all entries of the covariance matrix, and measures based on overall noncentrality give a good indication of the magnitudes of plausible biases. The third example is an empirical study that uses Holzinger-Swineford factor analysis data that shows how the procedures can be used in practice.
The Stability of Large‐Amplitude Shallow Interfacial Non‐Boussinesq Flows
Authors: Boonkasame Anakewit , Milewski Paul
Published: June 2011

The system of equations describing the shallow‐water limit dynamics of the interface between two layers of immiscible fluids of different densities is formulated. The flow is bounded by horizontal top and bottom walls. The resulting equations are of mixed type: hyperbolic when the shear is weak and the behavior of the system is internal‐wave like, and elliptic for strong shear. This ellipticity, or ill‐posedness is shown to be a manifestation of large‐scale shear instability. This paper gives sharp nonlinear stability conditions for this nonlinear system of equations. For initial data that are initially hyperbolic, two different types of evolution may occur: the system may remain hyperbolic up to internal wave breaking, or it may become elliptic prior to wave breaking. Using simple waves that give a priori bounds on the solutions, we are able to characterize the condition preventing the second behavior, thus providing a long‐time well‐posedness, or nonlinear stability result. Our formulation also provides a systematic way to pass to the Boussinesq limit, whereby the density differences affect buoyancy but not momentum, and to recover the result that shear instability cannot occur from hyperbolic initial data in that case.
A Comparison of Aspatial and Spatial Measures of Segregation
Authors: Cohn Molly J. , Jackman Saul P.
Published: June 2011

The modifiable areal unit problem arises when the boundaries that define neighborhoods affect perceived levels of segregation. Scholars postulate that this problem is exacerbated when one uses a definition of neighborhoods that is based on administrative units; doing so leads to an aspatial measure of segregation, which may or may not adequately account for the spatial relationships among residential locations. In this article, we assess whether aspatial and spatial definitions of neighborhoods produce different perceived levels of income segregation. Using an original individual‐level dataset on income in San Mateo County, California, we define each individual's neighborhood in three ways – two aspatial and one spatial. On the basis of these definitions of neighborhoods, we then estimate residential income segregation using the local Moran's I statistic. We report two primary findings. First, the three measures generate different perceived levels of income segregation. Specifically, we observe less income segregation when using the aspatial measures as compared with the spatial one. Second, the inconsistencies between these measures are systematic in such a way as to lead to different inferences when used to predict individual voter turnout.
Foreign Partners and Finance Constraints: The Case of Chinese Firms
Authors: Egger Peter , Nelson Douglas
Published: June 2011

In this paper, we consider the extent to which financial constraints cause domestic firms to seek foreign partners. We employ a large firm‐level panel dataset for China which allows us to analyse this question empirically by looking at changes in foreign ownership status. We find a significant impact of several variables reflecting finance constraints. In particular, the results suggest that observed changes in debt‐to‐turnover ratios tend to be more important than other financial indicators to attract foreign capital. Moreover, foreign ownership relaxes finance constraints in turn and, already in the short run, tends to boost investment at the firm level.
Financial Constraints, the Distribution of Wealth and International Trade
Authors: Amissah Emmanuel , Bougheas Spiros , Falvey Rod
Published: June 2011

We develop a simple theoretical model to examine the impact of the distribution of wealth on the patterns of trade when capital markets are imperfect. Our model predicts that the dispersion of wealth can be a determinant of comparative advantage for low income countries with poor financial institutions. We find support for these prediction using export and financial panel data from a large sample of countries.
Article use in Cameroon English and in non‐standard British English
Authors: TAKAM ALAIN FLAUBERT
Published: June 2011

ABSTRACT:  This study is concerned with the various uses of articles in certain non‐standard dialects of British English and in Cameroon English (CamE). Variations in the use of definite and indefinite articles are dealt with. More specifically, the paper examines various contexts in which definite and indefinite articles are used in Cameroon: specific and non‐specific reference, institutional and non‐institutional meaning, count and noncount uses, among others. This paper is based on the observation that the influence of the British colonists, especially missionaries (many of whom were not always speakers of Standardized varieties of British English), on various CamE grammatical usages in general and article use in particular has so far been grossly under‐researched. In fact, in some contexts, a sizable portion of educated CamE speakers use the articles in much the same way as speakers of certain non‐standard dialects of the British Isles. One of the conclusions this paper arrives at is that the history of colonization and evangelization through mission schools might have played a major role in the transportation to, and transplantation into, the colonies (Cameroon in this case), of British non‐standard dialects, many features of which eventually took root.
The pragmatic roles of as in in Nigerian English usage
Authors: OGOANAH FELIX NWABEZE
Published: June 2011

ABSTRACT:  No previous accounts of discourse or pragmatic markers have considered the contributions of as in as a marker in utterance interpretation. Yet, this particle, although essentially a Nigerian English usage, shares the same features with some of the most commonly discussed markers such as, that is, in short, in other words, so, you know, I mean and so on. Drawing examples from spoken data, which are analysed within the framework of relevance theory, this paper describes the contributions of as in as a pragmatic marker in the interpretation of utterances in Nigerian English usage. As a pragmatic marker, as in encodes procedural meaning by constraining the inferential process in a way that maximizes relevance. Specifically, this paper argues that as in in various ways and in diverse contexts signals the speaker's desire to get the hearer to recognize that a crucial aspect of his meaning is being communicated in the host utterance, and in the process encourages the hearer to arrive at that meaning with minimal processing effort.
South African Indian English: A qualitative study of attitudes
Authors: WIEBESIEK LISA , RUDWICK STEPHANIE , ZELLER JOCHEN
Published: June 2011

ABSTRACT:  This paper focuses on attitudes towards South African Indian English (SAIE), an L1 variety of English spoken in South Africa. The attitudes of the participants are considered against the backdrop of the socio‐political history of this variety and its speakers, and in contrast to their attitudes to what they perceive as ‘good’ English. While the research methodology is primarily based on lengthy, semi‐structured interviews with twenty young South African Indians (i.e. ingroup members), the paper also includes a discussion of some of the linguistic features of SAIE, which is mainly motivated by methodological considerations. Through an examination of SAIE wh‐questions, we show that the grammar of this variety differs systematically from that of the reference variety. Using examples of these wh‐questions, we elicited grammatical judgments from participants and compared these judgments to the attitudes of the participants as expressed in response to open‐ended questions in interviews. On the basis of the empirical data that we obtained and analysed, we argue that the young South African Indian students who participated in our study have a profoundly ambiguous attitude towards the variety associated with their own ethno‐linguistic group.
Saying and Doing: Speech Actions, Speech Acts and Related Events
Authors: Grünberg Angela
Published: June 2011

The question which this paper examines is that of the correct scope of the claim that extra‐linguistic factors (such as gender and social status) can block the proper workings of natural language. The claim that this is possible has been put forward under the apt label of silencing in the context of Austinian speech act theory. The ‘silencing’ label is apt insofar as when one's ability to exploit the inherent dynamic of language is ‘blocked’ by one's gender or social status then one might justly be said to be silenced. The notion that factors independent of any person's linguistic competence might block her ability to exploit the inherent dynamic of language is of considerable social as well as theoretical significance. I shall defend the claim that factors independent of a person's linguistic competence can indeed block her ability to do things with words but I will show that the cases that have been previously considered to be cases of illocutionary failure are instances of rhetic or locutionary act failure instead. I shall refine the silencing claim as previously advanced in the debate in at least one fundamental respect. I also show that considering the metaphysics of speech acts clarifies many of the issues previously appearing as thorny bones of contention between those who hold that the only notion of silencing that is coherent is that of physically preventing someone from speaking or writing and those who hold the opposite sort of claim sketched above.
Toxic epidermal necrolysis and Stevens‐Johnson syndrome at the Prague Burn Centre 1998–2008
Authors: Zajicek R. , Pintar D. , Broz L. , Suca H. , Königova R.
Published: June 2011

Background  Toxic epidermal necrolysis (TEN) and Stevens‐Johnson syndrome (SJS) are skin disorders characterized by extensive necrosis of the mucous membranes and the epidermis caused by an autoimmune response.

Objectives  To present experience of treating TEN and SJS at the Prague Burn Centre (PBC) 1998–2008.

Methods  22 patients with the diagnosis TEN or SJS were enrolled. We collected data including the extent of the skin involvement, the ratio of men : women, the average age, the mortality rate, presence of comorbidities, the length of hospital stay, the period from the first symptoms to the admission to the PBC, corticosteroids administration prior to admission.

Results  82% patients had injuries larger than 30% of body surface area. The ratio of men : women was 1 : 1.5; the average age was 48.4 years; the mortality was 32%. Significant comorbidities were present in 41% of the cases. The average length of hospital stay was 12.9 days. The period from the first symptoms to the admission to the PBC was 9.6 days; corticosteroids were administered to 68% of the cases.

Conclusion  Treatment strategies at the PBC are based upon a multidisciplinary approach and focus on the general principles of treating patients with extensive skin loss. Corticosteroids must be avoided, antibiotics are not indicated and intravenous immunoglobulins are not justified in the standard therapy. Early diagnosis, prompt transport to a burn center are essential for patients outcomes. The medical community should be informed about these rare but potentially life threatening diseases.
Transcriptomic profiles of Wnt3a and insulin in primary cultured rat cortical neurones
Authors: Hooper Claudie , Killick Richard , Fernandes Cathy , Sugden David , Lovestone Simon
Published: June 2011

J. Neurochem. (2011) 118, 512–520.

Glycogen synthase kinase 3 (GSK3) is a widely expressed, constitutively active, serine/threonine kinase that is negatively regulated by both Wnt and insulin via two independent signalling pathways. GSK3 is an important mediator in many physiological processes including glycogen metabolism, apoptosis and gene transcription. In addition, GSK3 is implicated in diseases such as Alzheimer’s, schizophrenia and cancer, where it exhibits deregulated activity. In this study, we sought to determine the neuronal genes regulated by both Wnt and insulin in an in vitro cell culture model to further elucidate the signalling roles GSK3 plays in the CNS. Affymetrix Rat Genome 230 2.0 whole genome microarrays were used to explore the expression profiles of rat primary cortical neurones treated with recombinant Wnt3a (10 nM) or insulin (50 nM) for 2 h. Following a conservative correction (Bonferroni) for multiple testing, seven genes were identified to be differentially expressed from controls; four of these genes were regulated by insulin and three genes were regulated by both insulin and Wnt3a. The data were also analysed using a false discovery rate cut off, which is a less stringent correction for multiple testing. This approach yielded 105 genes that were differentially regulated from controls; 72 of the gene changes were attributable to insulin treatment, 11 were because of Wnt3a treatment and 22 genes were altered by both insulin and Wnt3a. These data demonstrate that the Wnt and insulin pathways exhibit both divergent and overlapping signalling activities in neuronal cells. The overlapping transcriptional response was not attributable to Wnt3a activating Akt. These findings have ramifications for neurodevelopment and neurological diseases, in which the Wnt and insulin signalling pathways are implicated.
Inhibitory effect of caffeine on pacemaker activity in the oviduct is mediated by cAMP‐regulated conductances
Authors: Dixon RE , Hwang SJ , Britton FC , Sanders KM , Ward SM
Published: June 2011

BACKGROUND AND PURPOSE

Spontaneous electrical activity, termed slow waves, drives rhythmic, propulsive contractions in the smooth muscle of the oviduct (myosalpinx). Myosalpinx contractions cause egg transport through the oviduct. Agents that disrupt slow wave pacemaker activity will therefore disrupt myosalpinx contractions and egg transport. Caffeine is commonly used as a ryanodine receptor agonist and has been previously associated with delayed conception. Here we assessed the effects of caffeine on pacemaker activity in the murine myosalpinx.

EXPERIMENTAL APPROACH

The effects of caffeine on electrical pacemaker activity were studied using intracellular microelectrode and isometric force measurements on intact oviduct muscle preparations. Responses to caffeine were compared with responses caused by 3‐isobutyl‐1‐methylxanthine (IBMX) and forskolin.

KEY RESULTS

Caffeine caused hyperpolarization of membrane potential and inhibited slow wave generation and myosalpinx contractions. The effects of caffeine could be mimicked by the KATP channel agonist pinacidil and antagonized by the KATP channel antagonist glibenclamide. Caffeine is known to inhibit cyclic nucleotide phosphodiesterases (PDEs), leading to an increase in cytosolic cAMP and stimulation of downstream cAMP‐dependent mechanisms. The effects of caffeine were mimicked by the PDE inhibitor, IBMX, and the adenylyl cyclase activator forskolin. These effects were also reversed by glibenclamide.

CONCLUSIONS AND IMPLICATIONS

These results suggest that caffeine activates KATP channels in oviduct myosalpinx. Since caffeine abolishes slow waves and associated contractions of the myosalpinx, it would have a negative effect on egg transport through the oviduct and may contribute to the documented delayed conception in women consuming caffeinated beverages.
Drug targeting of sphingolipid metabolism: sphingomyelinases and ceramidases
Authors: Canals Daniel , Perry David M , Jenkins Russell W , Hannun Yusuf A
Published: June 2011

Sphingolipids represent a class of diverse bioactive lipid molecules that are increasingly appreciated as key modulators of diverse physiologic and pathophysiologic processes that include cell growth, cell death, autophagy, angiogenesis, and stress and inflammatory responses. Sphingomyelinases and ceramidases are key enzymes of sphingolipid metabolism that regulate the formation and degradation of ceramide, one of the most intensely studied classes of sphingolipids. Improved understanding of these enzymes that control not only the levels of ceramide but also the complex interconversion of sphingolipid metabolites has provided the foundation for the functional analysis of the roles of sphingolipids. Our current understanding of the roles of various sphingolipids in the regulation of different cellular processes has come from loss‐of‐function/gain‐of‐function studies utilizing genetic deletion/downregulation/overexpression of enzymes of sphingolipid metabolism (e.g. knockout animals, RNA interference) and from the use of pharmacologic inhibitors of these same enzymes. While genetic approaches to evaluate the functional roles of sphingolipid enzymes have been instrumental in advancing the field, the use of pharmacologic inhibitors has been equally important in identifying new roles for sphingolipids in important cellular processes.The latter also promises the development of novel therapeutic targets with implications for cancer therapy, inflammation, diabetes, and neurodegeneration. In this review, we focus on the status and use of pharmacologic compounds that inhibit sphingomyelinases and ceramidases, and we will review the history, current uses and future directions for various small molecule inhibitors, and will highlight studies in which inhibitors of sphingolipid metabolizing enzymes have been used to effectively treat models of human disease.
Designing for Designing: Information and Communication Technologies (ICTs) and Professional Education
Authors: Wang Tsungjuang
Published: June 2011

Information and Communication Technologies (ICTs) appear to be well fitted to the education of design professionals, such as architectural and engineering students, mainly because of the unique culture of these professional schools, where the emphasis is on creativity, collaboration, social relevance and rapid communication of ideas. Attention is focused on the reflection‐inaction theory of Donald Schön as well as the educational paradigm of constructivism as it is articulated by Dewey and Vygotsky. It is also argued that the full implementation of ICTs for professional education would also be extremely beneficial to the development of professional collegiality beyond the borders of geography and culture. All of this is followed by a consideration of important criticisms brought to bear upon both the use of ICTs in the classroom and the commonly held assumption that constructivism is the optimal educational paradigm.
A Critical Mapping of Practice‐Based Research as Evidenced by Swedish Architectural Theses
Authors: Büchler Daniela , Biggs Michael A.R. , Ståhl Lars‐Henrik
Published: June 2011

This article presents an investigation that was funded by the Swedish Institute into the role of creative practice in architectural research as evidenced in Swedish doctoral theses. The sample was mapped and analysed in terms of clusters of interest, approaches, cultures of knowledge and uses of creative practice. This allowed the identification of the ontological, epistemological and methodological attitudes of the researchers, and hence a glimpse of their implicit worldview. The authors claim that the relationship between worldview and research actions in emerging areas of research such as architecture is often under‐scrutinised, resulting in a disjunction between aims and strategies for action. Architectural research in which creative practices make an essential contribution to the aims, might represent something new in academic research. The investigators therefore focused on identifying cases in which creative practice was – or was claimed to be – integrated in an essential way into the research process.

There were two principal conclusions. The first was that the mere presence of practice was not necessarily an indicator of so‐called arts‐based research. The second was that cases of arts‐based research that could be regarded as a new paradigm – as opposed to a variant of existing paradigms – are less common than is claimed by the researchers themselves. As a result, this article makes a contribution to the debate on whether so‐called practice‐based research should be regarded as a distinct new paradigm.
What Teachers Can Learn from the Practice of Artists
Authors: Jarvis Michael
Published: June 2011

This article considers how primary teachers can learn from the practice of artists in their own teaching of art. Fundamental to artistic practice is the notion of practising with various materials and tools. In the article I look at some children's images, as well as scrutinising some statements made by the painter Francis Bacon. The practices of artists like Bacon and Cy Twombly identify the importance of instinct and spontaneity in the making of art. Both articulate the difference between a painting which enables the maker and viewer to engage more directly with the actual experience, or object being depicted, rather than a painting which is merely illustrative and descriptive. How can such ideas help us to re‐evaluate our own practice as teachers? An examination of the works, practices and statements made by artists can provide significant insights for teachers struggling with the constraints of a curriculum pedagogy based predominantly on outcomes, with little attention being paid to important processes. The National Curriculum in England, with its emphasis upon literacy and numeracy, has led to the visual arts being consigned to the margins of curricular practice, especially at the critical learning phases of primary schooling between the ages of 5 and 11. If teachers can learn from the examples and practices of artists about the importance of processes of exploration, experimentation and playing with visual materials and tools, then the critical loss of learning opportunities in the visual arts at the primary level might be addressed more carefully in future.
Managing Heuristics as a Method of Inquiry in Autobiographical Graphic Design Theses
Authors: Ings Welby
Published: June 2011

This article draws on case studies undertaken in postgraduate research at AUT University, Auckland. It seeks to address a number of issues related to heuristic inquiries employed by graphic design students who use autobiographical approaches when developing research‐based theses. For this type of thesis, heuristics as a system of inquiry may provide a useful approach because it engages the researcher in a process that affirms imagination, intuition, subjectivity and forms of creative/critical/reflective problem solving. When employed as a framework, heuristics offers a rewarding but challenging system for connecting investigation with the researcher's personal experience. This article provides a discussion of heuristic's applications, limitations and advantages in relation to a number of recent postgraduate theses in graphic design. Through this, it seeks to provide a useful reflection on challenges and opportunities inherent within it as a system of inquiry.
Doctoral Writing in the Visual and Performing Arts: Issues and Debates
Authors: Paltridge Brian , Starfield Sue , Ravelli Louise , Nicholson Sarah
Published: June 2011

Drawing from a larger study of doctorates in the visual and performing arts, we examine here the diversity of relations which can exist between the creative and written components of a doctoral thesis in these fields in terms of diversity of naming practices for these relations, institutional variation in guidelines and expectations, and fundamental functional roles for the respective components. By bringing together and highlighting key details in these debates and issues, this article provides a foundation for further studies in this complex area.
Measuring Students' Self‐Efficacy for Communication
Authors: Gaffney Amy L. Housley
Published: June 2011

Design students are asked to regularly communicate their ideas to a diverse audience. Students' abilities may be affected by their perceived self‐efficacy, the perception of abilities to perform a task. Because self‐efficacy is conceived of as context‐specific, it is vital to consider self‐efficacy as it specifically relates to design studios and the communication within that context, rather than to look at generalised self‐efficacy for communication. To that end, this article explains the development and validation of measures of students' perceived self‐efficacy for communicating in both formal (critique) and informal (studio working time) design circumstances. Using data from students at two institutions, the measures were found to be reliable; these results were further supported through their relationship to previously validated measures. The development of these measures and the results from pilot data provide insight into students' perceptions of their communication abilities that may be beneficial to educators seeking to help design students communicate competently.
Does it Matter How Parathyroid Hormone Levels are Suppressed in Secondary Hyperparathyroidism?
Authors: Stubbs Jason R. , Wetmore James B.
Published: June 2011

Because secondary hyperparathyroidism is associated with morbidity and mortality in patients with chronic kidney disease, suppression of parathyroid hormone (PTH) and minimization of associated derangements in mineral metabolism are cardinal therapeutic goals. There is an ongoing debate regarding the proper treatment strategy for PTH suppression in this population. While some practitioners believe that calcitriol analogues should be the primary therapy in this setting, others contend that calcimimetics offer unique treatment benefits. Recent advancements in the understanding of the pathophysiology of secondary hyperparathyroidism and the secondary effects of these agents may help clarify this debate. Here, we review the classical actions of calcitriol analogues and calcimimetics on mineral metabolism. We also examine the potential nonclassical effects of these therapies on the renin–angiotensin–aldosterone system, proteinuria, vascular calcification, fibroblast growth factor‐23, inflammation, and overall survival.