bluuebunny/crossref_metadata_2025 huggingface dataset:
Intra-axial Hepatic Cerebrospinal Fluid Pseudocyst: An Unusual Complication of Ventriculoperitoneal Shunt Placement
Authors: Chandran Ashikh , Narayanan Ramakrishna , Reddy Seema
Published: February 2024

Intra-abdominal Cerebrospinal Fluid (CSF) pseudocysts are a well-known and potentially serious complication of Ventriculoperitoneal (VP) shunt placement. These cysts are often found within the peritoneal cavity or along the serosal surface of solid organs. Here, we present an unusual case of an intrahepatic CSF pseudocyst in a 14-year-old female patient with a VP shunt placed three years ago, following the excision of a cerebellar pilocytic astrocytoma. The child presented with complaints of right hypochondriac pain and tenderness for one month. On ultrasound of the abdomen, the right lobe of the liver showed a complex anechoic cystic collection with multiple thick internal septations. A Contrast-enhanced Computed Tomography (CECT) examination revealed a well-defined hypodense collection in segments IV and V of the liver with a VP shunt tube within. Based on clinical and imaging features, differentials of intra-axial intrahepatic CSF pseudocyst, complex hepatic cyst, peri-shunt hemorrhagic cyst, and biliary cystadenoma were considered. Aspiration of the cyst revealed clear, colourless, non purulent, non sanguineous fluid which tested positive for beta-2-transferrin, confirming the collection to be a CSF pseudocyst. An elective laparoscopic cyst excision with shunt revision was performed with no recurrence on follow-up. The present case highlights the uncommon occurrence of intrahepatic CSF pseudocysts post-VP shunt, necessitating meticulous diagnostic evaluation. Successful laparoscopic excision and shunt revision underscore the efficacy of tailored interventions. This contribution enhances the understanding of atypical complications in VP shunt recipients, guiding clinicians and radiologists in both diagnosis and management.
Interdisciplinary Management of an Adolescent Cleft Patient with Skeletal Class III Malocclusion: A Case Report
Authors: Mishra Harsh Ashok , Ladani Parit Kumar , Maurya Rajkumar , Sawant Hitesh Ramdas , Khan Waseem
Published: February 2024

Cleft lip and palate are the most frequently observed congenital abnormalities affecting the maxillofacial region. They can occur isolated or together in various combinations. These deformities are also associated with features found in over 300 recognised syndromes. Additionally, there are several problems, including social limitations, such as difficulties in breastfeeding resulting in failure to grow properly, speech abnormalities, hearing loss, misalignment of teeth, significant facial abnormalities, and serious aesthetic, psychological, and psychosocial challenges. Treatment modalities involve a number of specialists, such as Maxillofacial and Plastic surgeons, Anaesthetists, Orthodontists, Restorative dentists, Paediatric dentists and Prosthodontists, who collaborate to determine the best treatment plan based on the site of the defect and the patient's age. The present case report discusses the treatment and management of a 16-year-old female patient who presented with cleft lip and palate, along with skeletal class III malocclusion, hypodontia, multiple decayed teeth and dental malformation. The patient had missing lateral incisors and canines in the maxillary arch, along with carious maxillary central incisors. The purpose of this article is to report the multidisciplinary management of a unilateral cleft lip and palate patient with class III malocclusion, utilising orthognathic surgery, as well as, incorporating endodontic and prosthodontic corrections.
Determinants of Adherence to Antiretroviral Therapy in People Living with HIV, Followed up at Lubumbashi, Democratic Republic of Congo
Authors: Georges Yumba Numbi , Serge Matanda Kapend , Catherine Sarr , Berthe Kamalo Mwad Kon , Thierry Kisoka Kimbungu , Jenny Ndua Tshijik , Patrick Mutombo Tshibang , Dubois Bakona Ilunga , Lievin Kapend A Kalal , Claude Mwamba Mulumba
Published: February 2024

Aims: The aim of the present study was to determine the level of adherence and the factors associated with good adherence to antiretroviral treatment (ART) among people living with HIV (PLHIV).

Study Design:  Cross Sectional Study.

Place and Duration of Study: Internal medicine department (Infectious Diseases Unit), Lubumbashi University Clinics, in Democratic Republic of Congo (DRC), between 15th May 2021 and 17th July 2021.

Methodology:  We included 137 patients (56 men, 81 women; age range 18-70 years) with HIV and, all participants were interviewed on a first-come, first-served basis. The association between factors affecting adherence and the level of adherence was analyzed using a multiple logistic regression model, and odds ratios (ORs) with 95% confidence intervals (CIs) calculated. Among 137 PLHIV, 76.64% had good ART adherence (≥95%). Bivariate analysis revealed numerous factors associated with adherence (P = 0.05). However, in multivariate analysis, being on ART for more than three years and abstinence from alcohol were the factors influencing good ART adherence (P = 0.05).

Results: Among 137 PLHIV, 76.64% had good ART adherence (≥95%). Bivariate analysis revealed numerous factors associated with adherence (P = .05). However, in multivariate analysis, being on ART for more than three years and abstinence from alcohol were the factors influencing good ART adherence (P = .05).

Conclusion: Raising awareness among PLHIV, regular counseling of patients regarding daily intake of antiretroviral drugs and abstinence from alcohol, could contribute to good adherence and long-term success of ART among PLHIV.
Morphometric Analysis of Dachigam Drainage Basin Using Geo-Spatial Technology (GST)
Authors: Pandey Yogesh , Mehraj Nifa , Qureshi Mahrukh , Dadhich Sushmita M. , Shukla Rakesh Mohan
Published: February 2024

The examination of morphometric parameters through quantitative analysis proves highly valuable in assessing river basins, prioritizing watersheds for soil and water conservation, and natural resources management. In this study, an in-depth analysis of the Dachigam Catchment has been conducted, focusing on the quantification of various morphometric parameters. The research employs Geographic Information System (GIS) techniques to assess morphometric parameters in the micro-watersheds of the Dachigam Catchment. Linear and areal morphometric parameters were systematically derived and tabulated based on linear and shape characteristics of drainage channels, utilizing GIS and topographical maps (scale 1:50,000). The morphometric analysis conducted in the Dachigam catchment indicates that the basin has an elongated shape, suggesting that peak discharges would generally exhibit a flat profile and take time to rise. The drainage network within the basin is predominantly of the dendritic type, signifying a degree of homogeneity in texture. The slope analysis shows that the Dachigam watershed has a significant amount of steep terrain, ranging from 0 to 74.63%. The majority of the area falls within the 24 to 35% slope range. Examination of the aspect indicates that slopes oriented towards the south and southwest are the most prevalent in the basin. The watershed's mean bifurcation ratio is 1.71. This low ratio suggests that the watershed hasn't experienced significant distortion. In contrast, high bifurcation ratios exceeding 5 typically indicate distorted drainage patterns. The research illustrates how remote sensing and GIS methods can effectively analyze watershed morphometrics. These techniques offer valuable insights for planners and decision-makers involved in watershed-level planning and drainage basin management.
Enhancing Productivity of Rajma (Phaseolus vulgaris L.) by Managing Soil Acidity and Organic Nutrient Management under Arunachal Hill Conditions
Authors: Chaturvedi Abhimanyu , Chaturvedi SK , Mishra TS , Pandey VK , Sharma Neha
Published: February 2024

A study was conducted at farmers’ field of Tirap District of Arunachal Pradesh to test the effect of organic sources of soil nutrient management with Lime for soil acidity management and for yield improvement of Rajma (Phaseolus vulgaris L.) variety Chitra. The experiment was conducted by following 3 treatments: T1: (Lime @ 350 kg/ ha+ FYM @ 4 t/ha + Neem cake @300 kg/ha+ vermicompost @ 4 t/ha + Azospirillum 10kg/ha, T2: FYM @ 4 t/ha + Neem cake @ 300 kg/ha + vermicompost @ 4 t/ha + Azospirillum 10 kg/ha. T3: (Farmers’ Practice) -FYM + N: P2O5: K2O: 40:20:15 kg/ha (imbalance doses of fertilizers) with 5 replications following randomized block design during 2021-22. From the results it is revealed that T1: (Lime @ 350 kg/ ha+ FYM @ 4 t/ha + Neem cake @300 kg/ha+ vermicompost @ 4 t/ha + Azospirillum 10kg/ha,  had showed significantly higher seed yield (10.2 q/ha), gross return (Rs 1,53,000/), net return (Rs 106,824)  and B:C ratio (2.31), followed by T2 (FYM @ 4 t/ha + Neem cake @ 300 kg/ha + vermicompost @ 4 t/ha + Azospirillum 10 kg/ha),  seed yield 9.3 q yield, Rs. 1,39,500/ gross return, Rs 95,620 net return and 2.17 B:C ratio. While, lowest yield and B:C ratio was recorded (7.1 q/ha, B: C ratio 1.84) with T3 (Farmer’s practice). Moreover, improved soil nutrient status was achieved in T1 followed by T2 and T3.
Synthesis and Characterization of Chitosan Encapsulated Zinc Oxide Nanoparticles and its Application in Maize under Zinc Deficit Soil
Authors: Saraswat Anuj , Ram Shri , Kumar Rajeew , Singh Veer , Singh Virendra , Salar Aakash , Durgude Shubham Anil
Published: February 2024

Zinc deficiency is a growing concern among the global population, and it can be attributed to the depletion of significant portions of agricultural land and the production of foods that are low in zinc. In the current study, an efficiency-centric method of maize cultivation with zinc oxide nanoparticles encapsulated in chitosan (Cs-ZnO NPs) is proposed and evaluated. In order to investigate, NPs were chemically synthesized using process improvement for better size and shape and characterized using Scanning electron microscope (SEM), Energy-dispersive X-ray spectroscopy (EDS) and Transmission electron microscope (TEM). The NPs under characterization showed less than 100 nm diametric globular particles. A field experiment was conducted in randomized block design with six different treatments to study the impact of foliar applied Zn at various concentrations (50, 100, and 150 mg L-1) through Cs-ZnO NPs on plant growth, SPAD and grain yield in maize plant, with respect to foliar ZnSO4 @0.5 %, chitosan @150 mg L-1 and the control.  The highest grain yield of 52.5 q ha-1 in maize was recorded with Zn supplied through Cs-ZnO NPs at 100 mg L-1, compare to other treatments. Similarly significant improvements in plant height and chlorophyll content were noted at 100 mg L-1 Zn through Cs-ZnO NPs. These results indicates that Cs-ZnO NPs can improve grain yield and plant growth performance of maize in a sustainable and efficiency centric manner.
Puerperal Sepsis and its Associated Factors: Review of Cases in a Tertiary Hospital in Jigawa, North-West Nigeria
Authors: Habib Abdullahi Abba , Ibrahim Musa Saulawa , Jabbo Mubarak Abdulkareem
Published: February 2024

Background: Puerperal sepsis is the 3rd leading cause of direct maternal death in developing countries. The case fatality rate of puerperal sepsis was reported to be as high as 8%, and it complicates 1-8% of all deliveries. It is an infection of the genital tract occurring anytime between the rupture of membranes and 42nd day postpartum. 

Objective: The aim of the study was to determine the prevalence of puerperal sepsis and associated factors.

Materials and Methods: This was a retrospective cross-sectional study carried out in the Department of Obstetrics and Gynecology of Rasheed Shekoni Federal University Teaching Hospital. The study participants were all the patients managed for puerperal sepsis during the period under review. The patients” data were collected using a structured proforma from their case files. Data obtained was analyzed with IBM SPSS version 21.0. Measured variables were expressed in descriptive statistics; mean ± SD for normally distributed quantitative variables, median and interquartile range for skewed quantitative variables. Qualitative variables were expressed in percentage and proportions.

Results: The prevalence of puerperal sepsis was of 10.7%.  The mean age of the patients was 25.85 + 7.5. The mean parity was 3.89 + 4.5. Most (74.71%) of the women were unbooked and had home delivery (69.3%). Fever (90.7%) was the most frequent presenting complaints. The commonest (75.0%) organism cultured was staphylococcus aureus. Anemia was the commonest (63.6%) complication.

Conclusion: The prevalence of Puerperal sepsis in this study is high. Low literacy level, unemployment, un-booked status and home delivery were found to be predisposing factors.
Effect of Nitrogen on the Performance of Finger Millet in Eastern Ghat High Land Zone of Odisha, India
Authors: Sial Parshuram , Das Himangshu , Nayak Lalatendu , Behera Biman Ranjan , Panigrahi Debabrata
Published: February 2024

An experiment was conducted to find out performance of finger millet varieties to different levels of nitrogen under rainfed condition in kharif season of 2019 to 2021 at Regional Research and Technology Transfer Station (OUAT), Semiliguda, Koraput, Odisha, India. Four varieties of finger millet (Kalua, OEB- 602, Bhairabi and Arjun) and three different nitrogen levels (40, 60 and 80 kg/ha) along with 30 kg/ha each of phosphorus and potassium were laid out in split-plot design with three replications. The varieties were taken in the main plots and different nitrogen levels were assigned to the sub plots. The results revealed that highest number of tillers (6.1/hill), fingers (8.3/ear head), finger length (8.8 cm) along with maximum grain yield (2491 kg/ha), net return (Rs. 39464 per ha) and B: C ratio (1.94) were obtained with finger millet variety Arjun followed by Bhairabi. The application of 80 kg N/ha gave highest number of tillers (5.7/hill), fingers (7.7/ear head), finger length (8.4 cm) and grain yield (2399 kg/ha) with highest net return (Rs. 36237 per ha) and B: C ratio (1.86). From the present investigation, it can be concluded that finger millet variety Arjun can be grown with application of 80 kg N/ha along with 30 kg/ha each of phosphorus and potassium for maximum yield and economic return.
Postharvest Losses and Management of Horticultural Produce: A Review
Authors: Bisht Abhishek , Singh Sury Pratap
Published: February 2024

Horticultural postharvest losses pose a significant challenge to the supply chain and economic growth, particularly in impoverished nations. This review paper explores the multifaceted issues surrounding postharvest losses in horticultural crops and emphasizes the critical role of technological innovations in mitigating these losses. Various stakeholders within the value chain, including farmers, handlers, and consumers, face substantial risks due to insufficient postharvest handling techniques. The study underscores the urgency of adopting advanced postharvest technologies, focusing on enhanced harvesting and packaging strategies. By using cutting-edge technologies, it is possible to lower losses after harvest and raise the general standard of fresh produce. The improper use of packing materials and inadequate packaging methods significantly contribute to these losses, making it imperative to address these aspects for sustainable solutions. This comprehensive review not only identifies the reason for fruit and vegetable losses after harvesting within the countries but also provides actionable insights into mitigating measures. This article intends to support the creation of a robust and successful horticulture supply chain by addressing the issues and offering workable solutions. The integration of technological advancements in harvesting, handling, and packaging processes emerges as a key element in the overall strategy to reduce postharvest losses and promote economic growth in resource-constrained regions.
Tendência da incidência e características epidemiológicas da leishmaniose visceral em cidade do nordeste do Brasil
Authors: Almeida Barros Ezequiel , Stabnow Santos Floriacy , Maia Pascal Lívia , Siqueira Santos Lívia Fernanda , Dos Santos Leonardo Hunaldo , Santos Neto Marcelino
Published: February 2024

Objetivo: determinar a tendência da incidência e descrever características epidemiológicas dos casos de leishmaniose visceral em Imperatriz – MA no período de 2011 a 2020. Metodologia: estudo observacional descritivo transversal, realizado a partir das notificações compulsórias de casos novos da doença disponíveis via DATASUS. Foram calculados os coeficientes de incidência a cada ano e a análise de tendência foi processada por meio de regressões de Prais-Winsten. As variáveis epidemiológicas foram tratadas por meio da estatistica descritiva. Resultados: Observou-se tendencia estável da incidência, com predomínio dos casos em indivíduos do sexo masculino, faixa etária de 1 a 4 anos, pardos, em idade não escolar, residentes na zona urbana, diagnosticados laboratorialmente, não coinfectados LV/HIV e que evoluíram para a cura. Conclusão: tais achados denotam a importância de programas de vigilância e prevenção direcionadas às populações vulneráveis e capacitação dos profissionais de saúde quanto à notificação, diagnóstico etratamento da doença.
A revolução política da burguesia: a França na obra de Karl Marx antes da Primavera dos Povos
Authors: De Oliveira Maciel Lucas
Published: February 2024

No que diz respeito à França, as reflexões de Karl Marx após a revolução de 1848 dispensam introduções. No entanto, o país foi objeto de análise do pensador mesmo antes da assim chamada Primavera dos Povos. Ao longo da década de 1840, a França aparece nos escritos do autor alemão em íntima conexão com temas políticos como emancipação política, emancipação humana, e a relação entre Estado e classes sociais. O presente trabalho visa elucidar o teor dos textos de Marx sobre a França, em especial sobre a Revolução Francesa, do período entre 1843 e 1846.
Feminismo, teoria da reprodução social e luta de classes: uma leitura estratégica
Authors: Barbosa Pedro Meira Gava Ramos
Published: February 2024

O presente trabalho busca discutir como o feminismo marxista contemporâneo pensa o lugar da luta de classes em meio à relação entre opressão das mulheres e capitalismo. Para tanto, analisamos principalmente as formulações de Cinzia Arruzza, uma referência atual e internacionalmente reconhecida desta vertente. Na primeira parte do trabalho, são recuperadas algumas formulações chave do feminismo materialista francês. Em seguida, ao analisar algumas das teses centrais do feminismo marxista, abordamos as críticas que foram endereçadas ao feminismo materialista e discutimos o lugar conferido para a luta de classes.
Teoria da Reprodução Social: a crise do trabalho reprodutivo educativo no contexto neoliberal e de crise pandêmica no Brasil
Authors: Sampaio Danielle , Pereira José
Published: February 2024

O presente artigo tem por objetivo analisar a Teoria da Reprodução Social, enquanto feminismo marxista que toma o trabalho reprodutivo a base para entender contradições sociais sobre um corte de classe, gênero e raça sobre a ordem do capital. Partindo dessa concepção dialética trataremos de examinar a crise do trabalho reprodutivo, no contexto de avanço das políticas neoliberais e sobre os efeitos da pandemia do Covid-19 sobre a classe trabalhadora brasileira. Em particular, buscando examinar seus reflexos sobre as políticas educacionais, entendendo a educação como parte do Trabalho reprodutivo, portanto, tomando a crise da educação como parte da crise do trabalho reprodutivo.
A Santa Joana dos Matadouros como crítica do modo de representação capitalista: da crítica da alienação religiosa à crítica da economia política
Authors: Campos Lindberg
Published: February 2024

Este artigo é uma leitura da peça A Santa Joana dos Matadouros, de Bertolt Brecht, como um ponto culminante de um processo de experimentação teatral que transitou dos dilemas da representabilidade do capitalismo para a tentativa de forjar meios representacionais apropriados à representação do capital.
Marxismo e a opressão às mulheres: rumo a uma teoria unitária [Lise Vogel]
Authors: Maciel Alien Fernanda
Published: February 2024

Resenha do livro Marxismo e a opressão às mulheres: rumo a uma teoria unitária, de Lise Vogel (Expressão Popular, 2022)
O racismo como arma de produção de hegemonia capitalista couraçada de coerção e a objetividade esmagadora do lugar de negro
Authors: Botelho Jacqueline
Published: February 2024

O presente artigo pretende abordar o racismo como arma de coerção e consenso no capitalismo. Considerando a contribuição de Clóvis Moura, quando afirma que o racismo é arma ideológica de dominação, e analisando a dinâmica do Estado ampliado (sociedade política e sociedade civil) nesta sociedade de classes, concluímos que o racismo, mais que arma ideológica de dominação é arma de produção de hegemonia capitalista, couraçada de coerção. A luta e resistência histórica do povo negro é apresentada neste trabalho como um movimento permanente de aquilombamento que vai do escravismo ao capitalismo dependente no Brasil, se mostrando atual e trazendo contribuições importantes para o avanço das lutas do conjunto da classe trabalhadora.
Clinical features of 78 adults with 22q11 deletion syndrome
Authors: Bassett Anne S. , Chow Eva W.C. , Husted Janice , Weksberg Rosanna , Caluseriu Oana , Webb Gary D. , Gatzoulis Michael A.
Published: October 2005

22q11 Deletion Syndrome (22q11DS) is a common microdeletion syndrome with multisystem expression. Phenotypic features vary with age, ascertainment, and assessment. We systematically assessed 78 adults (36 M, 42 F; mean age 31.5, SD 10.5 years) with a 22q11.2 deletion ascertained through an adult congenital cardiac clinic (n = 35), psychiatric‐related sources (n = 39), or as affected parents of subjects (n = 4). We recorded the lifetime prevalence of features requiring attention, with 95% confidence intervals (CI) not overlapping zero. Subtle learning difficulties, hypernasality and facial gestalt were not included. We investigated ascertainment effects using non‐overlapping subgroups ascertained with tetralogy of Fallot (n = 31) or schizophrenia (n = 31). Forty‐three features met inclusion criteria and were present in 5% or more patients, including several of later onset (e.g., hypothyroidism, cholelithiasis). Number of features per patient (median 9, range 3–22) correlated with hospitalizations (P = 0.0002) and, when congenital features were excluded, with age (P = 0.02). Adjusting for ascertainment, 25.8% (95% CI, 9.5–42.1%) of patients had cardiac anomalies and 22.6% (95% CI, 7.0–38.2%) had schizophrenia. Ascertainment subgroups were otherwise similar in median number and prevalence of features. Non‐characteristic features are common in 22q11DS. Adjusting for ascertainment effects is important. Many treatable conditions may be anticipated and features may accumulate over time. The results have implications for clinical assessment and management, genetic counseling and research into pathophysiological mechanisms. © 2005 Wiley‐Liss, Inc.
Comparison of three comorbidity measures for predicting health service use in patients with osteoarthritis
Authors: Dominick Kelli L. , Dudley Tara K. , Coffman Cynthia J. , Bosworth Hayden B.
Published: October 2005

Objective

To compare the ability of 3 database‐derived comorbidity scores, the Charlson Score, Elixhauser method, and RxRisk‐V, in predicting health service use among individuals with osteoarthritis (OA).

Methods

The study population comprised 306 patients who were under care for OA in the Veterans Affairs (VA) health care system. Comorbidity scores were calculated using 1 year of data from VA inpatient and outpatient databases (Charlson Score, Elixhauser method), as well as pharmacy data (RxRisk‐V). Model selection was used to identify the best comorbidity index for predicting 3 health service use variables: number of physician visits, number of prescriptions used, and hospitalization probability. Specifically, Akaike's Information Criterion (AIC) was used to determine the best model for each health service outcome variable. Model fit was also evaluated.

Results

All 3 comorbidity indices were significant predictors of each health service outcome (P < 0.01). However, based on AIC values, models using the RxRisk‐V and Elixhauser indices as predictor variables were better than models using the Charlson Score. The model using the RxRisk‐V index as a predictor was the best for the outcome of prescription medication use, and the model with the Elixhauser index was the best for the outcome of physician visits.

Conclusion

The Rx‐Risk‐V and Elixhauser are suitable comorbidity measures for examining health services use among patients with OA. Both indices are derived from administrative databases and can efficiently capture comorbidity among large patient populations.
Risk factors for functional limitations in patients with long‐standing ankylosing spondylitis
Authors: Ward Michael M. , Weisman Michael H. , Davis John C. , Reveille John D.
Published: October 2005

Objective

To identify risk factors for functional limitations in patients with ankylosing spondylitis (AS) of at least 20 years' duration.

Methods

Patients with AS for ≥20 years were enrolled in the cross‐sectional component of the Prospective Study of Outcomes in AS. All patients had clinical evaluations and completed questionnaires on functional limitations and potential risk factors. Functional limitations were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI; score range 0–100, higher scores indicate more limitations) and the Health Assessment Questionnaire for the Spondylarthropathies (HAQS). Risk factors included demographic characteristics, duration of AS, smoking status, number of comorbid medical conditions, recalled level of recreational activity in teens and twenties, occupational physical activity throughout life (rated 1 = little, 2 = moderate, 3 = heavy, and weighted by the number of years in each job), and history of AS in a first‐degree relative.

Results

The 326 patients (74% men) had a mean ± SD age of 55.0 ± 10.7 years, a mean duration of AS symptoms of 31.7 ± 10.2 years, and a mean BASFI score of 40.7 ± 25.6. BASFI scores increased with higher lifetime occupational physical activity (r = 0.31; P < 0.0001), the number of comorbid conditions (r = 0.25; P < 0.0001), and the duration of AS (r = 0.12; P = 0.04). BASFI scores were higher among current smokers compared with former/nonsmokers (55.5 versus 38.9; P = 0.0002), and among nonwhites compared with whites (49.9 versus 39.3; P = 0.02). In multivariable analyses, lifetime occupational physical activity, current smoking, education level, number of comorbid conditions, and family history were significantly associated with BASFI scores. The same risk factors were associated with the HAQS.

Conclusion

Functional limitations in patients with AS for ≥20 years are greater among those with a history of more physically demanding jobs, more comorbid conditions, and among smokers, and are less severe among those with higher levels of education and a family history of AS.
Patients' perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored
Authors: Hewlett Sarah , Cockshott Zoë , Byron Margaret , Kitchen Karen , Tipler Sue , Pope Denise , Hehir Maggie
Published: October 2005

Objective

Fatigue is commonly reported by patients with rheumatoid arthritis (RA) but is rarely a treatment target. The aim of this study was to explore the concept of fatigue as experienced by patients with RA.

Methods

Fifteen patients with RA and fatigue (≥7 on a 10‐cm visual analog scale) were individually interviewed and asked about the description, cause, consequence, and management of fatigue. Transcripts were systematically analyzed by 2 researchers independently, relevant phrases were coded, and earlier transcripts were checked for the emerging codes. A random sample of analyses were independently reviewed. A total of 191 codes arising from the data were grouped into 46 categories and overarching themes.

Results

Vivid descriptions reflect 2 types of fatigue: severe weariness and dramatic overwhelming fatigue. RA fatigue is different from normal tiredness because it is extreme, often not earned, and unresolving. Participants described physical, cognitive, and emotional components and attributed fatigue to inflammation, working the joints harder, and unrefreshing sleep. Participants described far‐reaching effects on physical activities, emotions, relationships, and social and family roles. Participants used self‐management strategies but with limited success. Most did not discuss fatigue with clinicians but when they did, they felt it was dismissed. Participants held negative views on the management of fatigue.

Conclusion

The data show that RA fatigue is important, intrusive, and overwhelming, and patients struggle to manage it alone. These data on the complexity of fatigue experiences will help clinicians design measures, interventions, and self‐managment guidance.
Evaluation of the human activity profile for use with persons with arthritis
Authors: Bilek Laura D. , Venema Dawn M. , Camp Kristine L. , Lyden Elizabeth R. , Meza Jane L.
Published: October 2005

Objective

To investigate the reliability, validity, and responsiveness to change of the Human Activity Profile (HAP), a questionnaire measuring physical activity, in persons with arthritis.

Methods

Twenty‐eight subjects completed the following self‐report questionnaires: HAP, Modified Health Assessment Questionnaire, Medical Outcomes Study 36‐Item Short Form Health Survey, and Arthritis Impact Measurement Scale 2. Subjects also completed a submaximal treadmill test, Timed‐Stands Test, and 50‐Foot Walk Test. Responses on the HAP resulted in 2 scores: the maximum activity score (MAS) and the adjusted activity score (AAS). These scores were correlated with the other tests and examined for test‐retest reliability. A subset of subjects participated in a 12‐week exercise program, repeating the same tests when finished.

Results

For all subjects, the intraclass correlation coefficient (ICC) was 0.76 for the MAS and 0.87 for the AAS. Significant correlations were found between the HAP scores and the questionnaires, submaximal treadmill test, Timed‐Stands Test, and 50‐Foot Walk Test. In response to 12 weeks of exercise, both HAP scores had an effect size of 0.5, similar to that of the other questionnaires.

Conclusion

The ICCs demonstrate that the HAP is reliable, and the correlations between the HAP and other questionnaires, Timed‐Stands Test, and 50‐Foot Walk Test demonstrate that the HAP is a valid measure of physical function in persons with arthritis. The HAP's correlation with maximum oxygen consumption estimated by the treadmill test validates it as a measure of physical activity. The medium effect size (0.5) demonstrates that the HAP is moderately responsive to change. Its ease of use and broad scope make it a valuable assessment tool for persons with arthritis.
Pericarditis associated with nickel hypersensitivity to the Amplatzer occluder device: A case report
Authors: Lai Dominic W. , Saver Jeffrey L. , Araujo Jesus A. , Reidl Marc , Tobis Jonathan
Published: October 2005

A 38‐year‐old man with a history of migraine headaches with aura and one episode of ischemic stroke was found to have a patent foramen ovale (PFO). After percutaneous closure with the nickel‐containing Amplatzer PFO occluder, the patient developed pericarditis, atrial fibrillation, and increased migraine headaches with aura that abated with oral prednisone. He tested positive for nickel hypersensitivity, which we conclude is the likely etiology of his pericarditis. © 2005 Wiley‐Liss, Inc.
Treatment of ischemic stroke complicating cardiac catheterization with systemic thrombolytic therapy
Authors: Serry Rod , Tsimikas Sotirios , Imbesi Steven G. , Mahmud Ehtisham
Published: October 2005

Ischemic stroke is a rare but serious complication of cardiac catheterization. We report a case in which systemic thrombolytic therapy was successfully utilized in treating a patient with a cerebellar stroke, leading to obtundation during elective cardiac catheterization. Underlying bilateral vertebrobasilar disease with thrombotic embolization to the basilar artery was postulated to be the pathophysiological basis for the stroke and subsequent success of thrombolytic treatment in this patient. As the consequences of this rare complication are severe, systemic thrombolytic therapy should be considered for patients suffering an acute ischemic stroke during cardiac catheterization or percutaneous coronary intervention. © 2005 Wiley‐Liss, Inc.
Prospective assessment of hemodialysis access patency after percutaneous intervention: Cox proportional hazards analysis
Authors: Bittl John A. , Feldman Robert L.
Published: October 2005

Vascular access failure is the greatest limitation of successful hemodialysis, but the factors associated with long‐term patency have not been fully elucidated. Outcomes in a consecutive series of 294 thrombosed or failing accesses [128 fistulas (43.5%) and 166 grafts (56.5%) in 179 patients] were analyzed with life table and multivariable Cox proportional hazards analysis. Initial success was achieved in 275 of 294 accesses (95.6%). The median patency after intervention was 206 days (interquartile range, 79–457 days). Fistulas had longer median patency after intervention than grafts (286 vs. 170 days). Nonthrombosed accesses had longer median patency than thrombosed accesses (238 vs. 136 days), but thrombosed fistulas had similar median patency as thrombosed grafts (140 vs. 136 days). The selective use of stents as a bailout for failed balloon dilatation did not significantly reduce long‐term patency (196 days for stented accesses vs. 210 days for unstented accesses). Long‐term patency was inversely related to final access pressure, but access patency was not related to the presence of central venous occlusions, graft age, patient age, sex, or diabetes. Catheter‐based intervention of thrombosed and failing dialysis accesses significantly prolongs patency and usefulness of dialysis accesses. The expanding use of fistulas, improved detection of early access failure, and selective use of bailout stents should enhance long‐term access patency. © 2005 Wiley‐Liss, Inc.
A Macrocycle/Molecular‐Clip Complex that Functions as a Quadruply Controllable Molecular Switch
Authors: Chiang Pinn‐Tsong , Cheng Pin‐Nan , Lin Chi‐Feng , Liu Yi‐Hung , Lai Chien‐Chen , Peng Shie‐Ming , Chiu Sheng‐Hsien
Published: October 2005

Herein, we report the synthesis of a molecular clip with TTF side‐walls and its binding behavior towards electron‐deficient guests, namely the formation of macrocycle/molecular‐clip supramolecular complexes in solution. Four different sets of external stimuli—the K+/[2.2.2]cryptand, NH4+/Et3N and (p‐BrPh)3NSbCl6/Zn pairs, and heating/cooling cycles—control the movement of this molecular switch between its threaded and unthreaded states and provide color changes that are observable by the naked eye. This macrocycle/molecular‐clip complex system can be considered not only as a quadruple‐use molecular switch, but can also be operated by three of these stimuli as a three‐input molecular NOR‐functioning logic gate that may be monitored by UV‐visible spectroscopy.
Rastertunnelmikroskopie an chiralen Molekülen: Nanochemie
Authors: Böhringer Matthias , Berndt Richard , Schneider Wolf‐Dieter
Published: October 2005

Mit dem Rastertunnelmikroskop (RTM) können Atome und Moleküle auf Oberflächen direkt abgebildet und gezielt manipuliert werden. Damit ermöglicht das RTM eine Chemie auf Nanometerskala basierend auf Experimenten an Einzelmolekülen. Am Beispiel des 1‐Nitronaphthalin beschreiben wir Elemente einer Stereochemie an Einzelmolekülen. 1‐Nitronaphthalin nimmt bei Adsorption auf der Au(111) Oberfläche eine chirale Konfiguration an. Hochaufgelöste RTM‐Bilder spiegeln die asymmetrische elektronische Struktur der Moleküle wider und ermöglichen die Bestimmung der absoluten Konfiguration jedes einzelnen Moleküls in komplexen Überstukturen. Auf diese Weise lassen sich stereochemische Phänomene wie strukturelle Übergänge von chiralen in achirale Phasen unmittelbar beobachten. Schließlich zeigen wir, dass chirale Strukturen mit dem RTM auch gezielt manipuliert werden können und trennen eine racemische Mischung chiraler 1‐Nitronaphthalin‐Aggregate in die enantiomerenreinen Komponenten.
Organische Leuchtdioden: Bilderzeugung
Authors: Hertel Dirk , Müller Christoph David , Meerholz Klaus
Published: October 2005

Der vorliegende Artikel beschreibt den aktuellen Stand der Erforschung und Anwendung organischer Festkörper in Leuchtdioden. Im Fokus stehen dabei konjugierte Polymere als aktive Komponenten. Es werden wesentliche Grundlagen zur elektronischen Struktur von organischen Materialien erläutert, die zum Verständnis der Funktionsweise organischer Leuchtdioden hilfreich sind, bevor Herstellungsaspekte, Materialentwicklung und Bauteilgestaltung dargelegt werden.
Protein‐Qualitätskontrolle
Authors: Feil Sylvia
Published: October 2005

Falsch gefaltete Proteine können neurodegenerative Erkrankungen auslösen. In Nervenzellen wurde nun das Hilfsmolekül HSJ1 entdeckt, das die fehlerhaften Proteine erkennt und sie einem Abbau über das Proteasom zuleitet.
Lebensgrundlage Methan
Authors: Brückmann Warner , Niemann Helge
Published: October 2005

Am pazifischen Kontinentalrand vor Zentralamerika, an dem die ozeanische Platte unter die Landbrücke Mittelamerikas subduziert, treten an submarinen Kuppen und Hangrutschungen Methan und Fluide aus dem Erdinneren aus. Anders als auf dem Land und in der lichtdurchfluteten Zone des Meeres, wo das Leben von der Sonne abhängig ist, bildet hier Methan die Lebensgrundlage für eine große Biomasse von chemosynthetischen Organismen.
Proposal for revision of the TNM classification system for renal cell carcinoma
Authors: Ficarra Vincenzo , Guillè François , Schips Luigi , de la Taille Alexander , Galetti Tommaso Prayer , Tostain Jacques , Cindolo Luca , Novara Giacomo , Zigeuner Richard , Bratti Emiliano , Li Guorong , Altieri Vincenzo , Abbou Claude C. , Zanolla Luisa , Artibani Walter , Patard Jean‐Jacques
Published: October 2005

BACKGROUND

The current study defined an optimal tumor size breakpoint to stratify localized renal cell carcinoma (RCC) into groups with significantly different cancer‐related outcomes and proposed a revision of the TNM classification system.

METHODS

The authors analyzed the data from 1138 patients who had undergone partial or radical nephrectomy for localized RCC at 7 European urologic centers. The optimal pathologic size breakpoint was calculated using the martingale residuals from a Cox proportional hazards regression model.

RESULTS

The mean follow‐up time was 87 months. The scatterplot of tumor size versus expected risk of death per patient suggested that an interval of 5–6 cm was appropriate. A total of 720 (63.3%) and 418 (36.7%) patients had tumors measuring ≤ 5.5‐cm and tumors measuring > 5.5‐cm, respectively. Significant cancer‐specific survival differences between the two groups of patients were reported in the series by all the centers participating in the study. On univariate analysis, the other variables found to be associated with cancer‐specific survival were the patient's age, symptomatic tumor presentation, and the Fuhrman nuclear grade. On multivariate analysis, the pathologic stage of the primary tumor defined according to the 5.5‐cm breakpoint was found to be an independent predictor of cancer‐specific survival, as well as age, mode of presentation, and nuclear grade. According to the multivariate analysis, the authors clustered patients into 3 groups with statistically significant outcome differences: 1) patients with ≤ 5.5‐cm incidentally detected RCC; 2) patients with ≤ 5.5‐cm symptomatic RCC; and 3) patients with > 5.5‐cm RCC. This cancer‐related outcome stratification was valid regardless of the patient's age.

CONCLUSIONS

The 5.5‐cm breakpoint was found to be the optimal tumor size breakpoint with which to stratify patients with organ‐confined RCC. The study supported the upgrade of the TNM classification system according to this breakpoint. Cancer 2005. © 2005 American Cancer Society.
Costimulatory molecule B7‐H1 in primary and metastatic clear cell renal cell carcinoma
Authors: Thompson R. Houston , Gillett Michael D. , Cheville John C. , Lohse Christine M. , Dong Haidong , Webster W. Scott , Chen Lieping , Zincke Horst , Blute Michael L. , Leibovich Bradley C. , Kwon Eugene D.
Published: October 2005

BACKGROUND

Cancer cell expression of costimulatory molecule B7‐H1 has been implicated as a potent inhibitor of T‐cell–mediated antitumoral immunity. The authors recently reported that B7‐H1 is aberrantly expressed in primary renal cell carcinoma (RCC). Blockade of B7‐H1, as demonstrated in several murine cancer models, now represents a promising therapeutic target in RCC. However, the potential expression of B7‐H1 in metastatic RCC has not been investigated. In the current study, the authors updated their primary RCC results with additional follow‐up and investigated the potential role of B7‐H1 in metastatic RCC.

METHODS

Between 2000 and 2004, 196 patients underwent nephrectomy and 26 patients had resection of RCC metastases for clear cell RCC. Immunohistochemical analysis was performed on tumor cryosections using a B7‐H1 monoclonal antibody (clone 5H1). A urologic pathologist quantified the percentage of B7‐H1–positive tumor cells and lymphocytes.

RESULTS

Variable levels of B7‐H1 were expressed on primary RCC tumor cells (n = 130 [66.3%]) and primary tumor‐infiltrating lymphocytes (n = 115 [58.7%]). Patients with high expression of B7‐H1 on primary tumor cells and/or lymphocytes were significantly more likely to die of RCC compared with patients with low B7‐H1 expression (risk ratio [RR] = 4.17; 95% confidence interval [95% CI], 1.97–8.84; P < 0.001) and this risk persisted in multivariate analysis after adjusting for the Mayo Clinic stage, size, grade, and necrosis score (RR = 2.63; 96% CI, 1.23–5.64; P = 0.013). Of the 26 metastatic specimens, cancer cell and lymphocyte B7‐H1 expression were demonstrated in 17 (65.4%) and 18 (69.2%) specimens, respectively. In total, 14 (54.3%) metastatic specimens had high aggregate B7‐H1 levels compared with 44.4% in primary RCC specimens.

CONCLUSIONS

Patients with RCC with high B7‐H1 expression were significantly more likely to die even after multivariate analysis. The authors also demonstrated that a high percentage of RCC metastases similarly harbored B7‐H1. The authors surmised that B7‐H1 blockade may augment current immunotherapy, including patients treated for metastases after cytoreductive nephrectomy. Cancer 2005. © 2005 American Cancer Society.
Inactivation of PTEN is associated with a low p27Kip1 protein expression in breast carcinoma
Authors: Tsutsui Shinichi , Inoue Hiroshi , Yasuda Kazuhiro , Suzuki Kosuke , Tahara Kouichirou , Higashi Hidefumi , Era Shoichi , Mori Masaki
Published: October 2005

BACKGROUND

It was previously demonstrated that PTEN protein expression is reduced in 67 of 236 (28%) breast carcinomas. Recent experimental studies suggested that the cell cycle inhibitor p27Kip1 (p27) is a downstream mediator through which PTEN negatively regulates cell cycle progression.

METHODS

The immunohistochemic expression of p27 and PTEN protein expression was evaluated in a series of 228 invasive ductal carcinomas of the breast.

RESULTS

PTEN protein expression was found to have decreased in 65 of 228 (29%) cases, while the nuclear accumulation of p27 protein was low in 99 of 228 (43%) cases. A reduced PTEN protein expression correlated significantly (P = 0.0214) with a low p27 protein expression. Univariate analysis indicated that the patients demonstrating a combined decrease in PTEN and p27 protein expression have a significantly (P = 0.0044) worse disease‐free survival (DFS) than those with other combinations of these two protein expression patterns, while multivariate analysis indicated that the lymph node status, MIB‐1 counts, and the combination of PTEN/p27 protein expression (P = 0.0452) are independently significant prognostic factors for DFS.

CONCLUSIONS

A reduced PTEN protein expression correlated significantly with a low p27 protein expression in breast carcinoma. The finding that the patients with a combined decrease in both protein expressions had a poor prognosis thus suggests that a combined loss of PTEN and p27 function is associated with an aggressive phenotype in breast carcinoma. Cancer 2005. © 2005 American Cancer Society.
Fine structure of the zeros of orthogonal polynomials III: Periodic recursion coefficients
Authors: Simon Barry
Published: October 2005

We discuss asymptotics of the zeros of orthogonal polynomials on the real line and on the unit circle when the recursion coefficients are periodic. The zeros on or near the absolutely continuous spectrum have a clock structure with spacings inverse to the density of zeros. Zeros away from the a.c. spectrum have limit points mod p and only finitely many of them. © 2005 Wiley Periodicals, Inc.
The results of the expression array studies correlate and enhance the known genetic basis of gastric and colorectal cancer
Authors: Galamb Orsolya , Sipos Ferenc , Fischer Krisztina , Tulassay Zsolt , Molnar Bela
Published: October 2005

Gastric and colorectal cancers belong to the most frequent cancer types in the world today. This fact emphasizes the importance of identification of useful diagnostic and prognostic markers, in the earliest stage of the disease. The examination of gene expression profile in gastric and colorectal cancer may develop the bases of early diagnosis and of individual therapeutic strategies. In the microarray examinations done so far for these types of cancers, the expression of hundreds and thousands of genes were studied, however, both the sample collection and the results showed wide variations. The diversity of expression array methods and data analysis makes the comparison of microarray results difficult. Beside the exposition of the practical aspects of the chip technology, our aims are the systematization of data that are currently available in the international scientific literature and the description of the results in a comprehensive way. Microarray results show that the gene expression pattern, detected in gastric and colon cancers, highly depends on the histological type and heterogeneity of the sample, array type, and softwares, used for data analysis. Recent experiments point out not just the changes of the alterations of tumor suppression, apoptosis, cell‐cycle regulation, and signal transduction, but tumor cell metabolism and cell‐microenvironment interactions also. Results show connection to and make more complete the already known molecular background of gastric and colorectal cancers. Based on the accumulation of recent and further data, such kind of multifunctional diagnostic microarrays that can be suited for completing the conventional histological diagnostics and subtypization will certainly become available in the near future. © 2005 Wiley‐Liss, Inc.
Synthesis and Linear Optical Properties of Tris(catecholato)metal(III,IV) Complexes with Acceptor‐Substituted Ligands
Authors: Kriegisch Volker , Lambert Christoph
Published: October 2005

The synthesis of C3‐symmetric chromophores (2–4, 9, 10, 14) with acceptor‐substituted catecholato ligands and different central metal atoms (Si, Al, Ti) is described. These complexes might serve as octupolar chromophores with first‐order nonlinear optical properties. UV/Vis spectroscopic investigations show a red‐shift of the lowest‐energy charge‐transfer band on going from SiIV, AlIII to TiIV complexes, dependent on the increasing ionic character of the M–O bond. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)