bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review: The Use of Rituximab in Neuromuscular Diseases
Authors: Ibrahim Homam , Dimachkie Mazen M , Shaibani Aziz 
Published: November 2010

Abstract

Autoimmunity plays a major role in the pathogenesis of many neuromuscular disorders such as chronic inflammatory demyelinating polyneuropathy, Guillain-Barré syndrome, polymyositis, dermatomyositis, myasthenia gravis, Lambert Eaton syndrome, and stiff person syndrome. Although most of these disorders respond favorably to the commonly used immunomodulatory agents such as steroids, intravenous gamma globulin, plasmapheresis, and chemotherapy, some are initially refractory, whereas others gradually lose responsiveness. Therefore, alternative, selective, and novel immunosuppressive agents are used to treat these cases. Among these agents, rituximab has shown promise in some of the neuromuscular disorders with minimal side effects. Rituximab is a genetically engineered antibody that depletes CD20+ B-cells and is Food and Drug Administration- approved for treatment of non-Hodgkin lymphoma, CD20+ CLL, and rheumatoid arthritis. It carries a favorable side effects profile. However, evidence of efficacy is limited to case series and large prospective randomized controlled trials are lacking. In this article, we review and discuss the available literature on rituximab in treatment of various autoimmune neuromuscular diseases.
Long‐term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high‐grade cervical intraepithelial neoplasia
Authors: Woo Y. L. , Badley C. , Jackson E. , Crawford R. 
Published: November 2010

Y. L. Woo, C. Badley, E. Jackson and R. CrawfordLong‐term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high‐grade cervical intraepithelial neoplasiaObjective:  This study examines the impact of excision margin status after large loop excision of the transformation zone (LLETZ) under local anaesthetic for high‐grade cervical intraepithelial neoplasia (HG‐CIN) on the cytological and histological outcomes up to 5 years after treatment.Methods:  Prospective cytological and histological data were obtained by examination of the colposcopy database at Addenbrooke’s Hospital, Cambridge, UK. All women aged between 19 and 50 years who underwent treatment for HG‐CIN by LLETZ under local anaesthetic were included in the study. Patients without follow‐up data were excluded from the study. The excision margin status was correlated with the subsequent cytological and histological outcomes.Results:  A series of 967 women with CIN2 and CIN3 underwent LLETZ excision under local anaesthetic. Overall, 42% of women had disease present at the excision margin following LLETZ. Women with CIN3 were more likely than those with CIN2 to have an involved excision margin (P < 0.0001). Cytological recurrence was highest at 12 months (16%) and did not correlate with the CIN grade or excision margin status. Histological recurrence/persistence was also highest at 12 months follow‐up (15%) and this correlated with grade of CIN and margin status (P < 0.0001).Conclusions:  Histological recurrence/persistence correlates with grade of CIN and excision margin status. Management of HG‐CIN in an outpatient setting under local anaesthetic is safe, cost effective and yields a favourable long‐term outcome.
Vulnerability in homeless adolescents: concept analysis
Authors: Dorsen Caroline 
Published: November 2010

dorsen c. (2010) Vulnerability in homeless adolescents: concept analysis.Journal of Advanced Nursing66(12), 2819–2827.AbstractAim. This paper is a report of an analysis of the concept of vulnerability in homeless adolescents.Background. Caring for vulnerable populations and reduction of health inequities are top international healthcare priorities. Homeless adolescents experience health disparities as compared to their housed counterparts and are among the most vulnerable of all populations. Understanding the concept of vulnerability as it relates to the homeless adolescent population will assist nurses in addressing the health and social concerns of this population.Data sources. The PubMed, Medline, Cochrane and CINAHL electronic databases were used to search for research papers published between 1980 and 2009. The keywords ‘vulnerable’, ‘vulnerability’ and ‘homeless’, ‘adolescent’, ‘street’ and ‘youth’ were used. Twenty‐three papers from multiple disciplines were reviewed in an effort to arrive at a global definition of homeless adolescents’ vulnerability.Method. Rodgers’ evolutionary method of concept analysis was used for the analysis.Results. Based on this analysis, vulnerability in homeless adolescents is defined as the constellation of past, present and future risk, perceived or real, because of the common human experience of risk, the increased vulnerability of the adolescent period, the consequences of family disruption, and the increased risks of life on the street.Conclusion. There was agreement in the literature regarding the antecedents, attributes, consequences and surrogate terms of the concept. However, differentiation between the concepts of risk and vulnerability, as suggested by seminal nurse researchers, was not supported. More research is needed into self‐perceptions of vulnerability and vulnerability in subgroups of homeless adolescents.
Lucerne‐dominated fields recover native grass diversity without intensive management actions
Authors: Török Péter , Kelemen András , Valkó Orsolya , Deák Balázs , Lukács Balázs , Tóthmérész Béla 
Published: November 2010

Summary1 Spontaneous succession is often underappreciated in restoration after the cessation of intensive agricultural management. Spontaneous succession could improve the success of restoration programmes, and offers a cost‐effective option with little active intervention.2 We studied the spontaneous recovery of loess grasslands in extensively managed lucerne Medicago sativa fields mown twice a year using space for time substitutions to highlight the importance of spontaneous processes in grassland restoration.3 With increasing field age a gradual replacement of lucerne by perennial native grasses and forbs and increase of mean species richness was detected. As the age of fields increased, lucerne decreased from 75% to 2% of total vegetation cover, whereas perennial graminoids increased from 0·5 to 50% cover. Mean total cover showed no significant differences between the age groups; weed cover was less than 10%.4 The phytomass of lucerne was negatively correlated with graminoid phytomass. As the age of the fields increased, lucerne phytomass decreased and grass phytomass increased. We found a negative correlation between litter and forb phytomass but there was no relationship with the age of the field. There was no litter accumulation and no increase of mean total phytomass as the age of fields increased.5 Synthesis and applications. Native grasses within loess grasslands recovered within 10 years, but characteristic native forbs remained rare. The advantages of spontaneous succession in lucerne fields compared to technical reclamation include: (i) no early stages dominated by weeds, (ii) minimal litter accumulation, (iii) a spontaneous decrease in lucerne over time, and (iv) negligible cost. In addition, the requirement for twice yearly mowing in the early years will guarantee farmer involvement because of the high forage value of lucerne. The complete restoration of species rich grasslands will require more active management such as propagule transfer by hay and/or moderate grazing to encourage the return of native forbs.
Postnatal disclosure of domestic violence: comparison with disclosure in the first trimester of pregnancy
Authors: Keeling June , Mason Tom 
Published: November 2010

Aims and objectives.  This study explored the prevalence rates of domestic violence reported during the first trimester of pregnancy and in the postnatal period.Background.  Domestic violence is known to have a deleterious effect on the physical and psychological well‐being of a woman, with an adverse effect on the unborn child.Design.  A validated anonymous and self‐administered questionnaire (Abuse Assessment Screen) using five closed questions was used for data collection in all samples. All women were approached alone, and the questionnaire was completed in private.Method.  Drawn from the same geographical area, this survey collected data from women accessing hospital clinics, in a large university teaching hospital in the UK.Results.  Comparing self‐reporting rates of domestic violence in the first trimester of pregnancy to the postnatal period yielded statistically significant results (p < 0·01). Only 7·3% booking‐in clinic and 8% postnatal women reported violence at some stage in their life, whilst higher rates in pregnancy counselling clinic (35·1%) and early pregnancy unit (26%) were reported. However, the reported rates of domestic violence in the year before the women were pregnant revealed a different trajectory. Lower rates of domestic violence were evident in three samples.Conclusions.  The disparity in disclosure rates of domestic violence suggests that an emotional inhibitory response to disclosure may occur at specific periods of pregnancy and that the timing of asking about domestic violence may be critical to this disclosure. The pandemic nature of domestic violence reflects the need for practice in maternity care to reflect the changing needs of a woman during her gestational experience.Relevance to clinical practice.  The primary objective of health care providers should be to engage a pregnant woman in a meaningful relationship, gaining her trust to facilitate the disclosure of domestic violence. Hence, whatever the policies for the provision of maternity care, the changing needs of a pregnant woman must be met.
Fluid manipulation among individuals with lower urinary tract symptoms: a mixed methods study
Authors: Elstad Emily A , Maserejian Nancy N , McKinlay John B , Tennstedt Sharon L 
Published: November 2010

Aims and objective.  To determine, qualitatively and quantitatively, how individuals use fluid manipulation to self‐manage the urinary symptoms of daytime frequency, urgency and urine leakage and the underlying rationale for this behaviour.Background.  Lower urinary tract symptoms are prevalent and burdensome, and little is known about how individuals with lower urinary tract symptoms manipulate their fluid intake.Design.  A mixed methods design included statistical analysis of data from a population‐based survey of urologic symptoms and qualitative analysis of in‐depth interviews.Method.  Quantitative data came from 5503 participants of the baseline Boston Area Community Health Survey, a population‐based, random sample epidemiologic survey of urologic symptoms. Qualitative data came from in‐depth interviews with a random subsample from Boston Area Community Health of 152 black, white and Hispanic men and women with LUTS.Results.  Qualitative data showed that some respondents restricted fluid intake while others increased it, in both cases with the expectation of improved symptoms. Quantitative data showed that fluid intake was greater in men and women reporting frequency (p < 0·001). Women with frequency drank significantly more water (p < 0·001), while women with urgency drank significantly less water (p = 0·047).Conclusions.  This study found divergent expectations of the role of fluids in alleviating symptoms, leading some individuals to restrict and others to increase fluid intake. Individuals with lower urinary tract symptoms may need guidance in fluid management.Relevance to clinical practice.  Nurses should be aware that patients may self‐manage lower urinary tract symptoms by restricting fluid intake, putting them at risk for dehydration, constipation and urinary tract infection, but also that they may be increasing their fluid intake, which could worsen symptoms. This study pinpoints a specific area of need among patients with lower urinary tract symptoms and provides a practical opportunity for nurses to assist their patients with behavioural and fluid management by emphasising the clinical guidelines.
Molecular epidemiology of malaria prevalence and parasitaemia in a wild bird population
Authors: KNOWLES SARAH C. L. , WOOD MATTHEW J. , ALVES RICARDO , WILKIN TEDDY A. , BENSCH STAFFAN , SHELDON BEN C. 
Published: November 2010

AbstractAvian malaria (Plasmodiumspp.) and other blood parasitic infections of birds constitute increasingly popular model systems in ecological and evolutionary host–parasite studies. Field studies of these parasites commonly use two traits in hypothesis testing: infection status (or prevalence at the population level) and parasitaemia, yet the causes of variation in these traits remain poorly understood. Here, we use quantitative PCR to investigate fine‐scale environmental and host predictors of malaria infection status and parasitaemia in a large 4‐year data set from a well‐characterized population of blue tits (Cyanistes caeruleus). We also examine the temporal dynamics of both traits within individuals. Both infection status and parasitaemia showed marked temporal and spatial variation within this population. However, spatiotemporal patterns of prevalence and parasitaemia were non‐parallel, suggesting that different biological processes underpin variation in these two traits at this scale. Infection probability and parasitaemia both increased with host age, and parasitaemia was higher in individuals investing more in reproduction (those with larger clutch sizes). Several local environmental characteristics predicted parasitaemia, including food availability, altitude, and distance from the woodland edge. Although infection status and parasitaemia were somewhat repeatable within individuals, infections were clearly dynamic: patent infections frequently disappeared from the bloodstream, with up to 26% being lost between years, and parasitaemia also fluctuated within individuals across years in a pattern that mirrored annual population‐level changes. Overall, these findings highlight the ecological complexity of avian malaria infections in natural populations, while providing valuable insight into the fundamental biology of this system that will increase its utility as a model host–parasite system.
Methylthioadenosine/S‐adenosylhomocysteine nucleosidase, a critical enzyme for bacterial metabolism
Authors: Parveen Nikhat , Cornell Kenneth A. 
Published: November 2010

SummaryThe importance of methylthioadenosine/S‐adenosylhomocysteine (MTA/SAH) nucleosidase in bacteria has started to be appreciated only in the past decade. A comprehensive analysis of its various roles here demonstrates that it is an integral component of the activated methyl cycle, which recycles adenine and methionine through S‐adenosylmethionine (SAM)‐mediated methylation reactions, and also produces the universal quorum‐sensing signal, autoinducer‐2 (AI‐2). SAM is also essential for synthesis of polyamines, N‐acylhomoserine lactone (autoinducer‐1), and production of vitamins and other biomolecules formed by SAM radical reactions. MTA, SAH and 5′‐deoxyadenosine (5′dADO) are product inhibitors of these reactions, and are substrates of MTA/SAH nucleosidase, underscoring its importance in a wide array of metabolic reactions. Inhibition of this enzyme by certain substrate analogues also limits synthesis of autoinducers and hence causes reduction in biofilm formation and may attenuate virulence. Interestingly, the inhibitors of MTA/SAH nucleosidase are very effective against the Lyme disease causing spirochaete, Borrelia burgdorferi, which uniquely expresses three homologous functional enzymes. These results indicate that inhibition of this enzyme can affect growth of different bacteria by affecting different mechanisms. Therefore, new inhibitors are currently being explored for development of potential novel broad‐spectrum antimicrobials.
Escape from growth restriction in small colony variants of Salmonella typhimurium by gene amplification and mutation
Authors: Pränting Maria , Andersson Dan I. 
Published: November 2010

SummaryAntibiotic resistance in bacteria is generally associated with fitness costs that often can be reduced by second‐site compensatory mutations. Here, we examined how a protamine‐resistant small colony variant of Salmonella typhimurium adapts to the growth reduction conferred by a resistance mutation in hemC (encoding a haem‐biosynthesis enzyme). We show that adaptation occurs in a multi‐step process where fitness is successively increased. Thus, the initial adaptive response was selection for an unstable gene amplification of the mutant hemC gene that provided a small fitness increase. Fitness was increased further by a mutation that restored HemC function in one gene copy, relaxing selection for the amplification. Subsequently, the amplification segregated back to the haploid state and even higher fitness. The end result was in most cases mutant strains with a hemC sequence different from that of the wild‐type strain. These findings suggest that gene amplification facilitates adaptive evolution. A higher gene dosage increases the target size for compensatory mutations and improves fitness of the cell, thereby allowing an increase in the population size, further increasing the probability of a subsequent stable mutation. Our results provide a novel genetic basis for growth compensation in small colony variants.
Mycobacteria exploit three genetically distinct DNA double‐strand break repair pathways
Authors: Gupta Richa , Barkan Daniel , Redelman‐Sidi Gil , Shuman Stewart , Glickman Michael S. 
Published: November 2010

SummaryBacterial pathogens rely on their DNA repair pathways to resist genomic damage inflicted by the host. DNA double‐strand breaks (DSBs) are especially threatening to bacterial viability. DSB repair by homologous recombination (HR) requires nucleases that resect DSB ends and a strand exchange protein that facilitates homology search. RecBCD and RecA perform these functions in Escherichia coli and constitute the major pathway of error‐free DSB repair. Mycobacteria, including the human pathogen M. tuberculosis, elaborate an additional error‐prone pathway of DSB repair via non‐homologous end‐joining (NHEJ) catalysed by Ku and DNA ligase D (LigD). Little is known about the relative contributions of HR and NHEJ to mycobacterial chromosome repair, the factors that dictate pathway choice, or the existence of additional DSB repair pathways. Here we demonstrate that Mycobacterium smegmatis has three DSB repair pathway options: HR, NHEJ and a novel mechanism of single‐strand annealing (SSA). Inactivation of NHEJ or SSA is compensated by elevated HR. We find that mycobacterial RecBCD does not participate in HR or confer resistance to ionizing radiation (IR), but is required for the RecA‐independent SSA pathway. In contrast, the mycobacterial helicase–nuclease AdnAB participates in the RecA‐dependent HR pathway, and is a major determinant of resistance to IR and oxidative DNA damage. These findings reveal distinctive features of mycobacterial DSB repair, most notably the dedication of the RecBCD and AdnAB helicase–nuclease machines to distinct repair pathways.
Spatially disaggregated disease transmission risk: land cover, land use and risk of dengue transmission on the island of Oahu
Authors: Vanwambeke Sophie O. , Bennett Shannon N. , Kapan Durrell D. 
Published: November 2010

SummaryVector‐borne diseases persist in transmission systems that usually comprise heterogeneously distributed vectors and hosts leading to a highly heterogeneous case distribution. In this study, we build on principles of classical mathematical epidemiology to investigate spatial heterogeneity of disease risk for vector‐borne diseases. Land cover delineates habitat suitability for vectors, and land use determines the spatial distribution of humans. We focus on the risk of exposure for dengue transmission on the Hawaiian island of Oahu, where the vectorAedes albopictusis well established and areas of dense human population exist. In Hawai’i, dengue virus is generally absent, but occasionally flares up when introduced. It is therefore relevant to investigate risk, but difficult to do based on disease incidence data. Based on publicly available data (land cover, land use, census data, surveillance mosquito trapping), we map the spatial distribution of vectors and human hosts and finally overlay them to produce a vector‐to‐host ratio map. The resulting high‐resolution maps indicate a high spatial variability in vector‐to‐host ratio suggesting that risk of exposure is spatially heterogeneous and varies according to land cover and land use.
A quasi‐experimental evaluation of a community‐based art therapy intervention exploring the psychosocial health of children affected by HIV in South Africa
Authors: Mueller Joanne , Alie Collin , Jonas Beatrice , Brown Elizabeth , Sherr Lorraine 
Published: November 2010

SummaryObjectives  To evaluate the efficacy of the Make A Difference about Art programme, a community art programme in South Africa for children affected by HIV and AIDS, which aims to reduce psychosocial problems by increasing self‐esteem, self‐efficacy and HIV insight.Methods  A quasi‐experimental cross‐sectional post‐intervention survey of 297 children aged 8–18 years (177 programme attendees and a control group of 120). Participants completed an inventory comprising standardized, validated psychosocial measures of depression, emotional and behavioural problems, self‐esteem and self‐efficacy and key sociodemographic variables potentially relevant as risk and protective factors.Results  Attending the intervention was predictive of significantly higher self‐efficacy, but was not associated with differences in self‐esteem, depression, or emotional/behavioural problems. This association remained in the multivariate analysis, controlling for potential confounders. Double parental death exerted a powerful effect on child psychosocial health, eliminating the association between intervention attendance and higher self‐efficacy. However, an interaction was found between bereavement status and intervention attendance on child self‐efficacy, indicating that the intervention programme may ameliorate some of the psychosocial vulnerabilities associated with becoming an orphan. Other key risk factors for poor psychosocial health in this sample were AIDS‐related stigma and community and household violence. Social connection emerged as a key protective factor.Conclusions  Our findings suggest that such interventions may offer opportunities to increase the self‐efficacy of vulnerable children to protect their psychological health.