bluuebunny/crossref_metadata_2025 huggingface dataset:
Consistency and change in the repeated narratives of Holocaust survivors
Authors: Schiff Brian , Skillingstead Heather , Archibald Olivia , Arasim Alex , Peterson Jenny
Published: September 2007

In this article, we study the oral history interviews of eight survivors of Auschwitz-Birkenau. We give a detailed analysis of a central narrative in their life story, the “selection narrative,” the experience of being forcibly separated from family into groups for labor or death, as it is told in the late 1970s-to-early 1980s and again in the 1990s. We study patterns of structure and variation in the referential aspects of narrative, how narratives recapitulate past actions, and the evaluative aspects of narrative, how narratives are interpreted. Our analysis of these eight sets of repeated narratives focuses on four processes that help structure consistent accounts over time: the past, previous tellings, culture and the interview situation. In each set of repeated narratives, the selection narrative maintains significant portions of the complicating action and evaluations over time. At the same time, various changes are evident that alter the style or interpretation of the narrative. In other words, changes were, in large measure, observed in “how” or “why” the narrative was told but not in “what” was recounted. Our data suggests that despite changes in context, critical aspects of our identities endure over long periods of time.
Lexically-based terminology structuring
Authors: Grabar Natalia , Zweigenbaum Pierre
Published: September 2007

Terminology structuring has been the subject of much work in the context of terms extracted from corpora: given a set of terms, obtained from an existing resource or extracted from a corpus, it consists in identifying hierarchical (or other types of) relations between these terms. The present work aims at assessing the feasibility of such structuring by studying it on an existing hierarchically structured terminology. Our overall goal is to test various structuring methods proposed in the literature and to check how they fare on this task. The specific goal at the present stage of our work, which we report here, is focussed on lexical methods that match terms on the basis on their content words, taking morphological variants and synonyms into account. We describe experiments performed on the French version of the US National Library of Medicine MeSH thesaurus. We compare the lexically-induced relations with the original MeSH relations and measure recall and precision metrics, taking two different views on the task: relation recovery and term placement. This method proposes correct term placement for up to 26% of the MeSH concepts, and its precision can reach 58%. After this quantitative evaluation, we perform a qualitative, human analysis of the ‘new’ relations not present in the MeSH. This analysis shows, on the one hand, the limits of the lexical structuring method. On the other hand, it reveals some specific structuring choices and naming conventions made by the MeSH designers, and emphasizes ontological commitments that cannot be left to automatic structuring.
Alignment and extraction of bilingual legal terminology from context profiles
Authors: Kwong Oi Yee , Tsou Benjamin K. , Lai Tom B. Y.
Published: September 2007

In this study, we propose a method for aligning terms and extracting translations from a small, domain-specific corpus consisting of parallel English and Chinese court judgments from Hong Kong. With a sentence-aligned corpus, translation equivalents are suggested by analysing the frequency profiles of parallel concordances. The method overcomes the limitations of conventional statistical methods which require large corpora to be effective, and those of lexical approaches which depend on existing bilingual dictionaries. Pilot testing on a parallel corpus of about 113K Chinese words and 120K English words gives an encouraging 79% precision and 38% recall on average. The method has its own limitations such as failure to detect multiple candidates and secondary translations, but it provides a good basis for acquiring an initial translation lexicon for legal terminology from indigenous bilingual legal texts.
Question terminology and representation for question type classification
Authors: Tomuro Noriko
Published: September 2007

Question terminology is a set of terms which appear in keywords, idioms and fixed expressions commonly observed in questions. This paper investigates ways to automatically extract question terminology from a corpus of questions and represent them for the purpose of classifying by question type. Our key interest is to see whether or not semantic features can enhance the representation of strongly lexical nature of question sentences. We compare two feature sets: one with lexical features only, and another with a mixture of lexical and semantic features. For evaluation, we measure the classification accuracy made by two machine learning algorithms, C5.0 and PEBLS, by using a procedure called domain cross-validation, which effectively measures the domain transferability of features.
Australian Schizophrenia Care and Assessment Programme: Real-World Schizophrenia: Economics
Authors: Fitzgerald Paul B. , Montgomery William , de Castella Anthony R. , Filia Kate M. , Filia Sacha L. , Christova Laura , Jackson Dan , Kulkarni Jayashri
Published: September 2007

Objective: The treatment of patients with schizophrenia consumes a considerable proportion of health service budgets, yet there have been few attempts to prospectively analyse the costs associated with this condition. Amid the current debate about where to invest scarce treatment resources to achieve optimal outcomes, real-world studies, such as the Schizophrenia Care and Assessment Programme (SCAP) contrast with hypothetically based models and provide comprehensive and broad-ranging data.

Method: Direct health-care costs were prospectively studied in a cohort of 347 patients with schizophrenia in Dandenong, Australia over 3 years. Indirect costs were estimated from patient self-reported information.

Results: The average annual societal cost was AU$32 160 per participant in the first year of the study, AU$27 190 in the second year and AU$29 181 in the third year. Indirect costs accounted for 46% of the total costs in the first year, 52% of the total costs in the second year and 50% of the total costs in the third year. The most expensive component of treatment was inpatient hospital care, which accounted for 42%, 34% and 36% of the total costs in the first, second and third year, respectively.

Conclusions: Considerable resources are required for the provision of treatment for patients with schizophrenia. But for the majority of people in this cohort, funding assertive treatment programmes and measures to reduce hospitalization was accompanied with enhanced functioning and quality of life, as well as a reduction in long-term societal and government costs. The distribution of health-care costs is highly skewed, with a relatively small proportion of patients (39%) consuming the majority of resources (80%). Improving rates of employment for this patient group could hold substantial benefits in reducing the overall economic and personal impact of this disorder.
Reflections on Masculinity, Culture and the Diagnosis of Depression
Authors: Mellsop Graham , Smith Barry
Published: September 2007

Objective: To inform the debate on the relationship between gender and depression by examining clinicians’ ratings on selected HoNos items in two cultural groups.

Method: Scores on items 1 (overactivity/aggression) and 2 (depression) as recorded by clinicians in the CAOS study of more than 12,000 unselected New Zealand psychiatric service users were analysed by gender and self identified ethnicity.

Results: The lowest ratings for depression and highest for overactivity/agression were assigned to Maori males. Female Maori, were rated next, followed by male non-Maori. Female non-Maori were rated highest on depression and lowest on overactivity/agression.

Conclusions: Amongst the hypotheses to explain these findings are those relating to service utilization, rater bias, criteria bias, and cultural pathoplastic effects. These questions need answers.
Commuting Inequality between Cars and Public Transit: The Case of the San Francisco Bay Area, 1990-2000
Authors: Kawabata Mizuki , Shen Qing
Published: September 2007

Equity in access to opportunities is increasingly recognised as an essential component of sustainable development and transport. This study presents a spatial and temporal examination of commuting inequality between cars and public transit in the San Francisco Bay Area. Results visualised in the maps show considerable inequality and temporal changes in job accessibility and commuting time between cars and public transit as well as among locations within the metropolitan area. Results from OLS and spatial regression models indicate that, in both 1990 and 2000, greater job accessibility was significantly associated with shorter commuting time for driving alone as well as for public transit, but the degree of this association was considerably greater for public transit than for driving alone. Urban and transport development that enhances mobility and accessibility for public transit relative to cars should be strongly encouraged.
Intrametropolitan Employment Structure: Polycentricity, Scatteration, Dispersal and Chaos in Toronto, Montreal and Vancouver, 1996-2001
Authors: Shearmur Richard , Coffey William , Dube Christian , Barbonne Rémy
Published: September 2007

There is little consensus on where and how employment is decentralising in metropolitan areas. However, a number of key processes have been brought to light, and different cities have tended to display different processes: strong CBDs, suburban polynucleation, job dispersal, scattering, edgeless cities and perhaps 'keno capitalism'. This paper explores the distribution and growth of employment at a fine spatial scale. It is shown that, at this scale, there are very dynamic processes of growth and decline throughout metropolitan areas, but that these processes are organised at a wider scale by stable employment centres and by links between these centres. The structures and processes thus revealed suggest that the spatial economy of metropolitan areas should be approached as a chaotic system. From an empirical perspective, this means that, depending on the scale of analysis and the way data are considered, polynucleation, dispersal and chaos are all observed: this may partly explain the lack of consensus in the literature. The only process not evident within Canadian cities is scattering, but this process may in fact be occurring within some areas identified as suburban employment zones.
London's and New York's Advertising and Law Clusters and their Networks of Learning: Relational Analyses with a Politics of Scale?
Authors: Faulconbridge James R.
Published: September 2007

A preoccupation in cluster literatures has been with theorising the way learning occurs and knowledge is produced. Studies have highlighted the complementary local and global learning networks involved. This paper engages with this debate through empirical examination of the networks of learning that exist within and between the clusters of advertising and law firms in London and New York. Based on data gained from interviews, the paper shows that existing literatures excessively devalue and differentiate local versus global learning networks, ignoring the ways the organisation and nature of learning and knowledge production at local and global scales can be similar and equally valuable. It therefore suggests using relational conceptualisations to understand and describe translocal relational learning networks. It also shows, however, that a politics of scale influences the behaviours of actors in these networks, suggesting that recent calls to jettison scale completely from geographers' analytical toolkits might be too hasty.
Does Walking in the Neighbourhood Enhance Local Sociability?
Authors: du Toit Lorinne , Cerin Ester , Leslie Evie , Owen Neville
Published: September 2007

The walkability of urban neighbourhoods has emerged as a strong component in policy and design models for active, liveable communities. This paper examines the proposition that more walkable neighbourhoods encourage local social interaction, a sense of community, informal social control and social cohesion; and that the relationship is explained by walking for transport or for recreation. Multilevel analyses of data from an Australian sample showed a modest association between the walkability of a neighbourhood and sense of community only. Walking for transport, but not recreation, mediated this relationship although the effect was small. These results support contentions that 'walkability' is more complex than usually defined and that factors influencing neighbourhood sociability extend beyond issues of urban form.
How to Turn a Beggar into a Bus Stop: Law, Traffic and the 'Function of the Place'
Authors: Blomley Nicholas
Published: September 2007

A review of recent Canadian case law on the constitutionality of legal controls on begging reveals the importance of an unacknowledged view of space and behaviour that I call the traffic code. The paper endeavours to take this code seriously, unpacking its logic and scope. In particular, it explores its legal effects, noting that it deflects rights-based arguments on behalf of the public poor. Its emphasis upon space, use and behaviour appears to be not only illiberal, but curiously aliberal, operating without reference to rights. It is suggested, however, that it may in fact rely upon some deeply liberal notions of rights and space. This, perhaps, allows for a rights-based critique of the traffic code. This, and other possibilities for challenges to the traffic code, are explored in the conclusion.
Human Skin in Organ Culture and Human Skin Cells (Keratinocytes and Fibroblasts) in Monolayer Culture for Assessment of Chemically Induced Skin Damage
Authors: Varani James , Perone Patricia , Spahlinger Diana M. , Singer Lisa M. , Diegel Kelly L. , Bobrowski Walter F. , Dunstan Robert
Published: September 2007

Human skin cells (epidermal keratinocytes and dermal fibroblasts) in monolayer culture and human skin in organ culture were exposed to agents that are known to produce irritation (redness, dryness, edema and scaly crusts) when applied topically to skin. Among the agents used were three well accepted contact irritants (i.e., all-trans retinoic acid [RA], sodium lauryl sulfate [SLS] and benzalkonium chloride) as well as the corrosive organic mercury compound, aminophenyl mercuric acetate (APMA), and 5 contact sensitizers (oxazolone, nickel sulfate, eugenol, isoeugenol and ethylene glycol dimethacrylate [EGDM]). As a group, the contact irritants (including the corrosive mercuric compound) were cytotoxic for keratinocytes and fibroblasts and suppressed growth at lower concentrations than the contact sensitizers. The contact irritants also produced histological changes (hyperplasia, incomplete keratinization, loss of the granular layer, acantholysis and necrosis) in organ-cultured skin at dose levels at which the contact sensitizers appeared to be inert. Finally, the profile of secreted molecules from organ-cultured skin was different in the presence of contact irritants versus contact sensitizers. Taken together, these data suggest that the use of organ-cultured skin in conjunction with cells derived from the skin in monolayer culture may provide an initial approach to screening agents for deleterious changes in skin.
Dose-Dependent Effects of Sertoli Cell Toxicants 2,5-Hexanedione, Carbendazim, and Mono-(2-ethylhexyl) phthalate in Adult Rat Testis
Authors: Moffit Jeffrey S. , Bryant Bronwyn H. , Hall Susan J. , Boekelheide Kim
Published: September 2007

Sertoli cells are the primary cellular target for a number of pharmaceutical and environmental testicular toxicants, including 2,5-hexanedione, carbendazim, and mono-(2-ethylhexyl) phthalate. Exposure to these individual compounds can result in impaired Sertoli cell function and subsequent germ cell loss. The loss of testicular function is marked by histopathological changes in seminiferous tubule diameter, seminiferous epithelial sloughing, vacuolization, spermatid head retention, germ cell apoptosis, and altered microtubule assembly. The present study investigates dose-response relationships for these classic Sertoli cell toxicants using histopathology endpoints. Understanding the relationship between the Sertoli cell toxicant dose and its histopathologic manifestations will help establish the sensitivity of these endpoints as markers of testicular injury. The results indicate that no single histopathology endpoint was sensitive on its own in identifying altered testicular morphology resulting from toxicant exposure. However, when multiple endpoints were combined dose-response relationships could be associated with incremental alterations in histopathology. The data generated from these experiments will be useful in further investigating the effects of Sertoli cell toxicant exposure in animal toxicity studies. In addition, this work is fundamental to a planned investigation of the histopathologic and gene expression changes associated with testicular toxicant co-exposures, which may occur both occupationally and environmentally.
An Immunohistochemical Approach to Differentiate Hepatic Lipidosis from Hepatic Phospholipidosis in Rats
Authors: Obert Leslie A. , Sobocinski Gregg P. , Bobrowski Walter F. , Metz Alan L. , Rolsma Mark D. , Altrogge Douglas M. , Dunstan Robert W.
Published: September 2007

Hepatocellular vacuolation can be a diagnostic challenge since cytoplasmic accumulations of various substances (lipid, water, phospholipids, glycogen, and plasma) can have a similar morphology. Cytoplasmic accumulation of phospholipids following administration of cationic amphiphilic drugs (CAD) can be particularly difficult to differentiate from nonphosphorylated lipid accumulations at the light microscopic level. Histochemical methods (Sudan Black, Oil Red-O, Nile Blue, etc.) can be used to identify both nonphosphorylated and/or phosphorylated lipid accumulations, but these techniques require non-paraffin-embedded tissue and are only moderately sensitive. Thus, electron microscopy is often utilized to achieve a definitive diagnosis based upon the characteristic morphologic features of phospholipid accumulations; however, this is a low throughput and labor intense procedure. In this report, we describe the use of immunohistochemical staining for LAMP-2 (a lysosome-associated protein) and adipophilin (a protein that forms the membrane around non-lysosomal lipid droplets) to differentiate phospholipidosis and lipidosis, respectively in the livers of rats. This staining procedure can be performed on formalin-fixed paraffin embedded tissues, is more sensitive than histochemistry, and easier to perform than ultrastructural evaluation.
Are Violent Video Games Harmful?
Authors: Porter Guy , Starcevic Vladan
Published: September 2007

Objective: The aim of this paper is to revisit the controversial issue of the association of violent video games and aggressive behaviour.

Conclusions: Several lines of evidence suggest that there is a link between exposure to violent video games and aggressive behaviour. However, methodological shortcomings of research conducted so far make several interpretations of this relationship possible. Thus, aggressive behaviour may be a consequence of playing violent video games, an expression of hostile traits that existed before exposure to these games, and/or it may be a result of several possible combinations of these and other factors. Mental health professionals need to be aware of these potentially negative effects of violent video games when assessing patients who present with aggression. There is a need for prospective, long-term studies similar to those evaluating the effects of television and film violence on children and adolescents.
EDUCATIONAL HOMOGAMY IN 22 EUROPEAN COUNTRIES
Authors: Domański Henryk , Przybysz Dariusz
Published: September 2007

Research on socioeconomic homogamy was developed by stratification researchers who used marriage patterns to describe how open stratification systems are. In cross-national studies primary concern on marriage homogamy lies in examination of commonality and differences in their social structures. Following large-scale international studies we use the European Social Survey data 2004–2005 to examine the association between spouses’ educational levels. Loglinear analysis is applied to assess: (i) degree of association between education of spouses, (ii) patterns of barriers to intermarriage, (iii) variation in homogamy for partners with the same education for primary, uncompleted secondary, secondary, and university levels, and (iv) asymmetry in marriage patterns between women and men. The strongest association between spouses’ education is in Slovakia, followed by Czech Republic, Norway, Germany, Ukraine, Poland, Hungary, Estonia, and Slowenia, whereas the lowest association displays in Luxembourg, France, Sweden, Finland and Belgium. In addition to previous research we found inter-country variation in division into post-communist and Western democracies. In line with all earlier studies we found – upon examination of parameters estimated for educational levels – a uniform tendency according to which the difficulties of intermarriage varies monotonically with differences between educational level of spouses. The tendency toward in-marriage proved to be the strongest in the lowest educational levels – such pattern takes place in the 14 countries. Finally, our analysis substantiated presence of net tendency to ‘marry up’ higher educated husbands by women but we find that it is by no means an universal rule and in seven, out of 22 countries examined, it is men who ‘marry up’ higher educated wives.
Scopolamine infused into perirhinal cortex improves object recognition memory by blocking the acquisition of interfering object information
Authors: Winters Boyer D. , Bartko Susan J. , Saksida Lisa M. , Bussey Timothy J.
Published: September 2007

In a previous study, we reported apparently paradoxical facilitation of object recognition memory following infusions of the cholinergic muscarinic receptor antagonist scopolamine into the perirhinal cortex (PRh) of rats. We attributed these effects to the blockade by scopolamine of the acquisition of interfering information. The present study tested this possibility directly by modifying the spontaneous object recognition memory task to allow the presentation of a potentially interfering object either before the sample phase or in the retention delay between the sample and choice phases. Presentation of an object between the sample and choice phases disrupted subsequent recognition of the sample object (retroactive interference), and intra-PRh infusions of scopolamine prior to the presentation of the irrelevant object prevented this retroactive interference effect. Moreover, presentation of an irrelevant object prior to the sample phase interfered proactively with sample object recognition, and intra-PRh infusions of scopolamine prior to the presentation of the pre-sample object prevented this proactive interference effect. These results suggest that blocking muscarinic cholinergic receptors in PRh can disrupt the acquisition of potentially interfering object information, thereby facilitating object recognition memory. This finding provides further, strong evidence that acetylcholine is important for the acquisition of object information in PRh.
Logical basis for morphological characters in phylogenetics
Authors: Sereno Paul C.
Published: September 2007

Systematists have questioned the distinction between characters and character states and their alignment with the traditional concept of homology. Previous definitions for character and character state show surprising variation. Here it is concluded thatcharactersare simply features expressed as independent variables andcharacter statesthe mutually exclusive conditions of a character. Together, characters and character states compose what are here termedcharacter statements. Character statements are composed of only four fundamental functional components here identified as locator, variable, variable qualifier, and character state, and these components exist in only two patterns, neomorphic and transformational. Several controversies in character coding and the use of “absent” as a character state are understood here as a consequence of incomplete character statements and the inappropriate mixing of neomorphic and transformational character statements. Only a few logically complete patterns for morphological character data exist; their adoption promises to greatly reduce current variability in character data between analyses.

© The Willi Hennig Society 2007.
Consistency of self‐reported smoking over a 6‐year interval from adolescence to young adulthood
Authors: Stanton Cassandra A. , Papandonatos George , Lloyd‐Richardson Elizabeth E. , Niaura Raymond
Published: September 2007

Aims  To examine the reliability of self‐report cigarette smoking questions by describing recanting (denial of previous smoking reports) in a nationally representative sample of US adolescents followed throughout young adulthood. Predictors of recanting across stages of smoking uptake/progression are examined.

Design  A total of 12 985 respondents to cigarette smoking questions during in‐home interviews at waves I and III (6 years apart) of the National Longitudinal Study of Adolescent Health (Add Health). The sample survey procedures of Stata 9.0 were used to produce nationally representative estimates, with standard errors adjusted for both clustering at the school level and stratification by geographical region.

Measurements  Recanting probabilities determined by reports of stages of smoking uptake/progression at each time‐point were predicted by race/ethnicity, parental education, household income, poverty level, depression and peer daily smoking.

Findings  Stage‐specific results indicated that recanting is higher when the earlier smoking was less frequent/intense. Recanters were older, from lower‐income households and had higher baseline depression levels. Non‐Hispanic black youth were significantly more likely to recant previous smoking compared to non‐Hispanic white youth, even in multivariate models controlling for socio‐demographic variables. Predictors of recanting differed by level of tobacco involvement. The greater likelihood of non‐Hispanic black respondents to deny previous smoking may be a reflection of less intense or more intermittent use of tobacco that leads to recall differences over time.

Conclusions  Racial/ethnic subgroups and/or respondents endorsing depressive symptoms may be more vulnerable to misclassification during interpretation of national survey data and subsequently not identified properly for prevention/intervention programs.
Longitudinal predictors of changes to illicit drug use among young Australian women
Authors: Yorkston Emily , Russell Anne , Turner Cathy
Published: September 2007

Aim  Much information regarding predictors of illicit drug initiation and cessation is drawn from cross‐sectional data. This paper aims to determine the longitudinal changes in factors associated with initiation and cessation of illicit drugs by young Australian women over a 3‐year period.

Participants  The sample was the cohort of young women moving from their mid‐ to late 20s, completing the Australian Longitudinal Study on Women's Health (ALSWH) survey in 2000 and 2003, who were either ‘new’ users or ‘quitters’ at the 2003 survey.

Measurements  Crude and multivariate associations between changes in predictor variables and the probability of illicit drug initiation or cessation were evaluated. Variables significant in univariate analyses were used to create multivariable logistic regression models which predicted initiation and cessation of illicit drugs.

Findings  All categories of smokers, except ex‐smokers and those who adopted and quit smoking between surveys, were less likely to cease the use of illicit drugs. Women who became pregnant were more likely to cease illicit drug use. Women who continued to drink at levels described as long‐/short‐term risk and women who suffered continuing emotional abuse were less likely to cease use of illicit drugs.

Conclusions  Longitudinal studies that examine factors associated with illicit drug initiation are best conducted in a cohort aged in their late teens to early 20s. Following the current cohort into their late 30s may further explain predictors of illicit drug cessation.
Rodent assemblage in a habitat mosaic within the Valley Thicket vegetation of the Eastern Cape Province, South Africa
Authors: Kryštufek Boris , Haberl Werner , Baxter Rod M.
Published: September 2007

We sampled small mammal assemblage in a mosaic of Valley Thicket vegetation in the Great Fish River Reserve during the summers of 2001 and 2002. Assemblage was dominated by seven rodent species with a single nonrodent species (Elephantulus edwardii) in the 357 trapped specimens. Rhabdomys dilectus was the most abundant in both years, followed by Mus minutoides (ranking 2nd in 2001) and Mastomys coucha (2nd in 2002). These three species, which are widespread generalists, made up 85.0% of the total rodent catch in 2001 and 74.3% in 2002. Individual species were captured on 2–14 sites of a total of 17 and M. minutoides was the most widespread. The majority of samples consisted of two (ten sites in a pooled sample for 2 years) or three species (ten sites). Significant morphological structuring was found only in two‐species samples. Species turnover was high both among sites and between the 2 years. We found no evidence of significant nested structure which would suggest hierarchical sets of ecological relationships among the species. Vegetation structure explained better than species interactions, the population variables in the rodent assemblage.
Effect of transcutaneous electrical nerve stimulation on onset of axillary plexus block
Authors: STEVENS M. F. , LINSTEDT U. , NERUDA B. , LIPFERT P. , WULF H.
Published: September 2007

We examined the effect of high frequency transcutaneous electrical nerve stimulation on the onset of brachial plexus block. Three groups of patients scheduled for surgery of the hand had a local anaesthetic block performed with 40 ml mepivacaine 1.5% using the axillary approach. After injection of the local anaesthetic transcutaneous electrical nerve stimulation was applied for 15 min either to the median nerve or the ulnar nerve; no stimulation was applied in the control group. Before and for 45 min after, the injection of local anaesthetic touch perception, pin prick, motor strength andskin temperature were tested by a blinded investigator in the areas supplied by the median, musculocutaneous, radial and ulnar nerves. There were no differences in the onset of block between the groups. Thus, the frequency‐dependent action of local anaesthetics could not be demonstrated.
The effect of introducing fibreoptic bronchoscopes on gas flow in laryngeal masks and tracheal tubes
Authors: BRIMACOMBE J. , DUNBAR‐REID K.
Published: September 2007

The laryngeal mask airway, reinforced laryngeal mask airway and tracheal tube were studied to determine (1) flow resistance during simulated inspiration and (2) the maximum size of fibreoptic scope which can he passed down the lumen at clinically useful ventilatory settings. In addition, the flow resistance imposed by the mask aperature bars was quantified. The laryngeal mask airway can accommodate a larger fibrescope than the corresponding sizes of reinforced laryngeal mask airway or tracheal tube. Mean (range)flow resistance was 2.3 (1.7‐35) times higher with the reinforced laryngeal mask airway compared to the laryngeal mask airway, 2.1 (1.2‐4.2) times higher with the tracheal tube compared with the laryngeal mask airway and 1.2 (0.7‐1.8) times lower with the tracheal compared with the reinforced laryngeal mask airway. Removal of the mask aperture bars resulted in a mean decrease in flow resistance of 3.6%. Our data have shown that the laryngeal mask airway can accommodate a larger fibrescope than either the reinforced laryngeal mask airway or tracheal tube at clinically useful ventilatory settings and that the current recommendations for maximum size of fibrescope should be revised.
Simulated difficult intubation
Authors: GATAURE P. S. , VAUGHAN R. S. , LATTO I. P.
Published: September 2007

A randomised study was carried out to compare the efficacy of the gum elastic bougie and the stylet in a simulated difficult intubation. A laryngoscopy assessment, as described by Cormack and Lehane, was made in 100 patients. A Grade 3 view was then simulated. In the Bougie First Group (50 patients) two attempts were made to pass a gum elastic bougie and a tracheal tube into the trachea. If these first two attempts were not successful, two further attempts at intubation were allowed with a stylet placed in the tracheal tube. In the Stylet First Group (50 patients) the order was reversed. After two attempts the tube was correctly placed in the trachea in 96% of cases in the Bougie First Group compared to only 66% of cases in the Stylet First Group (p < 0.001). We recommend that a gum elastic bougie should be readily available and that anaesthetists should use it in preference to a stylet whenever a good view of the glottis is not immediately available.
Anaesthesia with the Boyle's bottle vaporizer
Authors: WHITE S. A. , STRUNIN L.
Published: September 2007

Having used the Boyle's bottle vaporizer apparatus out of necessity in a developing country, the concentration of agent that had been administered was investigated retrospectively. Three anaesthetic agents, halothane, isoflurane and enflurane, were measured at different temperatures, using a Boyle's anaesthetic machine and a Boyle's bottle in circuit with a Magill breathing system connected to a Rascal II Agent Monitor. Bubbling a fresh gas flow of 5 l.min−1 through the anaesthetic liquids generated concentrations in excess of 12%. Elevating the initial temperature of the vaporizer increased the delivered concentration, although this effect was short‐lived. Therapeutic concentrations of vapour were achieved for all three agents by avoiding bubbling and manipulating the ‘splitting ratio’ lever. The Boyle's bottle vaporizer may be used with modern anaesthetic agents such as halothane, isoflurane and enflurane. However, the limitations of and variations between vaporizers should be borne in mind. An agent monitor employed at the patient end of the circuit would be an important safety feature.
Safety and efficacy of the laryngeal mask airway A prospective survey of 1400 children
Authors: Lopez‐Gil M. , Brimacombe J. , Alvarez M.
Published: September 2007

A survey of laryngeal mask airway usage in 1400 infants and children by ten trainee anaesthetists was undertaken to provide information about insertion and complication rates using the standard insertion technique and a limited range of standardised anaesthetic techniques. Placement was successful in 90% (1258/1400) at the first attempt, 8% (112/1400) at the second attempt and 2% (29/1400) required an alternative technique of insertion. One patient vomited during insertion and the procedure was abandoned, hut aspiration did not occur. The overall problem rate was 11.5% and there were significantly more problems during induction of anaesthesia (p < 0.02). Oxygen saturation decreased below 90% briefly on 23 occasions (1.7%). The incidence of problems was unrelated to the mode of ventilation, or whether isoflurane or total intravenous anaesthesia with propofol was used for maintenance. Most problems came with use of the size 1 laryngeal mask (p < 0.001). The subspecialty with the highest problem rate was ear, nose and throat surgery (p < 0.001). There was a significant decrease in problems with increasing experience (p < 0.001). There was no major morbidity associated with use of the device. We conclude that the laryngeal mask provides a safe and effective form of airway management for infants and children in the hands of supervised anaesthesia trainees both for spontaneous and controlled ventilation using either isoflurane or total intravenous anaesthesia.
A review of 560 Hickman catheter insertions
Authors: Ray S. , Stacey R. , Imrie M. , Filshie J.
Published: September 2007

Indwelling, cuffed, tunnelled, central venous (Hickman) catheters are increasingly being used for venous access and the administration of chemotherapy for oncological patients. This paper reviews the technical problems associated with the percutaneous insertion of these catheters and the complications arising from their use. Five hundred and sixty catheters were inserted; 31.3% had complications at insertion, most commonly precipitation of an arrhythmia (13.9%). Arterial puncture occurred in 3.8% and pneumothorax in 1.6%. Catheters remained in place for a median period of 91 days. Forty percent of catheters were removed electively on completion of treatment; 30.2% required removal because of complications, which included sepsis, migration, thrombosis and blockage. Twenty percent of patients died with their catheter in place, 8.5% were still in situ and 1.6% were removed because of patient non compliance. Sepsis remains the commonest, long term complication, with staphylococcus epidermidis being the organism isolated most frequently. There were no catheter‐related deaths.
Monitoring neutrophil engraftment in allogeneic stem cell transplantation by flow cytometric analysis of neutrophil‐specific antigens NA1 and NA2
Authors: Inukai Takeshi , Uno Kanako , Taniguchi Kikuyo , Goi Kumiko , Tezuka Toru , Nemoto Atsushi , Takahashi Kazuya , Sato Hiroki , Akahane Koshi , Hirose Kinuko , Honna Hiroko , Kagami Keiko , Hiraoka Asako , Tanihiro Misae , Nakazawa Shinpei , Sugita Kanji
Published: September 2007

Neutrophil‐specific antigen (NA) expression on neutrophils was analysed in 18 Japanese children before and after allogeneic stem cell transplantation (allo‐SCT) with myeloablative regimen. Donor–recipient NA‐incompatibility was present in one of eight NA1/NA2 heterozygous patients and eight of 10 NA1/NA1 or NA2/NA2 homozygous patients. After allo‐SCTs from NA‐incompatible donors, a neutrophil recipient‐to‐donor conversion was confirmed in all cases. Conversion to donor NA type was complete before the absolute neutrophil count reached 0·1 × 109/l. These observations indicate that flow cytometric analysis of NA antigens is a simple and useful method for monitoring neutrophil engraftment in NA‐incompatible allo‐SCT.
The relationship between gonadotrophins, gonadal hormones and bone mass in men
Authors: Karim N. , MacDonald D. , Dolan A. L. , Fogelman I. , Wierzbicki A. S. , Hampson G.
Published: September 2007

Objective  Inhibin A and B (Inh A and B), activin A (Act A) as well as FSH may play an important role in bone turnover in perimenopausal women. Data in men are lacking. The aim was to investigate the relationship between circulating concentrations of Inh B and Act A and FSH/LH/testosterone (T) and their contribution to bone mineral density (BMD) in a male population.

Design and subjects  Cross‐sectional case‐control study of 156 men, 63 with osteoporosis and 93 controls, aged (mean [SD]) 57·7 [13·7] years.

Measurements  Areal (aBMD) was measured at the femoral neck, total hip and lumbar spine. Volumetric BMD (vBMD) was calculated at the femoral neck and lumbar spine. Risk factors were assessed including the measurement of LH/FSH/T, Inh B and Act A.

Results  After correction for age and body mass index (BMI), associations were found between Inh B and FSH (beta regression coefficient β = −0·326; P < 0·0001), T (β = −0·36; P = 0·019) and Act A (β = −0·4; P = 0·007) and between Inh B and LH (β = 0·23; P < 0·0001) in all patients. The controls had higher Inh B concentrations compared to the cases (Inh B: controls: 139 [86] pg/ml vs. cases 88 [51] pg/ml; P = 0·005). Act A tended to be lower in the controls (Act A: controls 0·63 [0·24] ng/ml vs. cases 0·75 [0·4] ng/ml; P = 0·056). Univariate regression analyses showed a positive association between Inh B and BMD (P < 0·01) at the lumbar spine and total hip. In contrast a negative association was seen between FSH and BMD at the lumbar spine and femoral neck (P < 0·01). In a partial multivariate regression model that included the gonadal factors only, a positive association was seen between Inh B and BMD at the hip (β = 0·088; P = 0·04). When all hormones including the gonadotrophins were entered in a full multivariate model, FSH and LH were found to be better predictors of BMD than Inh B or Act A in the controls and cases.

Conclusions  These data suggest that the gonadal peptides and gonadotrophins may play a role in the maintenance of bone mass in men. Future confirmatory longitudinal studies are needed.
Growth hormone (GH) replacement in hypopituitary adults with GH deficiency evaluated by a utility‐weighted quality of life index: a precursor to cost–utility analysis
Authors: Kołtowska‐Häggström Maria , Kind Paul , Monson John P. , Jonsson Björn
Published: September 2007

Objectives  To examine quality of life (QoL) measured by a utility‐weighted index in GH‐deficient adults on GH replacement and analyse the impact of demographic and clinical characteristics on changes in utilities during treatment.

Design  Utilities for items in the QoL‐Assessment of Growth Hormone Deficiency in Adults (QoL‐AGHDAutility) were estimated based on data obtained from the general population in England and Wales (E&W). These estimates were used to calculate QoL changes in GH‐treated patients and compare these with normative population values.

Patients  A total of 894 KIMS patients (53% women) from E&W were followed for 1 to 6 years.

Measurements  QoL‐AGHDAutility at baseline and at the last reported visit, total QoL‐AGHDAutility gain and QoL‐AGHDAutility gain per year of follow‐up.

Results  QoL‐AGHDAutility in patients before GH treatment differed from the expected population values [0·67 (SD 0·174) vs. 0·85 (SD 0·038), P < 0·0001], constituting a mean deficit of –0·19 (SD 0·168). There was a difference in the mean QoL‐AGHDAutility deficit for men [–0·16 (SD 0·170)] and women [–0·21 (SD 0·162)] (P < 0·001). The main improvement occurred during the first year of treatment [reduction of a deficit to –0·07 (SD 0·163) (P < 0·001) in the total cohort]; however, patients’ utilities remained lower than those recorded for the general population during subsequent follow‐up (P < 0·001). Despite an observed impact of age, primary aetiology, disease onset and comorbidities on QoL‐AGHDAutility, all patients showed a similar beneficial response to treatment.

Conclusions  QoL‐AGHDAutility efficiently monitors treatment effects in patients with GHD. The study confirmed the QoL‐AGHDAutility deficit before treatment and a similar QoL‐AGHDAutility gain observed after commencement of GH replacement in all patients.
Pretransplant serum FT3 levels in kidney graft recipients are useful for identifying patients with higher risk for graft failure
Authors: Rotondi Mario , Netti Giuseppe Stefano , Rosati Alberto , Mazzinghi Benedetta , Magri Flavia , Ronconi Elisa , Becherucci Francesca , Pradella Fabio , Salvadori Maurizio , Serio Mario , Romagnani Paola , Chiovato Luca
Published: September 2007

Objective  End‐stage renal disease (ESRD) is a condition associated with thyroid disturbances both in function and morphology. Recent studies demonstrated that serum free triiodothyronine 3 (FT3) levels are negatively correlated with serum markers of inflammation and endothelial activation in patients with ESRD. However, no previous research evaluated serum thyroid function parameters in relation to kidney graft outcome, as we aim to do so in this study.

Design  Serum FT3, free thyroxine 4 (FT4) and TSH levels were measured before transplantation in 196 kidney graft recipients.

Results  The graft survival rate at 5 years for all patients was 92·3%. Kidney graft recipients with normally functioning grafts showed serum pretransplant thyroid parameters similar to patients who experienced graft failure. Life‐time analysis was performed after stratification of patients according to pretransplant serum FT3 levels < 3·1 pmol/l or > 3·1 pmol/l. A significantly different 5‐year death‐censored graft survival rate (93·9%vs. 76·5% for patients with normal or low FT3 levels, respectively; P < 0·01) and similar survival rate (death of patients with functioning grafts) (21·1%vs. 5·9%; P = 0·288) were observed. No similar feature was found for FT4 or TSH, suggesting that the effect is not related to hypothyroidism but rather dependent upon inappropriately low FT3 levels. Pretransplant serum FT3 levels were similar in patients who experienced early acute rejections as compared with nonrejector patients.

Conclusions  The results of this study demonstrate that among patients with ESRD undergoing kidney transplantation, those displaying lower pretransplant serum FT3 levels are at higher risk for subsequent graft failure. The demonstration of a predictive value of serum FT3 levels for graft survival suggests that measurement of pretransplant serum FT3 levels might represent a clinically useful parameter to identify patients with increased risk for graft failure.
Androgens stimulate endothelial progenitor cells through an androgen receptor‐mediated pathway
Authors: Foresta Carlo , Zuccarello Daniela , De Toni Luca , Garolla Andrea , Caretta Nicola , Ferlin Alberto
Published: September 2007

Background and objective  Testosterone (T) treatment has recently been shown to induce an increase in the number of endothelial progenitor cells (EPCs) through a possible effect on bone marrow. Hypogonadotrophic hypogonadal (HH) men have low circulating EPCs that increase significantly after T treatment. Moreover, expression of the androgen receptor (AR) has been demonstrated by immunohistochemistry in these cells, suggesting that T might also have a direct effect on EPC function. In the present study we investigated the expression and function of the AR in human EPCs and the in vitro effect of androgens on EPC function.

Design and patients  EPCs obtained from healthy male anonymous blood donors were analysed after androgen stimulation with and without AR antagonist administration (flutamide).

Results  Reverse transcriptase polymerase chain reaction (RT‐PCR), Western blotting and immunofluorescence analyses demonstrated the expression of AR mRNA and protein in human EPCs. Stimulation of these cells with the synthetic androgen methyltrienolone (R1881) caused AR translocation in the nucleus, suggesting its activation. Colony forming unit (CFU), proliferation and migration assays under different doses of R1881 demonstrated a dose‐dependent increase in EPC proliferation, migration and colony formation. All these effects are abolished by flutamide pretreatment.

Conclusions  This study showed that the increase in the proliferation, migration and colony formation activity of EPCs induced by androgens is an AR‐mediated pathway. Androgen exerts these effects at concentrations that are physiologically present in men and therefore further studies are needed to clarify the clinical significance of these effects in normal and pathological conditions.