bluuebunny/crossref_metadata_2025 huggingface dataset:
Agonistic anti‐human Fas monoclonal antibody induces fibroblast‐like synoviocyte apoptosis in haemophilic arthropathy: potential therapeutic implications
Authors: Romano E. , Manetti M. , Peruzzi F. , Melchiorre D. , Milia A. F. , Bellando‐Randone S. , Nishioka K. , Innocenti M. , Carulli C. , Linari S. , Morfini M. , Ibba‐Manneschi L. , Matucci‐Cerinic M. , Guiducci S.
Published: November 2013

Haemophilic arthropathy (HA) is characterized by chronic proliferative synovitis leading to cartilage destruction and shares some pathological features with rheumatoid arthritis (RA). Apoptosis has been implicated in RA pathogenesis, and an agonistic anti‐Fas monoclonal antibody (mAb) was found to induce RA fibroblast‐like synoviocyte (FLS) apoptosis and suppress synovial hyperplasia in animal models of RA. The aim of this study was to evaluate the effect of anti‐Fas mAb on HA‐FLS. FLS were isolated from knee synovial biopsies from six HA patients, six RA patients and six healthy subjects. The expression of Fas in synovial biopsies was investigated by immunohistochemistry. FLS were stimulated with anti‐Fas mAb at different concentrations, alone or in combination with tumour necrosis factor‐α (TNF‐α) and basic fibroblast growth factor (bFGF). Fas expression in FLS was assessed by Western blot. Cell viability was studied with the WST‐1 assay. Active caspase‐3 levels were measured using ELISA and Western blot. A strong Fas‐immunoreactivity was observed in different cells of HA synovium, including FLS, inflammatory cells and endothelial cells. Fas antigen was constitutively overexpressed in cultured HA‐FLS. Anti‐Fas mAb had a significant cytotoxicity on HA‐FLS in a dose‐dependent manner, either alone or in combination with TNF‐α and bFGF. These cytotoxic effects were due to the ability of anti‐Fas to induce HA‐FLS apoptosis, as shown by the increased active caspase‐3 levels. Anti‐Fas mAb exhibited a more pronounced pro‐apoptotic effect on HA‐FLS than RA‐FLS. Fas antigen is highly expressed on HA‐FLS and its stimulation by anti‐Fas mAb may be an effective strategy to induce HA‐FLS apoptosis.
Dental health and disease in patients with haemophilia – a case‐control study
Authors: Zaliuniene R. , Aleksejuniene J. , Peciuliene V. , Brukiene V.
Published: November 2013

Management of patients with hereditary bleeding disorders in dentistry causes considerable problems. This study examined different aspects of dental health or disease of Lithuanian children and adults with haemophilia and compared them with the general population. Two study groups of cases and controls were formed. Cases were recruited through census sampling and controls were randomly chosen from the general population matched for gender, age and place of residence. Dental health of permanent and deciduous dentitions was assessed by one examiner employing the WHO Criteria for Oral Health Surveys. The following aspects of dental health/disease were considered: overall caries experience, treatment experience, unmet dental treatment needs and the presence of functional dentition. Data were collected from 76 patients with haemophilia among which 27 were children and 49 were adults and a control group of 76 subjects comprising 30 children and 46 adults. Children with haemophilia had a significantly lower overall caries experience and less unmet dental treatment needs in deciduous teeth as compared to healthy children. In permanent dentitions, overall caries experience, unmet dental treatment needs or treatment experience did not differ between cases and controls either in older children or adult cohorts. There were no differences between the study groups regarding the functional dentition‐related indices. Healthier deciduous teeth were observed in children with haemophilia than in children without haemophilia, but other dental health or disease‐related outcomes did not differ between cases and controls.
International trends in health science librarianship Part 8: the UK and the Republic of Ireland Northern Ireland
Authors: Latimer Karen , Lawton Aoife
Published: November 2013

This is the 8th in a series of articles exploring international trends in health science librarianship with a focus on the UK and Ireland in the first decade of the 21st century. The invited authors are from Northern Ireland and the Republic of Ireland. Future issues will track trends from Scotland and Wales.

JM
What makes a good title?
Authors: Grant Maria J.
Published: November 2013

The chances are the first thing you when you set out to write an article is the title. But what factors transform a mediocre title into a good title? Firstly, it should be both informative and specific, using words or phrases likely to be used when searching for information, for example ‘nurse education’ rather than simply ‘nurse’. Secondly, it should be concise yet convey the main ideas clearly; articles with short titles reporting study findings have been found to attract higher numbers of viewing and citations. Thirdly, provide details of the study design to assist the reader in making an informed choice about the type of project your article is reporting. In taking these small steps when developing your title, your title can present a more concise, retrievable and clear articulation of your article.
Linkage to care following community‐based mobile HIV testing compared with clinic‐based testing in Umlazi Township, Durban, South Africa
Authors: Bassett IV , Regan S , Luthuli P , Mbonambi H , Bearnot B , Pendleton A , Robine M , Mukuvisi D , Thulare H , Walensky RP , Freedberg KA , Losina E , Mhlongo B
Published: November 2013

Objectives

The aim of the study was to assess HIV prevalence, disease stage and linkage to HIV care following diagnosis at a mobile HIV testing unit, compared with results for clinic‐based testing, in a Durban township.

Methods

This was a prospective cohort study. We enrolled adults presenting for HIV testing at a community‐based mobile testing unit (mobile testers) and at an HIV clinic (clinic testers) serving the same area. Testers diagnosed with HIV infection, regardless of testing site, were offered immediate CD4 testing and instructed to retrieve results at the clinic. We assessed rates of linkage to care, defined as CD4 result retrieval within 90 days of HIV diagnosis and/or completion of antiretroviral therapy (ART) literacy training, for mobile vs. clinic testers.

Results

From July to November 2011, 6957 subjects were HIV tested (4703 mobile and 2254 clinic); 55% were female. Mobile testers had a lower HIV prevalence than clinic testers (10% vs. 36%, respectively), were younger (median 23 vs. 27 years, respectively) and were more likely to live >5 km or >30 min from the clinic (64% vs. 40%, respectively; all P < 0.001). Mobile testers were less likely to undergo CD4 testing (33% vs. 83%, respectively) but more likely to have higher CD4 counts [median (interquartile range) 416 (287–587) cells/μL vs. 285 (136–482) cells/μL, respectively] than clinic testers (both P < 0.001). Of those who tested HIV positive, 10% of mobile testers linked to care, vs. 72% of clinic testers (P < 0.001).

Conclusions

Mobile HIV testing reaches people who are younger, who are more geographically remote, and who have earlier disease compared with clinic‐based testing. Fewer mobile testers underwent CD4 testing and linked to HIV care. Enhancing linkage efforts may improve the impact of mobile testing for those with early HIV disease.
Stable Temperature Dielectrics of (Ba,Ca)(Ti,Zr)O3‐BasedMLCCs with Non‐Core‐Shell Structure by Novel Sintering Approach
Authors: Wang Shih‐Hao , Lee Wen‐Hsi , Tsai Yin‐Lai , Lee Ying‐Chieh
Published: November 2013

In this study, the high stability temperature coefficient of capacitance (TCC) characteristics of (Ba,Ca)(Ti,Zr)O3‐based multilayer ceramic capacitors (MLCCs) were investigated using a novel sintering approach that combines rapid heating and constrained sintering. The novel sintering approach is based on a sandwich structure that the constrained (Ba,Ca)(Ti,Zr)O3‐basedMLCCs are covered withBaTiO3as a constraining layer on both sides. An in‐plane tensile stress resulting from the mismatch between the constraining layer and the constrained layer during heating can effectively inhibit grain growth of (Ba,Ca)(Ti,Zr)O3‐basedMLCCs and then modify theTCCcharacteristics of (Ba,Ca)(Ti,Zr)O3‐basedMLCCs fromY5V(−82%≦△C/C≦ + 22% from −30°C to 85°C) toX5R(−15%≦△C/C≦ + 15% from −55°C to 85°C). The high continuity (>95%) of inner electrode and the fine grain size (0.56 μm) ofBCTZ‐basedMLCCs with a non‐core‐shell structure can be attained by means of the rapid constrained sintering technique. The lifetime of the fine‐grain‐BCTZ‐basedMLCCfired by the novel sintering is superior to that of the coarse‐grain‐BCTZ‐basedMLCCfired by conventional sintering in a highly accelerated life test.
Which cleansing care is better, foot bath or shower? Analysis of 236 limb ulcers
Authors: Sano Hitomi , Ichioka Shigeru
Published: November 2013

Foot baths and showering are two widely used methods to cleanse limb ulcers. However, some clinicians warn that foot baths may contribute to the spread of infection at the ulcer site. This study aimed to retrospectively investigate the relationship between cleansing methods and the limb prognoses of 236 patients with chronic limb ulcers. These patients were divided into two groups according to the method used to cleanse their ulcers, foot bath and showering. Limb prognosis, including loss of all toes and major amputation, was retrospectively analysed. The rates of loss of all toes and major amputation were 53·0% and 30% in the foot bath group, and 35·3% and 18·4% in the showering group, respectively. The rates of loss of all toes (adjusted odds ratios = 2·07; P = 0·0066; 95% confidence intervals, 1·22–3·50) and major amputation (adjusted odds ratio = 1·90; P = 0·037; 95% confidence intervals, 1·03–3·50) were significantly higher in the foot bath group than those in the showering group. Our results demonstrate that showering is preferable to foot baths for the cleansing of chronic limb ulcers. Clinicians should be cautious that inappropriate cleansing may cause ulcer infections to spread.
Genetic and epitopic analysis of thyroid peroxidase (TPO) autoantibodies: markers of the human thyroid autoimmune response
Authors: MCLACHLAN S M , RAPOPORT B
Published: November 2013

TPO autoantibodies, the hallmark of human autoimmune thyroid disease, are of IgG class and are associated with thyroid destruction and hypothyroidism. Using the immunoglobulin gene combinatorial library approach, a panel of human monoclonal TPO autoantibodies (expressed as Fab) has been generated from thyroid tissue-infiltrating B cells. TPO-specific Fab closely resemble patients' serum autoantibodies in terms of L chain type, IgG subclass, affinities for TPO as well as epitopes recognized by > 80% of TPO autoantibodies in an individual's serum. TPO autoantibody V region genes are not unique; H chain V genes are usually mutated, while L chain V genes are sometimes in germ-line conformation. The autoantibodies recognize an immunodominant region involving conformational, overlapping epitopes in domains A and B. Finally, TPO autoantibody epitopic fingerprints are distinctive for individual sera, are not associated with hypothyroidism, but are conserved over time (indicating a lack of B cell epitope spreading). Evidence for conservation as well as inheritance of the fingerprints in some families, together with VH gene polymorphisms, may provide insight into the genetic basis of human autoimmune thyroid disease. Furthermore, monoclonal human TPO autoantibodies will be invaluable for B cell presentation of TPO to determine the T cell epitopes involved in TPO autoantibody production.
A vaccine conjugate of ‘ISCAR’ immunocarrier and peptide epitopes of the E7 cervical cancer-associated protein of human papillomavirus type 16 elicits specific Th1- and Th2-type responses in immunized mice in the absence of oil-based adjuvants
Authors: TINDLE R W , CROFT S , HERD K , MALCOLM K , GECZY A F , STEWART T , FERNANDO G J P
Published: November 2013

TraT protein, known as ISCAR (= Immunostimulatory Carrier), is one of a family of integral membrane proteins (Imps) of Escherichia coli representing powerful carrier molecules which when injected into experimental animals generate substantial antibody and T proliferative responses to molecules conjugated to it. We extend these findings to show that ISCAR functions to stimulate Th1- and Th2-type responses, including specific cytotoxic T cells and tumour protection. We report here that by conjugating to ISCAR a 19mer peptide containing linear B epitopes, a T helper (Th) epitope, and a H-2b-restricted T cytotoxic (CTL) epitope of E7 protein of human papillomavirus type 16 (HPV16), and immunizing C57B1/6 (H-2b) mice, we elicited (i) specific IgG2a and IgG1 antibodies; (ii) IL-2 and IL-4 production by specifically recalled lymph node cells in vitro; (iii) cytotoxic T lymphocytes which specifically killed both E7 peptide-pulsed, and whole E7 gene-transfected tumour target cells; and (iv) in vivo protection against an E7 gene-transfected tumour cell inoculum. These findings have implications for the design of vaccines to stimulate immune responses to endogenously processed target antigens (e.g. tumour-associated antigens) without the unwanted side effects of oil-based adjuvants. In addition they support the case for a E7-targeted therapeutic vaccine for HPV-associated human cervical cancer.
Anti-CD11b/CD18 antibodies reduce inflammation in acute colitis in rats
Authors: PALMEN M J H J , DIJKSTRA C D , VAN DER ENDE M B , PEÑA A S , VAN REES E P
Published: November 2013

The influx of monocytes and neutrophils into the inflamed tissue could be an important aspect in the pathogenesis of inflammatory bowel disease (IBD). A membrane protein involved in the monocyte/neutrophil adherence to endothelium is CD11b/CD18 or αMβ2 (complement receptor type 3 = CR3). In the present study the role of CD11b/CD18 in experimental IBD was studied by treatment with ED7 and OX42, two MoAbs against CD11b/CD18. Colitis was induced in rats by a single, rectal administration of 30 mg 2,4,6-trinitrobenzene sulfonic acid (TNBS) dissolved in ethanol 30%. Two hours before and 3 days after induction of colitis, the animals were given an i.v. dose of 0·5 mg of either ED7 or OX42 in 1 ml PBS. Controls received PBS or an irrelevant MoAb. Four days after the last treatment with the antibodies, the rats were killed, and macroscopic damage scores of the colon were determined. Macrophages and granulocytes were studied by immunohistochemistry and quantified by Interaktives Bild Analysen System (IBAS), and myeloperoxidase (MPO) activity in colonic tissue was measured. After treatment with ED7 and OX42 the mean damage score of the colon was reduced from 4·2 in IBD animals to 1·0 and 1·3, respectively. Smaller areas of ulcerations and a decrease in the number of ulcerations were observed compared with PBS-treated rats. Furthermore, the amount of infiltrating monocytes and leucocytes in the submucosa was enormously reduced, as well as MPO activity in the colonic tissue. These results show that treatment with MoAbs against CD11b/CD18 reduces clinical signs of experimental IBD in rats by a partial blockade of infiltrating macrophages and granulocytes.
Increased lipopolysaccharide-induced tumour necrosis factor levels and death in hypercholesterolaemic rabbits
Authors: BRITO B E , ROMANO E L , GRUNFELD C
Published: November 2013

Nutritional-induced hypercholesterolaemia in New Zealand rabbits causes increased susceptibility to experimental infections. Rabbits fed cholesterol (0·5 g%) for 8 weeks were injected intravenously with varying doses of Escherichia coli 0127: B8 lipopolysaccharide (LPS; 3–100 μg/kg). The levels of cholesterol, triglycerides, tumour necrosis factor (TNF), and the survival rates of treated rabbits were then measured. Rabbits fed either normal chow or chow impregnated with sesame oil were used as controls. LPS induced higher serum TNF levels in hypercholesterolaemic rabbits than in normal rabbits or rabbits fed with chow containing sesame oil. TNF levels rose faster in hypercholesterolaemic rabbits than in normal rabbits, reaching maximum levels at 60 min and 120 min, respectively, after LPS injection. The survival rate of hypercholesterolaemic rabbits (1/11) was lower than in normal rabbits (6/7) or rabbits fed with the sesame oil chow (4/4) at the higher LPS doses. No death occurred at lower doses. One possible interpretation of these results, also supported by neutralization experiments, is that increased TNF secretion in hypercholesterolaemic rabbits raises the host's susceptibility to experimental endotoxaemia and possibly to Gram-negative infection.
Both VH and VL chains of polyreactive IgM antibody are required for polyreactivity: expression of Fab inEscherichia coli
Authors: CHEUNG S C , TAKEDA S , NOTKINS A L
Published: November 2013

Monoclonal polyreactive antibodies can bind to many structurally dissimilar self and non-self antigens. Neither the precise antigen-binding site on the polyreactive antibody molecule nor the molecular basis of polyreactivity has been elucidated. The present study was initiated to see whether antibody genes encoding the Fab fragment of a human monoclonal polyreactive IgM antibody (MoAb 67) could be efficiently expressed in Escherichia coli, and whether the bacterially expressed Fab fragments possessed biological activity. cDNA encoding the variable domains of the heavy and light chains of MoAb 67 were cloned, amplified by polymerase chain reaction (PCR) and expressed in E. coli. Neither the recombinant heavy nor light chain showed antigen-binding activity. In contrast, the recombinant Fab 67 fragment showed the same antigen-binding reactivity profile as the native IgM antibody. It is concluded that the antigen-binding activity of polyreactive antibodies resides in the Fab fragment, and that both the heavy and light chains are required for activity.
INTERFERON‐GAMMA AND INTERLEUKIN‐2 SUPPRESS THE EXPERIMENTAL METASTASIS OF MOUSE RENAL ADENOCARCINOMA
Authors: Masumori Naoya , Tsukamoto Taiji , Kumamoto Yoshiaki
Published: November 2013

While cytokines such as interferon‐alpha (IFN‐α), interferon‐gamma (IFN‐γ) and interleukin‐2 (IL‐2) are partially effective in the treatment of metastatic renal cell carcinoma, these cytokines have not been investigated for their ability to suppress the development of metastasis. We investigated whether they suppressed experimental pulmonary metastasis by subline‐2 of streptozotocin‐induced mouse renal adenocarcinoma (MRAC‐PM2). IFN‐γ (1 × 104 and 1 × 105 U/mouse) and IL‐2 (1 × 104 and 1 × 105 U/mouse) suppressed the experimental pulmonary metastasis of MRAC‐PM2 in a dose‐dependent manner, but 1 × 105 lU/mouse of IFN‐α did not. The combination of 1 × 105 U IFN‐γ with 1 × 105 U IL‐2 had the most powerful inhibitory effect on pulmonary metastasis without any side‐effects. In addition, the combination of 1 × 105 U IFN‐γ with 1 × 105 U IL‐2 had a synergistic inhibitory effect on the growth of subcutaneous tumors. These results indicate that either IFN‐γ or IL‐2, or their combination, produce a more favorable effect than IFN‐α on the metastatic development of renal adenocarcinoma.
METASTATIC ADRENOCORTICAL CARCINOMA TREATED BY REPEATED RESECTION: A CASE REPORT OF LONG‐TERM SURVIVAL OVER 18 YEARS
Authors: Sakamoto Kimitaka , Ariyoshi Asami , Okazaki Masatoshi
Published: November 2013

A case of recurrent and metastatic nonfunctioning adrenocortical carcinoma in a 40‐year‐old woman is reported. The patient received 4 laparotomies and 1 thoracotomy for recurrent and metastatic disease after removal of the primary adrenal tumor. She has been alive for over 18 years following multiple surgery for diseases after the first adrenalectomy. In selected patients with recurrence and/or metastasis, repeated surgical resection offers the possibility of a cure or extended palliation.
The outcome of combined urethropexy and colposuspension for management of bitches with urinary incontinence associated with urethral sphincter mechanism incompetence
Authors: Martinoli Stefania , Nelissen Pieter , White Richard A. S.
Published: November 2013

Objective

To report 1) a combined technique of urethropexy and colposuspension; 2) intra‐ and postoperative complications; and 3) medium term outcome.

Study design

Retrospective case series.

Animals

Female dogs (n = 30) with urinary incontinence associated with urethral sphincter mechanism incompetence (USMI) unresponsive to medical management.

Methods

Through a ventral median celiotomy, the bladder was positioned abdominally to permit the urethra to be anchored with single interrupted polypropylene sutures to the prepubic tendon and linea alba. The vagina was freed from the vesicovaginal and rectovaginal attachments and advanced cranially by traction before attachment to the prepubic tendon with polypropylene mattress sutures. Bitches were re‐examined 2 weeks postoperatively; medium term outcome (>6 months) was evaluated by telephone interview of owners.

Results

At a median follow up of 39.5 months, 21 bitches (70%) were considered to have an “excellent” medium term outcome with complete resolution of their urinary signs; 8 (26.6%) had a “good” outcome, and 3 (10%) had mild transient dysuria postoperatively.

Conclusion

Combined urethropexy and colposuspension resulted in complete resolution of urinary incontinence in 70% of bitches with USMI and was not associated with major complications.
Obesity: An epidemiological perspective from Asia and its relationship to gastrointestinal and liver cancers
Authors: Goh Li‐Yen , Goh Khean‐Lee
Published: November 2013

Obesity is major health problem in the Asia‐Pacific region. The proportion of people who are overweight and obese in the region has increased dramatically and is closely linked to the increasing affluence in the region. While the body mass index has been used as a yardstick in many published studies, it has been noted that Asian patients have a greater percentage body fat for a given body mass index and especially abdominal or visceral obesity.

The association of obesity and cancers is intriguing and worrisome at the same time, as obesity is rising exponentially throughout the world especially in the Asia‐Pacific region. Evidence of its association with gastrointestinal cancers is well documented and is reported with cardioesophageal, colorectal, liver, pancreatic, and gallbladder cancers. The strength of association varies between individual cancers but is of particular concern with colorectal cancer, which is perhaps the fastest emerging cancer in this region. Biological mechanisms for obesity‐related carcinogenesis have been described, which includes insulin resistance and secretion of adipokines and chronic inflammation. A “dose–response” relationship between severity of excess body weight and risks of cancer has been reported. However, there is a paucity of data looking at a decrease in incidence of these cancers with a decrease in body weight with treatment, for example, bariatric surgery. Such studies will be difficult to perform and which would require a long period of longitudinal follow‐up.
LPS antagonism of TGF‐β signaling results in prolonged survival and activation of rat primary microglia
Authors: Mitchell Kendall , Shah Jill P. , Tsytsikova Lyubov V. , Campbell Ashley M. , Affram Kwame , Symes Aviva J.
Published: November 2013

Accumulating evidence indicates that activated microglia contribute to the neuropathology involved in many neurodegenerative diseases and after traumatic injury to the CNS. The cytokine transforming growth factor‐beta 1 (TGF‐β1), a potent deactivator of microglia, should have the potential to reduce microglial‐mediated neurodegeneration. It is therefore perplexing that high levels of TGF‐β1 are found in conditions where microglia are chronically activated. We hypothesized that TGF‐β1 signaling is suppressed in activated microglia. We therefore activated primary rat microglia with lipopolysaccharide (LPS) and determined the expression of proteins important to TGF‐β1 signaling. We found that LPS treatment decreased the expression of the TGF‐β receptors, TβR1 and TβR2, and reduced protein levels of Smad2, a key mediator of TGF‐β signaling. LPS treatment also antagonized the ability of TGF‐β to suppress expression of pro‐inflammatory cytokines and to induce microglial cell death. LPS treatment similarly inhibited the ability of the TGF‐β related cytokine, Activin‐A, to down‐regulate expression of pro‐inflammatory cytokines and to induce microglial cell death. Together, these data suggest that microglial activators may oppose the actions of TGF‐β1, ensuring continued microglial activation and survival that eventually may contribute to the neurodegeneration prevalent in chronic neuroinflammatory conditions.

image

We propose that LPS/TLR4 signaling interferes with key components in the TGF‐β1 signaling pathway in primary microglia. As a result, the ability of TGF‐ β1 to exert anti‐inflammatory effects is significantly reduced leading to prolonged survival of classically activated microglia. Identifying the mechanisms by which TGF‐ β1 signaling is targeted during microglia activation may yield novel strategies for deactivating chronically activated microglia.
Healing and recovering after a suicide attempt: a grounded theory study
Authors: Chi Mei‐Ting , Long Ann , Jeang Shiow‐Rong , Ku Yan‐Chiou , Lu Ti , Sun Fan‐Ko
Published: November 2013

Aims and objectives

To explore the healing and recovery process following a suicide attempt over 12 months ago.

Background

Literature has explored the process leading up to attempted suicide. However, there is a lack of information exploring the healing and recovery process after a suicide attempt.

Design

Qualitative research using the grounded theory approach.

Methods

Data were collected during 2010–2011 from the psychiatric outpatient's centre in Taiwan. Interviews were conducted with people who had attempted suicide more than 12 months prior to data collection and had not reattempted since that time (n = 14). Constant comparison analysis was used to scrutinise the data.

Results

Findings demonstrated that healing and recovering evolved in five phases: (1) self‐awareness: gained self‐awareness of their responsibilities in life and their fear of death; (2) the inter‐relatedness of life: awareness of the need to seek help from professionals, friends and family for support; (3) the cyclical nature of human emotions: reappearance of stressors and activators causing psyche disharmony; (4) adjustment: changes in adjustment patterns of behaviour, discovering and owning one's own unique emotions, deflecting attention from stressors and facing reality and (5) acceptance: accepting the reality of life and investing in life.

Conclusion

The healing and recovery process symbolises an emotional navigation wheel. While each phase might follow the preceding phase, it is not a linear process, and patients might move backwards and forwards through the phases depending on the nursing interventions they receive coupled with their motivation to heal. It is important for nurses to use advanced communication skills to enable them to co‐travel therapeutically with patients.

Relevance to clinical practice

Listening to patients' voices and analysing their healing and recovery process could serve as a reference for psychiatric nurses to use to inform therapeutic interventions.
The effect of individualised developmental care practices on the growth and hospitalisation duration of premature infants: the effect of mother's scent and flexion position
Authors: Kardaş Özdemir Funda , Güdücü Tüfekci Fatma
Published: November 2013

Aim and objective

To assess the effect of individualised developmental care practices on the growth and hospitalisation duration of premature infants.

Background

It is known that individualised developmental care practices enable premature infants to have enhanced weight gain, decreased intensive care complications, and earlier discharge from the hospital.

Design

The study used an experimental design.

Methods

The study was carried out with premature infants who received treatment and care in the newborn intensive care unit (n = 97). Infants were randomised into three groups: mother's scent, flexion and control. Infants were monitored each day until discharge and the measurements were recorded. The data obtained were analysed by t‐test, percentage distributions, means, chi‐square test, analysis of variance and Bonferroni test.

Results

There was a significant difference between experimental and control groups in terms of means of their discharge weight and height, and this difference was associated with the mother‐scent group (p < 0·05). While the within‐group difference between hospitalisation and discharge weight means was significant only in the mother‐scent group (p < 0·05), the within‐group difference between hospitalisation and discharge height means was significant in all three groups (p < 0·05). Even though the within‐group difference between means of hospitalisation duration of premature infants was insignificant (p > 0·05), means in the experimental groups were determined to be lower than the means in the control group.

Conclusion

As the methods of mother's smell and flexion position interventions support premature infants’ growth and shorten their hospitalisation duration, it is important to use them routinely at newborn intensive care unit.

Relevance to clinical practice

Newborn intensive care unit nurses may nurse premature infants in the flexion position to enable them to sense their mother's scent and this may to accelerate their growth and shorten their hospitalisation duration.
Effects of a suicide prevention programme for hospitalised patients with mental illness in South Korea
Authors: Jun Won Hee , Lee Eun Ju , Park Jeong Soon
Published: November 2013

Aims and objectives

To investigate the effects of a suicide prevention programme on the levels of depression, self‐esteem, suicidal ideation and spirituality in patients with mental illness.

Background

Instances of suicide have significant correlations with depression, low self‐esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self‐esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness.

Design

The study was a quasi‐experimental study with a nonequivalent control group, nonsynchronised design.

Participants

The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively.

Methods

The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital.

Results

The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self‐esteem and spirituality between the groups.

Conclusion

The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation.

Relevance to clinical practice

Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital.
Th1 immune responses can be modulated by varying dimethyldioctadecylammonium and distearoyl-sn-glycero-3-phosphocholine content in liposomal adjuvants
Authors: Hussain Mohammed Jubair , Wilkinson Alexander , Bramwell Vincent W , Christensen Dennis , Perrie Yvonne
Published: November 2013

Objectives

Cationic liposomes of dimethyldioctadecylammonium bromide (DDA) combined with trehalose 6,6′-dibehenate (TDB) elicit strong cell-mediated and antibody immune responses; DDA facilitates antigen adsorption and presentation while TDB potentiates the immune response. To further investigate the role of DDA, DDA was replaced with the neutral lipid of distearoyl-sn-glycero-3-phosphocholine (DSPC) over a series of concentrations and these systems investigated as adjuvants for the delivery of Ag85B–ESAT-6-Rv2660c, a multistage tuberculosis vaccine.

Methods

Liposomal were prepared at a 5 : 1 DDA–TDB weight ratio and DDA content incrementally replaced with DSPC. The physicochemical characteristics were assessed (vesicle size, zeta potential and antigen loading), and the ability of these systems to act as adjuvants was considered.

Key findings

As DDA was replaced with DSPC within the liposomal formulation, the cationic nature of the vesicles decreases as does electrostatically binding of the anionic H56 antigen (Hybrid56; Ag85B-ESAT6-Rv2660c); however, only when DDA was completed replaced with DSPC did vesicle size increase significantly. T-helper 1 (Th1)-type cell-mediated immune responses reduced. This reduction in responses was attributed to the replacement of DDA with DSPC rather than the reduction in DDA dose concentration within the formulation.

Conclusion

These results suggest Th1 responses can be controlled by tailoring the DDA/DSPC ratio within the liposomal adjuvant system.
A Comparison of DSM-IV-TR and DSM-5 Definitions for Sexual Dysfunctions: Critiques and Challenges
Authors: Sungur Mehmet Z. , Gündüz Anil
Published: November 2013

Introduction

The diagnostic criteria of sexual dysfunctions (SDs) are paramount for the development of sexual medicine as reliable diagnoses are essential to guide treatment plans. Prior Diagnostic and Statistical Manual of Mental Disorders (DSM) classifications based definitions of SD mostly on expert opinions and included imprecise terms. The validity of diagnoses of SD has only recently been challanged, and efforts are made to make more operational definitions.

Aim

This paper aims to compare and contrast the recently released Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) diagnostic criteria of SD with that of Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition Text Revision (DSM-IV-TR) and explains the rationale for making changes in the new DSM-5. It also aims to address some issues to be considered further for the future.

Methods

Online proposed American Psychiatric Association website DSM-5, the new released DSM-5, and DSM-IV-TR diagnostic criteria for SD were throughly inspected, and an extensive literature search was performed for comparative reasons.

Main Outcome Measures

Changes in diagnostic criteria of DSM-5 were detected, and DSM-IV-TR and DSM-5 diagnostic criteria for SD were compared and contrasted.

Results

Diagostic criteria were more operationalized, and explicit duration and frequency criteria were set up in DSM-5 for purposes of good clinical research. Classifications based on simple linear sexual response were abondoned, and diagnostic classifications were separetely made for males and females. Desire and arousal disorders in women were merged.

Conclusions

Drifting apart from linear sexual response cycle may be an advancement in establishing specific diagnostic criteria for different genders. However, it is still a question of debate whether there is enough evidence to lump sexual interest and arousal disorders in females. Making more precise definitions is important to differentiate disorders from other transient conditions. However, there is still room to improve our definitions and find a way to include gay and lesbian individuals. Further discussions and debates are expected to be continued in the future.
A 12‐Week, Open Label, Multi‐Center Study to Evaluate the Clinical Efficacy and Safety of Silodosin on Voiding Dysfunction in Patients with Neurogenic Bladder
Authors: MOON Kyung Hyun , PARK Choal‐Hee , JUNG Hee‐Chang , OH Tae‐Hee , KIM Jae‐Soo , KIM Duk‐Yoon
Published: November 2013

Objectives

The purpose of this study is to evaluate clinical effect and safety of α1A‐adrenoceptor blocker, silodosin, in patients with voiding dysfunction caused by neurogenic bladder.

Methods

From April 2011 to January 2012, patients who were diagnosed as potential voiding dysfunction associated with neurogenic bladder, aged ≥ 20 years were enrolled. Silodosin (8 mg/day) was administered once daily in the morning with food. The efficacy was assessed at the baseline and after 12 weeks of the treatment having following parameters of international prostate symptom score and other measures including the maximum flow rate and the postvoid residual urine volume.

Results

A total of 97 patients were screened and 95 were enrolled. Of these 95 patients, 82 patients were completed and included in analysis. After 12‐weeks of treatment, mean total international prostate symptom score decreased significantly from 22.23 ± 6.80 to 14.98 ± 9.48 (P = 0.0002). Voiding symptoms and storage symptoms were also improved by decreasing in international prostate symptom score‐QoL from 4.62 ± 0.92 to 3.48 ± 1.63 (P < 0.0001). Maximum flow rate increased significantly from 10.72 ± 2.66 to 15.14 ± 6.63 (P < 0.0001). The main adverse event was ejaculation disorder. No serious adverse events related to silodosin were noted.

Conclusions

This study indicates that silodosin was significantly effective, well tolerated and safe in patients who have voiding dysfunction associated with neurogenic bladder.
Management of Great Vessels and Nerves in Limb‐Salvage Surgery for Bone and Soft Tissue Tumors
Authors: Lun Deng‐xing , Hu Yong‐cheng , Huang Hong‐chao
Published: November 2013

In recent years, limb‐salvage surgery has gradually replaced amputations and become one of the main treatment strategies for patients with bone and soft tissue tumors of the extremities. The goals of tumor resection in limb‐salvage surgery are to reduce the recurrence rate and preserve as much limb function as possible. However, depending on the size and specific location of the tumor, large neurovascular bundles may be involved. In addition, management of large nerves and vessels can make wide marginal resection more difficult. Sites where these problems commonly arise include the sciatic and tibial common peroneal nerve, artery and vein in the lower limbs.
A New Surgical Technique for Extensive Exposure of the Proximal Humerus and Shoulder
Authors: Puthezhath Kishore , Puthur Dominic K
Published: November 2013

Different techniques have been described for surgical exposure of the shoulder and proximal humerus. However, the neurovascular and muscular anatomy in the proximity of the humerus precludes the use of a “safe” extensive approach. We here present a new technique for extensive exposure of the proximal humerus and shoulder for wide resection of tumors. By reflecting the deltoid with its origin as an osteomyocutaneous flap downwards and backwards, the entire shoulder, including the rotator cuff and proximal humerus, are exposed with minimal damage to the blood supply and function of the deltoid muscle. This approach, which is a logical combination of anterior, transacromial and deltoid splitting approaches, was used in 17 patients, 11 achieving satisfactory functional results. Our new surgical approach reduces intraoperative damage to the blood supply of the deltoid and results in better function of the shoulder postoperatively because both the powerful intermediate muscle fibers of the deltoid and its acromial origin remain intact.
Parent perspectives on decisions to participate in a phase I hepatocyte transplant trial
Authors: Dreyzin Alexandra , Barnato Amber E. , Soltys Kyle A. , Farris Coreen , Sada Rachel , Haberman Kimberly , Fox Ira J.
Published: November 2013

We examined factors that affect decision‐making for families presented with a phase I clinical trial of hepatocyte transplant as a potential alternative to liver transplant for their children among two groups: (i) families who were actually offered enrollment in the hepatocyte trial and; (ii) families whose children had liver transplants before the trial was available. We conducted semi‐structured interviews about actual and hypothetical decision‐making regarding trial participation and used grounded theory analysis to identify common themes. The most common motivator for participation was decline in the child's health. The most common deterrent was lack of data from prior hepatocyte transplants, particularly when compared with data available about liver transplant. Interviewees’ point of comparison for evaluating relative benefits and risks of hepatocyte transplant oscillated between the alternative of doing nothing while waiting for a liver (the relevant alternative) vs. the alternative of getting a liver. These results suggest that families’ reluctance to participate may result from misconceptions about severity of the child's disease, underestimating risks of liver transplant, or confusion about the role of hepatocyte transplant in the treatment pathway. Clarification of available treatment alternatives and associated risks as part of informed consent may improve the quality of decision‐making regarding trial enrollment.
Sociology of School Boards: A Social Capital Perspective
Authors: Saatcioglu Argun , Sargut Gokce
Published: November 2013

School boards have received little attention in sociology of education. Drawing on organizational sociology, a model of school board social capital is proposed that treats brokerage (external ties) and closure (internal ties) as the key dimensions of board functioning. The model brings together insights from limited research on school boards concerning members' internal and external ties and recasts them as the building blocks of a unifying theoretical framework. It also proposes specific performance outcomes at the district level. The model is tested using the data from a representative sample ofPennsylvania districts. The analysis not only explores brokerage and closure patterns among school boards, but also examines their implications for academic outcomes. Findings suggest that eighth grade reading and mathematics performance are highest in districts, where boards exhibit high levels of both brokerage and closure, and lowest in districts, where brokerage and closure are both low.
Donor T‐cell chimerism and early post‐transplant cytomegalovirus viremia in patients treated with myeloablative allogeneic hematopoietic stem cell transplant
Authors: Taimur S. , Askar M. , Sobecks R. , Rybicki L. , Warshawsky I. , Mossad S.
Published: November 2013

Background

Cytomegalovirus (CMV) is a common infection after myeloablative allogeneic hematopoietic stem cell transplant (M‐alloHSCT). Achievement of complete donor T‐cell chimerism (CDC‐T) post transplant is a measure of immune reconstitution. We investigated the association between CDC‐T post M‐alloHSCT and the incidence of CMV viremia.

Methods

We retrospectively reviewed all CMV and chimerism results of 47 patients for the first 6 months post M‐alloHSCT. CDC‐T was analyzed as a time‐varying covariate for association with post M‐alloHSCT CMV viremia.

Results

CMV viremia occurred in 15 (32%) and CDC‐T was achieved in 38 (81%) recipients within the first 6 months post M‐alloHSCT. On univariable analysis, increased CMV viremia was seen among patients with CDC‐T (hazard ratio 2.81 [P = 0.07, 95% confidence interval = 0.93–8.52]). A 30‐day landmark analysis showed that the incidence of CMV viremia at 6 months (regardless of recipient CMV serostatus) was 50% among those who had achieved CDC‐T by day 30, and 23% among those who had not (P = 0.06).

Conclusion

We conclude that shorter time to CDC‐T may be associated with higher risk of CMV viremia. If confirmed in a larger cohort, this might be a marker for risk stratification in the management of CMV in this population.
The impact of platelet additive solution apheresis platelets on allergic transfusion reactions and corrected count increment (CME)
Authors: Tobian Aaron A.R. , Fuller Alice K. , Uglik Kristin , Tisch Daniel J. , Borge Prabhakar D. , Benjamin Richard J. , Ness Paul M. , King Karen E.
Published: November 2013

Background

Allergic transfusion reaction (ATR) incidence ranges from 1% to 3% of all transfusions. We evaluated the impact of InterSol platelet additive solution (PAS) apheresis platelets (APs) on the incidence of ATRs and the posttransfusion platelet (PLT) increment.

Study Design and Methods

This retrospective study evaluated all ATRs among patients at a university hospital that maintained a mixed inventory of PAS APs and non‐PAS APs (standard plasma‐suspended PLTs). Corrected count increments (CCIs) were calculated for AP transfusions of individuals who received both a PAS and a non‐PAS AP transfusion within a 7‐day period. Hypothesis testing was performed with chi‐square test for dichotomous variables and t tests for continuous variables.

Results

The incidence of ATRs among the non‐PAS APs was 1.85% (72 ATRs/3884 transfusions) and 1.01% (12 ATRs/1194 transfusions) for PAS APs (risk ratio [RR], 0.54; 95% confidence interval [CI] = 0.30‐0.99; p = 0.04). However, there was no difference in the incidence of febrile nonhemolytic transfusion reactions between non‐PAS APs (incidence, 0.70%; 27/3884) compared to PAS APs (incidence, 0.59%; 7/1194; p = 0.69). Among 223 individuals with paired non‐PAS and PAS AP transfusions, the mean CCI at 1 to 4 hours after transfusion was 4932 (95% CI, 4452‐5412) for non‐PAS APs and was lower for PAS APs (CCI, 3766; 95% CI, 3375‐4158; p ≤ 0.001). However, there was no significant difference in mean CCI at 12 to 24 hours between non‐PAS (CCI, 2135; 95% CI, 1696‐2573) and PAS APs (CCI, 1745; 95% CI, 1272‐2217; p = 0.14).

Conclusions

PAS APs substantially reduce the number of ATRs. CCIs for PAS APs were lower immediately after transfusion, but not significantly different at 12 to 24 hours.
The impact of call centre employment on women in India
Authors: FOREY GAIL
Published: November 2013

The market for global business process outsourcing (BPO) is predicted to triple in size by 2020 (NASSCOM ). Such explosive growth has had and will continue to have huge economic benefits for Asia. The benefits are clearly manifest in India and the Philippines, who are both leading offshore outsourcing (O&O) destinations for the BPO industry. In India, this development has resulted in an initiative to increase the number of women in the BPO workforce by a staggering 50 per cent. The implications of such a huge push has tremendous social impact, yet little is known about the BPO industry and the role of language in these O&O destinations. The present paper focuses on the impact of English and the role of women in this global workforce by addressing the following question: ‘What is the impact of the BPO industry, and specifically call centre employment, on women in India?’ Drawing on data collected through interviews, the findings show that women's lives have changed in a number of different ways. Informants reported experiencing greater freedom, financial independence and other significant changes. The findings provide a lucid representation of the role of English language in globalisation within the BPO industry in Asia.