bluuebunny/crossref_metadata_2025 huggingface dataset:
Conceptions of early leaving: a comparison of the views of teaching staff and students
Authors: Young Pat , Glogowska Margaret , Lockyer Lesley
Published: November 2007

Recent synthesizing work on the student retention literature suggests two divergent discourses. The first is a discourse of assimilation which locates the problem in individual students' circumstances or abilities. This is challenged by an emerging discourse of adaptation. The new discourse focuses on higher education itself, proposing fundamental changes to adapt universities to a new purpose in a changed society. Here we present findings from interviews with teaching staff, which formed part of a multi-method investigation into attrition. Drawing on Zepke and Leach's (2005) model, we contrast the conceptions of early leaving suggested in these interviews with our previously reported findings from interviews with students who had considered leaving but stayed, and students who had withdrawn. We find staff more likely than students to externalize attrition in terms which problematize students. Students were more likely to focus on issues relating to their experiences of the university.
Empowering or compelling reluctant participators using audience response systems
Authors: Graham Charles R. , Tripp Tonya R. , Seawright Larry , Joeckel Georgel.
Published: November 2007

This article investigates the impact of an audience response system (ARS) on student engagement in undergraduate university courses. A survey was administered to students in a dozen courses piloting the ARS system. On 13 out of 14 measures the majority of students thought the system was helpful. Overall, students were more positive about the use of the ARS in courses that used the tool for formative feedback (empowering) rather than for grading or attendance purposes (compelling). The authors discuss the positive impact of the ARS on the engagement of `reluctant participators' or students who reported that they are least likely to participate in class under normal conditions. Reluctant participators' perceptions of the helpfulness of the ARS were compared to those of non-reluctant participators. Finally, student comments were analyzed to determine why students with the most negative feelings about the ARS felt the way they did and which teaching practices using the ARS were perceived to have the greatest value by the students.
Central issues in the use of computer-based materials for high volume entrepreneurship education
Authors: Cooper Billy
Published: November 2007

This article discusses issues relating to the use of computer-based learning (CBL) materials for entrepreneurship education at university level. It considers CBL as a means of addressing the increased volume and range of provision required in the current context. The issues raised in this article have importance for all forms of computer-based learning and also have relevance for emerging technologies in the field. Based on evidence reported in this article, it is argued that, while there is potential for gaining economies of scale by using CBL materials for entrepreneurship education, there are also potential trade offs and conflicts of interest involved in such approaches. The findings also point to the importance of the student perspective for the design and use of CBL materials for high volume entrepreneurship education.
Effects of performance assessment on the achievement and motivation of graduate students
Authors: Hancock Dawson R.
Published: November 2007

This study explored the impact of performance assessment versus traditional paper-and-pencil assessment on graduate students' achievement and motivation to learn while enrolled in a 16-lesson course on program evaluation methods. Students in two sections of the course were exposed to the same content and instructional methods, with one exception: students in one section were exposed to performance assessment during which they demonstrated their knowledge and skills while conducting a program evaluation in a 4th grade classroom, whereas students in the other section were provided with a written scenario of that 4th grade program and were required to answer questions on a traditional paper-and-pencil test about program evaluation methods. Results revealed that students exposed to performance assessment achieved somewhat higher scores on the final examination and demonstrated significantly higher levels of motivation to learn than did students evaluated by traditional paper-and-pencil tests. Qualitative analysis of the students' written expressions about the course and of their comments from group interviews revealed possible explanations for these outcomes.
HIV Progression and Predictors of Mortality in a Community-Based Cohort of Zambian Adults
Authors: Kitchen Maria , Quigley Maria A. , Mwinga Alwyn M. , Fuchs Dietmar , Lisse Ida M. , Porter John D. H. , McAdam Keith P. W. J. , Godfrey-Faussett Peter
Published: November 2007

This article describes immunological HIV progression, mortality, and its predictors in 974 Zambian adults. During 3138 person-years of follow-up, 281 deaths occurred, and the overall mortality rate was 9.0 per 100 person-years. Thirty-six percent of patients were dead within 5 years of enrollment. The median survival in patients with baseline CD4 count ≥500 cells/mm3 was 5.62 years, with CD4 count between 200 and 499 cells/mm3 5.46 years, and with CD4 count <200 cells/mm3 3.89 years. The mortality rate increased significantly with older age (6.9 in patients <25 years, 9.3 in individuals aged 25-39 years, 10.2 in patients ≥40 years) and was higher in women (rate ratio 1.29). The median annual change of progression markers was —29.6 cells/mm3 for CD4 count, —3.0% for CD4 count percentage, 1.2 nmol/L for neopterin, —1.9 g/L for hemoglobin, and —70 cells/ mm3 for total lymphocyte count. Hemoglobin and neopterin were as accurate as CD4 count to predict mortality.
Epidemiologic and Clinical Characteristics of HIV/AIDS Patients in Turkey, Where the Prevalence Is the Lowest in the Region
Authors: Celikbas Aysel , Ergonul Onder , Baykam Nurcan , Eren Sebnem , Esener Harika , Eroğlu Mustafa , Dokuzoguz Basak
Published: November 2007

The authors describe the epidemiologic and clinical characteristics of 97 human immunodeficiency virus (HIV)—infected patients, who were followed between 1993 and 2006. Seventy-two percent of the patients were male, and median age at diagnosis was 36 years (range, 13-71 years). The mean years of survival was 3, and maximum length of life after diagnosis was 9 years. The most common professions were truck drivers, workers, and housewives. Forty-six percent of the males had a history of working abroad. Heterosexual intercourse was the most common (84%) route of transmission. Seventy-four percent of the women acquired infection from their husbands. In Turkey, less educated or uneducated and poor men are the primary target of the HIV infection usually by sexual contact with foreign women. Considering the low education status of the patients, appropriate education programs should be developed to prevent the dissemination of HIV infection. Because a significant number of patients were diagnosed at very late stages, the physicians and other health care workers should be educated on the clinical pictures of HIV/AIDS.
The Lived Experience of Informal African American Male Caregivers
Authors: Weinland Jo Ann
Published: November 2007

Informal caregivers play a major role in providing care to loved ones within the home and demands for dependent care are likely to increase. Informal caregivers are likely to continue to be responsible for the majority of care for loved ones living well into late stages of life. This article describes the lived experience of African American men providing care to a relative within the home and explores their definition of caregiver distress. The phenomenological study was conducted using face-to-face interviews with 10 Christian African American men. Demographic data about the caregiver and the care recipient were collected. Common themes included: commitment, support (family support and formal health-related support), spirituality, and caregiver burden (stress, time strain and financial strain). Implications include the need for health care providers to expand their knowledge related to the diversity of caregivers and to use culturally relevant comprehensive assessments of caregivers and recipients, discharge planning tools, and community resources.
Age at First Birth and Fathers' Subsequent Health: Evidence From Sibling and Twin Models
Authors: Pudrovska Tetyana , Carr Deborah
Published: November 2007

Using a sample of 540 siblings and twins from the National Survey of Midlife Development in the United States, this study examines the relationship between the age at which men become biological fathers and their subsequent health. The analysis includes both between-family models that treat brothers as independent observations and within-family models that account for unobserved genetic and early-life environmental endowments shared by brothers within families. Findings indicate that age at first birth has a positive, linear effect on men's health, and this relationship is not explained by the confounding influences of unobserved early-life characteristics. However, the effect of age at first birth on fathers' health is explained by men's socioeconomic and family statuses. Whereas most research linking birth timing to specific diseases focuses narrowly on biological mechanisms among mothers, this study demonstrates the importance of reproductive decisions for men's health and well-being.
Speaking About the Unspeakable: Sexually Abused Men Striving Toward Language
Authors: Andersen Torbjørn Herlof
Published: November 2007

Traditionally, sexual abuse of males has not been an issue of priority among politicians or researchers. When addressed, focus is often on context or harmful effects of the abuse. This article is based on the idea of reality as socially constructed, examining possible ways for sexually abused males to come to terms with their experiences. The emphasis is on accessible discursive resources on “the abused male” and how cultural stereotypes of manliness influence and limit individual and societal constructions. An important key to reconstruction of abuse history and selfhood lies in acceptance of the idea of men as suppressed. Sexually abused males tend to feel marginalized and different. However, when given the opportunity, they offer alternative discourses of manliness with the potential for bringing sexually abused males out of the shadows, assisting them in better understanding, dealing with, and explaining their experiences to themselves and others. This article brings out the importance of a gender-sensitive approach to working politically as well as directly with men who have been sexually abused. The horizon of understanding in professional social work needs to include attention to stereotypical constructions of manliness that reject men's experiences of being “victims.”
Behavioral Medicine Review: Weight Control in a Land of Milk and Honey
Authors: Terre Lisa
Published: November 2007

Obesity and its cardiometabolic comorbidities are on a skyrocketing trajectory with ominous public health implications. Focusing on primary care as a microcosm of the broader obesity crisis, this review discusses considerations for the prevention and management of obesity and its associated risks.
Themed Review: Lifestyle Management of Obesity
Authors: Tyler Chermaine , Johnston Craig A. , Foreyt John P.
Published: November 2007

Obesity is one of the leading causes of preventable deaths in this country. Numerous approaches have been used to manage the disease without much success. The lifestyle management of obesity has been shown to be effi cacious for successful weight loss and maintenance. Diet, physical activity, and behavior modification are the key strategies used in lifestyle programs. They are combined to help obese individuals achieve a gradual reduction in weight over an extended time period. The components may be combined in a variety of ways to e fectively promote weight loss, allowing for flexibility and personal preference. Techniques and descriptions of these components are presented in this review. In addition, special populations that may benefit from this approach are reviewed. Optional treatments that may enhance the benefits of lifestyle intervention are also discussed. The authors hope to provide a resource for clinicians that will facilitate adoption of lifestyle approaches for managing the obese patient.
Special Article: Physical Activity, Physical Fitness, and Cardiovascular Risk Factors in Childhood
Authors: Gidding Samuel S.
Published: November 2007

In adults, physical activity and exercise training are associated with reduced cardiovascular morbidity and mortality, a reduced likelihood of developing adverse cardiovascular risk factors, and improved insulin sensitivity. In childhood, participation in appropriate physical activity may prevent the development of cardiovascular risk factors in the future and complement treatment of existing cardiovascular risk factors, including hypertension, dyslipidemia, and overweight. Exercise in children can also significantly improve insulin sensitivity independent of weight loss. These e fects are mediated in overweight children by increases in lean body mass relative to fat mass and associated improvements in inflammatory mediators, endothelial function, and the associated adverse hormonal milieu.
State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health
Authors: O'Neil Carol E. , Nicklas Theresa A.
Published: November 2007

Obesity and 4 of the leading causes of death—heart disease, cancer, stroke, and type 2 diabetes mellitus—are related to lifestyle. The combination of a healthy weight, prudent diet, and daily physical activity clearly plays a role in primary, secondary, and tertiary prevention of these and other chronic diseases. Because nearly 65% of the adult population is overweight or obese, weight loss and maintenance are central to this review article. Improved lipid profiles, blood pressure, insulin sensitivity, and euglycemia are associated with weight loss or a normal body weight; thus, maintaining a healthy weight is a universal recommendation for health. The methods for improving lifestyle described in the section on obesity include assessing nutritional status and stages of change of the client, setting realistic goals, eating a diet high in fruits and vegetables with low-fat sources of dairy and protein, and achieving appropriate physical activity levels. The importance of physicians discussing weight with clients and vice versa is stressed. The common features of lifestyle-related diseases make them amenable to similar lifestyle interventions.
State of the Art Review: Pharmacists' Approach to Selecting Dietary/Nutritional Supplements for Patients
Authors: Nickerson-Troy Julia , Morse Kristin , White Ruthan , Beals Amber , Hudson Macie , Kuczmarski Karen
Published: November 2007

Consumers' accessibility to over-the-counter dietary supplements is unlimited. Alarmingly, although dietary supplement use is on the rise, national surveys have shown a gross underreporting to health care practitioners. This has resulted in a growing concern in the concomitant use of dietary supplements with prescription medications and certain disease states; therefore, it is essential for health care providers to aid in the decision-making process to assess safety and efficacy of dietary supplement use. Although all health care practitioners can aid consumers in making informed decisions, pharmacists are in a key role due to their accessibility, knowledge of alternative medicines, and training in pathophysiology and pharmacology. In addition to assessing the safety and efficacy of dietary supplements when determining the appropriateness of use in consumers, pharmacists should also consider various patient characteristics, including the presence of disease states, concomitant use of other medications/ supplements, and cost. Thoroughly evaluating all of these factors should aid pharmacists in helping consumers make informed decisions prior to purchasing supplements. This article discusses an evidence-based approach to selecting dietary supplements, including the laws surrounding these products, professional organizations' position statements, con- cerns with use, special populations, quality control programs, and reliable databases/information resources to aid in selection.
Nutrition Review: Dietary Considerations for Obesity Treatment
Authors: Melanson Kathleen J.
Published: November 2007

Dietary modification is critical in obesity treatment. Energy intake must fall below energy expenditure, but not so low that excess lean tissue is lost, hunger escalates, diet quality declines, and health is compromised. Reductions in energy consumption of 500 to 1000 kilocalories per day should result in appropriate rates of weight loss in most obese patients. Very low-calorie diets are sometimes used when excess body weight poses an acute risk, but such diets carry potential for many complications, and their long-term results are often no better than low-calorie diets. Macronutrient composition is not as important as overall energy defi cit in terms of weight loss, so dieters have some flexibility in choosing combinations that suit their preferences and needs, as long as they promote long-term healthy weight management. Diets with extremes of macronutrients are usually defi cient in micronutrients and are diffi cult to follow for long periods of time, so they should not be advocated. Resources for implementing dietary recommendations include registered dietitians, selected Web sites, and an assortment of products and services. Patients should be guided to resources that are evidence based and do not make unrealistic promises for weight loss. Prevention of recidivism should be built into the treatment plan.
Lifestyle Management of Obesity: NHANES and Erectile Dysfunction— How to Motivate Change
Authors: Miner Martin
Published: November 2007

Weight loss represents a significant goal for improving physical and psychological health. Management to obtain this goal must include gradual changes in both diet and physical activity, incorporating modifiable and reachable goals. Self-monitoring, goal setting, and stimulus control are the framework of any successful plan. Recently, lifestyle recommendations have been added to the Diet and Lifestyle Recommendations Revision put forth by the American Heart Association Nutrition Committee to lower risk of cardiovascular disease. The relationship of erectile dysfunction as a harbinger of occult vascular disease may serve as a motivator to prompt men to make changes in diet and lifestyle, as improvements in body mass index and physical activity are independently associated with improvements in sexual function, as documented by a recent randomized controlled trial.
Preventing Obesity in America: Is It Achievable?
Authors: Greenstone Clinton L.
Published: November 2007

The prevalence of obesity has increased significantly in the past 40 years. Although difficult to treat, physicians must continue contributing to the solution by not only advocating for dietary interventions and increased exercise but also should target at-risk populations and promote more prevention strategies for combating obesity. Given the close association with the comorbidities of diabetes and hypertension, obesity is closely linked with the number one killer of all Americans: heart disease. This alone makes obesity an enormous public health threat. General, broad public health strategies for supporting weight loss are also discussed.
Policing the Drumcree Demonstrations in Northern Ireland: Testing Leadership Theory In Practice
Authors: Benington John , Turbitt Irwin
Published: November 2007

At issue is an annual Church Parade by some 1200 members of the all Protestant Orange Order and two bands who insist on what they see as their inalienable civil right to march along the Garvaghy Road in Portadown despite the fact that the Catholic community who live there are overwhelmingly opposed to the passage of the march and believe it is their right not to have to endure it. While many Orangemen regard the Order as a religious and cultural institution, others cherish it as an instrument of supremacy for asserting domination over Catholics. (Ryder and Kearney, 2001: xvi)
Exploring Servant Leadership across Cultures: A Study of Followers in Ghana and the USA
Authors: Hale Jeff R. , Fields Dail L.
Published: November 2007

In the shadow of corporate scandals such as Enron and Worldcom, an increase in attention has been directed towards an approach termed `servant leadership'. To date, servant leadership has been discussed and described almost entirely in the North American context (Farling et al., 1999; Spears, 1995). In the following study, we explored the extent to which followers from Ghana and the USA have experienced three servant leadership dimensions in a work situation, and the extent to which these followers relate servant leadership dimensions to judgments about leadership effectiveness in each culture. After testing for measurement equivalence and adjusting the item weights in each culture, we found that Ghanaians reported experiencing servant leadership behaviours significantly less than North Americans. We also found that vision had a significantly stronger relationship with leader effectiveness for Ghanaians in comparison to North Americans, but that both sub-samples relate service and humility with leader effectiveness similarly. We explored possible explanations and implications based on cultural differences.
The Role of the Transitional Leader: A Comparative Analysis of Adolfo Suárez and Boris Yeltsin
Authors: O'Brien Thomas A.
Published: November 2007

The role of leadership in transitional regimes is an issue that requires closer examination, given the ability of the leader to shape and determine the direction of the regime. This paper seeks to delineate some common features of leadership during such regimes and the factors influencing the ability of leaders to manipulate and shift the direction of the process. To illustrate, it adopts a comparative analysis of the leadership of Adolfo Suárez (Spain) and Boris Yeltsin (Russia). It will be shown that, despite the different outcomes of these cases, there are clear similarities that point to the existence of a form of transitional leadership. Central to the paper is an adoption of the notion of structure and agency to determine the extent actors in this position can affect change within the constraints faced.
The Impact of Goal Orientation on the Association between Leadership Style and Follower Performance, Creativity and Work Attitudes
Authors: Moss Simon A. , Ritossa Damian A.
Published: November 2007

This study examines whether goal orientation — which refers to whether individuals strive to learn skills, attract favourable evaluations, or minimize unfavourable judgments — influences whether transformational leadership improves employee performance, creativity and work attitudes. A sample of 263 employees completed a questionnaire in which they assessed their own goal orientation and commitment, as well as evaluated the leadership style of their supervisor. Moreover, these supervisors appraised the performance and creativity of their employees. The findings revealed that a learning orientation magnified the benefits of contingent reward — in which leaders provide clear incentives to motivate employees — on normative commitment. Furthermore, when employees endeavoured to attract favourable evaluations, intellectual stimulation was more likely to foster normative commitment. Finally, when employees endeavored to minimize unfavourable judgments, inspirational motivation diminished affective commitment to the organization. These findings suggest the goal orientation of employees should be optimized before plans to encourage transformational leadership are instituted.
Leadership Reconsidered as Historical Subject: Sketches from the Cold War to Post-9/11
Authors: Trethewey Angela , Goodall H.L.
Published: November 2007

In this essay, we seek to further an understanding of leadership as the evolution of perspectives embedded within a wider historical frame. It is our contention that recovering the historical, economic, and cultural basis for leadership theories since the Second World War reveals three hidden storylines; each one of them tied to the three dominant historical eras. By hidden storylines we refer to the subtexts and the forgotten and lesser known, but no less foundational aspects of the more popularized and codified leadership theories that came to define each of those historical eras. Those three eras are the Cold War , the Post-Cold War and the Post-9/11 era. Understanding the emergence of the `dark side' of leadership in a post-9/11 environment is intricately tied to uncovering and narrating the relationship of ideas about leadership to the dominant material and ideational struggles that defined each of these eras. Recovering the `bright side' of leadership as an oppositional narrative and reversing the trend toward fundamentalism requires a new model of leadership. We offer `pragmatic complexity' as a provisional step toward that new model.
Neutralism and adversarial challenges in the political news interview
Authors: Rendle-Short Johanna
Published: November 2007

This article aims to examine journalists' adversarial challenges within the Australian political news interview. Within the Australian context, journalists tend to challenge interviewees: (1) by challenging the content of the prior turn, (2) by `interrupting' the prior turn, and (3) by initially presenting their challenge as a freestanding assertion, not attributed to a third party. As a result, journalists could be interpreted as expressing their own perspective on the topic at hand, rather than maintaining a neutralistic stance. Although the challenging nature of journalistic questions has been previously noted within the Australian context (e.g. Adkins, 1992), there have been few analyses of such challenges. Using the framework of conversation analysis, the aim of the following article is to examine adversarial challenges in more detail. In particular, the article will focus on how interviewers (IR) and interviewees (IE) collaboratively produce the political news interview in such a way as to avoid accusations of bias or non-neutrality. First, the article will focus on the challenging nature of the IR's turn, by examining the various techniques used by journalists to ensure that they maintain a neutralistic stance. Second, it will examine the way in which IEs respond to such adversarial challenges. It will show how although politicians do not overtly accuse IRs of bias or impartiality, they clearly orient to the challenging nature of the journalists' turn.
Cooperation in interpreter-mediated monologic talk
Authors: Napier Jemina
Published: November 2007

Discourse-based interpreting research has determined that interpreters are participants within interaction. Grice (1975) established that conversation participants conform to a cooperative principle. With respect to interpreting, what is the cooperative principle? How do sign language interpreters and deaf people work together to negotiate meaning in interpretation? The aim of this article is to present a case study of a deaf presenter and two sign language interpreters and evidence of their strategies for cooperation in interpreter-mediated monologic talk. Drawing on a framework of interactional sociolinguistics, naturalistic data from a seminar presentation was analysed, focusing on the use of pauses, nods and eye contact as contextualization cues in the interpreter-mediated event. It was found that these three participants used these cues deliberately and strategically for signalling comprehension, marking episodes, clarification and controlling the pace of the presentation; drawing on their frames of reference. Thus, the data suggest that the cooperative principle of interpreting involves the establishment of particular cues for communication.
Leadership and communication: discursive evidence of a workplace culture change
Authors: Holmes Janet , Schnurr Stephanie , Marra Meredith
Published: November 2007

Communication is an important component in the construction of workplace identities, including leader and group identities. Micro-level analysis of everyday workplace discourse provides valuable insights into the way leadership is constructed and how workplace culture is created, maintained, and changed. In this context, leaders and managers are inevitably significant and influential participants, with a crucial impact on workplace culture. Drawing on audio and video data collected in 12 meetings of an IT department, the analysis demonstrates ways in which two leaders, who succeed each other in the role of Director, reinforce and shape the culture of the workplace in which they operate. While both leaders claim teamwork as an important cultural value for their teams, their respective instantiations of teamwork are rather different. To explore the leaders' effect on the culture of their department, this investigation of leadership change examines ways in which the leaders manage regular workplace meetings (communication with a predominantly transactional orientation) and how they contribute to workplace humour (more relationally oriented behaviour). The analysis provides detailed evidence of the ways in which a change in leadership style can create the conditions for a change in the culture of a community of practice.
Co-management in healthcare: negotiating professional boundaries
Authors: Schryer Catherine F. , Gladkova Olga , Spafford Marlee M. , Lingard Lorelei
Published: November 2007

This article investigates discursive practices associated with the co-management of patients between healthcare providers. Specifically, we focus on two genres (38 referral letters and 37 consultant reports) written by optometrists and ophthalmologists — two groups who are experiencing interprofessional tension over their scopes of practice. In our analysis we foreground four kinds of modality associated with verbs — epistemic, deontic, phatic and subjective. We found that these healthcare providers shared in the epistemic resources used to hedge their sense of clinical certainty, and that ophthalmologists used deontic resources to control future action. However, we also noted that both professions used deontic, phatic and subjective resources to create dialogical space for each other to participate in some future relationship. In fact, one of the main points of this correspondence might be to establish personal relationships between practitioners. Unfortunately, however, this subtle use of modality to negotiate professional boundaries is fading as many ophthalmologists, due to workload issues, are not responding to referral letters or are converting their correspondence to form letters.
Critical role for the mitochondrial permeability transition pore and cyclophilin D in platelet activation and thrombosis
Authors: Jobe Shawn M. , Wilson Katina M. , Leo Lorie , Raimondi Alejandro , Molkentin Jeffery D. , Lentz Steven R. , Di Paola Jorge
Published: November 2007

Many of the cellular responses that occur in activated platelets resemble events that take place following activation of cell-death pathways in nucleated cells. We tested the hypothesis that formation of the mitochondrial permeability transition pore (MPTP), a key signaling event during cell death, also plays a critical role in platelet activation. Stimulation of murine platelets with thrombin plus the glycoprotein VI agonist convulxin resulted in a rapid loss of mitochondrial transmembrane potential (Δψm) in a subpopulation of activated platelets. In the absence of cyclophilin D (CypD), an essential regulator of MPTP formation, murine platelet activation responses were altered. CypD-deficient platelets exhibited defects in phosphatidylserine externalization, high-level surface fibrinogen retention, membrane vesiculation, and procoagulant activity. Also, in CypD-deficient platelet-rich plasma, clot retraction was altered. Stimulation with thrombin plus H2O2, a known activator of MPTP formation, also increased high-level surface fibrinogen retention, phosphatidylserine externalization, and platelet procoagulant activity in a CypD-dependent manner. In a model of carotid artery photochemical injury, thrombosis was markedly accelerated in CypD-deficient mice. These results implicate CypD and the MPTP as critical regulators of platelet activation and suggest a novel CypD-dependent negative-feedback mechanism regulating arterial thrombosis.
Prospective multicenter trial comparing repeated immunosuppressive therapy with stem-cell transplantation from an alternative donor as second-line treatment for children with severe and very severe aplastic anemia
Authors: Kosaka Yoshiyuki , Yagasaki Hiroshi , Sano Kimihiko , Kobayashi Ryoji , Ayukawa Hiroshi , Kaneko Takashi , Yabe Hiromasa , Tsuchida Masahiro , Mugishima Hideo , Ohara Akira , Morimoto Akira , Otsuka Yoshitoshi , Ohga Shouichi , Bessho Fumio , Nakahata Tatsutoshi , Tsukimoto Ichiro , Kojima Seiji
Published: November 2007

We conducted a prospective multicenter study to compare the efficacy of repeated immunosuppressive therapy (IST) with stem-cell transplantation (SCT) from an alternative donor in children with acquired aplastic anemia (AA) who failed to respond to an initial course of IST. Patients with severe (n = 86) and very severe disease (n = 119) received initial IST consisting of antithymocyte globulin (ATG) and cyclosporine. Sixty patients failed to respond to IST after 6 months from the initial IST and were eligible for second-line treatment. Among them, 21 patients lacking suitable donors received a second course of IST. Three patients developed an anaphylactoid reaction to ATG and could not complete the second IST. A trilineage response was seen in only 2 of 18 (11%) evaluable patients after 6 months. Thirty-one patients received SCT from an alternative donor. At 5 years from the initiation of second-line therapy, the estimated failure-free survival (FFS), defined as survival with response, was 83.9% (± 16.1%, SD) in the SCT group compared with 9.5% (± 9.0%) in the IST group (P = .001). These results suggest that SCT from an alternative donor offers a better chance of FFS than a second IST in patients not responding to an initial IST.
The Modifier of hemostasis (Mh) locus on chromosome 4 controls in vivo hemostasis of Gp6−/− mice
Authors: Cheli Yann , Jensen Deborah , Marchese Patrizia , Habart David , Wiltshire Tim , Cooke Michael , Fernandez José A. , Ware Jerry , Ruggeri Zaverio M. , Kunicki Thomas J.
Published: November 2007

Platelet glycoprotein VI (GPVI) is a key receptor for collagens that mediates the propagation of platelet attachment and activation. Targeted disruption of the murine gene Gp6 on a mixed 129 × 1/SvJ × C57BL/6J background causes the expected defects in collagen-dependent platelet responses in vitro. The extent of this dysfunction in all Gp6−/− mice is uniform and is not affected by genetic background. However, the same Gp6−/− mice exhibit 2 diametrically opposed phenotypes in vivo. In some mice, tail bleeding times are extremely prolonged, and thrombus formation in an in vivo carotid artery ferric chloride-injury model is significantly impaired. In other littermates, tail bleeding times are within the range of wild-type mice, and in vivo thrombus formation is indistinguishable from that of control mice. Directed intercrosses revealed that these phenotypes are heritable, and a genome-wide single-nucleotide polymorphism scan revealed the most significant linkage to a single locus (8 megabases) on chromosome 4 (logarithm of the odds [LOD] score = 6.9, P < .0001) that we designate Modifier of hemostasis (Mh). Our results indicate that one or more modifier genes in Mh control the extent to which in vivo platelet thrombus formation is disrupted by the absence of platelet GPVI.
COPD patients' ability to follow exercise influences short-term outcomes of rehabilitation
Authors: Puhan M. A. , Schünemann H. J. , Buesching G. , vanOort E. , Spaar A. , Frey M.
Published: November 2007

Chronic obstructive pulmonary disease (COPD) patients with limited ability to follow exercise protocols may receive smaller benefits from rehabilitation. The association between the ability to follow exercise protocols and short-term outcomes of rehabilitation was assessed in COPD patients.

As a measure of the ability to follow exercise protocols, the number of major breaks lasting ≥1 min was determined in 98 COPD patients during supervised exercise sessions. The benefits from rehabilitation were compared between patients with, on average, more than one and one or fewer major breaks per session.

Patients with one or fewer major breaks per session showed significantly greater improvements in exercise capacity (between-groups difference of 38 m for 6-min walking distance, 22.1 W for short-time maximum exercise capacity (steep ramp test) and 5.5 W for maximum exercise capacity). Quality of life also tended to be better in patients with one or fewer major breaks per session, but the differences were nonsignificant (adjusted between-groups difference in Chronic Respiratory Disease Questionnaire total score of 0.14).

Limited ability to follow exercise protocols is associated with smaller benefits of rehabilitation. This finding highlights the importance of choosing tolerable exercise protocols for chronic obstructive pulmonary disease patients.
Local immunodiagnosis of pulmonary tuberculosis by enzyme-linked immunospot
Authors: Jafari C. , Ernst M. , Strassburg A. , Greinert U. , Kalsdorf B. , Kirsten D. , Lange C.
Published: November 2007

Lymphocytes are crucial in the immune defence againstMycobacterium tuberculosis(MTB) infection. The aim of the present study was to ascertain whether or not MTB-specific lymphocytes are selectively compartmentalised in the lungs of patients with minimal active pulmonary tuberculosis (PTB).

Patients with smear-negative MTB-culture-confirmed PTB were prospectively recruited. Differential cell counts, immunophenotyping with monoclonal antibodies directed against the cell surface markers CD4, CD8, CD4CD45RA, CD4CD45R0, CD38, human leukocyte antigen DR, CD19, CD3, CD57 and CD16 and MTB-specific enzyme-linked immunospot assays of peripheral blood mononuclear cells and bronchoalveolar lavage (BAL) mononuclear cells with 6-kDa early secretory antigenic target and culture filtrate protein 10 were performed.

Among 12 patients with culture-confirmed smear-negative PTB, no differences were found in the distribution of total CD4 or CD8 T-cells in peripheral blood or BAL fluid (BALF). Activated human leukocyte antigen-DR-positive cells, as well as memory CD4CD45R0-positive T-cells, were expanded among cells of the BALF. Compared with a group of control patients with alternative pulmonary pathologies, there was no significant difference in lymphocyte subpopulations. However, 6-kDa early secretory antigenic target- and culture filtrate protein 10-specific lymphocytes were more concentrated, with a median BALF:peripheral blood ratio of 9.9 and 8.9, respectively, in patients with PTB.

Mycobacterium tuberculosis-specific T-cells are highly selectively compartmentalised at the site of infection in active pulmonary tuberculosis.
Validation and comparison of reference equations for the 6-min walk distance test
Authors: Cote C. G. , Casanova C. , Marín J. M. , Lopez M. V. , Pinto-Plata V. , de Oca M. M. , Dordelly L. J. , Nekach H. , Celli B. R.
Published: November 2007

Exercise impairment as measured by the 6-min walk distance (6MWD) test afflicts many patients with chronic obstructive pulmonary disease (COPD) and is known to predict mortality. Reference equations for the 6MWD in adults have been published but not yet validated.

The present authors prospectively followed 1,379 COPD patients for 55±30 months and tested the predictive value of the baseline 6MWD in metres, the 6MWD work (kg·m−1) and as a percentage of predicted values the 6MWD in meters according to two reference equations. All-cause mortality was the validating outcome. The best threshold values were identified for each of the tests using receiver operating characteristic (ROC) curves.

The threshold values obtained were: 350 m for the 6MWD, 25,000 kg·m−1for the 6MWD work, and 67 and 54% predicted for the two reference equations.All modalities of the testing were similar at predicting COPD mortality and correlated well with the 6MWD test.

In conclusion, all modalities of testing predict mortality in chronic obstructive pulmonary disease equally well. In the 6-min walk distance test, a value <350 m is associated with increased mortality and should be regarded as abnormal.
Palliative and end-of-life care for patients with severe COPD
Authors: Curtis J. R.
Published: November 2007

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life.

Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient–physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of-life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness.

The purpose of the present review is to summarise recent research regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning.

Improving communication represents an important opportunity for the improvement of the quality of palliative and end-of-life care received by these patients.
Longitudinal lung function decline and wood dust exposure in the furniture industry
Authors: Jacobsen G. , Schlünssen V. , Schaumburg I. , Taudorf E. , Sigsgaard T.
Published: November 2007

The aim of the present study was to investigate the relationship between change in lung function and cumulative exposure to wood dust.

In total, 1,112 woodworkers (927 males, 185 females) and 235 reference workers (104 males, 185 females) participated in a 6-yr longitudinal study. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), height and weight were measured, and questionnaire data on respiratory symptoms, wood dust exposure and smoking habits were collected. Cumulative inhalable wood dust exposure was assessed using a study-specific job exposure matrix and exposure time.

The median (range) for cumulative wood dust exposure was 3.75 (0–7.55) mg·year·m−3. A dose–response relationship between cumulative wood dust exposure and percent annual decrease in FEV1was suggested for female workers. This was confirmed in a linear regression model adjusted for confounders, including smoking, height and age. An additional difference of -14.50 mL·yr−1and −27.97 mL·yr−1was revealed for females exposed to 3.75–4.71 mg·yr·m−3or to >4.71 mg·yr·m−3, respectively, compared with non-/low-exposed females. For females, a positive trend between wood dust exposure and the cumulative incidence proportion of FEV1/FVC <70% was suggested.

In conclusion, in the present low-exposed cohort, female woodworkers had an accelerated decline in lung function, which may be clinically relevant.
The role of IFN-γ in regulation of IFN-γ-inducible protein 10 (IP-10) expression in lung epithelial cell and peripheral blood mononuclear cell co-cultures
Authors: Torvinen Maria , Campwala Hinnah , Kilty Iain
Published: November 2007

Background

Interferons play a critical role in regulating both the innate and adaptive immune responses. Previous reports have shown increased levels of IFN-γ, IFN-γ-inducing IL-12 and IFN-γ-inducible chemokine IP-10 in patients with chronic obstructive pulmonary disease (COPD).

Methods

The present study focuses on the regulation of the IP-10 secretion in co-cultures of lung epithelial cells and peripheral blood mononuclear cells (PBMCs).

Results

No IP-10 secretion was detected in cells cultured alone, whereas a significant increase in IP-10 levels was observed in epithelial cell/PBMC co-cultures. Furthermore, the results show that interactions between lung epithelial cells, lymphocytes and monocytes are needed for basal IP-10 secretion. Interestingly, we have also shown that incubation with IL-12 can induce an IFN-γ independent increase in IP-10 levels in co-cultures. Furthermore, inhibition studies supported the suggestion that different intracellular pathways are responsible of IFN-γ and IL-12 mediated IP-10 secretion.

Conclusion

These studies demonstrate a novel diversity in IFN-γ/IL-12 pathways, showing that the IP-10 expression in co-cultures is regulated by multiple factors, such as intercellular interactions in addition to IFN-γ and IL-12 levels. These results may be valuable in designing novel strategies to antagonize IP-10 mediated immunological reactions and chemotactic effects on T cells.
Identifications of conserved 7-mers in 3'-UTRs and microRNAs in Drosophila
Authors: Gu Jin , Fu Hu , Zhang Xuegong , Li Yanda
Published: November 2007

Background

MicroRNAs (miRNAs) are a class of endogenous regulatory small RNAs which play an important role in posttranscriptional regulations by targeting mRNAs for cleavage or translational repression. The base-pairing between the 5'-end of miRNA and the target mRNA 3'-UTRs is essential for the miRNA:mRNA recognition. Recent studies show that many seed matches in 3'-UTRs, which are fully complementary to miRNA 5'-ends, are highly conserved. Based on these features, a two-stage strategy can be implemented to achieve the de novo identification of miRNAs by requiring the complete base-pairing between the 5'-end of miRNA candidates and the potential seed matches in 3'-UTRs.

Results

We presented a new method, which combined multiple pairwise conservation information, to identify the frequently-occurred and conserved 7-mers in 3'-UTRs. A pairwise conservation score (PCS) was introduced to describe the conservation of all 7-mers in 3'-UTRs between any two Drosophila species. Using PCSs computed from 6 pairs of flies, we developed a support vector machine (SVM) classifier ensemble, named Cons-SVM and identified 689 conserved 7-mers including 63 seed matches covering 32 out of 38 known miRNA families in the reference dataset. In the second stage, we searched for 90 nt conserved stem-loop regions containing the complementary sequences to the identified 7-mers and used the previously published miRNA prediction software to analyze these stem-loops. We predicted 47 miRNA candidates in the genome-wide screen.

Conclusion

Cons-SVM takes advantage of the independent evolutionary information from the 6 pairs of flies and shows high sensitivity in identifying seed matches in 3'-UTRs. Combining the multiple pairwise conservation information by the machine learning approach, we finally identified 47 miRNA candidates in D. melanogaster.