bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrient issues on Irish farms and solutions to lower losses
Authors: HUMPHREYS JAMES
Published: February 2008

Agriculture in Ireland utilizes 63% of total land area and has a big environmental impact accounting for 70% of phosphorus and 82% of nitrogen in surface waters, and for 97% of ammonia, 81% of nitrous oxide and 86% of methane emissions to air. Phosphorus loss to water is Ireland's most serious pollution problem. The deterioration of water quality that has been evident since the 1970s has been halted and reduction targets for ammonia and greenhouse gas emissions from agriculture are being achieved. These achievements are largely attributable to declining ruminant livestock populations and declining inputs of manufactured fertilizers as a result of increasing emphasis on extensification of production practices in the Common Agricultural Policy during the past decade. Nevertheless, substantial improvements in water quality are needed by 2015 to meet the requirements of the Water Framework Directive. To meet this and a broad range of environmental targets and to comply with the Nitrates Directive, a wide ranging set of regulations governing agricultural practices was implemented into law in 2006. These include general limits on stocking rates on farms of no greater than 170 kg/ha of N in livestock manures applied mechanically or deposited by grazing livestock. There are periods between September and January when the application of fertilizers and manures is prohibited and minimum winter storage requirements apply for manures generated on farms of between 16 and 26 weeks depending on location and agricultural enterprise. The use of phosphorous is stringently curtailed; there are limits on phosphorous concentrations in soil as determined by a soil test and limits on imports of phosphorus onto farms, which generally cannot exceed exports. These regulations are likely to make an important contribution to achieving environmental targets in Ireland, particularly the improvement in water quality required by the Water Framework Directive.
Activation of brain protein phosphatase‐1I following cardiac arrest and resuscitation involving an interaction with 14‐3‐3γ
Authors: Platholi Jimcy , Heerdt Paul M. , Lim Tung H. Y. , Hemmings Hugh C.
Published: February 2008

The intracellular signaling mechanisms that couple transient cerebral ischemia to cell death and neuroprotective mechanisms provide potential therapeutic targets for cardiac arrest. Protein phosphatase (PP)‐1 is a major serine/threonine phosphatase that interacts with and dephosphorylates critical regulators of energy metabolism, ionic balance, and apoptosis. We report here that PP‐1I, a major regulated form of PP‐1, is activated in brain by approximately twofold in vivo following cardiac arrest and resuscitation in a clinically relevant pig model of transient global cerebral ischemia and reperfusion. PP‐1I purified to near homogeneity from either control or ischemic pig brain consisted of the PP‐1 catalytic subunit, the inhibitor‐2 regulatory subunit, as well as the novel constituents 14‐3‐3γ, Rab GDP dissociation protein β, PFTAIRE kinase, and C‐TAK1 kinase. PP‐1I purified from ischemic brain contained significantly less 14‐3‐3γ than PP‐1I purified from control brain, and purified 14‐3‐3γ directly inhibited the catalytic subunit of PP‐1 and reconstituted PP‐1I. These findings suggest that activation of brain PP‐1I following global cerebral ischemia in vivo involves dissociation of 14‐3‐3γ, a novel inhibitory modulator of PP‐1I. This identifies modulation of PP‐1I by 14‐3‐3 in global cerebral ischemia as a potential signaling mechanism‐based approach to neuroprotection.
A role for glutamate in growth and invasion of primary brain tumors
Authors: Sontheimer Harald
Published: February 2008

The vast majority of primary brain tumors derive from glial cells and are collectively called gliomas. While, they share some genetic mutations with other cancers, they do present with a unique biology and have developed adaptations to meet specific biological needs. Notably, glioma growth is physically restricted by the skull, and, unless normal brain cells are destroyed, tumors cannot expand. To overcome this challenge, glioma cells release glutamate which causes excitotoxic death to surrounding neurons, thereby vacating room for tumor expansion. The released glutamate also explains peritumoral seizures which are a common symptom early in the disease. Glutamate release occurs via system Xc, a cystine–glutamate exchanger that releases glutamate in exchange for cystine being imported for the synthesis of the cellular antioxidant GSH. It protects tumor cells from endogenously produced reactive oxygen and nitrogen species but also endows tumors with an enhanced resistance to radiation‐ and chemotherapy. Pre‐clinical data demonstrates that pharmacological inhibition of system Xc causes GSH depletion which slows tumor growth and curtails tumor invasion in vivo. An Food and Drug Administration approved drug candidate is currently being introduced into clinical trials for the treatment of malignant glioma.
ON THE LINKAGE BETWEEN FINANCIAL RISK TOLERANCE AND RISK AVERSION
Authors: Faff Robert , Mulino Daniel , Chai Daniel
Published: February 2008

We explore the linkage between financial risk tolerance (FRT) and risk aversion. To do this, we obtain FRT scores from a psychometrically validated survey and conduct a battery of online lottery choice experiments involving the same nonstudent participants. We contrast: real and hypothetical payoffs, low and high stakes, decisions involving gains and losses, and order effects. Our key finding is that the two approaches to analyzing decision making under uncertainty are strongly aligned. We present evidence that this is particularly the case for the female participants in our sample and when high‐stake gambles are employed.
LIQUIDITY COMMONALITY BEYOND BEST PRICES
Authors: Kempf Alexander , Mayston Daniel
Published: February 2008

Previous market microstructure research focuses on commonality in liquidity at the inside spread. However, liquidity at the inside spread only determines the systematic liquidity risk of small and medium trades. We study commonality in displayed liquidity beyond best prices, which determines the systematic liquidity risk of large trades. We show that it is much larger than commonality at the inside spread. The deeper we look into the order book, the higher is the level of commonality. In addition, it rises in the morning and when markets fall.
GLAMOUR VERSUS VALUE: TRADING BEHAVIOR OF INSTITUTIONS AND INDIVIDUAL INVESTORS
Authors: Sharma Vivek , Hur Jungshik , Lee Heiwai
Published: February 2008

We design a new metric to measure the net buying and selling by institutions and individual investors and find that from 1980 to 2004 institutional investors were net buyers of growth stocks and net sellers of value stocks, implying that individual investors were net buyers of value stocks and net sellers of glamour stocks. The institutional preference for glamour and value stocks seems to be related to sell‐side analysts' recommendations and recent favorable stock price performances, especially during the post‐1994 period. Finally, the institutional buying of growth stocks and sale of value stocks was not based on superior information.
Kabbalah: A Medieval Tradition and Its Contemporary Appeal
Authors: Tirosh‐Samuelson Hava
Published: February 2008

Popular culture today is suffused with kabbalah, an elitist, intellectual strand of medieval Judaism that claimed to disclose the esoteric meaning of the rabbinic tradition. While rooted in esoteric speculations in late antiquity, kabbalah emerged in the tenth century as an internal debate among Jewish theologians about the ontological status of divine attributes. At the end of the twelfth century speculations about the nature of God emerged among the Pietists of Germany and the ‘masters of kabbalah’ in Provence. During the thirteenth century kabbalah flourished in Spain where its self‐understanding as redemptive activity was expressed in two paradigms – the ‘theosophy‐theurgic’ and the ‘ecstatic‐prophetic’. Kabbalah continued to evolve in the early modern period, shaping both Jewish and European cultures. The modern period saw the rise of the academic study of kabbalah, but it was employed in two conflicting manners: in the nineteenth century scholars associated with the Enlightenment used historical analysis of kabbalah to debunk Jewish traditionalism, but in the first half of the twentieth century, the academic study of kabbalah was used to generate a secular, collective Zionist identity. Although scholarship on kabbalah has flourished in the twentieth century, kabbalah has become a variant of New‐Age religions, accessible to all, regardless of ethnic identity or spiritual readiness.
The Oceans as the Common Property of Mankind from Early Modern Period to Today
Authors: Heidbrink Ingo Klaus
Published: February 2008

Today's Law of the Sea is the result of multiple attempts to organize the utilization of marine resources since the Early Modern period. Starting with Hugo Grotius, the concept of the Freedom of the Seas and an open access approach, the author describes the development of territorial waters and fisheries limits until today. Special consideration is given to the Cod Wars between distant‐water fishing nations and coastal nations like Iceland as well as to Arvid Pardo's vision of the oceans as a Common Heritage of Mankind, the United Nations Conferences on the Law of the Sea and the development of the 200 nautical mile (nm) Exclusive Economic Zones. Based on an historical analysis in the context of the theories of the Tragedy of the Commons and de‐colonization the author discusses why all systems of the Law of the Sea until today failed and could not safeguard a responsible and sustainable use of marine resources. Furthermore the article provides a set of mechanisms that can be applied to the regulation of all open‐access resources.
Combination Polypharmacy for Cardiovascular Disease Prevention in Men: A Decision Analysis and Cost‐Effectiveness Model
Authors: Newman Jonathan , Grobman William A. , Greenland Philip
Published: February 2008

Pharmacotherapies to lower blood pressure and cholesterol are effective in the primary prevention of cardiovascular disease (CVD). The use of fixed‐dose medication combinations has not been well studied. The authors created a Markov model to analyze the cost‐effectiveness of 4 fixed‐dose medications for primary CVD prevention in men. The initial decision node was to treat or not treat men older than 55 years, without CVD, hypertension, or dyslipidemia with a combination of simvastatin, captopril, hydrochlorothiazide, and atenolol. Probability, costs, and effectiveness were derived from the literature. The outcome variable was marginal cost per quality‐adjusted life‐year (QALY). Sensitivity analyses were performed. The average cost of treatment was $70,000 compared with $93,000 for non‐treatment. Treatment resulted in 13.62 QALYs vs 12.96 QALYs without treatment. Primary prevention of CVD with fixed‐dose medications dominated “no‐treatment.” The use of a fixed‐dose polypharmacy approach to CVD prevention in men older than 55 years may be cost‐effective.
Childhood Diet, Overweight, and CVD Risk Factors: The Healthy Start Project
Authors: Williams Christine L. , Strobino Barbara A.
Published: February 2008

Cardiovascular disease (CVD) risk factors can be identified in children and tracked over time. We studied 519 children (mean age, 3.9 years) and reevaluated CVD risk factors 4 years later. Baseline and follow‐up (FU) measures included height, weight, body mass index (BMI), blood pressure level, blood lipid values, and 24‐hour dietary intake. Nutritional predictors of CVD risk factors (lipid levels and BMI) were identified using regression analysis at follow‐up. Energy intake at baseline and FU, as well as increasing BMI over time, were directly associated with total cholesterol levels. Dietary intake of monounsaturated fat and dietary fiber were significant predictors of total cholesterol level at follow‐up (inverse associations). Increasing BMI, waist circumference at FU, and intake of sucrose at FU were inversely associated with high‐density lipoprotein cholesterol levels at FU. Waist circumference and BMI at FU were associated with higher triglyceride levels, while percent energy from monounsaturated fat was associated with lower values. This study provides further evidence that dietary intake influences CVD risk factors in childhood.
Physicians' Perceptions of Barriers and Facilitators Regarding Adoption of the National Cholesterol Education Program Guidelines
Authors: Parker Donna R. , Gramling Robert , Goldman Roberta E. , Eaton Charles B. , Ahern David , Cover Rebecca T. , Borkan Jeffrey
Published: February 2008

Despite the impact of high‐visibility evidence‐based clinical practice guidelines, physician adherence to guidelines remains low. This study explored primary care physicians' perceptions of barriers and facilitators in following the National Cholesterol Education Program guidelines. The authors conducted 9 focus groups and performed qualitative content analysis utilizing immersion‐crystallization processes, codebooks, and qualitative coding software. Key barriers to implementing guidelines included the complexity and transience of existing cholesterol guidelines as well as perceived threats to multidimensional care of the patient that unifocal single‐decision guidelines may create. Key facilitators included growing patient awareness regarding cholesterol, patients' willingness to take cholesterol medication, and technological breakthroughs. These findings have helped identify factors that prevent or enhance the adoption of cholesterol guidelines. While factors considered to be facilitators are significant, barriers may be sufficient to limit adherence. Opportunities may exist for improving adherence to cholesterol guidelines by providing training to providers and developing structural support through patient‐physician activation tools.
The Effect of Beta‐Blockade on Heart Rate Recovery Following Exercise Stress Echocardiography
Authors: Karnik Rahool S. , Lewis William , Miles Peter , Baker Larry
Published: February 2008

The purpose of this study was to determine the effects of β‐blockers (BBs) on heart rate recovery (HRR) following exercise stress testing. HRR is a predictor of mortality following exercise stress testing and is thought to be due to reinstitution of vagal tone. Exercise testing in the presence of BBs should have no effect on reinstitution of vagal tone and therefore no effect on HRR. One published study contradicts this understanding. The authors performed a retrospective analysis of the University of California, Davis, treadmill database and found 334 patients who underwent exercise stress echocardiography (ESE) with complete data. Patients undergoing ESE without a BB were compared with patients who were receiving a BB. HRR was not affected by BB use in patients without stress‐induced echocardiographic abnormalities (negative ESE result). In patients with stress‐induced echocardiographic abnormalities (positive ESE result), HRR was delayed compared with patients with negative ESE. BB use improved HRR in patients with positive ESE. BBs do not affect HRR in patients with a negative ESE result, and HRR can be used for mortality prediction. In patients with a positive ESE result, HRR is improved in the presence of a BB.
Statin Pretreatment Is Protective Despite an Association With Greater Coronary Artery Disease Burden in Patients Presenting With a First ST‐Elevation Myocardial Infarction
Authors: Moran Lynn , Fugate Tyler , Xiang Yufei , Cianci Christopher , Eid Sherrine , Matsumura Martin
Published: February 2008

The relationship of chronic pre‐event statin use with coronary disease severity at the time of presentation with a first acute ST‐elevation myocardial infarction (STEMI) is unknown. A retrospective review was performed of consecutive patients presenting with STEMI and without a prior history of vascular disease, divided into those whom had been treated with statins before presentation (n=50) and those whom were not pretreated (n=231). Patients pretreated with statins were more likely to have left main (24.0% vs 8.3%; P=.001) or 3‐vessel disease (44.0% vs 25.1%; P=.007) vs untreated patients. After matching for risk factors, a trend toward higher likelihood of 3‐vessel disease persisted in the statin pretreatment group (47.6% vs 28.6%; P=.07). Significantly lower peak troponin‐I levels (87.8 mg/dL vs 134.5 mg/dL; P=.006) were found in patients pretreated with statins, suggesting that statin pretreatment is protective in patients with STEMI despite the presence of greater disease burden. This finding supports the concept that statin therapy alters the natural history of coronary artery disease development leading to a first STEMI and is cardioprotective in those patients who experience a first STEMI.
Nocturnal Blood Pressure Elevation Predicts Progression of Albuminuria in Elderly People With Type 2 Diabetes
Authors: Palmas Walter , Pickering Thomas , Teresi Jeanne , Schwartz Joseph E. , Eguchi Kazuo , Field Lesley , Weinstock Ruth S. , Shea Steven
Published: February 2008

Ambulatory 24‐hour pulse pressure predicts progression of albuminuria in persons with diabetes mellitus. The authors assessed whether nocturnal blood pressure (BP) patterns added predictive information and examined the multivariate‐adjusted association of nocturnal BP patterns with progression of urine albumin excretion during follow‐up in a multiethnic cohort of older people (n=957) with type 2 diabetes mellitus who were free of macroalbuminuria. Albuminuria was assessed by spot urine measurement of albumin‐to‐creatinine ratio at baseline and annually for 3 years. Participants were categorized according to their sleep/wake systolic BP ratio as dippers (ratio ≤0.9; n=295), nondippers (flat nocturnal pattern, ratio >0.9 to 1; n=475), and nocturnal BP risers (ratio >1; n=187). The proportion exhibiting progression of albuminuria in dippers, nondippers, and risers was 17.6%, 22.9%, and 27.3%, respectively (P for linear trend = .01). A nocturnal BP rise was independently associated with progression of albuminuria (hazard ratio, 1.68; 95% confidence interval [CI], 1.09–2.60; P=.02), whereas office pulse pressure was not. When ambulatory 24‐hour pulse pressure was added to the model, the nocturnal BP rise remained an independent predictor of progression of albuminuria (hazard ratio, 1.58; 95% CI, 1.02–2.45; P=.04). Nocturnal nondipping (without BP increase) was not an independent predictor. In conclusion, nocturnal BP rise on ambulatory monitoring is superior to office BP to predict worsening of albuminuria in elderly individuals with type 2 diabetes and adds to the information provided by 24‐hour pulse pressure.
Relationship Between Morning Hypertension Identified by Home Blood Pressure Monitoring and Brain Natriuretic Peptide and Estimated Glomerular Filtration Rate: The Japan Morning Surge 1 (JMS‐1) Study
Authors: Ishikawa Joji , Hoshide Satoshi , Shibasaki Seiichi , Matsui Yoshio , Kabutoya Tomoyuki , Eguchi Kazuo , Ishikawa Shizukiyo , Pickering Thomas G. , Shimada Kazuyuki , Kario Kazuomi
Published: February 2008

We evaluated whether morning minus evening systolic blood pressure (SBP) difference (MEdif) in home blood pressure measurements can be a marker for hypertensive target organ damage. The authors analyzed 611 hypertensive patients who had high morning SBP levels (≥135 mm Hg). The patients with morning hypertension (MEdif ≥15 mm Hg, average of morning and evening SBP [MEave] ≥135 mm Hg) were older (P<.001) and had a longer duration of hypertension and antihypertensive medication use, a higher prevalence of left ventricular hypertrophy (LVH) on electrocardiography, a lower glomerular filtration rate by the Cockcroft‐Gault equation (P=.002), and a higher brain natriuretic peptide (BNP) level (P<.001) than those with well‐controlled blood pressure (MEdif <15 mm Hg, MEave <135 mm Hg). The patients with morning hypertension had a higher BNP level than those with well‐controlled blood pressure after adjustment for the confounding factors (28.7 pg/mL vs 20.0 pg/mL; P=.033). In conclusion, morning hypertension is more likely seen among patients with older age and longer duration of hypertension and antihypertensive medication use, and it may be associated with a higher prevalence of LVH and a higher BNP level.
Patterns and Associated Health Services Costs of Antihypertensive Drug Modifications
Authors: Saleh Shadi S. , Szebenyi Steven , Carter Judith A. , Zacher Chris , Belletti Dan
Published: February 2008

This study sought to identify patterns of antihypertensive drug modifications in initial drug therapy as well as to examine the effect of modifications on costs. The study population included adults who initiated antihypertensive drug therapy during 12 months of therapy. Approximately three‐fourths of study participants had a change in therapy within the first 12 months of treatment. Discontinuation (57.1%) of antihypertensive drug treatment was the most prevalent modification type, followed by titrations (14.6%). Initiating treatment with fixed‐dose combinations was associated with the lowest likelihood of a nondiscontinuation modification (12.5%); the use of 2 separate drugs was associated with the least likelihood of complete discontinuation (28.7%). The presence of therapy changes was associated with increased health services costs in the first 12 months of antihypertensive drug therapy. Clinicians and payers should be aware of the association between starting specific antihypertensive treatment regimens and the likelihood of changes in medication and changing costs.
Treatment With Metoprolol Succinate, a Selective Beta Adrenergic Blocker, Lowers Blood Pressure Without Altering Insulin Sensitivity in Diabetic Patients
Authors: Falkner Bonita , Kushner Harvey
Published: February 2008

Insulin resistance is a risk factor for cardiovascular disease. Therapies to lower blood pressure should not decrease insulin sensitivity, especially among high‐risk patients such as diabetics. This study examined the effect of the β1‐selective adrenergic receptor‐blocking agent extended‐release metoprolol succinate (ER metoprolol) on insulin sensitivity in type 2 diabetic patients with suboptimal blood pressure control. Diabetic patients with average blood pressure levels >130/85 mm Hg despite antihypertensive therapy had insulin sensitivity quantified by insulin clamp. ER metoprolol was then added to their ongoing therapy. Following 12 weeks of ER metoprolol plus other therapy, the insulin clamp study was repeated. There were no significant changes in measures of insulin sensitivity, plasma lipids, or hemoglobin A1c with use of ER metoprolol. When β‐blocker therapy is considered, it appears that this agent can be used to treat hypertension without adverse effects on insulin sensitivity in patients with type 2 diabetes, at least over the period of time treated.
The Importance of Prompt Blood Pressure Control
Authors: Basile Jan
Published: February 2008

Hypertension affects almost one‐third of adults in the United States, but blood pressure is adequately controlled in only about 50% to 60% of persons with treated hypertension. Abundant clinical trial evidence has shown that antihypertensive therapy significantly reduces the risk of vascular events, and meta‐analyses of observational and clinical trials have shown that greater reductions in blood pressure are associated with greater reductions in risk. Recent trials have also suggested that prompt control of blood pressure is beneficial in high‐risk patients with hypertension. A post hoc analysis of a trial comparing an angiotensin II receptor blocker‐based program with a calcium channel blocker‐based treatment regimen found that the blood pressure response after 1 month (regardless of the drug used) predicted the risk of vascular events and survival. Therapy with ≥2 medications given separately or as a fixed combination is more likely than monotherapy to lower blood pressure to goal in part because drugs from different classes target different mechanisms that regulate blood pressure. Moreover, the likelihood of achieving blood pressure goals is greater if the time to achieve control is shortened, and prompt control of blood pressure is more likely with multiple‐drug therapy than with monotherapy.
Combined Therapy With a Calcium Channel Blocker and an Angiotensin II Type 1 Receptor Blocker
Authors: Bakris George L.
Published: February 2008

Fixed‐dosed combination regimens consisting of a calcium channel blocker and an angiotensin II type 1 receptor blocker represent a new addition to the available antihypertensive treatment options. Clinical trials demonstrate that both the dihydropyridine calcium channel blocker amlodipine and angiotensin II receptor blockers are effective agents for the management of hypertension in individuals with or without cardiovascular disease. When combined, these 2 classes of agents have complementary effects on blood pressure, as each targets separate signaling pathways in the vasculature pivotal to the regulation of vascular function. In clinical trials this combination has demonstrated better efficacy, defined by time to reach blood pressure targets as well as levels of blood pressure achieved, compared with the individual agents. In a comparative trial, a combination of amlodipine plus valsartan (an angiotensin II receptor blocker) also produced greater reductions in blood pressure compared with a combination of lisinopril (an angiotensin‐converting enzyme inhibitor) and hydrochlorothiazide. The combination of amlodipine and an angiotensin II receptor blocker is well tolerated, including in patients with stage 2 hypertension and the elderly.
Hypertension Control in the Elderly
Authors: Neutel Joel M. , Gilderman Lawrence I.
Published: February 2008

Hypertension is highly prevalent in older persons and most often presents as isolated systolic hypertension. Systolic blood pressure (BP) is a stronger predictor of risk than diastolic BP in persons older than 50 years. Most of these patients will require multiple drug therapies to achieve the substantial reductions in systolic BP needed to reach target levels. Clinical trials have demonstrated that antihypertensive therapy with β‐blockers and diuretics as well as with calcium channel blockers, angiotensin‐converting enzyme inhibitors, and angiotensin II type 1 receptor blockers reduces cardiovascular risk in older patients. Studies examining safety and BP‐lowering efficacy have shown that a renin‐angiotensin‐aldosterone system blocker plus a calcium channel blocker as well as a combination of diuretics and β‐blockers or diuretics plus an angiotensin‐converting enzyme inhibitor or angiotensin II type 1 receptor blocker achieves greater BP reductions than monotherapy. Such multiple drug regimens are well tolerated in older patients.
The D Allele of Angiotensin‐Converting Enzyme Polymorphism as a Predictor of Renal Function Decline over 4 Years in an Apparently Healthy Chinese Population Aged 60 and Older
Authors: Lee Ya‐Ting , Chiu Herng‐Chia , Su Ho‐Ming , Voon Wen‐Chol , Lin Tsung‐Hsien , Lai Wen‐Ter , Sheu Sheng‐Hsiung
Published: February 2008

OBJECTIVES: To test the association between angiotensin‐converting enzyme (ACE) insertion or deletion (I/D) polymorphism and decline of renal function in people aged 60 and older.

DESIGN: Population‐based prospective study with 4‐year follow‐up.

SETTING: Department of Internal Medicine and Family Medicine, Kaohsiung Medical University (KMU) Hospital and Graduate Institute of Medicine and Public Health, KMU.

PARTICIPANTS: Of 1,500 people screened, 193 subjects were enrolled, and 144 completed 4 years of follow‐up, 112 non‐diabetic normotensive elderly people were analyzed.

MEASUREMENTS: Subjects received biochemistry examination at baseline and at 2‐ and 4‐year follow‐ups. Serum creatinine and calculated renal parameters, including the Cockroft‐Gault (CG) formula, the Jelliffe formula, and the Modification of Diet in Renal Disease (MDRD) Study equation, were used. Genetic polymorphism was analyzed according to the polymerase chain reaction.

RESULTS: The mean age±standard deviation of the subjects was 71.9±3.7 (range 60–81). Serum creatinine, CG creatinine clearance (CrCl), Jelliffe CrCl, and MDRD glomerular filtration rate (GFR) were significantly lower at the 2‐ and 4‐year follow‐ups (all P≤.001). At the 4‐year follow‐up, the magnitude of declines of the above four renal parameters was significantly higher in subjects with the ACE D allele than in the non‐D‐allele carriers (P=.01, .01, .04, and .01 for creatinine, CG CrCl, Jelliffe CrCl, and MDRD GFR, respectively). This association was still significant in multivariate analyses (P≤.02 for all parameters).

CONCLUSION: This longitudinal study showed the ACE I/D gene polymorphism might modulate renal function decline in elderly Chinese. This provides further knowledge essential in the assessment of renal disease and determination of renal function in older Chinese.
Tricuspid Prosthesis Stenosis Associated with Endocarditis: A New M‐Mode Finding
Authors: Logue Michael A. , Perk Gila , Kronzon Itzhak
Published: February 2008

A man with endocarditis was found to have prosthetic tricuspid valve (TV) stenosis without regurgitation. The large vegetation moved into the TV prosthesis orifice in diastole. A seldom‐recognized echocardiographic finding was observed in which the interatrial septum bulged toward the left atrium in diastole.
Familial Cutaneous Collagenoma
Authors: Dawn Marianne E. , Deng April C. , Petrali John , Wessely Caroline , Jaffe David , Gaspari Anthony A.
Published: February 2008

A 41‐year‐old woman presented to our dermatology clinic in February 2005 with a chief complaint of numerous flesh‐colored nodules on her back and abdomen. She initially noticed the lesions at age 17 years. The plaques had increased in size and number over time, but remained asymptomatic. The patient reported multiple similar lesions on a maternal uncle and a cousin. Her family history was also notable for cardiomyopathy, resulting in the death of her mother. The patient's past medical history was notable for poorly controlled type I diabetes, currently managed with an insulin pump; and coronary artery disease. The patient had undergone multiple cardiac procedures before the age of 40 years, including quadruple coronary artery bypass grafting surgery and placement of 9 cardiac stents. Her ejection fraction on cardiac catheterization in November 2004 was 65% with no wall motion abnormalities. On physical examination, numerous spongy, discrete, flesh‐colored plaques and nodules were seen concentrated across the upper part of her back between the scapulae as well as underneath the breasts and across the flanks (Figure 1). All lesions were asymptomatic. Prior workup of this patient had included plain films of the long bones and hands, which were within normal limits. A biopsy from lesional skin on the back highlighted by trichome stain showed an increased number of markedly thickened and eosinophilic dermal collagen bundles compared with adjacent normal skin. Immunohistochemical studies with anticollagen type I and type III antibodies confirmed that the increased collagen material consisted of type I collagen fibers, which is the same type of collagen found in normal dermis. The elastic fibers, highlighted by Verhoeff‐van Gieson stain (Figure 2), were diminished and haphazardly arranged. No increased cellular component or inflammatory infiltrate was observed. These findings were consistent with a collagenoma. Further analysis of the lesional tissue by electron microscopy revealed that the ultrastructural appearance of the collagen fibers, including arrangement and diameters, were not significantly different from that of the normal tissue (Figure 3).

On physical examination, numerous spongy, flesh‐colored plaques and nodules were seen concentrated across the upper part of the patient's back between the scapulae.

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Elastic stain of lesional tissue demonstrates a diminished number of abnormal elastic fibers intermingled with thickened collagen bundles; Verhoeff‐van Gieson stain, original magnification ×40.

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On electron microscopy, the ultrastructural appearance of the collagen fibers, including arrangement and diameters, was not significantly different from that of the normal tissue.

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Use of Oral Isotretinoin in Photoaging Therapy
Authors: Kalil Célia Luiza Petersen Vitello , Fachinello Fernanda Zatti , Lamb Flávia Maria , Comunello Luciane Nardi
Published: February 2008

Background
. Many drugs are being used for prevention and treatment of photoaging, especially topical retinoids. The use of systemic retinoids, more specifically, isotretinoin, for this purpose has not been properly addressed to date. Our study was designed to assess the systemic use of isotretinoin used alone for the therapy of cutaneous photoaging.

Objective
. To demonstrate that isotretinoin is converted into retinoid and improves the appearance of the photoaged skin.

Methods
. Fifty women aged 40 to 60 years, phototype I, II, or III according Fitzpatrick, were selected to receive 20 mg of isotretinoin orally 3 times a week for a 3‐month period. Patients underwent clinical and laboratory evaluation. Two biopsies and photographic control were performed. Patients were requested to use only topical photoprotecting agents during the treatment. Improvement in photoaging clinical parameters were evaluated through pictures taken and also through an evaluation form. Anatomopathologic parameters were obtained by comparing collagen degeneration and skin trophism.

Results
. Thirty patients fully complied with study requirements and were adequately analyzed. From the anatomopathologic data, an improvement of photoaging in 20 patients was observed.

Conclusions
. Isotretinoin improves photoaging with few adverse events because of the low dose used and to the short treatment duration.
Diagnosis and Management of Primary Cicatricial Alopecia: Part I
Authors: Otberg Nina , Wu Wen‐Yu , McElwee Kevin John , Shapiro Jerry
Published: February 2008

In this 2‐part article, the authors review the primary cicatricial alopecias. Primary cicatricial alopecia can be defined as predominantly lymphocytic, neutrophilic, or mixed based on the nature of the follicular infiltrate that is present around affected hair follicles. Lymphocytic primary cicatricial alopecias include chronic cutaneous lupus erythematosus (discoid lupus erythematosus), lichen planopilaris, classic pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. In this first part, the authors summarize the classification, epidemiology, diagnostic approach, and patient management of lymphocytic cicatricial alopecias. In part II, the authors will focus on neutrophilic cicatricial alopecias and mixed cicatricial alopecias.
Use of a Keratolytic Agent With Occlusion for Topical Treatment of Hyperkeratotic Seborrheic Keratoses
Authors: Burkhart Craig G. , Burkhart Craig N.
Published: February 2008

Background
. Seborrheic keratoses are the most common benign tumors in adults. Despite their negative cosmetic appearance, no topical treatment is commonly recommended for these lesions.

Objective
. Our objective was to assess whether clinical benefit could be achieved by using a keratolytic topical agent and superficial scraping for this condition.

Methods
. A topical 50% urea‐containing product under occlusion was applied daily to large and/or thick hyperkeratotic seborrheic keratoses on the truck and extremities. The patients were instructed to digitally scrape the surface of the lesions in an attempt to reduce the thickness of the lesions.

Results
. In a pilot nonrandomized open‐label survey, patients expressed satisfaction with using this topical therapeutic technique.

Conclusions
. Hyperkeratotic seborrheic keratoses can be satisfactorily managed with topical agents and scraping with reasonable patient satisfaction. Further studies with various keratolytic agents using other delivery systems are warranted.
The antiproliferative activity of melatonin in B65 rat dopaminergic neuroblastoma cells is related to the downregulation of cell cycle‐related genes
Authors: Pizarro Javier G. , Yeste‐Velasco Marc , Esparza José Luis , Verdaguer Ester , Pallàs Mercè , Camins Antoni , Folch Jaume
Published: February 2008

Abstract:  A potential application of melatonin is its ability to rescue many cell types from cell death, because of its antioxidant properties. Likewise, recent studies suggest that melatonin may also be used as an anti‐tumor drug, due to its anti‐proliferative properties in tumor cells when administered at physiologic or pharmacologic doses. In the present study, we investigated the mechanisms involved in the apoptosis induced by acute exposure to melatonin and roscovitine in the rat dopaminergic neuroblastoma B65 cell line. Cell growth studies revealed that, at 24 hr of treatment, roscovitine blocked cell growth and induced apoptosis whereas melatonin delayed cell growth and induced a slight increase in the number of apoptotic nuclei. Melatonin also increased the percentage of cells in the G1‐phase of the cell cycle, whereas roscovitine blocked cells in the G2/M‐phase. Both compounds significantly downregulated the transcriptional activity of cdk4, while melatonin also downregulated cdk2 and cyclin D1. Taken together, our data show that melatonin at millimolar concentrations inhibits dopaminergic B65 proliferation, induces cell apoptosis, and modulates cell cycle progression by inhibiting the transcriptional activity of cyclins and cdks related to the progression of the G1‐phase.
Genome‐wide quantitative trait locus association scan of general cognitive ability using pooled DNA and 500K single nucleotide polymorphism microarrays
Authors: Butcher L. M. , Davis O. S. P. , Craig I. W. , Plomin R.
Published: February 2008

General cognitive ability (g), which refers to what cognitive abilities have in common, is an important target for molecular genetic research because multivariate quantitative genetic analyses have shown that the same set of genes affects diverse cognitive abilities as well as learning disabilities. In this first autosomal genome‐wide association scan of g, we used a two‐stage quantitative trait locus (QTL) design with pooled DNA to screen more than 500 000 single nucleotide polymorphisms (SNPs) on microarrays, selecting from a sample of 7000 7‐year‐old children. In stage 1, we screened for allele frequency differences between groups pooled for low and high g. In stage 2, 47 SNPs nominated in stage 1 were tested by individually genotyping an independent sample of 3195 individuals, representative of the entire distribution of g scores in the full 7000 7‐year‐old children. Six SNPs yielded significant associations across the normal distribution of g, although only one SNP remained significant after a false discovery rate of 0.05 was imposed. However, none of these SNPs accounted for more than 0.4% of the variance of g, despite 95% power to detect associations of that size. It is likely that QTL effect sizes, even for highly heritable traits such as cognitive abilities and disabilities, are much smaller than previously assumed. Nonetheless, an aggregated ‘SNP set’ of the six SNPs correlated 0.11 (P < 0.00000003) with g. This shows that future SNP sets that will incorporate many more SNPs could be useful for predicting genetic risk and for investigating functional systems of effects from genes to brain to behavior.
Generalist genes and the Internet generation: etiology of learning abilities by web testing at age 10
Authors: Davis O. S. P. , Kovas Y. , Harlaar N. , Busfield P. , McMillan A. , Frances J. , Petrill S. A. , Dale P. S. , Plomin R.
Published: February 2008

A key translational issue for neuroscience is to understand how genes affect individual differences in brain function. Although it is reasonable to suppose that genetic effects on specific learning abilities, such as reading and mathematics, as well as general cognitive ability (g), will overlap very little, the counterintuitive finding emerging from multivariate genetic studies is that the same genes affect these diverse learning abilities: a Generalist Genes hypothesis. To conclusively test this hypothesis, we exploited the widespread access to inexpensive and fast Internet connections in the UK to assess 2541 pairs of 10‐year‐old twins for reading, mathematics and g, using a web‐based test battery. Heritabilities were 0.38 for reading, 0.49 for mathematics and 0.44 for g. Multivariate genetic analysis showed substantial genetic correlations between learning abilities: 0.57 between reading and mathematics, 0.61 between reading and g, and 0.75 between mathematics and g, providing strong support for the Generalist Genes hypothesis. If genetic effects on cognition are so general, the effects of these genes on the brain are also likely to be general. In this way, generalist genes may prove invaluable in integrating top‐down and bottom‐up approaches to the systems biology of the brain.
Mainstreaming nutrition in maternal, newborn and child health: barriers to seeking services from existing maternal, newborn, child health programmes
Authors: Streatfield Peter K. , Koehlmoos Tracey P. , Alam Nurul , Mridha Malay K.
Published: February 2008

Table of Contents

Summary
237

Introduction
238

Objectives
238

Approach and methodology for the study
238

Background to barriers to use of health services
239

 Models of health service utilization
239

  Mosley and Chen Child Survival framework
239

  Explanatory models
239

  Hierarchy of resort
240

 Dimensions of access
240

 Framework for categorization of barriers
241

 Summary
242

Barriers to use of health services
242

  Geographic access
243

  Temporal access
244

  Socio‐cultural access
245

  Financial access
248

  Quality of care
249

Discussion
250

References
252

In the light of mainstreaming nutrition programs into health services, this review article approaches the issue of barriers to existing maternal child health programs from both theoretical and applied perspectives. It begins with a discussion of salient literature on models of health service utilization. The mid‐section of the paper presents the results of a review of research studies that illuminate the barriers to care. Categorical themes emerged from the review of studies in the form of barriers based on geographic factors, temporal factors, a myriad of socio‐cultural factors, financial factors and quality of care. The discussion focuses on the need to overcome existing restrictions to health services in order to facilitate initiatives to mainstream nutrition and achieve Millennium Development Goal #1.
Mainstreaming nutrition into maternal and child health programmes: scaling up of exclusive breastfeeding
Authors: Bhandari Nita , Kabir A.K.M. Iqbal , Salam Mohammed Abdus
Published: February 2008

Table of Contents

Summary
5

Background
6

Methods and search strategy
6

The scale‐up process
7

Issues that need to be addressed while scaling up a programme for exclusive breastfeeding
7

Conclusions
13

Acknowledgements
14

References
14

Appendix 1
18

Appendix 2
22

Interventions to promote exclusive breastfeeding have been estimated to have the potential to prevent 13% of all under‐5 deaths in developing countries and are the single most important preventive intervention against child mortality. According to World Health Organization and United Nations Children Funds (UNICEF), only 39% infants are exclusively breastfed for less than 4 months. This review examines programme efforts to scale up exclusive breastfeeding in different countries and draws lesson for successful scale‐up. Opportunities and challenges in scaling up of exclusive breastfeeding into Maternal and Child Health programmes are identified. The key processes required for exclusive breastfeeding scale‐up are: (1) an evidence‐based policy and science‐driven technical guidelines; and (2) an implementation strategy and plan for achieving high exclusive breastfeeding rates in all strata of society, on a sustainable basis. Factors related to success include political will, strong advocacy, enabling policies, well‐defined short‐ and long‐term programme strategy, sustained financial support, clear definition of roles of multiple stakeholders and emphasis on delivery at the community level. Effective use of antenatal, birth and post‐natal contacts at homes and through community mobilization efforts is emphasized. Formative research to ensure appropriate intervention design and delivery is critical particularly in areas with high HIV prevalence. Strong communication strategy and support, quality trainers and training contributed significantly to programme success. Monitoring and evaluation with feedback systems that allow for periodic programme corrections and continued innovation are central to very high coverage. Legal framework must make it possible for mothers to exclusively breastfeed for at least 4 months. Sustained programme efforts are critical to achieve high coverage and this requires strong national‐ and state‐level leadership.
Sustaining Trust Within Family Businesses
Authors: Sundaramurthy Chamu
Published: February 2008

Trust, a competitive advantage for family businesses in the early stages, often deteriorates as the firm grows, putting it under considerable risk. While sustaining trust within family businesses is a critical topic, we have limited understanding of this issue. Yet, the trust research within the organizational sciences provides considerable insight on this topic. Therefore, in this paper a model of sustaining trust is presented based on an integration of this trust literature with the family business literature. The basic premise of the model is that trust is dynamic and multiple dimensions of trust need to be developed through structures and processes to sustain interpersonal trust inherent in the early stages. Implications of the model and future research directions are outlined.
Earnings Management in Family Firms: Evidence From R&D Cost Capitalization in Italy
Authors: Prencipe Annalisa , Markarian Garen , Pozza Lorenzo
Published: February 2008

Recent accounting-related scandals have underscored the prevalence of earnings management in financial markets. This article provides empirical evidence on the motivations for earnings management in publicly listed family companies, highlighting the differences from public nonfamily firms. Basing our predictions on an analysis of the salient characteristics of family firms in both an agency and a stewardship framework, we hypothesize that family firms are less sensitive to income-smoothing motivations than are nonfamily firms, while they are similarly motivated to manage earnings for debt-covenant and leverage-related reasons. We test our hypotheses by looking at a specific accrual, R&D cost capitalization, where statistical tests confirm our hypothesized relationships.
Measuring changes in activity participation of older Australians: Validation of the Activity Card Sort – Australia
Authors: Doney Robyn M , Packer Tanya L
Published: February 2008

Objectives:  This study explored the psychometric properties of the Australian version of the Activity Card Sort (ACS‐Aus), a recently developed measure of activity participation for use with older adults. Concurrent, convergent construct, and discriminative construct validity were examined.

Methods:  The study included 93 Australian adults aged 60–95 years. Participants completed the ACS‐Aus, as well as an existing Australian measure of activity participation (The Adelaide Activities Profile) and an Australian measure of subjective well‐being (the Personal Well‐being Index).

Results:  The ACS‐Aus demonstrated moderate concurrent validity (r = 0.434), moderate convergent construct validity (r = 0.354), and strong discriminative validity (P = 0.000).

Conclusions:  The World Health Organization has recently promoted participation as an important component of the healthy ageing process. This study has validated the use of the ACS‐Aus in measuring participation of community‐dwelling older adults in Australia.