Evidence for local inflammation in complex regional pain syndrome type 1.

BACKGROUND: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1) is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.g. oedema, local temperature changes and chronic pain) local inflammation is suspected. AIM: To determine the involvement of neuropetides, cytokines and eicosanoids as locally formed mediators of inflammation. METHODS: In this study, nine patients with proven CRPS 1 were included. Disease activity and impairment was determined by means of a Visual Analogue Scale, the McGill Pain Questionnaire, the difference in volume and temperature between involved and uninvolved extremities, and the reduction in active range of motion of the involved extremity. Venous blood was sampled from and suction blisters made on the involved and uninvolved extremities for measurement of cytokines interleukin (IL)-6, II-1beta and tumour necrosis factor-alpha (TNF-alpha), the neuropetides NPY and CRGP, and prostaglandin E2RESULTS: The patients included in this study did have a moderate to serious disease activity and impairment. In plasma, no changes of mediators of inflammation were observed. In blister fluid, however, significantly higher levels of IL-6 and TNF-alpha in the involved extremity were observed in comparison with the uninvolved extremity. CONCLUSIONS: This is the first time that involvement of mediators of inflammation in CRPS 1 has been so clearly and directly demonstrated. This observation opens new approaches for the succesful use and development of immunosuppressives in CRPS 1

"They go for gender first"

There have been many recent media reports about the online harassment of women journalists working in technology, particularly the video gaming industry. However, little research has focused on this aspect, by looking at specific occupations, or analysing the implications for women and society. This paper is a feminist study of the experiences of sexist abuse of a sample of women journalists writing about technology. It is a commentary on the results of a questionnaire-based study of 102 women (and their approximately 300 comments) that work in what has emerged as one of the frontlines of the struggle for gender equality. The research looks at the extent of the abuse, the harm it causes and how women are reacting to it. Most of the participants have experienced abuse, many have changed their working practices and some have disguised their identity to avoid it. An examination of their comments suggests that sexist abuse is now often normalised, alongside a new kind of "invisible" feminism. It also reveals a mood of defiance and an appetite for radical change to address the problems of exclusion and loss of identity. Overall, results indicate that the abuse is damaging women’s lives and impacting journalism and society in a negative way

Aggravated bone density decline following symptomatic osteonecrosis in children with acute lymphoblastic leukemia

Osteonecrosis and decline of bone density are serious side effects during and after treatment of childhood acute lymphoblastic leukemia. It is unknown whether osteonecrosis and low bone density occur together in the same patients, or whether these two osteogenic side-effects can mutually influence each other's development. Bone density and the incidence of symptomatic osteonecrosis were prospectively assessed in a national cohort of 466 patients with acute lymphoblastic leukemia (4-18 years of age) who were treated according to the dexamethasone-based Dutch Child Oncology Group-ALL9 protocol. Bone mineral density of the lumbar spine (BMDLS) (n= 466) and of the total body (BMDTB) (n=106) was measured by dual X-ray absorptiometry. Bone density was expressed as age-and gender-matched standard deviation scores. Thirty patients (6.4%) suffered from symptomatic osteonecrosis. At baseline, BMDLS and BMDTB did not differ between patients who did or did not develop osteonecrosis. At cessation of treatment, patients with osteonecrosis had lower mean BMDLS and BMDTB than patients without osteonecrosis (respectively, with osteonecrosis: -2.16 versus without osteonecrosis: -1.21, P</p

Modelling entomological-climatic interactions of Plasmodium falciparum malaria transmission in two Colombian endemic-regions: contributions to a National Malaria Early Warning System

BACKGROUND: Malaria has recently re-emerged as a public health burden in Colombia. Although the problem seems to be climate-driven, there remain significant gaps of knowledge in the understanding of the complexity of malaria transmission, which have motivated attempts to develop a comprehensive model. METHODS: The mathematical tool was applied to represent Plasmodium falciparum malaria transmission in two endemic-areas. Entomological exogenous variables were estimated through field campaigns and laboratory experiments. Availability of breeding places was included towards representing fluctuations in vector densities. Diverse scenarios, sensitivity analyses and instabilities cases were considered during experimentation-validation process. RESULTS: Correlation coefficients and mean square errors between observed and modelled incidences reached 0.897–0.668 (P > 0.95) and 0.0002–0.0005, respectively. Temperature became the most relevant climatic parameter driving the final incidence. Accordingly, malaria outbreaks are possible during the favourable epochs following the onset of El Niño warm events. Sporogonic and gonotrophic cycles showed to be the entomological key-variables controlling the transmission potential of mosquitoes' population. Simulation results also showed that seasonality of vector density becomes an important factor towards understanding disease transmission. CONCLUSION: The model constitutes a promising tool to deepen the understanding of the multiple interactions related to malaria transmission conducive to outbreaks. In the foreseeable future it could be implemented as a tool to diagnose possible dynamical patterns of malaria incidence under several scenarios, as well as a decision-making tool for the early detection and control of outbreaks. The model will be also able to be merged with forecasts of El Niño events to provide a National Malaria Early Warning System

Tegen de draaikolk in. Het kunstmatige effect van de vertelsituatie en de metafictie in 'Letter en Geest. Een spookverhaal'

Frans Kellendonk heeft in zijn essay ‘Idolen, over het tweede gebod’ (1987) beschreven dat wanneer literatuur de pretentie heeft om meer voor te stellen dan een kunstmatige en fictionele constructie, zij het gevaar loopt om ‘teruggezogen’ te worden door de vernietigende kracht van een draaikolk. Het meest belangrijke poëticale devies van Kellendonk heeft te maken met deze onderlinge relatie tussen de fictionele wereld van literatuur en de ‘werkelijkheid’, die de wereld van het boek omhult. De roman 'Letter en Geest. Een spookverhaal' (1982) bevat binnen Kellendonks oeuvre de meeste ingrediënten om aan zijn zogenaamde ‘kunstmatigheidseis’ te voldoen. Alles in 'Letter en Geest' wordt uiteindelijk teruggevoerd naar het uitgangspunt van een gesloten systeem. In mijn scriptie heb ik op twee manieren naar een antwoord gezocht op de hoofdvraag naar de verhouding tussen de vertelsituatie en de metafictie en het kunstmatige effect van deze verhouding. Na een inleidend eerste hoofdstuk over de schrijver Kellendonk, biedt hoofdstuk II een zuiver theoretisch antwoord op de hoofdvraag, waarin de vertelsituatie en metafictie zijn omschreven als twee constanten van de roman, die variabel zijn in hun verschijning. Een van de uitkomsten van dit tweede hoofdstuk was dat de diëgetische metafictie afhankelijk is van een gedramatiseerde verteller, terwijl de linguïstische variant geen afhankelijkheidsrelatie met de vertelsituatie onderhoudt. In hoofdstuk III heb ik het antwoord op de hoofdvraag gezocht binnen de context van de roman 'Letter en Geest', waarbij het begrippenapparaat van hoofdstuk II als richtsnoer heeft gediend. De zelfreflexiviteit van metafictie bleek voor alle structuuraspecten van 'Letter en Geest' te gelden, waarmee de roman omgeven lijkt te zijn door een spiegelende stolp die, samen met de metafictionele passages, resulteert in een afname van de verwijzingen naar de tekstexterne wereld. De verteller verandert van een raadselachtige gedramatiseerde instantie die in een meervoudsvorm vertelt, naar een niet-gedramatiseerde personale verteller. In hoofdstuk IV heb ik het principe van hoofdstuk III herhaald, met het verschil dat ik me in dit hoofdstuk heb gericht op de scharnierpositie die 'Letter en Geest' binnen Kellendonks oeuvre vervult. Kellendonks anti-mimetische romans verbeelden op zich zelf staande werelden die voorlopigheid uitstralen en het kunstmatige effect van de vertelsituatie en de metafictie mondt uit in een verzelfstandiging van de roman ten aanzien van de tekstexterne wereld. In 'Letter en Geest' roepen de polariteiten elkaar in rap tempo op en het hermetische karakter van 'Letter en Geest', dat door de grootschalige zelfreflexiviteit wordt bereikt, maakt deze roman tot een overwinning op de strijd met de vernietigende kracht van de draaikolk

Confirmatory fctor analysis of the career development questionnaire and the career decision-making self-efficacy scale for South African high school students

The original publication is available at http://www.sajip.co.zaThis study investigated the construct validity of the Career Development Questionnaire and the Career Decision- Making Self-Efficacy Scale for Grade 12 students from a low socioeconomic area in South Africa. The results of confirmatory factor analyses provided support for the construct validity of the Career Development Questionnaire and the Career Decision-Making Self-Efficacy Scale as measures of career maturity and career decision-making self-efficacy respectively. In accordance with theoretical predictions, a moderate degree of overlap between the constructs measured by the two instruments was observed. It appears that a general factor, labelled General Career Decision-Making, underlies responses to the two questionnaires. In addition to the general factor, the Career Decision-Making Self-Efficacy Scale also measures self-efficacy expectations regarding decision-making.Hierdie studie het ondersoek ingestel na die konstrukgeldigheid van die Loopbaanontwikkelingsvraelys en die Loopbaan-besluitneming-selfdoeltreffendheidskaal vir Graad 12 leerlinge van ‘n lae sosio-ekonomiese gebied. Die resultate van bevestigende faktorontledings het ondersteuning gebied vir die konstrukgeldigheid van die twee vraelyste as meetinstrumente van onderskeidelik loopbaanvolwassenheid en loopbaanbesluit-nemingselfdoeltreffendheid.Publisher's versio