bluuebunny/crossref_metadata_2025 huggingface dataset:
Validity and Reliability of Nutrition Screening Administered by Nurses
Authors: Lim Su Lin , Ang Emily , Foo Yet Li , Ng Lian Ye , Tong Chung Yan , Ferguson Maree , Daniels Lynne
Published: October 2013

Background: Nutrition screening is usually administered by nurses. However, most studies on nutrition screening tools have not used nurses to validate the tools. The 3‐Minute Nutrition Screening (3‐MinNS) assesses weight loss, dietary intake, and muscle wastage, with the composite score of each used to determine risk of malnutrition. The aim of the study was to determine the validity and reliability of 3‐MinNS administered by nurses, who are the intended assessors. Methods: In this cross‐sectional study, 3 ward‐based nurses screened 121 patients aged 21 years and over using 3‐MinNS in 3 wards within 24 hours of admission. A dietitian then assessed patients' nutrition status using Subjective Global Assessment within 48 hours of admission, while blinded to the results of the screening. To assess the reliability of 3‐MinNS, 37 patients screened by the first nurse were rescreened by a second nurse within 24 hours, who was blinded to the results of the first nurse. The sensitivity, specificity, and best cutoff score for 3‐MinNS were determined using the receiver operator characteristics curve. Results: The best cutoff score to identify all patients at risk of malnutrition using 3‐MinNS was 3, with sensitivity of 89% and specificity of 88%. This cutoff point also identified all (100%) severely malnourished patients. There was strong correlation between 3‐MinNS and SGA (r = .78, P < .001). The agreement between 2 nurses conducting the 3‐MinNS tool was 78.3%. Conclusion: The 3‐MinNS is a valid and reliable tool for nurses to identify patients at risk of malnutrition.
Risks and Benefits of Prophylactic Cyclic Parenteral Nutrition in Surgical Neonates
Authors: Nghiem‐Rao T. Hang , Cassidy Laura D. , Polzin Elizabeth M. , Calkins Casey M. , Arca Marjorie J. , Goday Praveen S.
Published: October 2013

Background: Cyclic parenteral nutrition (PN) is used for both the treatment and prevention of parenteral nutrition–associated liver disease (PNALD). Early initiation of prophylactic cyclic PN may not be well tolerated in young neonates. Our objective was to test the hypothesis that prophylactic cyclic PN initiated prior to the onset of hyperbilirubinemia is associated with younger age at initiation, lower bilirubin levels, and similar rates of adverse events compared to therapeutic cyclic PN initiated after established cholestasis in surgical neonates. Methods: A retrospective review of infants with gastrointestinal disorders requiring surgical intervention who received cyclic PN 2006‐2011 was performed. Results: Of the 43 infants eligible for analysis, 23 received prophylactic and 20 received therapeutic cyclic PN. Infants in both groups were comparable in demographics, surgical diagnoses, and illness severity. At initiation of cyclic PN, infants with prophylactic cyclic PN were significantly younger in chronologic (P = .003) and postmenstrual age (P = .029). Prophylactic cyclic PN was associated with a significantly lower incidence of hyperbilirubinemia (P = .001), lower maximum conjugated bilirubin (P < .0001), and lower last checked conjugated bilirubin (P = .032) compared to the therapeutic cyclic PN. The incidence of hypoglycemia, hyperglycemia, and hypertriglyceridemia was similar for the 2 groups. Conclusions: There may be a potential benefit to initiating cyclic PN prior to the development of hyperbilirubinemia in surgical neonates. Early initiation of prophylactic cyclic PN does not appear to increase the risk for adverse events.
Cell-free cartilage engineering approach using hyaluronic acid–polycaprolactone scaffolds: A study in vivo
Authors: Lebourg M , Martínez-Díaz S , García-Giralt N , Torres-Claramunt R , Ribelles JL Gómez , Vila-Canet G , Monllau JC
Published: October 2013

Polycaprolactone scaffolds modified with cross-linked hyaluronic acid were prepared in order to establish whether a more hydrophilic and biomimetic microenvironment benefits the progenitor cells arriving from bone marrow in a cell-free tissue-engineering approach. The polycaprolactone and polycaprolactone/hyaluronic acid scaffolds were characterized in terms of morphology and water absorption capacity. The polycaprolactone and polycaprolactone/hyaluronic acid samples were implanted in a chondral defect in rabbits; bleeding of the subchondral bone was provoked to generate a spontaneous healing response. Repair at 1, 4, 12, and 24 weeks was assessed macroscopically using the International Cartilage Repair Society score and the Oswestry Arthroscopy Score and microscopically using immunohistological staining for collagen type I and type II, and for Ki-67. The presence of hyaluronic acid improves scaffold performance, which supports a good repair response without biomaterial pre-seeding.
The Temporal Evolution of Proactiveness in Family Firms
Authors: De Massis Alfredo , Chirico Francesco , Kotlar Josip , Naldi Lucia
Published: October 2013

We extend prior work on proactiveness in family firms by examining the relationship between firm age and proactiveness. Specifically, we propose an S-shaped effect of aging of family firms on proactiveness. Additionally, we provide a contingency perspective by considering the moderating role of the dispersion of managerial control among family members. Using a sample of Swiss family firms, we find that proactiveness first declines, then increases, and finally decreases again as the family firm ages, and that this relationship is steeper when the managerial control is dispersed among multiple family members.
Emotional Economic Man: Power and Emotion in the Corporate World
Authors: Andrade Daniel Pereira
Published: October 2013

This article maps out the genealogy of the anthropological concept of emotional economic man, which emerged in the 1990s tied to the concept of emotional capital. Analysis of the discourse about emotional capital in management and neoliberal economics explains how economic man is linked to emotions and how the management of emotional capital creates an emotional power (or ‘pathospower’) that is manifested in three main corporate dispositifs: emotional intelligence, organizational culture and the commercialization of experiences. These power dispositifs have led to unprecedented cohesiveness in the construction of workers’ and consumers’ emotional lives, introducing the management logos as rationality over emotions. Emotions are converted into a vehicle through which power penetrates bodies and subjectivities, sustains active economic conducts, imposes corporate goals for life and disseminates the logic of capital. This emotional power is part of the history of the ways that people feel in contemporary societies.
Impact of the Fracture Risk Assessment on Patient and Physician Behavior in Osteoporosis Prevention
Authors: McConaha Jamie L. , Berdine Hildegarde J. , Skomo Monica L. , Laux Robert V. , Higginbotham Suzanne K. , O'Neil Christine K.
Published: October 2013

Objective:

To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior.

Methods:

Postmenopausal women 45 to 65 years with Achilles T score <−1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants.

Results:

A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups ( P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity.

Conclusion:

Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.
After trafficking: Togolese girls’ orientations to life in a West African city
Authors: Buchbinder Liza
Published: October 2013

This article offers an alternative explanation for why people “traffic” their children from Togo into Nigeria. Rather than explain parents’ motivations for sending their children to work as domestic servants as an escape from poverty (per the human rights discourse) or a rite of passage into adulthood (as described by informants), I argue that it is rooted in a future-oriented strategy of survival in an age of economic decline. Instead of a means towards short-term profits, the practice delivers on a different imaginary of the future for post–Cold War Togolese, where the most common strategy for success is to leave the country. To track this shifting sensibility, this article presents the cultural styles of Togolese girls living in Lagos after they have been “trafficked” and categorizes them into two figures: the cosmopolitanist and the localist. These styles of living are emblematic of different orientations toward the future with respect to investments in city or “local” relations. Despite the terms “cosmopolitanist” and “localist,” these types are not spatially bound, rather they reflect young migrants’ refusal or commitment to the value constraints of rural society, as manifested in their choice of dress, companions, leisure activities, and so on.
The Burmese traffic-jam explored: Changing dynamics and ambiguous reforms
Authors: Feingold David A
Published: October 2013

Burma/Myanmar has been the epicenter of human trafficking and unsafe migration in mainland Southeast Asia. While “root causes” of trafficking are always complex, clearly, counter-productive agricultural and tax policies, political repression, military actions, and widespread human rights violations are heavily implicated in the underlying political ecology of trafficking/unsafe migration. Burma has been the embodiment of an “ethnocratic state,” in that the majority ethnic group in the country seeks to both dominate and exclude minorities. One result is that ethnic minorities have been disproportionately represented among irregular migrants and those most at risk of trafficking. Today, reforms are taking place in Burma. An eager international community embraces an optimism that may be the triumph of hope over experience. Yet Aung San Suu Kyi has warned of the dangers of “reckless optimism.” This paper examines the dynamics of trafficking in Burma and the possible implications of the current reform process.
Human trafficking and challenges to States’ compliance with International Human Rights Law: The case of Brazil
Authors: Gueraldi Michelle
Published: October 2013

This article identifies some challenges faced by the Brazilian State in eradicating human trafficking. International Human Rights Law is the instrument I adopt as a conceptual paradigm for analysis of the State’s conduct, arguing that Brazilian National Policy implemented since 2008 does not meet the preventative needs, the repression of perpetrators, nor victim protection as proposed by International Human Rights Law. The conduct of State powers shows that human trafficking is still conceived as a criminal offense, rather than as a human rights violation. Existing published Brazilian studies commonly approach human trafficking in terms of criminal law. I analyze it under the umbrella of International Human Rights Law, disassociating human trafficking from an exclusively feminist approach, and describing it in terms of a global human rights violation pattern related to international migration flows. I emphasize some interior legal concepts commonly overlooked by juridical doctrine, such as vulnerability and exploitation, with attention to cultural attitudes that help determine policy.
Borders, buscones, brothels, and bi-national markets: Haitian women negotiate how to get through
Authors: Petrozziello Allison J , Wooding Bridget
Published: October 2013

The 2010 earthquake and cholera outbreak in Haiti have given a push to women’s migration to the Dominican Republic, and risk of being trafficked. Employing a feminist ethnographic approach, this case study examines the experiences of Haitian women and girls in the Dominican border town of Comendador, Elías Piña, to understand the choices and calculated risks they take in order to “get through.” The authors situate trafficking within a spectrum of violence against women along a border marked by radically asymmetrical power relations, and call for coordinated social interventions beyond law enforcement that guarantee effective protection in the cross-border context.
Atazanavir and chest pain
Authors: Phillips Matthew , Saxon Cara , Lee Vincent
Published: October 2013

We present a case of a 41-year-old man complaining of chest pain, which he directly attributed to his antiretrovirals, specifically atazanavir and ritonavir. The chest pain resolved on stopping the treatment, and recurred when atazanavir was restarted, again resolving on discontinuation. Cardiovascular risk factors are an important consideration with any antiretroviral therapy but particularly with protease inhibitors. The association between atazanavir and cardiac arrhythmias has been reported elsewhere including the British National Formulary, and it may be good practice to perform electrocardiogram assessments in patients commencing and using atazanavir-based regimens.
Toxoplasma encephalitis in an HIV-infected patient on highly active antiretroviral therapy despite sustained immune response
Authors: Atreya Auras R , Arora Sonali , Gadiraju Vijay T , Martagon-Villamil José , Skiest Daniel J
Published: October 2013

Toxoplasma encephalitis (TE) is usually diagnosed in advanced stages of HIV infection when the CD4+ count is <100–200 cells/µl. A 55-year-old woman with HIV/AIDS, well controlled on antiretroviral therapy (ART), CD4+ count in the 300 cells/μl range for >1 year presented with acute onset of headache, nausea and vomiting. She had been on her current ART regimen consisting of raltegravir, co-formulated emtricitabine/tenofovir and etravirine for three years and had been off Pneumocystis prophylaxis for 10 months (trimethoprim-sulfamethoxazole). Brain MRI showed multiple ring-enhancing, supratentorial and infra-tentorial parenchymal lesions suspicious for metastases. She had no other evidence of metastatic disease in her body. The possibilities of TE and primary CNS lymphoma were considered but deemed unlikely given the high CD4+ count. A brain biopsy demonstrated Toxoplasma tachyzoites. There was no evidence of lymphoma or carcinoma. Anti-toxoplasma treatment yielded good initial clinical and radiographic responses. While on TE maintenance therapy, she developed similar symptoms. Repeat MRI showed progression of lesions. Further work-up including CSF Epstein-Barr virus PCR and SPECT Th 201 imaging was not conclusive for CNS lymphoma. The patient’s clinical condition deteriorated and she died. We postulate that functional immunological dysfunction is a possible mechanism by which our patient developed TE despite demonstrating sustained immune response on ART.
Bringing testing to the people – benefits of mobile unit HIV/syphilis testing in Lima, Peru, 2007–2009
Authors: Lipsitz Mindy C , Segura Eddy R , Castro José Luis , Smith Edward , Medrano Carlos , Clark Jesse L , Lake Jordan E , Cabello Robinson
Published: October 2013

Mobile unit (MU) HIV testing is an alternative method of providing healthcare access. We compared demographic and behavioural characteristics, HIV testing history and HIV prevalence between participants seeking testing at a MU vs. fixed clinic (FC) in Lima, Peru. Our analysis included men and transgender women (TW) in Lima aged ≥ 18 years old seeking HIV testing at their first visit to a community-based MU or FC from October 2007 to November 2009. HIV testing history, HIV serostatus and behavioural characteristics were analysed. A large percentage of MU attendees self-identified as transgender (13%) or heterosexual (41%). MU attendees were more likely to engage in transactional sex (24% MU vs. 10% FC, p < 0.001), use alcohol/drugs during their last sexual encounter (24% MU vs. 20% FC, p < 0.01) and/or be a first-time HIV tester (48% MU vs. 41% FC, p < 0.001). MU HIV prevalence was 9% overall and 5% among first-time testers (49% in TW and 11% in men who have sex with men [MSM] first-time testers). MU testing reached large numbers of at-risk (MSM/TW) populations engaged in unsafe sexual behaviours, making MU outreach a worthy complement to FC testing. Investigation into whether MU attendees would otherwise access HIV testing is warranted to determine the impact of MU testing.
Diosbulbin B-induced liver injury in mice and its mechanism
Authors: Ma Yibo , Niu Chengwei , Wang Junming , Ji Lili , Wang Zhengtao
Published: October 2013

Dioscorea bulbifera L., a commonly used medicinal plant in China, is reported to induce hepatotoxicity. The present study is undertaken to investigate the hepatotoxicity induced by diosbulbin B (DB), a diterpene lactone isolated from D. bulbifera L., and to further explore its underlying mechanism. DB was administered to mice at the doses of 0, 16, 32, and 64 mg/kg once daily for 12 consecutive days. Liver injury induced by DB was evidenced by the increased activity of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Liver histological evaluation showed that the mice treated with DB exhibited liver damage with the swelling of hepatocytes. Further results showed that the amount of malondialdehyde (MDA) in the liver was increased in mice treated with DB, while the glutathione amount and the enzymatic activity of glutathione peroxidase (GPx), glutathione-S-transferase (GST), copper/zinc–superoxide dismutase (CuZn-SOD), manganese-SOD (Mn-SOD), and catalase (CAT) were all decreased. DB also decreased the gene expression of CuZn-SOD and CAT. Taken together, our results indicate that oral administration of DB for 12 consecutive days can lead to the oxidative stress liver injury in mice.
The effects of vitamin B6 on lens antioxidant system in valproic acid-administered rats
Authors: Tunali S
Published: October 2013

Valproic acid (VPA, 2-propyl pentanoic acid) is a broad-spectrum antiepileptic drug (AED) and is commonly used in the treatment of bipolar disorders and epilepsy. AEDs are known to result in vascular disturbances. Vitamin B6 (Vit B6) is water soluble vitamin essential for normal growth, development, and metabolism. In this study, we aimed to investigate the protective effects of Vit B6 against VPA-induced lens damage in experimental animals. In this study, male 4-month-old, Sprague-Dawley rats were used. The animals were divided into four groups. Group I was intact control animals. Group II rats were administered with Vit B6 (50 mg/kg/day) for 7 days. Group III rats were administered with only VPA (500 mg/kg/day) for 7 days. Group IV was given VPA + Vit B6 (in a same dose and time). Vit B6 was given to rats by gavage and VPA was given by intraperitoneally. On the 8th day of experiment, all of the animals were fasted overnight and then killed under ether anesthesia. Lens tissues were taken from animals, homogenized in 0.9% saline to make up a 10% homogenate. The homogenates was used for glutathione (GSH), lipid peroxidation (LPO), protein levels, and enzyme analysis. In VPA groups, levels of lens GSH and LPO and activities of glutathione- S-transferase, glutathione peroxidase, glutathione reductase, and aldose reductase were increased, while superoxide dismutase activity was decreased. Treatment with Vit B6 reversed these effects. These results demonstrated that administration of Vit B6 is potentially beneficial agent to reduce the lens damage in VPA toxicity, probably by decreasing oxidative stress.
Nuclear factor erythroid 2-related factor gene variants and susceptibility of arsenic-related skin lesions
Authors: Cordova EJ , Valenzuela OL , Sánchez-Peña LC , Escamilla-Guerrero G , Hernández-Zavala A , Orozco L , Razo LM Del
Published: October 2013

Inorganic arsenic (iAs) is an important pollutant associated with various chronic-degenerative diseases. The cytoprotective protein nuclear factor erythroid 2-related factor (NRF2) has been proposed as an important responsive mechanism against iAs exposure. The aim of this study was to determine whether the risk of skin lesions in people exposed to iAs-contaminated water could be modified by the presence of single nucleotide polymorphisms in the NRF2 coding gene. We studied 117 individuals with long-term iAs exposure and 120 nonexposed individuals. Total As was determined in water, meanwhile iAs and its metabolites were measured in urine. The iAs-induced skin lesion status was evaluated by expert dermatologists. We sequenced the promoter region of NRF2 in a sample of 120 healthy donors. We found four polymorphisms previously reported and one novel polymorphism in the 5′ regulatory region of the NRF2. In this study, we did not find allelic and genotype association of NRF2 polymorphisms with iAs-related skin lesion. However, the analysis of haplotypes composed by –653GA, and –617CA NRF2 single nucleotide polymorphisms showed a significant association with protection against skin lesions in the low-As exposure group. This is the first report studying the association between NRF2 polymorphisms and susceptibility of As-related skin lesions. Increasing the sample size will allow us to confirm this data.
Neuroprotective effect of resveratrol on arsenic trioxide–induced oxidative stress in feline brain
Authors: Cheng Y , Xue J , Jiang H , Wang M , Gao L , Ma D , Zhang Z
Published: October 2013

Arsenic trioxide (As2O3) is a known environmental toxicant and potent chemotherapeutic agent. Significant correlation has been reported between arsenic exposure (including consumption of arsenic-contaminated water and clinical use of As2O3) and dysfunction in the nervous system. In this study, we aimed to elucidate the effect of resveratrol with neuroprotective activities on As2O3-induced oxidative damage and cerebral cortex injury. Twenty-four healthy Chinese Dragon Li cats of either sex were randomly divided into four groups: control (1 ml/kg physiological saline), As2O3 (1 mg/kg), resveratrol (3 mg/kg) and As2O3 (1 mg/kg) + resveratrol (3 mg/kg). As2O3+resveratrol-treated group were given resveratrol (3 mg/kg) 1 h before As2O3 (1 mg/kg) administration. Pretreatment with resveratrol upregulated the activities of antioxidant enzymes and attenuated As2O3-induced increases in reactive oxygen species and malondialdehyde production. In addition, resveratrol attenuated the As2O3-induced reduction in the level of reduced glutathione and the ratio of reduced glutathione to oxidised glutathione, and accumulation of arsenic in the cerebral cortex. These findings support neuroprotective effect of resveratrol on As2O3 toxicity in feline brain and provide a better understanding of the mechanism that resveratrol modulates As2O3-induced oxidative damage and a stronger rational for clinical use of resveratrol to protect brain against the toxicity of arsenic.
A 6-week oral gavage toxicity study of a novel galacto-oligosaccharide in juvenile rats
Authors: Kobayash T , Ishida S , Kaneko K , Onoue M
Published: October 2013

A novel galacto-oligosaccharide (GOS) was administered by gavage to groups (10 males and 10 females) of Sprague-Dawley specific pathogen-free rats for 6 weeks from day 4 after birth at doses of 0, 500, 1000, or 2000 mg/kg/day. Each pup was subjected to a variety of observations to examine for development effects/changes after birth: general condition, clinical signs, functional examinations, grip strength and spontaneous movement, body weight and feed consumption, external differentiation, ophthalmological examination, urinalysis (including water consumption), hematology, blood chemistry, necropsy, organ weight, and histopathology. During the study period, no deaths occurred in any group and there were no observed effects from administration of GOS. Therefore, it was concluded that GOS had no effects on the development of animals 4 days after birth. Since, there were no abnormalities due to administration of GOS in the macroscopic examination, organ weight or histopathology of the reproductive organs or differentiation (incisor eruption and eyelid opening) of males or females, it was concluded that repeated oral administration of GOS at 2000 mg/kg/day for 6 weeks from day 4 after birth hadno effects on postnatal development. The no observed effect level of GOS by repeated oral administration for 6 weeks from day 4 after birth was 2000 mg/kg/day for both males and females under the conditions of this study.
The effect of melatonin on acetylsalicylic acid-induced kidney and testis damage
Authors: Altintas R , Polat A , Parlakpinar H , Vardi N , Beytur A , Oguz F , Sagir M , Yildiz A , Duran ZR
Published: October 2013

The aim of this study was to evaluate the acute effect of high-dose acetylsalicylic acid (ASA) on kidney and testis, and the potential protective and therapeutic effects of melatonin on ASA-related pathology. A total of 40 rats were randomly divided into the following 5 groups ( n = 8): group 1: control, not given any drug; group 2: only 200 mg/kg ASA was given; group 3: 5 mg/kg melatonin was given 45 min before administering 200 mg/kg ASA; group 4: 5 mg/kg melatonin was given 45 min after administering 200 mg/kg ASA; and group 5: only 5 mg/kg melatonin was given. The histopathological changes and the biochemical findings; such as malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), reduced glutathione (GSH), and blood urea nitrogen (BUN) as well as serum creatinine (Cr) levels were evaluated. ASA significantly increased MDA levels in both kidney and testis, whereas it significantly decreased the values of SOD, CAT, GPX, and GSH in kidney and CAT levels in testis. Melatonin significantly decreased MDA levels in kidney and ameliorated it in testis, whereas it caused elevation in the levels of antioxidants. BUN and Cr levels were higher after ASA, whereas these levels were diminished after melatonin administration. The improvement obtained by melatonin on ASA-induced histological alterations was more prominent when it was used after ASA in kidney and before ASA in testis. In this study, we demonstrated the beneficial effect of melatonin on high-dose ASA-related pathology of kidney and testis for the first time.
Robust inference for mixed censored and binary response models with missing covariates
Authors: Sarkar Angshuman , Das Kalyan , Sinha Sanjoy K
Published: October 2013

In biomedical and epidemiological studies, often outcomes obtained are of mixed discrete and continuous in nature. Furthermore, due to some technical inconvenience or else, continuous responses are censored and also a few covariates cease to be observed completely. In this paper, we develop a model to tackle these complex situations. Our methodology is developed in a more general framework and provides a full-scale robust analysis of such complex models. The proposed robust maximum likelihood estimators of the model parameters are resistant to potential outliers in the data. We discuss the asymptotic properties of the robust estimators. To avoid computational difficulties involving irreducibly high-dimensional integrals, we propose a Monte Carlo method based on the Metropolis algorithm for approximating the robust maximum likelihood estimators. We study the empirical properties of these estimators in simulations. We also illustrate the proposed robust method using clustered data on blood sugar content from a clinical trial of individuals who were investigated for diabetes.
Linear spline multilevel models for summarising childhood growth trajectories: A guide to their application using examples from five birth cohorts
Authors: Howe Laura D , Tilling Kate , Matijasevich Alicia , Petherick Emily S , Santos Ana Cristina , Fairley Lesley , Wright John , Santos Iná S. , Barros Aluísio JD , Martin Richard M , Kramer Michael S , Bogdanovich Natalia , Matush Lidia , Barros Henrique , Lawlor Debbie A
Published: October 2013

Childhood growth is of interest in medical research concerned with determinants and consequences of variation from healthy growth and development. Linear spline multilevel modelling is a useful approach for deriving individual summary measures of growth, which overcomes several data issues (co-linearity of repeat measures, the requirement for all individuals to be measured at the same ages and bias due to missing data). Here, we outline the application of this methodology to model individual trajectories of length/height and weight, drawing on examples from five cohorts from different generations and different geographical regions with varying levels of economic development. We describe the unique features of the data within each cohort that have implications for the application of linear spline multilevel models, for example, differences in the density and inter-individual variation in measurement occasions, and multiple sources of measurement with varying measurement error. After providing example Stata syntax and a suggested workflow for the implementation of linear spline multilevel models, we conclude with a discussion of the advantages and disadvantages of the linear spline approach compared with other growth modelling methods such as fractional polynomials, more complex spline functions and other non-linear models.
Studying noncollapsibility of the odds ratio with marginal structural and logistic regression models
Authors: Pang Menglan , Kaufman Jay S , Platt Robert W
Published: October 2013

One approach to quantifying the magnitude of confounding in observational studies is to compare estimates with and without adjustment for a covariate, but this strategy is known to be defective for noncollapsible measures such as the odds ratio. Comparing estimates from marginal structural and standard logistic regression models, the total difference between crude and conditional effects can be decomposed into the sum of a noncollapsibility effect and confounding bias. We provide an analytic approach to assess the noncollapsibility effect in a point-exposure study and provide a general formula for expressing the noncollapsibility effect. Next, we provide a graphical approach that illustrates the relationship between the noncollapsibility effect and the baseline risk, and reveals the behavior of the noncollapsibility effect for a range of different exposure and covariate effects. Various observations about noncollapsibility can be made from the different scenarios with or without confounding; for example, the magnitude of effect of the covariate plays a more important role in the noncollapsibility effect than does that of the effect of the exposure. In order to explore the noncollapsibility effect of the odds ratio in the presence of time-varying confounding, we simulated an observational cohort study. The magnitude of noncollapsibility was generally comparable to the effect in the point-exposure study in our simulation settings. Finally, in an applied example we demonstrate that collapsibility can have an important impact on estimation in practice.
Preserved and violated dignity in surgical practice – nurses’ experiences
Authors: Lindwall Lillemor , von Post Iréne
Published: October 2013

The aim of this article was to obtain an understanding of what is experienced as human dignity by nurses in surgical practice. In order to obtain experiences from practice, the critical incident technique was chosen. A total of 11 nurses from surgical practice wrote 49 stories about positive and negative incidents. The text was analysed using hermeneutical text interpretation. The findings revealed patient dignity in terms of preserved dignity, that is, healthcare professionals paid attention to the patient. Nurses experienced preserved dignity when healthcare professionals allowed the patient to tell their story, allowed themselves to get close to the patient and in turn received the patient’s trust. Violated dignity included circumstances when the nurses were forced to see what they did not want to see. Nurses experienced violated dignity when healthcare professionals behaved rudely towards the patient, acted as if he or she was invisible or humiliated the patient at the end of life.
Blastocysts and Family Planning: IVF and Tracking a Developmental Context for Biomedical Research in Singapore (1966–1994)
Authors: DiMoia John
Published: October 2013

If Singapore has rapidly become known internationally for its work in recruiting large numbers of elite foreign scientists—or ‘foreign talent’ (FT) in Singapore’s terms—there remains much to learn about the state’s current biotech programme through prior work conducted at National University Hospital (NUH), recognising that recent ambitions derive in part from a much more modest set of origins. Specifically, Dr Ariff Bongso’s career mirrors this same series of incremental transitions, as he would move from working with in vitro fertilisation (IVF) per se to working with HESC (human embryonic stem cells) in the early to mid-1990s (1987–1994), at which point he came close to experiencing success in isolating HESC, a result which he qualified carefully with the language of ‘stem-cell like’ objects. This article considers the implications of reframing recent Singapore’s biotech efforts by re-examining the state family-planning initiatives of the mid-1960s. In fact, many of the biological materials Bongso worked with in his research derived from the hospital’s IVF programme, providing a material link between distinct research agendas possessing very different trajectories. Many of the same policy issues now being debated at Biopolis and in Singapore policy circles—how to mobilise productive international collaborative networks of researchers, as well as appropriate treatment and storage policies for a diverse range of human tissues—date to this earlier period (1966–1987) when precedents were first being established, suggesting that current policy can and should continue to be informed by the decisions of the past.
The Itinerary of a North Vietnamese Surgeon: Medical Science and Politics during the Cold War
Authors: Aso Michitake , Guénel Annick
Published: October 2013

This article argues that science was inextricably bound up with politics in the life and career of Tốn Thất Tùng. Nationalism motivated Tùng to join the Việt Minh fight against the French in the First Indochina War, but it was his colonial-era training as a surgeon that made him invaluable for the resistance. The widespread recognition of the Democratic Republic of Vietnam (DRV) in 1954 gave Tùng, in turn, access to human and material resources that would not have been available otherwise. With these resources, including equipment and human livers, Tùng developed surgical techniques that enabled him to publish in internationally recognised journals. In return, Tùng trained doctors for the state, focusing on knowledge that helped the DRV battle the Republic of Vietnam’s and the United States’ (US) armies. During the 1960s, Tùng engaged in medical diplomacy that allowed those against US intervention, yet uncomfortable with DRV politics, to support the North. For his part, Tùng tapped into his far-flung network to access the latest medical advances as well as obtain training for his students. These developments, international and domestic, came together in Tùng’s struggle to identify and treat the effects of exposure to herbicides and their contaminant dioxin, popularly known as Agent Orange.
The Human Proteome and the Chinese Liver
Authors: Chee Liz P.Y. , Clancey Gregory
Published: October 2013

The Human Liver Proteome Project (HLPP) is the largest international scientific research project ever headquartered in China. At the same time, the HLPP is one component of the global Human Proteome Project (HPP), which in 2001–2002 began dividing the organs and systems of the human body between different national laboratories and institutes. Research on the kidney was assigned to Japan, brain research to Germany, liver research to China, etc. Only in China, however, did the project take on the character of ‘big science’, successfully competing with other scientific initiatives for funding and prestige at the highest level, and developing ‘national’ characteristics similar to that of genomics research in the United States. Our article considers this flagship Chinese bioscience project from two complementary angles: as ‘big science’ at the cutting edge of biomedical research, and as a discursive and practice-oriented meeting ground between modern and ‘traditional’ Chinese medicine. We also discuss how these strands are politically and philosophically convergent.
Governing International Biobank Collaboration: A Case Study of China Kadoorie Biobank
Authors: Chen Haidan
Published: October 2013

Population-based biobanks collect donors’ biological samples and associated data, following them over time to study gene–environment interactions as causes of human diseases. International biobank collaboration is envisioned as necessary for a better understanding of causes of morbidity and mortality. However, determining how to govern international biobank collaboration remains challenging due to nations’ heterogeneous ethical and legal frameworks. This article explores how China Kadoorie Biobank (CKB), a China-UK collaborative project, coped with ethical issues, such as informed consent, benefit sharing and community engagement. The CKB case study provides insights into ethical issues and governance challenges for international biobank collaboration. The transformation of biobank research from a localised endeavour to networked, internationalised projects in the context of post-genomic medical research has created a highly challenging constellation for biobank governance. The governance of global collaboration, such as between China and the UK, will depend on developing joint governance protocols based on mutual recognition and respect.
Scientific Multipolarisation: Its Impact on International Clinical Research Collaborations and Theoretical Implications
Authors: Rosemann Achim
Published: October 2013

The article explores the contemporary dynamics of global scientific multipolarisation, and the empirical and theoretical implications of this trend for international clinical research collaborations. The focal point of the article is an ethnographic study of the China Spinal Cord Injury Network (China SCI Net), a transcontinental clinical research infrastructure that is active in Mainland China, Hong Kong, Taiwan and the US. Based on findings from this case study, the author suggests that the transition toward a multipolarising science world is associated with significant changes in the ways international collaborations are initiated, organised and justified. For many years, clinical research collaborations between partners in high- and low-to-middle-income countries have involved geographically bound hierarchies between the sponsors, intellectual creators and facilitating technicians of the research. However, the data from the China SCI Net indicate that these boundaries are in important respects transcending, and that a new modality of international clinical research organisation may gradually be taking shape. Theoretically, this article engages in a reflective dialogue with post-colonial theory, and post-colonial science and technology studies. The author suggests that several of the analytical tools that post-colonial science studies offer remain of great relevancy also in the context of a multipolarising science world. Simultaneously, however, the conceptual, methodological and ideological presumptions embedded in post-colonial theory require careful scrutiny, and other complementary strategies are required to capture the impact of the current multipolarisation process in the sciences more completely.
Regulating ‘Respect’ for the Embryo: Social Mindscapes and Human Embryonic Stem Cell Research in Japan
Authors: Sleeboom-Faulkner Margaret
Published: October 2013

This article explores the relationship between the science community and the bioethical regulation of human embryonic stem cell research (hESR) in the laboratory and in daily life in Japan. It develops a perspective that takes into account the diversity of views among principle investigators (PIs) and scientists working in the laboratory. Deploying Eviatar Zerubavel’s notion of social mindscapes and the notion of mindsets, I elucidate the relationships between the personal and the professional, scientists and the public. Introducing the concept of mindset switching, I argue that scientists’ views of embryonic substances cannot be understood adequately in terms of the rhetoric of boundary making alone. The use of cognitive notions of social mindscape applied to situations in the life of scientists has far-reaching consequences for both the implementation of research regulation involving respect for the embryo and for the public discussion on the use of embryonic substances. The article is based on interviews with over thirty scientists working with embryos and stem cells during fieldwork visits in eleven science institutes in Japan.
Biopolis: Asian Science in the Global Circuitry
Authors: Fischer Michael M.J.
Published: October 2013

Biopolis is the major life sciences investment by Singapore to become a global player in a new knowledge economy, as well as a promissory construction, a future-oriented emergent form of life constituted by and constitutive of a series of ethical plateaus or terrains of decision-making under entrepreneurial, policy and scientific conditions of risk and inadequate knowledge. Singapore’s Biopolis partakes in general cultural shifts towards biological and ecological sensibilities as responses to fears of pandemics, climate change, destruction of biodiversity, and toxicities produced by industrial agriculture and manufacturing. The issue is learning about biorepair mechanisms and creating new ecologies of knowledge involving not only interest in infectious or chronic diseases but also stem and iPS cells, cancers and regenerative medicine. Using the Genome Institute of Singapore’s first ten years as a partial focus, this article suggests metrics of success (beyond merely money, jobs, patents) which lie in three arenas: infectious diseases, cross-national science diplomacy and regenerative medicine. In October 2010, Biopolis underwent a sudden shift towards ‘industrial alignment’, raising ethical questions about the nature of future biologies, bioeconomies and bioecologies that have been spliced into the messenger RNA of different social networks and technical platforms of emergent twenty-first century biological sensibilities.
Engineering Biology and Society: Reflections on Synthetic Biology
Authors: Calvert Jane
Published: October 2013

Synthetic biology, according to some definitions, is the attempt to make biology into an engineering discipline. I ask what is meant by this objective, which seems to have excited and energised many people and encouraged them to start working in the field. I show how synthetic biologists make a point of distinguishing their work from previous genetic ‘engineering’, which is described as bespoke and artisan. I examine synthetic biologists’ accounts of the differences between biology and engineering, which often oppose comprehension to construction. I argue that synthetic biology, like other branches of engineering, aims to meet recognised needs, and to make the world more manipulable and controllable. But there are tensions within the field—some synthetic biologists have reservations about the extent to which biology can be engineered, and ask whether it is necessary to develop a new type of engineering when working with living systems. After exploring these debates, I turn to some of the broader consequences of making biology easier to engineer, particularly the deskilling and democratisation of the technology. I end by arguing that because synthetic biologists are skilled at bringing together both technical and social forces, they are appropriately described as ‘heterogeneous engineers’.
Early recognition of anti-N-methyl D-aspartate (NMDA) receptor encephalitis presenting as acute psychosis
Authors: Tidswell Jessica , Kleinig Timothy , Ash David , Thompson Philip , Galletly Cherrie
Published: October 2013

Objective:

We present a case of anti-N-methyl D-aspartate (NMDA) receptor encephalitis that illustrates the dilemma that psychiatrists face in evaluating patients with first episode psychosis.

Conclusions:

The discovery that acute psychosis can be the presenting feature of autoimmune encephalitis (in particular encephalitis caused by anti-NMDA receptor antibodies) has both practical and theoretical consequences. First, this condition is an important, but often overlooked, differential diagnosis of first episode psychosis. Antibody testing is not currently part of routine screening, though delayed (or missed) diagnosis can lead to prolonged hospital stay, medical complications and incomplete or delayed recovery. Widespread screening of patients with first presentation psychosis for anti-NMDA receptor and anti-voltage-gated potassium channel (anti-VGKC) antibodies is warranted for a number of reasons: to expedite appropriate treatment, to determine the true proportion of patients with these conditions presenting as psychosis, and to help elucidate the neurochemical causes of psychosis.
Identifying and Defining the Activities of Participant Direction Programs
Authors: Gross Judith M. S. , Blue-Banning Martha , Turnbull H. Rutherford , Francis Grace L.
Published: October 2013

We analyzed the design of various U.S. programs of participant direction offering participants (individual with a disability or his or her surrogate decision-maker) some level of choice and control over the individual’s long-term care supports and services. We used grounded theory methods to conduct a document analysis of 53 documents published from 2004 through 2008 representing multiple disabilities and program funding sources. In our analysis, we identified three major components (planning, budgeting, and employing) over which participants had the opportunity to exercise choice and control and the activities associated with each. Activities were represented by one or more continua illustrating the range of participant choice and control over the indicator. The component of planning consisted of the activity of care plan development. The budgeting component included the activities of (a) development, (b) individualization, and (c) authority. The employing component included the activities of (a) identifying/selecting providers, (b) hiring/employing providers, (c) scheduling providers, (d) training providers, (e) managing/directing/supervising providers, (f) disciplining/dismissing providers, (g) keeping records, (h) managing payroll, (i) locating emergency back-up, and (j) monitoring service quality. The findings of this study have implications for improving policy, practice, and research in the field of long-term care.