bluuebunny/crossref_metadata_2025 huggingface dataset:
Conformational changes of Newcastle disease virus envelope glycoproteins triggered by gangliosides
Authors: Ferreira Laura , Villar Enrique , Muñoz‐Barroso Isabel
Published: December 2004

We have investigated the conformational changes of Newcastle disease virus (NDV) glycoproteins in response to receptor binding, using 1,1‐bis(4‐anilino)naphthalene‐5,5‐disulfonic acid (bis‐ANS) as a hydrophobicity‐sensitive probe. Temperature‐ and pH‐dependent conformational changes were detected in the presence of free bovine gangliosides. The fluorescence of bis‐ANS was maximal at pH 5. The binding of bis‐ANS to NDV was not affected by chemicals that denature the fusion glycoprotein, such as reducing agents, nor by the presence of neuraminidase inhibitors such as N‐acetyl neuramicic acid. Gangliosides partially inhibited fusion and hemadsorption, but not neuraminidase hemagglutinin‐neuraminidase glycoprotein (HN) activity. A conformational intermediate of HN, triggered by the presence of gangliosides acting as receptor mimics, was detected. Our results indicate that, upon binding to free gangliosides, HN undergoes a certain conformational change that does not affect the fusion glycoprotein.
A specific C‐terminal deletion in tropomyosin results in a stronger head‐to‐tail interaction and increased polymerization
Authors: Paulucci Adriana A. , Katsuyama Angela M. , Sousa Aurea D. , Farah Chuck S.
Published: December 2004

Tropomyosin is a 284 residue dimeric coiled‐coil protein that interacts in a head‐to‐tail manner to form linear filaments at low ionic strengths. Polymerization is related to tropomyosin's ability to bind actin, and both properties depend on intact N‐ and C‐termini as well as α‐amino acetylation of the N‐terminus of the muscle protein. Nα‐acetylation can be mimicked by an N‐terminal Ala‐Ser fusion in recombinant tropomyosin (ASTm) produced in Escherichia coli. Here we show that a recombinant tropomyosin fragment, corresponding to the protein's first 260 residues plus an Ala‐Ser fusion [ASTm(1–260)], polymerizes to a much greater extent than the corresponding full‐length recombinant protein, despite the absence of the C‐terminal 24 amino acids. This polymerization is sensitive to ionic strength and is greatly reduced by the removal of the N‐terminal Ala‐Ser fusion [nfTm(1–260)]. CD studies show that nonpolymerizable tropomyosin fragments, which terminate at position 260 [Tm(167–260) and Tm(143–260)], as well as Tm(220–284), are able to interact with ASTm(1–142), a nonpolymerizable N‐terminal fragment, and that the head‐to‐tail interactions observed for these fragment pairs are accompanied by a significant degree of folding of the C‐terminal tropomyosin fragment. These results suggest that the new C‐terminus, created by the deletion, polymerizes in a manner similar to the full‐length protein. Head‐to‐tail binding for fragments terminating at position 260 may be explained by the presence of a greater concentration of negatively charged residues, while, at the same time, maintaining a conserved pattern of charged and hydrophobic residues found in polymerizable tropomyosins from a variety of sources.
A multi‐protein complex containing cold shock domain (Y‐box) and polypyrimidine tract binding proteins forms on the vascular endothelial growth factor mRNA
Authors: Coles Leeanne S. , Bartley M. Antonetta , Bert Andrew , Hunter Julie , Polyak Steven , Diamond Peter , Vadas Mathew A. , Goodall Gregory J.
Published: December 2004

Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis and post‐transcriptional regulation plays a major role in VEGF expression. Both the 5′‐ and 3′‐UTR are required for VEGF post‐transcriptional regulation but factors binding to functional sequences within the 5′‐UTR have not been fully characterized. We report here the identification of complexes, binding to the VEGFmRNA 5′‐ and 3′‐UTR, that contain cold shock domain (CSD) and polypyrimidine tract binding (PTB) RNA binding proteins. Analysis of the CSD/PTB binding sites revealed a potential role in VEGF mRNA stability, in both noninduced and induced conditions, demonstrating a general stabilizing function. Such a stabilizing mechanism had not been reported previously for the VEGF gene. We further found that the CSD/PTB‐containing complexes are large multiprotein complexes that are most likely preformed in solution and we demonstrate that PTB is associated with the VEGF mRNA in vivo. Complex formation between CSD proteins and PTB has not been reported previously. Analysis of the CSD/PTB RNA binding sites revealed a novel CSD protein RNA recognition site and also demonstrated that CSD proteins may direct the binding of CSD/PTB complexes. We found the same complexes binding to an RNA‐stabilizing element of another growth factor gene, suggesting a broader functional role for the CSD/PTB complexes. Finally, as the VEGF gene is also regulated at the transcriptional level by CSD proteins, we propose a combined transcriptional/post‐transcriptional role for these proteins in VEGF and other growth factor gene regulation.
Reversal of pancytopenia following kidney transplantation in a patient of primary hyperoxaluria with bone marrow involvement
Authors: SUD KAMAL , SWAMINATHAN SUNDARARAMAN , VARMA NEELAM , KOHLI HARBIR SINGH , JHA VIVEKANAND , GUPTA KRISHAN LAL , SAKHUJA VINAY
Published: December 2004

Combined liver and kidney transplantation is the ideal treatment for patients with end‐stage renal failure secondary to primary hyperoxaluria and systemic oxalosis, with a functioning liver providing replacement of the deficient enzyme and a functioning kidney providing the route of excretion for the oxalate crystals. Pancytopenia from bone marrow infiltration of oxalate crystals is a rare complication of primary hyperoxaluria, and its reversal following transplant has not been described. We report the first case of pancytopenia from marrow infiltration by oxalate crystals reversing following a successful kidney transplant alone. Although kidney alone transplants do not provide the best chance of survival or quality of life as compared to a combined kidney and liver transplant, a well functioning kidney transplant is able to take care of the systemic oxalate load and ameliorate, at least for a period of time, the systemic complications of oxalosis.
Managing Henoch–Schonlein purpura in children with fish oil and ACE inhibitor therapy
Authors: DIXIT MEHUL P , DIXIT NAZNIN M , SCOTT KATHERINE
Published: December 2004

Background:  Henoch–Schonlein purpura (HSP) is a vasculitic syndrome with palpable purpura and renal involvement. The treatment for HSP with persistent renal disease remains controversial. The kidney biopsy in HSP shows IgA deposits and fish‐oil therapy has proven to be promising in halting the progression of IgA nephropathy.

Methods:  Five children with biopsy‐proven HSP with repeated episodes of haematuria and proteinuria were treated with fish oil  (1 g  orally  twice  daily).  In  three  of  the  five  patients  an  angiotensin‐converting enzyme inhibitor (ACEI) was added for hypertension.

Results:  The mean duration of follow up after starting fish‐oil therapy was 49.2 weeks. The protein excretion rate prior to starting fish oil was 1041 mg/day and on the last follow‐up visit the rate had decreased to 104 mg/day (P < 0.05). The average blood pressure (BP) prior to therapy was 135/82. On the last follow‐up visit the average BP off ACEI had decreased to 100/54 (P < 0.05). After a year of follow up serum creatinine and glomerular filtration rates have remained stable at 51.2 µmol/L and 128 mL/min/1.73 m2, respectively.

Conclusion:  This is the first report of abatement of HSP with fish oil and ACEI in children. There is a need for randomized prospective trials to confirm this observation.
Non‐convulsive status epilepticus and consciousness disturbance after star fruit (Averrhoa carambola) ingestion in a dialysis patient
Authors: CHANG CHUNG‐HSIN , YEH JIANN‐HORNG
Published: December 2004

SUMMARY:  Star fruit ingestion may induce severe neurological complications in chronic renal failure patients. We present a case on maintenance dialysis therapy who developed a consciousness disturbance without convulsion after eating star fruit. The symptoms became aggravated after haemodialysis. The brain computed tomography scan showed no abnormal findings, but the electroencephalogram found active focal sharp waves in the left central regions and diffusion‐weighted magnetic resonance imaging also showed hyperintense lesions in the left central regions that were compatible with non‐convulsive status epilepticus. His condition improved dramatically after anticonvulsant therapy and regular haemodialysis. The patient was discharged 20 days later without neurological sequela.
Research an exciting journey and a career statement: a means to an end, putting rurality on the nursing research agenda
Authors: Allen Sonia , Francis Karen , O'Connor Margaret
Published: December 2004

Two issues were of importance to nurses in rural areas considering postgraduate studies. The first was the need for part‐time study and what this entails. The second was a request that there be no research component within the postgraduate courses they identified. It is this second issue that I wish to address. I was a nonbeliever in the merit of research studies being integrated into nursing specialist programs. Following a long career in rural clinical nursing and management I have come full circle and now acknowledge the need to understand the role to base practice evidence that is generated through empirical research.
Change of bilirubin photoisomers in the urine and serum before and after phototherapy compared with light source
Authors: Okada Hitoshi , Masuya Kumiko , Kurono Yuki , Nagano Keiko , Okubo Kensuke , Yasuda Saneyuki , Kawasaki Ayako , Kawada Kou , Kusaka Takashi , Namba Masanori , Nishida Tomoko , Imai Tadashi , Isobe Kenichi , Itoh Susumu
Published: December 2004

Background
: The clinical effect of phototherapy for neonatal hyperbilirubinemia is based on the production and elimination of cyclobilirubin. Generally, the clinical effect of light sources is estimated by the reduction in the total serum bilirubin level. One procedure with less invasiveness than blood collecting is urine collection. Whether the effectiveness of light sources used for phototherapy could be assessed using measurements of bilirubin photoisomers in urine was studied.

Methods
: This study was a retrospective analysis of 38 term infants with hyperbilirubinemia who underwent phototherapy. Bilirubin fractions in serum and urine before and 24 h after the phototherapy were measured by high‐performance liquid chromatography. The light sources used for the phototherapy were blue‐white light (n = 11), Biliblanket plus high output (n = 13) or green light (n = 14). The relationships between serum and urine bilirubin photoisomers after phototherapy and whether the levels of urine bilirubin photoisomer are affected by the light sources with different wavelength characteristic were analyzed.

Results
: There was no correlation between serum (ZE)‐bilirubin and urine configurational isomers, but a weak positive correlation between serum (EZ)‐cyclobilirubin and urine structural isomers after phototherapy. Although serum (ZE)‐bilirubin levels depended on the wavelength characteristic of each light source during phototherapy, the urine configurational isomer levels did not depend on it. The increase in serum (EZ)‐cyclobilirubin levels and the urine structural isomer levels were mostly in agreement.

Conclusions
: The urine bilirubin structural isomers may be used to estimate the serum (EZ)‐cyclobilirubin levels and to evaluate the clinical effects of light sources.
Oral iron supplementation in preterm infants treated with erythropoietin
Authors: Fujiu Toru , Maruyama Kenichi , Koizumi Takenobu
Published: December 2004

Background
: It is not known whether a moderate dose of oral iron supplementation would further enhance erythropoiesis in recombinant human erythropoietin (EPO)‐treated very low‐birthweight (VLBW) infants.

Methods
: In total, 24 preterm infants with birthweights 750–1499 g were enrolled at the age of 14–28 days to receive 400 IU/kg per week EPO subcutaneously for 8 weeks. The infants were randomly allocated either to receive oral iron supplementation 4 mg/kg per day or to serve as controls.

Results
: Hemoglobin and the absolute reticulocyte count in the iron supplementation and the control groups remained identical throughout the study period, whereas serum ferritin was significantly lower in the control group at study exit and follow up. Rates of treatment success (no need for transfusion and hemoglobin never below 8 g/dL) also did not differ between the groups.

Conclusions
: In this study we did not find a clear advantage in a moderate dose of oral iron supplementation on erythropoiesis in EPO‐treated VLBW infants. Whether a higher dose would lead to enhanced erythropoiesis remains to be answered.
Long‐term expressed human α‐Galactosidase A in tissues of HαG transgenic mice
Authors: Hoshikawa Masahiro , Kase Ryoichi , Tadokoro Mamoru , Sakuraba Hitoshi , Sakiyama Takeshi
Published: December 2004

Background
: Human alpha‐galactosidase A (hαG) is an essential lysosomal enzyme in catalyzing the hydrolysis of ceramide trihexoside in humans. Effects have been directed to develop effective gene and replacement therapies for the deficiency of hαG, Fabry disease. In recent years, hαG transgenic mice (TGM) have been established, and the expression of hαG in their general organs has been reported. However, detailed distribution of the cells expressing hαG have not yet been defined.

Methods
: The distribution of hαG in organs of the hαG‐TGM was studied by means of immunohistochemistry and enzyme assay.

Results
: Immunohistochemical analysis revealed a systematic hαG expression in the TGM, including endothelial cells of the bone marrow, liver, spleen, pancreas, lungs, uriniferous tubules in the kidneys, and choroids plexus in the brain. Enzyme assay demonstrated a persistent expression of hαG in the TGM during 14–20 months after birth.

Conclusion
: A long‐term expression of hαG in organs may indicate hαG‐TGM as a useful tool in the research of gene and replacement therapies for Fabry disease.
Testis‐sparing surgery in an adult with bilateral synchronous seminomatous tumor
Authors: DEMIR ASLAN , ÖNOL F. FATIH , EREN FUNDA , TÜRKERI LEVENT
Published: December 2004

Abstract  Bilateral synchronous testicular cancer is a rare occurrence and is usually associated with similar histological findings in each testicle. The standard therapy of bilateral testis cancer is generally considered to be orchiectomy. We present a case of synchronous bilateral testicular germ cell tumor treated with testis‐sparing surgery. The patient was disease free for 30 months after surgery without local recurrence or distant metastases. Testis‐sparing surgery provides a better quality of life and may be considered a safe, feasible alternative in the treatment of carefully selected patients with bilateral testicular germ cell tumor.
Unreliable residual volume measurement after increased water load diuresis
Authors: ALIVIZATOS GERASIMOS , SKOLARIKOS ANDREAS , ALBANIS STEPHANOS , FERAKIS NIKOS , MITROPOULOS DIONYSIOS
Published: December 2004

Abstract  Background  The aim of the present study was to examine whether increased water load intake prior to ultrasound examination of the lower urinary tract, affects the measurement of postvoid residual urine volume.

Patients and methods  Ninety four male patients with postvoid residual volumes after increased water load diuresis of more than 100 mL (PVR1) were included in the present study. All patients underwent a second PVR measurement by an urologist with a portable transabdominal bladder ultrasound scan without having received an increased water load (PVR2). A comparison of the measurements was performed and the PVR values were also correlated with other parameters, such as age, International Prostate Symptom Score, prostate volume and serum prostate‐specific antigen (PSA) values.

Results:  Postvoid residual urine volume after increased water load diuresis (PVR1) differed from that recorded after normal bladder filling and voiding at first desire (PVR2), with the former being larger than the later in every patient (P < 0.001). The PVR values, PVR1 and PVR2, were independent to patient age, symptom score prostate volume and PSA value.

Conclusions  Measurement of postvoid residual volume in a relaxed patient, who voids at first desire, represents everyday life and should be the correct method of testing.
Radio‐frequency ablation of renal cell carcinoma in patients who were at significant risk
Authors: UKIMURA OSAMU , KAWAUCHI AKIHIRO , FUJITO AKIRA , MIZUTANI YOICHI , OKIHARA KOJI , MIKAMI KAZUYA , SOH JINTETSU , NAKAMURA TERUKAZU , NAKANISHI HIROYUKI , USHIJIMA SO , MIKI TSUNEHARU
Published: December 2004

Abstract  Objective:  Although radio‐frequency ablation (RFA) has been recently applied as a minimally invasive treatment option for renal cell carcinoma (RCC), indication of this modality remains a critical issue due to the lack of complete tumor destruction as well as the uncertainty of its long‐term efficacy. We report the efficacy of RFA for nine carefully selected patients with RCC who had significant reason to avoid invasive surgical treatment under general anesthesia.

Methods:  Radio‐frequency ablation was performed under epidural or local anesthesia by ultrasound or computed tomography (CT) guidance in nine patients with biopsy proven RCC (mean diameter, 38 mm; range, 20–53 mm), who were at significant operative or anesthetic risk for invasive surgery. Follow‐up enhanced CT scans or magnetic resonance images were evaluated every 3–6 months and an evaluation of metastasis was performed every 6 months.

Results:  At a mean follow‐up of 17 months, seven (78%) of the nine patients with renal tumor showed no tumor enhancement. The renal function of all patients was well preserved. All patients were able to continue undergoing their respective treatments for active diseases in other organs in parallel to the RFA treatment. No distant metastasis, urine leakage were reported and one case of temporary hematuria and one case of peri‐renal hemorrhage not requiring blood transfusion were encountered. Intra‐operative ultrasonography was useful in the real‐time monitoring of the minimally excessive extension of ablation into the normal parenchyma.

Conclusion:  Radio‐frequency ablation appears to be an effective and safe minimally invasive therapeutic option for selected patients with RCC who have reason to avoid invasive surgery under general anesthesia.
A national retinal screening programme for diabetes in Scotland
Authors: Leese G. P. , Morris A. D. , Olson J.
Published: December 2004

The Health Technology Board Scotland (HTBS) have issued recommendations for eye screening in patients with diabetes. These are based on evidence‐based clinical studies. Evidence‐based studies do not answer all the practical issues, and some conclusions have thus been extrapolated from the known evidence base. Other factors such as patient issues, organizational issues and cost effectiveness have also been incorporated into the recommendations. HTBS recommend single‐field digital retinal photography. Retinal photography best addresses the issues of adequate sensitivity and accountable quality assurance. Non‐mydriatic photography is recommended, followed by immediate use of dilating eye drops if it is unsuccessful, followed by slit‐lamp examination if both of these approaches fail. An independent grading scheme has been established, which is similar to the ‘Global’, and compatible with the National Screening Committee (NSC) grading scheme. The rationale for these recommendations, and debate behind some of the decisions, is laid out in this article.
Tale of two churches: differential impact of a church‐based diabetes control programme among Pacific Islands people in New Zealand
Authors: Simmons D. , Voyle J. A. , Fou F. , Feo S. , Leakehe L.
Published: December 2004

Aims  To compare the impact on weight and exercise of a 2‐year church‐based diabetes risk reduction programme in four churches in South Auckland, New Zealand.

Methods  A prospective non‐randomized controlled study of a modular lifestyle and diabetes awareness intervention programme applying community development principles. The study involved four complete church congregations, two Samoan and two Tongan, with 516 participants at commencement. Risk of Type 2 diabetes is high among both ethnic groups.

Results  Overall, 285 subjects were available for their second assessment. In one intervention church, weight gain was controlled (vs. control 0 ± 4.8 vs. +3.1 ± 9.8 kg, respectively; P = 0.05), diabetes knowledge (+46 ± 26% vs. +4 ± 17%; P < 0.001) and regular exercise (at least 3 days per week: +22% vs. −8%; P = 0.032) increased and readiness to change weight (P = 0.007) shifted towards maintenance (e.g. maintenance +41% vs. +8%, respectively). The other intervention church increased diabetes knowledge (+19 ± 24 vs. +8 ± 25; P < 0.024), but no other significant personal changes occurred. Attendance and perceived utility of the programme were greater in the first intervention church.

Conclusions  A moderate intensity, community‐based, structured diabetes awareness and lifestyle programme can reduce diabetes risk, but increasing diabetes knowledge alone is not necessarily associated with healthier lifestyle choices. Continuous and detailed monitoring of penetration of interventions may be essential to help guide the timing of interventions and identify the need for additional strategies to increase participation and motivation.

Diabet. Med. 21, 122–128 (2004)
The New Zealand Diabetes Passport Study: a randomized controlled trial of the impact of a diabetes passport on risk factors for diabetes‐related complications
Authors: Simmons D. , Gamble G. D. , Foote S. , Cole D. R. , Coster G.
Published: December 2004

Aims  To assess the efficacy (change in HbA1c) of a patient‐held communication, self‐empowerment and educational device for people with diabetes (the New Zealand Diabetes Passport) in patients with poor glycaemic control.

Research design and methods  A 12‐month, multicentre, general practice‐based randomized controlled trial in urban, provincial and rural New Zealand involving 398 people with poorly controlled Type 1 or Type 2 diabetes. The intervention included a specifically designed and piloted New Zealand Diabetes Passport including information relating to diabetes knowledge, self‐assessments, and guidance concerning how to engage with diabetes health professionals. The primary end point was change in HbA1c. Assessments were made at 0, 6 and 12 months.

Results  Two hundred and twenty‐two patients received the Passport, 176 the control booklet, coming from 69 and 66 general practitioners, respectively. Use of the Passport was associated with a relative reduction in HbA1c of 0.4% (P = 0.017) and a relative increase in weight of 1.0 kg/m2 (P = 0.028), but no changes in diabetes knowledge, attitudes to diabetes or risk factors for diabetic tissue damage.

Conclusions  The dissemination of the New Zealand Diabetes Passport, in isolation, was not associated with improvements in either diabetes knowledge or self‐empowerment. While a small improvement in glycaemic control occurred, this was probably due to changes in insulin therapy in the intervention group. It is possible that linking the use of the Passport with other behavioural and educational interventions may make the Passport more useful. Further study is required to confirm the effect of such multifaceted interventions.
Hospital outcome of acute myocardial infarction in patients with and without diabetes mellitus
Authors: Otter W. , Kleybrink S. , Doering W. , Standl E. , Schnell O.
Published: December 2004

Aims  To assess hospital mortality and morbidity in diabetic and non‐diabetic patients with acute myocardial infarction and to compare the results between the two groups.

Methods  All patients admitted in 1999 to the intensive care unit of the Schwabing City Hospital with diagnosis of acute myocardial infarction were assessed for hospital mortality and co‐morbidity.

Results  Three hundred and thirty patients with acute myocardial infarction were admitted. Of those, 126 (38%) were diabetic and 204 (62%) were non‐diabetic patients. Mortality within 24 h after admission was 13.5% in diabetic patients and 5.4% in non‐diabetic patients (P < 0.01). Mortality during entire hospitalization was higher in diabetic than in non‐diabetic patients (29.4% vs. 16.2%; P = 0.004). Diabetic patients were resuscitated more frequently than non‐diabetic patients (24% vs. 11%, P < 0.01). In diabetic patients, heart rate at admission was increased (91 ± 27 vs. 82 ± 23/min; P < 0.01) and presence of angina pectoris was reported less frequently (59% (n = 72) vs. 82% (n = 167); P < 0.001). Preceding myocardial infarction, microalbuminuria, peripheral artery disease and arterial hypertension were more frequent in diabetic than in non‐diabetic patients. Diabetic patients demonstrated higher C‐reactive protein (CRP) levels than non‐diabetic patients (91.4 ± 78.2 mg/l vs. 45.2 ± 62.4 mg/l; P < 0.001).

Conclusions  In diabetic patients with acute myocardial infarction, early hospital mortality is increased and signs of cardiac autonomic dysfunction and microangiopathy are detected more frequently than in non‐diabetic patients. The need for advanced treatment strategies early in the course of diabetic patients with myocardial infarction is emphasized.

Diabet. Med. 21, 183–187 (2004)
Coronary heart disease risk assessment in diabetes mellitus: comparison of UKPDS risk engine with Framingham risk assessment function and its clinical implications
Authors: Song S. H. , Brown P. M.
Published: December 2004

Aims  To assess differences between absolute coronary heart disease (CHD) risks calculated by Joint British Societies (JBS) risk calculator and UKPDS risk engine and its impact on CHD primary prevention management in diabetes mellitus (DM).

Methods  Seven hundred Type 2 DM patients without arterial complications were identified from nine general practices in the Scarborough area. Their absolute 10‐year CHD risks were calculated. The differences in the proportion of patients identified for aspirin and statin under JBS and National Institute for Clinical Excellence (NICE) guidelines by these two methods were determined. The proportion of additional patients identified for statin in the Scarborough population as a consequence of CHD risk threshold reduction from 30 to 15% (as recommended by NICE) was also determined.

Results  UKPDS risk engine calculated significantly higher mean 10‐year CHD risk (UKPDS vs. JBS, 21.5 vs. 18.3%, P < 0.0001). Both methods identified approximately 65% of patients to be eligible for aspirin and statin if NICE recommendations were followed. At a risk threshold of 30%, the UKPDS risk engine identified more patients for statin. Reducing the CHD risk threshold from 30 to 15% for statin initiation will identify an additional 0.5% of the total population for this treatment.

Conclusions  Both methods are comparable in identifying at‐risk patients under NICE recommendations. A high proportion has risk levels that merits primary CHD prevention. Lowering the risk threshold for statin treatment has a small numerical impact on the whole population.
The effects of smoking and its cessation on 8‐epi‐PGF2α and transforming growth factor‐beta 1 in Type 1 diabetes mellitus
Authors: Flores L. , Vidal M. , Abian J. , Cases A. , Campistol J. Ma. , Clària J. , Lario S. , Esmatjes E.
Published: December 2004

Background  Oxidative stress and transforming growth factor‐beta 1 (TGF‐β1) are associated with diabetic complications, and smoking is a risk factor.

Aims  This study aimed (i) to compare urinary 8‐epi‐PGF2α and plasma and urinary TGF‐β1 levels obtained in heavy smokers with Type 1 diabetes with those observed in age‐matched non‐smoker patients with Type 1 diabetes and controls, and (ii) to investigate the effects of smoking cessation (SC) on the above‐mentioned parameters in patients with Type 1 diabetes.

Methods and results  Compared with control subjects (n = 12), non‐smoker diabetic patients (n = 12) presented higher values of urinary 8‐epi‐PGF2α (74.2 ± 29.6 vs. 29.6 ± 11.1 pg/mg urinary creatinine, P = 0.01), plasma TGF‐β1 (7.7 ± 4.7 vs. 3.6 ± 1.7 ng/ml, P = 0.001) and urinary TGF‐β1 (15.3 ± 6.3 vs. 8.1 ± 4.4 ng/mg urinary creatinine, P = 0.02). Compared with non‐smoker diabetic patients, smoker diabetic patients (n = 16) showed higher levels of urinary 8‐epi‐PGF2α (107.8 ± 40.2 vs. 74.2 ± 29.6 pg/mg urinary creatinine, P = 0.0001), plasma TGF‐β1 (12.6 ± 4.9 vs. 7.7 ± 4.7 ng/ml, P = 0.001) and urinary TGF‐β1 (27.5 ± 16.0 vs. 15.3 ± 6.3 ng/mg urinary creatinine, P = 0.01). Smoker patients were included in a smoking cessation programme. In the 10 patients that gave up smoking there was a reduction of urinary 8‐epi‐PGF2α (basal: 110.47 ± 47.0 vs. week 12: 73.2 ± 25.6; P < 0.001), plasma TGF‐β1 (basal: 11.2 ± 5.9 vs. week 12: 4.89 ± 2.25; P < 0.01) and urinary TGF‐β1 (basal: 18.12 ± 9.27 vs. week 12: 10.32 ± 2.0; P < 0.01) levels.

Conclusions  In patients with Type 1 diabetes, smoking increased oxidative stress, evaluated by lipid peroxidation, and TGF‐β1 production. Smoking cessation decreased these parameters, providing additional support to encourage diabetic patients to give up smoking.
Young children with autism show atypical brain responses to fearful versus neutral facial expressions of emotion
Authors: Dawson Geraldine , Webb Sara J. , Carver Leslie , Panagiotides Heracles , McPartland James
Published: December 2004

Evidence suggests that autism is associated with impaired emotion perception, but it is unknown how early such impairments are evident. Furthermore, most studies that have assessed emotion perception in children with autism have required verbal responses, making results difficult to interpret. This study utilized high‐density event‐related potentials (ERPs) to investigate whether 3–4‐year‐old children with autism spectrum disorder (ASD) show differential brain activity to fear versus neutral facial expressions. It has been shown that normal infants as young as 7 months of age show differential brain responses to faces expressing different emotions. ERPs were recorded while children passively viewed photos of an unfamiliar woman posing a neutral and a prototypic fear expression. The sample consisted of 29 3–4‐year‐old children with ASD and 22 chronological age‐matched children with typical development. Typically developing children exhibited a larger early negative component (N300) to the fear than to the neutral face. In contrast, children with ASD did not show the difference in amplitude of this early ERP component to the fear versus neutral face. For a later component, typically developing children exhibited a larger negative slow wave (NSW) to the fear than to the neutral face, whereas children with autism did not show a differential NSW to the two stimuli. In children with ASD, faster speed of early processing (i.e. N300 latency) of the fear face was associated with better performance on tasks assessing social attention (social orienting, joint attention and attention to distress). These data suggest that children with ASD, as young as 3 years of age, show a disordered pattern of neural responses to emotional stimuli.
The development of complex sentence interpretation in typically developing children compared with children with specific language impairments or early unilateral focal lesions
Authors: Dick Frederic , Wulfeck Beverly , Krupa‐Kwiatkowski Magda , Bates Elizabeth
Published: December 2004

This study compared sentence comprehension skills in typically developing children 5–17 years of age, children with language impairment (LI) and children with focal brain injuries (FL) acquired in the pre/perinatal period. Participants were asked to process sentences ‘on‐line’, choosing the agent in sentences that varied in syntactic complexity (actives, passives, subject clefts and object clefts), and in the presence or absence of a subject‐verb agreement contrast. Results revealed that accuracy and processing speeds vary with syntactic complexity in all groups, reflecting the frequency and regularity of sentence types. Developmental changes continued throughout childhood, as children became faster and more accurate at processing more complex sentence structures. Children with LI and children with FL were quite profoundly delayed, displaying profiles similar to, or more impaired than those of younger children, but there was no evidence in the FL group for a disadvantage in left‐ vs. right‐hemisphere‐damaged children. Children with LI showed one unique pattern: higher than normal costs (reflected in reaction times) in using converging information from subject‐verb agreement, in line with studies suggesting special vulnerabilities in grammatical morphology in this group. Results are discussed in terms of the Competition Model, a theory of language processing designed to account for the statistical changes in performance that are observed during development, and the probabilistic deficits in children with language impairments.
DIVISIONS OF LABOUR, SPECIALIZATION AND THE ENFORCEMENT OF A SYSTEM OF PROPERTY RIGHTS: A GENERAL EQUILIBRIUM ANALYSIS
Authors: Ke Li , Smyth Russell
Published: December 2004

Abstract.  This paper uses a model of endogenous theft and endogenous network division of labour to formalize some of the main principles of the economics of the state and to explore related issues concerning why new constitutional rules emerge and evolve. The model suggests that fiscal competition between states facilitates important circular effects, which propel improvements in economic welfare and promote economic growth. In particular, improvements in institutional efficiency expand the demand for transactions, which in turn increases the need for further third‐party protection of property rights. We illustrate our results using the growth of the state system in Western Europe.
A MIXED NASH–WALRASIAN EQUILIBRIUM MODEL WITH ENDOGENOUS STEALING AND ENDOGENOUS SPECIALIZATION
Authors: Ke Li , Shuntian Yao
Published: December 2004

Abstract.  Using a price vector and a conjecture about a population's activities, this paper suggests that a mixed Nash–Walrasian equilibrium (NWE) occurs if, when every individual maximizes her utility under her conjecture, the trading markets and the theft ‘markets’ are all cleared. Thus, in our model the property rights system, instead of giving protection directly to producers, is aimed mainly at discouraging illegal behaviour. As a result, the equilibrium of the economy is seen to depend not only on self‐protection and/or the legal system itself, but also on the transportation efficiency of the economy.
PRIVATE EDUCATION AND ‘EDUCATION FOR ALL’
Authors: Tooley James
Published: December 2004

Government schools cannot provide quality education for all. If the goal of education for all is to be achieved, the private sector must be encouraged and not squeezed out. Development agencies need to wake up to this because large‐scale government education leads to failure on a large scale that can cause serious harm to the poor.
EFA AND PRIVATE EDUCATION: SOME REGIONAL EXPERIENCES AND FINDINGS
Authors: Kitaev Igor
Published: December 2004

Many developing and transitional countries do not have sufficient resources or capacities to meet the Education for All goals. Given that private education is a growing reality around the world, partnerships between governments and private providers may support attempts to meet the goals of EFA. This article uses recent empirical research from a variety of regions to examine the appropriate roles of the government and the private sector in the provision of primary, basic and secondary levels of instruction.
LIFE INSURANCE: REGULATION AS CONTRACT ENFORCEMENT1
Authors: Morrison Alan D.
Published: December 2004

Debating the minutiae of insurance regulation without a clear understanding of why insurance companies are regulated is futile. In this article I discuss the economic rationale for insurance business regulation and conclude that the appropriate role of the regulator is to enforce contracts which might otherwise be broken. I argue that if this is the case, regulation should be optional, and that it need not be a monopoly activity.
FEDERATION WITH MAJORITY DECISIONS: ECONOMIC LESSONS FROM THE HISTORY OF THE UNITE D STATES, GERMANY AND THE EUROPEAN UNION
Authors: Vaubel Roland
Published: December 2004

This article examines the potential impact of qualified majority voting on decision‐making within the EU. It draws on the experience of US federalism, Germany under Bismarck and the UK in the European Union. In each case, it is shown that geographical majorities (nations, states or regions) have used majority decision‐making as a means of increasing their rivals’ costs. It is argued that to prevent such behaviour in the future in the EU, the proposed Constitutional Treaty should raise, not lower, the decision‐making quorum.
Role of fluids in migmatites: CO2‐H2O fluid inclusions in leucosomes from the Deep Freeze Range migmatites (Terra Nova Bay, Antarctica)
Authors: GIORGETTI G. , FREZZOTTI M.‐L.E , PALMERI R. , BURKE E. A. J.
Published: December 2004

ABSTRACT The metasedimentary sequence of the Deep Freeze Range (northern Victoria Land, Antarctica) experienced high‐T/low‐F metamorphism during the Cambro‐Ordovician Ross orogeny. The reaction Bt + Sil + Qtz = Grt + Crd + Kfs + melt was responsible for the formation of migmatites. Peak conditions were c. 700–750° C, c. 3.5–5 kbar and xH2Oc. 0.5).

Distribution of fluid inclusions is controlled by host rock type: (1) CO2‐H2O fluid inclusions occur only in graphite‐free leucosomes; (2) CO2–CH4± H2O fluid inclusions are the most common type in leucosomes, and in graphite‐bearing mesosomes and gneiss; and (3) CO2–N2–CH4 fluid inclusions are observed only in the gneiss, and subordinately in mesosomes.

CO2–H2O mixtures (41% CO2, 58% H2O, 1% Nad mol.%) are interpreted as remnants of a synmig‐matization fluid; their composition and density are compatible P–T–aH2O conditions of migmatization (c. 750° C, c. 4 kbar, xH2Oc. 0.5). CO2‐H2O fluid in graphite‐free leucosomes cannot originate via partial melting of graphite‐bearing mesosomes in a closed system; this would have produced a mixed CO2–CH4 fluid in the leucosomes by a reaction such as Bt + Sil + Qtz + C ± H2O = Grt + Crd + Kfs + L + CO2+ CH4. We conclude that an externally derived oxidizing CO2‐H2O fluid was present in the middle crust and initiated anatexis.

High‐density CO2‐rich fluid with traces of CH4 characterizes the retrograde evolution of these rocks at high temperatures and support isobaric cooling (P–T anticlockwise path). In unmigmatized gneiss, mixed CO2–N2–CH4 fluid yields isochores compatible with peak metamorphic conditions (c. 700–750° C, c. 4–4.5 kbar); they may represent a peak metamorphic fluid that pre‐dated the migmatization.
Fluid production and isograd reactions at contacts of carbonate‐rich and carbonate‐poor layers during progressive metamorphism
Authors: WALTHER J. V.
Published: December 2004

ABSTRACT With increasing temperature during prograde metamorphism reactions will occur first at the lithological contacts of mixed pelite and calcsilicate terranes. At these interfaces, a fluid of lower chemical potential of H2O and CO2 than that required to produce a fluid in either layer can be produced whether reaction is caused by fluid infiltration or is initially fluid absent. If the interface region does not allow fluid transport then as temperature increases, a fluid pressure greater than lithostatic can develop. At some degree of over‐pressure relative to rock pressure, the fluid hydraulically fractures the rock and a gradient in fluid composition away from the contact can be produced. These phenomena occur at the compositional interfaces whenever univariant reactions in the differing layers cross on a temperature vs. mole fraction of CO2 diagram with slopes of opposite sign. The first occurrence of these reaction products at lithological contacts delineates an isograd that defines temperature as well as the mole fraction of CO2 at constant pressure in systems open to fluid transport. These isograds can be contrasted with fluid‐producing isograds in closed systems. As an illustration of possible effects, the reactions quartz + clinozoisite + muscovite = anorthite + K‐feldspar + H2O and phlogopite + quartz + calcite = tremolite + K‐feldspar + H2O + CO2 at 4 kbar are analysed and equations for fluid production and transport are developed.
Development and Positioning Reliability of a TMS Coil Holder for Headache Research
Authors: Chronicle Edward P. , Pearson A. Jane , Matthews Cheryl
Published: December 2004

Objective.—Accurate and reproducible coil positioning is important for headache research using transcranial magnetic stimulation protocols. We aimed to design a transcranial magnetic stimulation coil holder and demonstrate reliability of test–retest coil positioning.

Methods.—A coil holder was developed and manufactured according to three principles of stability, durability, and three‐dimensional positional accuracy. Reliability of coil positioning was assessed by stimulating over the motor cortex of four neurologically normal subjects and recording finger muscle responses, both at a test phase and a retest phase several hours later.

Results.—In all four subjects, repositioning of the transcranial magnetic stimulation coil solely on the basis of coil holder coordinates was accurate to within 2 mm.

Conclusions.—The coil holder demonstrated good test–retest reliability of coil positioning, and is thus a promising tool for transcranial magnetic stimulation‐based headache research, particularly studies of prophylactic drug effect where several laboratory visits with identical coil positioning are necessary.
Migraine Therapy: A Survey of Pharmacists' Knowledge, Attitudes, and Practice Patterns
Authors: Wenzel Richard G. , Lipton Richard B. , Diamond Merle L. , Cady Roger
Published: December 2004

Objective.—Study pharmacists' knowledge, attitudes, and practice patterns with regard to migraine therapy.

Background.—Pharmacists interact with headache sufferers at least 53,000 times daily, thus are well positioned to improve the less than optimal medication management of these disorders.

Methods.—Two hundred self‐administered surveys, distributed at a migraine symposium, assessing pharmacists' demographic characteristics and level of agreement or disagreement with treatment approaches were conducted.

Results.—A total of 171 useable surveys (86%) were received. Of the sample, 35% were community pharmacists, 29% were hospital pharmacists, and the remainder were from other work environments. Exclusively among community pharmacists, 80% feel that headache is an important part of their practice, 85% make between one and five over‐the‐counter (OTC) headache product suggestions per day, and 12% make six or more daily OTC recommendations. Among all the sample's pharmacists, more than half feel migraine patients should try OTC drugs prior to prescription medications, only half ask patients about headache‐related morbidity, and one‐third feel migraine‐specific medications should be reserved only for patients who initially fail nonspecific drugs. Few pharmacists utilize published migraine treatment guidelines. Approximately two‐thirds of pharmacists do not feel migraine is a neurobiological illness. The majority is comfortable with their ability to identify people needing a physician referral.

Conclusions.—Our results show pharmacists, particularly those in community pharmacies, interact with headache sufferers multiple times daily. Most pharmacists were neither familiar with nor practice migraine therapies endorsed by evidence‐based guidelines. Further training of pharmacists is warranted.
Executive Control Mediates Memory's Association with Change in Instrumental Activities of Daily Living: The Freedom House Study
Authors: Royall Donald R. , Palmer Raymond , Chiodo Laura K. , Polk Marsha J.
Published: December 2004

Objectives: To assess the relative independent contribution of changes in executive control function (ECF) and memory to changes in functional status.

Design: Three‐year longitudinal cohort study.

Setting: A comprehensive care retirement community.

Participants: Five hundred forty‐seven noninstitutionalized people aged 70 and older.

Measurements: The California Verbal Learning Test (CVLT) and Executive Interview (EXIT25). Functional status was assessed using instrumental activities of daily living (IADLs). Latent growth curves of CVLT, EXIT25, and IADLs were modeled. The rate of change in IADLs (adjusted for baseline IADLs and cognition) was regressed on the rate of change in each cognitive measure. Models were also adjusted for baseline age, level of care, and comorbid illnesses.

Results: There was significant variability around the baseline means and slopes for all variables. The rate of change in EXIT25 was independently correlated with the rate of change in IADLs (correlation coefficient (r)=−0.52, P<.001). This remained significant after adjusting for baseline EXIT25 scores, IADLs, age, comorbid disease, and level of care. The EXIT25's effect on the rate of change in IADLs was stronger than those of age, baseline IADLs, comorbid disease, or level of care. The rate of change in CVLT scores was not significantly associated with the rate of change in IADLs.

Conclusion: ECF is a strong, significant, and independent correlate of functional status in normal aging. In contrast, decline in memory, as measured using the CVLT, has no independent association with the rate of change in functional status. This suggests that amnestic mild cognitive impairment can be associated with dementia only though the subsequent or comorbid development of ECF impairment.
Drop Attacks in Older Adults: Systematic Assessment Has a High Diagnostic Yield
Authors: Parry Steve W. , Kenny Rose Anne
Published: December 2004

Objectives: To investigate the causes of recurrent drop attacks in older patients with a comprehensive battery of investigations in the largest series reported to date.

Design: Observational with mean followup of 18 months.

Setting: Inner city emergency department and tertiary facility in Newcastle upon Tyne, United Kingdom.

Participants: Ninety‐three consecutive patients aged 55 and older with three or more drop attacks in the 6 months before evaluation.

Methods: Subjects underwent a comprehensive diagnostic evaluation, with particular attention to traditional (e.g., gait and balance abnormalities, medications) and more recently identified (e.g., carotid sinus hypersensitivity) risk factors for drop attacks.

Results: Subjects tended to be older (mean age±standard deviation 77.4±9.0) and female (70; 75%) and to have a mean of 10.4 drop attacks before evaluation. Fifty‐three (57%) had suffered soft tissue injuries needing medical attention and 32 (34%) fractures secondary to drop attacks. An attributable diagnosis was achieved in all but nine subjects (90%). Cardiovascular diagnoses (49; 53%) were most commonly implicated, with neurological (27; 29%) and gait and balance abnormalities (17; 18%) and drug‐related causes (11; 12%) providing the majority of the remaining diagnoses.

Conclusion: Drop attacks in older subjects are associated with high levels of morbidity and healthcare resource utilization. Attributable diagnoses are achievable in the majority of cases with a systematic investigative approach. The high diagnostic yield more than justifies the approach described.