bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Birth Weight Is Associated With Higher Adult Total Cholesterol Concentration in Men
Authors: Davies Anna A. , Smith George Davey , Ben-Shlomo Yoav , Litchfield Paul
Published: August 2004

Background—

The majority of studies investigating the association between birth weight and adult total cholesterol (TC) concentration have been small and underpowered: not surprisingly, the findings have been inconsistent. We aimed to determine whether birth weight predicted adult TC in a large sample population.

Methods and Results—

Between 1994 and 1996, 132 000 British Telecom employees undertook voluntary occupational health screening. Birth weight and lifestyle factors were self-reported; TC concentration and body size were measured by occupational health nurses. Complete measurements were available for 18 286 men and 7557 women (age range, 17 to 64 years). We found that sex and birth weight significantly interacted to predict adult TC (birth weight/sex interaction term,
P
=0.002). In men, lower birth weight was associated with higher adult TC levels (a −0.07 reduction in TC for each 1-kg increase in birth weight; 95% CI, −0.09 to −0.04 mmol/L;
P
<0.001), whereas no association was observed in women. Adjustment for potential confounding factors, including current body size and menopausal status, did not alter the findings. Analysis by SD score showed that in men, a 1-SD decrease in body mass index lowered TC concentration ≈5-fold more than a 1-SD increase in birth weight.

Conclusions—

This is the largest study to investigate the association between birth weight and TC and suggests that the association may be dependent on sex. The absence of an association in women was not explained by menopausal status. The influence of fetal environment on adult TC is small compared with the influence of adult adiposity.
Aspirin-Triggered, Cyclooxygenase-2–Dependent Lipoxin Synthesis Modulates Vascular Tone
Authors: von der Weid Pierre-Yves , Hollenberg Morley D. , Fiorucci Stefano , Wallace John L.
Published: August 2004

Background—

Aspirin-triggered production of 15-(
R
)-epilipoxin A
4
(ATL) has been shown to exert potent antiinflammatory effects and gastric-protective effects, but little is known of its actions on the vasculature. In the present study, we have assessed the contribution of ATL to changes in vascular tone induced by aspirin and have examined the role of nitric oxide (NO) as a mediator of such effects.

Methods and Results—

Intravenous administration of lipoxin A
4
resulted in a short-lived (3 to 4 minutes) reduction in blood pressure (BP; ≈13 mm Hg at 2.5 μg/kg). Aspirin administered alone resulted in a significant increase in serum ATL and an increase in BP of ≈10 mm Hg. When ATL synthesis was inhibited by pretreatment with a selective cyclooxygenase-2 inhibitor (celecoxib) or a 5-lipoxygenase inhibitor (zileuton), the aspirin-induced increase in BP was significantly augmented. These agents alone did not affect BP. A lipoxin receptor antagonist, Boc2, also increased the pressor effects of aspirin. Moreover, immunodepletion of neutrophils, a major source of 5-lipoxygenase, resulted in a significant reduction of ATL formation and augmented aspirin’s pressor effects. Studies of rat aortic and mesenteric artery ring segments confirmed the vasorelaxant effects of lipoxin A
4
and showed them to be endothelium dependent.

Conclusions—

Aspirin-triggered lipoxin synthesis can modulate vascular tone, possibly contributing to changes in regional blood flow during inflammatory reactions, and to the modulation of systemic BP.
Relation of Biventricular Function Quantified by Stress Echocardiography to Cardiopulmonary Exercise Capacity in Adults With Mustard (Atrial Switch) Procedure for Transposition of the Great Arteries
Authors: Li Wei , Hornung Tim S. , Francis Darrel P. , O’Sullivan Christine , Duncan Alison , Gatzoulis Michael , Henein Michael
Published: August 2004

Background—

Mustard repair for transposition of the great arteries (TGA) is frequently associated with impaired systemic (right) ventricular function and sometimes exercise intolerance. We hypothesized that a simple quantitative measurement of ventricular function, during rest and pharmacological stress, could identify abnormalities and predict objective exercise capacity.

Methods and Results—

We quantified the performance of systemic and pulmonary (left) ventricles by using echocardiography, at rest and during dobutamine stress, in 27 adults who had undergone Mustard repair for TGA. Systolic and diastolic function of the systemic ventricle were markedly disturbed with respect to pulmonary ventricular function. We also measured exercise capacity by cardiopulmonary exercise testing for peak oxygen uptake. Exercise capacity was significantly predicted by systemic ventricular long-axis excursion both at rest (
r
=0.66,
P
<0.001) and at peak dobutamine stress (
r
=0.53,
P
=0.006) but not by pulmonary ventricular long-axis excursion at rest (
r
=0.04) or on stress (
r
=0.11). Exercise capacity was also predicted by the septal long-axis excursion at rest (
r
=0.61,
P
=0.001) but not pulmonary ventricular free wall excursion (
P
>0.05) or fractional shortening (
P
>0.05). Peak aortic velocity at maximum dobutamine stress correlated with exercise capacity (
r
=0.46,
P
=0.029) but not at rest (
r
=0.36). Multivariate analysis revealed systemic ventricular long-axis excursion to be the sole significant independent predictor of exercise capacity.

Conclusions—

Systemic ventricular function is depressed in most patients with Mustard repair. Quantitative echocardiographic evaluation shows systemic ventricular function to be a key determinant of exercise capacity.
Improved Vascular Gene Transfer With a Helper-Dependent Adenoviral Vector
Authors: Wen Shan , Graf Shannon , Massey Philip G. , Dichek David A.
Published: August 2004

Background—

Adenoviral vectors are the most widely used agents for vascular gene transfer. However, the utility of adenoviral vectors for vascular gene transfer is limited by brevity of expression and by the induction of a significant host inflammatory response. Third-generation or “helper-dependent” adenoviral vectors have achieved prolonged recombinant gene expression in liver and muscle with minimal associated inflammation; however, they have never been tested for vascular gene transfer.

Methods and Results—

We constructed a helper-dependent adenoviral vector expressing rabbit urokinase plasminogen activator (HD-AduPA). HD-AduPA was compared, in a rabbit model of carotid gene transfer, with a first-generation adenovirus, also expressing rabbit uPA (FG-AduPA). uPA expression and vector DNA were measured in arteries harvested from 3 to 56 days after gene transfer. Vector-specific mRNA, vascular inflammation, and neointimal formation were assessed 14 days after gene transfer. uPA expression was lost, and vector DNA declined rapidly in arteries infused with FG-AduPA. In contrast, uPA expression and vector DNA persisted in HD-AduPA arteries for ≥56 days, with stable expression from 14 to 56 days. Increased uPA expression in HD-AduPA arteries was accompanied by high levels of vector-specific uPA mRNA. Moreover, HD-AduPA arteries had significantly less inflammation and neointimal formation than FG-AduPA arteries.

Conclusions—

Helper-dependent adenoviral vectors can stably express a therapeutic gene in the vascular wall for ≥8 weeks, with minimal associated inflammation. Helper-dependent adenoviral vectors will be useful agents for vascular gene transfer and gene therapy.
Oxidative Stress and Preeclampsia
Authors: Raijmakers Maarten T. M. , Dechend Ralf , Poston Lucilla
Published: August 2004

Preeclampsia remains a frequent and potentially dangerous complication of pregnancy. The cause remains largely unknown, but oxidative stress and a generalized inflammatory state are features of the maternal syndrome. The placenta appears to be the principal source of free radical synthesis but maternal leukocytes and the maternal endothelium are also likely contributors. Recent reports have suggested an important role for placental trophoblast NAD(P)H oxidase in free radical generation in preeclampsia. The antioxidant vitamin E is now known to have multiple actions in addition to prevention of lipid peroxidation (ie, inhibition of NAD(P)H oxidase activation and the inflammatory response). In view of the abnormally low plasma vitamin C concentrations in preeclampsia, a combination of vitamins C and E is a promising prophylactic strategy for prevention of preeclampsia. Several multicenter randomized clinical trials are now underway. The potential use of antioxidants and the recognized, albeit modest, benefit of low-dose aspirin prophylaxis have heightened the need for a reliable predictive test for preeclampsia. A combination test involving several relevant biomarkers is likely to provide the best predictive potential.
Myocardial Perfusion During Long-Term Angiotensin-Converting Enzyme Inhibition or β-Blockade in Patients With Essential Hypertension
Authors: Buus Niels H. , Bøttcher Morten , Jørgensen Claus G. , Christensen Kent L. , Thygesen Kristian , Nielsen Torsten T. , Mulvany Michael J.
Published: August 2004

Hypertension is associated with reduced coronary vasodilatory capacity, possibly caused by structural changes in the coronary resistance vessels. Because vasodilatory treatment may correct abnormal structure better than nonvasodilating treatment, we compared whether long-term angiotensin-converting enzyme (ACE) inhibition has a greater effect on coronary reserve and cardiovascular structure than β-blockade in patients with essential hypertension. Thirty previously untreated hypertensive patients were randomized in a double-blind design to treatment for 1 year with either perindopril (4 to 8 mg per day, n=15) or atenolol (50 to 100 mg per day, n=15) and furthermore compared with normotensive controls. Cardiac output and left ventricular mass were measured with echocardiography and resistance artery structure was determined in vitro. Using positron emission tomography, myocardial perfusion (MP) was determined at rest and during dipyridamole-induced hyperemia while still on medication. Perindopril reduced left ventricular mass by 14±4% (
P
<0.01), peripheral vascular resistance by 12±6% (
P
<0.01), and media thickness-to-lumen diameter ratio of resistance arteries by 16±4% (
P
<0.05), whereas atenolol had no effect. Resting MP was decreased both by perindopril (−11±4%,
P
<0.01) and by atenolol (−25±4%,
P
<0.01) in parallel to the reduction in rate pressure product. Hyperemic MP was unaltered by perindopril (+2±6%,
P
=NS), but reduced by atenolol (−32±5%,
P
<0.01). Compared with atenolol, perindopril treatment resulted in higher coronary reserve (
P
<0.05). We conclude that compared with β-blockade, ACE inhibition increases coronary reserve and results in regression of hypertensive resistance artery structure and left ventricular hypertrophy. Vasodilating may thus be superior to nonvasodilating treatment in repairing the hypertensive myocardial microcirculation.
α-Adducin Gly460Trp Polymorphism and Renal Hemodynamics in Essential Hypertension
Authors: Beeks Esther , van der Klauw Melanie M. , Kroon Abraham A. , Spiering Wilko , Fuss-Lejeune Monique J.M.J. , de Leeuw Peter W.
Published: August 2004

Previous studies have shown an association between the α-adducin Gly460Trp polymorphism and salt-sensitive hypertension. Not much is known about the effects of the variants of this polymorphism on renal hemodynamics and function. Therefore, we performed the present study to investigate the effect of the 460Trp allele of the α-adducin gene on renal hemodynamics in one hundred and seventeen essential hypertensive patients who were put on a low and high sodium diet (randomized order). On the last day of each one-week dietary period, blood pressure, effective renal plasma flow (ERPF), glomerular filtration rate (GFR), and neurohormones were measured. Effective renal blood flow (ERBF), renal vascular resistance, and filtration fraction were calculated. ERPF, ERBF, and GFR were lower in patients homozygous for the 460Trp allele compared with patients with the Gly460Gly genotype on low sodium diet but no differences were found at the higher sodium intake. On the other hand, levels of atrial natriuretic peptide were significantly higher in patients with the Trp460Trp genotype as compared with patients with the Gly460Gly genotype on both diets. In multivariate analysis, Trp460Trp genotype, age, and mean arterial pressure were predictors of ERPF, whereas Trp460Trp genotype and age were predictors of GFR during the phase of low sodium diet. The present study shows that the Trp460Trp genotype is significantly associated with reduced renal plasma flow and glomerular filtration rate as compared with the wild-type variant.
Nonpeptide AVE 0991 Is an Angiotensin-(1–7) Receptor Mas Agonist in the Mouse Kidney
Authors: Pinheiro Sérgio Veloso Brant , Simões e Silva Ana Cristina , Sampaio Walkyria Oliveira , de Paula Renata Dutra , Mendes Elizabeth Pereira , Bontempo Elizabete Dias , Pesquero João Bosco , Walther Thomas , Alenina Natalia , Bader Michael , Bleich Markus , Santos Robson Augusto Souza
Published: August 2004

It has been described recently that the nonpeptide AVE 0991 (AVE) mimics the effects of angiotensin-(1–7) [Ang-(1–7)] in bovine endothelial cells. In this study, we tested the possibility that AVE is an agonist of the Ang-(1–7) receptor Mas, in vitro and in vivo. In water-loaded C57BL/6 mice, AVE (0.58 nmol/g body weight) produced a significant reduction in urinary volume (0.06±0.03 mL/60 min [n=9] versus 0.27±0.05 [n=9];
P
<0.01), associated with an increase in urinary osmolality. The Ang-(1–7) antagonist A-779 completely blocked the antidiuretic effect of AVE. As observed previously for Ang-(1–7), the antidiuretic effect of AVE after water load was blunted in
Mas
-knockout mice (0.37±0.10 mL/60 min [n=9] versus 0.27±0.03 mL/60 min [n=11] AVE-treated mice). In vitro receptor autoradiography in C57BL/6 mice showed that the specific binding of
125
I-Ang-(1–7) to mouse kidney slices was displaced by AVE, whereas no effects were observed in the binding of
125
I-angiotensin II or
125
I-angiotensin IV. Furthermore, AVE displaced the binding of
125
I-Ang-(1–7) in
Mas
-transfected monkey kidney cells (COS) cells (IC
50
=4.75×10
−8
mol/L) and of rhodamine–Ang-(1–7) in
Mas
-transfected Chinese hamster ovary (CHO) cells. It also produced NO release in
Mas
-transfected CHO cells blocked by A-779 but not by angiotensin II type-1 (AT
1
) and AT
2
antagonists. Contrasting with these data, the antidiuretic effect of AVE was totally blocked by AT
2
antagonists and partially blocked (≈60%) by AT
1
antagonists. The binding data, the results obtained in
Mas
-knockout mice and in
Mas
-transfected cells, show that AVE is a Mas receptor agonist. Our data also suggest the involvement of AT
2
/AT
1
-related mechanisms, including functional antagonism, oligomerization or cross-talk, in the renal responses to AVE.
Determinants of JNC VI Guideline Adherence, Intensity of Drug Therapy, and Blood Pressure Control by Race and Ethnicity
Authors: Hicks LeRoi S. , Fairchild David G. , Horng Mark S. , Orav E. John , Bates David W. , Ayanian John Z.
Published: August 2004

The relationship between blood pressure control and racial differences in the processes of hypertension care have not been well examined. We reviewed medical records of 15 768 visits to 12 general internal medicine clinics during July 1, 2001 to June 30, 2002 to determine whether visits were adherent to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) by identifying medications selected for hypertension therapy. We compared JNC adherence, blood pressure control, and intensification of therapy by patient characteristics. Using repeated measures logistic regression, we determined the adjusted odds of obtaining blood pressure control when therapy was intensified the visit before, and tested the interaction of intensification of therapy and patient race/ethnicity in predicting blood pressure control. JNC adherence was more frequent among blacks (83.7%) and Hispanics (83%) than whites (78.4%) (
P
<0.001). Blood pressure was controlled most often among whites (38.7% versus 34.8% for blacks and 33.3% for Hispanics;
P
<0.001). Blacks (81.5%) and whites (80.9%) were more likely than Hispanics (70.8%) to have therapy intensified (
P
=0.02). After adjustment for baseline blood pressure, intensifying therapy was associated with higher odds of subsequent blood pressure control (odds ratio, 1.55;
P
<0.001). There were no significant interactions between race/ethnicity and intensification in predicting control. We found that therapy intensification is associated with subsequent blood pressure control in all racial/ethnic groups and that Hispanics were least likely to have their therapy intensified. Interventions to reduce disparities in cardiovascular outcomes should consider the need to intensify drug therapy more aggressively among all high-risk populations.
Genetic Risk of Atherosclerotic Renal Artery Disease
Authors: van Onna Marieke , Kroon Abraham A. , Houben Alphons J.H.M. , Koster Derk , Zeegers Maurice P.A. , Henskens Léon H.G. , Plat Arian W. , Stoffers Henri E.J.H. , de Leeuw Peter W.
Published: August 2004

It is largely unknown to what extent genetic abnormalities contribute to the development of atherosclerotic renal artery disease. Among the potential candidate genes, those of the renin-angiotensin system and the endothelial nitric oxide synthase (eNOS) rank high because of their importance in the atherosclerotic process. We investigated the association of polymorphisms in these genes (the angiotensinogen Met235Thr, the angiotensin-converting enzyme insertion/deletion, the angiotensin II type-1 receptor A1166C, and the eNOS Glu298Asp) with the presence or absence of atherosclerotic renovascular disease in 456 consecutive hypertensive patients referred for renal angiography on the suspicion of renovascular hypertension. Nondiseased normotensive (n=200) and hypertensive (n=154) patients from a family practice served as external controls. Renal artery disease was present in 30% of our angiography group. The Asp allele of the eNOS Glu298Asp polymorphism was associated with atherosclerotic renal artery stenosis with an odds ratio of 1.44 (95% confidence interval 1.00 to 2.09) versus hypertensives with angiographically proven patent arteries, of 1.89 (1.24 to 2.87) versus hypertensive family practice controls, and of 2.09 (1.29 to 3.38) versus normotensive family practice controls. However, this allele also differed significantly between patients with patent renal arteries and normotensive and hypertensive controls. No differences were found with respect to the other genetic polymorphisms. We hypothesize that the Asp allele of the Glu298Asp polymorphism may predispose to the development of atherosclerotic lesions but that renal artery involvement depends on other factors, also.
Prognostic Significance of Electrocardiographic Voltages and Their Serial Changes in Elderly With Systolic Hypertension
Authors: Fagard Robert H. , Staessen Jan A. , Thijs Lutgarde , Celis Hilde , Birkenhäger Willem H. , Bulpitt Christopher J. , de Leeuw Peter W. , Leonetti Gastone , Sarti Cinzia , Tuomilehto Jaakko , Webster John , Yodfat Yair
Published: August 2004

The aim of the present study was to assess the prognostic value of ECG voltages at baseline and their serial changes during follow-up in a large prospective study with standardized follow-up and strictly defined end points. Patients who were 60 years old or older, with systolic blood pressure of 160 to 219 mm Hg and diastolic pressure <95 mm Hg, were randomized into the double-blind placebo-controlled Systolic Hypertension in Europe trial. Active treatment consisted of nitrendipine, which could be combined with or replaced by enalapril, hydrochlorothiazide, or both. At the end of the double-blind part of the trial (median follow-up, 2.0 years), follow-up was extended and all patients received active study drugs (median total follow-up, 6.1 years). Electrocardiography was performed at baseline and yearly thereafter. Electrocardiographic left ventricular mass was prospectively defined as the sum of 3 voltages (RaVL+SV1+RV5), which averaged 3.1±1.0 mV. The adjusted relative hazard rate, associated with a 1 mV higher sum at baseline, amounted to 1.10 and 1.15 for all-cause and cardiovascular mortality and to 1.21 and 1.18 for strokes and cardiac events, respectively (
P
≤0.01 for all). A 1-mV decrease in electrocardiographic voltages during follow-up independently predicted a lower incidence of cardiac events (relative hazard rate: 0.86;
P
≤0.05), but not of stroke or mortality. In conclusion, electrocardiographic voltages at baseline and their serial changes during follow-up predict subsequent events in older patients with systolic hypertension.
The Burden of Adult Hypertension in the United States 1999 to 2000
Authors: Fields Larry E. , Burt Vicki L. , Cutler Jeffery A. , Hughes Jeffrey , Roccella Edward J. , Sorlie Paul
Published: August 2004

This study aims to estimate the absolute number of persons with hypertension (the hypertension burden) and time trends using data from the National Health and Nutrition Examination Survey of United States resident adults who had hypertension in 1999 to 2000. This information is vitally important for health policy, medical care, and public health strategy and resource allocation. At least 65 million adults had hypertension in 1999 to 2000. The total hypertension prevalence rate was 31.3%. This value represents adults with elevated systolic or diastolic blood pressure, or using antihypertensive medications (rate of 28.4%; standard error [SE], 1.1), and adults who otherwise by medical history were told at least twice by a physician or other health professional that they had high blood pressure (rate of 2.9%; SE, 0.4). The number of adults with hypertension increased by ≈30% for 1999 to 2000 compared with at least 50 million for 1988 to 1994. The 50 million value was based on a rate of 23.4% for adults with elevated blood pressure or using antihypertensive medications and 5.5% for adults classified as hypertensive by medical history alone (28.9% total;
P
<0.001). The ≈30% increase in the total number of adults with hypertension was almost 4-times greater than the 8.3% increase in total prevalence rate. These trends were associated with increased obesity and an aging and growing population. Approximately 35 million women and 30 million men had hypertension. At least 48 million non-Hispanic white adults, ≈ 9 million non-Hispanic black adults, 3 million Mexican American, and 5 million other adults had hypertension in 1999 to 2000.
Fertilizing the Tree of Knowledge: Environmental History Comes of Age
Authors: Steinberg Ted
Published: August 2004

A recently published encyclopedia of environmental history reflects both the strengths and weaknesses attending this growing ªeld of study. The encyclopedia succeeds in showing that natural forces constrain and structure human history. But it is less successful at exploring the interface between environment and social relations, as evidenced in its treatment of political economy, free trade, and natural disasters.
The Missions of Paraguay: The Demography of an Experiment
Authors: Livi-Bacci Massimo , Maeder Ernesto J.
Published: August 2004

The Jesuits' political, social, and economic régime had a profound impact on the Guaraní demographic system. In the relatively long period of peace and stability, between the early 1640s and the early 1730s, the population increased from 40,000 to more than 140,000. In spite of high mortality and recurrent epidemics introduced from abroad, the Jesuits' emphasis on early and monogamous unions maintained the birth rate at the maximum level under normal conditions, generating a large enough surplus of births relative to deaths to compensate for deªcits during years of crisis. The expulsion and departure of the Jesuits in 1767/68, however, set in motion a process of irreversible decline, and led to the diaspora of the missions' population.
Institutional Change and the Longevity of the Ottoman Empire, 1500–1800
Authors: Pamuk Şevket
Published: August 2004

The central bureaucracy of the Ottoman Empire adapted the empire's economic, monetary, and military institutions to changing circumstances with a degree of flexibility and pragmatism that permitted the empire to endure longer than contemporary empires in Asia and Western Europe. However, because it directed its policies primarily toward preserving the traditional order, including its own dominance, it tended to stifle capital accumulation in private hands and the creation of a broad power base, thus ultimately leading to the empire's disintegration.
Understanding Disenfranchisement: Civil Society and Developing Countries' Influence and Participation in Global Governance for Sustainable Development
Authors: Fisher Dana R. , Green Jessica F.
Published: August 2004

This paper explores the ways in which civil society actors and developing countries are limited in their engagement in global governance for sustainable development. Beginning with the relevant literature about how these social actors face obstacles to full participation, we present the notion of what we call “disenfranchisement” to describe the condition of being marginalized within the global policy-making arena. We put forward a conceptual framework that outlines what we identify as the three dimensions of disenfranchisement. By dis-aggregating the notion of disenfranchisement into its constituent dimensions, we outline potential operationalizations of these dimensions. Through the dimensions, the framework explicitly describes the mechanics of disenfranchisement, outlining the reasons that these actors become disenfranchised. We conclude by presenting the ways in which this framework can be applied in future empirical research, which will be critical to understanding the challenges to meaningful inclusion of stakeholders in global governance for sustainable development.
Expert Advice and Desertification Policy: Past Experience and Current Challenges
Authors: Martello Marybeth Long
Published: August 2004

As the United Nations Convention to Combat Desertification (CCD) enters its implementation phase, its technical advisory bodies are endeavoring to define their purpose. Parties to the Convention have questioned the effectiveness and even the relevance of CCD science advice, recommended reforms, and estab-lished a new Group of Experts to support existing advisory processes. These efforts, however, are unlikely to bring about effective change because they overlook the mutually constitutive relationship linking natural and social order (i.e., co-production) evidenced by a century of intergovernmental cooperation on dryland degradation. Historically, knowledge about desertification has been integral to the locus of desertification governance, the definition and application of cognitive resources, and the design of policy remedies. In the CCD former sites of co-production are now sites of incongruous knowledge and policy. A comparison of past and present desertification initiatives illuminates these incompatibilities and points to ideas for fostering greater coherence in the CCD's expert advisory and implementation activities.
The WTO and the Environment: Its Past Record is Better than Critics Believe, but the Future Outlook is Bleak
Authors: Neumayer Eric
Published: August 2004

This article argues that the WTO's past environmental record is much better than critics would have it. Its jurisprudence has become increasingly environmentally friendly and many charges against the dispute settlement process are based on misunderstandings. WTO rules have, so far at least, not deterred any multilateral environmental agreements. The lack of ambitious environmental protection measures is not the fault of the WTO, but the responsibility of policy-makers from its member states. At the same time, the WTO has done little to actually promote environmental protection and the treatment of the precautionary principle in WTO rules is highly unsatisfactory. Unfortunately, this is unlikely to change in the future. The reason for this is that there is not enough support among member countries, particularly those from the developing world, to render the multilateral trade regime more environmentally friendly. The challenge is to green WTO rules in a way that is beneficial and therefore acceptable to developing countries.
Trade and the Environment: Stuck in a Political Impasse at the WTO after the Doha and Cancun Ministerial Conferences
Authors: Thomas Urs P.
Published: August 2004

This article assesses the political dynamics and the legal status of environmental concerns in WTO case law and in the recent WTO negotiations. It explains how the WTO's Dispute Settlement Body plays a crucial role in the determination of the profile of environmental concerns in a trade policy context. It is not only respected by the biggest economic powers but it often has to assume a law-making function due to the vagueness of parts of the WTO agreements. The trade regime takes the environment into consideration only as exceptions to the trade disciplines. The article argues that the political dynamics are stacked against a balanced consideration of trade and environmental priorities, and the perspectives for a significantly improved treatment of environmental issues in today's negotiation climate are assessed pessimistically.
The Short-Term Impact of SARS on the Chinese Economy
Authors: Hai Wen , Zhao Zhong , Wang Jian , Hou Zhen-Gang
Published: August 2004

During the peak of the outbreak of severe acute respiratory syndrome (SARS), we conducted a survey in Beijing on 18 April 2003 to determine the economic impact of SARS, in particular its effects on several service sectors in China. The survey indicated that SARS had significant negative impacts on China's economy. The tourism sector was hit the hardest. We estimated that by the end of 2003, China's tourism revenue from foreigners would decrease by about 50–60 percent (amounting to about US$10.8 billion) compared with the tourism revenue in 2002 and revenue from domestic tourists would decrease by around 10 percent (amounting to about US$6.0 billion). Thus, we predicted that the total loss to China's tourism industry would be around US$16.8 billion by the end of 2003. We also concluded that SARS would cause, through a multiplier effect, a total loss of US$25.3 billion to China's economy and that the growth rate of China's GDP in 2003 would be 1–2 percentage points lower than it would have been if the SARS outbreak had not occurred.
Overcoming Chinese Monetary Division and External Anchoring in East Asia
Authors: Furstenberg George M. von , Wei Jianjun
Published: August 2004

There are few recent historical precedents for maintaining the high degree of separation that still prevails between the internal monetary arrangements of Hong Kong and mainland China. This paper explains why this separation is likely to erode and considers the economics of the different forms that monetary unification of China could take. It argues that achieving such unification without resorting to capital controls or expropriation is a precondition for developing a second major international currency in East Asia that would rival the yen. Until the renminbi has been established as an international currency within a unified and sound financial system that has achieved Hong Kong's current standards, there can be no progress toward a regional monetary union in East Asia. An internal goal of Chinese monetary union is banking reform and financial integration, and an external goal is to help emancipate both China and East Asia as a whole safely from the U.S. dollar standard.
Potential Impacts of the SARS Outbreak on Taiwan's Economy
Authors: Chou Ji , Kuo Nai-Fong , Peng Su-Ling
Published: August 2004

In addition to describing the history of severe acute respiratory syndrome (SARS) in Taiwan, the government's measures to contain the outbreak, and the actual economic impacts of SARS on Taiwan's economy, this paper presents the results of a multiregional computable general equilibrium model (Global Trade Analysis Project model version 6.2) that predicts the outbreak's consequences to 31 service and manufacturing sectors in Taiwan and to the GDP of 16 regions. The results of a short-term outbreak (less than 1 year), taking into account capital accumulation, are compared with those of a longer outbreak (more than 1 year). The losses to GDP are also predicted for the cases in which (1) China provides complete information on its SARS cases and (2) it fails to fully disclose the progress of the outbreak there to the international community. For a short-term outbreak, the simulation predicts losses to GDP of the service and manufacturing sectors of 0.67 percent in Taiwan, 0.20 percent in mainland China, and 1.56 percent in Hong Kong. If SARS is a long-run phenomenon, a lack of transparent disclosure about the progress of SARS on the part of the Chinese authorities could cause an additional 1.6 percent decline in China's GDP, according to the simulation.
Economic Impact of SARS: The Case of Hong Kong
Authors: Siu Alan , Wong Y. C. Richard
Published: August 2004

SARS is the first deadly infectious disease of the 21st century. It started in the Chinese province of Guangdong in November 2002, and by August 2003, it had spread to 29 countries and 3 regions, with a cumulative total of 8,422 cases and 916 deaths. This paper describes the spread of the disease in Hong Kong and discusses its impact on the economy. SARS was an unexpected negative shock. The most significant negative effects were on the demand side, with local consumption and the export of services related to tourism and air travel severely affected in the short run. The economy did not experience a supply shock, as the manufacturing base in the Pearl River Delta was unaffected, and goods continued to be exported through Hong Kong normally. Initial alarmist reports and estimates about the negative economic impacts were not borne out. Fear and panic subsided quickly once the outbreak was under control, and the economy rebounded rapidly.
Synthesis of Li/Al layered double hydroxide-guest composites under mild acid conditions
Authors: Yang Deng-Shiu , Wang Ming-Kuang , Wang Shan-Li
Published: August 2004

Layered double hydroxides (LDHs) are known as ‘anionic clays’. They comprise a class of material with positively charged octahedral double hydroxyl layers and exchangeable anions. The Li/Al LDH term includes a group of LDHs with Li/Al octahedral double hydroxyl layers. We have demonstrated a modifed method, using Li/Al LDH-OH (OH− as interlayer anions) as the starting material, for preparing Li/Al LDH-X (X represents interlayer anions, including dioctyl sulphosuccinate (DOSS), dodecyl sulphate (DDS), mercaptoacetate (MA), EDTA, Tiron and dichromate) under mild acid conditions (pH in the range 4 to 5). However, in the case of acidsensitive anions, Fe(CN)64−, Li/Al LDH-Fe(CN)64− can be prepared by a two-step procedure using Li/Al LDH-DOSS or similar compounds as intermediates to react with acid-sensitive anions under mild alkaline conditions (pH ≈ 9).
Changes in clay organization due to structural iron reduction in a flooded vertisol
Authors: Favre F. , Jaunet A. M. , Pernes M. , Badraoui M. , Boivin P. , Tessier D.
Published: August 2004

The purpose of this study was to investigate the impact of redox-induced changes in the organization of the clay fraction of a bulk vertisol using transmission electron microscopy. Chemical and X-ray powder diffraction (XRD) analyses indicated that the oxidized clay was composed of 32% kaolinite and 68% non-pure smectitic material, mostly a dioctahedral beidellite with octahedral Fe, according to Quantarg2 and DecompXR models.

The cation exchange capacity of the soil increased from 26.1 to 65 cmolc+kg-1due to structural iron (FeStr) reduction and dissolution of oxide coatings. Transmission electron micrographs revealed dramatic changes upon reduction. Oxides were dissolved and the smectite increased in particle darkness, lateral extension, thickness, compactness and stacking order. These changes were interpreted to be a consequence of sorption of ferrous Fe and reduction of FeStr, as found in previous studies on pure Fe-bearing smectites.
Influence of grinding on the structure and colour properties of talc, bentonite and calcite white fillers
Authors: Christidis G. E. , Makri P. , Perdikatsis V.
Published: August 2004

The influence of grinding on colour and particle-size properties of talc and smectite from a white bentonite were studied and compared with a fine-grained calcite from a chalk. Grinding decreased the grain size of all three minerals. The crystallite size and structure of smectite was not affected but the crystallite size of talc decreased. The Si–O–Mg and Mg–O bonds of talc were disrupted and cation exchange capacity increased with increasing grinding. Delamination of talc crystallites was observed in the initial stages of grinding, whereas with more intense treatment, amorphous material was formed. Comminution improved the colour properties of all three minerals, namely brightness, L* (lightness) and ΔE*ab (deviation from perfect white diffuser). Grinding time exerts greater influence on the reflectance from calcite surfaces than from clay minerals. This difference is attributed to continuous formation of progressively smaller diffuse reflection units forming a smoother calcite surface. Decrease of grain size does not form considerably smaller diffuse reflection units in clay minerals unless delamination takes place. With prolonged grinding, amorphization forms additional diffuse reflection units and a smoother surface due to comminution.
Thermal evolution of Mg-Al-CO3 hydrotalcites
Authors: Stanimirova Ts. , Piperov N. , Petrova N. , Kirov G.
Published: August 2004

The thermal decomposition of hydrotalcite (HT), with chemical composition Mg1-xAlx(OH)2(CO3)x/2.(1-3x/2)H2O, (0.20 < x ≤ 0.33), is a complex sequence of dehydration, dehydroxylation and decarbonization and leads to the formation of a series of metaphases: HT-D (dehydrated HT), HT-B (partially dehydroxylated HT) and MO (mixed oxides with periclase-like structure). The evolution of water and CO2 in natural and synthetic hydrotalcites (a Mg/Al ratio between 2:1and 3.7:1), heated to 800°C, was investigated by differential thermal analysis, thermogravimetry and evolved gas analysis. At least six endothermic and two exothermic effects were established by computer-aided resolving of the curves. The formation of each HT metaphase was related to the release of a discrete number of water molecules depending on the Al content in the samples and each appeared as a corresponding endothermic peak in the DTA curves. The exothermic processes associated with the crystallization of HT-B and MO metaphases were specified by decomposition of DTA curves. The evolution of CO2 during the thermal decomposition of the carbonate groups was found to be different for the samples studied. The preservation of CO3 even at high temperatures was established for synthetic samples with a high Al content. The release of volatile H2O and CO2 (which comprise ~40% of the sample mass) provokes fine cracking both along and across the layers.
Factors influencing the intercalation degree (‘reactivity’) of kaolin minerals with potassium acetate, formamide, dimethylsulphoxide and hydrazine
Authors: Franco F. , Ruiz Cruz M. D.
Published: August 2004

Factors influencing the degree of intercalation (‘reactivity’) of kaolinite group minerals have been investigated using six kaolin minerals, with variable crystallinity and particle size. Tests were performed to measure the degree of intercalation with potassium acetate, formamide, dimethylsulphoxide and hydrazine.

These experiments indicate that intercalation degree depends on a number of factors, including particle size, degree of ordering, type of guest molecules, method of intercalation, and presence and types of impurities. Anew method for determination of the degree of intercalation is proposed, which is not dependent on the intensity of complex reflections. The results indicate that formamide is the most sensitive reagent to distinguish differently ordered kaolin minerals whereas hydrazine appears as the most appropriate reagent to differentiate kaolin minerals from other 7 Å phases.
Authigenic halloysite from El-Gideda iron ore, Bahria Oasis, Egypt: characterization and origin
Authors: Baioumy H. M. , Hassan M. S.
Published: August 2004

Halloysite in El-Gideda iron mine occurs as very soft, light and white-to-pinkish white pockets and lenses ranging in diameter from 50 cm to 1 m within the iron ore. Highly hydrated halloysite is the main constituent of these pockets beside some kaolinite and alunite. The diffraction pattern of the clay fraction (<2 mm) shows a rather broad and diffuse 001 reflection spread between 10.3 and 13.6°2θ. Upon treatment, the 001 reflection of halloysite expands up to 10.94 Å and 11.9 Å corresponding to ethylene glycol and dimethyl formamide treatment, respectively. After these treatments, kaolinite appeared with its characteristic basal spacing (~7 Å). The percentage of halloysite in halloysite-intercalated kaolinite ranged between 80 and 90%. Heating to 350°C, produces a kaolinite-like structure (~7.1 Å) that developed to a metakaolinite-structure when heated to 550°C. Morphologically, halloysite appears as well developed tubes composed entirely of SiO2 and Al2O3, while kaolinite is characterized by very fine platelets arranged in book-like or rosette-like shapes. A differential thermal analysis curve of the studied halloysite showed an endothermic peak at ~138°C due to the dehydration of interlayer water of halloysite. The small shoulder at ~540°C and the endothermic peak at ~593°C is attributed to the dehydroxylation of halloysite, kaolinite and alunite. On the other hand the exothermic peak that appeared at 995°C is due to the formation of new phases such as mullite and/or spinel. The infrared vibrational spectrum is typical of highly disordered halloysite and kaolinite.

Halloysite was formed as a result of alteration of the overlying glauconite suggesting intensive chemical alteration during a humid wet period that prevailed in the Bahria Oasis during the late Eocene. Glauconite alteration releases K, Fe, silica and alumina. Iron forms at least part of the iron ore in the El-Gideda mine while alumina forms halloysite as well as alunite when interacted with silica in an acidic environment.
Origin of the Basoren (Kutahya, W Turkey) bentonite deposits
Authors: Yildiz A. , Kuscu M.
Published: August 2004

Bentonite deposits in Basoren Kutahya, West Anatolia, Turkey formed from alteration of perlite and pyroclastic rocks of Pliocene age. The distribution of bentonite deposits along faults in the study area indicates that the alteration solutions were hydrothermal. Although lateral zonation is observed in bentonite deposits in some regions (i.e. Demirli, Akyokus, Seklice- Sarıokuz, etc.), alteration zones are extremely irregular in the Cayırlık bentonite deposit.

X-ray diffraction studies have shown that Basoren bentonites contain dioctahedral Ca-smectite.

The Greene-Kelly test (Li-saturation and heating) showed that the Demirli and Akyokus bentonites consist of montmorillonite and that the Cayırlık bentonite consists of montmorillonite and/or beidellite. Spherulitic or hemispherical ‘crystals’ of opal-CT minerals formed from hydrothermal alteration of volcanic glass. The MgO, CaO and total Fe2O3 enrichment in bentonites, compared to parent rocks, is related to the chemical composition of hydrothermal solutions that passed through the ophiolitic rocks such as serpentinite.
Hematopoietic stem cell transplantation does not restore dystrophin expression in Duchenne muscular dystrophy dogs
Authors: Dell'Agnola Chiara , Wang Zejing , Storb Rainer , Tapscott Stephen J. , Kuhr Christian S. , Hauschka Stephen D. , Lee Richard S. , Sale George E. , Zellmer Eustacia , Gisburne Serina , Bogan Janet , Kornegay Joe N. , Cooper Barry J. , Gooley Theodore A. , Little Marie-Térèse
Published: August 2004

Duchenne muscular dystrophy (DMD) is caused by mutations in the dystrophin gene on the X-chromosome that result in skeletal and cardiac muscle damage and premature death. Studies in mice, including the mdx mouse model of DMD, have demonstrated that circulating bone marrow–derived cells can participate in skeletal muscle regeneration, but the potential clinical utility of treating human DMD by allogeneic marrow transplantation from a healthy donor remains unknown. To assess whether allogeneic hematopoietic cell transplantation (HCT) provides clinically relevant levels of donor muscle cell contribution in dogs with canine X-linked muscular dystrophy (c-xmd), 7 xmd dogs were given hematopoietic cell (HC) transplants from nonaffected littermates. Compared with the pretransplantation baseline, the number of dystrophin-positive fibers and the amount of wild-type dystrophin RNA did not increase after HCT, with observation periods ranging from 28 to 417 days. Similar results were obtained when the recipient dogs were given granulocyte colony-stimulating factor (G-CSF) after their initial transplantation to mobilize the cells. Despite successful allogeneic HCT and a permissive environment for donor muscle engraftment, there was no detectable contribution of bone marrow–derived cells to either skeletal muscle or muscle precursor cells assayed by clonal analyses at a level of sensitivity that should detect as little as 0.1% donor contribution.
Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review
Authors: Arabi Yaseen , Haddad Samir , Shirawi Nehad , Al Shimemeri Abdullah
Published: August 2004

Introduction

Despite the integral role played by tracheostomy in the management of trauma patients admitted to intensive care units (ICUs), its timing remains subject to considerable practice variation. The purpose of this study is to examine the impact of early tracheostomy on the duration of mechanical ventilation, ICU length of stay, and outcomes in trauma ICU patients.

Methods

The following data were obtained from a prospective ICU database containing information on all trauma patients who received tracheostomy over a 5-year period: demographics, Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II, Glasgow Coma Scale score, Injury Severity Score, type of injuries, ICU and hospital outcomes, ICU and hospital length of stay (LOS), and the type of tracheostomy procedure (percutaneous versus surgical). Tracheostomy was considered early if it was performed by day 7 of mechanical ventilation. We compared the duration of mechanical ventilation, ICU LOS and outcome between early and late tracheostomy patients. Multivariate analysis was performed to assess the impact of tracheostomy timing on ICU stay.

Results

Of 653 trauma ICU patients, 136 (21%) required tracheostomies, 29 of whom were early and 107 were late. Age, sex, Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II and Injury Severity Score were not different between the two groups. Patients with early tracheostomy were more likely to have maxillofacial injuries and to have lower Glasgow Coma Scale score. Duration of mechanical ventilation was significantly shorter with early tracheostomy (mean ± standard error: 9.6 ± 1.2 days versus 18.7 ± 1.3 days; P < 0.0001). Similarly, ICU LOS was significantly shorter (10.9 ± 1.2 days versus 21.0 ± 1.3 days; P < 0.0001). Following tracheostomy, patients were discharged from the ICU after comparable periods in both groups (4.9 ± 1.2 days versus 4.9 ± 1.1 days; not significant). ICU and hospital mortality rates were similar. Using multivariate analysis, late tracheostomy was an independent predictor of prolonged ICU stay (>14 days).

Conclusion

Early tracheostomy in trauma ICU patients is associated with shorter duration of mechanical ventilation and ICU LOS, without affecting ICU or hospital outcome. Adopting a standardized strategy of early tracheostomy in appropriately selected patients may help in reducing unnecessary resource utilization.