bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technology affordances: the ‘real story’ in research with K‐12 and undergraduate learners
Authors: Kay J. Wijekumar , Meyer Bonnie J.F. , Wagoner Diane , Ferguson Lon 
Published: November 2005

AbstractComputer technologies for learning environments have been introduced with great expectations for improved learning outcomes. However, the great improvements have not materialised; some of these extant studies are examined. Of all the explanations for these disappointing results, the least examined are the affordances of the computer tools. This paper provides a rationale for studying affordances and presents two studies in K‐12 and undergraduate settings showing how powerful affordances are in affecting outcomes. Finally, the paper presents guidelines on how to gradually move students from a game affordance of a computer to a learning mode.
Cervical screening in HIV‐positive women: characteristics of those who default and attitudes towards screening
Authors: Shah S , Montgomery H , Smith C , Madge S , Walker P , Evans H , Johnson M , Sabin C 
Published: November 2005

ObjectivesTo determine the characteristics of HIV‐positive women who undergo cervical screening and to identify negative attitudes and experiences of these women to screening and the factors associated with these.MethodsWe compared the Royal Free Cohort data from 59 newly diagnosed HIV‐infected women, 31 of whom did and 28 of whom did not attend for cervical screening in 2001, and from 227 women under active cervical screening follow‐up (at least one cervical screen since June 2001) and 88 HIV‐infected women lost to follow‐up (not screened since January 2001). Attitudes to screening were investigated with the aid of a questionnaire given to all women attending clinic who had had a previous colposcopy.ResultsOf the 59 newly HIV diagnosed women, 31 (53%) underwent cervical screening. These 31 women were more likely to be heterosexual (100 vs 89%, P=0.05), to have lower median viral loads (< 50 vs 3210 HIV‐1 RNA copies/mL) and to be receiving antiretrovirals (ARVs) (74 vs 54%, P=0.1) than those not screened. Of the 315 women who had at least one screen, 72% returned for further follow‐up. There were no differences in age or ethnicity between these groups. Those under active follow‐up had a higher CD4 count (P=0.04) and lower viral load (P=0.0001) at their last visit. They were also more likely to be on highly active antiretroviral therapy (HAART) (68 vs 52%, P=0.006). A total of 78 of 104 questionnaires (75%) were returned. Women participating in the questionnaire study were mainly of back ethnicity (68%), did not speak English as their first language (59%) and were taking ARVs (76%). Most agreed that regular smears and colposcopy were valuable. Women of white ethnicity, and those speaking English as a first language, were more likely to dislike colposcopy compared with those of nonwhite ethnicity (87 vs 25%, respectively, P=0.0007) and not speaking English as a first language (74 vs 26%, respectively, P=0.002). Those of white ethnicity were more likely to find smears and colposcopy painful (60 and 73%) compared with those of black ethnicity (46 and 51%, P=0.47 and 0.28, respectively).ConclusionsOur results suggest that women on HAART with better disease control, older women, and those of black African ethnicity are more likely to take up cervical screening. Cervical screening experience varies by ethnicity and language.
Determinants of response to first HAART regimen in antiretroviral‐naïve patients with an estimated time since HIV seroconversion
Authors: Thiébaut R , Jacqmin‐Gadda H , Walker S , Sabin C , Prins M , Del Amo J , Porter K , Dabis F , Chêne G ,   the CASCADE Collaboration
Published: November 2005

ObjectiveTo study the determinants of immunological and virological response to highly active antiretroviral therapy (HAART) in naïve patients, adjusting for time since HIV‐1 seroconversion.DesignData from HIV‐cohort studies where dates of seroconversion have been reliably estimated.MethodsIn previously untreated patients, short‐ and long‐term marker responses from HAART initiation (three or more antiretroviral drugs) to the end of follow‐up or any treatment modification were considered using mixed effects models accounting for undetectable HIV viral load and informative dropout.ResultsIn total, 943 patients were treated with a first HAART regimen for a median of 29 months. In adjusted analyses, compared with a reference group of homosexual men without AIDS initiating treatment 4 years after seroconversion, injecting drug users (IDUs) were treated at similar CD4 and HIV RNA levels but had poorer short‐term virological response (2.54 vs 2.13 log10 HIV‐1 RNA copies/mL at 1.5 months, P=0.03) and poorer long‐term immunological response (522 vs 631 cells/μL at 24 months, P<0.0001). Although individuals with AIDS at HAART initiation had lower CD4 counts (206 vs 382 cells/μL, P<0.0001), their immunological responses were similar to those of individuals without AIDS. Similarly, individuals further from seroconversion started HAART at lower CD4 counts (e.g. 311 vs 382 cells/μL at vs before 9 years from seroconversion, P<0.0001), but had similar CD4 responses. However, they experienced poorer long‐term virological response (0.67 log10 copies/mL/year smaller decline, P<0.0001) compared to those treated before 9 years from seroconversion.ConclusionTaking into account the time elapsed since seroconversion, this study suggests that careful choices of initial treatment should be made and intensive follow‐up carried out in high‐risk subgroups such as IDUs who have poorer responses.
Impact of highly active antiretroviral therapy on blood pressure in HIV‐infected patients. A prospective study in a cohort of naive patients
Authors: Palacios R , Santos J , García A , Castells E , González M , Ruiz J , Márquez M 
Published: November 2005

ObjectivesTo assess the impact of highly active antiretroviral therapy (HAART) on the blood pressure (BP) of naive patients after 1 year of treatment.MethodsA prospective, observational study of 95 HIV‐positive patients in our Unit starting HAART between January 2001 and October 2002 and maintaining the same regimen for 48 weeks of follow‐up was carried out. Data on blood pressure (BP) and demographic, epidemiological, clinical, immunovirological and therapeutic characteristics related to HIV infection were collected prior to HAART and at week 48. High blood pressure (HBP) [systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg] was defined according to international criteria.ResultsOf the 95 patients, 78 were men, 44% had AIDS and 68% were smokers, and their mean age was 40 years. At week 48 the prevalence of HBP was 26% and SBP, DBP and pulse pressure (PP) increased (121.8 versus 116.6 mm Hg, P=0.0001; 76.3 versus 69.7 mm Hg, P=0.004; 46.9 versus 43.8 mm Hg, P=0.001, respectively). Univariate analysis showed that HBP was associated with older age, higher body mass index (BMI), higher baseline lipids, and higher baseline BP. A linear regression model adjusting for age and sex suggested a significant impact of older age, higher baseline SBP, higher baseline hypercholesterolaemia and lower baseline CD4‐cell count on SBP increase.ConclusionsBlood pressure increased after 48 weeks of HAART, leading to an important prevalence of hypertension. The increase in SBP depended on age and baseline lipid profile and immunological status. BP should be periodically measured and treated when necessary in HIV‐infected patients on HAART.
Pronounced lipoatrophy in HIV‐infected men receiving HAART for more than 6 years compared with the background population
Authors: Hansen AB , Lindegaard B , Obel N , Andersen O , Nielsen H , Gerstoft J 
Published: November 2005

ObjectivesTo establish the prevalence and quantify the severity of body fat redistribution and dyslipidaemia in HIV‐infected men after long‐term highly active antiretroviral therapy (HAART) compared with the background population.MethodsIn a cross‐sectional study, we included 87 HIV‐infected men who had received HAART for at least 6 years and 34 HIV‐negative men. Regional body composition was assessed using dual‐energy X‐ray absorptiometry. Fasting metabolic parameters were obtained. Associations between regional body fat distribution and metabolic parameters were evaluated.ResultsHIV‐infected patients and controls did not differ with regard to height and lean body mass. Compared with controls, HIV‐infected men had reduced total fat mass (median 12.3 versus 19.2 kg, P<0.001), limb fat mass (4.3 versus 7.9 kg, P<0.001), and trunk fat mass (6.7 versus 10.8 kg, P<0.001) and higher trunk/limb fat ratio (1.7 versus 1.2, P<0.001). Also, patients without clinical lipodystrophy had reduced amounts of limb and trunk fat. In HIV‐infected men, triglyceride levels were higher (2.0 versus 1.2 mmol/L, P<0.001), high‐density lipoprotein (HDL)‐cholesterol levels were lower (1.2 versus 1.3 mmol/L, P<0.05) and insulin levels were higher (40.8 versus 29.9 pmol/L, P<0.01) than in controls. All adverse metabolic parameters correlated with increased trunk/limb fat ratio, and insulin levels correlated positively with trunk fat mass (P<0.01).ConclusionPeripheral as well as central fat loss is a general characteristic of HIV‐infected men after long‐term HAART. Although lipoatrophy was the dominant morphological presentation, the adverse metabolic parameters were mainly associated with the increased ratio of trunk/limb fat.
Depletion of mitochondrial DNA copies/cell in peripheral blood mononuclear cells in HIV‐1‐infected treatment‐naïve patients
Authors: Maagaard A , Holberg‐Petersen M , Kvittingen EA , Sandvik L , Bruun JN 
Published: November 2005

ObjectivesMitochondrial toxicity is believed to be the main reason for adverse effects related to nucleoside reverse transcriptase inhibitors (NRTIs). The aim of the present study was to compare mitochondrial toxicity in NRTI‐treated HIV‐positive patients, HIV‐positive treatment‐naïve patients and HIV‐negative controls by comparing mitochondrial DNA (mtDNA) copies/cell in peripheral blood mononuclear cells (PBMCs) and lactate/pyruvate (L/P) ratios in the different groups.MethodsWe enrolled 60 participants in the study: 31 patients on combined antiretroviral therapy (CART), 14 HIV‐positive treatment‐naive patients and 15 HIV‐negative controls. mtDNA (copies/cell) in peripheral blood was analysed using quantitative real‐time polymerase chain reaction (PCR). Standard curves and serial dilutions of plasmid‐cloned mitochondrion and retinoblastoma (RB1) PCR products with known concentrations were generated to estimate the mtDNA and nuclear DNA (nDNA) copy numbers in each sample. The L/P ratio was enzymatically and spectrophotometrically analysed in samples from individuals in a fasted, non‐exercise state.ResultsThe median mtDNA copy number was 63 copies/cell (interquartile range 33–94) in HIV‐positive patients and 153 (132–283) in HIV‐negative controls (P<0.001). No significant difference was seen between the HIV‐positive NRTI‐exposed patients and the HIV‐positive treatment‐naive patients. Current use of didanosine was negatively correlated with depletion of mtDNA (r=−0.36, P=0.046). HIV‐positive patients also had a higher L/P ratio compared with HIV‐negative controls (P=0.004).ConclusionsThe number of mtDNA copies/cell in PBMCs was depleted in HIV‐positive treatment‐naive patients as well as in HIV‐positive NRTI‐exposed patients. HIV‐positive patients also had a higher L/P ratio compared with HIV‐negative controls, which supports this conclusion. The study suggests that neither mtDNA in PBMCs nor L/P ratio is a good marker of NRTI‐associated mitochondrial toxicity.
Antiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real‐life situation in 2002
Authors: Fischer A , Karasi J‐C , Kibibi D , Omes C , Lambert C , Uwayitu A , Hemmer R , Van Den Ende J , Schmit J‐C , Arendt V 
Published: November 2005

Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency and reasons for treatment interruptions but also antiviral efficay, resistance to ARVs and genotypic variability of the viruses present in Rwanda were analysed. Among the 233 patients included in the study, it appeared that a vast majority (91%) were under triple therapy and that half of them had experienced at least one treatment interruption caused mainly by drug shortage or financial difficulties. Among 60 blood samples analysed, 26 were in virological failure with a viral load above 1000 RNA copies/ml and 11 presented major drug resistance mutations.Finally, virological failure could mainly be explained by the high frequency of treatment interruptions but also by the emergence of drug resistance mutations. Consequently the major objective for the ESTHER programme to improve the situation in Rwanda will be to reduce the drug shortage and facilitate the financial accessibility of the treatments.
Effect of GB virus C on response to antiretroviral therapy in HIV‐infected Brazilians*
Authors: Souza IE , Zhang W , Diaz RS , Chaloner K , Klinzman D , Stapleton JT 
Published: November 2005

ObjectivesGB virus C (GBV‐C) infection is associated with delayed mortality in HIV‐infected people in most, but not all, studies. Previous investigations of the effect of GBV‐C viraemia on response to antiretroviral therapy (ART) were inconclusive. To determine the effect of GBV‐C on ART, we retrospectively analysed plasma samples taken from patients in a prospective randomized clinical trial of ART in HIV‐positive Brazilians.MethodsGBV‐C viraemia was characterized by testing stored serum samples from 175 participants by reverse transcriptase–polymerase chain reaction (RT‐PCR). Subjects were randomized to receive indinavir (n=59), zidovudine and lamivudine (n=58), or zidovudine, lamivudine and indinavir (n=58). The effect of GBV‐C viraemia on the average change in HIV viral load and CD4 count following initiation of therapy was evaluated in a multiple regression analysis.ResultsThe prevalence of GBV‐C viraemia was similar to that observed in previous studies (24%). HIV viral load decreased following ART to a significantly greater extent in patients with GBV‐C viraemia (by 0.48 log10 HIV‐1 RNA copies/mL, P=0.009, adjusting for age, ART group, and baseline CD4 count). Although there was no significant difference in change in CD4 count between individuals with and without GBV‐C viraemia overall, CD4 counts were higher following 48 weeks of therapy in GBV‐C viraemic individuals receiving the least potent ART regimen (zidovudine and lamivudine) compared with those without GBV‐C infection.ConclusionsGBV‐C viraemia is associated with an enhanced reduction of HIV viral load in response to ART. In this study of treatment‐naive individuals during 48 weeks of follow up, patients with GBV‐C viraemia had reductions in HIV viral load that were approximately 0.5 log copies/mL greater than those found in patients without GBV‐C viraemia. This is similar to reductions observed with nucleoside reverse transcriptase inhibitors.
Clinical outcomes of first antiretroviral regimen in HIV/hepatitis C virus co‐infection
Authors: Cooper CL , Breau C , LaRoche A , Lee C , Garber G 
Published: November 2005

ObjectivesDespite the benefits of HAART, initiation of antiretroviral therapy in HIV‐HCV co‐infected patients is often delayed as a consequence of patient and physician concern pertaining to liver toxicity. It is unclear whether this is justified.MethodsWe retrospectively evaluated treatment duration and outcome in 186 patients initiating a first HAART regimen.ResultsDespite frequent HIV RNA suppression and CD4 T‐cell increase following initiation of HAART, the median duration of therapy was only 8 months. Therapy was discontinued primarily for gastrointestinal intolerance (26%), poor adherence (19%), neurocognitive side effects (13%), and substance abuse (6%). Regimes were changed to reduce pill burden and/or frequency of dosing as well (11%). Only six (4%) subjects interrupted therapy as a result of clinically apparent liver toxicity. None were on low dose ritonavir‐containing therapy. In those subjects remaining on HAART for at least 12 months, the median ALT level increased marginally from a baseline of 44 IU/mL to 56 IU/mL. The median AST was 44 IU/mL at baseline and at month 12.ConclusionsThese results support our contention that regimen potency, durability, and extrahepatic side effect profile should remain the paramount considerations related to the selection of HAART regimen in HIV‐HCV co‐infection.
Potentiation strategies for treatment‐resistant depression
Authors: Ros S. , Agüera L. , de la Gándara J. , E. Rojo J. , de Pedro J. M. 
Published: November 2005

Objective:  To review the pharmacological basis of antidepressant potentiation in combination therapy and the clinical evidence for its efficacy.Method:  Literature searches were undertaken and the results reviewed.Results:  Treatment‐resistant depression is common (15–30%). Various strategies exist for dealing with resistant depression, including pharmacological potentiation, i.e. adding a treatment that itself does not have antidepressant actions but that enhances the efficacy of the original treatment. Lithium, triiodothyronine (T3) and buspirone are the best studied potentiating drugs, although other options include pindolol, dopaminergic agents, second‐generation antipsychotics, psychostimulants, hormones and anticonvulsants.Conclusion:  Several pharmacological potentiation strategies exist. Whilst good evidence exists for lithium combined with antidepressants, although good results have also been reported with augmentation strategies involving T3 or buspirone.
Combined antidepressants: clinical experience
Authors: Rojo J. E. , Ros S. , Agüera L. , de la Gándara J. , de Pedro J. M. 
Published: November 2005

Objective:  To review the current literature on the use of combinations of antidepressive agents.Method:  Literature searches were undertaken and reviewed on the use of combinations of antidepressants.Results:  Data sources included surveys, analyses of prescription records, decision algorithms, clinical reports, and studies comparing the monotherapy with combination therapy. More recent surveys recommend combining different selective serotonin reuptake inhibitors (SSRIs), an SSRI plus bupropion or dual action antidepressants plus an SSRI. Decision algorithms recommend an SSRI plus tricyclic antidepressant (TCA) and more recently bupropion plus venlafaxine or mirtazapine. Few controlled clinical trials comparing the combined therapy with monotherapy have been conducted. Beneficial effects have been reported with combinations of TCAs plus mianserin or SSRIs plus mirtazapine.Conclusion:  Adding or combining antidepressant medications has advantages for the speed of onset and maintaining the existing response. More rigorous clinical trials comparing combination therapy with monotherapy and for the development of rational treatment guidelines are required.
Use of antidepressant combinations: which, when and why? Results of a Spanish survey
Authors: de la Gándara J. , Agüera L. , Rojo J. E. , Ros S. , de Pedro J. M. 
Published: November 2005

Objective:  The present study uses the data from a large survey conducted to examine the general practice of Spanish psychiatrists on the use of antidepressant combinations in the treatment of depressive disorders.Method:  The sample was drawn from specialists and psychiatric residents practicing in Spain who were respondents to a questionnaire distributed during an annual national psychiatry meeting and sent by mail.Results:  A total of 1032 questionnaires were collected; following the data‐filtering, 831 were analysed. Most psychiatrists (89%) believe that many patients do not respond to the first treatment; in such cases of non‐response, 58% choose a combination of antidepressants as the next treatment option. Reasons for using the combined treatments include greater efficacy (57%), overcoming resistance to the first antidepressant (27%), faster onset of action (21%) and avoidance of side effects (17%). The most sought after pharmacological profile was serotonergic‐noradrenergic (96%) and the most popular combinations were selective serotonin reuptake inhibitor (SSRI) + mirtazapine, SSRI + reboxetine and SSRI + tricyclic antidepressant.Conclusion:  Antidepressant combinations are frequently used in clinical practice. Pharmacological profiles are always considered and SSRIs + mirtazapine is the option usually chosen.
Nurses’ short‐term prediction of violence in acute psychiatric intensive care
Authors: Björkdahl A. , Olsson D. , Palmstierna T. 
Published: November 2005

Objective:  To evaluate the short‐term predictive capacity of the Brøset Violence Checklist (BVC) when used by nurses in a psychiatric intensive care unit.Method:  Seventy‐three patients were assessed according to the BVC three times daily. Violent incidents were recorded with the Staff Observation Aggression Scale, revised version.An extended Cox proportional hazards model with multiple events and time‐dependent covariates was estimated to evaluate how the highest BVC sum of the last 24 h and its separate items affect the risk for severe violence within the next 24 h.Results:  With a BVC sum of one or more, hazard for severe violence was six times higher than if the sum was zero. Four of the six separate items significantly increased the risk for severe violence with hazard ratios between 3.0 and 6.3.Conclusion:  Risk for in‐patient violence in a short‐term perspective can to a high degree be predicted by nurses using the BVC.
Protective effect of the apo ɛ2 allele in major depressive disorder in Taiwanese
Authors: Fan P.‐L. , Chen C.‐D. , Kao W.‐T. , Shu B.‐C. , Lung F.‐W. 
Published: November 2005

Objective:  Major depression is an important comorbidity in Alzheimer's disease, which is definitely associated with the apolipoprotein E (apo E) polymorphism. The aim of this study was to explore the role of the different apo E polymorphisms in major depressive disorder (MDD) in a Taiwanese population.Method:  We examined apo E genotypes in 273 Taiwanese patients with MDD and 429 healthy community controls, and compared their polymorphism distribution.Results:  The allelic frequency of apo ɛ2 was significantly lower in patients with MDD than in the controls, whereas no significant difference in apo ɛ4 allelic frequency between these two groups was found.Conclusion:  The apo ɛ4 allele was not associated with MDD in this study. However, the finding of a lower frequency of the apo ɛ2 allele in MDD could lead to the conclusion that the apo ɛ2 allele likely provides a protective effect against MDD in the Taiwanese population.