bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Organization and Parasite Risk in Mammals: Integrating Theory and Empirical Studies
Authors: Altizer Sonia , Nunn Charles L. , Thrall Peter H. , Gittleman John L. , Antonovics Janis , Cunningham Andrew A. , Dobson Andrew P. , Ezenwa Vanessa , Jones Kate E. , Pedersen Amy B. , Poss Mary , Pulliam Juliet R.C.
Published: December 2003

▪ Abstract  Mammals are exposed to a diverse array of parasites and infectious diseases, many of which affect host survival and reproduction. Species that live in dense populations, large social groups, or with promiscuous mating systems may be especially vulnerable to infectious diseases owing to the close proximity and higher contact rates among individuals. We review the effects of host density and social contacts on parasite spread and the importance of promiscuity and mating structure for the spread and evolution of sexually transmitted diseases. Host social organization and mating system should influence not only parasite diversity and prevalence but may also determine the fitness advantages of different transmission strategies to parasites. Because host behavior and immune defenses may have evolved to reduce the spread and pathogenicity of infectious diseases, we also consider selective pressures that parasites may exert on host social and mating behavior and the evolutionary responses of hosts at both the immunological and behavioral levels. In examining these issues, we relate modeling results to observations from wild populations, highlighting the similarities and differences among theoretical and empirical approaches. Finally, the epidemiological consequences of host sociality are very relevant to the practical issues of conserving mammalian biodiversity and understanding the interactions between extinction risk and infectious diseases.
Paleobiogeography: The Relevance of Fossils to Biogeography
Authors: Lieberman Bruce S.
Published: December 2003

▪ Abstract  Paleobiogeography has advanced as a discipline owing to the increasing utilization of a phylogenetic approach to the study of biogeographic patterns. Coupled with this, there has been an increasing interdigitation of paleontology with molecular systematics because of the development of techniques to analyze ancient DNA and because of the use of sophisticated methods to utilize molecules to date evolutionary divergence events. One pervasive pattern emerging from several paleontological and molecular analyses of paleobiogeographic patterns is the recognition that repeated episodes of range expansion or geo-dispersal occur congruently in several different lineages, just as congruent patterns of vicariance also occur in independent lineages. The development of new analytical methods based on a modified version of Brooks Parsimony Analysis makes it possible to analyze both geo-dispersal and vicariance in a phylogenetic context, suggesting that biogeography as a discipline should focus on the analysis of a variety of congruent phenomena, not just vicariance. The important role that extinction plays in influencing apparent biogeographic patterns among modern and fossil groups suggests that this is another area ripe for new methodological developments.
Platelets in patients with acute ischemic stroke are exhausted and refractory to thrombin, due to cleavage of the seven-transmembrane thrombin receptor (PAR-1)
Authors: Jurk Kerstin , Jahn Uli-Rüdiger , Van Aken Hugo , Schriek Carsten , Droste Dirk , Ritter Martin , Ringelstein E.Bernd , Kehrel Beate
Published: December 2003

Platelet activation is involved in the pathogenesis of cerebrovascular ischemia, but the major agonist involved has yet to be identified. To investigate the role of thrombin in platelet activation in patients with acute ischemic stroke, and while thrombin is the most likely candidate for activation of the thrombin receptor PAR-1 in vivo, we assessed its cleavage and internalization using the antibodies SPAN12, binding to uncleaved PAR-1, and WEDE15, recognizing cleaved and uncleaved, but not internalized PAR-1. In contrast to healthy age-matched controls, platelets from stroke patients exhibited significant cleavage and internalization of PAR-1 (P<0.001) and failed to respond to thrombin in vitro. Enhanced surface expression of CD62P, CD63, TSP-1 and less mepacrine uptake showed platelet degranulation during stroke. Platelets from patients with acute cerebral ischemia are exhausted and desensitized to thrombin through cleavage of PAR-1, indicating that high concentrations of thrombin occur with acute cerebrovascular ischemic events in vivo.
A novel gene mutation in the 60s loop of human coagulation factor VII – inhibition of interdomain crosstalk
Authors: Kavlie Anita , Wiiger Merete , Husbyn Mette , Stormorken Helge , Prydz Hans
Published: December 2003

A novel mutation in the factor VII gene resulting in procoagulant activity of 7.5% and antigen levels of 23% is presented. Single-stranded conformational polymorphism and DNA sequencing analysis revealed heterozygous shifts, and mutations were detected in exons 5, 7 and 8. The mutant L204P in exon 7 was novel, while the common polymorphisms, H115H and R353Q, were located in exons 5 and 8, respectively.The molecular effect of the L204P mutation was characterized using recombinant mammalian expression in Chinese hamster ovary cells. Low levels (4 ng/ml) of secreted mutant protein were found in transiently transfected cells compared to wild-type factor VII (83 ng/ml). Metabolic labeling demonstrated that the rate of mutant protein synthesis was similar to that of wild-type FVII, and the mutant protein accumulated intracellularly with no signs of increased degradation during a four-hour chase. No interaction between secreted P204 protein and immobilized soluble tissue factor was detected using surface plasmon resonance. The activation rate of recombinant mutant FVII protein was strongly reduced compared to wild-type FVII. A 9-fold reduction in the rate of FX activation was detected whereas Km was nearly the same for wild-type and the mutant. This slow rate was caused by a correspondingly lowered rate of P204 activation. A synthetic peptide sequence comprising amino acids 177−206 blocked binding of FVIIa to the TF-chip, and the subsequent factor X activation with an IC50 value of 0.5 μM in a chromogenic factor Xa assay. Additionally, evaluation of the peptide by surface plasmon resonance analysis resulted in inhibition of complex formation with an apparent Ki of 7 μM.
Factor VIII expression in liver disease
Authors: Hollestelle Martine , Geertzen Hendrika , Straatsburg Irene , van Gulik Thomas , van Mourik Jan
Published: December 2003

Liver disease is associated with markedly elevated plasma factor VIII (FVIII) levels, whereas the synthesis of many other coagulation factors and proteins is reduced. In order to define the mechanism of FVIII increase, we have determined the expression levels of FVIII, both at mRNA and protein level, in patients with liver disease who underwent partial liver resection. In addition, the expression of von Willebrand factor (VWF) and low density lipoprotein receptor-related protein (LRP), proteins known for their ability to modulate FVIII plasma levels, were examined. Tissue samples for RNA extraction were obtained from 4 patients with cirrhosis, 9 patients with liver failure without cirrhosis and 6 patients with liver metastasis of a colon or rectum carcinoma (control group). In patients with liver cirrhosis hepatic FVIII and LRP mRNA levels were significantly lower than controls (p ≤ 0.010), while VWF mRNA was significantly higher (p ≤ 0.050). Immunohistochemical analysis revealed that cellular VWF protein distribution was also increased in cirrhotic livers compared to liver tissue from patients with non-cirrhotic liver disease. In cirrhotic tissue enlarged portal veins appeared to overgrow FVIII producing sinusoidal endothelial cells. Similarly, the number of LRP-producing cells appeared to be lower in cirrhotic tissue than in controls. The plasma concentration of both FVIII and VWF was significantly higher in patients with cirrhosis than control subjects (p = 0.038 and 0.010 respectively). These results demonstrate that elevated plasma FVIII levels in liver cirrhosis are associated with increased hepatic biosynthesis of VWF and decreased expression of LRP, rather than increased FVIII synthesis.
Metabolism of tumour-derived urokinase receptor and receptor fragments in cancer patients and xenografted mice
Authors: Santovito Maria , Frandsen Thomas , Aletti Giovanni , Ferrari Augusto , Lissoni Andrea , Giavazzi Raffaella , Blasi Francesco , Sier Cornelis , Nicoletti Ines , Sidenius Nicolai
Published: December 2003

The urokinase-type plasminogen activator receptor (uPAR) is involved in cell migration and tissue remodelling, as a receptor for pro-uPA, as a cell adhesion component, and in a soluble form as a chemoattractant. We have analyzed the presence and the molecular forms of uPAR and uPAR-fragments in urine of ovarian cancer patients in comparison with tumour tissue, ascites, and serum. Carcinoma tissue contained high levels of uPAR, but more abundantly the D2D3-fragment. Ascitic fluid contained similar ratio’s of suPAR fragments as corresponding tumour tissue, but serum only contained intact suPAR. Interestingly, urine contained predominantly the uPAR-fragments D1 and D2D3, and the pattern of these fragments was different in cancer patients as compared to healthy individuals. To confirm the hypothesis that circulating and urinary suPAR and suPAR-fragments originate from the tumour tissue, the presence of human suPAR (fragments) was analyzed in mice xenografted with human tumours. Indeed, high levels of urinary D1 fragment were found in mice carrying a tumour displaying cleaved uPAR on the cell surface, but little or no D1 was found in the urine from mice carrying a tumour with full-length uPAR. Mouse serum contained only intact suPAR. Our data demonstrate that the enhanced levels of suPAR fragments in the urine of cancer patients is likely to originate from uPAR expressed in the tumour tissue. Considering the biological activities that uPAR fragments display, the level and typing of uPAR fragments in urine might therefore be clinically more relevant than the plain serum uPAR content.
Thrombin activatable fibrinolysis inhibitor (TAFI) affects fibrinolysis in a plasminogen activator concentration-dependent manner
Authors: Guimarães Ana , Rijken Dingeman
Published: December 2003

TAFIa was shown to attenuate fibrinolysis. In our in vitro study, we investigated how the inhibitory effect of TAFIa depended on the type and concentration of the plasminogen activator (PA). We measured PA-mediated lysis times of plasma clots under conditions of maximal TAFI activation by thrombin-thrombomodulin in the absence and presence of potato carboxypeptidase inhibitor. Seven different PAs were compared comprising both tPA-related (tPA, TNK-tPA, DSPA), bacterial PA-related (staphylokinase and APSAC) and urokinase-related (tcu-PA and k2tu-PA) PAs. The lysis times and the retardation factor were plotted against the PA concentration. The retardation factor plots were bell-shaped. At low PA concentrations, the retardation factor was low, probably due to the limited stability of TAFIa. At intermediate PA concentrations the retardation factor was maximal (3-6 depending on the PA), with TNK-tPA, APSAC and DSPA exhibiting the strongest effect. At high PA concentrations, the retardation factor was again low, possibly due to inactivation of TAFIa by plasmin or to a complete conversion of glu-plasminogen into lys-plasminogen. Using individual plasmas with a reduced plasmin inhibitor activity (plasmin inhibitor Enschede) the bell-shaped curve of the retardation factor shifted towards lower tPA and DSPA concentrations, but the height did not decrease. In conclusion, TAFIa delays the lysis of plasma clots mediated by all the plasminogen activators tested. This delay is dependent on the type and concentration of the plasminogen activator, but not on the fibrin specificity of the plasminogen activator. Furthermore, plasmin inhibitor does not play a significant role in the inhibition of plasma clot lysis by TAFI.
Efficacy of AT in pre-eclampsia: a case-control prospective trial
Authors: Fantinato Sara , Manganelli Francesca , Milani Massimo , Nicolini Umberto , Girolami Antonio , Paternoster Delia
Published: December 2003

Pre-eclampsia is an extremely severe condition. It is associated with vasospasm, activation of the coagulation system and abnormal haemostasis. In pre-eclamptic patients increased plasmatic concentrations of fibronectin, laminin, von Willebrand factor (VWF) and endothelin are observed. Experimental studies on rats have also shown that the doses of antithrombin III (AT) needed to mediate anti-inflammatory processes are much higher than those required to obtain the anti-coagulant effect. The study aimed to evaluate the clinical efficacy of treatment with high AT doses (HD) in comparison with standard doses (SD). The primary endpoint was the prolongation of pregnancy defined as time (in days) from enrollment to delivery and to assess the maternal bleeding at and after delivery. The secondary endpoint was to demonstrate a role for AT in controlling haemostasis at conventional doses, and the inflammatory state at higher doses. The biochemical parameters assessed were: AT activity (%), Fibronectin (Fn), Fibrinogen, D-dimer, Uricemia, Proteinuria 24h, Protein C Reactive (PCR), Granulocyte Elastase and Endothelin. This study included 23 pre-eclamptic women. Patients were randomly subdivided into two groups: 10 patients (“cases”) were treated with high doses of AT (6 vials: 3000 units) once daily for 5 days, or until delivery, while 13 women (“controls”) were treated with doses of AT sufficient to maintain at least 80% of the activity. High-dose therapy was associated with prolongation of pregnancy by 2.5 days more when compared with controls (p = 0.03; Mann-Whitney test). The incidence of clinical significant bleeding was lower in cases than in controls (mean 550 mL vs. 650 mL, respectively). Preventiveand conservative-type treatment of moderatesevere pre-eclampsia, based on the administration high doses of AT, allows a significant prolongation of pregnancy, and thus a better neonatal outcome, as well as less maternal intra-and post-operative bleeding. Fn, PCR and elastase levels (markers of inflammation) decrease in the HD group in comparison with SD group. In the HD group, the AT plasma levels were obviously higher both at the end of the treatment (p < 0.0001) and after delivery (p = 0.03), in comparison with SD group. The fibrinogen and D-dimer levels were above the reference interval in both groups. TPA and PAI 1 were found to be significantly raised in the course of pre-eclampsia. In conclusion, the biochemical findings support a role for AT in controlling the haemostasis at conventional doses, and the inflammatory state at higher doses.
E-Selectin and restenosis after femoropopliteal angioplasty: prognostic impact of the Ser128Arg genotype and plasma levels
Authors: Mlekusch Wolfgang , Exner Markus , Schillinger Martin , Sabeti Schila , Mannhalter Christine , Minar Erich , Wagner Oswald
Published: December 2003

Perivascular inflammation plays a key role in the development of restenosis after percutaneous transluminal angioplasty (PTA).The adherence of leucocytes to the activated endothelium, an essential feature in the restenotic process, is mediated by the cellular adhesion molecule E-Selectin. A DNA polymorphism in the regulator region of E-Selectin at codon 561 (Ser128Arg) is suggested to modulate the molecule’s physiological effects. Therefore, we investigated the association between the E-Selectin Ser128Arg genotype, E-Selectin plasma levels and restenosis after femoropopliteal PTA. We prospectively studied 175 consecutive patients with peripheral artery disease and intermittent claudication (n=126) or critical limb ischemia (n=49) who underwent primary successful femoropopliteal balloon angioplasty. E-Selectin Ser128Arg genotype and baseline E-Selectin plasma levels were determined and patients were followed up for median 12 months (IQR 11 to 14, total range 6 to 24) for the occurrence of postangioplasty restenosis (≥50%). E-Selectin plasma levels in homozygous Arg128Arg and heterozygous Ser128Arg patients were significantly higher compared to wildtype Ser128Ser patients (p=0.041). Patency rates for wildtype Ser128Ser, heterozygous Ser128Arg and homozygous Ser128Ser patients were 57%, 44% and 50% at 6 months, and 46%, 40% and 17%, at 12 months, respectively (Log Rank p=0.31). Patency rates for increasing tertiles of E-Selectin were 61%, 58% and 37% at 6 months, and 54%, 45% and 30% at 12 months, respectively (Log Rank p=0.020). Patients with an E-Selectin plasma level above 44.9 mg/dL (third tertile) had an 1.9-fold increased adjusted risk for restenosis (95% CI 1.09 to 3.30). E-Selectin plasma levels are modulated by the E-Selectin Ser128Arg genotype, and predict the risk for restenosis after PTA in patients with PAD. A direct association of the Ser128Arg polymorphism with late postangioplasty failure could not be demonstrated.
Myocardial damage, coagulation activity and the response to thrombin inhibition in unstable coronary artery disease
Authors: Siegbahn Agneta , Grip Lars , Linder Rikard , Thygesen Kristian , Wallentin Lars , Oldgren Jonas
Published: December 2003

Unstable coronary artery disease is in most cases associated with plaque rupture, activation of the coagulation system and subsequent intracoronary thrombus formation which may cause myocardial cell damage. The aim of the present analysis was to assess the relation between troponin T, markers of coagulation activity, i.e. prothrombin fragment 1+2, thrombin-antithrombin complex, soluble fibrin and D-dimer, and ischemic events, i.e. death, myocardial (re-)infarction or refractory angina. 320 patients with unstable coronary artery disease were randomized to 72 hours infusion with inogatran, a low molecular weight direct thrombin inhibitor, or unfractionated heparin. Patients with elevated troponin levels had higher levels of prothrombin fragment 1+2, soluble fibrin and D-dimer before, during, and at 24 hours after cessation of anticoagulant treatment. These troponin-positive patients tended to have worse short-term clinical outcome, without relation to markers of coagulation activity. Troponin-negative patients with unchanged or early increased thrombin generation during treatment had a cluster of ischemic events within 24 hours after cessation of the study drug. The 30-day ischemic event rate was 19 % in troponin-negative patients with unchanged or early increased prothrombin fragment 1+2, and 5.7 % in patients with decreased prothrombin fragment 1+2, p=0.006, and similarly 15 % in troponin-negative patients with unchanged or early increased thrombin-antithrombin complex and 4.5 % in patients with decreased thrombin-antithrombin complex, p=0.02. In conclusion, in unstable coronary artery disease a troponin elevation indicates higher risk and higher coagulation activity. However, among the troponin negative patients, with a lower risk and lower coagulation activity, a part of the patients seem to be non-responders to treatment with a thrombin inhibitor expressed as unchanged or raised coagulation activity and a raised risk of ischemic events early after cessation of treatment.
Extracorporeal adsorption of anti-Factor VIII allo-antibodies on randomly functionalized polystyrene resins
Authors: Lasne Dominique , Rothschild Chantal , Siali Rosa , Jozefonvicz Jacqueline , Huguet Hélène-Céline
Published: December 2003

The occurrence of anti-factor VIII (FVIII) allo-antibodies is a severe complication of the treatment of haemophilia A patients, leading to the inhibition of transfused FVIII activity. The effective elimination of these inhibitory antibodies plays a decisive role in the management of affected patients. To achieve this, immunoadsorption devices employing synthetic adsorbers, which selectively eliminate inhibitors, are of interest in the treatment strategy of haemophilia A patients with inhibitors. Adsorbers consisting of polystyrene-based beads substituted with sulphonate and L-tyrosyl methylester groups, which mimic part of epitope of FVIII molecule recognized by inhibitors, exhibit selective binding capacities towards anti-FVIII antibodies. The adsorption of FVIII inhibitors was investigated by simulating an extracorporeal circulation of haemophilic plasma over these functionalized resins. These innovative adsorbers are able to remove around 25% of anti-FVIII antibodies in 15 minutes depending on the plasma tested. Furthermore, they do not modify the amount of essential plasmatic proteins or residual immunoglobulins G. Experiments which were carried out using different plasmas with various inhibitor titres demonstrate a good reproducibility regarding the adsorption capacity of the synthetic resin. The characteristics of adsorption are similar on either native or regenerated resins. Both the purely synthetic nature of the resin and its easy processability demonstrate the real advantages over currently available protocols. This synthetic adsorber is a major technological advance in selective removal of FVIII inhibitory antibodies.
Long term prognosis of patients with myocardial infarction and normal coronary angiography: impact of inherited coagulation disorders
Authors: Tardy Brigitte , Haouchette Kamel , Mismetti Patrick , Cerisier Alexis , Lamaud Michel , Guyotat Denis , Isaaz Karl , Da Costa Antoine
Published: December 2003

The prognosis of patients with myocardial infarction (MI) and normal coronary arteries (NCA) in the presence of an inherited coagulation disorder is unknown. The purpose of this study was to compare the clinical thrombosis outcome of patients with (GpI) or without (GpII), inherited coagulation disorders, who suffered from an acute MI with NCA. Eighty two consecutive patients (mean age 49 ± 15 years; 29 females) with MI, but NCA, were recruited. Twelve patients (15%) had an inherited coagulation disorder. GpI and GpII were statistically similar regarding age (45 ± 11 vs 50 ± 16 years-old), gender (33 vs. 36% female), tobacco consumption (50 vs. 53%), diabetes mellitus (8 vs. 10%), hypertension (25 vs. 17%), obesity (8.3 vs. 14%), family history of coronary heart disease (33 vs. 19%), hypercholesterolemia (50 vs. 21%; p = . 08), left ventricular ejection fraction (58 ± 13 vs. 61 ± 13%) and spasm (8.3% vs. 17%). All patients were initially treated with antiplatelet agents with the exception of one (8%) in GpI, and 6 (9%) in GpII who were taking oral anticoagulant therapy (ns). The mean follow-up was 57 ± 26 (range from 2-91 months). During the outcome, 12/78 (15.4%) thrombosis events occurred, including venous thrombosis or pulmonary embolism (1/12 vs. 1/66), reinfarction (2/12 vs. 4/66), and stroke (2/12 vs. 2/66), with two events in one patient (GpI). Kaplan-Meier event-free survival, with combined end-point, defined as venous thrombo-embolic event, reinfarction, or stroke differed between the two groups: 4/12 (33.3%) in GpI and 7/66 (10.6%) in Gp II (p <. 02). Patients with MI, NCA and congenital coagulation disorder present a high risk of thrombosis recurrence under antiplatelet agent.

Presented in part at the 52nd Annual Scientific Session of the American College of Cardiology; March 30-April 2, Chicago USA 2003, Abstract.
The complex between urokinase-type plasminogen activator (uPA) and its type-1 inhibitor (PAI-1) independently predicts response to first-line endocrine therapy in advanced breast cancer
Authors: Tjan-Heijnen Vivianne , Span Paul , Grebenchtchikov Nicolai , Geurts-Moespot Anneke , van Tienoven Doorléne , Beex Louk , Sweep Fred , Manders Peggy
Published: December 2003

It has been shown that urokinase-type plasminogen activator (uPA) and its main inhibitor (PAI-1) have predictive value for therapy success in advanced breast cancer. Levels of the complex between uPA and PAI-1, formed when both molecules are in their active form, might have superior predictive power. Here, we investigate the association between levels of uPA:PAI-1 complex and rate of response to first-line systemic therapy for advanced breast cancer. Tumor tissues of 170 patients with advanced breast cancer were analyzed for uPA:PAI-1 complex concentrations using a quantitative enzyme-linked immunosorbent assay. The patients received either endocrine therapy (n=96) or chemotherapy (n=74) as first-line treatment after diagnosis of advanced disease. Of the endocrine treated patients, those with high levels of uPA:PAI-1 complex showed a shorter progression-free survival (PFS) compared to patients with lower uPA:PAI-1 complex levels (P=0.035). Furthermore, in the multivariate regression analysis a significant lower rate of response to first-line endocrine therapy was found in patients with high uPA:PAI-1 complex levels compared to patients with low uPA:PAI-1 complex levels (odds ratio (OR)=0.27, 95% CI, 0.09–0.59, P=0.018), in addition to the predictive impact of the steroid hormone receptor (ER/PgR) status (OR=2.68, 95% CI, 1.08–6.63, P=0.033). Complex levels did not predict efficacy of chemotherapy in patients with advanced breast cancer. The results show that the plasminogen activation system affects the response to endocrine therapy independent of steroid hormone receptor status and may be of help to further refine the indication for this treatment in individual patients. Further studies are warranted to explain this underlying resistance to endocrine therapy when uPA:PAI-1 levels are high.
Influence of plasma and erythrocyte factors on red blood cell aggregation in survivors of acute myocardial infarction
Authors: Falcó Cristina , Réganon Edelmiro , Vila Virtudes , Martínez-Sales Vicenta , Corella Dolores , Contreras Teresa , Aznar Justo , Vayá Amparo
Published: December 2003

Increased erythrocyte aggregation (EA) has been observed in patients with ischaemic heart disease (IHD), although most of these studies have been performed in the acute phase when reactant proteins may account for this increase. Little is known about the role played by the erythrocyte itself in this aggregation process. To ascertain the contribution of both plasma and erythrocyte factors to EA in IHD, we investigated the following parameters in 78 survivors of acute myocardial infarction (AMI) and in a well-matched control group of 98 subjects: EA, glucose, total cholesterol (T-Chol), low-density lipoprotein-cholesterol (LDL-Chol), high-density lipoprotein–cholesterol (HDL-Chol), triglycerides, apolipoproteins A1 and B, protein and functional fibrinogen, plasma sialic acid, membrane sialic acid, and the cholesterol and phospholipid content of the erythrocyte membrane. AMI survivors showed higher glucose (p<0.001), a borderline increase in triglycerides (p= 0.043), and a statistical decrease in Apo A1 (p= 0.003) relative to controls. EA, functional fibrinogen, and plasma sialic acid were statistically higher in AMI survivors than in controls (p= 0.001; p<0.001; p= 0.011, respectively). Membrane sialic acid content was statistically lower in AMI patients than in controls (p= 0.026). No differences were observed in either membrane cholesterol or phospholipids. Multivariate logistic regression analysis, in which EA was dichotomized as higher or lower than 8.7, demonstrated that triglyceride levels higher than 175 mg/dL (OR= 7.7, p= 0.001) and functional fibrinogen levels higher than 320 mg/dL (OR= 3.7, p= 0.004) were independently associated with a greater risk of erythrocyte hyperaggregability. Our results suggest that plasma lipids, predominantly triglycerides, and fibrinogen may not only enhance the development of ischaemic events by their recognized atherogenic mechanisms, but also by increasing EA.
‘Post-productivist’ agricultural regimes and the South: discordant concepts?
Authors: Wiilson Geoff A. , Rigg Jonathan
Published: December 2003

In this paper we review current assumptions about post-productivist agricultural regimes - developed largely within a UK/advanced economies framework - and attempt to answer the question whether the concept of post-productivism can be used to understand contemporary agricultural change in developing world regions. Our analysis is loosely based around six interconnected ‘indicators’ of post-productivism: policy change; organic farming; counter-urbanization; the inclusion of environmental NGOs at the core of policy-making; the consumption of the countryside; and on-farm diversification activities. We argue that the successful ‘exporting’ of the theory of post-productivism to the South relies on shared definitions, meanings and - ultimately - discourses of post-productivism. Although similar patterns can be observed in rural areas of the developing world, there is confusion about the exact meaning of complex agricultural/rural activities. Further, our analysis questions the implied linearity of the traditional concept of the productivist/post-productivist transition. Ultimately, a relative assessment of the shift towards post-productivism would circumvent discursive problems related to definitions and meanings of specific post-productivist concepts and indicators. We conclude by arguing that the notion of post-productivism and the developing world are not necessarily ‘discordant concepts', but we suggest that the concept needs to be adapted and developed to address specific conditions in the rural South, possibly by combining theoretical approaches surrounding the notion of ‘post-productivism’ developed largely from a Northern perspective, and ‘deagrarianization’ from a Southern perspective.
Anthropologies and geographies of globalization
Authors: Rankin Katharine N.
Published: December 2003

Anthropologists and geographers are increasingly tuming to one another for tools to analyze the present global political-economic conjuncture. Yet to date there has been no adequate accounting of the comparative advantages each field brings to studies of globalization Anthropology with its emphasis on the role of culture in anchoring (or resisting) globalizing processes within particular societies and Geography with its more comparative emphasis on the politics of place and scale. This paper is intended to contribute to interdisciplinary exchange through such an accounting and argues for a constructive synthesis geared toward understand-ing how ‘local’ cultural systems articulate with political-economic currents operating at wider spatial scales.
Science(s) which, when and whose? Probing the metanarrative of scientific knowledge in the social construction of nature
Authors: Pedynowski Dena
Published: December 2003

The role of ‘scientific knowledges’ in the social construction of nature(s) and realities has become a focal point of deconstruction and debate in both geography and science and technology studies over the past decades. In this article, I demonstrate that many authors have constructed a metanarrative of ‘science’ as a discursive strategy for their critiques of society. Science is portrayed as a homogenous activity with its ‘products’ implicated in various aspects of poltical-economic-social exploitation/oppression. This metanarrative belies the contempo-rary complexity of scientific endeavor and its diverse epistemic cultures. Suggestions to clarify the epistemologies of scientific knowledges and arbitrate between competing knowledges are presented.
The geography and climatology of aerosols
Authors: Power Helen C.
Published: December 2003

Aerosols affect climate by scattering and absorbing radiation and by modifying the physical and radiative properties of clouds. Despite their importance in the climate system, the temporal and spatial variability of aerosols is not well understood. This paper briefly describes the nature of aerosols, their influence on the climate system and methods for quantifying atmospheric turbidity, which is the total column amount of aerosol. The main focus of the paper is a review of turbidity research that serves to document how and why aerosols vary over time and space. This analysis reveals that temporal and spatial variability in aerosol emissions is superimposed by temporal and/or spatial variability in meteorological and climatic factors. These factors include variability in wind speed, humidity, stability, insolation, frontal and cyclonic activity, the position of the Intertropical Convergence Zone and the polar front, rates of precipitation and convection, and the source regions of air masses. This interaction between aerosol emission characteristics and atmospheric processes is manifested in distinct trends in total column aerosol -described herein by geographic region - at a variety of spatial and temporal scales.
Quaternary pollen analysis: recent progress in palaeoecology and palaeoclimatology
Authors: Seppä Heikki , Bennett K.D.
Published: December 2003

During the last decade Quaternary pollen analysis has developed towards improved pollen-taxonomical precision, automated pollen identification and more rigorous definition of pollen assemblage zones. There have been significant efforts to model the spatial representation of pollen records in lake sediments which is important for more precise interpretation of the pollen records in terms of past vegetation patterns. We review the difficulties in matching modelled post-glacial plant migration patterns with pollen-based palaeorecords and discuss the potential of DNA analysis of pollen to investigate the ancestry and past migration pathways of the plants. In population ecology there has been an acceleration of the widely advocated conceptual advance of pollen-analytical research from vaguely defined ‘environmental reconstructions’ towards investigating more precisely defined ecological problems aligned with the current ecological theories. Examples of such research have included an increasing number of investigations about the ecological impacts of past disturbances, often integrating pollen records with other palaeoecological data. Such an approach has also been applied to incorporate a time perspective to the questions of ecosystem restoration, nature conservation and forest management. New lines of research are the use of pollen analysis to study long-term patterns of vegetation diversity, such as the role of glacial-age vegetation fragmentation as a cause of Amazonian rain forest diversity, and to investigate links between pollen richness and past plant diversity. Palaeoclimatological use of pollen records has become more quantitative and has included more precise and rigorous testing of pollen-climate calibration models with modern climate data. These tests show the approximate nature of the models and warn against a too straightforward climatic interpretation of the small-scale variation in reconstructions. Pollen-based climate reconstructions over the Late Glacial-early Holocene boundary have indicated that pollen-stratigraphical changes have been rapid with no evidence for response lags. This does not rule out the possibility of migrational disequilibrium, however, as the rapid changes may be mostly due to nonmigrational responses of existing vegetation. It is therefore difficult to assess whether the amplitude of reconstructed climate change reflects real climate change. Other outstanding problems remain the obscure relationship of pollen production and climate, the role of human impact and other nonclimatic factors, and nonanalogue situations.
‘Catching the development train’: perspectives on ‘top-down’ and ‘bottom-up’ development in post-apartheid South Africa
Authors: Bek David , Binns Tony , Nel Etienne
Published: December 2003

Government policy in post-1994 South Africa, whilst upholding the principles of community participation and development, has been firmly wedded to a neoliberal growth agenda. This paper critically examines whether one element of that new growth agenda, that of Spatial Development Initiatives, has catalysed both ‘bottom-up’ development and also meaningfully assisted micro-entrepreneurs through more ‘top-down’ interventions. The paper focuses on two specific projects, namely the Saldanha Steel Plant and the Paternoster Fish Market, which have been components of a Spatial Development Initiative in the Western Cape. The serious constraints faced by communities in engaging with opportunities for socio-economic upliftment is clearly a cause for concern, and it is suggested that a careful re-evaluation of South Africa’s development paradigm is urgently required.
Government intervention or market liberalization: the Korean financial crisis as a case of market failure
Authors: Sharma Shalendra D.
Published: December 2003

This paper questions the conventional view that the Korean financial crisis of 1997 was simply the result of pervasive government intervention in the economy. While Korea has had a long history of state involvement, and while state policies did contribute to inefficient resource allocation and inefficiencies, the strategy of market liberalization introduced in the early 1990s hardly performed any better. In fact, this paper illustrates that, although not the immediate trigger of the Korea’s financial and currency meltdown, the poorly sequenced and implemented financial liberalization contributed greatly to the scale and pace of the crisis.
A clinical and educational telemedicine link between Bulgaria and Greece
Authors: Anogianakis George , Ilonidis George , Anogeianaki Antonia , Milliaras Spyros , Klisarova Anelia , Temelkov Temel , Vlachakis-Milliaras Emmanuel
Published: December 2003

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During its transition to a market economy, Bulgaria benefited from foreign aid provided by Greece. One of the projects was the clinical and educational telemedicine link between the Medical University of Varna in Bulgaria and the Faculty of Medicine of Aristotle University of Thessaloniki in Greece. This began in 1997. In terms of the educational activities, the Bulgarian side of the network supports: an electronic classroom equipped with personal workstations, multimedia projectors and videoconference facilities; electronic design and publishing activities; Web hosting and mail server activities; and satellite communications. Communications are via ISDN. The main clinical experience has been remote consultations in immunology. This experience (admittedly limited) demonstrates that telemedicine can be used to provide assistance to remote colleagues. In addition, the use of telemedicine can greatly improve the quality of care available to travellers and migrant workers in cases where the patient cannot communicate with the attending physician because of a language barrier.
Developing prison telemedicine systems: The Greek experience
Authors: Anogianakis George , Ilonidis George , Milliaras Spyros , Anogeianaki Antonia , Vlachakis-Milliaras Emmanuel
Published: December 2003

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Prison telemedicine systems operate in circumstances in which the provision of medical care is very expensive. In 1999 the Greek Ministry of Justice decided to use telemedicine to improve health services in the largest prison in Greece (Korydallos Prison, in Athens). The Nikea Hospital in Piraeus undertook to support the effort in order: to enable prison paramedics and guards to call for remote evaluation of inmates when the prison's doctors were off duty; to provide second opinions; and to allow screening and primary care coverage for inmates through teleconsultations with Nikea Hospital specialists. For 12 months following installation, intensive ‘hands-on’ training on the use of the system was offered to the staff of both the Korydallos Prison and the Nikea Hospital. In all, 400 physicians, nurses and paramedics were trained. Despite all this effort, there were serious operational problems related either to prison bureaucracy or to the inflexibility of the Greek national health system, which annulled the effectiveness of the prison telemedicine system. The experience suggests that prison telemedicine is a viable option if freed from bureaucratic and labour-related obstacles, and can improve the quality of care available to prisoners.
Implementation of videoconferencing to support a managed clinical network in Scotland: Lessons learned during the first 18 months
Authors: Barry N , Campbell P , Reed N , Reid M E , Bower D J , Norrie J , Currie G D
Published: December 2003

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Managed clinical networks (MCNs) are usually built on established groups of health professionals from both acute and primary care sectors. We have used videoconferencing to support the gynaecological oncology MCN in the west of Scotland. Videoconferencing was implemented simultaneously at five sites in 2001 and DICOM image-capture software was added in 2003. Videoconferencing and live PC links allowed the multidisciplinary teams to discuss individual cancer diagnoses without the extensive travelling previously required. Our experience of the implementation suggests that local ownership is crucial. In the present project, each of the stakeholders had an important role in the delivery of a successful system. High-quality project management is required during implementation and for some time thereafter to achieve sustainability.
Remote critical care consultation: Telehealth projection of clinical specialty expertise
Authors: Berg Benjamin W , Vincent Dale S , Hudson Donald A
Published: December 2003

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Remote critical care consultations have been employed between the Naval Hospital in Guam and the Tripler Army Medical Center in Hawaii, a distance of 5300 km. During a 10-week study period there were physician-physician daily consultation rounds for patients in the intensive care unit at the Naval Hospital. Physiological data, video-images and sound were transmitted via a 768 kbit/s frame relay connection, albeit with a 1–3 s delay. During the study there were 87 consultations concerning 25 patients. Preliminary results showed that a broad range of critical care patients could be managed effectively through daily remote critical care consultation. Broader implementation of this strategy may represent a method of making critical care expertise available to front-line military health-care facilities and to remote civilian facilities with limited critical care expertise.
Fetal endoscopic telesurgery using an Internet Protocol connection: Clinical and technical challenges
Authors: Chan F Y , Soong B , Taylor A , Bornick P , Allen M , Cincotta R , Quintero R
Published: December 2003

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Until recently, fetoscopic laser surgery to seal the placental anastomoses that cause severe twin-to-twin transfusion syndrome has been available in only a few centres worldwide. The technique typically takes a long time to learn. We have used a dedicated Internet Protocol (IP) connection for tele-education to assist the introduction of fetoscopic laser surgery to Australia. During the implementation of the international telemedicine link, there were multiple clinical and technical problems, which were eventually overcome. The quality of images and of video-sequences was comparable to that supported by an ISDN connection. Pictures of live surgery performed by an expert in Florida, USA, were transmitted and viewed by a novice team in Brisbane, Australia. The Australian team has performed 19 fetoscopic laser operations to date. Preliminary results are comparable to those from centres that have performed over 100 procedures.
A profile of success and failure in telehealth – evidence and opinion from the Successes and Failures in Telehealth conferences
Authors: Hailey David , Crowe Bernard
Published: December 2003

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Papers presented at the three Successes and Failures in Telehealth conferences have made a helpful contribution to what is known about the practicalities of implementing and using telehealth. Ten of the 89 papers covered general concepts, 40 described primary studies and 26 discussed telehealth programmes or networks. Common themes that emerged on determinants of success and failure included the reliability of equipment, the reliability of vendors, political and budgetary issues, the perceived need for telehealth, the involvement of stakeholders, health professionals’ opinions, the stability of management structures, the turnover of personnel and cooperation between organizations. Limitations in some papers included an absence of data, weak study designs, short-term perspectives and lack of information on health outcomes. Despite these limitations, the papers have made a valuable contribution to our knowledge of what has worked and what has failed in the field of telehealth.
A Web-based approach to low-cost telemedicine
Authors: Hersh Dov , Hersch Fred , Mikuletic Lilijana , Neilson Scott
Published: December 2003

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We have developed a Web-based application for managing e-consultations. This solves some of the problems inherent in peer-to-peer email communication. Referrals were from three hospitals in Vietnam. Each hospital was provided with Internet access for up to 4 hours a day for an initial 12-month period. In the first six months, six doctors from the Vietnamese hospitals submitted a total of 30 cases. Specialists in Sydney provided their expertise on a voluntary basis. Preliminary data suggest that the Vietnamese doctors found the system benefited their diagnostic and management decision making. Challenges have included equipment failures, language barriers and the difficulty of obtaining feedback. Successes have included the relationship building between doctors in the two countries. Preliminary results were encouraging and most of the Vietnamese doctors (five of the six) reported that they were slowly incorporating use of the system into their daily practice.
A partnership model for the delivery of health education to rural and remote communities using multipoint videoconferencing
Authors: Mcclelland Linda , Faulkner Kathryn , Gale Jennifer , Johnstone Kylie
Published: December 2003

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Multipoint videoconferencing has been used by Women's Health Queensland Wide (WHQW) for the delivery of health education to the residents of regional, remote and rural Queensland communities. The educational programme was a partnership between WHQW and health professionals in the participating communities. Telephone interviews with the health professionals were used in a follow-up study. Fifty-one interviews were conducted in October and November 2002; these involved 43 of the 64 participating towns. The results suggested that the project contributed to improved social capital in the participating communities. In addition, it gave rise to unexpected but valuable outcomes for WHQW and, potentially, for the Queensland community. The project demonstrated that success in telehealth can be measured in terms of social and community effects, as well as clinical outcomes and cost-effectiveness.
Can telepharmacy provide pharmacy services in the bush?
Authors: Nissen Lisa , Tett Susan
Published: December 2003

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Rural and remote community pharmacies service large areas of rural Queensland, and because of the distances involved often do not meet the patients for whom they provide medication. Telepharmacy would improve the quality of pharmaceutical services provided in rural and remote areas, by allowing community pharmacists to have realtime contact with dispensing doctors, aboriginal health workers and patients via a video-phone. We used commercial (analogue) videophones to connect community pharmacists to dispensing doctors, patients in depot pharmacies (i.e. those with no pharmacist) and aboriginal health workers. However, various problems occurred and only 10 video-phone interactions were recorded during the six-month project. In all of the recorded interactions, the video-phone was actually used as a conventional telephone because a video-connection could not be established at the time of the call. (This may have been due to telephone network problems in the rural areas.) Despite these problems, all project participants showed great enthusiasm for the potential benefits of such a service.