bluuebunny/crossref_metadata_2025 huggingface dataset:
Integration and adaptation
Authors: Zepke Nick , Leach Linda
Published: February 2005

Tertiary institutions are under increasing pressure to improve student outcomes such as retention, persistence and completion. In 2002, the New Zealand Ministry of Education commissioned a team of Massey University researchers to conduct a best evidence synthesis of literature on how institutions might improve student outcomes. Our study found two different discourses on this. One predominates, centring on what institutions do to fit students into their existing cultures. The other is still emerging and challenges the dominant discourse. Rather than requiring students to fit the existing institutional culture, it suggests that cultures be adapted to better fit the needs of increasingly diverse students. This article has four sections. First, a survey of background literature introduces competing theoretical approaches to outcomes research. Second, we explain how the survey was conducted. Third, we summarize the findings of 146 research studies. Finally we raise some challenges for practice based on the emerging discourse.
Strategies of Distancing from Emotional Experience
Authors: Enosh Guy , Buchbinder Eli
Published: February 2005

Through autobiographical memory people give meaning to what has happened to them. When people are involved in traumatic events, they are faced with essential and existential questions regarding their identity and relation with others and the world. On the one hand, they have the need to recollect and process those memories; on the other hand, they feel a need to distance themselves and forget or detach from the pain and threat involved in such memories. Data was collected from in-depth interviews of 20 couples involved in domestic violence. Data analysis revealed that the reconstruction of narrative memory serves as a tool for positioning oneself vis-a-vis the violent experience. We describe and analyse the ways by which interviewees regard their emotional processes, values, and identities as vehicles by which they construct the recollection and the narrative of a violent event.
‘I Got Married to Get Free of Home’
Authors: Krumer-Nevo Michal
Published: February 2005

This article describes a life-story study of 13 women living in deep and long-term poverty in Israel. Most of the women married at a young age and became mothers a short time thereafter. A combination of narrative and feminist-critical analysis shows that the women perceive marriage as a kind of ‘fate', and as the critical stage of their lives. Most of them were coerced into marriage whether by economic circumstances or by their families. Nevertheless, their stories give evidence of an interior dialogue concerning marriage as an expression of self-definition and as a struggle to escape distress. The article gives some directions for the ‘ methodological awareness’ necessary in such research and suggests some implications for social work.
Co-researching with Adults with Learning Disabilities
Authors: Redmond Mark
Published: February 2005

Traditional social research rarely considers ‘research as it is experienced' (Stanley and Wise, 1993: 153). Instead, it promotes a detached, objective stance, where sanitized accounts hide the issues and dilemmas researchers encounter. Yet the researcher is a central player in the research exercise, and ‘cannot be left behind... from discussions and written accounts’ (Stanley and Wise, 1993: 161) about the process. This article explores the journey and the dilemmas the author has experienced whilst coordinating a participatory research programme with adults with learning disabilities. It considers the roles he has assumed, and explores his relationship with those with whom he is working. As one member of a research team, the author found himself introduced to issues related to the everyday lives of the co-researchers, and which appeared to have little to do with the wider project. Yet these symbolized the need for independence and autonomy, issues implicit in the wider project. As such, this article traces a journey from a position of objective detachment to one which requires the clearer articulation of values and principles, and which ultimately demands alignment.
A Response to Heather Fraser ‘Doing Narrative Research’
Authors: Blacher Martin
Published: February 2005

This response to Heather Fraser's recent article describes the transition to narrative inquiry in the course of research on out of hours social work practice undertaken by the writer. Some of the specific points that Fraser makes are related to interviews with out of hours practitioners and practitioner/ managers.
The First International Congress of Qualitative Inquiry
Authors: Denzin Norman K.
Published: February 2005

This is a call for the international community of qualitative researchers to address the implications of the attempt by federal governments to regulate scientific inquiry by defining what is good science. Around the globe governments are attempting to enforce biomedical, evidence-based models of evidence. These efforts must be resisted by critical, qualitative scholars.
A Numerical Study into the Reconstruction of Impact Forces on Railway Track-like Structures
Authors: Lee M. L. , Chiu W. K. , Koss L. L.
Published: February 2005

This article presents the development of a process by which an impact experienced by a track-like structure can be reconstructed based on its vibration response. The process is essentially based on an inverse analysis technique, while a cepstral analysis technique is also used to improve waveform reconstructions. Firstly, a finite element (FE) model of a simple track structure was generated and calibrated to a real laboratory model to show that it was able to simulate impact events. The rail geometry was then replaced with a simple rectangular beam in order to allow simulation of a rolling wheel by means of a moving mean load. The simple beam geometry was necessary because the rail geometry carried an excessive computational cost when incorporating a moving mean load. This is a legitimate substitution because the inverse analysis technique is geometrically independent. It was found that the acceleration response of the track structure due to the dynamic impact was largely unaffected by the moving mean loading condition. It was also found that the inverse analysis technique shows potential for reconstructing input forces, but in some instances the reconstructed waveform has ambiguous peaks and excessive signal pollution around the force waveform. The cepstral analysis was then found to be useful in sufficiently ‘smoothing’ the transfer function spectrum such that an improved waveform reconstruction could be obtained. An error analysis showed that the regular transfer function as obtained by the inverse analysis technique when ‘smoothed’ by cepstral analysis gave a lower order of error. It was found that to provide sufficient coverage of a full crib of rail, three calibration points were required for the transfer function, with four accelerometers to pick up the track responses along the crib.
Fiber Optic Sensors for Strain Measurement of CFRP-strengthened RC Beams
Authors: Gheorghiu Catalin , Labossiére Pierre , Proulx Jean
Published: February 2005

There is a growing need for built-in monitoring systems for new and aging civil engineering structures, due to problems such as increasing traffic loads and rising costs of maintenance and repair. Fiber optic sensors FOS), capable of reading strains, loads, deflections, and temperature are promising candidates for life-long health monitoring of these structures. However, since FOS have only been introduced recently into the field of structural monitoring, their acceptance and widespread implementation will be conditioned by their durability under severe climatic and loading conditions. This article reports on the performance of strain extrinsic FOS attached to carbon fiber-reinforced polymer CFRP) plates used to strengthen concrete structures. The specimens tested in this project are reinforced concrete RC) beams with an additional external CFRP reinforcement. The strain data obtained from the FOS were compared with data obtained from collocated electrical strain gauges. The FOS-instrumented beams were first subjected to fatigue loading for various numbers of cycles and load amplitudes. Then they were tested monotonically for failure under four-point-bending. The test results provide an insight on the fatigue and postfatigue behavior of FOS used for strain measurement in reinforced concrete structures.
Structural Health Monitoring in the Railway Industry: A Review
Authors: Barke D. , Chiu W. K.
Published: February 2005

Wayside detection monitors critical parameters relating to the condition of in-service railway vehicles. Economic decisions about the maintenance of vehicles can be made, and servicing can occur when a particular vehicle is likely to cause even small amounts of damage to the track, to itself, or when the cost of damage is significant, such as in catastrophic failure.

Vehicles with poorly performing axle bearings, out-of-round (skidded or spalled) wheels, vehicles which exhibit transient lateral motion (‘hunting’), and vehicles with poorly performing brakes are all likely to fall into the category of requiring maintenance, in order to save the track and the vehicle owner's money.

In the present paper, the parameters that define vehicle condition and their measurable effects are stated. There are frequently a number of wayside detection methods of inspecting a vehicle for the same vehicle condition and each of these is described in detail.

This investigation reveals the need for further research to enable rollingstock owners to make better decisions about the cost of operating their vehicles, based on the output from wayside detectors and the observed trends in wheel impact.
An Application of Discrete Wavelet Analysis and Connection Coefficients to Parametric System Identification
Authors: Zabel Volkmar
Published: February 2005

Most system identification methods are based on a time or frequency domain analysis of data that were measured in dynamic tests. In this article, an algorithm for the identification of a finite element model's parameters is presented that utilizes wavelet coefficients of the measured data and their integrals or derivatives, respectively. How the wavelet coefficients of derivatives and integrals can be related to each other by connection coefficients is shown. These relations are then applied within the proposed parameter identification algorithm. The performance of the method is demonstrated by means of numerical and experimental investigations.
Anaphylatoxin C3a receptors in asthma
Authors: Ali Hydar , Panettieri Reynold A
Published: February 2005

The complement system forms the central core of innate immunity but also mediates a variety of inflammatory responses. Anaphylatoxin C3a, which is generated as a byproduct of complement activation, has long been known to activate mast cells, basophils and eosinophils and to cause smooth muscle contraction. However, the role of C3a in the pathogenesis of allergic asthma remains unclear. In this review, we examine the role of C3a in promoting asthma. Following allergen challenge, C3a is generated in the lung of subjects with asthma but not healthy subjects. Furthermore, deficiency in C3a generation or in G protein coupled receptor for C3a abrogates allergen-induced responses in murine models of pulmonary inflammation and airway hyperresponsiveness. In addition, inhibition of complement activation or administration of small molecule inhibitors of C3a receptor after sensitization but before allergen challenge inhibits airway responses. At a cellular level, C3a stimulates robust mast cell degranulation that is greatly enhanced following cell-cell contact with airway smooth muscle (ASM) cells. Therefore, C3a likely plays an important role in asthma primarily by regulating mast cell-ASM cell interaction.
Out of Tanganyika: Genesis, explosive speciation, key-innovations and phylogeography of the haplochromine cichlid fishes
Authors: Salzburger Walter , Mack Tanja , Verheyen Erik , Meyer Axel
Published: February 2005

Background

The adaptive radiations of cichlid fishes in East Africa are well known for their spectacular diversity and their astonishingly fast rates of speciation. About 80% of all 2,500 cichlid species in East Africa, and virtually all cichlid species from Lakes Victoria (~500 species) and Malawi (~1,000 species) are haplochromines. Here, we present the most extensive phylogenetic and phylogeographic analysis so far that includes about 100 species and is based on about 2,000 bp of the mitochondrial DNA.

Results

Our analyses revealed that all haplochromine lineages are ultimately derived from Lake Tanganyika endemics. We find that the three most ancestral lineages of the haplochromines sensu lato are relatively species poor, albeit widely distributed in Africa, whereas a fourth newly defined lineage – the 'modern haplochromines' – contains an unparalleled diversity that makes up more than 7% of the worlds' ~25,000 teleost species. The modern haplochromines' ancestor, most likely a riverine generalist, repeatedly gave rise to similar ecomorphs now found in several of the species flocks. Also, the Tanganyikan Tropheini are derived from that riverine ancestor suggesting that they successfully re-colonized Lake Tanganyika and speciated in parallel to an already established cichlid adaptive radiation. In contrast to most other known examples of adaptive radiations, these generalist ancestors were derived from highly diverse and specialized endemics from Lake Tanganyika. A reconstruction of life-history traits revealed that in an ancestral lineage leading to the modern haplochromines the characteristic egg-spots on anal fins of male individuals evolved.

Conclusion

We conclude that Lake Tanganyika is the geographic and genetic cradle of all haplochromine lineages. In the ancestors of the replicate adaptive radiations of the 'modern haplochromines', behavioral (maternal mouthbrooding), morphological (egg-spots) and sexually selected (color polymorphism) key-innovations arose. These might be – together with the ecological opportunity that the habitat diversity of the large lakes provides – responsible for their evolutionary success and their propensity for explosive speciation.
Comparative promoter region analysis powered by CORG
Authors: Dieterich Christoph , Grossmann Steffen , Tanzer Andrea , Röpcke Stefan , Arndt Peter F , Stadler Peter F , Vingron Martin
Published: February 2005

Background

Promoters are key players in gene regulation. They receive signals from various sources (e.g. cell surface receptors) and control the level of transcription initiation, which largely determines gene expression. In vertebrates, transcription start sites and surrounding regulatory elements are often poorly defined. To support promoter analysis, we present CORG http://corg.molgen.mpg.de, a framework for studying upstream regions including untranslated exons (5' UTR).

Description

The automated annotation of promoter regions integrates information of two kinds. First, statistically significant cross-species conservation within upstream regions of orthologous genes is detected. Pairwise as well as multiple sequence comparisons are computed. Second, binding site descriptions (position-weight matrices) are employed to predict conserved regulatory elements with a novel approach. Assembled EST sequences and verified transcription start sites are incorporated to distinguish exonic from other sequences.

As of now, we have included 5 species in our analysis pipeline (man, mouse, rat, fugu and zebrafish). We characterized promoter regions of 16,127 groups of orthologous genes. All data are presented in an intuitive way via our web site. Users are free to export data for single genes or access larger data sets via our DAS server http://tomcat.molgen.mpg.de:8080/das. The benefits of our framework are exemplarily shown in the context of phylogenetic profiling of transcription factor binding sites and detection of microRNAs close to transcription start sites of our gene set.

Conclusion

The CORG platform is a versatile tool to support analyses of gene regulation in vertebrate promoter regions. Applications for CORG cover a broad range from studying evolution of DNA binding sites and promoter constitution to the discovery of new regulatory sequence elements (e.g. microRNAs and binding sites).
Customized birth weight for gestational age standards: Perinatal mortality patterns are consistent with separate standards for males and females but not for blacks and whites
Authors: Joseph K S , Wilkins Russell , Dodds Linda , Allen Victoria M , Ohlsson Arne , Marcoux Sylvie , Liston Robert
Published: February 2005

Background

Some currently available birth weight for gestational age standards are customized but others are not. We carried out a study to provide empirical justification for customizing such standards by sex and for whites and blacks in the United States.

Methods

We studied all male and female singleton live births and stillbirths (22 or more weeks of gestation; 500 g birth weight or over) in the United States in 1997 and 1998. White and black singleton live births and stillbirths were also examined. Qualitative congruence between gestational age-specific growth restriction and perinatal mortality rates was used as the criterion for identifying the preferred standard.

Results

The fetuses at risk approach showed that males had higher perinatal mortality rates at all gestational ages compared with females. Gestational age-specific growth restriction rates based on a sex-specific standard were qualitatively consistent with gestational age-specific perinatal mortality rates among males and females. However, growth restriction patterns among males and females based on a unisex standard could not be reconciled with perinatal mortality patterns. Use of a single standard for whites and blacks resulted in gestational age-specific growth restriction rates that were qualitatively congruent with patterns of perinatal mortality, while use of separate race-specific standards led to growth restriction patterns that were incompatible with patterns of perinatal mortality.

Conclusion

Qualitative congruence between growth restriction and perinatal mortality patterns provides an outcome-based justification for sex-specific birth weight for gestational age standards but not for the available race-specific standards for blacks and whites in the United States.
Polymorphisms in immunoregulatory genes and the risk of histologic chorioamnionitis in Caucasoid women: a case control study
Authors: Annells Margaret F , Hart Prue H , Mullighan Charles G , Heatley Susan L , Robinson Jeffrey S , McDonald Helen M
Published: February 2005

Background

Chorioamnionitis is a common underlying cause of preterm birth (PTB). It is hypothesised that polymorphisms in immunoregulatory genes influence the host response to infection and subsequent preterm birth. The relationship between histologic chorioamnionitis and 22 single nucleotide polymorphisms in 11 immunoregulatory genes was examined in a case-control study.

Methods

Placentas of 181 Caucasoid women with spontaneous PTB prior to 35 weeks were examined for histologic chorioamnionitis. Polymorphisms in genes IL1A, IL1B, IL1RN, IL1R1, tumour necrosis factor (TNF), IL4, IL6, IL10, transforming growth factor beta-1 (TGFB1), Fas (TNFRSF6), and mannose-binding lectin (MBL2) were genotyped by polymerase chain reaction and sequence specific primers. Multivariable logistic regression including demographic and genetic variables and Kaplan-Meier survival analyses of genotype frequencies and pregnancy outcome were performed.

Results

Sixty-nine (34%) women had histologic evidence of acute chorioamnionitis. Carriage of the IL10-1082A/-819T/592A (ATA) haplotype [Multivariable Odds ratio (MOR) 1.9, P = 0.05] and MBL2 codon 54Asp allele (MOR 2.0, P = 0.04), were positively associated with chorioamnionitis, while the TNFRSF6-1377A/-670G (AG) haplotype (MOR 0.4, P = 0.03) and homozygosity for TGFB1-800G/509T (GT) haplotype (MOR 0.2, P = 0.04) were negatively associated.

Conclusion

These findings demonstrate that polymorphisms in immunoregulatory genes IL10, MBL2, TNFRSF6 and TGFB1 may influence susceptibility to chorioamnionitis.
Quality of life in patients with personality disorders seen at an ordinary psychiatric outpatient clinic
Authors: Narud Kjersti , Mykletun Arnstein , Dahl Alv A
Published: February 2005

Background

Epidemiological studies have found reduced health-related quality of life (QoL) in patients with personality disorders (PDs), but few clinical studies have examined QoL in PDs, and none of them are from an ordinary psychiatric outpatient clinic (POC). We wanted to examine QoL in patients with PDs seen at a POC, to explore the associations of QoL with established psychiatric measures, and to evaluate QoL as an outcome measure in PD patients.

Methods

72 patients with PDs at a POC filled in the MOS Short Form 36 (SF-36), and two established psychiatric self-rating measures. A national norm sample was compared on the SF-36. An independent psychiatrist diagnosed PDs and Axis-I disorders by structured interviews and rated the Global Assessment of Functioning (GAF). All measurements were repeated in the 39 PD patients that attended the 2 years follow-up examination.

Results

PD patients showed high co-morbidity with other PDs and Axis I mental disorders, and they scored significantly lower on all the SF-36 dimensions than age- and gender-adjusted norms. Adjustment for co-morbid Axis I disorders had some influence, however. The SF-36 mental health, vitality, and social functioning were significantly associated with the GAF and the self-rated psychiatric measures. Significant changes at follow-up were found in the psychiatric measures, but only on the mental health and role-physical of the SF-36.

Conclusion

Patients with PDs seen for treatment at a POC have globally poor QoL. Both physical and mental dimensions of the SF-36 are correlated with established psychiatric measures in such patients, but significant changes in these measures are only partly associated with changes in the SF-36 dimensions.
Optimal sampling of MRI slices for the assessment of knee cartilage volume for cross-sectional and longitudinal studies
Authors: Zhai Guangju , Ding Changhai , Cicuttini Flavia , Jones Graeme
Published: February 2005

Background

MRI slices of 1.5 mm thickness have been used in both cross sectional and longitudinal studies of osteoarthritis, but is difficult to apply to large studies as most techniques used in measuring knee cartilage volumes require substantial post-image processing. The aim of this study was to determine the optimal sampling of 1.5 mm thick slices of MRI scans to estimate knee cartilage volume in males and females for cross-sectional and longitudinal studies.

Methods

A total of 150 subjects had a sagittal T1-weighted fat-suppressed MRI scan of the right knee at a partition thickness of 1.5 mm to determine their cartilage volume. Fifty subjects had both baseline and 2-year follow up MRI scans. Lateral, medial tibial and patellar cartilage volumes were calculated with different samples from 1.5 mm thick slices by extracting one in two, one in three, and one in four to compare to cartilage volume and its rate of change. Agreement was assessed by means of intraclass correlation coefficient (ICC) and Bland & Altman plots.

Results

Compared to the whole sample of 1.5 mm thick slices, measuring every second to fourth slice led to very little under or over estimation in cartilage volume and its annual change. At all sites and subgroups, measuring every second slice had less than 1% mean difference in cartilage volume and its annual rate of change with all ICCs ≥ 0.98.

Conclusion

Sampling alternate 1.5 mm thick MRI slices is sufficient for knee cartilage volume measurement in cross-sectional and longitudinal epidemiological studies with little increase in measurement error. This approach will lead to a substantial decrease in post-scan processing time.
Resorbable screws versus pins for optimal transplant fixation (SPOT) in anterior cruciate ligament replacement with autologous hamstring grafts: rationale and design of a randomized, controlled, patient and investigator blinded trial [ISRCTN17384369]
Authors: Stengel Dirk , Matthes Gerrit , Seifert Julia , Tober Volker , Mutze Sven , Rademacher Grit , Ekkernkamp Axel , Bauwens Kai , Wich Michael , Casper Dirk ,   the SPOT Group
Published: February 2005

Background

Ruptures of the anterior cruciate ligament (ACL) are common injuries to the knee joint. Arthroscopic ACL replacement by autologous tendon grafts has established itself as a standard of care.

Data from both experimental and observational studies suggest that surgical reconstruction does not fully restore knee stability. Persisting anterior laxity may lead to recurrent episodes of giving-way and cartilage damage. This might at least in part depend on the method of graft fixation in the bony tunnels. Whereas resorbable screws are easy to handle, pins may better preserve graft tension. The objective of this study is to determine whether pinning of ACL grafts reduces residual anterior laxity six months after surgery as compared to screw fixation.

Design/ Methods

SPOT is a randomised, controlled, patient and investigator blinded trial conducted at a single academic institution. Eligible patients are scheduled to arthroscopic ACL repair with triple-stranded hamstring grafts, conducted by a single, experienced surgeon. Intraoperatively, subjects willing to engage in this study will be randomised to transplant tethering with either resorbable screws or resorbable pins. No other changes apply to locally established treatment protocols. Patients and clinical investigators will remain blinded to the assigned fixation method until the six-month follow-up examination.

The primary outcome is the side-to-side (repaired to healthy knee) difference in anterior translation as measured by the KT-1000 arthrometer at a defined load (89 N) six months after surgery. A sample size of 54 patients will yield a power of 80% to detect a difference of 1.0 mm ± standard deviation 1.2 mm at a two-sided alpha of 5% with a t-test for independent samples.

Secondary outcomes (generic and disease-specific measures of quality of life, magnetic resonance imaging morphology of transplants and devices) will be handled in an exploratory fashion.

Conclusion

SPOT aims at showing a reduction in anterior knee laxity after fixing ACL grafts by pins compared to screws.
Sarcocystosis of chital-dhole: conditions for evolutionary stability of a predator parasite mutualism
Authors: Jog Maithili M , Watve Milind G
Published: February 2005

Background

For parasites with a predator-prey life cycle, the completion of the life cycle often depends on consumption of parasitized prey by the predator. In the case of such parasite species the predator and the parasite have common interests and therefore a mutualistic relationship is possible. Some evidence of a predator-parasite mutualism was reported from spotted deer or chital (Axix axis) as a prey species, dhole or Indian wild-dog (Cuon alpinus) as the predator and a protozoan (Sarcocystis axicuonis) as the parasite. We examine here, with the help of a model, the ecological conditions necessary for the evolution and stability of such a mutualistic relationship. A two – level game theory model was designed in which the payoff of a parasite is decided not only by alternative parasite strategies but also by alternative host strategies and vice versa. Conditions for ESS were examined.

Results

A tolerant predator strategy and a low or moderately virulent parasite strategy which together constitute mutualism are stable only at a high frequency of recycling of parasite and a substantial prey – capture benefit to the predator. Unlike the preliminary expectation, parasite will not evolve towards reduced virulence, but reach an optimum moderate level of virulence.

Conclusion

The available data on the behavioral ecology of dhole and chital suggest that they are likely to meet the stability criteria and therefore a predator-parasite mutualism can be stable in this system. The model also points out the gaps in the current data and could help directing further empirical work.
Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory
Authors: Varma Rajesh , Tiyagi Ekta , Gupta Janesh K
Published: February 2005

Background

Our obstetrics and gynaecology undergraduate teaching module allocates 40–50 final year medical students to eight teaching hospital sites in the West Midlands region. Based on student feedback and concerns relating to the impact of new curriculum changes, we wished to objectively assess whether the educational environment perceived by students varied at different teaching hospital centres, and whether the environment was at an acceptable standard.

Methods

A Dundee Ready Education Environment (DREEM) Questionnaire, a measure of educational environment, was administered to 206 students immediately following completion of the teaching module.

Results

The overall mean DREEM score was 139/200 (70%). There were no differences in the education climate between the teaching centres.

Conclusion

Further research on the use of DREEM inventory, with follow up surveys, may be useful for educators to ensure and maintain high quality educational environments despite students being placed at different teaching centres.
What is important in evaluating health care quality? An international comparison of user views
Authors: Groenewegen Peter P , Kerssens Jan J , Sixma Herman J , van der Eijk Ingrid , Boerma Wienke GW
Published: February 2005

Background

Quality of care from the perspective of users is increasingly used in evaluating health care performance. Going beyond satisfaction studies, quality of care from the users' perspective is conceptualised in two dimensions: the importance users attach to aspects of care and their actual experience with these aspects. It is well established that health care systems differ in performance. The question in this article is whether there are also differences in what people in different health care systems view as important aspects of health care quality. The aim is to describe and explain international differences in the importance that health care users attach to different aspects of health care.

Methods

Data were used from different studies that all used a version of the QUOTE-questionnaire that measures user views of health care quality in two dimensions: the importance that users attach to aspects of care and their actual experience. Data from 12 European countries and 5133 individuals were used. They were analysed using multi-level analysis.

Results

Although most of the variations in importance people attach to aspects of health care is located at the individual level, there are also differences between countries. The ranking of aspects shows similarities. 'My GP should always take me seriously' was in nearly all countries ranked first, while an item about waiting time in the GP's office was always ranked lowest.

Conclusion

Differences between countries in how health care users value different aspects of care are difficult to explain. Further theorising should take into account that importance and performance ratings are positively related, that people compare their experiences with those of others, and that general and instrumental values might be related through the institutions of the health care system.
Muscle oxidative metabolism accelerates with mild acidosis during incremental intermittent isometric plantar flexion exercise
Authors: Homma Toshiyuki , Hamaoka Takafumi , Sako Takayuki , Murakami Motohide , Esaki Kazuki , Kime Ryotaro , Katsumura Toshihito
Published: February 2005

Background

It has been thought that intramuscular ADP and phosphocreatine (PCr) concentrations are important regulators of mitochondorial respiration. There is a threshold work rate or metabolic rate for cellular acidosis, and the decrease in muscle PCr is accelerated with drop in pH during incremental exercise. We tested the hypothesis that increase in muscle oxygen consumption ("Equation missing"o2mus) is accelerated with rapid decrease in PCr (concomitant increase in ADP) in muscles with drop in pH occurs during incremental plantar flexion exercise.

Methods

Five male subjects performed a repetitive intermittent isometric plantar flexion exercise (6-s contraction/4-s relaxation). Exercise intensity was raised every 1 min by 10% maximal voluntary contraction (MVC), starting at 10% MVC until exhaustion. The measurement site was at the medial head of the gastrocnemius muscle. Changes in muscle PCr, inorganic phosphate (Pi), ADP, and pH were measured by 31P-magnetic resonance spectroscopy. "Equation missing"o2mus was determined from the rate of decrease in oxygenated hemoglobin and/or myoglobin using near-infrared continuous wave spectroscopy under transient arterial occlusion. Electromyogram (EMG) was also recorded. Pulmonary oxygen uptake ("Equation missing"o2pul ) was measured by the breath-by-breath gas analysis.

Results

EMG amplitude increased as exercise intensity progressed. In contrast, muscle PCr, ADP, "Equation missing"o2mus, and "Equation missing"o2pul did not change appreciably below 40% MVC, whereas above 40% MVC muscle PCr decreased, and ADP, "Equation missing"o2mus, and "Equation missing"o2pul increased as exercise intensity progressed, and above 70% MVC, changes in muscle PCr, ADP, "Equation missing"o2mus, and "Equation missing"o2pul accelerated with the decrease in muscle pH (~6.78). The kinetics of muscle PCr, ADP, "Equation missing"o2mus, and "Equation missing"o2pul were similar, and there was a close correlation between each pair of parameters (r = 0.969~0.983, p < 0.001).

Conclusion

With decrease in pH muscle oxidative metabolism accelerated and changes in intramuscular PCr and ADP accelerated during incremental intermittent isometric plantar flexion exercise. These results suggest that rapid changes in muscle PCr and/or ADP with mild acidosis stimulate accelerative muscle oxidative metabolism.
Umbilical metastases: current viewpoint
Authors: Gabriele Raimondo , Conte Marco , Egidi Federico , Borghese Mario
Published: February 2005

Background

Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment.

Method

A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references.

Results

The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site.

Conclusion

A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.
The role of NGOs in global health research for development
Authors: Delisle Hélène , Roberts Janet Hatcher , Munro Michelle , Jones Lori , Gyorkos Theresa W
Published: February 2005

Background

Global health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world's greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research – Canada (CGHRC) in 2001, the Canadian Society for International Health (CSIH) decided to review the role of non-governmental organizations (NGOs) in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role.

Approach

This paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research.

Highlights

NGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research), resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies.

Conclusion

There is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs, moreover, can and should play an instrumental role in coalitions for global health research, such as the CGHRC. With a renewed sense of purpose and a common goal, NGOs and their partners intend to make strong and lasting inroads into reducing the disease burden of the world's most affected populations through effective research action.
A phase I study of dexosome immunotherapy in patients with advanced non-small cell lung cancer
Authors: Morse Michael A , Garst Jennifer , Osada Takuya , Khan Shubi , Hobeika Amy , Clay Timothy M , Valente Nancy , Shreeniwas Revati , Sutton Mary Ann , Delcayre Alain , Hsu Di-Hwei , Le Pecq Jean-Bernard , Lyerly H Kim
Published: February 2005

Background

There is a continued need to develop more effective cancer immunotherapy strategies. Exosomes, cell-derived lipid vesicles that express high levels of a narrow spectrum of cell proteins represent a novel platform for delivering high levels of antigen in conjunction with costimulatory molecules. We performed this study to test the safety, feasibility and efficacy of autologous dendritic cell (DC)-derived exosomes (DEX) loaded with the MAGE tumor antigens in patients with non-small cell lung cancer (NSCLC).

Methods

This Phase I study enrolled HLA A2+ patients with pre-treated Stage IIIb (N = 4) and IV (N = 9) NSCLC with tumor expression of MAGE-A3 or A4. Patients underwent leukapheresis to generate DC from which DEX were produced and loaded with MAGE-A3, -A4, -A10, and MAGE-3DPO4 peptides. Patients received 4 doses of DEX at weekly intervals.

Results

Thirteen patients were enrolled and 9 completed therapy. Three formulations of DEX were evaluated; all were well tolerated with only grade 1–2 adverse events related to the use of DEX (injection site reactions (N = 8), flu like illness (N = 1), and peripheral arm pain (N = 1)). The time from the first dose of DEX until disease progression was 30 to 429+ days. Three patients had disease progression before the first DEX dose. Survival of patients after the first DEX dose was 52–665+ days. DTH reactivity against MAGE peptides was detected in 3/9 patients. Immune responses were detected in patients as follows: MAGE-specific T cell responses in 1/3, increased NK lytic activity in 2/4.

Conclusion

Production of the DEX vaccine was feasible and DEX therapy was well tolerated in patients with advanced NSCLC. Some patients experienced long term stability of disease and activation of immune effectors
Fructose, insulin resistance, and metabolic dyslipidemia
Authors: Basciano Heather , Federico Lisa , Adeli Khosrow
Published: February 2005

Obesity and type 2 diabetes are occurring at epidemic rates in the United States and many parts of the world. The "obesity epidemic" appears to have emerged largely from changes in our diet and reduced physical activity. An important but not well-appreciated dietary change has been the substantial increase in the amount of dietary fructose consumption from high intake of sucrose and high fructose corn syrup, a common sweetener used in the food industry. A high flux of fructose to the liver, the main organ capable of metabolizing this simple carbohydrate, perturbs glucose metabolism and glucose uptake pathways, and leads to a significantly enhanced rate of de novo lipogenesis and triglyceride (TG) synthesis, driven by the high flux of glycerol and acyl portions of TG molecules from fructose catabolism. These metabolic disturbances appear to underlie the induction of insulin resistance commonly observed with high fructose feeding in both humans and animal models. Fructose-induced insulin resistant states are commonly characterized by a profound metabolic dyslipidemia, which appears to result from hepatic and intestinal overproduction of atherogenic lipoprotein particles. Thus, emerging evidence from recent epidemiological and biochemical studies clearly suggests that the high dietary intake of fructose has rapidly become an important causative factor in the development of the metabolic syndrome. There is an urgent need for increased public awareness of the risks associated with high fructose consumption and greater efforts should be made to curb the supplementation of packaged foods with high fructose additives. The present review will discuss the trends in fructose consumption, the metabolic consequences of increased fructose intake, and the molecular mechanisms leading to fructose-induced lipogenesis, insulin resistance and metabolic dyslipidemia.
Australia's international health relations in 2003
Authors: Barraclough Simon
Published: February 2005

A survey for the year 2003 of significant developments in Australia's official international health relations, and their domestic ramifications, is presented. The discussion is set within the broader context of Australian foreign policy. Sources include official documents, media reports and consultations with officers of the Department of Health and Ageing responsible for international linkages.
Citrullinated proteins have increased immunogenicity and arthritogenicity and their presence in arthritic joints correlates with disease severity
Authors: Lundberg Karin , Nijenhuis Suzanne , Vossenaar Erik R , Palmblad Karin , van Venrooij Walter J , Klareskog Lars , Zendman AJW , Harris Helena Erlandsson
Published: February 2005

Autoantibodies directed against citrulline-containing proteins have an impressive specificity of nearly 100% in patients with rheumatoid arthritis and have been suggested to be involved in the disease pathogenesis. The targeted epitopes are generated by a post-translational modification catalysed by the calcium-dependent enzyme peptidyl arginine deiminase (PAD), which converts positively charged arginine to polar but uncharged citrulline. The aim of this study was to explore the effects of citrullination on the immunogenicity of autoantigens as well as on potential arthritogenicity. Thus, immune responses to citrullinated rat serum albumin (Cit-RSA) and to unmodified rat serum albumin (RSA) were examined as well as arthritis development induced by immunisation with citrullinated rat collagen type II (Cit-CII) or unmodified CII. In addition, to correlate the presence of citrullinated proteins and the enzyme PAD4 with different stages of arthritis, synovial tissues obtained at different time points from rats with collagen-induced arthritis were examined immunohistochemically. Our results demonstrate that citrullination of the endogenous antigen RSA broke immunological tolerance, as was evident by the generation of antibodies directed against the modified protein and cross-reacting with the native protein. Furthermore we could demonstrate that Cit-CII induced arthritis with higher incidence and earlier onset than did the native counterpart. Finally, this study reveals that clinical signs of arthritis precede the presence of citrullinated proteins and the enzyme PAD4. As disease progressed into a more severe and chronic state, products of citrullination appeared specifically in the joints. Citrullinated proteins were detected mainly in extracellular deposits but could also be found in infiltrating cells and on the cartilage surface. PAD4 was detected in the cytoplasm of infiltrating mononuclear cells, from day 21 after immunisation and onwards. In conclusion, our data reveal the potency of citrullination to break tolerance against the self antigen RSA and to increase the arthritogenic properties of the cartilage antigen CII. We also show that citrullinated proteins and the enzyme PAD4 are not detectable in healthy joints, and that the appearance and amounts in arthritic joints of experimental animals are correlated with the severity of inflammation.
The P2X7receptor is a candidate product of murine and human lupus susceptibility loci: a hypothesis and comparison of murine allelic products
Authors: Elliott James I , McVey John H , Higgins Christopher F
Published: February 2005

Systemic lupus erythematosus and its murine equivalent, modelled in the New Zealand Black and New Zealand White (NZB × NZW)F1 hybrid strain, are polygenic inflammatory diseases, probably reflecting an autoimmune response to debris from cells undergoing programmed cell death. Several human and murine loci contributing to disease have been defined. The present study asks whether the proinflammatory purinergic receptor P2X7, an initiator of a form of programmed cell death known as aponecrosis, is a candidate product of murine and human lupus susceptibility loci. One such locus in (NZB × NZW)F1 mice is lbw3, which is situated at the distal end of NZW chromosome 5. We first assess whether NZB mice and NZW mice carry distinct alleles of the P2RX7 gene as expressed by common laboratory strains, which differ in sensitivity to ATP stimulation. We then compare the responses of NZB lymphocytes, NZW lymphocytes and (NZB × NZW)F1 lymphocytes to P2X7 stimulation. NZB and NZW parental strains express the distinct P2X7-L and P2X7-P alleles of P2RX7, respectively, while lymphocytes from these and (NZB × NZW)F1 mice differ markedly in their responses to P2X7 receptor stimulation. NZB mice and NZW mice express functionally distinct alleles of the proinflammatory receptor, P2X7. We show that current mapping suggests that murine and human P2RX7 receptor genes lie within lupus susceptibility loci lbw3 and SLEB4, and we argue that these encode a product with the functional characteristics consistent with a role in lupus. Furthermore, we argue that aponecrosis as induced by P2X7 is a cell death mechanism with characteristics that potentially have particular relevance to disease pathogenesis.