bluuebunny/crossref_metadata_2025 huggingface dataset:
Blogging down a dictatorship: Human rights, citizen journalists and the right to communicate in Zimbabwe
Authors: Moyo Last
Published: September 2011

This article examines the use of blogs to mediate the experiences of citizens during a violent election in Zimbabwe. It focuses specifically on how people disseminated and shared information about their tribulations under a regime that used coercive measures in the face of its crumbling hegemonic edifice. The article frames these practices within theories of alternative media and citizen journalism and argues that digitization has occasioned new counter-hegemonic spaces and new forms of journalism that are deinstitutionalized and deprofessionalized, and whose radicalism is reflected in both form and content. I argue that this radicalism in part articulates a postmodern philosophy and style as seen in its rejection of the elaborate codes and conventions of mainstream journalism. The internet is seen as certainly enhancing the people’s right to communicate, but only to a limited extent because of access disparities on the one hand, and its appropriation by liberal social movements whose configuration is elitist, on the other. I conclude by arguing that the alternative media in Zimbabwe, as reflected by Kubatana’s bloggers, lack the capacity to envision alternative social and political orders outside the neoliberal framework. This, I contend, is partly because of the political economy of both blogging as a social practice and alternative media as subaltern spaces. Just as the bloggers are embedded to Kubatana’s virtual space to self-publish, Kubatana is likewise embedded to a neoliberal discourse that is traceable to its funding and financing systems.
Journalists or activists? Self-identity in the Ethiopian diaspora online community
Authors: Skjerdal Terje S
Published: September 2011

This study investigates the role of the diaspora online media as stakeholders in the transnational Ethiopian media landscape. Through content analysis of selected websites and interviews with editors, the research discusses how the sites relate to recognized journalistic ideals and how the editors view themselves in regard to journalistic professionalism. It is argued that the journalistic ideals of the diaspora media must be understood towards the particular political conditions in homeland Ethiopia. Highly politicized, the diaspora websites display a marked critical attitude towards the Ethiopian government through an activist journalism approach. The editors differ slightly among themselves in the perception of whether activist journalism is in conflict with ideal-type professional norms, but they justify the practice either because of the less than ideal conditions back home or because they maintain that the combination of activism and professionalism is a forward-looking journalism ideology. The online initiatives of the Ethiopian diaspora are found to prolong media contestations in the homeland as well as reinforcing an ideal-type professional journalism paradigm.
Government, professional and public efforts in Japan to change the designation of dementia (chihō)
Authors: Miyamoto Misa , George Daniel R. , Whitehouse Peter J.
Published: September 2011

In 2004, the label for dementia was officially changed in Japan as part of a publicity campaign to raise public awareness about dementia and replace the previously stigmatizing word ‘ chihō’, which translates as a ‘disease of cognition associated with idiocy’. The aim of this study is to examine the name-changing process and to explore its implications for Japan and the field of dementia studies in general. First, this article explains the process through which the new name for ‘dementia’, ‘ ninchishō’, was selected and why. It then addresses Alzheimer’s Association Japan (AAJ), describing the influence of this organization on the name-changing process. Finally, the article delineates how an educational initiative was developed in response to the decision to advance a new terminology, ninchishō, and evaluates the initial impact of the name-changing project.
Translating research evidence to service provision for prevention of type 2 diabetes: development and early outcomes of the ‘New life, New you’ intervention
Authors: Penn Linda , Lordon Jean , Lowry Ray , Smith Will , Mathers John C , Walker Mark , White Martin
Published: September 2011

We report the development and early outcomes of an innovative intervention, directed to people at risk of type 2 diabetes, delivered by fitness trainers in leisure and community settings in Middlesbrough, UK. Men and women aged 45 to 65, living in socio-economically disadvantaged areas were assessed for risk of type 2 diabetes and recruited to the intervention. Weight, height, waist circumference and physical activity were measured at baseline and six months. A social marketing campaign attracted 217 recruits. Baseline means (standard deviation; SD) were as follows: age 53.1(5.9) years, FINDRISC-score (a questionnaire-based prospective risk score to predict development of type 2 diabetes) 13.2 (3.3), body mass index 32.9 kgm2 (6.0), physical activity level 49.2 (6.4) self-report metabolic equivalent tasks (MET)-hours/day. Follow-up was completed by 144 participants with mean (SD) reduction in weight −2.2 kg (4.3) (95% confidence interval (CI) −3.0 to −1.5) and waist circumference −5.5 cm (4.5) (95% CI −6.6 to −4.5); increase in physical activity level +5.5 (5.4) (95% CI 4.5–6.4) self report MET-hours/day and variety +1.4 (1.2) (95% CI 1.1–1.6) activity types. High retention and positive outcomes at six months are indications of initial success. The interim results of this real-world intervention are comparable to early intermediate health outcomes in the European Diabetes Prevention Study (EDIPS)-Newcastle randomised controlled trial suggesting potential for translation of lifestyle intervention into practice. Longer term follow-up and controlled evaluation are warranted.
Drug therapy for the prevention of type 2 diabetes – is there a medical rationale?
Authors: Hanefeld Markolf , Schaper Frank
Published: September 2011

Type 2 diabetes is a major risk factor for cardiovascular disease. At diagnosis more than 50% of patients already exhibit co-morbidities of the metabolic syndrome. Moreover, many individuals with pre-diabetes already show diabetes-related complications and cardiovascular disease. People with pre-diabetes represent a population already at high risk for cardiovascular and diabetes-related complications. Many of these people need a therapy with the focus on harmful effects of impaired glucose tolerance. Therefore prevention of diabetes, including drug treatment of people with abnormal glucose tolerance is of high medical and economic relevance. With a priority of lifestyle intervention drug treatment should be risk adjusted. Medical treatment should be considered for patients with diabetes-related complications, cardiovascular diseases and with co-morbidities of the metabolic syndrome.
Different approaches of physical training used in the management of type 2 diabetes
Authors: de Moura Bruno Pereira , Natali Antônio José , Marins João Carlos Bouzas , Amorim Paulo Roberto Santos
Published: September 2011

Background

Type 2 diabetes is now a common and serious global health problem, which, for most countries, has evolved in association with rapid cultural and social changes, ageing populations, increasing urbanisation, dietary changes, reduced physical activity and other unhealthy lifestyle and behavioural patterns.

Aims

To identify the different approaches to physical training used in the last decade in the management of type 2 diabetes.

Methods

We searched PubMed and Science Direct for all randomised clinical trials from 1999 to 30 May 2010.

Results

We selected 17 randomised controlled trials, five studies with aerobic exercise, five with resistance exercise and seven combined exercise studies.

Conclusions

The use of resistance training for the treatment of type 2 diabetes is becoming more commonly used in the management of type 2 diabetes. The number of studies using resistance exercise has been growing over the last decade, and has actually become as widely used as the popular aerobic exercise. In turn, most of the reviewed studies have used interventions combining resistance and aerobic exercise. An exercise programme for diabetic patients should be seen as a form of treatment. Hence, there were no established guidelines for the duration of the programme, because exercise should become a habitual daily task, and assumed in a new lifestyle for long-term glucose control.
Implicit food associations as obstacles to healthy nutrition: the need for further research
Authors: Mai Robert , Hoffmann Stefan , Helmert Jens R , Velichkovsky Boris M , Zahn Susann , Jaros Doris , EH Schwarz Peter , Rohm Harald
Published: September 2011

Healthy nutrition is the driving force behind measures to address the obesity and diabetes epidemic. Therefore, the relevance of healthy nutrition to public health is steadily increasing. Although many consumers have positive attitudes towards healthy nutrition, their eating habits do not always match these attitudes. This paper suggests that individuals can overcome the discrepancy between attitude/intention and behaviour if they consider implicit associations with healthy or unhealthy nutrition. Our paper aims to develop a research strategy to analyse the impact of the interplay between explicit and implicit food associations on food consumption. The suggested process comprises the following steps: consumer segmentation, isolated analysis of different implicit drivers, holistic examination of interaction effects of different drivers and development of implications for policy makers and managers.
Considering the patient perspective for assessing the outcomes of diabetes lifestyle modification programmes: what should we measure, and how?
Authors: Barbosa Carla Dias , Arnould Benoit , Gruenberger Jean Bernard , EH Schwarz Peter
Published: September 2011

Current evidence shows that type 2 diabetes can be effectively prevented and delayed by lifestyle modification. After careful development and pilot testing, a rigorous evaluation of such programmes is crucial to assess their effectiveness prior to large scale implementation. Integrating the patient perspective in this evaluation is essential. In principle, Patient-Reported Outcomes (PRO) questionnaires can address this key question. However, researchers and clinicians lack a clear framework to make a sound selection of appropriate measures among the large set of possible questionnaires. As a consequence, it is unclear what is the most useful information to be captured from patients when assessing a new programme, so that it can be determined whether the programme can be generalised to a larger population: is it health-related quality of life, satisfaction or something different which could predict the long-term success of the programme? We recommend a specific approach, better adapted to the nature of the intervention, and suggest a selection of a few existing PRO measures that could satisfy the requirements.
Quality management in diabetes prevention
Authors: Ruch C , EH Schwarz Peter , Köhler D , Hoffmann R , Landgraf R
Published: September 2011

The rising prevalence of type 2 diabetes is having an impact on limited medical and economic resources making increased efficiency and effectiveness of medical care and preventative strategies imperative. Quality management indicators that are fit for purpose will permit improvements and shortcomings to be identified in the strategies being employed and may provide information on how to better achieve objectives. This article considers two approaches to how indicators, which were developed by the Implementation of A European Guideline and training standards for diabetes prevention project, can be used in clinically applicable quality management, including benchmarking, in order to compare the quality of work among prevention managers and to develop an overall benchmark for preventive intervention.
IMAGE: Development of a European curriculum for the training of prevention managers
Authors: Kronsbein Peter , Fischer Martin R , Tolks Daniel , Greaves Colin , Puhl Sabine , Stych Kate E , EH Schwarz Peter ,   on behalf of the IMAGE Study group*
Published: September 2011

IMAGE (Development and Implementation of a European Guideline and Training Standards for Diabetes Prevention) was a European Union funded project (2003–2008) in the field of public health which focussed on diabetes prevention. The IMAGE study group comprised a Europe-wide consortium of healthcare professionals and behavioural and health scientists. This group has published guidelines, a toolkit and quality indicators for diabetes prevention and more recently a comprehensive curriculum for the training of diabetes prevention managers, the development of which is described herein.
Thinking differently about guidance: Power, children’s autonomy and democratic environments
Authors: Millei Zsuzsa
Published: September 2011

This article critiques guidance approaches to discipline, that are employed in early childhood environments with an aim to create democratic environments for children, and as part of ‘good’ practices. Advocates of guidance claim that this is a more humane or democratic approach to discipline that empowers children, and therefore, power in the classroom appears as more equalized or distributed. The author adopts a particular perspective in the field of educational psychology by using Foucault’s conceptualization of power and confession (1981). This analytical context opens up avenues to problematize guidance’s claims about the nature of teacher–child power relations, and children’s autonomy. Guidance is then re-read as a subtle, often invisible way of regulation, that sheds new light on a particular kind of autonomy children are allowed. The article concludes with an emphasis on the necessity to be vigilant with guidance. Vigilance is needed to keep in sight that guidance is a discourse that positions subjects in power relations and its quest for democracy is a part of its discourse with power implications rather than its ultimate goal.
Chronic Stroke Survivors Benefit From High-Intensity Aerobic Treadmill Exercise
Authors: Globas Christoph , Becker Clemens , Cerny Joachim , Lam Judith M. , Lindemann Ulrich , Forrester Larry W. , Macko Richard F. , Luft Andreas R.
Published: September 2011

Background and objective. Ambulatory subjects after stroke may benefit from gait-oriented cardiovascular fitness training, but trials to date have not primarily assessed older persons. Methods. Thirty-eight subjects (age >60 years) with residual hemiparetic gait were enrolled >6 months after stroke. Participants were randomized to receive 3 months (3×/week) progressive graded, high-intensity aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary outcome measures were peak exercise capacity (Vo2peak) and sustained walking capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated mobility (Rivermead Mobility Index), and quality of life (SF-12). Results. Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not conventional care improved Vo2peak (difference 6.4 mL/kg/min, P < .001) and 6MW (53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance ( P < .05), and the mental subscore of the SF-12 ( P < .01) improved more after TAEX. Gains in Vo2peak correlated with the degree at which training intensity could be progressed in the individual participant ( P < .01). Better walking was related to progression in treadmill velocity and training duration ( P < .001). Vo2peak and 6MW performances were still higher 1 year after the end of training when compared with the baseline, although endurance walking (6MW) at 1 year was lower than immediately after training ( P < .01). Conclusion. This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke.
Methodological Challenges to Research Among Chinese
Authors: Zeng Wen , North Nicola , Kent Bridie
Published: September 2011

The article offers an example of using a mixed methods design that was implemented when investigating depression among Chinese older persons in Macau. A challenge in designing the study was that in light of literature on Chinese culture and somatization theory, the acceptability of the methodology was uncertain. Participants ( n = 31) were purposively selected and quantitative data were collected using multiple standardized measures. Questions raised by the quantitative approach were then reflected through in-depth interviews. Four dominant categories emerged: (a) negative thinking, (b) physical limitations and complaints, (c) present living conditions and social support, and (d) the lives participants have lived. There was a high level of congruence between quantitative scores and narratives. The research approach was acceptable to the participants, and the findings contributed to an understanding of depression and therapeutic interventions for that population within Chinese culture.
Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies
Authors: Mueller Oliver M. , Schlamann Marc , Mueller Daniela , Sandalcioglu I. Erol , Forsting Michael , Sure Ulrich
Published: September 2011

Objective: Intracranial aneurysms (IAs) require deliberately selected treatment strategies as they are incrementally found prior to rupture and deleterious subarachnoid haemorrhage (SAH). Multiple and recurrent aneurysms necessitate both neurointerventionalists and neurosurgeons to optimize aneurysmal occlusion in an interdisciplinary effort. The present study was conducted to condense essential strategies from a single neurovascular centre with regard to the lessons learned.

Method: Medical charts of 321 consecutive patients treated for IAs at our centre from September 2008 until December 2010 were retrospectively analysed for clinical presentation of the aneurysms, multiplicity and treatment pathways. In addition, a selective Medline search was performed.

Results: A total of 321 patients with 492 aneurysms underwent occlusion of their symptomatic aneurysm: 132 (41.1%) individuals were treated surgically, 189 (58.2%) interventionally; 138 patients presented with a SAH, of these 44.2% were clipped and 55.8% were coiled. Aneurysms of the middle cerebral artery were primarily occluded surgically (88), whereas most of the aneurysms of the internal carotid artery and anterior communicating artery (114) were treated endovascularly. Multiple aneurysms (range 2–5 aneurysms/individual) were diagnosed in 98 patients (30.2%). During the study period 12 patients with recurrent aneurysms were allocated to another treatment modality (previously clip to coil and vice versa).

Conclusions: Our data show that successful interdisciplinary occlusion of IAs is based on both neurosurgical and neurointerventional therapy. In particular, multiple and recurrent aneurysms require tailored individual approaches to aneurysmal occlusion. This is achieved by a consequent interdisciplinary pondering of the optimal strategy to occlude IAs in order to prevent SAH.
Facilitating Successful Substitute School Nurse Programs
Authors: Galemore Cynthia A.
Published: September 2011

Fortunate indeed are schools that have adequate school nurse-to-student ratios, let alone schools that also value and provide substitute registered nurses (RNs) in the absence of the contracted school nurse. In a recent article in the Journal of School Nursing, Vollinger, Bergren, and Belmonte-Mann discussed personnel who staff the school health office in the absence of the school nurse; the authors found substandard coverage in the majority of the schools. The article recommended, among other things, that school nurses engage in dialogue to encourage programs to increase the number of RN substitutes. The purpose of this roundtable article is to provide initial dialogue on this subject.
Guidelines for Youth Sports Safety
Authors: Robinson Brian
Published: September 2011

With the beginning of each school year, athletes of all ages are gearing up to play. The National Athletic Trainers’ Association offers several important tips for consideration before a player begins formal participation, including information regarding pre-participation physicals; beating the heat; locker room cleanliness; emergency action plans; and exercising caution with head injuries, including new information concerning the difference between concussions in girls and boys.
Mastering the Metered-Dose Inhaler
Authors: Corjulo Michael T.
Published: September 2011

School nurses can have significant cohorts of students with asthma. Effectively managing asthma in school can be challenging in terms of time, resources, and outcomes. A valuable focus for the school nurse is inhaled medication administration. Understanding the details required for optimal inhalation technique with metered-dose inhalers is the foundation for developing the skills to deliver and teach this vital aspect of asthma management. The school nurse can play a pivotal role in the partnership of asthma education that can benefit the student in school and at home.
Eating Behavior and Obesity in Canada
Authors: Azagba Sunday , Sharaf Mesbah F.
Published: September 2011

Background: Although a growing body of research has examined the association between food prices and the availability of fast food restaurants on weight outcomes, there is limited empirical evidence on the direct effect of eating behavior on body weight. Objective: The effect of eating behavior on obesity prevalence among Canadians is examined. Methods: A nationally representative sample from the Canadian National Population Health Survey (2000-2008) with 29 722 observations is used. Obesity prevalence is estimated by a linear probability model using cross-sectional and panel estimation methods. Separate regressions are estimated for males and females. Results: Multivariate analyses suggest that eating behavior has a statistically significant effect on obesity prevalence. In particular, individuals who reported excellent, very good, and good eating behavior have a lower risk of obesity compared with those with fair or poor eating behavior. Although cross-sectional and panel data methods produce consistent results, the cross-sectional model overestimates the effect of eating behavior on the risk of obesity. This highlights the importance of controlling for unobserved individual factors that may affect how eating behavior is related to body weight. Conclusion: Evidence is found showing that eating behavior is an important determinant of obesity prevalence. The findings suggest that improving the eating behavior of individuals would help reduce excessive body weight and its induced health risks.
Cervical carotid artery disease in sickle cell anemia: clinical and radiological features
Authors: Telfer Paul T. , Evanson Jane , Butler Paul , Hemmaway Claire , Abdulla Chenya , Gadong Nimze , Whitmarsh Simon , Kaya Banu , Kirkham Fenella J.
Published: September 2011

Cervical internal carotid artery (cICA) occlusion is a recognized cause of acute ischemic stroke (AIS) in sickle cell disease (SCD), but the associated clinical and radiologic features are not well described. We reviewed data on cervical magnetic resonance angiography (cMRA) performed prospectively in 67 patients (55 children) for indications including transcranial Doppler (TCD) abnormalities, AIS, or previous AIS. cICA lesions were seen in 10 (15%) patients, including 4 of 7 patients presenting with AIS, and appear to have been missed on first presentation in 4 of 10 patients with previous AIS. Radiologic features in 7 patients were consistent with dissection. In 2 patients, there was strong clinical and radiologic evidence for thromboembolic AIS, and this was also considered possible in 4 other patients. Three of the 4 AIS patients were anticoagulated acutely, and the nontreated patient had recurrent, probably thromboembolic, AIS. TCD findings were variable, but in 4 patients there were high velocities in the cerebral vessels contralateral to the cICA stenosis. We suggest that all patients with AIS should have cMRA during acute evaluation to identify cICA occlusions that may require anticoagulation. Routine screening of children with SCD should also include evaluation of neck vessels by carotid Doppler followed by cMRA if a cervical vascular lesion is suspected.
Proof of principle for transfusion of in vitro–generated red blood cells
Authors: Giarratana Marie-Catherine , Rouard Hélène , Dumont Agnès , Kiger Laurent , Safeukui Innocent , Le Pennec Pierre-Yves , François Sabine , Trugnan Germain , Peyrard Thierry , Marie Tiffany , Jolly Séverine , Hebert Nicolas , Mazurier Christelle , Mario Nathalie , Harmand Laurence , Lapillonne Hélène , Devaux Jean-Yves , Douay Luc
Published: September 2011

In vitro RBC production from stem cells could represent an alternative to classic transfusion products. Until now the clinical feasibility of this concept has not been demonstrated. We addressed the question of the capacity of cultured RBCs (cRBCs) to survive in humans. By using a culture protocol permitting erythroid differentiation from peripheral CD34+ HSC, we generated a homogeneous population of cRBC functional in terms of their deformability, enzyme content, capacity of their hemoglobin to fix/release oxygen, and expression of blood group antigens. We then demonstrated in the nonobese diabetes/severe combined immunodeficiency mouse that cRBC encountered in vivo the conditions necessary for their complete maturation. These data provided the rationale for injecting into one human a homogeneous sample of 1010 cRBCs generated under good manufacturing practice conditions and labeled with 51Cr. The level of these cells in the circulation 26 days after injection was between 41% and 63%, which compares favorably with the reported half-life of 28 ± 2 days for native RBCs. Their survival in vivo testifies globally to their quality and functionality. These data establish the proof of principle for transfusion of in vitro–generated RBCs and path the way toward new developments in transfusion medicine. This study is registered at http://www.clinicaltrials.gov as NCT0929266.
How I treat autoimmune lymphoproliferative syndrome
Authors: Rao V. Koneti , Oliveira João Bosco
Published: September 2011

Autoimmune lymphoproliferative syndrome (ALPS) represents a failure of apoptotic mechanisms to maintain lymphocyte homeostasis, permitting accumulation of lymphoid mass and persistence of autoreactive cells that often manifest in childhood with chronic nonmalignant lymphadenopathy, hepatosplenomegaly, and recurring multilineage cytopenias. Cytopenias in these patients can be the result of splenic sequestration as well as autoimmune complications manifesting as autoimmune hemolytic anemia, immune-mediated thrombocytopenia, and autoimmune neutropenia. More than 300 families with hereditary ALPS have now been described; nearly 500 patients from these families have been studied and followed worldwide over the last 20 years by our colleagues and ourselves. Some of these patients with FAS mutations affecting the intracellular portion of the FAS protein also have an increased risk of B-cell lymphoma. The best approaches to diagnosis, follow-up, and management of ALPS, its associated cytopenias, and other complications resulting from infiltrative lymphoproliferation and autoimmunity are presented. This trial was registered at www.clinicaltrial.gov as #NCT00001350.
Pulmonary vascular resistances during exercise in normal subjects: a systematic review
Authors: Kovacs G. , Olschewski A. , Berghold A. , Olschewski H.
Published: September 2011

The physiological range of pulmonary vascular resistance (PVR) and total pulmonary resistance (TPR), and the impact of exercise, age and posture have been a matter of debate for many years.

We performed a systematic literature review including all right heart catheterisation data where individual PVR and TPR of healthy subjects both at rest and exercise were available. Data were stratified according to age, exercise level and posture.

Supine resting PVR in subjects aged <24 yrs, 24–50 yrs, 51–69 yrs and ≥70 yrs was 61±23, 69±28, 86±15 and 90±39 dyn·s·cm−5, respectively. Corresponding TPR was 165±50, 164±46, 226±64 and 223±45 dyn·s·cm−5, respectively. During moderate exercise in subjects aged ≤50 yrs, an 85% increase in cardiac output was associated with a 25% decrease in TPR (p<0.0001) and a 12% decrease in PVR (p<0.01). At 51–69 yrs of age there was no significant decrease in TPR and PVR. In individuals aged ≥70 yrs TPR even increased by 17% (p=0.01), while PVR did not change significantly. At higher exercise levels, TPR decreased in all age groups. In the upright position, based on a limited number of data, resting TPR and PVR were higher than in the supine position and decreased more prominently during exercise, suggesting the release of resting pulmonary vasoconstriction.

These data may form a basis to define normal PVR at rest and exercise.
ASPIRE registry: Assessing the Spectrum of Pulmonary hypertension Identified at a REferral centre
Authors: Hurdman J. , Condliffe R. , Elliot C.A. , Davies C. , Hill C. , Wild J.M. , Capener D. , Sephton P. , Hamilton N. , Armstrong I.J. , Billings C. , Lawrie A. , Sabroe I. , Akil M. , O’Toole L. , Kiely D.G.
Published: September 2011

Pulmonary hypertension (PH) is a heterogeneous condition. To date, no registry data exists reflecting the spectrum of disease across the five diagnostic groups encountered in a specialist referral centre.

Data was retrieved for consecutive, treatment-naïve cases diagnosed between 2001 and 2010 using a catheter-based approach. 1,344 patients were enrolled, with a mean follow-up of 2.9 yrs.

The 3-yr survival was 68% for pulmonary arterial hypertension (PAH), 73% for PH associated with left heart disease, 44% for PH associated with lung disease (PH-lung), 71% for chronic thromboembolic PH (CTEPH) and 59% for miscellaneous PH. Compared with PAH, survival was inferior in PH-lung and superior in CTEPH (p<0.05). Multivariate analysis demonstrated that diagnostic group independently predicted survival. Within PAH, Eisenmenger’s survival was superior to idiopathic PAH, which was superior to PAH associated with systemic sclerosis (p<0.005). Within PH-lung, 3-yr survival in sleep disorders/alveolar hypoventilation (90%) was superior to PH-lung with chronic obstructive pulmonary disease (41%) and interstitial lung disease (16%) (p<0.05). In CTEPH, long-term survival was best in patients with surgically accessible disease undergoing pulmonary endarterectomy.

In this large registry of consecutive, treatment-naïve patients identified at a specialist PH centre, outcomes and characteristics differed between and within PH groups. The current system of classification of PH has prognostic value even when adjusted for age and disease severity, emphasising the importance of systematic evaluation and precise classification.
The prognostic impact of follow-up assessments in patients with idiopathic pulmonary arterial hypertension
Authors: Nickel N. , Golpon H. , Greer M. , Knudsen L. , Olsson K. , Westerkamp V. , Welte T. , Hoeper M.M.
Published: September 2011

Current guidelines for the treatment of patients with idiopathic pulmonary arterial hypertension (IPAH) recommend basing therapeutic decision-making on haemodynamic, functional and biochemical variables. Most of these parameters have been evaluated as risk predictors at the time of diagnosis. The aim of the present study was to assess the prognostic impact of changes in these parameters after initiation of targeted therapy.

A cohort of 109 patients with IPAH who had undergone haemodynamic, functional and biochemical assessments at baseline and 3–12 months after initiation of pulmonary arterial hypertension (PAH)-targeted therapy, were followed for a median 38 months in order to determine predictors of mortality at baseline and during the course of their disease.

Within the observation period, 53 (48.6%) patients died and four (3.7%) underwent lung transplantation. Kaplan–Meier estimates for transplantation-free survival were 92%, 67%, and 51% at 1, 3, and 5 yrs, respectively. Among baseline variables, 6-min walk distance, right atrial pressure, cardiac index, mixed-venous oxygen saturation (Sv,O2) and N-terminal-pro brain natriuretic peptide (NT-proBNP) were independent predictors of survival. During follow-up, changes in World Health Organization functional class, cardiac index,Sv,O2and NT-proBNP proved significant predictors of outcome. When assigned to prognostic groups, improvements as well as deteriorations in these parameters after initiation of PAH-targeted therapy had a strong impact on survival. Measurements obtained at follow-up had a higher predictive value than variables obtained at baseline.

Changes in established predictors of outcome during the course of the disease provide important prognostic information in patients with IPAH.
Overweight is not a comorbidity factor during childhood asthma: the GrowthOb study
Authors: Mahut Bruno , Beydon Nicole , Delclaux Christophe
Published: September 2011

While being overweight is a risk factor for subsequent asthma in children, the importance of body mass index (BMI) as a comorbidity factor remains debated. The aim of this study was to assess the relationships between being overweight and the characteristics of childhood asthma.

The BMI, BMI z-scores and International Obesity Task Force (IOTF) grades were evaluated in asthmatic children according to atopic status, symptoms during the past 3 months, exercise breathlessness, treatment and lung function in 6–15-yr-old children with confirmed asthma.

491 asthmatic children (mean±sdage 10.8±2.6 yrs; 179 females) were prospectively enrolled. There were 78 (15.5%) overweight (IOTF grade 1) and eight (1.6%) obese (grade 2) children. The children's BMI z-scores did not differ according to atopy, exacerbation, symptom-free days or treatment. The BMI z-score correlated positively with forced vital capacity and forced expiratory volume in 1 s in females, which could be related to earlier puberty in overweight females (growth spurt with increased volumes). Compared with normal weight children, overweight and obese children had reduced lung volume ratios (functional residual capacity/total lung capacity (TLC) and residual volume/TLC), no evidence of airflow limitation and similar symptoms.

In conclusion, the observed functional relationships with BMI are not specific to asthma and being overweight is not associated with significant clinical impacts on asthma during childhood.
Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis
Authors: Hook J.L. , Arcasoy S.M. , Zemmel D. , Bartels M.N. , Kawut S.M. , Lederer D.J.
Published: September 2011

The supplemental oxygen flow rate is a common bedside measure of gas exchange impairment. We aimed to determine whether a titrated oxygen requirement (TOR) predicted mortality in idiopathic pulmonary fibrosis (IPF).

We examined 104 adults with IPF enrolled in a prospective cohort study and a validation cohort of 151 adults with a variety of interstitial lung diseases (ILDs). The TOR was defined as the lowest oxygen flow rate required to maintain an oxyhaemoglobin saturation of 96% while standing. Cox proportional hazards models and time-dependent receiver operating characteristic curves were used to examine survival time.

A higher TOR was associated with a greater mortality rate independent of forced vital capacity and 6-min walk test results in IPF (adjusted hazard ratio (per 1 L·min−1) 1.16, 95% CI 1.06–1.27). The TOR was at least as accurate as pulmonary function and 6-min walk testing at predicting 1-yr mortality. Findings were similar in other ILDs.

The TOR is a simple, inexpensive bedside measurement that aids prognostication in IPF.
Neutrophil chemotaxis in granulomatosis with polyangiitis (Wegener’s) and idiopathic pulmonary fibrosis
Authors: Richter A.G. , Perkins G.D. , Chavda A. , Sapey E. , Harper L. , Thickett D.R.
Published: September 2011

The presence of antineutrophil cytoplasmic antibodies in granulomatosis with polyangiitis (Wegener’s) (GPA) implicates the neutrophil as a key effector cell. Previous studies have reported elevated neutrophil counts in the lung, although the determinants of neutrophil chemotaxis in the GPA lung are unknown.

Bronchoalveolar lavage fluid (BALF) cell counts, myeloperoxidase (MPO) and chemokines were measured in 27 patients with GPA, 20 disease controls with idiopathic pulmonary fibrosis (IPF) and six healthy controls. CXC chemokine ligand (CXCL)8, interleukin (IL)-1β, epithelial neutrophil-activating protein 78, granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor were measured by ELISA. The neutrophil chemotactic potential of BALF was investigated using the under-agarose method, and specific antibodies were used to examine the role of CXCL8 and IL-1β.

GPA BALF had an increased neutrophil percentage, and elevated MPO, CXCL8 and G-CSF concentrations compared with healthy controls. Chemotaxis of control neutrophils towards BALF from patients with active (p=0.006) and remission (p=0.077) GPA, and IPF (p=0.001) patients was increased compared with normal controls. BALF-induced chemotaxis correlated with BALF IL-1β (r=0.761, p=0.001) and CXCL8 (r=0.640, p=0.012) in GPA, and was inhibited by anti-CXCL8 (85%; p<0.001) and anti-IL-1β (69%; p<0.001).

Our study confirms a neutrophilia and pro-inflammatory alveolar milieu that persists in clinical remission. CXCL8 and IL-1β appear to play important roles in the neutrophil chemotactic response to BALF.
MHC polymorphism and disease resistance to vibrio anguillarum in 8 families of half-smooth tongue sole (Cynoglossus semilaevis)
Authors: Du Min , Chen Song-lin , Liu Yan-hong , Liu Yang , Yang Jing-feng
Published: September 2011

Background

Genes in the major histocompatibility complex (MHC) have a critical role in both the innate and adaptive immune responses because of their involvement in presenting foreign peptides to T cells. However, the nature has remained largely unknown.

Results

We examined the genetic variation in MHC class IIB in half-smooth tongue sole (Cynoglossus semilaevis) after challenge withvibrio anguillarum. Two thousand and four hundred fry from 12 half-smooth tongue sole families were challenged withVibrio anguillarum. To determine any association between alleles and resistance or susceptibility toV. anguillarum, 160 individuals from four high-resistance (HR, < 40.55% mortality) families and four low-resistance (LR, > 73.27% mortality) families were selected for MHC IIB exon2 gene sequence analysis. The MHC IIB exon2 genes of tongue sole displayed a high level of polymorphism and were discovered at least four loci. Meanwhile, the dN/dS[the ratio of non-synonymous (dN) substitutions to synonymous (dS) substitutions] in the peptide-binding region (PBR) was higher than that in the non-peptide-binding region (non-PBR). Eighty-eight alleles were discovered among 160 individuals, and 13 out of 88 alleles were used to analyze the distribution pattern between the resistant and susceptible families. Certain alleles presented in HR and LR with a different frequency, while other alleles were discovered in only the HR or LR families, not both. Five alleles,Cyse-DBB*6501,Cyse-DBB*4002,Cyse-DBB*6102,Cyse-DBB*5601andCyse-DBB*2801, were found to be associated with susceptibility toV. anguillarumwith a frequency of 1.25%, 1.25%, 1.25%, 1.25% and 2.5% in the HR families, and 35%, 33.75%, 27.5%, 16.25%, 15% in the LR families (p< 0.01, 0.01, 0.01, 0.01, 0.01), respectively. Four alleles,Cyse-DBB*3301,Cyse-DBB*4701,Cyse-DBB*6801andCyse-DBB*5901, were found to be associated with resistance toV. anguillarum, with a frequency of 13.75%, 11.25%, 11.25%, 8.75% in the HR families and 1.25%, 1.25%, 1.25%, 1.25% and 1.25% in the LR families (p< 0.01, 0.05, 0.05 and p = 0.064), respectively.

Conclusions

Elucidation of the role of MHC II B genes in half-smooth tongue sole should prove to be helpful to the in-depth development of marker-assisted selective breeding in half-smooth tongue sole.
Temporal trends (1977-2007) and ethnic inequity in child mortality in rural villages of southern Guinea Bissau
Authors: Fazzio Ila , Mann Vera , Boone Peter
Published: September 2011

Background

Guinea Bissau is one of the poorest countries in the world, with one of the highest under-5 mortality rate. Despite its importance for policy planning, data on child mortality are often not available or of poor quality in low-income countries like Guinea Bissau. Our aim in this study was to use the baseline survey to estimate child mortality in rural villages in southern Guinea Bissau for a 30 years period prior to a planned cluster randomised intervention. We aimed to investigate temporal trends with emphasis on historical events and the effect of ethnicity, polygyny and distance to the health centre on child mortality.

Methods

A baseline survey was conducted prior to a planned cluster randomised intervention to estimate child mortality in 241 rural villages in southern Guinea Bissau between 1977 and 2007. Crude child mortality rates were estimated by Kaplan-Meier method from birth history of 7854 women. Cox regression models were used to investigate the effects of birth periods with emphasis on historical events, ethnicity, polygyny and distance to the health centre on child mortality.

Results

High levels of child mortality were found at all ages under five with a significant reduction in child mortality over the time periods of birth except for 1997-2001. That period comprises the 1998/99 civil war interval, when child mortality was 1.5% higher than in the previous period. Children of Balanta ethnic group had higher hazard of dying under five years of age than children from other groups until 2001. Between 2002 and 2007, Fula children showed the highest mortality. Increasing walking distance to the nearest health centre increased the hazard, though not substantially, and polygyny had a negligible and statistically not significant effect on the hazard.

Conclusion

Child mortality is strongly associated with ethnicity and it should be considered in health policy planning. Child mortality, though considerably decreased during the past 30 years, remains high in rural Guinea Bissau. Temporal trends also suggest that civil wars have detrimental effects on child mortality.

Trial Registration

Current Controlled Trials ISRCTN52433336
Tubular immunostimulating complex based on cucumarioside A2-2 and monogalactosyldiacylglycerol from marine macrophytes
Authors: Kostetsky Eduard Y , Sanina Nina M , Mazeika Andrey N , Tsybulsky Alexander V , Vorobyeva Natalia S , Shnyrov Valery L
Published: September 2011

Background

There is an urgent need to develop safe and effective adjuvants for the new generation of subunit vaccines. We developed the tubular immunostimulating complex (TI-complex) as a new nanoparticulate antigen delivery system. The morphology and composition of TI-complexes principally differ from the known vesicular immunostimulating complexes (ISCOMs). However, methodology for the preparation of TI-complexes has suffered a number of shortcomings. The aim of the present work was to obtain an antigen carrier consisting of triterpene glycosides from Cucumaria japonica, cholesterol, and monogalactosyldiacylglycerol from marine macrophytes with reproducible properties and high adjuvant activity.

Results

The cucumarioside A2-2 - cholesterol - MGalDG ratio of 6:2:4 (by weight) was found to provide the most effective formation of TI-complexes and the minimum hemolytic activity in vitro. Tubules of TI-complexes have an outer diameter of about 16 nm, an inner diameter of 6 nm, and a length of 500 nm. A significant dilution by the buffer gradually destroyed the tubular nanoparticles. The TI-complex was able to increase the immunogenicity of the protein antigens from Yersinia pseudotuberculosis by three to four times.

Conclusions

We propose an optimized methodology for the preparation of homogeneous TI-complexes containing only tubular particles, which would achieve reproducible immunization results. We suggest that the elaborated TI-complexes apply as a universal delivery system for different subunit antigens within anti-infectious vaccines and enhance their economic efficacy and safety.
Two novel low-power and high-speed dynamic carbon nanotube full-adder cells
Authors: Bagherizadeh Mehdi , Eshghi Mohammad
Published: September 2011

In this paper, two novel low-power and high-speed carbon nanotube full-adder cells in dynamic logic style are presented. Carbon nanotube field-effect transistors (CNFETs) are efficient in designing a high performance circuit. To design our full-adder cells, CNFETs with three different threshold voltages (low threshold, normal threshold, and high threshold) are used. First design generates SUM and COUT through separate transistors, and second design is a multi-output dynamic full adder. Proposed full adders are simulated using HSPICE based on CNFET model with 0.9 V supply voltages. Simulation result shows that the proposed designs consume less power and have low power-delay product compared to other CNFET-based full-adder cells.
Anisotropic in-plane spin splitting in an asymmetric (001) GaAs/AlGaAs quantum well
Authors: Ye Huiqi , Hu Changcheng , Wang Gang , Zhao Hongming , Tian Haitao , Zhang Xiuwen , Wang Wenxin , Liu Baoli
Published: September 2011

The in-plane spin splitting of conduction-band electron has been investigated in an asymmetric (001) GaAs/Al
x
Ga1-x
As quantum well by time-resolved Kerr rotation technique under a transverse magnetic field. The distinctive anisotropy of the spin splitting was observed while the temperature is below approximately 200 K. This anisotropy emerges from the combined effect of Dresselhaus spin-orbit coupling plus asymmetric potential gradients. We also exploit the temperature dependence of spin-splitting energy. Both the anisotropy of spin splitting and the in-plane effective g-factor decrease with increasing temperature.

PACS: 78.47.jm, 71.70.Ej, 75.75.+a, 72.25.Fe,
Cellular kinases incorporated into HIV-1 particles: passive or active passengers?
Authors: Giroud Charline , Chazal Nathalie , Briant Laurence
Published: September 2011

Phosphorylation is one of the major mechanisms by which the activities of protein factors can be regulated. Such regulation impacts multiple key-functions of mammalian cells, including signal transduction, nucleo-cytoplasmic shuttling, macromolecular complexes assembly, DNA binding and regulation of enzymatic activities to name a few. To ensure their capacities to replicate and propagate efficiently in their hosts, viruses may rely on the phosphorylation of viral proteins to assist diverse steps of their life cycle. It has been known for several decades that particles from diverse virus families contain some protein kinase activity. While large DNA viruses generally encode for viral kinases, RNA viruses and more precisely retroviruses have acquired the capacity to hijack the signaling machinery of the host cell and to embark cellular kinases when budding. Such property was demonstrated for HIV-1 more than a decade ago. This review summarizes the knowledge acquired in the field of HIV-1-associated kinases and discusses their possible function in the retroviral life cycle.