bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Concerns in Patients With Advanced Cancer: An Observational Study at Regional Cancer Centre, India
Authors: Mishra Seema , Bhatnagar Sushma , Philip Freeny Ann , Singhal Vasudha , Shiv Pratap Singh Rana  , Surjya Prasad Upadhyay  , Chauhan Govindi
Published: February 2010

Introduction: The diagnosis and treatment of cancer is associated with substantial physical, psychological, and social morbidity. The objective of this study was to identify the prevalence of psychosocial concerns in the patients with advanced cancer admitted to our institute. Materials and Methods: A total of 100 patients admitted to the inpatient palliative care unit of our institute were enrolled in this study. A descriptive questionnaire that dealt with the patient’s psychological acceptance of the disease and emotional distress that accompanies the diagnosis was prepared. Patient’s social and spiritual needs were addressed, and the future concerns that the patient is preoccupied with were discussed on a one-on-one basis with the patient himself or herself. Results: It was found that a majority of patients, though aware of their diagnosis, were not aware of the disease prognosis. There was a generalized anxiety regarding the treatment of the disease and fear of suffering. Most patients preferred to keep the revelation of the diagnosis to those close to them and not reveal it publicly. Financial drain out of resources was a major concern. Future concerns about their own fitness, the settlement of their children, and the family’s well-being were seen commonly in almost all the patients. Conclusions: Attention to psychosocial and spiritual health needs of patients with cancer is an integral part of an effective palliation, though they are less commonly expressed but are strongly felt by patients with cancer. It is therefore recommended that all clinicians and health care providers should address psychosocial health needs as a part of their routine practice.
A Genetic Algorithm-based Two-phase Design for Optimal Placement of Semi-active Dampers for Nonlinear Benchmark Structure
Authors: Li L. , Song G. , Ou J.
Published: February 2010

Optimal placement of dampers for structural vibration control is both important and challenging. Though this issue is adequately addressed for linear structures in the literature, optimal placement of dampers for nonlinear structures is rarely studied. In this paper, a two-phase optimization process using genetic algorithms is proposed for the placement of semi-active MR dampers for a nonlinear benchmark structure. In the first phase, an optimization algorithm is used to obtain the active control force that is most suitable for semi-active implementation. In the second phase, the placement of semi-active MR dampers is optimized to mimic the optimal active control force obtained in the first phase. Simulation results show that the lower and upper stories will be the first choice for the placement of the dampers, and also the optimal number of the MR dampers for a structure is suggested in this paper.
Does MRI lesion activity regress in secondary progressive multiple sclerosis?
Authors: Zhao Y. , Petkau AJ , Traboulsee A. , Riddehough A. , Li DKB
Published: February 2010

Background: The rate of new contrast-enhancing lesions (CELs) on monthly magnetic resonance imaging (MRI) scans has been shown to decrease over a 9-month period in placebo-treated patients with relapsing—remitting (RR) multiple sclerosis (RRMS).

Objective: We examined this phenomenon in placebo-treated secondary progressive MS (SPMS) patients.

Methods: Patients were chosen from two clinical trials. Monthly scans were taken at screening, baseline and months 1—9 for Cohort-1 and months 1—6 for Cohort-2. We examined the monthly new CEL rates according to initial CEL level: 0, 1—3, >3 CELs at screening, and presence and absence of pre-study relapses.

Results: Respectively, 59, 21 and 14 of the 94 Cohort-1 patients, and 36, 17 and 9 of the 62 Cohort-2 patients had 0, 1—3 and >3 initial CELs. For Cohort-1, the monthly new CEL rates did not change during follow-up, regardless of initial CEL level. For Cohort-2, the monthly rate was unchanged in the 0 initial CEL subgroup, but decreased 33% (95% confidence interval: 8%, 52%) from months 1—3 to months 4—6 in the other two subgroups. For the combined cohorts, a decreasing rate was observed in the 12 patients with >3 initial CELs and pre-study relapses.

Conclusions: The short-term trend of new CEL activity in placebo-treated SPMS patients may vary across cohorts.
Traditionalists vs. Convergers
Authors: Robinson Sue
Published: February 2010

As newspapers move toward web platforms, journalists struggle with their authoritative role in society. A documentation of policy development for commenting on news articles, this research considers these reader-content areas as places of boundary work for the journalist—audience relationship in interactive news environments. This ethnographic examination demonstrated significant internal conflict among both journalists and readers. The ‘traditionalists’ — those who want to maintain a hierarchal relationship between journalists and audiences — clashed with the ‘convergers’ — those who felt users should be given more freedoms within the news site. The resulting policy privileged journalism by relegating reader input to specific, structured spaces. But for the first time, audiences participated in that policy development, asserting their own textual privilege according to a value system apart from journalistic norms. The result was a grand identity complex for the news profession characterized by interrupted information flow patterns and diffused power over knowledge. Institutional hierarchies for policymaking and execution are radically changing.
Where Do We Go From Here? Readers' Responses to Interactive Fiction
Authors: Pope James
Published: February 2010

Interactive fiction has excited huge interest amongst scholars and experimental artists since the pioneering work of Michael Joyce in the 1980s. However, it has not reached out to a wide community of writers and readers, largely because of the twin problems of poor reader engagement with fractured narrative structures, and the heavy cognitive demands of the interfaces used by hyper-writers. This article reports upon an empirical study of readers’ responses to a range of interactive fictions, a study which aimed to uncover in detail the key factors affecting readers’ experience of this narrative form. On the basis of the study’s findings, it is argued that interactive fiction can offer an enjoyable reading experience, if core issues around narrative structure and interface design are addressed by writers. The article suggests guidelines for writers, based on the findings of the empirical study.
Cross-cultural patterns in mobile-phone use: public space and reachability in Sweden, the USA and Japan
Authors: Baron Naomi S. , af Segerstad Ylva Hård
Published: February 2010

Contemporary mobile-phone technology is becoming increasingly similar around the world. However, cultural differences between countries may also shape mobile-phone practices. This study examines a group of variables connected to mobile-phone use among university students in Sweden, the USA and Japan. Key cultural issues addressed are attitudes towards quiet in public space, personal use of public space and tolerance of self-expression. Measures include the appropriateness of using mobiles in various social contexts and judgments of what respondents like most and like least about having a mobile phone. Analysis revealed a number of culturally associated differences, as well as a shared conflicting attitude towards the advantages and disadvantages of reachability by mobile phone.
Mobile phones and the inexorable advance of multimodal connectedness
Authors: Schroeder Ralph
Published: February 2010

The aim of this article is to put mobile phones and uses of other new media into the broader context of cross-cultural comparison. The article focuses on two countries (Sweden and the USA) and on leisure and sociability. A problem with studies narrowly focusing on mobile phones is that the mobile’s uses cannot easily be separated from uses of other information and communication technologies (ICTs), as when ICTs compete for time spent or when key functions such as maintaining relationships are distributed across devices. Therefore the concept of multimodal connectedness is introduced to examine the whole range of ICTs. Once we can see how various technologies for maintaining relationships complement each other, we often find that convergences outweigh divergences between cultures. The implications for cross-cultural comparison are that we can distinguish between culture in an anthropological sense (that is, as a unique way of life) as against mediated culture, where there are increasingly common patterns of multimodally communicative relationships across cultures, even if differences also persist.
Lineage-specific positive selection at the merozoite surface protein 1 (msp1) locus of Plasmodium vivax and related simian malaria parasites
Authors: Sawai Hiromi , Otani Hiroto , Arisue Nobuko , Palacpac Nirianne , de Oliveira Martins Leonardo , Pathirana Sisira , Handunnetti Shiroma , Kawai Satoru , Kishino Hirohisa , Horii Toshihiro , Tanabe Kazuyuki
Published: February 2010

Background

The 200 kDa merozoite surface protein 1 (MSP-1) of malaria parasites, a strong vaccine candidate, plays a key role during erythrocyte invasion and is a target of host protective immune response. Plasmodium vivax, the most widespread human malaria parasite, is closely related to parasites that infect Asian Old World monkeys, and has been considered to have become a parasite of man by host switch from a macaque malaria parasite. Several Asian monkey parasites have a range of natural hosts. The same parasite species shows different disease manifestations among host species. This suggests that host immune responses to P. vivax-related malaria parasites greatly differ among host species (albeit other factors). It is thus tempting to invoke that a major immune target parasite protein such as MSP-1 underwent unique evolution, depending on parasite species that exhibit difference in host range and host specificity.

Results

We performed comparative phylogenetic and population genetic analyses of the gene encoding MSP-1 (msp1) from P. vivax and nine P. vivax-related simian malaria parasites. The inferred phylogenetic tree of msp1 significantly differed from that of the mitochondrial genome, with a striking displacement of P. vivax from a position close to P. cynomolgi in the mitochondrial genome tree to an outlier of Asian monkey parasites. Importantly, positive selection was inferred for two ancestral branches, one leading to P. inui and P. hylobati and the other leading to P. vivax, P. fieldi and P. cynomolgi. This ancestral positive selection was estimated to have occurred three to six million years ago, coinciding with the period of radiation of Asian macaques. Comparisons of msp1 polymorphisms between P. vivax, P. inui and P. cynomolgi revealed that while some positively selected amino acid sites or regions are shared by these parasites, amino acid changes greatly differ, suggesting that diversifying selection is acting species-specifically on msp1.

Conclusions

The present results indicate that the msp1 locus of P. vivax and related parasite species has lineage-specific unique evolutionary history with positive selection. P. vivax and related simian malaria parasites offer an interesting system toward understanding host species-dependent adaptive evolution of immune-target surface antigen genes such as msp1.
Evaluation of the Adsorption States of H2O on Oxide Surfaces by Vibrational Absorption: Near- and Mid-Infrared Spectroscopy
Authors: Takeuchi Masato , Martra Gianmario , Coluccia Salvatore , Anpo Masakazu
Published: February 2010

The interactions of H2O molecules with various oxide surfaces were investigated using vibrational absorption spectroscopies, Fourier transform infrared (FT-IR), near infrared (NIR) and an analysis of the adsorption isotherms with regard to the intermolecular hydrogen bonds for H2O molecules. The combination bands of the fundamental vibration modes for H2O molecules in the NIR region provided very useful information on their intermolecular hydrogen bonds. The physicochemical properties of the solid surfaces such as hydrophilicity or hydrophobicity were also investigated as they relate to the viewpoint of the distribution of “hydrogen-bonded H2O” and the “hydrogen bond-free H2O”. It was found that SiO2 surfaces adsorb smaller amounts of H2O and hydrocarbon molecules as compared to TiO2 or Al2O3, showing hydrophobicity. The smaller amounts of H2O molecules adsorbed on the SiO2 surfaces enabled them to spread out to form H2O thin layers due to the small interaction between the H2O molecules and SiO2 surface as well as the small contribution of the intermolecular hydrogen bonds. These results clearly indicate that the hydrophobic SiO2 surfaces show high wettability against the H2O molecules. On the other hand, larger amounts of H2O molecules and hydrocarbons were found to adsorb not only on the surface hydroxyl groups but also on the cationic (Ti4+ or Al3+) sites of the TiO2 or Al2O3 surfaces, suggesting that TiO2 or Al2O3 surfaces show both hydrophilic and oleophilic properties. Moreover, larger amounts of H2O molecules were found to form aggregated bulky H2O networks on TiO2 or Al2O3 surfaces due to the large contribution of the intermolecular hydrogen bonds of the H2O molecules. The results revealed that TiO2 or Al2O3 surfaces, on which large amounts of H2O and hydrocarbons can adsorb, show low wettability against H2O molecules. The hydrophilic or hydrophobic properties of oxide surfaces are indicated by the direct interaction between the guest molecules and host solid surfaces and these interactions can be analysed by vibrational absorption (FT-IR and NIR) and adsorption isotherm measurements at the molecular level. Moreover, we discuss the wettability of solid surfaces as determined by the contact angle of the H2O droplets and by the macroscopic interaction of H2O with oxide surfaces on which not only H2O but also hydrocarbon molecules are adsorbed in air until saturation.
Water Absorbance Pattern of Physically-Damaged Mushrooms Stored at Ambient Conditions
Authors: Esquerre Carlos , Gowen Aoife A. , O'Donnell Colm P. , Downey Gerard
Published: February 2010

Partial least squares (PLS) regression models were constructed from near infrared spectra to predict weight loss in mushrooms stored at ambient conditions (20°C, 78% RH). Regression coefficients were examined with the aim of estimating the water absorbance pattern for a better understanding of the process of mechanical damage in mushrooms. Sequential spectra of 32 mushrooms, harvested at two different times, were obtained over the 400–2498 nm range; half of the samples were physically damaged by vibration. Data analysis focussed on the region of the combination of asymmetric and symmetric stretching modes of water molecules (i.e. 1300–1600 nm). Standard normal variate (SNV) transformation of second derivative spectra performed better than other spectral pre-treatments tested to correct the baseline shift and scatter present in the data; mean centring of both weight loss and pre-treated spectra was necessary to correct variability between mushroom samples (i.e. size, shape, initial moisture content, maturity). Main spectral variations were found at the following wavelengths: 1408–1410 nm, 1434 nm, 1462–1464 nm and 1520nm. Previous researchers have assigned these bands to free (1408–1410 nm), intermediate strongly-bound (1434nm and 1462–1464nm) and strongly-bound (1520 nm) water molecules. The regression coefficient vector of undamaged mushrooms presented relevant features at all four bands; that for damaged mushrooms lacked significant coefficients around 1520 nm. Additionally, the regression vector and weight loss of damaged mushrooms exhibited opposing trends around the 1460 nm band.
Use of near Infrared Hyperspectral Imaging to Identify Water Matrix Co-Ordinates in Mushrooms (Agaricus Bisporus) Subjected to Mechanical Vibration
Authors: Gowen Aoife A. , Tsenkova Roumiana , Esquerre Carlos , Downey Gerard , O'Donnell Colm P.
Published: February 2010

In this study, white mushrooms ( Agaricus bisporus) were subjected to physical perturbation by mechanical vibration. Hyperspectral images were obtained after perturbation using a pushbroom line-scanning instrument operating in the wavelength range of 1000–1700 nm (7nm spectral resolution). Changes in sample spectra arising from perturbation were examined by observation of difference spectra and partial least squares regression (PLSR) coefficients. Different spectral pre-treatments [multiplicative scatter correction (MSC), extended multiplicative scatter correction (EMSC) and standard normal variate (SNV)] were employed in order to decrease spectral variability caused by scattering and differences in the optical path length due to physical changes in the mushrooms induced by the perturbation. Candidate water matrix co-ordinates were proposed at 950 nm, 1174 nm, 1398 nm, 1433 nm, 1454 nm, 1496 nm and 1510 nm. Mechanical vibration increased the concentration of weakly hydrogen-bonded water and decreased that of strongly hydrogen-bonded water in the mushrooms without causing changes in the bulk moisture content.
Sugars as a Perturbation of the Water Matrix
Authors: Giangiacomo Roberto , Pani Paola , Barzaghi Stefania
Published: February 2010

Near infrared (NIR) and nuclear magnetic resonance (NMR) spectroscopy studies were performed to determine the behaviour of water during an osmotic process of apple spheres in concentrated sugar solutions. The osmotic dehydration is a process of water removal from cellular structures through immersion in a hypertonic solution. Relationships between sugars and water were studied using both two-dimensional correlation, calculated on NIR spectra recorded during the process, and NIR–NMR outer product analysis (OPA). We found that there was a shift of 7nm towards higher wavelengths in the maximum absorbance of the first overtone range of the water O–H stretching, due to the increase of hydrogen bonds implicated in the binding of the sugars progressively increasing in concentration during water removal. The absorptions detected by two-dimensional correlation, using processing time as the dynamic variable, belong to the elements which have more OH free as indicated from the outer product analysis, i.e. free water at 1936 nm followed by bonded water at 1393 nm and 1518 nm and sugars at 2131 nm, respectively.
Influence of Water on Prediction of Composition and Quality Factors: The Aquaphotomics of Low Moisture Agricultural Materials
Authors: Williams Phil
Published: February 2010

The main constituents of agricultural materials are starch, protein, oil (lipid), cellulose and minerals. These constituents all exist in the molecular state and are constantly in motion, but are essentially functionally static in the raw materials from which foods and feeds are made. It is only when the molecules are brought together by an external medium that brings them into contact with each other in a way in which they can interact more freely, that the molecules are able to create new products. The most important medium is water. Water has a profound influence on the behaviour and the spectra of agricultural commodities. The paper will demonstrate that during the development of near infrared (NIR) calibration models, using several different approaches, the selection of wavelengths in areas where water is known to absorb in the NIR region, is widespread among calibrations for prediction of composition, and functionality in systems in which the moisture content is not high (up to about 15% moisture), and water is not the dominant constituent. Over 200 references have been made to assignments for water in some form, between 700–2200 nm. The influence of water on NIR calibration models for prediction of composition and functionality of materials of even fairly low moisture content is convincing. Evidence is presented in terms of partial least squares loadings for NIR calibration models developed on these materials. The relevance of this is discussed with respect to the possibility of interaction with other absorbers at the same, or adjacent wavelengths. The concept is presented that studies of changes in the intensity and positions of the absorbances of water, and those of other major constituents during development of NIR calibration models, can provide new information on the interaction among these constituents that result in differences in the structure and functionality of the materials, and on the efficiency of NIR analysis.
Effects of Work Permits on Illegal Employment Among Youth Workers: Findings of a School-Based Survey on Child Labor Violations
Authors: Dal Santo Janet Abboud , Bowling J. Michael , Harris Thomas A.
Published: February 2010

We compared self-reported child labor violations between teenagers with and without work permits. Data were obtained from a school-based survey of working teenagers in 16 randomly selected high schools in North Carolina. We examined associations between work hour violations, hazardous order violations (performance of illegal tasks), and possession of a work permit. Work permits appear to be protective against performance of illegal tasks but not against work hour violations, demonstrating the need for stricter enforcement policies and improvements in work permit screening processes.
Clinical features of HIV/AIDS and various opportunistic infections in relation to antiretroviral status among HIV seropositive individuals from Central Nepal
Authors: Sharma S , Dhungana GP , Pokharel BM , Rijal BP
Published: February 2010

Background: So far, antiretroviral therapy is the only effective treatment available to HIV/AIDS patients. Provision of combined package of treatment, care and support service as well as regular assessment of the therapy increases its effectiveness. Objective: The aim of this study was to establish the relationship between antiretroviral therapy status and clinical features/opportunistic infections among HIV seropositive individuals. Materials and methods: This is a cross-sectional study. Study was carried out between October 2007 and May 2008 in 150 HIV patients of Kathmandu, Central Nepal. After taking informed consent pre-structured questionnaire was filled to assess clinical features and specimen were collected to investigate major OIs as per standard microbiological procedure. All the information were entered into SPSS 11.5 system and analysed. Result: Of the 150 patients, 100 (66.7%) were males and 50 (33.3%) were females. The age group 21-30 years was predominant followed by 31-40 years (42%). Significant relationship could be established between intake of ART and cardinal symptoms of HIV/AIDS (χ2 value ranging from 4.11 to 9.34). However, no significant relationship could be established between the intake of ART and distribution of different OIs (χ2 values ranging from 0.15 to 1.6). Conclusion: Antiretroviral therapy was found to effective enough to reduce the clinical features of AIDS. Diagnosis and treatment of opportunistic infections should be routinely done for both groups of patients. Key words: Antiretroviral therapy; CD4 count; HIV/AIDS; Nepal DOI: 10.3126/kumj.v7i4.2754 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 355-359
Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children
Authors: Dumre SP , Sapkota K , Adhikari M , Acharya D , Karki M , Bista S , Basnyat SR , Joshi SK
Published: February 2010

Background: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. Objectives: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. Materials and methods: Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines. Results: S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was statistically insignificant (P>0.05) with sex and age sub-groups, although the rate was slightly higher among girls and age sub-group 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). All isolates were susceptible to azithromycin. No resistance was detected for penicillin and its derivative antibiotic ampicillin. Highest resistance rate was observed for cotrimoxazole (71.0%) followed by chloramphenicol (7.8%), ciprofl oxacin (5.2%) and erythromycin (5.2%). Conclusion: Antibiotic resistant GAS isolated from asymptomatic Nepalese school children is a public health concern. When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the school environment and the community. Preventing cross infections would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimise GAS carriage/infections and resistance. Key words: Streptococcus pyogenes; Antibiotics Resistance; Throat carriage; Children; Nepal. DOI: 10.3126/kumj.v7i4.2760 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 392-396
Observation of hearing loss in patients with chronic suppurative otitis media tubotympanic type
Authors: Maharjan M , Kafle P , Bista M , Shrestha S , Toran KC
Published: February 2010

Background: It is acknowledged that size and site of tympanic membrane perforation is proportional to degree of hearing loss but there are many studies which suggests otherwise. Persistent ear discharge is also supposed to deteriorate hearing level with passage of time. This study is carried out to find out the relation between size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Objectives: The objective of this study is to study the effect of size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Materials and methods: This is a cross-sectional prospective study conducted at Kathmandu Medical College, department of ear nose and throat from January till July 2009. One hundred patients aged between 8 to 60 years with pars-tensa perforations were included in the study. Detail clinical examination and history was carried out followed by hearing evaluation by audiometry was done in all cases. All the data is collected, statistical analysis is done using SPSS program and documented for study. Results: One hundred patients with 119 perforated tympanic membrane, age ranged between 8 to 60 years, 44 males and 56 females were studied. Bilateral tympanic membrane perforation were seen in 19 patients, right sided perforation in 39 and left sided in 42 patients respectively. Large central perforation involving all four quadrants was the most common otologic findings seen in 72 ears (60.50%) whereas perforation in posterosuperior quadrant was the least common finding seen in 3 patients (2.52%). Significant relation is observed between site of perforation and degree of hearing loss; posterior placed perforations seem to have larger hearing loss. Ninety-five perforations (79.83%) showed more loss in low frequencies with larger air bone gap at low frequencies. The longer the duration of ear discharge, the more the hearing loss. Conclusion: The larger the perforation, the greater the decibel loss in sound perception. The location of perforation on the tympanic membrane and the duration of ear discharge have significant effect on the magnitude of hearing loss. Key words: chronic suppurative otitis media; tympanic membrane perforation; hearing loss DOI: 10.3126/kumj.v7i4.2761 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 397-401
Laryngocele masquerading as a soft tissue neck mass
Authors: Dhungel K , Gupta MK , Ahmad K , Sah PL , Rauniyar RK
Published: February 2010

Laryngocele is a rare entity which can clinically present as a neck mass and requires Computed Tomography (CT) and laryngoscopy for diagnosis. We present an interesting case of bilateral laryngocele in a 45 -year-old male presented clinically as hoarseness and left sided neck mass without any history of predisposing factors. Ultrasonography (USG) and CT features of laryngocele is also presented here. Key words: Laryngocele; Cervical mass; Ultrasonography; Computed Tomography DOI: 10.3126/kumj.v7i4.2767 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 423-425
Opportunities and challenges in school-based sex and sexual health education in Nepal
Authors: Acharya DR , Van Teijlingen ER , Simkhada P
Published: February 2010

This article identifies and addresses opportunities for and challenges to current school-based sex and sexual health education in Nepal. Key literature searches were conducted of electronic databases and relevant web-sites, furthermore personal contact with experts and the hand searching of key journals was included. The review of this literature generated the following challenges: Limitations to teaching including lack of life skill-based and human right-based approach, inappropriate teaching aid and reliance on conventional methods, existing policy and practice, parental/community support, and lack of research into and evaluation of sex education. Diverse methodology in teaching, implementation of peer education programme, partnership with parents, involvement of external agencies and health professionals, capacity building of teachers, access to support and service organisation, and research and evaluation in sex education have been suggested for improving the current practice of sex and sexual health education in Nepalese schools. Key words: Sex education; education; school; adolescence; Nepal DOI: 10.3126/kumj.v7i4.2773 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 445-453
Family Values, Land Sales and Agricultural Commodification in South-Eastern Ghana
Authors: Amanor Kojo Sebastian
Published: February 2010

It is argued that land shortage and the decline of new frontier areas results in increasing conflicts over rights to land and to labour. This constrains land sales and agricultural land becomes increasingly transferred though sharecropping and the commodification of user rights in land, rather than through the evolution of clearly defined land markets. Smallholder agriculture increasingly becomes an individual undertaking, in which labour is hired, and rights to land are acquired rather than allocated within the family. Agricultural relations of production become increasingly commodified and the moral economy of the family is undermined and increasingly socially differentiated. The article traces historically the emergence of these production relations in south-east Ghana.
Description of an Outbreak of Acute Sterile Peritonitis in Iran
Authors: Nouri-Majalan Nader , Najafi Iraj , Sanadgol Hoshang , Ganji Mohammad-Reza , Atabak Shahnaz , Hakemi Monirossadat , Soleymanian Tayebeh
Published: February 2010

Background

Outbreaks of sterile or chemical peritonitis are uncommon and often not well documented. It is therefore important to describe the characteristics of sterile peritonitis in continuous peritoneal dialysis (PD) patients.

Methods

Characteristics of acute chemical peritonitis (ACP) are described in 20 patients (5 males, 15 females; mean age 50 ± 15 years; range 29 – 72 years). Cultures and Gram stains were negative for micro-organisms. All patients with symptoms of peritonitis were using glucose bags with the same lot number and resolution of peritonitis occurred only after changing the suspicious bags. The first measurements of dialysate-to-plasma creatinine (D/P creat) and glomerular filtration rate (GFR) before and after ACP were compared in 14 patients with no separate episode of bacterial peritonitis during that time.

Results

Cloudy dialysate was observed in 19 patients and 13 experienced abdominal pain. Mean dialysate white blood cell count and percentage neutrophils were 520/mm3 (range 100 – 1600/mm3) and 65% (range 14% – 98%) respectively. Analysis of the unused PD solution showed that endotoxin (0.06 endotoxin unit/mL), 5-hydroxymethyl furaldehyde (8 μg/mL), and acetaldehyde (0.4 μg/mL) concentrations were within acceptable ranges. In 14 patients without episodes of bacterial peritonitis, D/P creat was significantly higher after than before ACP (0.77 ± 0.07 vs 0.55 ± 0.1, p = 0.036), whereas GFR was not (4.5 ± 2.9 vs 4.9 ± 2.53 mL/minute, p = 0.62).

Conclusion

Although chemical peritonitis in glucose-based PD solution is uncommon, it should be distinguished from bacterial peritonitis in outbreaks of peritonitis. Facilities to measure glucose degradation products are required, especially in developing countries. Acute chemical peritonitis increases small-molecule transport in the short term.
Endoscopic Transluminal Insertion of a Peritoneal Dialysis Catheter
Authors: Mettang Thomas , Krumme Bernd , Wilhelm Arne , Duschka Lothar
Published: February 2010

Background

At present there are various more or less invasive surgical and laparoscopic ways to place a catheter suitable for peritoneal dialysis (PD); however, once the catheter is in place, there is no possibility to inspect the peritoneal cavity without de novo laparotomy or laparoscopy.

Patients and Methods

To establish a minimally invasive technique and allowing for maximal options, we used a PD catheter with an extra large inside diameter of 3.5 mm. Because of the enlarged inner diameter of 3.5 mm (compared to 2.6 mm in standard Tenckhoff catheters), this device can be passed by a very thin video-endoscope with an external diameter of 2.8 mm. Using a stepwise approach, we applied this device in placing PD catheters in 2 patients. The procedure could be done without complications. Both patients were doing well 4 and 6 months later, respectively, without any PD-related complications. Intraperitoneal view by the endoscope was limited; an attempt to obtain a peritoneal biopsy failed.

Conclusions

If the drawbacks of this method can be overcome it will have a wide spectrum of applications ( i.e., inspection of the peritoneal cavity and obtaining peritoneal biopsies at any time during PD treatment). In this way it can be used scientifically and clinically when a problem of flow or ultrafiltration occurs or when encapsulating sclerosing peritonitis is suspected.
Peritoneal Dialysis in Africa
Authors: Abu-Aisha Hasan , Elamin Sarra
Published: February 2010

Background

Africa is the world's second-largest and second most populous continent. It is also the poorest and most underdeveloped continent. Struggling to provide the essential health interventions for its occupants, the majority of African countries cannot regard renal replacement therapy a health priority.

Review

In 2007, Africa's dialysis population constituted only 4.5% of the world's dialysis population, with a prevalence of 74 per million population (pmp), compared to a global average of 250 pmp. In almost half the African countries, no dialysis patients are reported. The prevalence of peritoneal dialysis (PD) was 2.2 pmp, compared to a global prevalence of 27 pmp, with the bulk of African PD patients (85%) residing in South Africa. In North African countries, which serve 93% of the African dialysis population, the contribution of PD to dialysis is only 0% – 3%. Cost is a major factor affecting the provision of dialysis treatment and many countries are forced to ration dialysis therapy. Rural setting, difficult transportation, low electrification rates, limited access to improved sanitation and improved water sources, unsuitable living circumstances, and the limited number of nephrologists are obstacles to the provision of PD in many countries.

Conclusion

The potential for successful regular PD programs in tropical countries has now been well established. Cost is a major prohibitive factor but the role of domestic manufacture in facilitating widespread use of PD is evidenced by the South African example. Education and training are direly needed and these are areas where international societies can be of great help.
Encapsulating Peritoneal Sclerosis in a Patient with Primary Hyperoxaluria Type 1: A Case Report
Authors: Vanmassenhove Jill , Vanholder Raymond , Forsyth Ramses , Dhondt Annemieke
Published: February 2010

Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder caused by a defect in glyoxylate metabolism attributable to low or absent activity of the liver-specific peroxisomal enzyme alanine/glyoxylate aminotransferase. This defect leads to enhanced conversion of glyoxylate to poorly soluble oxalate, which is then excreted into the urine. This process may lead to deposition of calcium oxalate crystals in many tissues as well as in the kidneys, resulting in nephrolithiasis, nephrocalcinosis, and/or renal failure.

We present a 39-year-old patient with end-stage renal failure due to PH1, who was admitted with symptoms of feeling bloated, vomiting, diarrhea, and abdominal pain related to encapsulating peritoneal sclerosis (EPS). He had been treated with peritoneal dialysis for a total period of 5 years.

EPS is a rare condition characterized by fibrosis and adhesions of the peritoneum to loops of the small intestine and has been described secondary to treatment with peritoneal dialysis. It also occurs in a variety of other clinical conditions such as autoimmune diseases and peritoneal and intra-abdominal malignancies.

The calcium oxalate crystals found in the peritoneal fascia of this particular patient may suggest a causative relationship between crystal deposits and evolution to fibrosis and sclerosis of the peritoneum. The degree of impact of the peritoneal dialysis treatment itself on the development of EPS, however, is uncertain.
Glucose Degradation Products Result in Cardiovascular Toxicity in a Rat Model of Renal Failure
Authors: Müller–Krebs Sandra , Kihm Lars P. , Zeier Benjamin , Gross Marie-Luise , Wieslander Anders , Haug Ulrike , Zeier Martin , Schwenger Vedat
Published: February 2010

Background

It has been shown that glucose degradation products (GDP) generated during heat sterilization of peritoneal dialysis (PD) fluids impair the peritoneal membrane locally, then enter the systemic circulation and cause damage to the remnant kidney. Here we examined in subtotally nephrectomized (SNX) rats whether GDP also affect the cardiovascular system.

Materials and Methods

Standard 5/6 nephrectomy was carried out in Sprague–Dawley rats; other rats were sham operated and left untreated for 3 weeks. Through an osmotic mini-pump, SNX+GDP group received GDP intravenously for 4 weeks; the SNX and the sham-operated groups remained without GDP. The experiment was terminated for all groups 7 weeks postoperatively. We analyzed cardiovascular damage by serum analyses and immunohistochemical investigation.

Results

In SNX+GDP animals, expression of the advanced glycation end product (AGE) marker carboxymethyllysine and receptor of AGE (RAGE) were significantly higher in the myocardium and the aorta compared to the SNX rats. We also found significantly higher levels of apoptosis measured by caspase 3 staining in the cardiovascular system in the SNX+GDP group. Moreover, we observed a more pronounced expression of oxidative stress in the SNX+GDP rats compared to the SNX rats. In serum analyses, advanced oxidation protein products and reactive oxygen species were increased, as was immunohistochemical endothelial nitric oxide synthase.

Conclusions

In addition to local toxic effects, GDP cause systemic toxicity. Here we showed that, in SNX rats, administration of GDP increased cardiovascular damage. In particular, we found increased levels of AGE, RAGE, oxidative stress, and apoptosis. Whether these findings are of clinical relevance has to be further investigated.
Prolylprolinol‐Catalyzed Asymmetric Michael Addition of Aliphatic Aldehydes to Nitroalkenes
Authors: Lu Dengfu , Gong Yuefa , Wang Weizhou
Published: February 2010

Several novel prolylprolinol catalysts have been designed and synthesized. This type of compound showed high catalytic efficiency on promoting the direct addition of unmodified aldehydes to nitroalkenes. Among the catalysts surveyed, the least bulky member (8d) exhibited the best performance on both efficiency and stereoselectivity, providing the products with up to 97% ee value with 1.5–5 mol% catalyst loading. Additionally, computational studies of the transition state have been conducted to explain the high diastereo‐ and enantioselectivity.
Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis
Authors: Talman Lauren S. , Bisker Esther R. , Sackel David J. , Long David A. , Galetta Kristin M. , Ratchford John N. , Lile Deacon J. , Farrell Sheena K. , Loguidice Michael J. , Remington Gina , Conger Amy , Frohman Teresa C. , Jacobs Dina A. , Markowitz Clyde E. , Cutter Gary R. , Ying Gui‐Shuang , Dai Yang , Maguire Maureen G. , Galetta Steven L. , Frohman Elliot M. , Calabresi Peter A. , Balcer Laura J.
Published: February 2010

Objective

Cross‐sectional studies of optical coherence tomography (OCT) show that retinal nerve fiber layer (RNFL) thickness is reduced in multiple sclerosis (MS) and correlates with visual function. We determined how longitudinal changes in RNFL thickness relate to visual loss. We also examined patterns of RNFL thinning over time in MS eyes with and without a prior history of acute optic neuritis (ON).

Methods

Patients underwent OCT measurement of RNFL thickness at baseline and at 6‐month intervals during a mean follow‐up of 18 months at 3 centers. Low‐contrast letter acuity (2.5%, 1.25% contrast) and visual acuity (VA) were assessed.

Results

Among 299 patients (593 eyes) with ≥6 months follow‐up, eyes with visual loss showed greater RNFL thinning compared to eyes with stable vision (low‐contrast acuity, 2.5%: p < 0.001; VA: p = 0.005). RNFL thinning increased over time, with average losses of 2.9μm at 2 to 3 years and 6.1μm at 3 to 4.5 years (p < 0.001 vs 0.5–1‐year follow‐up interval). These patterns were observed for eyes with or without prior history of ON. Proportions of eyes with RNFL loss greater than test‐retest variability (≥6.6μm) increased from 11% at 0 to 1 year to 44% at 3 to 4.5 years (p < 0.001).

Interpretation

Progressive RNFL thinning occurs as a function of time in some patients with MS, even in the absence of ON, and is associated with clinically significant visual loss. These findings are consistent with subclinical axonal loss in the anterior visual pathway in MS, and support the use of OCT and low‐contrast acuity as methods to evaluate the effectiveness of putative neuroprotection protocols. ANN NEUROL 2010;67:749–760
Pilot trial of low‐dose naltrexone and quality of life in multiple sclerosis
Authors: Cree Bruce A. C. , Kornyeyeva Elena , Goodin Douglas S.
Published: February 2010

Objective

To evaluate the efficacy of 4.5mg nightly naltrexone on the quality of life of multiple sclerosis (MS) patients.

Methods

This single‐center, double‐masked, placebo‐controlled, crossover study evaluated the efficacy of 8 weeks of treatment with 4.5mg nightly naltrexone (low‐dose naltrexone, LDN) on self‐reported quality of life of MS patients.

Results

Eighty subjects with clinically definite MS were enrolled, and 60 subjects completed the trial. Ten withdrew before completing the first trial period: 8 for personal reasons, 1 for a non–MS‐related adverse event, and 1 for perceived benefit. Database management errors occurred in 4 other subjects, and quality of life surveys were incomplete in 6 subjects for unknown reasons. The high rate of subject dropout and data management errors substantially reduced the trial's statistical power. LDN was well tolerated, and serious adverse events did not occur. LDN was associated with significant improvement on the following mental health quality of life measures: a 3.3‐point improvement on the Mental Component Summary score of the Short Form‐36 General Health Survey (p = 0.04), a 6‐point improvement on the Mental Health Inventory (p < 0.01), a 1.6‐point improvement on the Pain Effects Scale (p =.04), and a 2.4‐point improvement on the Perceived Deficits Questionnaire (p = 0.05).

Interpretation

LDN significantly improved mental health quality of life indices. Further studies with LDN in MS are warranted. ANN NEUROL 2010
From Enzyme Models to Model Enzymes. By Anthony J. Kirby and Florian Hollfelder.
Authors: Bols Mikael
Published: February 2010

RSC, Cambridge 2009, 273 pp., hardcover £ 69.95.—ISBN 978‐0‐85404‐175‐6
ChemInform Abstract: Highly Efficient and Chemoselective Reduction of Sulfoxides Using the System Silane/Oxo‐Rhenium Complexes.
Authors: Sousa Sara C. A. , Fernandes Ana C.
Published: February 2010

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Iridium‐Catalyzed Regio‐ and Enantioselective Allylic Alkylation of Fluorobis(phenylsulfonyl)methane.
Authors: Liu Wen‐Bo , Zheng Sheng‐Cai , He Hu , Zhao Xiao‐Ming , Dai Li‐Xin , You Shu‐Li
Published: February 2010

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Petiolins F—I, Benzophenone Rhamnosides from Hypericum pseudopetiolatum var. kiusianum.
Authors: Tanaka Naonobu , Kubota Takaaki , Kashiwada Yoshiki , Takaishi Yoshihisa , Kobayashi Jun'ichi
Published: February 2010

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
Adsorption Characteristics of Rhodamine B from Aqueous Solution onto Baryte
Authors: Vijayakumar Govindasamy , Yoo Chang Kyoo , Elango Kuppana Gounder P. , Dharmendirakumar Mahendiradas
Published: February 2010

Batch sorption experiments were carried out for the adsorption of the basic dye Rhodamine B from aqueous solution using baryte as the adsorbent. The effect of adsorbent dosage, temperature, initial dye concentration and pH were studied. Adsorption data were modeled using first and second order kinetic equations and the intra particle diffusion model. Kinetic studies showed that the adsorption process followed second order rate kinetics with an average rate constant of 0.05458 g mg–1 min–1. Dye adsorption equilibrium was attained rapidly after 30 min of contact time. The equilibrium data was fitted to the Langmuir, Freundlich and Tempkin isotherms over a dye concentration range of 50–250 mg/L. The adsorption thermodynamic parameters showed that adsorption was an exothermic, spontaneous and less ordered arrangement process. The adsorbent, baryte, was characterized by Fourier transform infrared spectroscopy and scanning electron microscopy. The results showed that baryte has good potential for the removal of Rhodamine B from dilute aqueous solution.