bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Sleep Disturbance in Closed Head Injury Patients in a Rehabilitation Unit
Authors: Makley M. J. , English J. B. , Drubach D. A. , Kreuz A. J. , Celnik P. A. , Tarwater P. M.
Published: July 2008

Traumatic brain injury (TBI) is a leading cause of disability in young people in the United States. Disorders of arousal and attention are common in closed head injury (CHI). Daytime drowsiness impairs participation in rehabilitation, whereas nighttime wakefulness leads to falls and behavioral disturbances. Sleep disturbances in TBI reported in the literature have included excessive daytime somnolence, sleep phase cycle disturbance, narcolepsy, and sleep apnea. Although well known to the clinician treating these patients, the extent and prevalence of disrupted sleep in patients in an acute inpatient rehabilitation unit has not been described. Objective. To determine the prevalence of sleep wake cycle disturbance (SWCD) in patients with CHI in a TBI rehabilitation unit. Design. Prospective observational. Setting. Inpatient specialized brain injury rehabilitation unit. Patients. Thirty-one consecutive admissions to a brain injury rehabilitation unit with the diagnosis of CHI. Results. Twenty-one patients (68%) had aberrations of nighttime sleep. There was no significant difference in Glasgow Coma Score on admission to trauma nor was there any significant difference in age between the affected and unaffected groups. Patients with SWCD had longer stays in both the trauma center ( P < .003) and the rehabilitation center ( P < .03). Conclusions. There is a high prevalence of SWCD in CHI patients admitted to a brain injury rehabilitation unit. Patients with SWCD have longer stays in both acute and rehabilitation settings and may be a marker for more severe injury.
Preparation of amine free silica-coated Agl nanoparticles with modified Stöber method
Authors: Kobayashi Y. , Shimizu N. , Misawa K. , Takeda M. , Ohuchi N. , Kasuya A. , Konno M.
Published: July 2008

In recent years, the authors studied on fabrication of silica-coated Agl (Agl–SiO2) nanoparticles with a Stöber method toward new X-ray contrast agents. In the Stöber method, amines are often used as catalysts for silica formation, so that it is probable that amine is left in the silica-coated particles. Since amines are harmful to the human body, amine free particles are desired for medical use. From this viewpoint, amine free Agl–SiO2 nanoparticles were prepared with a modified Stöber method using NaOH as a catalyst instead of amine in the present work. The Agl nanoparticles were prepared from AgClO4 and KI with the use of 3-mercaptopropyltrimethoxysilane (MPS) as a silane coupling agent and NaOH catalyst for alkoxide hydrolysis. The silicacoating was performed at 4·5 × 10−5M MPS, 15–22·5M water, 0·0008–0·0024M NaOH and 0·0004–0·009M tetraethylorthosilicate at an Agl concentration of 0·001M. Agl–SiO2 particles as small as ca. 30 nm could be successfully fabricated at the concentrations of 4·5 × 10−5M MPS, 20M water, 0·0011M NaOH, 0·001M Agl and 0·004M tetraethylorthosilicate.
Effect of electrolyte on surface potential of haematite in aqueous electrolyte solutions
Authors: Preočanin T. , Kallay N.
Published: July 2008

A method for determination of the surface potential Ψ0 by single crystal metal oxide electrodes is demonstrated. Theoretical analysis of metal oxides using the surface complexation model was based on the general surface reaction equation. It was shown that the slope of Ψ0(pH) function should be lower than the Nernstian slope. This reduction was found to depend on the nature of the counterions and to be more pronounced at higher electrolyte concentrations. Quantitative analysis of the surface potential data enables evaluation of the ratio of surface concentrations of positive (protonated) to negative (deprotonated) surface sites, as well as activity coefficients of charged surface species. These data, along with data obtained by other methods, enable complete characterisation of the electrical interfacial layer at the metal oxide aqueous interface.
Effect of temperature and zinc concentration on zinc coatings deposited with pack cementation
Authors: Chaliampalias D. , Pistofidis N. , Vourlias G.
Published: July 2008

Zinc coatings are proved to be corrosion resistant as they react with atmospheric compounds forming an adherent film on their surface. This work investigates the feasibility of zinc deposition on low alloy steels by pack cementation at temperatures from 380 to 450°C. The effect of zinc concentration in the pack powder is also examined to increase the corrosion resistance of the coating without affecting its mechanical properties. The duration of the process was stable at 2 h. From this research it was finally observed that the formation of the zinc coating begins over 390°C and that the zinc content affects exponentially the coating thickness, but not the phase distribution of the as produced coating which refers to γ-Fe11Zn40 and δ-FeZn10 phases of the Fe–Zn phase diagram.
Examination of microstructural features of zinc protective coatings on low carbon steel formed in fluidised bed reactor
Authors: Chaliampalias D. , Pistofidis N. , Vourlias G.
Published: July 2008

Galvanising is the most widely used process for zinc coating. However alternative methods exist with less environmental impact such as fluidised bed process. In this work the structure of Zn coatings formed with fluidised bed process technique at 400°C for 1 h holding time has been studied. The coated samples were observed with scanning electron microscopy and characterised with energy dispersive spectroscopy and X-ray diffraction. The as formed phases correspond to gamma and delta phases of the Fe–Zn system. Some of the as deposited coatings are likely to provide sufficient anticorrosive protection while others are of low quality, as many porous areas are present in their mass.
Effect of montmorillonite on properties of nanocomposite coatings
Authors: Špírková M. , Strachota A. , Strachotová B. , Urbanová M.
Published: July 2008

Unmodified or chemically modified montmorillonite (MMT) dispersed in water was added into the reaction mixture forming hybrid organic–inorganic (O–I) nanocomposite coating. Two basic systems made from functionalised trialkoxysilane and oligomeric diamine v. functionalised dialkoxysilane and triamine were prepared and compared. End properties depend not only on the concentration and kind of MMT used but also on the inner constitution of the O–I matrix. Already 1 wt-% of unmodified MMT influences considerably surface and mechanical properties, but the effect of chemically modified MMT is not so pronounced. This can be due to worse dispersion (scattering) of chemically modified MMT within the O–I matrix compared with unmodified one: while unmodified MMT is partially intercalated, partially exfoliated in the product, substantial amount of original, unaffected MMT clusters was found there. Solid state nuclear magnetic resonance spectroscopy confirmed the interaction of MMT platelets with the O–I matrix.
Transcriptional repression of the RUNX3/AML2 gene by the t(8;21) and inv(16) fusion proteins in acute myeloid leukemia
Authors: Cheng Chi Keung , Li Libby , Cheng Suk Hang , Lau Kin Mang , Chan Natalie P. H. , Wong Raymond S. M. , Shing Matthew M. K. , Li Chi Kong , Ng Margaret H. L.
Published: July 2008

RUNX3/AML2 is a Runt domain transcription factor like RUNX1/AML1 and RUNX2/AML3. Regulated by 2 promoters P1 and P2, RUNX3 is frequently inactivated by P2 methylation in solid tumors. Growing evidence has suggested a role of this transcription factor in hematopoiesis. However, genetic alterations have not been reported in blood cancers. In this study on 73 acute myeloid leukemia (AML) patients (44 children and 29 adults), we first showed that high RUNX3 expression among childhood AML was associated with a shortened event-free survival, and RUNX3 was significantly underexpressed in the prognostically favorable subgroup of AML with the t(8;21) and inv(16) translocations. We further demonstrated that this RUNX3 repression was mediated not by P2 methylation, but RUNX1-ETO and CBFβ-MYH11, the fusion products of t(8;21) and inv(16), via a novel transcriptional mechanism that acts directly or indirectly in collaboration with RUNX1, on 2 conserved RUNX binding sites in the P1 promoter. In in vitro studies, ectopically expressed RUNX1-ETO and CBFβ-MYH11 also inhibited endogenous RUNX3 expression. Taken together, RUNX3 was the first transcriptional target found to be commonly repressed by the t(8;21) and inv(16) fusion proteins and might have an important role in core-binding factor AML.
OFS Model-Based Adaptive Control for Block-Oriented Non-Linear Systems
Authors: Zhang Haitao , Zhang Chi , Chen Zonghai , Li Ming , Xiang Wei
Published: July 2008

A non-linear state feedback algorithm based on an OFS (orthonormal functional series) model combined with Volterra Functional Series is proposed to solve block-oriented non-linear systems. This algorithm has excellent approximation ability for the variance of system time-delay, and can guarantee the closed-loop robust stability and the zero steady-state error property. In addition, it has lower online optimization computational load when dealing with the hard input constraints in contrast to traditional NMPC (non-linear model predictive control) based on the OFS model. The analyses of the stability and robustness of this algorithm are put forward systemically, and the steady-state performance analysis is also given. Case studies involving simulations on a Wiener-type non-linear system and temperature experiments on a simulation chemical reactor are used to validate the efficiency and superiority of this proposed algorithm.
A Novel Linear Recurrent Neural Network for Multivariable System Identification
Authors: Fei Minrui , Zhang Jian , Hu Huosheng , Yang Taicheng
Published: July 2008

This paper proposes a novel linear recurrent neural network for multivariable system identification, namely a linerec neural network (LNN). Based on this network, the transfer function matrix model of a multivariable system can be identified directly according to its input and output data. In this way, LNNs differ from existing neural networks. An LNN is constructed based on the identification of prior knowledge in a system, and its weights have definite physical meaning. An LNN is equivalent to a linear equation set, and its training algorithm is based on Widrow-Hoff learning rules. In this paper, the theoretical foundation, structural algorithm and learning rules of LNNs are proposed and studied. To guarantee learning convergence, network training stability is analysed using discrete Lyapunov stability theory. Finally, simulation results show the feasibility of LNNs for multivariable system identification.
Some principles of second language phonology
Authors: Eckman Fred R. , Elreyes Abdullah , Iverson Gregory K.
Published: July 2008

The research we report here is intended to build an understanding of several well-known yet poorly comprehended problems relating to phonemic contrasts in the learning of L2 pronunciation. The competing influences of similarity and difference between native and target language sound systems, in particular, are central to this understanding, which we believe show that L2 phonology is a highly abstract enterprise parallel to the phonologies of primary languages, rather than - as has been assumed - a mere imitation of the target language’s pronunciations. We identify three interesting learning situations which involve the target language’s having different phonemic contrasts from the native language. In the first situation, the native language has neither of two sounds which contrast in the target language; in the second situation, the native language includes just one of two sounds which contrast in the target language. And in the third situation, the native language has both of the sounds in question but shows no contrast between them, i.e., a phoneme of the native language has two (or more) allophones that categorize as separate phonemes in the target language.
Modified ultrafiltration in surgical correction of congenital heart disease with cardiopulmonary bypass
Authors: Maluf Miguel A
Published: July 2008

The surgical correction of congenital heart disease using haemodilution and hypothermia with cardiopulmonary bypass (CPB) may expose patients to tissue ischaemia and initiate a systemic inflammatory response, increasing the total body water and inducing impairment, especially of heart, lung and brain function.

It is possible to use ultrafiltration during CPB in the rewarming phase to remove water accumulation in the third space (conventional ultrafiltration). The reduced volume of prime used in children and the ability only to filter the reservoir blood during CPB led the Great Ormond Street Group to modify the method of ultrafiltration with regards to the placement of the filter and the timing of filtration (post-CPB). The main advantage of the modified technique is the ultrafiltration of the patient.

A prospective nonrandomized study has been conducted to compare conventional with conventional+modified ultrafiltration. From January 1996 to March 1998, 41 patients underwent correction of congenital heart disease and were submitted to a comparative study (homogeneous groups), using either the conventional or the conventional+modified ultrafiltration techniques. There were no technical complications, no patient required mediastinal re-exploration due to bleeding and it was possible to close all the chests.

There were significant differences in the ultrafiltrate volume balance (143.39 /54.3 versus 2279 /71.4 mL; P B /0.001) but there were no significant differences in clinical postoperative evolution between the conventional and the conventional+modified ultrafiltration.
Selective regional alterations in the content or distribution of neuronal and glial cytoskeletal proteins in brain of rats chronically exposed to 2,5-hexanedione
Authors: Hernandez-Viadel Mari Luz , Rodrigo Regina , Felipo Vicente
Published: July 2008

Hexane is used in many industrial processes and induces neurotoxic effects in the central and peripheral nervous system. Hexane is metabolized to 2,5-hexanedione, which is the neurotoxic agent. Continued exposure to hexane or 2,5-hexanedione results in loss of sensorial and motor function in arms and legs and to alterations in axonal neurofilament proteins. The effects of 2,5-hexanedione on different cytoskeletal proteins in different brain areas have not been studied in detail. The aim of this work was to study the effects of chronic exposure of rats to 2,5-hexanedione (1% in the drinking water) on tubulin, neurofilament NF-L, microtubule-associated protein MAP-2, and on glial fibrillary acidic protein (GFAP), in cerebellum, hippocampus and cerebral cortex. The amount of each protein was determined by immunoblotting and its distribution was analysed by immunohistochemistry. The results obtained show a regional selectivity in the 2,5-hexanedione effects on cytoskeletal proteins. NF-L content decreased in all brain areas. MAP-2 decreased in cerebellum and hippocampus and tubulin decreased only in cerebellum. GFAP decreased only in cerebral cortex, but its distribution was altered in cerebellum, with increased content in the granular layer and decreased content in the molecular layer. The area most affected was the cerebellum, where all the proteins analysed were altered. These cytoskeletal proteins alterations may impair the transfer of information involved in the regulation by the cerebellum of motor function and contribute to the altered motor performance in rats exposed to 2,5-hexanedione and humans exposed to hexane.
Review of analytical methods for prospective cohort studies using time to event data: single studies and implications for meta-analysis
Authors: Bennett Derrick A
Published: July 2008

Prospective cohort studies are extremely important in epidemiological research as they give direct information on the sequence of events, which can be used to demonstrate causality. They also have the advantage that many diseases can be studied simultaneously. However, they are usually very time consuming and expensive to run. In addition, practitioners of evidence-based medicine prefer to make decisions based on several studies rather than a single study, hence the need for meta-analysis. The use of meta-analyses in order to synthesize the evidence from randomized controlled trials is extremely popular in medicine and is also being utilized increasingly in epidemiology. The statistical methodology for meta-analyses of epidemiological studies is a long way behind in terms of the advances made in the methodology for randomized controlled trials. Numerous methodological issues, particularly in respect to dealing with biases inherent in these types of studies, have made the results of meta-analyses of epidemiological studies that use summary data open to criticism. This review mainly concentrates on analytical methods for prospective cohort studies that have survival outcomes. In addition, the implications for meta-analysis assuming that the analyst has access to individual participant data are also discussed. The approaches are described with respect to underlying theory and assumptions. It is hoped that this review will promote the use of these approaches in meta-analyses conducted in epidemiology as well as providing some directions for future research.
Use of a Markov transition model to analyse longitudinal low-back pain data
Authors: Yu Fei , Morgenstern Hal , Hurwitz Eric , Berlin Thomas R
Published: July 2008

In a randomized clinical trial to assess the effectiveness of different strategies for treating low-back pain in a managed-care setting, 681 adult patients presenting with low-back pain were randomized to four treatment groups: medical care with and without physical therapy; and chiropractic care with and without physical modalities. Follow-up information was obtained by questionnaires at two and six weeks, six, 12 and 18 months and by a telephone interview at four weeks. One outcome measurement at each follow-up is the patient’s self-report on the perception of low-back pain improvement from the previous survey, recorded as ‘A lot better,’ ‘A little better,’ ‘About the same’ and ‘Worse.’ Since the patient’s perception of improvement may be influenced by past experience, the outcome is analysed using a transition (first-order Markov) model. Although one could collapse categories to the point that logistic regression analysis with repeated measurements could be used, here we allow for multiple categories by relating transition probabilities to covariates and previous outcomes through a polytomous logistic regression model with Markov structure. This approach allows us to assess not only the effects of treatment assignment and baseline characteristics but also the effects of past outcomes in analysing longitudinal categorical data.
Mixed effects multivariate adaptive splines model for the analysis of longitudinal and growth curve data
Authors: Zhang Heping
Published: July 2008

In this article, I review the use of nonparametric methods in the analysis of longitudinal and growth curve data, particularly the multivariate adaptive splines models for the analysis of longitudinal data (MASAL). These methods combine nonparametric techniques (B-splines, kernel smoothing, piecewise polynomials) and models with random effects, and provide fruitful alternatives to mixed effects linear models. Similarities, differences, strengths and limitations among these methods are presented. The analysis of a real example is also presented to illustrate the application and interpretation of MASAL. Open questions are posed for further investigation.
Treating to goal: new strategies for initiating and optimizing lipid-lowering therapy in patients with atherosclerosis
Authors: Fonarow Gregg C
Published: July 2008

The National Cholesterol Education Program (NCEP) guidelines prepared by the Adult Treatment Panel (ATP) provide clinicians with recommendations for the clinical management of abnormal blood cholesterol to reduce the risk of cardiovascular events. The recently updated NCEP guidelines have included a number of key amendments such as the recognition of low high-density lipoprotein cholesterol (HDL-C) as a risk factor for cardiovascular disease, while maintaining the focus of treatment on lowering low-density lipoprotein cholesterol (LDL-C) levels. Several agents can be used to modify the lipid profile in-line with the NCEP ATP-III recommendations, but hydroxymethyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) remain the most effective and best-tolerated drugs for lowering LDL-C. The optimal time to initiate drug therapy had been in question, although recent studies suggest in-hospital initiation following admission with cardiovascular disease reduces the risk of recurrent events and improves long-term patient compliance. Inpatient physicians and nurses therefore play a pivotal role in influencing not only short-term management needs, but also the long-term recovery of their patients. This role should not be underestimated, as recent surveys have highlighted a significant problem of undertreatment in patients with documented atherosclerosis with regards to lipid-lowering and other cardioprotective therapy. Although reversing patient under-treatment will require clinicians to address a variety of issues, systematic in-hospital initiation of currently available lipid-lowering therapies in patients with atherosclerotic vascular disease is likely to have major benefits, reducing the occurrence of cardiovascular events and saving lives. Several statins, cholesterol absorption inhibitors, novel metabolic inhibitors, and combinations of agents are currently in clinical development and it is hoped that these will also assist clinicians in the important task of getting patients to recommended LDL-C and HDL-C levels.
New developments in hip fracture treatment
Authors: Parker Martyn J
Published: July 2008

With current surgical and anaesthetic methods almost all hip fractures should be treated surgically. Delays to surgery continue to be reduced, although the optimum timing for surgery remains controversial. More intensive or specialized perioperative care, particularly for fluid resuscitation and analgesia, may improve outcome. Many of the implants used have not changed much over the last 50 years, but there have been considerable improvements in surgical technique. For intracapsular fractures there is little evidence to suggest that total hip replacements or bipolars have any advantage over the traditional hemiarthroplasties. For trochanteric fractures the sliding hip screw remains the implant of choice, although the newer intramedullary nails are valuable for more specific fracture types and their use will become more common. After surgery the majority of patients should be allowed to mobilize without any restrictions on weight bearing or hip movements. Optimum surgical rehabilitation should enable the majority of patients to be able to go home with hospital stays of less than two weeks.
Trauma scores and trauma outcome measures
Authors: Revell MP , Pynsent PB , Abudu A , Fairbank JCT
Published: July 2008

Objective measurement and quantification of injury severity are necessary for triage, performance evaluation and research. In order to evaluate interventions, outcomes must also be compared. While this can be done using hospital stay or mortality, these will fail to detect subtle differences. Impact of injury on health can be quantified using a variety of scoring systems. Trauma scoring and outcome measurement have grown increasingly complex in recent years and are likely to become more so in the future.
Driving performance with and preference for high-intensity discharge headlamps
Authors: Sivak M , Flannagan MJ , Schoettle B , Mefford ML
Published: July 2008

This in-traffic study evaluated driving performance with and preference for high-intensity discharge (HID) low beam headlamps. Subjects drove two identical luxury sedans. One vehicle was equipped with HID low beams and the other with tungsten halogen low beams. The main difference between the two beams was that the HID lamps provided more spread light. Driving performance was evaluated by analysing steering frequencies. The hypothesis was that the wider beam pattern of the HID lamps would be beneficial by reducing the steering effort in the 0.3-0.6 Hz range, which has been used in previous studies as an index of steering-task difficulty. The main finding is that the wider HID beam pattern made lane maintenance less demanding, as measured by a reduction in the steering frequencies between 0.3 and 0.6 Hz. The implication is that HID headlamps may be beneficial to safety, because their wider beam pattern allows more of the limited information processing resources of drivers to be allocated to other tasks. When the subjects were not primed before driving to pay attention to the headlamps, they did not show, as a group, preference for either type of lamp. However, when they were told to pay attention to the headlamps, they overwhelmingly preferred the HID lamps.
The contribution of vehicle lights in urban and peripheral urban environments
Authors: Bacelar A
Published: July 2008

In this study, the influence of vehicle lights on other drivers in urban and peripheral urban environments is evaluated in two perspectives. Initially, the contribution of car headlights to visibility of the road and targets located on the road is analysed, with and without street lighting. It was observed that the contribution of the street lighting was adequate for satisfactory visibility of the targets and the use of car headlights did not, under all circumstances, improve the visibility of a target on the road. In a second phase, the influence of glare from vehicle headlights on the vision of a driver was studied under the same lighting conditions. This was found to have an important negative effect on a dark night, so much so that an object located on a road can be hidden from the driver’s view when the driver meets a vehicle approaching from the opposite direction.
Fluorescence Properties of Individual Charge-transfer Complexes in Polymer Films Revealed by Single Molecule Fluorescence Spectroscopy
Authors: Masuo Sadahiro , Endo Tohru , Yamame Yasumasa , Machida Shinjiro , Itaya Akira
Published: July 2008

This is the first report of fluorescence dynamics of singly isolated charge-transfer (CT) complexes in a polymer film. It was suggested that relative geometrical structures of donor and acceptor molecules change during the measurement and that microenvironment around individual CT complexes is different.
Asymmetric Cycloaddition of 1,2-Dihydropyridine Derivatives in the Presence of Lewis Acids
Authors: Hirama Masafumi , Kato Yuji , Seki Chigusa , Matsuyama Haruo , Oshikiri Noriko , Iyoda Masahiko
Published: July 2008

Asymmetric cycloaddition of 1-phenoxycarbonyl- (1) or 1-methoxycarbonyl-1,2-dihydropyridine (2) with N-acryloyl-(1S)-2,10-camphorsultam (3) produced chiral isoquinuclidine 4a or 5a in good yields with excellent diastereoselectivity in the presence of a Lewis acid such as titanium tetrachloride, zirconium tetrachloride, or hafnium tetrachloride. The absolute stereochemistry assignment of endo-cycloaddition products 4a and 5a has been established to be 1S, 4R, and 7S.
Enhancement of Glycerol Conversion to Acetol in High-temperature Liquid Water by High-pressure Carbon Dioxide
Authors: Yamaguchi Aritomo , Hiyoshi Norihito , Sato Osamu , Rode Chandrashekhar V , Shirai Masayuki
Published: July 2008

Dehydration of glycerol to acetol proceeded in high-temperature liquid water at 573 K in a batch reactor. The acetol formation rate increased with an addition of high-pressure carbon dioxide.
Preparation and Photoluminescence of ZnO Nanocrystals by a High-temperature Organometallic Route
Authors: Chiang I-Chen , Chen Dong-Hwang
Published: July 2008

ZnO nanocrystals have been prepared via a high-temperature organometallic route. By XRD analysis, the effects of reaction temperature and time on the formation of ZnO were recognized. A possible mechanism was proposed. The product’s size, optical absorption, and photoluminescence were also described.
Chronic colitis associated with HIV infection can be related to intraepithelial infiltration of the colon by CD8+ T lymphocytes
Authors: Fernandes Elaine Raniero , Pagliari Carla , Tuon Felipe Francisco , De Andrade Heitor Franco , Averbach Marcelo , Duarte Maria Irma Seixas
Published: July 2008

Gastrointestinal complications in AIDS patients with diarrhoea are common clinical manifestations, frequently diagnosed by colonoscopy as non-specific colitis. We retrospectively study colon biopsies diagnosed as chronic colitis associated with HIV (CCH). Biopsies were sorted as patients with AIDS (serum CD4 <200 cell/mm3) but without any clear infectious process (n = 12) and patients without HIV infection (n = 24). There are low numbers of CD4+ T lymphocytes in lamina propria of AIDS patients, but CD8+ T populations in this area appear to be similar in all studied groups, regardless of HIV infection or laboratory evidence of a specific agent. We found the clear evidence of CD8+ T cells infiltration in colonic mucosa in HIV patients with microscopic colitis. An imbalance of lymphocyte subpopulations in the colon, both in the lamina propria and epithelium, could result in an intraepithelial CD8 infiltration, involved in the pathogenesis of CCH in AIDS patients.
Outpatient management of severe gonococcal ophthalmia without genital infection
Authors: Annan N T , Boag F C
Published: July 2008

We report a case of severe gonococcal ophthalmia and peri-orbital cellulitis in an HIV-positive man without genital infection who was treated successfully in the outpatient department. We also highlight the importance of early diagnosis, treatment and liaison with ophthalmology in order to prevent visual complications.
Efficacy and tolerability of a fosamprenavir-ritonavir-based versus a lopinavir-ritonavir-based antiretroviral treatment in 82 therapy-naïve patients with HIV-1 infection
Authors: Calza L , Manfredi R , Pocaterra D , Chiodo F
Published: July 2008

Recent data indicate that fosamprenavir/ritonavir as part of an initial antiretroviral regimen in HIV-1 -infected patients is associated with favourable efficacy and tolerability and in the KLEAN study (kaletra versus lexiva with epivir and abacavir in antiretroviral-naive patients) it was found to be non-inferior to lopinavir/ritonavir in association with abacavir/lamivudine. In our open-label, observational study conducted in 82 therapy-naíve HIV-1-infected patients followed-up for 18 months, virological and immunological efficacy was comparable in subjects receiving a fosamprenavir/ritonavir-based and a lopinavir/ritonavir-based treatment (proportions of patients with HIV RNA <50 copies/mL at month 18 were 76.9% and 74.4%, respectively, when discontinuations were counted as failures). At the same time, frequency of treatment discontinuations and adverse events were similar in both groups, whereas incidence of diarrhoea and hypertriglyceridaemia was significantly higher in lopinavir-treated patients than in fosamprenavir-treated ones (53.5% vs. 25.6% and 69.8% vs. 43.6%, respectively; P < 0.01). In subjects with virological failure, no viral protease resistance mutations were detected by genotype analysis.
Extensive vulval oedema secondary to severe pelvic infection
Authors: O'mahony C , Mullin N , Sissons G
Published: July 2008

A 17-year-old female developed a complex pelvic abscess a few weeks post-surgical abortion. Despite surgical drainage, a debilitating infection induced a low albumen. The resulting pelvic oedema caused gross vulval oedema that was difficult to manage. She had previously been treated for chlamydia.
Diagnostic yield of fine-needle aspiration cytology in HIV-infected patients with lymphadenopathy in the era of highly active antiretroviral therapy
Authors: Lowe S M , Kocjan G I , Edwards S G , Miller R F
Published: July 2008

Fine-needle aspiration (FNA) cytology has an established role in the investigation of lymphadenopathy in HIV-infected patients. However, changes in the spectrum of disease have been observed since the introduction of highly active antiretroviral therapy (HAART). The aim of the study was to establish whether FNA cytology remains a useful investigative tool in the post-HAART era and to determine whether the cytology results reflect the changing patterns of disease. Retrospective search of the cytopathology database at University College London Hospitals identified 73 FNA cytology procedures performed in 62 patients between January 1998 and December 2006. FNA cytology showed significant disease in 90% of adequate samples. The most common diagnoses were persistent generalized lymphadenopathy (PGL, 50%), infection (22%) and malignancy (18%). Diagnoses could not be made in 31 % of patients because of inadequate sampling. An open lymph node biopsy was subsequently performed in 27% of patients. FNA cytology remains an important initial investigation in the post-HAART era, particularly in the diagnosis of PGL, infection and malignancy. Difficulties in diagnosis of Castleman disease and Hodgkin's lymphoma by FNA cytology are recognized.
Would offering rapid point-of-care testing or non-invasive methods improve uptake of HIV testing among high-risk genitourinary medicine clinic attendees? A patient perspective
Authors: Forsyth S F , Agogo E A , Dipgum L Lau , Jungmann E , Man S , Edwards S G , Robinson A J
Published: July 2008

While most genitourinary (GU) medicine clinics achieve a high uptake for testing HIV in new patients, they may still miss testing those at highest risk. Point-of-care testing (POCT) and salivary samples are acceptable and feasible but have not yet been shown to increase uptake among high-risk patients (HRP). This study aimed to describe reasons why HRP decline HIV testing and whether offering POCT along with standard testing would increase the uptake of testing HIV in two London GU medicine clinics. Anonymous self-administered questionnaires were offered to all new and rebooked patients. Eight hundred and ninety-nine questionnaires were analysed of which 598 were HRP. Uptake of HIV testing was 77.1 % among HRP and 65.8% among the rest. A total of 51.1 % of HRP who declined HIV testing said they would be more likely to accept a POCT and 32.8% a salivary test. Introduction of rapid POCT for HIV would increase patient's choice and may increase the likelihood of HRP accepting an HIV test.
The epidemiology of Molluscum contagiosum in HIV-seropositive patients: a unique entity or insignificant finding?
Authors: Gur I
Published: July 2008

Molluscum contagiosum (MC) is common in human immunodeficiency virus (HIV) seropositive and immunocompromised patients. This study evaluates the current literature concerning the clinical features of MC in this population, the utility of MC as a predictor of immunocompromised state and the natural history of MC and HIV in patients with these co-morbidities. PubMed database search for English-written original studies found 10 of them, all enrolled for HIV patients. There was no unique feature of MC in adult HIV patients; nevertheless, the appearance of MC lesions in adult men should require evaluation for immunocompromised state. In HIV-positive patients, MC tends to occur during the advanced phase of the disease. MC in children is rarely associated with immunodeficiency and usually no further evaluation is needed. In patients with known HIV infection, the presence of MC may signify advancing immunosuppression.
Endovenous laser ablation for persistent and recurrent venous ulcers after varicose vein surgery
Authors: Kambal A A , De'Ath H D , Albon H , Watson A , Shandall A , Greenstein D
Published: July 2008

A 75-year-old woman presented with painful recurrent venous ulcers (VU) continuously for the past 33 months on a background of frequent intermittent problems for the last 16 years. She had previously been treated with varicose vein surgery and trials of compression bandaging. Subsequently, she underwent endovenous laser ablation (EVLA) targeting the distal incompetent remnant of her great and small saphenous veins. This resulted in complete healing of her ulcers within four weeks. The dramatic response demonstrated in this case suggests that EVLA may represent an effective intervention in the management of postsurgery refractory VU.
Aneurysm of the inferior vena cava: case report and review of the literature
Authors: Davidovic L , Dragas M , Bozic V , Takac Đ
Published: July 2008

Aneurysms of the inferior vena cava (IVC) are extremely rare. To the best of our knowledge, only 29 cases of IVC aneurysms are published in literature. We present a new case of surgically treated symptomatic saccular aneurysm of the infrarenal IVC and review previously published cases. Following resection of the aneurysm and the thrombosed infrarenal IVC, the patient fully recovered. Thrombosed IVC aneurysm may mimic a retroperitoneal tumour. In some cases, CT and MRI findings may be equivocal. Surgical treatment is indicated in all symptomatic and low-risk asymptomatic cases.
The use of therapeutic ultrasound in venous leg ulcers: a randomized, controlled clinical trial
Authors: Taradaj J , Franek A , Brzezinska-Wcislo L , Cierpka L , Dolibog P , Chmielewska D , Blaszczak E , Kusz D
Published: July 2008

Objectives

To estimate the usefulness of therapeutic ultrasound for healing of venous leg ulcers.

Methods

Eighty-one patients were included in this study. Patients in groups 1 and 2 were treated surgically. Patients in groups 3 and 4 were treated conservatively. Patients in groups 1 and 3 were additionally treated with the ultrasound (1 MHz, 0.5 W/cm2) once daily, six times a week for seven weeks.

Results

Comparison of the number of complete healed wounds indicated statistically significant differences between groups 1 and 4 ( P = 0.03), 2 and 4 ( P = 0.03), 3 and 4 ( P = 0.03) in favour of groups 1, 2 and 3. Comparison of the other parameters also demonstrated more efficient therapy effects in groups 1, 2 and 3 than in group 4. There were no statistical differences in all examined parameters between groups 1, 2 and 3 ( P > 0.05).

Conclusions

The ultrasound is an efficient and useful method only in conservatively treated venous leg ulcers. There are no special reasons for application of the ultrasound in surgically treated patients. A well-conducted surgical operation is much more effective for a healing process than conservative pharmacological procedures.
Chronic deep venous obstruction: definition, prevalence, diagnosis, management
Authors: Neglén Peter
Published: July 2008

Ilio-caval venous obstruction has an important role in the expression of symptomatic chronic venous disease regardless of aetiology. The presence of obstruction has been more or less previously ignored and emphasis placed on reflux alone. Stenting of the ilio-femoral veins guided by intravascular ultrasound (IVUS) can now be performed with low morbidity and mortality using appropriate technique. Current diagnostic modalities do not allow a definitive assessment of haemodynamically critical venous obstruction, which hampers selection of limbs for treatment. The diagnosis must be based on morphological studies (preferably IVUS) in patient selected with specific history, signs and symptoms. A high index of suspicion and generous use of morphological investigations are critical in the initial recognition of venous outflow obstruction. Stenting of the ilio-femoral vein appears to be durable with a substantial improvement in limb pain and swelling, high rate of ulcer healing, enhanced quality of life and decreased disability. The beneficial clinical outcome occurs regardless of the presence of remaining reflux, adjunct saphenous procedures or aetiology of obstruction.
Evaluation of a Deuterium-Labeled Internal Standard for the Measurement of Sirolimus by High-Throughput HPLC Electrospray Ionization Tandem Mass Spectrometry
Authors: O'Halloran Sean , Ilett Kenneth F
Published: July 2008

Background: Matrix effects in HPLC–electrospray ionization–tandem mass spectrometry (HPLC-ESI-MS/MS)1 can cause differences in the ionization of an internal standard (IS) compared with the analyte of interest. Unless sample cleanup or chromatographic conditions eliminate or minimize ion suppression or enhancement, variability in interpatient matrices may cause erroneous results. A stable isotope-labeled IS can be used to minimize analytical interpatient variation.

Methods: We used protein precipitation and HPLC-ESI-MS/MS to quantify sirolimus (SIR) with both desmethoxyrapamycin (DMR) and deuterium-labeled sirolimus (SIR-d3) as the IS to analyze a range of whole-blood and extraction-matrix samples, and to estimate recovery, matrix effects, process efficiency, and interpatient variation. We also analyzed a series of blood samples from 72 patients taking SIR, including external proficiency-testing samples, with these ISs.

Results: The range of interpatient assay imprecision (CV) values for the SIR assay was consistently lower with SIR-d3 (2.7%–5.7%) than with DMR (7.6%–9.7%). The results obtained with the 2 different ISs for the patient samples showed a linear relationship, but the results were higher with DMR as the IS than with SIR-d3.

Conclusions: The use of SIR-d3 as the IS in the high-throughput HPLC-ESI-MS/MS assay of SIR yielded improved results compared with the use of DMR. SIR-d3 appears to be less affected by differences in the ionization of SIR and its IS caused by the variability of interpatient matrices. The IS-related difference in SIR estimation needs further investigation.
Bilingualism in international schools. A model for enriching language education. Maurice Carder (2007)
Authors: Hamers Josiane
Published: July 2008

Bilingualism in international schools. A model for enriching language education. Maurice Carder (2007) Clevedon: Multilingual Matters. pp. 207. ISBN 978–1-85359–940–8
A sociolinguistic approach to the use of entonces (so) in the oral narratives of young bilinguals in the United States
Authors: Said-Mohand Aixa
Published: July 2008

The main objective of this study was to assess the impact of English in the Spanish spoken by young Spanish heritage speakers with regard to the use of the Spanish connector entonces(so). The sociolinguistic variables of Spanish language competence and  generational adscription were taken into account. The data stem from 56 semi-formal interviews with Spanish heritage language students at the University of Florida. All occurrences of Spanish entonces and English so were codified according to their functions  to later correlate those functions with the sociolinguistic variables mentioned above. The results revealed that entonces is used to mark primarily narrative progression, consequence and conclusion while so is used to express consequence and conclusion, as reported in previous studies (Torres, 2002; Aaron, 2004). While both so and entonces share those functions, so never is used to mark temporality. With respect to the social variables, the most significant one is participants’ Spanish level of proficiency. The general results indicate that Spanish dominant speakers tend to use more entonces and fewer so, in contrast to those least proficient in Spanish. Also, for the English dominant speakers so triggers a code-switch from Spanish into English, and for the Spanish-dominant speakers the insertion of so is considered an integrated borrowing.
Water troubles in a Pacific atoll town
Authors: Moglia Magnus , Perez Pascal , Burn Stewart
Published: July 2008

South Tarawa is a town on an isolated Pacific atoll of approximately 46,000 people, with absolute water scarcity, poor water safety and consequently water-related problems. It relies on shallow groundwater, with contributions from rainwater tanks and desalination. Due to a combination of factors such as small scale, limited human resources, system complexity, isolation and lack of financial resources, water management capacity is inadequate. Sustainability of groundwater resources is also uncertain and there are indications that groundwater has been extracted above the sustainable pumping rates. Social complexity is highlighted by the resistance from traditional landowners to the attempts to deal with the supply-side deficit through establishment of new infiltration galleries. In this paper, issues relating to water management in South Tarawa are reviewed. This follows on to an exploration of possible strategies to improve the existing situation. This research forms an empirical building block in the foundation of a larger study, aiming at developing a framework for strategic and adaptive small town water management. In particular, the larger study explores the options and viability of co-management of water and land resources in small scale urban areas as an alternative to traditional urban management approaches.
Womanhood Is Not For Sale
Authors: Shissler A. Holly
Published: July 2008

This paper discusses the views of Turkish journalist Sabiha Zekeriya Sertel (1895–1968) on prostitution and women’s participation in the paid labor force. By examining her ideas on these issues and on women’s legal rights as they appeared in her journal, Resimli Ay, the paper shows how Sertel analytically linked women’s economic dependence with ideologies of sexual honor that limited and controlled access to women’s sexuality. This led her to identify the origins of prostitution as economic, to oppose the licensing of brothels and the regulation of prostitutes by the state, to advocate the entrance of women into the labor force, and to inveigh against the legal and social exclusion of women from many areas of commercial activity. The paper describes how, through her commentaries, Sertel sought to influence social and legal reforms taking place in the new Republic of Turkey.
Origins of Iran’s Modern Girls’ Schools
Authors: Rostam-Kolayi Jasamin
Published: July 2008

This article sketches a history of Iran’s early girls’ school movement and examines its origins, goals, curricular content, and relationship to the state. It revises the tendency in the existing scholarship on modern education and reform to credit the Pahlavi state as the initiator of female education. Specifically, I argue that modern-style girls’ schooling did not begin in the 1920s with the founding of statesponsored girls’ schools of the late Qajar and early Riza Shah era, but in an earlier period under the auspices of indigenous religio-ethnic minorities and Muslims. The Riza Shah era was an important phase of a longer-term trend that placed both state support and propaganda behind the early twentieth-century girls’ school movement. But it was the founders of the first modern Iranian girls’ schools who had already made important decisions in framing the structure, content, and organization of these schools. The study is based primarily on the memoirs of Iranian educators, the writings of foreign observers in Iran active in Iranian education circles, and Persian-language press sources.