bluuebunny/crossref_metadata_2025 huggingface dataset:
Size‐Dependent Female Mate Copying in the Guppy (Poecilia reticulata): Large Females are Role Models but Small Ones are not
Authors: Vukomanovic Jelena , Rodd F. Helen
Published: May 2007

Previous work on guppies has shown that small females copy the mate‐choice decisions of larger females, but not vice versa. We extended this work to ask, when put in a situation where they have little information available to distinguish between males, whether large females will also copy large females, and small females will copy small ones. Using Dugatkin's criteria, our study suggests that large females copy the mate‐choice decisions of large females, that small females might copy the decisions of large females, but that neither small nor large females copy small females. Our results provide support for the notion that females are more likely to copy when they perceive that there is an imbalance between their ability to assess a male's quality and the ability of another female to assess that male. However, we did not find evidence of mate copying using criteria used by other researchers.
Adjustment of Temporal Call Usage During Vocal Exchange of Coo Calls in Japanese Macaques
Authors: Sugiura Hideki
Published: May 2007

Japanese macaques (Macaca fuscata) exchange coo calls with group members to maintain contact. I examined the relationship between the distance between group members and (1) the latency of vocal responses to spontaneous calls, and (2) the latency of spontaneous call repetition in the absence of vocal responses. After a subject monkey's spontaneous call, the latency of vocal response by another group member was longer when the subject was farther from the group members than when the subject was near the group members. Furthermore, subject repeated calls with longer intervals in the absence of vocal response, which suggests that they wait longer for the vocal responses of other group members when the expected response latency is longer. These results reveal that Japanese macaques flexibly alter the timing of their calls based on others’ vocal responses.
Egg Rejection and Brain Size among Potential Hosts of the Common Cuckoo
Authors: Avilés Jesús M. , Garamszegi László Z.
Published: May 2007

Interspecific brood parasitism by the common cuckoo (Cuculus canorus) lowers host fitness, and has selected for discrimination and rejection of parasitic eggs in their commonly parasitized hosts. Cognitive demands needed to discriminate and reject cuckoo eggs may have led to augmentation of relative brain size among passerine hosts parasitized by cuckoos. This hypothesis predicts for across species positive relationships of brain size with rejection rate, host suitability and parasitism level. Here we test these predictions while controlling for phylogenetic, ecological and developmental factors known to affect brain size and egg rejection in a comparative study using the cuckoo and their hosts in Europe as a model system. Contrary to expected the rate of rejection of non‐mimetic cuckoo eggs covaried negatively with relative brain size across bird species. Either suitability as cuckoo host, which reflects long‐time duration of exposure to cuckoo parasitism, and level of parasitism, did not relate to brain size. Our results do not support the hypothesis that cuckoo parasitism was a main direct force affecting brain size variation across passerine hosts.
Regulation of Activity in Desert‐Living Striped Mice: The Importance of Basking
Authors: Schradin Carsten , Krackow Sven , Schubert Melanie , Keller Christina , Schradin Brigitte , Pillay Neville
Published: May 2007

Deserts represent challenging, energy restricted environments for small mammals, but offer ample exposure to sunlight that might be used for energy saving during basking. The Succulent Karoo desert in southern Africa is a seasonal environment with cold moist winters, followed by maximum food availability in spring and dry hot summers with food shortage. The striped mouse (Rhabdomys pumilio) from the Succulent Karoo desert is diurnal and its activity is influenced by photoperiod in captivity. However, in contrast to standardized laboratory conditions, it can be expected that several factors other than photoperiod influence its activity pattern in the field. We expected that striped mice behave in a way that indicates that they use basking to passively warm up and thus reduce endogenous energy expenditure. We studied activity and basking patterns in 56 social groups of striped mice for a period of 4 yr, comprising 1534 observation sessions at their nests. Mice generally started activity around the time the sun illuminated their nest and terminated activity when their nest was no longer sunlit, i.e. they were strictly diurnal. The onset of activity was delayed on days when ambient temperature was colder and when group sizes were smaller. During the breeding season when food availability was high, striped mice usually left the nest before it was sunlit without basking. Outside the breeding season, they emerged and basked in front of nests mainly after nests were sunlit. These findings concur with the view that striped mice trade‐off between active energy gain via foraging and passive energy acquisition by sun basking.
First Documentation of Cultural Transmission of Predator Recognition by Larval Amphibians
Authors: Ferrari Maud C. O. , Messier François , Chivers Douglas P.
Published: May 2007

Predation is a pervasive selective agent shaping a prey's behaviour, morphology and life history. To survive, prey animals have to respond adaptively to predation threats and this can be achieved through learned predator recognition. Cultural transmission of predator recognition is likely a widespread means of learning in social animals, including mammals, birds and fishes. However, no studies have investigated the cultural transmission of predator recognition in amphibians. In our study, we examined whether naïve woodfrog (Rana sylvatica) tadpoles can acquire the recognition of the odour of a predatory tiger salamander (Ambystoma tigrinum) from experienced conspecifics. After conditioning some tutors to recognize salamander odour, we paired naïve observer tadpoles with either a salamander‐naïve or salamander‐experienced tutor and exposed the pairs to either salamander odour or a water control. Observers were subsequently tested alone for a response to salamander odour. We found that when given salamander odour, observer tadpoles that were paired with a salamander‐experienced tutor successfully learned to recognize the salamander odour as a threat, whereas the observers paired with salamander‐naïve tutors did not. Likewise, tadpoles exposed to the water control did not learn to recognize the salamander regardless of whether they were paired with a naïve or experienced tutor. This is the first study demonstrating cultural transmission of predator recognition in an amphibian species.
Ca2+ Cascade and Meiotic Resumption of the Caprine Primary Oocyte
Authors: Zhou HM , Jin SY
Published: May 2007

Contents

In this study, we investigated the fluctuations of concentration of intracytoplasmic free Ca2+ during in vitro maturation of caprine primary oocytes and its role in meiotic resumption. Oocytes that were extracted from caprine ovaries were cultured and allowed to mature in vitro to determine their developmental stages including germinal vesicle (GV), germinal vesicle breakdown (GVBD), metaphase of the first meiotic division (MI) and metaphase of the second meiotic division (MII). Intracytoplasmic free Ca2+ turnovers of caprine oocytes at these different developmental stages were measured using the calcium fluorescent probe Fura‐2/AM (C44H47N3O24) to investigate the dynamics of cytosolic free Ca2+ during in vitro maturation of oocytes and the role of Ca2+ in inducing the initiation of meiotic resumption of oocytes. Moreover, the oocytes were cultured in Ca2+ culture medium and Ca2+‐free culture medium to examine the effect of extracellular Ca2+ on the oocyte maturation. The results indicated that Ca2+ concentrations at GV, GVBD, MI and MII stages were 78.06, 147.41, 126.97 and 97.73 nmol/l, respectively, and that 86.30% of oocytes remained at the GV stage and no oocyte developed to MII in Ca2+‐free culture medium, and 1.1% of oocytes stayed at the GV stage and 83.5% of oocytes developed to MII in Ca2+ culture medium. These results suggest that the occurrence of GVBD and cell cycle progression to MI and MII stages are closely related to Ca2+, and that extracellular Ca2+ performs a specific function for the initiation of meiotic resumption in caprine oocytes.
Heparanase expression in gallbladder carcinoma and its correlation to prognosis
Authors: Wu Wujun , Pan Cheng'en , Yu Haibo , Gong Huilin , Wang Youli
Published: May 2007

Background and Aim:  Heparanase is an endo‐β‐glucuronidase that cleaves heparan sulfate and has been implicated in tumor angiogenesis and metastasis. The present study was to analyze the expression of and explore the prognostic value of heparanase and two important transcriptional factors, namely hypoxia‐inducible factor‐1α (HIF‐1α) and nuclear transcriptional factor kappa B p65 (NF‐κB p65) in gallbladder cancer.

Methods:  Heparanase, HIF‐1α and NF‐κB p65 protein levels in 38 patients with gallbladder carcinoma were detected by immunohistochemistry and analyzed for clinicopathological significance.

Results:  The heparanase, HIF‐1α and NF‐κB p65 proteins were found in 24 (63.2%), 13 (34.2%) and 22 (57.9%) specimens, respectively. High heparanase expression was closely related to advanced TNM stage (P = 0.007), depth of tumor invasion (P = 0.016), lymph node metastasis (P = 0.040) and decreased postoperative survival at 3 years (50.0% vs 20.8%, P = 0.001). Both HIF‐1α and NF‐κB p65 proteins were correlated with tumor size (P = 0.039 and P = 0.027, respectively) and patients positive for HIF‐1α expression had a decreased survival rate compared with those negative for HIF‐1α expression (40.0% vs 15.4%, P = 0.035). In addition, heparanase‐positive cases had high expression of NF‐κB p65 compared with the heparanase‐negative cases (P = 0.047).

Conclusion:  Heparanase and HIF‐1α are frequently expressed in gallbladder carcinoma and are associated with decreased survival. High expression of heparanase, combined with NF‐κB p65, may contribute to the highly invasive and metastatic behavior of gallbladder carcinoma.
Do paediatricians provide brief intervention for adolescents who smoke?
Authors: Milne Bronwyn , Towns Susan
Published: May 2007

Aims:  This study aimed to describe the self‐reported practice of paediatricians in brief interventions for adolescents who smoke. We also aimed to compare practice with confidence, skills and knowledge of brief intervention and nicotine replacement therapy after a targeted training programme.

Methods:  Medical staff at The Children’s Hospital at Westmead completed a questionnaire of clinical practice and confidence in brief intervention for smoking cessation. Data were analysed comparing self‐reported practice with confidence, skill and knowledge of brief interventions, based on Fiore’s 5A’s approach (Ask about smoking at every opportunity, Assess willingness to quit, Advise patients to quit smoking, Assist quit attempts and Arrange follow up).

Results:  Fifty‐seven clinicians completed questionnaires, 55 (96%) recognised the importance of asking adolescents about smoking. Thirty‐one (54%) identified adolescent smokers all or most of the time, increasing to 50 (88%) if their presenting condition was associated with smoking. Twenty‐five (44%) clinicians assessed the stage of change, 33 (58%) advised the adolescent to quit smoking, nine (16%) assisted quit attempts and 10 (17.5%) arranged follow up. Clinicians more confident in brief intervention skills, motivational interviewing and relapse prevention were more likely to use the 5A’s (P < 0.05). Training increased clinician’s confidence in brief intervention skills and knowledge of nicotine replacement therapy (P < 0.01); however, there was no statistically significant change in clinical practice 1 month post training.

Conclusion:  Training paediatricians in brief intervention skills, motivational interviewing and relapse prevention can increase the use of 5A’s brief intervention in clinical practice, potentially increasing quit attempts in adolescents who smoke.
Effect of number of BCG vaccination on tuberculin induration size
Authors: Gundogdu Zuhal , Aydogan Metin , Arisoy Emin Sami , Gokalp Ayse Sevim
Published: May 2007

Aim:  The aim of this study is to interpret purified protein derivative (PPD) induration sizes with respect to the number of Bacillus Calmette–Guérin (BCG) scars.

Methods:  We have considered 1879 school children between the ages of 7 and 14 years from seven primary schools in Kocaeli, Turkey. Children were injected with 5TU 0.1 mL PPD and induration sizes were measured at 72 h. Number of BCG scars, PPD application dates and induration sizes were recorded for each pupil. This study was also evaluated further for 312 households.

Results:  The mean diameter of PPD induration size for 0, 1, 2 and 3 BCG vaccination scars were 1.43 mm (95% confidence interval (CI): 0.84–2.02), 6.39 mm (95% CI: 5.91–6.87), 10.46 mm (95% CI: 10.04–10.88) and 11.35 mm (95% CI: 9.36–13.34), respectively. Furthermore, 90% and 95% percentiles of PPD induration 0, 1, 2 and 3 vaccinations were 10 and 12 mm, 16 and 19 mm, 17 and 19 mm and 19.2 and 20 mm, respectively. There was evidence for a linear trend across from 0 to 3 BCG vaccinations, indicating that mean induration size increases with the number of vaccination scars. The size of indurations directly correlated with the number of vaccination scars, PPD induration size of children with no vaccination scar was quite small and it was generally less than 5 mm.

Conclusion:  This study shows the importance of the number of BCG scars in the determination of PPD induration size limit when tuberculosis infection is evaluated.
Changing pattern of child bicycle injury in the Bay of Plenty, New Zealand
Authors: Moyes Simon A
Published: May 2007

Aim:  To determine if helmet laws and safety campaigns have had an impact on bicycle injuries in children.

Methods:  A comparison of the number of bicycle injuries presented to Whakatane Hospital’s Emergency Department in the period 1982–1986 to the period July 1998–December 2005.

Results:  In the first period there were 597 per 100 000 presentations per annum which increased to 890 per 100 000 per annum in the later period (P < 0.01). Fractures increased from 115 to 234 per 100 000 per annum respectively (P = 0.02). Injuries from a collision with a moving motor vehicle decreased from 72 to 30 per 100 000 per year and of those the proportion of serious head injuries dropped from 65% to 33%. There were four deaths in the earlier period but none in recent years.

Conclusions:  Injuries from bicycle use have increased but there has been a marked reduction in collisions with motor vehicles. This is a result of the changing use of bicycles by children.
Single or double bubble: Sign of trouble! Congenital pyloric atresia: Report of two cases and review of literature
Authors: Parshotam Gera , Ahmed Saeed , Gollow Ian
Published: May 2007

Abstract:  Congenital pyloric atresia is a very rare anomaly. It can occur as an isolated anomaly and can be associated with other conditions such as aplasia cutis congenital/epidermolysis bullosa or multiple intestinal atresias. We present two cases of congenital pyloric atresia, solitary air bubble on X‐ray abdomen being pathognomonic sign of pyloric atresia. However, it might present with an intermittent double bubble sign.
Potentially inappropriate prescribing among Australian veterans and war widows/widowers
Authors: Roughead E. E. , Anderson B. , Gilbert A. L.
Published: May 2007

This study examined the extent of potentially inappropriate medicine, as defined by explicit criteria, dispensed to Australian veterans using the Repatriation Pharmaceutical Benefits Scheme Pharmacy Claims database. Twenty‐one per cent of the 192 363 veterans aged 70 years, with an eligible gold card, were dispensed at least one potentially inappropriate medicine in the first 6 months of 2005. Long‐acting benzodiazepines, amitriptyline, amiodarone, oxybutynin and doxepin were the medicines most commonly implicated. Strategies to support quality prescribing of medicines to the elderly must include a focus on these medicines.
Severe hypoglycaemia after long‐acting octreotide in a patient with an unrecognized malignant insulinoma
Authors: Healy M. L. , Dawson S. J. , Murray R. M. L. , Zalcberg J. , Jefford M.
Published: May 2007

Insulinomas are the most common hormone‐producing pancreatic neuroendocrine tumours (NETs), and patients usually present with symptoms secondary to hypoglycaemia. Octreotide has been widely used in the symptomatic treatment of patients with pancreatic NETs, including insulinomas. We describe a case of a patient with a metastatic NET, subsequently identified as a malignant insulinoma, who developed severe hypoglycaemia after treatment with long‐acting octreotide.
Determinants of ejaculatory dysfunction in a community‐based longitudinal study
Authors: Gan Melanie , Smit Marij , Dohle Gert R. , Bosch J.L.H. Ruud , Bohnen Arthur
Published: May 2007

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVE

To analyse the incidence of ejaculatory dysfunction (EJD) and its associated bother, and to determine which factors predispose to incident EJD.

SUBJECTS AND METHODS

Men aged 50–78 years, registered in the general practices in Krimpen a/d Ijssel, the Netherlands, were recruited. Men were excluded if they had a history of prostatectomy, carcinoma of the bladder or prostate and neurogenic bladder disease. A baseline study and three follow‐up assessments (I‐III), all with questionnaires, i.e. the Benign Prostatic Hyperplasia impact index, International Prostate Symptom Score, International Continence Society (ICS)male sex questionnaire, and additional measurements, e.g. prostate volume, prostate specific antigen, were made at a mean of 2.2‐year intervals. We assessed the objective variables of EJD as the ability to ejaculate, ejaculatory volume, painful ejaculation, and their associated bother (information extracted from the ICSmale sex questionnaire).

RESULTS

At baseline 671 of 1661 (40.4%) men already had EJD; the cumulative incidence of EJD was 16.5%, 24.7% and 33.1% after follow‐up I, II and III, respectively. The mean percentage of men who were bothered with reduced ejaculatory volume or painful ejaculation was 18.3% and 40.6%, respectively. Multivariate analysis showed age, Sickness Impact Profile ‘social’ (questions on social impairment) and erectile dysfunction to be predisposing factors of EJD (P < 0.05 and R2 = 0.048). When EJD was defined as a significantly reduced ejaculatory volume or anejaculation only, age and previous transurethral resection of the prostate (TURP) were determinants of EJD (P < 0.05 and R2 = 0.083). Of the men who had TURP after the follow‐up, 51.6% already had EJD at baseline.

CONCLUSIONS

The cumulative incidence of EJD after 6.5 years of follow‐up was significant (33.1%) and EJD was bothersome, especially in men with painful ejaculation. Determinants of EJD were age, social impairment and erectile dysfunction. Predisposing factors of significant reduction of ejaculatory volume and anejaculation were age and TURP, although 51.6% of men already had EJD before TURP. Age appears to be the most significant predisposing factor of EJD.
The Return to Social Policy and the Persistent Neglect of Unpaid Care
Authors: Razavi Shahra
Published: May 2007

The failure of orthodox economic policies to generate growth and eradicate poverty has led to renewed interest in social policies. The return to ‘the social’ has seen contending conceptualizations of social policy, premised on different values, priorities and understandings of state responsibility, vying for influence. This article argues that the currently dominant agenda of social sector restructuring is likely to entrench gender inequalities in access to social services and income supports because of its failure to recognize the structures that underpin those inequalities, which are pervasive across labour markets and the unpaid care economy. Despite the ‘pro‐poor’ and occasionally ‘pro‐women’ rhetoric, the design of social policies remains largely blind to these gender structures. Addressing them would require a major rethinking of dominant approaches, placing redistribution more firmly at the heart of policy design, valuing and supporting unpaid care, and providing incentives for it to be shared more equally between women and men, and between families/households and society more broadly.
Manufacturing Disorder: Liberalization, Informal Enterprise and Economic ‘Ungovernance’ in African Small Firm Clusters
Authors: Meagher Kate
Published: May 2007

Small enterprise clusters are viewed as an important means of promoting competitive small‐firm development even in contexts of unstable markets and weak states. Yet the emergence of successful enterprise clusters in developing regions of Southern Europe, Asia and Latin America contrasts with their conspicuous absence in Africa. This article challenges ahistorical and culturalist explanations regarding the lack of successful enterprise clusters in Africa through a comparative analysis of three dynamic and increasingly globalized informal manufacturing clusters in two different regions of Nigeria. Focusing on a Muslim Yoruba weaving cluster in the town of Ilorin in south‐western Nigeria, and two Christian Igbo shoe and garment clusters in the town of Aba in south‐eastern Nigeria, this article explores the role of culture, religion and the state in shaping informal economic governance in an African context. An account of the varied and complex history of these Nigerian enterprise networks reveals both their capacity for institutional innovation and economic linkages across ethnic, religious and gender boundaries, as well as their vulnerability to fragmentation and involution in the context of liberalization, state neglect and political opportunism. Far from demonstrating the inadequacies of African cultural institutions, the slide of African entrepreneurial networks into social disorder and economic ‘ungovernance’1 is traced to the destructive impact of neoliberal reforms in a context of poverty and formal institutional exclusion.
Information Technology and Productivity Changes in the Banking Industry
Authors: Casolaro Luca , Gobbi Giorgio
Published: May 2007

This paper analyses the effects of investment in information technologies (IT) in the financial sector using micro‐data from a panel of 600 Italian banks over the period 1989–2000. Stochastic cost and profit functions are estimated allowing for individual banks’ displacements from the best practice frontier and for non‐neutral technological change. The results show that both cost and profit frontier shifts are strongly correlated with IT capital accumulation. Banks adopting IT capital‐intensive techniques are also more efficient. On the whole, over the past decade IT capital‐deepening contribution to total factor productivity growth of the Italian banking industry can be estimated in a range between 1.3 and 1.8 per cent per year.
Supporting Pupils with Dyspraxia in the Visual Arts Does Drawing from Observation Function as an Official and Discriminatory Discourse?
Authors: Penketh Claire
Published: May 2007

This article examines the demands that pupils with dyspraxia may face when engaging with the secondary art and design curriculum in a mainstream secondary school. It explores the possibility that there is an exclusive approach to art and design, prioritising a formalist approach to the teaching of specific skills and mastery of techniques, and considers the implications that this may have for such pupils. Specific attention is paid to the role of observational drawing and the demands that this may make for pupils with dyspraxia. The article will explore existing guidance offered for subject‐based practitioners and aims to contextualise this within the current debates on art and design education and the recollections of individual experiences of art and design. It will outline the hypothesis that pupils with dyspraxia may be one group of pupils amongst many for whom their art and design experience does not offer an inclusive experience, and it seeks to question the existence of a hierarchy of practice and its subsequent relevance.
Recording the Creative Process: An Empirical Basis for Practice‐Integrated Research in the Arts
Authors: Gillham Bill , McGilp Helen
Published: May 2007

A case is made for a form of narrative reporting (the Creative Process Journal) as a methodology for practice‐integrated research in the arts. It is argued that this stage of research creativity, which applies in all domains of academic study but is often not reported, is fundamental to the kind of arts research which allocates practice a central role. The practical and technological character of making a CPJ, and its consequent benefits to the maker‐researcher are outlined.
Provoking Points of Convergence: Museum and University Collaborating and Co‐evolving
Authors: Kalin Nadine , Grauer Kit , Baird Jill , Meszaros Cheryl
Published: May 2007

This article outlines art education courses undertaken in museum and gallery contexts as a component of the Certificate Programme in Visual and Material Culture within the University of British Columbia's Department of Curriculum Studies. With the creation of this programme and through the forging of relationships with area museums, unique ways have evolved for graduate students from diverse areas of education and art teacher education candidates to interact with works of art, museum professionals, artists, and the museum space itself. The purpose of these courses is to use museum and gallery settings as sites to test ideas, critique educational programmes, and advance new approaches for teachers to use museums in more creative and integrated ways in their teaching while expanding theoretical knowledge and interpretive repertoires. Through participating in this collaborative venture we have learned that when you invite teachers into museums, make efforts to increase their comfort within these spaces, while recognising what interpretive insights they offer as active participants in museum discourses, points of convergence between teachers, universities, and museums are formed.
Preferences of patients, doctors, and nurses regarding wound dressing characteristics: A conjoint analysis
Authors: Vermeulen Hester , Ubbink Dirk T. , De Zwart Femke , Goossens Astrid , De Vos Rien
Published: May 2007

The different choices doctors, nurses, and patients make regarding wound dressing materials are generally based on personal preferences, because strong evidence and guidelines on local wound care for open wounds are lacking. We studied which attributes of a wound dressing doctors, nurses, and patients consider the most important. A conjoint analysis questionnaire comprising paper‐based descriptions with six attributes, and questions regarding the willingness‐to‐pay for these attributes were sent out to surgical patients, (assistant)‐surgeons and nurses. Preferences for wound dressing attributes were similar for doctors (n=50), nurses (n=150), and patients (n=74). Pain during dressing changes, duration of hospitalization, and wound healing time were ranked highest. Doctors would spend more money on a shorter hospitalization, nurses on pain reduction, and patients on quicker wound healing. Patients were willing to pay a relatively small monthly amount out of pocket for a dressing that would result in a quicker and less‐painful wound healing. Doctors, nurses, and patients prefer similar attributes of wound dressing materials, but differ in their willingness‐to‐pay. To achieve a more consistent local wound care, clinical decision‐making should be in accordance with these preferences. These should also be the focus for manufacturers and researchers to obtain more evidence on which materials best match these attributes.
Alteration of Smad3 signaling in ischemic rabbit dermal ulcer wounds
Authors: Kloeters Oliver , Jia Sheng‐Xian , Roy Nakshatra , Schultz Gregory S. , Leinfellner Gabrielle , Mustoe Thomas A.
Published: May 2007

Impaired reepithelialization is a hallmark of chronic, ischemic wounds; however, the pathogenesis of the delayed reepithelialization in these wounds remains poorly understood. Transforming growth factor β is involved in both the normal and hypoxic wound‐healing response and exogenous overexpression of Smad3, which has been known to accelerate reepithelialization. Recently, it was shown in the rabbit ear dermal ulcer model that Ad‐Smad3 injection enhanced reepithelialization and granulation tissue formation suggesting a positive effect of Smad3 on wound healing. However, little is known about the role of Smad3 in the ischemic wound healing process. In this study, we examined the effect of Smad3 in an ischemic wound model. Ad‐Smad3 or Ad‐LacZ (108 pfu/wound) was injected into either ear of white New Zealand rabbits. Twenty‐four hours later, these ears were rendered ischemic using an established model, and four 7 mm full‐thickness punch wounds were made on each ear. Histological evaluation showed a significant increase in reepithelialization parameters in Ad‐Smad3–transfected wounds (p<0.01). In contrast, granulation tissue parameters were not affected by Smad3 in ischemia. Smad4 and Smad7 mRNA‐expression was not affected by Smad3 overexpression. Connective tissue growth factor protein was up‐regulated under ischemic conditions but was unaffected by Smad3 transfection in both ischemic and nonischemic wounds. Our results suggest an enhancing effect of Smad3 on reepithelialization in an ischemic wound model that, in turn, might provide novel therapeutic options. Furthermore, the lack of alteration of Smad‐dependent intermediates by Smad3 overexpression suggests the activation of Smad‐independent pathways in ischemia.
Fibrin‐embedded administration of VEGF plasmid enhances skin flap survival
Authors: Michlits Wolfgang , Mittermayr Rainer , Schäfer Romana , Redl Heinz , Aharinejad Seyedhossein
Published: May 2007

The aim of the present study was to experimentally evaluate whether topical fibrin‐mediated administration of a vascular endothelial growth factor (VEGF)‐A plasmid to the wound bed can protect skin flaps from necrosis. A plasmid expression vector containing the VEGF‐A cDNA was constructed. The plasmid was then administered to the wound bed of rat abdominal skin flaps in a fibrin sealant. The percentage of viable, ischemic and necrotic tissue was assessed postoperatively as a baseline and after 3 and 7 days using digital surface area morphometry. Laser Doppler imaging of the flaps and VEGF‐A Western blot analysis of flap tissue were performed to assess angiogenesis and VEGF‐A tissue levels. Flaps treated with VEGF plasmids in the presence of uptake enhancing Lipofectamine transfection reagent increased flap survival 7 days postoperatively significantly associated with markedly elevated tissue perfusion and enhanced tissue VEGF‐A protein expression. Our results indicate that topical fibrin‐mediated administration of a VEGF‐A plasmid may serve as an alternative to previous strategies in treating ischemic skin flaps. The suggested therapeutic approach is easily applicable and inexpensive in preparation. Thus, this protocol may also enhance wound healing in posttrauma skin lacerations or in skin grafts.
Basic fibroblast growth factor in an artificial dermis promotes apoptosis and inhibits expression of α‐smooth muscle actin, leading to reduction of wound contraction
Authors: Akasaka Yoshikiyo , Ono Ichiro , Tominaga Akihiro , Ishikawa Yukio , Ito Kinji , Suzuki Takeya , Imaizumi Risa , Ishiguro Shigeki , Jimbow Kowichi , Ishii Toshiharu
Published: May 2007

To clarify the mechanisms underlying declines in wound contraction caused by basic fibroblast growth factor (bFGF) and the role of autologous fibroblasts in modulating wound healing, we have examined the expression of α‐smooth muscle actin (α‐SMA) and apoptosis in a model of wound healing using collagen sponges with and without bFGF (1 μg) and/or fibroblasts (1 × 106 cells/cm2) applied to experimentally produced full‐thickness skin wounds in rats (n=10 for each group). At 7 days postoperatively, wounds filled with a fibroblast‐seeded collagen sponge (fibroblast‐seeded group) displayed a greater area of collagen sponge and a smaller area of fibroblasts compared with control wounds filled with collagen sponge alone (control group). Therefore, seeding of fibroblasts in the dermal substitute might retard degradation of the collagen sponge, inhibiting fibroblast infiltration into the substitute. By day 14, wounds filled with bFGF‐treated collagen sponge without fibroblast seeding (bFGF group) displayed decreased α‐SMA expression and significantly increased apoptosis compared with other wounds. Double staining revealed that apoptosis in α‐SMA‐positive fibroblastic cells was significantly increased in the bFGF group, suggesting that bFGF treatment is a potent stimulator of myofibroblast apoptosis. Furthermore, morphometric analysis demonstrated the significant decrease in the level of wound contraction and the degree of mature collagen bundle formation in the bFGF group by day 42. The bFGF group also showed increased bFGF expression in macrophages by day 28. These results suggest that bFGF administration to an artificial dermis promotes apoptosis of α‐SMA‐positive fibroblastic cells and inhibits α‐SMA expression in the treated wound, thus reducing wound contraction.
Differential regulation of free‐floating collagen gel contraction by human fetal and adult dermal fibroblasts in response to prostaglandin E2 mediated by an EP2/cAMP‐dependent mechanism
Authors: Parekh Aron , Sandulache Vlad C. , Lieb Audrey S. , Dohar Joseph E. , Hebda Patricia A.
Published: May 2007

In contrast to fetal wound healing, dermal adult wound healing results in imperfect repair and scar formation. Fibroblasts are responsible for the contraction and remodeling of the wound matrix, which is influenced by inflammatory mediators including prostaglandin E2 (PGE2). This study addresses the mechanism by which PGE2 regulates contraction of collagen gels by human fetal and adult dermal fibroblasts. We hypothesized that the intrinsic phenotypic properties of the two types of fibroblasts and their responses to PGE2 alter their contraction properties and contribute to different wound healing outcomes. Contraction was evaluated using free‐floating fibroblast‐populated collagen gels that contract by migratory forces. PGE2 was found to differentially inhibit collagen gel contraction by fetal and adult fibroblasts. This effect was mimicked by a specific PGE2 receptor agonist as well as by two pharmacological agents, indicating a cyclic adenosine monophosphate‐dependent signaling pathway mediated through the EP2 receptor. Our results indicate that fetal fibroblast contraction is maintained by a more stable actin cytoskeleton. Therefore, the migratory phenotype may be sufficient for physical remodeling of the wound matrix leading to regenerative repair. Maintenance of this phenotype in the later stages of wound healing could potentially be achieved by targeting cyclic adenosine monophosphate via the EP2 receptor.
Inhibition of osteogenic differentiation of human mesenchymal stem cells
Authors: Moioli Eduardo K. , Hong Liu , Mao Jeremy J.
Published: May 2007

Mesenchymal stem cells (hMSCs) have been shown to differentiate into osteoblasts that, in turn, are capable of forming tissues analogous to bone. The present study was designed to investigate the inhibition of osteogenesis by hMSCs. Bone marrow‐derived hMSCs were treated with transforming growth factor β‐3 (TGFβ3) at various doses during or after their differentiation into osteogenic cells. TGFβ3 was encapsulated in poly(dl‐lactic‐co‐glycolic acid) (PLGA) microspheres and released via controlled delivery in the osteogenic culture of hMSCs and hMSC‐derived osteoblasts for up to 28 days. Controlled release of TGFβ3 inhibited the osteogenic differentiation of hMSCs, as evidenced by significantly reduced alkaline phosphatase activity and staining, as well as decreased mineral deposition. After hMSCs had been differentiated into osteoblasts, controlled release of TGFβ3 further inhibited not only alkaline phosphatase and mineral deposition but also osteocalcin expression. These findings demonstrate the potential for sustained modulation of the behavior of stem cells and/or stem cell‐derived lineage‐specific cells via controlled release of growth factor(s). The attenuation of osteogenic differentiation of MSCs may facilitate understanding not only the regulation and patterning of osteogenesis in development but also several pathological models such as osteopetrosis, craniosynostosis, and heart valve calcification.
A Statewide Primary Care Approach to Cardiovascular Risk Factor Control in High‐Risk Diabetic and Nondiabetic Patients With Hypertension
Authors: Basile Jan N. , Lackland Daniel T. , Basile Jeffrey M. , Riehle Jessica E. , Egan Brent M.
Published: May 2007

Patients with multiple cardiovascular risk factors benefit from having them all controlled, but this rarely occurs. Fifty‐seven primary care providers were enrolled in a program to monitor cardiovascular risk factor control. Data were obtained on 7315 hypertensives. This analysis focuses on 3460 high‐risk hypertensives including 2199 with diabetes and 1261 with clinical cardiovascular disease. Blood pressures were <140/90 mm Hg and <130/80 mm Hg in only 44.3% and 20.4% of diabetics and 49.6% and 26.6% nondiabetics, respectively, despite the use of an average of 2.7±1.8 anti‐hypertensive medications. Among high‐risk dyslipidemic hypertensives, the low‐density lipoprotein cholesterol level was <100 mg/dL in only 34% of diabetic and 33% of nondiabetic patients. Among 1696 diabetic hypertensives, the most recent glycosylated hemoglobin value averaged 7.5%, with 46.6% less than 7%. Among 805 diabetic, dyslipidemic hypertensives, all three risk factors were controlled to goal in only 6.6% with higher rates in whites than in African Americans (14.8% vs. 1.6%, p<0.001). An angiotensin‐converting enzyme inhibitor, angiotensin receptor blocker, or both were prescribed in 89.9% of diabetic and 70.8% of nondiabetic patients, p<0.05. Primary care providers use evidence‐based combination therapy in high‐risk hypertensive patients with and without diabetes. These findings confirm the low rates of multiple risk factor control and highlight challenges of reaching evidence‐based goals in primary care.
Abdominal Aortic Aneurysm
Authors: Prisant L. Michael , Mondy J. Sheppard
Published: May 2007

An abdominal aortic aneurysm (AAA) is defined as a localized dilation of the artery that is 1.5 times the diameter of the normal segment. The most common location for an aortic aneurysm is the infrarenal segment where a diameter that exceeds 3 cm in diameter is considered aneurysmal. Duplex ultrasonography and spiral computerized tomography are the imaging modalities most commonly performed to detect the longitudinal and transverse diameter of the aorta. The prevalence of AAA may be increasing. Smoking, male gender, and increasing age are the most powerful predictors of AAA. Considering the higher prevalence of hypertension, it is surprising that the prevalence of AAA among African‐American men is 39% less than white men. The risk of rupture is independently associated with female gender, large initial aneurysm diameter, lower forced expiratory volume in the first second, current smoking, and higher mean blood pressure. Inflammation rather than atherosclerosis may be essential to the development of AAA. Treatment is directed at smoking cessation and control of blood pressure and lipids. Beta blockers (propranolol) have not been shown to modify aneurysm growth rates, but drop out rates in the studies have been high. Antibiotics do show a modest benefit. Surgery is generally performed when the aneurysm exceeds 5.5 cm in men. For women, an AAA size between 4.5 cm and 5.0 cm is recommended for elective repair.
Angiotensin‐Converting Enzyme Inhibitors Side Effects—Physiologic and Non‐Physiologic Considerations
Authors: Sica Domenic A.
Published: May 2007

Angiotensin‐converting enzyme (ACE) inhibitors are increasingly recognized as having an important role in the treatment of hypertension and/or end‐organ disease. The sheer number of ACE inhibitors in the United States—now numbering 10 different chemical entities—has created a sense of comfort with these compounds, which is particularly evident when these compounds are used in the patient with essential hypertension; conversely, when comorbid conditions are present in the ACE inhibitor‐treated patient, circumstances change and physician vigilance becomes more of a necessity. ACE inhibitor therapy in patients with either cardiac and/or renal disease is as much an art as it is a science, and even in the most skilled hands can prove a challenging undertaking. This review discusses the physiologic and non‐physiologic basis for side effects with ACE inhibition.
Coarctation of the Aorta: A Secondary Cause of Hypertension
Authors: Prisant L. Michael , Mawulawde Kwabena , Kapoor Deepak , Joe Clarence
Published: May 2007

Coarctation of the aorta is a constriction of the aorta located near the ligamentum arteriosum and the origins of the left subclavian artery. This condition may be associated with other congenital disease. The mean age of death for persons with this condition is 34 years if untreated, and is usually due to heart failure, aortic dissection or rupture, endocarditis, endarteritis, cerebral hemorrhage, ischemic heart disease, or concomitant aortic valve disease in uncomplicated cases. Symptoms may not be present in adults. Diminished and delayed pulses in the right femoral artery compared with the right radial or brachial artery are an important clue to the presence of a coarctation of the aorta, as are the presence of a systolic murmur over the anterior chest, bruits over the back, and visible notching of the posterior ribs on a chest x‐ray. In many cases a diagnosis can be made with these findings. Two‐dimensional echocardiography with Doppler interrogation is used to confirm the diagnosis. Surgical repair and percutaneous intervention are used to repair the coarctation; however, hypertension may not abate. Because late complications including recoarctation, hypertension, aortic aneurysm formation and rupture, sudden death, ischemic heart disease, heart failure, and cerebrovascular accidents may occur, careful follow‐up is required.
Aortic Calcification Is Associated With Age and Sex but Not Left Ventricular Mass in Essential Hypertension
Authors: Tsakiris Alexandros , Doumas M. , Nearchos N. , Mavrokefalos A. , Mpatakis N. , Skoufas P.
Published: May 2007

The aim of this study was to investigate the prevalence of aortic calcification in patients with essential hypertension and its relationship with age, sex, and left ventricular hypertrophy. Two hundred ninety consecutive patients with essential hypertension were studied. A chest radiograph and an echocardiograph were performed. Aortic calcification was observed in 74/290 (25.5%) patients. Patients with calcification were mostly female (67.6%) and older (71.8±1.9 years), whereas patients without calcification were younger (59.0±0.79) and of both sexes (51.85% female). Left ventricular mass index in male patients with aortic calcification was 147.3±4.32 g/m2 and without calcification was 132.7±2.28 g/m2 (p=0.023). Female patients' values were 131.9±4.32 g/m2 with calcification and 121.2±2.85 g/m2 without calcification (p=0.025). Left ventricular mass was independently associated with age and sex but not with aortic calcification. The prevalence of aortic calcification in essential hypertension is considerably higher compared to the general population. Essential hypertension and age seem to contribute to the concurrent appearance of aortic calcification and increased left ventricular mass.
Hypertension and the Elderly: More Than Just Blood Pressure Control
Authors: Baruch Lawrence
Published: May 2007

Hypertension is a major risk factor for cardiovascular disease in both young and elderly persons; therefore, good blood pressure control is at the center of improved cardiovascular health. The recently issued seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the European Society of Hypertension/European Society of Cardiology 2003 guidelines for hypertension management emphasize the importance of treatment efficacy rather than age in treating elderly persons with hypertension. Most hypertension clinical trials have been carried out with younger hypertensives, but this is changing with trials such as the Systolic Hypertension in the Elderly Program, the first Swedish Trial of Old Patients With Hypertension, and the Systolic Hypertension in Europe trial. These trials have clearly demonstrated the benefits of good blood pressure control in reducing the risk of stroke in elderly persons. With many safe and effective antihypertensive drugs on the market, the question becomes how elderly persons should be treated. Elderly patients often have isolated systolic hypertension, which is related to loss of arterial elasticity or compliance with aging and is more recalcitrant to treatment than essential hypertension. In addition, with advancing age there is the likelihood that other disease states are present in addition to hypertension. The newer antihypertensive drugs that interfere with the renin angiotensin system, such as angiotensin‐converting enzyme inhibitors and angiotensin‐receptor blockers, have the potential of improving cardiovascular outcomes in elderly persons in addition to offering effective blood pressure reduction. Their use should be considered within a comprehensive risk assessment that includes individualized risk‐benefit considerations.
Treatment of Hypertension in the Elderly
Authors: Pickering Thomas G.
Published: May 2007

The aging of the United States population means that treatment of hypertension in the elderly is becoming an increasingly important issue, and the pathophysiology, consequences, and benefits of treatment are quantitatively different in older and younger people. There are several issues to be addressed, which include the significance of pulse pressure as a risk factor, the reliability of measurement of blood pressure in the elderly, choice of drugs and lifestyles, and management of the very old.
Antihypertensive Utility of Perindopril in a Large, General Practice‐Based Clinical Trial
Authors: Julius Stevo , Cohn Jay N. , Neutel Joel , Weber Michael , Turlapaty Prasad , Shen Yannan , Dong Victor , Batchelor Alicia , Lagast Hjalmar
Published: May 2007

The authors evaluated, in a community‐based open‐label trial, the effectiveness and safety of perindopril in 13,220 US hypertensive patients and studied how physicians adhere to hypertension treatment guidelines. Patients received perindopril 4 mg q.d. for 6 weeks. Based on physicians' perception of blood pressure response, the patient was either maintained on 4 mg or the dose was increased to 8 mg for an additional 6 weeks. From baseline to week 12, the mean sitting blood pressure significantly declined from 156.9/94.5 mm Hg to 139.2/84.0 mm Hg. Further dose titration resulted in a clinically significant reduction in blood pressure in all patients with inadequate response on 4 mg at week 6. Blood pressure control (<140/<90 mm Hg) was achieved at 12 weeks in 48.8% patients. The subpopulation analyses demonstrated that perindopril monotherapy was effective in both men and women, in patients of all ethnicities, and in patients <65 and ≥65 years of age. Perindopril was safe and well tolerated in all hypertensive subgroups including high‐risk patients. Physicians were more attuned to controlling diastolic than systolic blood pressure, and their adherence to the treatment guidelines was found to be not optimal.