bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Economic Crisis
Authors: Dubey Muchkund
Published: June 2010

The global financial and economic crisis has had a devastating impact on the world economy, including those of the developed countries. The impact was considerably mitigated because major economic powers put in operation rescue packages of unprecedented dimensions and adopted a set of co-ordinated measures. The preferred institution and the forum for this purpose were the IMF and G-20 respectively. The recognition of G-20 as the principal forum for international economic co-operation is only the institutionalisation of the radical change that has taken place in the global economic power structure. In their three conferences at the summit level within a space or less than a year, the G-20 took measures for making substantial resources available to help developing countries to cope with the crisis, for regulating financial markets and for strengthening the IMF. G-20 decisions helped in restoring confidence, maintaining the momentum of rescue measures and restraining contingent trade protection. But most of the fundamental problems besetting the international financial system have been left intact or only tinkered with. The right forum for bringing about changes of a fundamental nature in the international financial system, and for coordination of macro-economic policies of member governments which can serve the widest possible interest, is the United Nations. This is in fact mandated in the UN Charter.
The Mitigation Challenge in Climate Change—Where Do We Stand?
Authors: Saran Shyam
Published: June 2010

The UN Framework Convention on Climate Change (UNFCCC) does not impose mitigation obligations on developing countries since it recognises that Climate Change is taking place due to the cumulative accumulation of GHGs in the atmosphere, for which developed countries are responsible. This is the principle of historical responsibility and this is acknowledged by developed countries, including the US. Notwithstanding the principles and provisions of the UNFCCC, developed countries in the EU and the US argue that major developing countries like China, India, Brazil and South Africa, should also undertake mitigation actions, since their GHG emissions are rising rapidly and will overwhelm any reductions carried out by developed countries. While mitigation actions by developing countries, in the initial stages, need not involve absolute reductions, they need to represent a ‘Significant deviation from their business as usual emission trajectories’. There is a demand that such deviation be quantified and be included in the form of a commitment.
The neoliberalization of football: Rethinking neoliberalism through the commercialization of the beautiful game
Authors: Dubal Sam
Published: June 2010

This ethnographic study explores how football (soccer) fandoms respond to neoliberal reforms, adding to a growing debate on the nature of neoliberalism by scholars such as geographer David Harvey, sociologist Nikolas Rose, and anthropologist Anna Tsing. In order to critique spatially and temporally coherent characterizations of neoliberalism, brief case analyses of fan reactions to the commercialization of Brazilian club Corinthians and English club Manchester United are used. Specifically, comparative insights from fans’ negotiation of market-based restructurings reveal how neoliberal ‘flows’ are implemented and experienced differently in different places. Particularities in these flows are employed to disassemble hegemonic and universal visions of neoliberalism through the notion of friction.
Forgetting the future
Authors: Kaplan Paul J.
Published: June 2010

This article aims to push the boundaries of definitions of capital cause lawyering to include a more potentially radical ‘cause’ that takes on one key ideological underpinning of state killing: individualism. This article studies whether and how capital trial lawyers take up a ‘radical’ cause by challenging individualism. To the extent that they oppose state killing and illuminate social inequality, the defenders studied in this project engage in something beyond the parameters of their particular trials, and thus fall partially within current definitions of cause lawyering. However, considering that they are unaware of, avoid, or suppress subversive arguments within the expansive discursive space afforded by penalty phase proceedings, they may be ‘forgetting the future’ precisely so that their clients may avoid a death sentence. Rather, defenders construct narratives that portray a liminal conceptualization of the influence of social forces on human free will, a concept known in the defense bar as ‘diminished autonomy’.
The transnational security consultancy industry
Authors: O'Reilly Conor
Published: June 2010

This article examines state—corporate organizational complexes within the transnational policing sphere. Its specific focus is upon the transnational security consultancy industry and its interaction with state security agencies. Exemplifying the proposed theoretical construct of state—corporate symbiosis, leading firms are held out as key facilitators for this ongoing close association between dominant interests. Their activities reflect how this security amalgamation imposes itself upon the agendas, discourse, methods and ideologies of the global policing environment. As well as highlighting the degree to which both behaviour and techniques traverse the state—corporate security nexus, this article also identifies core factors which have driven this convergence of interests. It concludes by suggesting that this evolution towards state—corporate symbiosis exacerbates those trends within transnational policing that prompt most concern, while undercutting those for which hope is harboured.
The online support group as a community: A micro-analysis of the interaction with a new member
Authors: Stommel Wyke , Koole Tom
Published: June 2010

Generally, online support groups are viewed as low-threshold services. We challenge this assumption with an investigation, based on Conversation Analysis and Membership Categorization Analysis, of contributions to an online support group on eating disorders. In this analysis we show how a new member interacts with existing members in order to display legitimacy for membership of the group. The group operates as a Community of Practice, since membership is organized as joined participation in a writing practice. It becomes clear that becoming a member involves subscribing to normative requirements, centrally, displaying the insight that you are ill. In the case we focus on, this involves the requirement to leave pro-anorexia as a membership category behind. The novice does not yet seem ready to subscribe to this norm and thus the threshold for seeking support is heightened.
Questions and explanations in French and Anglo-American Usenet newsgroups
Authors: von Münchow Patricia , Rakotonoelina Florimond
Published: June 2010

Within the conceptual framework of comparative discourse linguistics, this article examines the similarities and the differences between Anglo-American and French Usenet newsgroups and builds hypotheses about the implicit rules which govern the respective ethnolinguistic communities. The comparison is focused on cultural perceptions of questions and explanations occurring in the messages posted in these newsgroups. Both discursive operations have different conversational functions in the Anglo-American and the French messages. Their cross-cultural analysis shows that within the Anglo-American newsgroup, the purpose of the discussion is to get a better comprehension of the complexity of (environmental) issues, whereas the purpose within the French newsgroup is to maintain an ordinary conversation between equals.
Minimal answers to yes/no questions in the service of sequence organization
Authors: Keevallik Leelo
Published: June 2010

In conversation analytic and interactional studies, some responses are analyzed as being minimal.This article explores minimality in regard to two types of answers that appear to be used interchangeably as minimal responses to yes/no questions in Estonian. The answers represent typologically different formats, particles and echo answers (verb repeats). It is argued that minimality should be defined in a sequentially sensitive manner and that the two answer formats are used to display speakers’ understanding of the status of the social action implemented in the preceding question. The data come from audio recordings of phone calls and face-to-face interaction.
The Feasibility of Tissue Expanders in Reconstruction of Giant Congenital Melanocytic Nevi in Children
Authors: Baky Fahmy Mohamed A , Mazy Alaa
Published: June 2010

Background. Children with giant congenital melanocytic nevi (GCMN) pose a great challenge to pediatric and reconstructive surgeons because they have to cover the widely exposed area after its excision. A variety of treatment options exist for the management of such cases. In this retrospective review of a selected group of children who had a GCMN of their abdominal walls managed with implantation of tissue expanders (TEs) for staged reconstruction, patients were evaluated with respect to complications and general and esthetic criteria for patient and parent satisfaction. Objective. The purpose was to study the feasibility of use of TEs in the management of children who had GCMN, with special emphasis on the complications and children’s and parents’ satisfaction. Material and methods. Retrospective data from the 12 patients’ charts, operative data of 86 surgical procedures, and follow up visits were analyzed using the Student’s t test, and P < .05 was considered statistically significant. Results. In a period of 4 years, from 2004 to 2008, the results of using 37 different sizes of TEs and 86 operative procedures in 12 children (9 boys and 3 girls) aged from 2 to 12 years with different types of abdominal wall GCMN are discussed. Conclusion. The TE is a useful and feasible tool for reconstruction of the abdominal wall in cases of GCMN in children. Parents and children are satisfied in general and also with the body image.
Influence of heat treatment on stress–strain behaviour and lattice parameters of Sn–In alloy
Authors: Al-Ganainy G S , Abd El-Khalek A M , Sakr M S
Published: June 2010

Sn based alloys have important industrial applications specially as pewters and soldering materials. One of these alloys, Sn–5·2 wt-In alloy, is designed to be examined in the present work. The differential thermal analysis of this alloy gives a melting temperature value of 493 K. An empirical equation that can be used to determine the melting temperature of some Sn–In alloys is derived. Two different heat treated groups of samples, slowly cooled and quenched, are prepared. The phases present in these two groups of samples are determined from their X-ray diffraction patterns. The isothermal tensile stress–strain tests of all samples are reported at temperatures between 343 and 403 K. The changes of the work hardening parameters and also of the lattice parameters of the β-Sn phase with the deformation temperature are discussed. The values of the activation energy characterise a dislocation fracture mechanism.
Microstructural features of spray-formed AZ31 magnesium alloy
Authors: Dhar A , Anandani R C , Srivastava A K
Published: June 2010

Mg alloy AZ31 was spray-formed using an indigenously developed spray atomisation and deposition unit under protective atmosphere and various processing parameters were optimised. The microstructural features of the bell shaped AZ31 spray-formed deposit were characterised using optical microscope, scanning electron microscope/energy dispersive spectrometer, X-ray diffraction and high resolution transmission electron microscope. It was observed that the microstructural features are critically dependent on location in the spray-formed deposits. Under optimised processing conditions, the central region of the bell shaped deposit exhibited minimal porosity and a uniform fine grained equiaxed microstructure with fine Mg17Al12 intermetallics preferably located at the grain boundaries. However, the peripheral regions of the spray-formed deposit indicate higher porosity with distinct microstructural characteristics different from those in the central region. These microstructural features, observed at different locations in the spray-formed deposit, have been analysed and their evolution is discussed in the light of variations in thermal and solidification conditions of the droplets in flight, during impingement as well as those of the deposition surface.
Prediction of grain growth of coarse-grained austenite in Nb–V–Ti microalloyed steel
Authors: Sha Q Y , Sun Z Q
Published: June 2010

Grain growth of coarse-grained austenite in Nb–V–Ti microalloyed steel during equalisation was predicted by extending the previous investigation. The prediction worked with initial austenite grain size distribution instead of average grain size. An improved model taking into account the holding time was used in the prediction. The result showed that only part of initial austenite grains grow at each equalisation temperatures, but the grain size of growing grains is expanded to a wider range with increasing equalisation temperature, which indicates that grain size distribution should be considered when grain growth of coarse-grained austenite is evaluated. The predicted austenite grain size distribution is close fit to the measured one and further work is expected to improve the quality of model prediction.
Delocalization and Development: Empirical Findings from Selected European Countries
Authors: Kalogeresis Athanasios , Labrianidis Lois
Published: May 2010

Viewing delocalization as a fairly complex phenomenon affecting firms, sectors, regions and countries, this study aims at analysing the various interconnections between delocalization and development. To do so, we have developed an elaborate conceptual framework where upgrading and embeddedness are pivotal. Viewing development as a product of firm or network strategies and actions, assets and institutions, we find firms involved in delocalization to have benefited. On the other hand, delocalization often implies a weakening of linkages in the home economy, while the transfer of knowledge and other intangible assets is often non-existent. Moreover, our framework allows for more macroscopic assessments, where outcomes are products of complex processes involving quite unique factors, such as history, civil society and policies.
Regul(ariz)ation of Fringe Credit: Payday Lending and the Borders of Global Financial Practice
Authors: Aitken Rob
Published: May 2010

The recent financial crisis has been punctuated by a discussion of the future of global financial governance in terms of a ‘regulation/deregulation’ formula. This paper argues for a broadening of this frame by taking seriously recent claims of performativity. To place changes associated with financial globalization in a more complicated critical context, this paper explores the ways in which global finance has often entailed a redrawing of the boundaries between the financial and the everyday. To develop this argument, the paper focuses, in particular, on practices of payday lending and on recent regulatory changes which have performed payday lending in a particular set of ways. Reading payday lending as both a repertoire of market devices and a set of dividing practices, this paper concludes that regulation performs the object it seeks to manage by invoking ambiguous, and not singular, territories of governance.
Revisited role for mucus hypersecretion in the pathogenesis of COPD
Authors: Cerveri I. , Brusasco V.
Published: June 2010

Chronic obstructive pulmonary disease (COPD) is a heterogeneous and complex disease of which the basic pathophysiological mechanisms remain largely unknown. On the basis of recent results from pathological studies and large clinical trials, the presence of airway inflammation does not seem to be sufficient to explain the complexity of the disease and the relatively poor response to treatment. It is probably time to abandon the concept of COPD as a unique disease and define, identify and treat the various aspects, which may differ between individuals.

Among the different phenotypic distinctions, the classical distinction “chronic bronchitis” has mucus hypersecretion as the key presenting symptom. Its role in COPD has been the subject of an ongoing debate; however, it now appears to be being re-evaluated due to findings from recent epidemiological and pathological studies. In this context, the view that chronic mucus hypersecretion plays a secondary role in the pathogenesis of COPD should be abandoned and instead, drugs targeting mucus hypersecretion should be considered as a treatment option.
Prevention of exacerbations of COPD with pharmacotherapy
Authors: Miravitlles M.
Published: June 2010

Exacerbations are a frequent event in the evolution of chronic obstructive pulmonary disease (COPD) patients. Individuals with COPD have a mean of 1–3 episodes per year, some of which lead to hospital admission and may even be a cause of death. The importance of COPD exacerbations has become increasingly apparent due to the impact these episodes have on the natural history of disease. It is now known that frequent exacerbations can adversely affect health-related quality of life and short- and long-term pulmonary function. Optimising treatment for stable COPD will help to reduce exacerbations.

Long-acting bronchodilators, alone or combined with inhaled corticosteroids, have demonstrated efficacy in reducing the rate of exacerbations in patients with COPD. Other innovative approaches are being investigated, such as the long-term use of macrolides or the use of antibiotics in an effort to suppress bronchial colonisation and consequent exacerbations. Other drugs, such as mucolytics and immunomodulators, have recently provided positive results.

Non-pharmacological interventions such as rehabilitation, self-management plans and the maintenance of high levels of physical activity in daily life are also useful strategies to prevent exacerbations in patients with COPD and should be implemented in regular clinical practice.
Mucoactive therapy in COPD
Authors: Decramer M. , Janssens W.
Published: June 2010

It has been shown that mucus hypersecretion is associated with greater susceptibility for chronic obstructive pulmonary disease (COPD), excess forced expiratory volume in 1 s decline, hospitalisations and excess mortality. The effects of mucoactive drugs on outcomes have been reviewed in several meta-analyses, the largest one including 26 studies. 21 studies were performed in patients with chronic bronchitis and five in patients with COPD. The majority of these trials were performed withN-acetylcysteine (n = 13) and carbocysteine (n = 3).

Overall, there was a significant reduction in exacerbations (0.05 per patient per month) and the number of days with disability (0.56 days per patient per month). Mucolytics were well tolerated and the number of adverse events was lower than with placebo (odds ratio 0.78). In the largest and best designed study withN-acetylcysteine in 523 patients with COPD, the reduction in exacerbations was only observed in patients not taking inhaled corticosteroids. In addition, a 374 mL reduction in functional residual capacity was found. A recent large study (n = 709) with high-dose carbocysteine (1,500 mg·day−1) demonstrated a significant effect on exacerbations (25% reduction) and also reported an improvement in health-related quality of life (-4.06 units in St George's Respiratory Questionnaire).

It is unclear what the mechanisms underlying these effects may be and which phenotypes benefit from this treatment. On the basis of this evidence mucoactive drugs may deserve consideration in the long-term treatment of COPD.
What does the respiratory physician interested in sleep need to know about bariatric surgery?
Authors: Ramsey H. , Pournaras D.J. , Ahmed A. , le Roux C. , Partridge M.R.
Published: June 2010

Educational aims

To understand the relationship between obstructive sleep apnoea/hypopnoea syndrome, obesity and bariatric surgery.

To learn the mechanisms, techniques and non-respiratory benefits of bariatric surgery.

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is reported to affect 4% of middle-aged males and 2% of middle-aged females in the UK [1], with one of the most widely recognised major risk factors being obesity [2]. The prevalence of obesity in many countries is rising – in England, 24% of males and 24% of females were classified as obese in 2007 (body mass index (BMI) ≥30 kg per m2), compared with 13.2% of males and 16.4% of females in 1993 [3]. The prevalence of OSAHS within the obese population is widely reported to range between 55–90% in people with a BMI of >40 kg per m2[4], and many studies have found a reduction in the apnoea/hypopnoea index (AHI) and symptoms of OSAHS with weight loss [5], although it is widely recognised that weight loss by medical methods does not yield good results in the long term. The mainstay of treatment for OSAHS is nocturnal continuous positive airway pressure (CPAP) therapy. This has been shown to have a discontinuation rate of 18–24% [2], which adds to the need for alternative therapy for OSAHS associated with obesity.

Bariatric surgery is the field of weight-loss surgery, from the Greek words ‘baros’ meaning ‘weight’ and ‘iatrike’ meaning ‘medicine’, and is widely accepted as the most effective, long-term treatment for obesity, especially in those with a BMI of >40 kg per m2. The Swedish Obese Subjects Trial, the largest trial studying surgicalversusmedical treatment of weight loss, showed an average weight loss of approximately 25.6% 2 yrs after surgery and 18.3% after 10 yrs, compared with a weight change of ±2% in the medically managed group [6].
Continuous positive airway pressure and humidification
Authors: Nilius G. , Ruhle K-H.
Published: June 2010

Educational aims

To demonstrate the side-effects of CPAP on the upper airways.

To discuss the principles of humidification of breathing.

To explain the operating mode and distinctions of different heated humidifiers.

Upper airway complications are very common during noninvasive positive-pressure ventilation, particularly continuous positive airway pressure (CPAP). Acceptance of CPAP is compromised if such complaints occur; thus proactive management is very important for the achievement of good compliance. The use of conventional heated humidifiers is standard therapy when complications with upper airways arise during CPAP therapy. The performance of different types of heated humidifiers has not been fully considered in terms of their therapeutic effect. In particular, changes in ambient conditions should be taken into account. Advanced controlled heated humidifiers with heated breathing tubes monitor the amount of air flow,e.g.when mouth or mask leaks occur, as well as changes in ambient temperature. These more advanced techniques have been proven to reduce side-effects.
Pulmonary rehabilitation: today and tomorrow
Authors: Nici L. , ZuWallack R.
Published: June 2010

Educational aims

To review the rationale for and the components of comprehensive pulmonary rehabilitation.

To evaluate the role of pulmonary rehabilitation in chronic obstructive pulmonary disease exacerbation.

To discuss the potential role of pulmonary rehabilitation in the critically ill patient and the patient with lung cancer

Comprehensive and effective clinical management of chronic obstructive pulmonary disease (COPD) requires an interdisciplinary, integrated care approach that includes both pharmacological and nonpharmacological therapies. Pulmonary rehabilitation is a nonpharmacological, interdisciplinary, patient-centred intervention that is a crucial component of the optimal care for patients with COPD, and, as such, has a prominent place in all current guidelines for the treatment of this disease [1–3].

This article will begin by outlining the components of pulmonary rehabilitation and the rationale behind its effectiveness. It will then focus on some emerging areas of clinical and research interest which will illustrate how the principles of pulmonary rehabilitation can be adapted to nontraditional areas to improve patient outcomes. These include COPD exacerbations, lung cancer and critical illness.
Integrated care of the COPD patient: a pulmonary rehabilitation perspective
Authors: ZuWallack R. , Nici L.
Published: June 2010

Educational aims

To demonstrate that the current care system for chronic obstructive pulmonary disease (COPD) patients often falls short of desired outcomes.

To describe the concepts of the chronic care model and integrated care.

To emphasise the positioning of pulmonary rehabilitation and self-management and self management strategies within integrated care.

The current acute care model for COPD is, in general, insufficient for optimal management of the disease. Single disease guidelines often fall short for diseases such as COPD that have prominent systemic manifestations and frequent comorbidities contributing to disease burden. Coordination of services is often inadequate, especially at the time of the COPD exacerbation, which is characterised by high morbidity, increased healthcare utilisation and increased mortality risk. The integrated care model for COPD may reduce some of these inefficiencies. On one level, integrated care means giving the right patient the right therapy at the right time. This can include smoking cessation therapies, the promotion of a healthy lifestyle, including regular exercise and increased activity, optimal pharmacotherapy, collaborative self-management strategies, palliative therapy and end-of-life care. Additionally, integrated care improves access to care and reduces fragmentation of care through partnering, communication and coordination among healthcare professionals, patients and their families. Integration at the time of the exacerbation includes a comprehensive assessment of the patient at the time of hospital discharge, proper discharge planning, early discharge services, a self-management plan, sharing this plan with all pertinent healthcare providers, utilisation of a professional for case management and facilitation of the exchange of information with modern information technology. Pulmonary rehabilitation provides many of these services and can be considered a component of integrated care.
Outpatient pulmonary rehabilitation
Authors: Singh S. , Wagg K.
Published: June 2010

Educational aims

To consider the fundamental aims of pulmonary rehabilitation.

To give an overview of the outcome measures used and how they can be applied

To review the content of a course of rehabilitation and methods by which it can be delivered.

To review the structure and format of rehabilitation including setting, location and duration.

Pulmonary rehabilitation provides a package of education, nutritional support and physical training that promotes the skills required for patients to successfully self manage their respiratory condition. Improvements in quality of life, exercise tolerance, physical activity and function are key outcomes for the individual. There are many tools available which measure these changes and can be used to identify individual deficits and needs. Most of the literature describes the intervention in chronic obstructive pulmonary disease (COPD), but there is emerging evidence that the benefits translate to other respiratory conditions, and improvements are achievable regardless of disease severity, smoking status, gender or age. To maintain the benefits from rehabilitation it is critical to identify barriers and address behaviour change that will provoke better lifestyle choices.
Pathogenesis and diagnosis of bronchiectasis
Authors: King P.T. , Daviskas E.
Published: June 2010

Educational aims

To describe the important factors involved in the pathogenesis of bronchiectasis.

To define how a diagnosis of bronchiectasis is made.

Bronchiectasis is an important cause of respiratory morbidity but one that has generally had a low profile. The prevalence of this condition varies but is common in certain indigenous populations and, anecdotally, in developing nations. It also has been recently recognised to be an ongoing problem in developed countries. As bronchiectasis is heterogeneous with a large number of predisposing factors and, generally, a long clinical history, the pathogenesis has not been well defined. The combination of a microbial insult and a defect in host defence allow the establishment of persistent bronchial infection and inflammation leading to progressive lung damage. Lung function testing usually demonstrates a mild to moderate obstructive pattern, which arises from inflammation in the small airways. There are a number of risk factors associated with this condition, which is commonly idiopathic. The microbiology of bronchiectasis is complex and changes as the disease progresses. The diagnosis is made by a combination of clinical symptoms and high-resolution computed tomography (HRCT) demonstrating abnormal airway dilatation.
Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China
Authors: Cui Wei , Zhao Hongwen , Lu Xu , Wen Ying , Zhou Ying , Deng Baocheng , Wang Yu , Wang Wen , Kang Jian , Liu Pei
Published: June 2010

Background

During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009.

Methods

We carried out a retrospective chart review of 68 patients who were hospitalized with pneumonia and confirmed to have 2009 H1N1 virus infection by a real time RT-PCR assay of respiratory specimens.

Results

Of the 68 patients we studied, 30 (44%) were admitted to an intensive care unit and 10 (14.7%) died. The median age of patients was 41 years (range, 18-66), and only one patient was over 65 years of age. The male to female ratio was 2.78:1 (50:18). Of the 68 patients, 23 (34%) had at least one underlying medical condition, 9 (13%) had a cigarette index ≥400 and 22 (32%) were obese. All patients underwent chest radiography on admission and the findings were consistent with pneumonia in all cases. All patients were treated with oseltamivir and treatment was initiated at a median time of seven days after the onset of illness. The laboratory test results indicated lymphopenia, hypoproteinemia and elevated lactic dehydrogenase and C reactive protein levels. Of the 68 patients, 33 (52%) showed a reduction in CD4 T cell counts. Of the 58 patients who survived, 31 (53%) had lymphopenia and 27 recovered from this condition after five days. Of the 10 patients who died, nine (90%) had lymphopenia and only two patients recovered from this condition after five days. Obesity and recovery from lymphopenia after five days were factors associated with death, as determined by multivariate logistic-regression analysis (obesity, odds ratio = 23.06; lymphocytopenia reversion, odds ration = 28.69).

Conclusions

During the evaluation period in Shenyang, China, 2009 H1N1 influenza caused severe illness requiring hospitalization in 68 patients, 10 (14.7%) of which died. Many of these patients were considered healthy adults and few were elderly (65 years or older). Obesity and lymphopenia, which was not restored after five days of treatment, were factors associated with poor outcomes of 2009 H1N1 influenza infection.
Surveillance of active human cytomegalovirus infection in hematopoietic stem cell transplantation (HLA sibling identical donor): search for optimal cutoff value by real-time PCR
Authors: Peres Renata MB , Costa Cláudia RC , Andrade Paula D , Bonon Sandra HA , Albuquerque Dulcinéia M , de Oliveira Cristiane , Vigorito Afonso C , Aranha Francisco JP , de Souza Cármino A , Costa Sandra CB
Published: June 2010

Background

Human cytomegalovirus (CMV) infection still causes significant morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Therefore, it is extremely important to diagnosis and monitor active CMV infection in HSCT patients, defining the CMV DNA levels of virus replication that warrant intervention with antiviral agents in order to accurately prevent CMV disease and further related complications.

Methods

During the first 150 days after allogeneic HSTC, thirty patients were monitored weekly for active CMV infection by pp65 antigenemia, nested-PCR and real-time PCR assays. Receiver operating characteristic (ROC) plot analysis was performed to determine a threshold value of the CMV DNA load by real-time PCR.

Results

Using ROC curves, the optimal cutoff value by real-time PCR was 418.4 copies/104 PBL (sensitivity, 71.4%; specificity, 89.7%). Twenty seven (90%) of the 30 analyzed patients had active CMV infection and two (6.7%) developed CMV disease. Eleven (40.7%) of these 27 patients had acute GVHD, 18 (66.7%) had opportunistic infection, 5 (18.5%) had chronic rejection and 11 (40.7%) died - one died of CMV disease associated with GVHD and bacterial infection.

Conclusions

The low incidence of CMV disease in HSCT recipients in our study attests to the efficacy of CMV surveillance based on clinical routine assay. The quantification of CMV DNA load using real-time PCR appears to be applicable to the clinical practice and an optimal cutoff value for guiding timely preemptive therapy should be clinically validated in future studies.
Effect of obesity on constant workrate exercise in hyperinflated men with COPD
Authors: Laviolette Louis , Sava Francesco , O'Donnell Denis E , Webb Katherine A , Hamilton Alan L , Kesten Steven , Maltais François
Published: June 2010

Background

Chronic obstructive pulmonary disease (COPD) and a high body mass index (BMI) can both affect pulmonary volumes as well as exercise tolerance, but their combined effect on these outcomes is not well known. The aim of this study was to investigate the effects of increased BMI during constant workrate cycle ergometry in patients with COPD.

Methods

Men with COPD and hyperinflation were divided according to World Health Organization BMI classification: 84 normal BMI (NBMI), 130 overweight (OW) and 64 obese (OB). Patients underwent spirometric and lung volumes assessment and an incremental cycling exercise test. This was followed by a constant workrate exercise test (CET) at 75% of peak capacity. Inspiratory capacity and Borg dyspnea scores were measured at baseline, during and at the end of CET.

Results and discussion

FEV1 % predicted was not different across BMI classes. Total lung capacity and functional residual capacity were significantly lower in OB and OW compared to NBMI patients. Peak VO2 in L·min-1 was significantly higher in OB and OW patients than in NBMI patients. CET time was not different across BMI classes (p = 0.11). Changes in lung volumes and dyspnea during CET were not different between BMI categories.

Conclusions

OB and OW patients with COPD had a higher peak VO2 than their lean counterparts. Endurance time, dyspnea and changes in lung volumes during CET were similar between BMI categories.
US public opinion regarding proposed limits on resident physician work hours
Authors: Blum Alexander B , Raiszadeh Farbod , Shea Sandra , Mermin David , Lurie Peter , Landrigan Christopher P , Czeisler Charles A
Published: June 2010

Background

In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue.

Methods

We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations.

Results

Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with ≥5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor.

Conclusions

The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.
Early uptake and continuous accumulation of thallium-201 chloride in a benign mixed tumor of soft tissue: Case Report
Authors: Nagata Shigenori , Jin Yu-Fen , Yoshizato Katsuhiko , Kitamura Masanori , Iizuka Norishige , Song Misa , Tomoeda Miki , Yuki Michiko , Kubo Chiaki , Yoshizawa Hidenori , Outani Hidetatsu , Hamada Kenichiro , Araki Nobuhito , Funauchi Masahiro , Tomita Yasuhiko
Published: June 2010

A case of benign mixed tumor of the soft tissue in a 64-year-old Japanese male is presented. He noticed a painless, elastic hard mass sized 3 cm in the right knee, which gradually grew larger and harder in the last 5 years. Magnetic resonance imaging demonstrated a mass lesion embedded in the subcutaneous tissue with low and high signal intensity at T1- and T2-weighted images, respectively. Tl-201 scintigraphy showed an early uptake of Tl-201 within the lesion at 10 minutes after injection, which was slightly decreased but still continued at 2 hours later. The patient underwent a resection of tumor, and the pathological diagnosis was a benign mixed tumor of soft tissue without high vascularity, characterized by histological features similar to pleomorphic adenomas in the salivary glands. Immunohistochemical study proved expression of Na+/K+-ATPase of tumor cells. Overexpression of Na+/K+-ATPase of the tumor might be responsible for the early uptake of Tl-201, and poor vascular structure in this tumor might lead to continuous accumulation. The Tl-201 scintigraphic features of mixed tumor of soft tissue are assessed to resemble those of malignant soft tissue tumors.
The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain
Authors: Muthukrishnan Ramprasad , Shenoy Shweta D , Jaspal Sandhu S , Nellikunja Shankara , Fernandes Svetlana
Published: June 2010

Background

The purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.

Methods

This was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).

Results

The MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedges's g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).

Conclusions

In this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.

Trial registration

UTRN095032158-06012009423714
5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention: summary of key research and implications for policy and practice – Biomedical prevention
Authors: Mascolinli Mark , Kort Rodney
Published: June 2010

No major findings were reported at the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) on currently enrolled microbicides, pre‐exposure prophylaxis (PrEP) or vaccine trials, although important findings in all three areas of biomedical prevention research are expected within the next few years.

A study found that daily acyclovir did not reduce HIV transmission, but was a factor in modest reductions in viral load, which could confer some clinical benefit. Research demonstrating rapid viral replication in mucosal tissue and subsequent dissemination throughout the body suggested that research priorities should shift towards a mucosal vaccine. Findings reported in Track C indicated that, in addition to reducing vertical transmission, antiretroviral therapy (ART) also lowers the risk of prematurity, stillbirth and abortion.

Challenging concerns about the potential “disinhibiting” effect of ART as prevention, a Kenyan study found that widespread ART encourages greater use of condoms and does not increase the rate of risky sex. Another Kenyan study found that pregnancy increases the risk of HIV transmission in a cohort of serodiscordant couples. Although three randomized trials have conclusively demonstrated that circumcision reduces HIV transmission among heterosexual men, research presented at IAS 2009 found no evidence of a preventive impact for women.

19‐22 July 2009, 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009), Cape Town, South Africa
Entering Research: A Course That Creates Community and Structure for Beginning Undergraduate Researchers in the STEM Disciplines
Authors: Balster Nicholas , Pfund Christine , Rediske Raelyn , Branchaw Janet
Published: June 2010

Undergraduate research experiences have been shown to enhance the educational experience and retention of college students, especially those from underrepresented populations. However, many challenges still exist relative to building community among students navigating large institutions. We developed a novel course called Entering Research that creates a learning community to support beginning undergraduate researchers and is designed to parallel the Entering Mentoring course for graduate students, postdocs, and faculty serving as mentors of undergraduate researchers. The course serves as a model that can be easily adapted for use across the science, technology, engineering, and mathematics (STEM) disciplines using a readily available facilitator's manual. Course evaluations and rigorous assessment show that the Entering Research course helps students in many ways, including finding a mentor, understanding their place in a research community, and connecting their research to their course work in the biological and physical sciences. Students in the course reported statistically significant gains in their skills, knowledge, and confidence as researchers compared with a control group of students, who also were engaged in undergraduate research but not enrolled in this course. In addition, the faculty and staff members who served as facilitators of the Entering Research course described their experience as rewarding and one they would recommend to their colleagues.
Teaching Bioinformatics and Neuroinformatics by Using Free Web-based Tools
Authors: Grisham William , Schottler Natalie A. , Valli-Marill Joanne , Beck Lisa , Beatty Jackson
Published: June 2010

This completely computer-based module's purpose is to introduce students to bioinformatics resources. We present an easy-to-adopt module that weaves together several important bioinformatic tools so students can grasp how these tools are used in answering research questions. Students integrate information gathered from websites dealing with anatomy (Mouse Brain Library), quantitative trait locus analysis (WebQTL from GeneNetwork), bioinformatics and gene expression analyses (University of California, Santa Cruz Genome Browser, National Center for Biotechnology Information's Entrez Gene, and the Allen Brain Atlas), and information resources (PubMed). Instructors can use these various websites in concert to teach genetics from the phenotypic level to the molecular level, aspects of neuroanatomy and histology, statistics, quantitative trait locus analysis, and molecular biology (including in situ hybridization and microarray analysis), and to introduce bioinformatic resources. Students use these resources to discover 1) the region(s) of chromosome(s) influencing the phenotypic trait, 2) a list of candidate genes—narrowed by expression data, 3) the in situ pattern of a given gene in the region of interest, 4) the nucleotide sequence of the candidate gene, and 5) articles describing the gene. Teaching materials such as a detailed student/instructor's manual, PowerPoints, sample exams, and links to free Web resources can be found at http://mdcune.psych.ucla.edu/modules/bioinformatics .
Does Displaying the Class Results Affect Student Discussion during Peer Instruction?
Authors: Perez Kathryn E. , Strauss Eric A. , Downey Nicholas , Galbraith Anne , Jeanne Robert , Cooper Scott
Published: June 2010

The use of personal response systems, or clickers, is increasingly common in college classrooms. Although clickers can increase student engagement and discussion, their benefits also can be overstated. A common practice is to ask the class a question, display the responses, allow the students to discuss the question, and then collect the responses a second time. In an introductory biology course, we asked whether showing students the class responses to a question biased their second response. Some sections of the course displayed a bar graph of the student responses and others served as a control group in which discussion occurred without seeing the most common answer chosen by the class. If students saw the bar graph, they were 30% more likely to switch from a less common to the most common response. This trend was more pronounced in true/false questions (38%) than multiple-choice questions (28%). These results suggest that observing the most common response can bias a student's second vote on a question and may be misinterpreted as an increase in performance due to student discussion alone.
Laura Carruth
Authors: Hoopes Laura L. Mays
Published: June 2010

Note from the Editor

Educator Highlights for CBE—LSE show how professors at different kinds of institutions educate students in life sciences with inspiration and panache. If you have a particularly creative teaching portfolio yourself, or if you wish to nominate an inspiring colleague to be profiled, please e-mail Laura Hoopes at lhoopes@pomona.edu .