bluuebunny/crossref_metadata_2025 huggingface dataset:
Six‐minute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations
Authors: POH Hermione , EASTWOOD Peter R. , CECINS Nola M. , HO Kheng Thye , JENKINS Sue C.
Published: February 2006

Objectives:  The 6‐min walk test (6MWT) is commonly used to assess the functional exercise capacity of individuals with cardiopulmonary disease. Recent studies have established regression equations to predict the 6‐min walk distance (6MWD) in healthy Caucasian populations; however, regression equations have yet to be established for the Singaporean population. The aim of this study was to determine 6MWD in healthy Singaporeans and identify contributors to 6MWD in this population. We also compared measured 6MWD with predicted 6MWD from two regression equations derived in Caucasian subjects.

Methodology:  Thirty‐five healthy subjects (32 Chinese, 16 men) aged between 45 and 85 years performed three walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the three tests. Heart rate (HR) was recorded each minute during the 6MWT. Other measurements included age, height, leg length, smoking history and self‐reported physical activity.

Results:  6MWD was 560 ± 105 m and was not significantly different between men and women (P = 0.19). 6MWD was related to age (r = −0.36, P = 0.03), height (r = 0.35, P = 0.04), leg length (r = 0.38, P = 0.02) and the maximum HR achieved on the 6MWT when expressed as a percentage of the predicted maximum HR (%predHRmax, r = 0.73, P < 0.001). Stepwise multiple regression analysis showed that age, height, weight and %predHRmax were independent contributors (P < 0.01) to 6MWD, explaining 78% of the variance. Predicted 6MWD using regression equations derived from Caucasian subjects exceeded measured 6MWD by more than 75 m (P < 0.001).

Conclusions:  This is the first study to report 6MWD for healthy Singaporeans aged 45–85 years. The regression equation developed in this study explained 78% of the variance in 6MWD. Published equations derived from Caucasian subjects overestimate 6MWD in Singaporean Chinese.
Asthma severity is associated with an increase in both blood CXCR3+ and CCR4+ T cells
Authors: KURASHIMA Kazuyoshi , FUJIMURA Masaki , MYOU Shigeharu , ISHIURA Yoshihisa , ONAI Nobuyuki , MATSUSHIMA Kouji
Published: February 2006

Objectives:  A predominance of type 2 helper T cells (Th2) in the bronchoalveolar space and peripheral blood is a well‐accepted feature of bronchial asthma. However, the relationship between peripheral blood Th2 cells and asthma severity has not been thoroughly investigated.

Methods:  As Th1 cells predominantly express the chemokine receptor CXCR3 and Th2 cells express CCR4, we assessed the distribution of peripheral blood CXCR3+ and CCR4+ lymphocytes using flow cytometry in 186 patients with asthma and 75 normal subjects.

Results:  The proportion of CXCR3+/CD45RO+ cells in CD4+ T cells increased as the severity of asthma increased. The percentage of CCR4+/CD45RO+ cells in CD4+ T cells were elevated in mild to severe asthma patients compared with controls. However, there was no significant difference in CCR4+/CD45RO+ cells between the mild to severe asthma patients. There was no relationship between the patient's age and the numbers of CXCR3+ or CCR4+ T cells. The percentage of CCR4+ cells in CD45RO+/CD4+ T cells correlated with the levels of total serum IgE (r = 0.630, P < 0.0001).

Conclusions:  The proportion of CCR4+ cells in blood memory helper T cells may be increased in patients with asthma and is associated with the level of serum IgE, but severity of asthma is also associated with the increase of blood CXCR3+ cells in memory helper T cells.
Increased endothelin‐1 levels of BAL fluid in patients with pulmonary sarcoidosis
Authors: TERASHITA Kyoko , KATO Shuichi , SATA Makoto , INOUE Sumito , NAKAMURA Hidenori , TOMOIKE Hitonobu
Published: February 2006

Objective and background:  Pulmonary fibrosis in sarcoidosis is a significant cause of morbidity and mortality. Various factors have been intensely studied to define the pathogenesis of lung fibrosis in sarcoidosis. Endothelin (ET) consists of three isoforms and is known for its potent vasoconstrictor properties. ET plays an important role in the fibroproliferative process of interstitial lung diseases.

Methods:  To investigate the role of ET in the progression of pulmonary fibrosis in sarcoidosis, ET‐1 and ET‐3 concentrations were measured in BAL fluid (BALF) in 22 non‐smoking patients with sarcoidosis and in control subjects (n = 12). Immunoreactivity of ET‐1 was also evaluated in alveolar macrophages (AMs) from sarcoidosis patients. To assess the effects of ET in BALF on fibroblast proliferation, human foetal lung fibroblasts were cultured with sarcoidosis or control BALFs in the presence or absence of the ET‐receptor antagonist TAK‐044.

Results:  ET‐1 levels in sarcoidosis BALF were significantly higher than those in control, whereas ET‐3 levels were not different between sarcoidosis and control. ET‐1 levels were correlated with the number of AMs in BALF. ET‐1‐immunoreactivity was found mainly in AM of sarcoidosis BALF. Sarcoidosis BALF significantly stimulated fibroblast proliferation, compared with control BALF, and the fibroblast proliferation induced by sarcoidosis BALF was inhibited by TAK‐044.

Conclusions:  Increased levels of ET‐1 in AM could enhance fibrogenesis in pulmonary sarcoidosis.
Emphysema detected by lung cancer screening with low‐dose spiral CT: Prevalence, and correlation with smoking habits and pulmonary function in Japanese male subjects
Authors: OMORI Hisamitsu , NAKASHIMA Rumi , OTSUKA Nobuko , MISHIMA Yoshiko , TOMIGUCHI Seigi , NARIMATSU Akiko , NONAMI Yoshio , MIHARA Shuichi , KOYAMA Wasaku , MARUBAYASHI Tohru , MORIMOTO Yasuo
Published: February 2006

Objective:  Screening with low‐dose spiral CT is a promising new tool for early lung cancer detection. A study was undertaken to assess the prevalence of emphysema detected by CT screening, and to assess the correlation between the extent of emphysema and the severity defined according to the recently published Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.

Methods:  After informed consent, CT screening and pulmonary function tests were performed on 615 men between the ages of 40 and 69. Severity of emphysema was assessed visually. Only the pulmonary function data for male subjects were analysed because there were too few female subjects with emphysema.

Results:  Emphysema was detected in 30.5% of current smokers, 14.1% of former smokers and 3.0% of non‐smokers. In male current smokers, airflow obstruction (FEV1/FVC < 0.7) was seen in 18.1% of subjects with mild emphysema, and in 33.3% of subjects with moderate emphysema. FEV1 values were less than 80% of the predicted normal in 8.5% of subjects with mild emphysema, and 28.6% of subjects with moderate emphysema. The percentage of male subjects with emphysema equivalent to GOLD stage 0 was 90.0% for subjects in their 40s, 82.5% for those in their 50s, and 68.2% for those in their 60s.

Conclusion:  A considerable percentage of the subjects with emphysema as detected by CT screening had GOLD stage 0. CT screening assists in detecting early‐stage emphysema.
Mechanisms by which systemic salbutamol increases ventilation
Authors: TOBIN Antony E. , PELLIZZER Anne‐Marie , SANTAMARIA John D.
Published: February 2006

Background and objective: Salbutamol (SAL) has systemic effects that may adversely influence ventilation in asthmatic patients. The authors sought to determine the magnitude of this effect and mechanisms by which i.v. SAL affects ventilation.

Methods: A prospective study of nine healthy subjects (eight men, one woman; age 23 ± 1.4 years (SD)) was undertaken. Each subject received i.v. SAL at 5, 10 and 20 µg/min each for 30 min at each dose and was observed for 1 h post infusion. Minute ventilation (V̇E), oxygen consumption (V̇O2), CO2production (V̇CO2), occlusion pressure (P0.1), heart rate, blood pressure, respiratory rate, glucose, arterial blood gases, lactate and potassium (K+) were recorded at baseline and at 30‐min intervals. The effect of 100% oxygen onV̇Eand P0.1during SAL infusion at 20 µg/min was observed. Results are expressed as mean ± SEM.

Results: V̇Ewas significantly increased at 20 µg/min SAL (37.8 ± 12.1%,P = 0.01), as were V̇O2(22.5 ± 5.1%,P < 0.01) and V̇CO2(40.9 ± 10.6%,P < 0.01). Ventilation was in excess of metabolic needs as demonstrated by a rise in the respiratory exchange ratio (0.87 ± 0.03 to 0.99 ± 0.04,P < 0.05). Serum lactate rose by 124 ± 30.4% from baseline to 20 µg/min (1.1 ± 0.1 to 2.3 ± 0.25 mmol/L,P < 0.01) and base excess decreased (0.89 ± 0.56 to vs. −1.75 ± 0.52 mmol/L,P < 0.01) consistent with a lactic acidosis contributing to the excess ventilation. There was no significant differences inV̇Eor P0.1with FIO2 = 1.0, suggesting peripheral chemoreceptor stimulation was not responsible for the rise inV̇E. At 20 µg/min SAL, K+fell significantly from baseline (3.8 ± 0.06 to 2.8 ± 0.09 mmol/L,P < 0.001).

Conclusion: Systemic SAL imposes ventilatory demands by increasing metabolic rate and serum lactate. This may adversely affect patients with severe asthma with limited ventilatory reserve.
Systems for implementing best practice for a chronic disease: management of osteoarthritis of the hip and knee
Authors: Brand C. , Cox S.
Published: February 2006

Background: Effective implementation of evidence‐based care has been associated with better health outcomes; however, evidence‐based clinical practice guidelines have been used with varying success.

Aims: This study aimed to develop integrative tools to support implementation of best practice recommendations for nonsurgical management of osteoarthritis (OA) of the hip and knee and to identify barriers to effective implementation.

Methods: Published, peer reviewed clinical practice guidelines were updated and translated into an OA care pathway. Key decision nodes in the pathway were identified by a Multidisciplinary Working Group. Qualitative research methods were used to inform pathway development and to identify barriers and enablers for pathway implementation. Qualitative components included purposively selected stakeholder focus groups, key informant interviews and patient process mapping of 10 patient journeys in different settings over a 3‐month period. All interviews, facilitated by a trained project officer, were semistructured, recorded, then thematically analysed and summarized.

Results: An OA care pathway, clinician and patient toolkits were developed that met the needs of multidisciplinary end‐users. Several system‐ and setting‐specific barriers to pathway implementation were identified. Opportunities to improve patient access, interprofessional communication, patient information and education and continuity of care processes were identified.

Conclusion: Integrative tools for implementation of best evidence care for patients with OA of the hip and knee were tailored to end‐user needs and preferences. Multiple barriers exist that potentially limit effective implementation of best evidence. Comprehensive assessment of barriers and enablers to effective guideline or pathway implementation is recommended before implementation and evaluation.
Neurally mediated syncope and unexplained or nonaccidental falls in the elderly
Authors: Anpalahan M.
Published: February 2006

Falls and syncope are among the leading causes for which older patients seek hospital admissions. The prevalence of unexplained or nonaccidental falls is high in this group. The clinical spectrum of falls and syncope has been shown to overlap significantly in the elderly. Carotid sinus syndrome and vasovagal syncope, the two common examples of neurally mediated syncope (NMS), have been increasingly recognised as important attributable causes for unexplained falls and syncope. However, in clinical practice NMS is not widely investigated as a cause of fall and is likely to be underdiagnosed.
Clinical use of a shortened alcohol withdrawal scale in a general hospital*
Authors: Foy A. , McKay S. , Ling S. , Bertram M. , Sadler C.
Published: February 2006

Background: Multi‐item scales for monitoring alcohol withdrawal reactions have been used since the 1970s, and since 1985 we have used a modified version of the Clinical Institute Withdrawal Assessment (CIWA) in our general hospitals. This study was conducted to determine whether a shorter version of the scale would prove easier to use without loss of accuracy.

Methods: A simultaneous ‘crossover’ clinical audit using two hospitals. The shortened scale was developed from the existing one, and had 10 items as opposed to the previous 18. The patients were followed throughout their course and the incidences of complication, the frequency of sedation, the delay in initiating monitoring and the ease of use were recorded.

Results: There were 106 patients managed with the old scale and 96 with the new. The rate of complication was not different, being 16% in patients managed using the old scale and 14.5% using the new scale; the rates of sedation were 49 and 48%, respectively. Patients managed with the new scale had a shorter course with a median duration of 27.6 h compared with 40 h. The time from admission to first recording of a score was 5.4 h for the new scale and 4.8 h for the old, which is not a significant difference. Both scores were used according to instructions, but staff reported that the shortened scale was easier to use.

Conclusions: We conclude that a shortened form of the CIWA alcohol withdrawal scale works as well as the original and is simple to use.
Is there a risk to safety when working in the New South Wales underground coal‐mining industry while having binaural noise‐induced hearing loss?
Authors: Viljoen D. A. , Nie V. , Guest M.
Published: February 2006

Background: Underground coal‐mine workers suffer noise‐induced hearing loss and continue working in the industry while having varying degrees of deafness. Few studies have researched the risk to safety arising from the loss of hearing.

Aims: This study is designed to investigate the possible association between hearing loss and accidents in the New South Wales underground coal‐mining industry.

Methods: A study was conducted, gathering data over a 10‐year period from 1994 to 2003, which identified 97 cases that have had accidents and 983 controls that have had no accidents. Hearing loss levels were noted and compared in the cases and controls. Multiple logistic regression was used to determine whether the variables were significant risk factors in the occurrence of accidents.

Results: Hearing loss levels in the total cohort varied from 0 to 54%. The proportion of cases with hearing loss appeared to be significantly higher in the young age group of <29 years than in the controls, but was not significantly different in the older age groups.

Conclusions: This study indicates that workers who have lost up to 54% binaural high tone hearing and are older than 29 years do not appear to have an increased risk to safety when compared with workers who do not have hearing loss. However, workers in the young age group of <29 years who have high tone hearing loss may be at an increased risk of accident.
Pneumonitis associated with leflunomide: a profile of New Zealand and Australian reports
Authors: Savage R. L. , Highton J. , Boyd I. W. , Chapman P.
Published: February 2006

Background: Pneumonitis has very rarely been observed in patients taking leflunomide in clinical trials. Evidence is emerging that it is more frequent in clinical practice.

Aim: The aim of this study was to investigate voluntary reports of suspected respiratory reactions to leflunomide held by the New Zealand Pharmacovigilance Centre (NZPhvC) and the Australian Adverse Drug Reactions Unit (ADRU) to ascertain if they fulfilled the criteria for pneumonitis and to define characteristics of this reaction.

Method: Reports of respiratory adverse reactions attributed to leflunomide and received by the NZPhvC and the ADRU were analysed to identify those that were likely to be pneumonitis based on the criteria of Searles and McKendry. Features of these reports were examined to provide further information about this adverse reaction.

Results: The NZPhvC and the ADRU received 14 reports considered to be pneumonitis occurring in patients taking leflunomide. Two case reports fulfilled the Searles and McKendry criteria for definite or probable hypersensitivity pneumonitis. The patients in the remaining reports had radiological evidence of pulmonary infiltrates, an acute respiratory illness and no evidence of precipitating infection. In two cases the patients were taking leflunomide alone; one improved when it was withdrawn. In the other 12 cases, patients were taking leflunomide in combination with methotrexate. In nine of these 12 patients pneumonitis occurred after leflunomide was added to methotrexate, usually within 12–20 weeks. One of the two patients who died had possible previous methotrexate pneumonitis. Leflunomide washout with cholestyramine was used to treat three patients, one with life‐threatening illness, with good results.

Conclusion: This case series supports observations that leflunomide can cause pneumonitis either as monotherapy or in combination with methotrexate. The case histories indicate that prompt recognition is important to avoid life‐threatening disease and support the use of cholestyramine to remove leflunomide.
Retrospective data for diabetic foot complications: only the tip of the iceberg?
Authors: Wraight P. R. , Lawrence S. M. , Campbell D. A. , Colman P. G.
Published: February 2006

Admission rates for diabetes‐related foot complications to an Australian hospital were assessed by comparing the frequently used method of retrospectively identifying patients according to International Classification of Diseases (ICD) codes with that of prospectively identifying patients at the time of admission. The aim was to determine the true admission rate of diabetes‐related foot complications and to assess the ability of ICD discharge codes to accurately represent the clinical severity of each identified admission. The retrospective study of ICD codes identified approximately one‐third of the patients admitted during the prospective studies. Furthermore, ICD codes allocated in the prospective studies failed to accurately represent the clinical condition in 61% of cases and the corresponding Weighted Inlier Equivalent Separations weighting resulted in a $215 000/year deficit for admissions to a single hospital.
Emergency department use by nonagenarian patients
Authors: Iwata Mitsunaga , Kuzuya Masafumi , Kitagawa Yoshimi , Iguchi Akihisa
Published: February 2006

Background:  In accord with the rapid growth of the nonagenarian population, their emergency departments (ED) visits are increasing. The aim of our study was to examine ED use by nonagenarian patients and their dispositions.

Method:  We analyzed 275 consecutive ED visits of nonagenarian patients in Japan during 1 year. Demographic data, chief complaint, diagnosis, categories of urgency, and disposition following the ED visit were recorded. A 1‐year follow up was conducted on all discharged nonagenarian patients.

Results:  A total of 199 patients made 275 visits. Of these patients, 56.4% were transferred by ambulance, 15.6% were classified as emergency, and 65.1% led to hospitalization. Fever, fall, altered mental status, anorexia, focal neurological deficits and general fatigue accounted for 72% of the reasons for ED visits, and 43% of their ED visits resulted in a diagnosis of pneumonia, stroke, head trauma or hip fracture. In hospitalized patients, the mean length of stay was 23.4 days. Most of the patients had geriatric problems such as disability (78%), comorbidity (86%) and polypharmacy (82%). The in‐hospital mortality of the 179 hospitalized patients was 19.6% (35/179). Eighty‐six percent of alive patients were discharged to long‐term care facilities (124/144). The total 1‐year mortality of the 199 patients who visited the ED accounted for 49.2% (98/199).

Conclusion:  Nonagenarians’ ED visits were associated with prolonged admissions, postdischarge institutionalizations, and high risk of in‐hospital and postdischarge death. Their ED visits seemed to be a major transition in their own life.
Relation of age and smoking to serum levels of total testosterone and dehydroepiandrosterone sulfate in aged men
Authors: Mizushima Yutaka , Mizuno Hiroshi , Urata Yukitomo
Published: February 2006

Background:  Hormonal factors have been extensively investigated in the area of geriatric medicine in the search for potential anti‐aging agents or useful biomarkers for senescence in men. However, inconsistent results have been published so far concerning the relation of anthropometric and life‐style factors to endocrine factors. To confirm the relationships between epidemiological parameters and sex hormone levels, we examined the relation of age and smoking to serum levels of total testosterone (T) and dehydroepiandrosterone sulfate (DHEA) in aged men.

Methods:  The subjects included men aged 50–74 years, 40 current smokers and 27 never smokers. Serum levels of T and DHEA were assayed with a radioimmunoassay kit.

Results:  Serum T did not decrease with age, and was significantly higher in smokers than for non‐smokers. Serum DHEA decreased with age more sharply in non‐smokers than for smokers.

Conclusion:  These data suggest that serum DHEA decreases with aging, but serum T does not, and that serum levels of these hormones are influenced by cigarette smoking.
Oral condition and health status of people aged 80–85 years
Authors: Hashimoto Masanori , Yamanaka Katsumi , Shimosato Tukasa , Furuzawa Hiroshi , Tanaka Hikaru , Kato Hiroshi , Ozawa Akira , Sakai Takeshi , Noguchi Toshihide
Published: February 2006

Objectives:  To clarify the relationship between oral condition and health status, particularly bone mineral density (BMD), in the elderly aged 80 years or more.

Methods:  We examined the oral conditions and health status of two groups. One was elderly who lived at home and had at least 20 teeth at the age of 80 (8020 elderly). The other group consisted of elderly people residing in long‐term care facilities (institutionalized elderly). The oral conditions we examined were the number of teeth, masticatory ability, occlusal force, stimulated salivary flow rate, saliva buffer ability, community periodontal index (CPI) and salivary occult blood test. The health status indicators we examined were BMD, grip strength, height, weight and body mass index (BMI).

Results:  The number of teeth, stimulated salivary flow rate, masticatory ability, and occlusal force in the 8020 elderly were significantly higher than in the institutionalized elderly. BMD, grip strength, height, weight and BMI in these 8020 elderly were also significantly higher than in the institutionalized elderly. Masticatory ability and occlusal force in the institutionalized elderly with high BMD (high BMD group) were significantly higher than in the institutionalized elderly with low BMD (low BMD group). Grip strength, height and weight in the high BMD group were higher than in the low BMD group.

Conclusions:  The 8020 elderly had good oral condition and health status compared to the institutionalized elderly. There may be a relationship between number of teeth and BMD in elderly aged 80–84.
Polypoid prolapsing mucosal folds with diverticulosis and colonic muco‐submucosal elongated polyps
Authors: Kanazawa Nobuo , Kawahara Yuichi , Kasahara Ichirou , Higuchi Yoshiki , Arai Tomio , Kuroiwa Kojiro
Published: February 2006

Background:  In 1991, Kelly first reported the presence of red or brown mucosal protrusions or polyps associated with diverticular disease and described this syndrome as ‘polypoid prolapsing mucosal folds in diverticular disease.’ In 1994, Matake et al. independently reported several long mucosal intraluminal protrusions as ‘colonic muco‐submucosal elongated polyps.’ The purpose of the present study is to address the relationship between the two syndromes.

Methods:  We performed a careful review of the published work on the clinicopathological features of these syndromes.

Results:  The clinical symptoms associated with these two syndromes do not differ notably. Because of the mucosal redundancy of the colonic mucosa, the excessive propulsive power of peristalsis may play an important role in generating both types of polyps. Neither ‘polypoid prolapsing mucosal folds in diverticular disease’ nor ‘colonic muco‐submucosal elongated polyps’ fit into any of the conventional classifications, and their histological characteristics are similar. In addition, we describe the diagnosis and clinical management at our institution of an emergent case of polypoid prolapsing mucosal folds in diverticular disease.

Conclusion:  In light of their similar etiology and pathology, we propose that these conditions are different manifestations of the same entity. Unifying these two classifications into one makes the diagnosis of either type of polyp less onerous for clinicians, endoscopists and pathologists. As a consequence, it is likely that more cases will be diagnosed and reported. The accumulation of more cases will lead to deeper understanding and further clinicopathological characterization of diverticular polyps.
Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderly
Authors: Arai Hidenori , Takechi Hajime , Wada Taizo , Ishine Masayuki , Wakatsuki Yoshio , Horiuchi Hisanori , Murayama Toshinori , Yokode Masayuki , Tanaka Makoto , Kita Toru , Matsubayashi Kozo , Kume Noriaki
Published: February 2006

Background:  To determine the utility of various serum markers for assessment of cognitive and mental functions in the elderly, we performed a Comprehensive Geriatric Assessment (CGA) in the out‐patient clinic in Kyoto University Hospital.

Methods:  We measured serum levels of dehydroepiandrosterone (DHEA), DHEA‐S, malondialdehyde low‐density lipoproteins (MDA‐LDL), and high‐sensitivity C‐reactive protein (hs‐CRP) in 145 patients to find the association of these markers with activities of daily living (ADL), cognitive impairment and depressive symptoms.

Results:  We found that the levels of hs‐CRP were significantly higher in patients with lower scores in Mini‐Mental State Examination (MMSE) and Kohs block design test, and higher scores in the button test, indicating that hs‐CRP may be associated with the cognitive function in elderly patients. We also found that the levels of DHEA‐S were lower in patients with higher scores (9 or over) on the Geriatric Depression Scale‐15 (GDS), indicating that DHEA‐S may be associated with depressive mode in elderly patients. Total cholesterol, high‐density cholesterol (HDL‐C), or albumin were not statistically different in each group studied.

Conclusions:  Thus, our data indicate that measuring hs‐CRP and DHEA‐S would be helpful to assess the cognitive function and depressive symptoms in elderly patients.
Application of artificial neural network for predicting plain strain fracture toughness using tensile test results
Authors: KANG J. Y. , CHOI B. I. , LEE H. J.
Published: February 2006

A back‐propagation neural network was applied to predicting the KIC values using tensile material data and investigating the effects of crack plane orientation and temperature. The 595 KIC data of structural steels were used for training and testing the neural network model. In the trained neural network model, yield stress has relatively the most effect on KIC value among tensile material properties and KIC value was more sensitive to KIC test temperature than to crack plane orientation valid in the range of material data covered in this study. The performance of the trained artificial neural network (ANN) was evaluated by comparing output of the ANN with results of a conventional least squares fit to an assumed shape. The conventional linear or nonlinear least squares fitting methods gave very poor fitting results but the results predicted by the trained neural network were considerably satisfactory. This study shows that the neural network can be a good tool to predict KIC values according to the variation of the temperature and the crack plane orientation using tensile test results.
AMP‐activated protein kinase: role in metabolism and therapeutic implications
Authors: Schimmack Greg , DeFronzo Ralph A. , Musi Nicolas
Published: February 2006

AMP‐activated protein kinase (AMPK) is an enzyme that works as a fuel gauge which becomes activated in situations of energy consumption. AMPK functions to restore cellular ATP levels by modifying diverse metabolic and cellular pathways. In the skeletal muscle, AMPK is activated during exercise and is involved in contraction‐stimulated glucose transport and fatty acid oxidation. In the heart, AMPK activity increases during ischaemia and functions to sustain ATP, cardiac function and myocardial viability. In the liver, AMPK inhibits the production of glucose, cholesterol and triglycerides and stimulates fatty acid oxidation. Recent studies have shown that AMPK is involved in the mechanism of action of metformin and thiazolidinediones, and the adipocytokines leptin and adiponectin. These data, along with evidence that pharmacological activation of AMPK in vivo improves blood glucose homeostasis, cholesterol concentrations and blood pressure in insulin‐resistant rodents, make this enzyme an attractive pharmacological target for the treatment of type 2 diabetes, ischaemic heart disease and other metabolic diseases.
State Socialism in Australian Political Thought: A Reconsideration
Authors: Moore Tod , Walter James
Published: February 2006

In understanding the origins of conventional tenets in political thought, we should attend to cross‐spectrum analysis of usage. Taking state socialism as an instance, this paper argues that the practice of treating it historically either as an element within a radical tradition (by Labour historians) or as a discredited part of a socialist agenda (by liberals) ignores the ways in which it was it was deployed across the political spectrum. Outsiders (such as the Webbs and Métin) skewed the record, describing the pragmatic accommodations they saw as “socialism without doctrines”, unconscious of the debates amongst Australian political elites. We need to explore anew where ideas came from, how they were taken up and adapted in the Australian context (by all sides) and the circumstances that determined their duration within everyday discourse.
A Troika of Agitators: Three Comintern Liaison Agents in Australia, 1920–22
Authors: Windle Kevin
Published: February 2006

Peter Simonoff, Consul‐General in Australia for the Bolshevik regime from early 1918 to mid‐1921, is known to have played an active role in the founding of the Communist Party of Australia in 1920, and in promoting the “Trades Hall” faction against the ASP faction when the new party divided. Paul Freeman and Alexander Zuzenko, both deported from Australia in 1919, made return visits to Australia from Moscow in 1921 and 1922 to carry the process further. Freeman, however, backed the ASP faction, while Zuzenko lent his support to “Trades Hall”. This paper uses previously unknown reports to the Comintern's Executive Committee (ECCI) from Simonoff, Freeman and Zuzenko, as well as Australian sources, to study the relations between these men and their mutually contradictory actions.
The Middle Way: The Discourse of Planning in Britain, Australia and at the League in the Interwar Years*
Authors: Pemberton Joanne
Published: February 2006

Through an examination of speeches, articles and scholarly writing, this article traces the development of the idea of planning and the related doctrine of rationalization in Australia, Britain and at the League of Nations up to the Second World War. These terms denoted scientific control of social forces, an idea that emerged as the major response to interwar perceptions of crisis. Although rationalization and planning were viewed as potentially international in scope by the League's Economic Section, their treatment in Britain and Australia tended towards the provincial, with the rhetoric surrounding them progressively being tailored to suit local and imperial concerns and commitments. The defences of planning often relied on sentimental appeals to British character and traditions, although these same appeals were later used to undermine its rhetorical status.
First aid for obstetric haemorrhage: the pilot study of the non‐pneumatic anti‐shock garment in Egypt
Authors: Miller S , Hamza S , Bray EH , Lester F , Nada K , Gibson R , Fathalla M , Mourad M , Fathy A , Turan JM , Dau KQ , Nasshar I , Elshair I , Hensleigh P
Published: February 2006

Objective  To compare the effect of non‐pneumatic anti‐shock garment (NASG) on blood loss from obstetric haemorrhage with standard management of obstetric haemorrhage.

Design  Observational study of consecutive obstetric haemorrhage cases before and after introduction of the NASG.

Setting  Four tertiary care maternity facilities in Egypt.

Sample  The sample consisted of women with obstetric haemorrhage and signs of shock and the entry criteria were: >750 mL of blood loss and either pulse of >100 beats per minute or systolic blood pressure of <100 mmHg. A total of 158 women were in the preintervention group and 206 in the postintervention group.

Methods  All the women with haemorrhage meeting the eligibility criteria were treated according to the standard protocol for 4 months (May–August 2004); blood loss was measured and recorded. The NASG was then introduced, and all the women meeting the eligibility criteria were treated according to the standard haemorrhage protocol plus the NASG for 4 months (September–December 2004).

Main outcome measures  Measured blood loss collected in a closed‐end, graduated, plastic, under buttocks collection drape.

Results  Median measured blood loss in the drape following study entry was 50% lower in those treated with the NASG (250 versus 500 mL, P < 0.001). There was also a non‐statistically significant decrease in morbidity and mortality.

Conclusions  This is the first comparative study of the NASG with a standard obstetric haemorrhage treatment protocol. The NASG shows promise for management of obstetric haemorrhage, particularly in lower resource settings. Larger studies will be needed to determine if the NASG contributes to statistically significant decreases in morbidity and mortality.
Nifedipine inhibits picrotoxin‐induced seizure activity: further evidence on the involvement of L‐type calcium channel blockers in epilepsy
Authors: Otoom Sameer , Hasan Zuhair
Published: February 2006

A large body of evidence supports the role of L‐type calcium channels in epileptogenesis. The aim of the present study was to study the efficacy of the specific L‐type calcium channel blocker nifedipine on seizure activity induced by picrotoxin (PTX). Adult female Sprague–Dawley rats were used in these experiments. The intraperitoneal administration of nifedipine (5 mg/kg) did not significantly alter the latency to onset of clonic seizure induced by intraperitoneal injection of PTX (4 mg/kg). Higher doses of the drug (10 and 20 mg/kg) significantly increased the latency of onset of clonic seizure in a dose‐dependent manner. Nifedipine (10 mg/kg) did not reduce the incidence of clonic seizures in the animals injected with PTX, but inhibited tonic seizure and the progression of clonic seizures into maximal tonic seizures in four of eight of the animals. The drug (20 mg/kg) inhibited clonic seizure in four of six of the animals and abolished minimal or maximal tonic seizures in all the animals. In conclusion, our study provides further evidence on the antiepileptic effect of L‐type calcium channel blocker nifedipine by showing its protective effect on seizure activity induced by PTX.
Cardioprotection of cariporide evaluated by plasma myoglobin and troponin I in myocardial infarction in pigs
Authors: Létienne Robert , Bel Lydia , Bessac Anne‐Marie , Denais Delphine , Degryse Anne‐Dominique , John Gareth W. , Le Grand Bruno
Published: February 2006

The cardioprotective effects of cariporide were investigated against myoglobin and troponin I elevation in a model of myocardial infarction in pig, and the possible relationship between these markers and myocardial infarct size. The left circumflex coronary artery was ligated for 60‐min and then reperfused for 48‐h. Plasma levels of myoglobin and troponin I were quantified during reperfusion. Vehicle or cariporide (2.5 mg/kg) were administered i.v. before ischaemia and infused throughout ischaemia and for the beginning of reperfusion. In vehicle‐treated pigs, the infarct size represented 26% ± 3% of the area at risk. Cariporide significantly decreased the infarct size by 66% ± 9%, and significantly reduced plasma levels of myoglobin and troponin I. A strongly correlated linear relationship between myocardial necrosis and plasma levels of myoglobin (R = 0.966, P < 0.0001) or troponin I (R = 0.855, P < 0.0001) was clearly identified. In conclusion, in our porcine model of myocardial infarction, even with small infarcts (in the presence of cariporide), plasma levels of myoglobin and troponin I are predictive of the presence of necrosis and its extent.
Effect of rofecoxib, a cyclo‐oxygenase‐2 inhibitor, on various biochemical parameters of brain associated with pentylenetetrazol‐induced chemical kindling in mice
Authors: Dhir Ashish , Naidu Pattipati S. , Kulkarni Shrinivas K.
Published: February 2006

Cyclo‐oxygenase (COX) has been reported to play a significant role in neurodegeneration and other brain‐related disorders. Recent studies have reported that COX plays a significant role in the pathophysiology of brain‐related disorders and COX‐2 inhibitors could be useful drug therapy in neurodegenerative disorders. The aim of the present study was to explore the possible role of COX and the effect of COX‐2 inhibitor, rofecoxib in epilepsy. In the present study, kindling was induced in mice by chronic administration of a subconvulsive dose of pentylenetetrazol (PTZ, 40 mg/kg, i.p.) on every other day for a period of 15 days. Rofecoxib was administered orally daily 45 min before either PTZ or vehicle. The kindling score was recorded after PTZ administration. Seizure severity was measured according to a prevalidated scoring scale. Biochemical estimations were performed on the day 16 of PTZ treatment (24 h after the last dose of PTZ). Chronic treatment with selective COX‐2 inhibitor, rofecoxib (2.0 and 5.0 mg/kg, p.o.) for 15 days showed significant decrease in PTZ‐induced kindling score. Biochemical analysis showed that chronic treatment with PTZ significantly increased lipid peroxidation, nitrite levels (NO levels), and myeloperoxidase levels and decreased the reduced glutathione levels in brain homogenate. Chronic treatment with rofecoxib, a selective COX‐2 inhibitor, significantly reversed the PTZ‐induced kindling score as well as various biochemical alterations suggesting the use of COX‐2 inhibitor rofecoxib in epilepsy. In conclusion, results of the present study suggested that COX‐2 plays an important role in the pathophysiology of PTZ‐induced kindling in mice and rofecoxib is protective against various biochemical alterations against PTZ‐induced kindling in mice.
Distribution of calcineurin activity in blood cell fractions and impact of tacrolimus inhibition
Authors: Blanchet Benoit , Hulin Anne , Ghaleh Bijan , Giraudier Stéphane , Jouault Hélène , Astier Alain
Published: February 2006

The aim of this study was to investigate calcineurin (PP2B) activity in different blood cell fractions and its inhibition by tacrolimus. Basal PP2B activity was measured in each blood cellular fraction collected from healthy volunteers. The inhibition profile of PP2B activity was explored in isolated peripheral blood mononuclear cells (PBMC) and platelets exposed directly to tacrolimus and in PBMC and platelets isolated from whole blood previously exposed to tacrolimus. Constrasting with red blood cells (30%) and platelets (25%), PBMC represented only 8.7% of PP2B activity of unfractionated whole blood. After tacrolimus exposure of isolated PBMC and platelets, the concentration of tacrolimus required to inhibit 50% of PP2B acti‐vity (EC50) in PBMC was significantly lower than in platelets (0.26 ng/mL vs. 0.83 ng/mL, P < 0.001). EC50 values were similar in PBMC and platelets isolated from whole blood previously exposed to tacrolimus (7.69 ng/mL vs. 7.42 ng/mL, respectively). These results suggest PBMC is a very suitable matrix for PP2B measurement in monitoring transplant recipients but clinical studies are necessary to solve clearly this issue.
A field trial to evaluate the pollution potential to ground and surface waters from woodchip corrals for overwintering livestock outdoors
Authors: Vinten A. J. A. , Donnelly S. , Ball B. C. , Crawford C. E. , Ritchie R. M. , Parker J. P.
Published: February 2006

Outwintering beef cattle on woodchip corrals offers stock management, economic and welfare benefits when compared with overwintering in open fields or indoors. A trial was set up on a loamy sand over sand soil to evaluate the pollution risks from corrals and the effect of design features (size and depth of woodchips, stocking density, and feeding on or off the corral). Plastic‐lined drainage trenches at 9–10 m spacing under the woodchips allowed sampling of the leachate. Sampling of the soil to 3.6 m below the corral allowed evaluation of pollutant mitigation during vadose zone transport. Mean corral leachate pollutant concentrations were 443–1056 mg NH4‐N L−1, 372–1078 mg dissolved organic carbon (DOC) L−1, 3–13 mg NO3‐N L−1, 8 × 104–1.0 × 106Escherichia coli 100 mL−1 and 2.8 × 102–1.4 × 103 faecal enterococci 100 mL−1. Little influence of design features could be observed. DOC, NH4 and (in most cases) E. coli and faecal enterococci concentrations decreased 102–103 fold when compared with corral leachate during transport to 3.6 m but there were some cores where faecal enterococci concentrations remained high throughout the profile. Travel times of pollutants (39–113 days) were estimated assuming vertical percolation, piston displacement at field moisture content and no adsorption. This allowed decay/die‐off kinetics in the soil to be estimated (0.009–0.044 day−1 for DOC, 0.014–0.045 day−1 for E. coli and 0–0.022 day−1 for faecal enterococci). The mean [NO3‐N] in pore water from the soil cores (n = 3 per corral) ranged from 114 ± 52 to 404 ± 54 mg NO3‐N L−1, when compared with 59 ± 15 mg NO3‐N L−1 from a field overwintering area and 47 ± 40 mg NO3‐N L−1 under a permanent feeding area. However, modelling suggested that denitrification losses in the soil profile increased with stocking density so nitrate leaching losses per animal may be smaller under corrals than for other overwintering methods. Nitrous oxide, carbon dioxide and methane fluxes (measured on one occasion from one corral) were 5–110 g N ha−1 day−1, 3–23 kg C ha−1 day−1, and 5–340 g C ha−1 day−1 respectively. Ammonia content of air extracted from above the woodchips was 0.7–3.5 mg NH4‐N m−3.
A Multiscale Method for Selecting Indicator Species and Priority Conservation Areas: a Case Study for Broadleaved Forests in Lombardy, Italy
Authors: BANI LUCIANO , MASSIMINO DARIO , BOTTONI LUCIANA , MASSA RENATO
Published: February 2006

Abstract:  Our purpose was to define a quantitative and expeditious method to analyze the effects of processes that influence species distribution and abundance at different organizational scales. We considered habitat loss, the breaking apart of habitat patches, and habitat structural alteration critical processes that affect species distribution and abundance. We evaluated the effects of these processes by considering the response of selected indicator species to isolation (landscape scale), patch size and edge effect (patch scale), and habitat structure (plot scale). We used broadleaf forests as our case‐study ecosystem and birds as indicator species. Faunal data came from a georeferenced, long‐term, breeding‐bird database, and environmental data were obtained from field surveys and land‐use digital cartography. Birds, grouped according to their sensitivity to patch isolation, patch size, edge effect, and habitat structure, indicated how environmental conditions affected species abundance. The most sensitive group to the above‐mentioned processes included the Marsh Tit (Parus palustris), Nuthatch (Sitta europaea), and Short‐toed Treecreeper (Certhia brachydactyla). We evaluated the umbrella effect of these species for the conservation of the other co‐occurring birds and found that their effectiveness varied according to the criterion used to select sites for protection. Site selection based on indicator species identified forest patches with greater species abundance than an alternative criterion that chose sites based on patch isolation and size, edge effect, and forest structure. The alternative criterion, although not as efficient as indicator species, may nevertheless be useful and effective for conservation when faunal data are lacking and guidelines for habitat management or restoration are needed. Our method is applicable to other ecosystems and taxa because the processes we considered occur in many ecosystems and may have significant effects on species from all taxonomic groups.
Detecting Population Declines over Large Areas with Presence‐Absence, Time‐to‐Encounter, and Count Survey Methods
Authors: POLLOCK JACOB F.
Published: February 2006

Abstract:  Ecologists often discount presence‐absence surveys as a poor way to gain insight into population dynamics, in part because these surveys are not amenable to many standard statistical tests. Still, presence‐absence surveys are sometimes the only feasible alternative for monitoring large areas when funds are limited, especially for sparse or difficult‐to‐detect species. I undertook a detailed simulation study to compare the power of presence‐absence, count, and time‐to‐encounter surveys to detect regional declines in a population. I used a modeling approach that simulates both population numbers and the monitoring process, accounting for observation and other measurement errors. In gauging the efficacy of presence‐absence surveys versus other approaches, I varied the number of survey sites, the spatial variation in encounter rate, the mean encounter rate, and the type of population loss. My results showed that presence‐absence data can be as or more powerful than count data in many cases. Quantitative guidelines for choosing between presence‐absence surveys and count surveys depend on the biological and logistical constraints governing a conservation monitoring situation. Generally, presence‐absence surveys work best when there is little variability in abundance among the survey sites, the organism is rare, and the species is difficult to detect so that the time spent getting to each survey site is less than or equal to the time spent surveying each site. Count surveys work best otherwise. I present a case study with count data on the Northern Flicker (Colaptes auratus) from the North American Breeding Bird Survey to illustrate how the method might be used with field‐survey data. The case study demonstrates that a count survey would be the most cost‐effective design but would entail reduction in the number of sites. If this site reduction is not desirable, a presence‐absence survey would be the most cost‐effective survey.