bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived Advantages and Disadvantages of Using Drug Samples in a University Hospital Center: A Case Study
Authors: Tardif Lyne , Bailey Benoît , Bussières Jean-François , Lebel Denis , Soucy Geneviève
Published: December 2008

BACKGROUND

The distribution of drug samples is both permitted and a common practice in Canada and the US. The impact of this strategy on healthcare workers’ opinions and habits is a reason for concern.

OBJECTIVE

To evaluate the perceived advantages and disadvantages of using drug samples in a university hospital center.

METHOD

An observational, descriptive case study was conducted in a 500-bed university hospital center between October 18 and November 1, 2007. To obtain feedback from the healthcare staff, our research team, which was made up of a physician, pharmacy resident, 2 pharmacists, and a student in health administration, designed a 26-question survey using a Likert scale (fully agree, partially agree, partially disagree, totally disagree, do not know). The questions focused on 8 different variables (rapid treatment initiation, free cost and availability, practicality of use, patient risk, pharmacist's role, impact on choice of treatment, storage and stock management, risk of pilfering).

RESULTS

In total, 39 physicians, 18 medical residents, 17 medical clerks, 83 nurses, and 23 pharmacists working in various healthcare units and outpatient clinics (N = 180) agreed to take part in the survey and fill out the questionnaire. Generally speaking, there was a high degree of variation among the professional groups in their levels of agreement with the statements on the questionnaire. For example, 71% of the nurses, 43% of the physicians, 71% of the medical residents, and 36% of the medical clerks believed that drug samples encouraged treatment adherence, whereas only 17% of the pharmacists were of this opinion.

CONCLUSIONS

Our results show that the perceived advantages and risks of using drug samples vary by healthcare provider group and in terms of exposure or nonexposure to their use. Concerned professionals must be provided with this information and strict measures must be instituted to ensure patient security.
Probable Trimethoprim/Sulfamethoxazole–Induced Higher-Level Gait Disorder and Nocturnal Delirium in an Elderly Man
Authors: Dakin Lucy E
Published: December 2008

OBJECTIVE

To report a case of probable trimethoprim/sulfamethoxazole (TMP/SMX)– induced higher-level gait disorder (HLGD) and nocturnal delirium in an elderly patient on high-dose oral therapy.

CASE SUMMARY

An 82-year-old man with a recent history of depression became comatose following an overdose of escitalopram and oxazepam. He was admitted, ventilated for 7 days in the intensive care unit, and treated with piperacillin/tazobactam and cefepime for aspiration pneumonia. Following discharge to a medical ward, respiratory symptoms persisted and imaging confirmed pulmonary abscesses. Stenotrophomonas maltophilia was isolated from sputum and, on day 15, TMP/SMX 800 mg/160 mg 1 tablet every 12 hours was initiated. On day 35, the dose was increased to 800 mg/160 mg 2 tablets every 12 hours. By day 37, the patient was unsteady when attempting to stand. From day 40, he was noted to have features of HLGD with gait ignition failure, poor balance, and frequent falls. His other medications at this time were thiamine 100 mg daily, multivitamin 1 tablet daily, omeprazole 20 mg every 12 hours, and modified-release venlafaxine 150 mg daily. Investigation did not reveal any cause for his acute gait disturbance. TMP/SMX was stopped on day 48 and, by day 51, the patient's gait had returned to normal.

DISCUSSION

Neuropsychiatric adverse reactions with TMP/SMX have been infrequently reported. The Naranjo probability scale indicated that TMP/SMX was the probable cause of HLGD in this patient.

CONCLUSIONS

At time of writing, this was the first reported case of HLGD associated with TMP/SMX. Clinicians should consider this adverse reaction as a potential cause of HLGD, especially in the elderly and those with malnutrition and hepatic or renal dysfunction.
Normal Pregnancy and Healthy Child After Continued Exposure to Gliclazide and Ramipril During Pregnancy
Authors: Kolagasi Oykun , Sari Funda , Akar Munire , Sari Ramazan
Published: December 2008

OBJECTIVE

To report a case of exposure to gliclazide and ramipril during pregnancy in a patient with diabetes mellitus and hypertension.

CASE SUMMARY

A 42-year-old female with type 2 diabetes mellitus and hypertension who had been taking gliclazide 30 mg/day and ramipril 10 mg/day for 2 years was admitted in the 16th week of gestation. The following week, gliclazide and ramipril were discontinued and methyldopa 500 mg 4 times daily and intensive insulin therapy were instituted. Blood glucose concentrations and blood pressure remained within acceptable levels throughout the pregnancy. The patient gave birth to a healthy child (3200 g) by cesarean section after completing an uneventful gestation period.

DISCUSSION

Oral antidiabetic drug use in pregnancy is not recommended secondary to known effects on the fetus such as congenital abnormalities, fetal hyperinsulinemia, macrosomia, and neonatal hypoglycemia. Although this infant had no abnormalities after being exposed to gliclazide and ramipril during the first 16 weeks of gestation, this case is not an unconditionally acceptable indication for safety of these medications in pregnancy. Angiotensin-converting enzyme inhibitors increase fetal risks and therefore should not be used during pregnancy, according to data from animals and humans. There are few data available on use of sulfonylureas; thus, their use should also be avoided during pregnancy.

CONCLUSIONS

Although the normal pregnancy outcome in our patient does not indicate that use of gliclazide and ramipril is safe during gestation, these data contribute to limited information regarding human exposure to these drugs.
Activation of the Neuronal Extracellular Signal-Regulated Kinase 2 in the Spinal Cord Dorsal Horn Is Required for Complete Freund's Adjuvant-Induced Pain Hypersensitivity
Authors: Xu Qinghao , Garraway Sandra M. , Weyerbacher Amanda R. , Shin Sarah J. , Inturrisi Charles E.
Published: December 2008

Extracellular signal-regulated kinase 1 (ERK1) and ERK2 signaling in the spinal cord dorsal horn (SCDH) has been implicated in injury-induced pain hypersensitivity. Available ERK pathway inhibitors cannot distinguish between ERK1 and ERK2, nor can they differentially target the expression of neuronal or glial ERK1/2. We selectively inhibited the expression of ERK2 in neurons of the adult mouse SCDH by use of an ERK2 small interfering RNA (siRNA) delivered by a neurotropic adenoassociated viral vector.In situhybridization revealed a siRNA vector-induced decrease in ERK2 mRNA in the ipsilateral SCDH. Immunohistochemistry showed a decreased neuronal phospho-ERK1/2 (pERK1/2), and Western blot analysis revealed that both ERK2 expression and phosphorylation were reduced by the siRNA vector. In contrast, basal ERK1 expression was not affected, although pERK1 was slightly increased. The siRNA vector-induced knockdown of ERK2 expression in the SCDH did not alter the baseline mechanical or thermal paw withdrawal thresholds. Hindpaw intraplantar injection of complete Freund's adjuvant (CFA) produced peripheral inflammation, mechanical allodynia, and thermal hyperalgesia in vector control animals that persisted for at least 96 h. It also caused an increase in SCDH ERK1 and ERK2 levels at 96 h and pERK1 and pERK2 levels at 1 and 96 h. The ERK2 siRNA vector prevented changes in ERK1, ERK2, and pERK2. In addition, the siRNA vector protected the animals from developing mechanical allodynia and thermal hyperalgesia throughout the 96 h after CFA. These findings indicate that ERK2 in the SCDH neurons is critical for the development of inflammatory pain hypersensitivity.
Retracted:Lmx1b-Controlled Isthmic Organizer Is Essential for Development of Midbrain Dopaminergic Neurons
Authors: Guo Chao , Qiu Hai-Yan , Shi Ming , Huang Ying , Johnson Randy L. , Rubinstein Marcelo , Chen Sheng-Di , Ding Yu-Qiang
Published: December 2008

The Journal of Neuroscience has received a report describing an investigation by the Shanghai Institute of Biological Sciences, Chinese Academy of Sciences, which found major data misrepresentation in the article by Guo et al. Because the results cannot be considered reliable, The Journal is retracting the paper.
Memory Enhancement with Event-Related Stimulation of the Rostral Intralaminar Thalamic Nuclei
Authors: Mair Robert G. , Hembrook Jacqueline R.
Published: December 2008

The rostral intralaminar thalamic nuclei (ILn) are organized to activate pathways originating in medial prefrontal cortex (mPF) that mediate memory-guided responding during alert, wakeful states. Previous studies have shown that rostral ILn or mPF lesions produce deficits in delayed matching to position (DMTP). Here, we manipulated rostral ILn activity in rats by microinjecting drugs or applying electrical current and examined effects on DMTP. Inhibiting activity with the GABAAagonist muscimol impaired DMTP. Decreasing GABAAtone with FG-7142 (N-methyl-β-carboline-3-carboxamide) improved DMTP at low but not high doses. Orexin A, which depolarizes thalamocortical neurons locally within the ILn, improved DMTP, whereas the cholinergic agonist carbachol impaired performance at the highest dose tested. These drug effects were unaffected by partial mPF lesions in a subset of animals. Microinjection results are consistent with an inverted-U relationship between thalamic activity and DMTP. This relationship was confirmed by event-related electrical stimulation, which produced improvement at low stimulation currents and impairment at higher currents. Electrical stimulation affected DMTP when applied at the start of the memory delay or choice response, but not earlier when trials began or the sample lever was presented. Our results are consistent with evidence that the rostral ILn play a role in retrieval, carrying response-related information across brief memory delays and facilitating memory-guided responding. They also provide evidence that treatments stimulating rostral ILn activity may be an effective means to enhance working memory and related cognitive processes and thus to treat disorders that affect these functions.
Rapid Microglial Response Around Amyloid Pathology after Systemic Anti-Aβ Antibody Administration in PDAPP Mice
Authors: Koenigsknecht-Talboo Jessica , Meyer-Luehmann Melanie , Parsadanian Maia , Garcia-Alloza Monica , Finn Mary Beth , Hyman Bradley T. , Bacskai Brian J. , Holtzman David M.
Published: December 2008

Aggregation of amyloid-β (Aβ) peptide in the brain in the form of neuritic plaques and cerebral amyloid angiopathy (CAA) is a key feature of Alzheimer's disease (AD). Microglial cells surround aggregated Aβ and are believed to play a role in AD pathogenesis. A therapy for AD that has entered clinical trials is the administration of anti-Aβ antibodies. One mechanism by which certain anti-Aβ antibodies have been proposed to exert their effects is via antibody-mediated microglial activation. Whether, when, or to what extent microglial activation occurs after systemic administration of anti-Aβ antibodies has not been fully assessed. We administered an anti-Aβ antibody (m3D6) that binds aggregated Aβ to PDAPP mice, an AD mouse model that was bred to contain fluorescent microglia. Three days after systemic administration of m3D6, there was a marked increase in both the number of microglial cells and processes per cell visualizedin vivoby multiphoton microscopy. These changes required the Fc domain of m3D6 and were not observed with an antibody specific to soluble Aβ. These findings demonstrate that some effects of antibodies that recognize aggregated Aβ are rapid, involve microglia, and provide insight into the mechanism of action of a specific passive immunotherapy for AD.
Increasing Human Brain Excitability by Transcranial High-Frequency Random Noise Stimulation
Authors: Terney Daniella , Chaieb Leila , Moliadze Vera , Antal Andrea , Paulus Walter
Published: December 2008

For >20 years, noninvasive transcranial stimulation techniques like repetitive transcranial magnetic stimulation (rTMS) and direct current stimulation (tDCS) have been used to induce neuroplastic-like effects in the human cortex, leading to the activity-dependent modification of synaptic transmission. Here, we introduce a novel method of electrical stimulation: transcranial random noise stimulation (tRNS), whereby a random electrical oscillation spectrum is applied over the motor cortex. tRNS induces consistent excitability increases lasting 60 min after stimulation. These effects have been observed in 80 subjects through both physiological measures and behavioral tasks. Higher frequencies (100–640 Hz) appear to be responsible for generating this excitability increase, an effect that may be attributed to the repeated opening of Na+channels. In terms of efficacy tRNS appears to possess at least the same therapeutic potential as rTMS/tDCS in diseases such as depression, while furthermore avoiding the constraint of current flow direction sensitivity characteristic of tDCS.
Network Dynamics Underlying the Formation of Sparse, Informative Representations in the Hippocampus
Authors: Karlsson Mattias P. , Frank Loren M.
Published: December 2008

During development, activity-dependent processes increase the specificity of neural responses to stimuli, but the role that this type of process plays in adult plasticity is unclear. We examined the dynamics of hippocampal activity as animals learned about new environments to understand how neural selectivity changes with experience. Hippocampal principal neurons fire when the animal is located in a particular subregion of its environment, and in any given environment the hippocampal representation is sparse: less than half of the neurons in areas CA1 and CA3 are active whereas the rest are essentially silent. Here we show that different dynamics govern the evolution of this sparsity in CA1 and upstream area CA3. CA1, but not CA3, produces twice as many spikes in novel compared with familiar environments. This high rate firing continues during sharp wave ripple events in a subsequent rest period. The overall CA1 population rate declines and the number of active cells decreases as the environment becomes familiar and task performance improves, but the decline in rate is not uniform across neurons. Instead, the activity of cells with initial peak spatial rates above ∼12 Hz is enhanced, whereas the activity of cells with lower initial peak rates is suppressed. The result of these changes is that the active CA1 population comes to consist of a relatively small group of cells with strong spatial tuning. This process is not evident in CA3, indicating that a region-specific and long timescale process operates in CA1 to create a sparse, spatially informative population of neurons.
Recovery from Chronic Demyelination by Thyroid Hormone Therapy: Myelinogenesis Induction and Assessment by Diffusion Tensor Magnetic Resonance Imaging
Authors: Harsan Laura-Adela , Steibel Jérôme , Zaremba Anita , Agin Arnaud , Sapin Rémy , Poulet Patrick , Guignard Blandine , Parizel Nathalie , Grucker Daniel , Boehm Nelly , Miller Robert H. , Ghandour M. Said
Published: December 2008

The failure of the remyelination processes in multiple sclerosis contributes to the formation of chronic demyelinated plaques that lead to severe neurological deficits. Long-term cuprizone treatment of C57BL/6 mice resulted in pronounced white matter pathology characterized by oligodendrocyte depletion, irreversible demyelination and persistent functional deficits after cuprizone withdrawal. The use of a combination ofin vivodiffusion tensor magnetic resonance imaging (DT-MRI) and histological analyses allowed for an accurate longitudinal assessment of demyelination. Injection of triiodothyronine (T3) hormone over a 3 week interval after cuprizone withdrawal progressively restored the normal DT-MRI phenotype accompanied by an improvement of clinical signs and remyelination. The effects of T3were not restricted to the later stages of remyelination but increased the expression of sonic hedgehog and the numbers of Olig2+and PSA-NCAM+precursors and proliferative cells. Our findings establish a role for T3as an inducer of oligodendrocyte progenitor cells in adult mouse brain following chronic demyelination.
Ambushed by History: Paul Mus and Colonial France's "Forced Re-entry" into Vietnam (1945–1954)
Authors: Larcher-Goscha Agathe
Published: December 2008

An engaged intellectual, Paul Mus drew upon his affective memory, his lived experiences, and his colonial past to provide a lucid explanation of the most inexplicable. His most famous work on Vietnam, Vietnam: A Sociology of War, coincided with the debut of the war of decolonization in Indochina. It reflected his obsession with understanding why and how this divisive conflict between the French and the Vietnamese was not only a political and international one, but also a social, cultural and human one. In this essay, I attempt to cast new light on his exceptional lucidity during the Franco-Vietnamese War.
Visceral fat mass is a strong predictor of circulating ghrelin levels in premenopausal women
Authors: Sondergaard E , Gormsen L C , Nellemann B , Vestergaard E T , Christiansen J S , Nielsen S
Published: December 2008

Objective

A well known inverse relationship exists between obesity and circulating ghrelin concentrations. However, obesity is a heterogeneous disease entity and upper-body obesity (UBO) is associated with more profound metabolic disturbances than lower-body obesity (LBO). We therefore aimed to investigate the impact of body composition on circulating ghrelin levels in women spanning a wide range of body composition phenotypes.

Subjects and methods

Ten (UBO; waist-to-hip ratio (WHR) >0.85, body mass index (BMI) >28 kg/m2), ten LBO (WHR <0.80, BMI >28 kg/m2) and ten lean women (BMI<25 kg/m2) were studied. Total ghrelin levels were measured under basal and hyperinsulinemic (0.6 mU/kg per min) conditions. Body fat distribution was determined by dual X-ray absorptiometry in combination with computed tomography at the L2-L3 level.

Results

As expected, an inverse correlation existed between basal ghrelin concentration and BMI (r=−0.40,P=0.03) and total fat mass (r=−0.39,P=0.04). Visceral fat mass was a strong predictor (r=−0.56,P=0.003) of circulating ghrelin levels, even when adjusted for BMI (P=0.02) or body composition group (P=0.04). The suppressive effect of insulin on ghrelin concentration was significantly diminished in the UBO compared with the lean controls (P=0.012) and a highly significant inverse correlation existed with visceral fat mass (r=−0.52,P=0.004).

Conclusions

Visceral fat mass is a strong predictor of basal ghrelin concentrations and also attenuates the suppressive effect of insulin on ghrelin concentrations. These data provide further evidence that the UBO phenotype is associated with more profound metabolic abnormalities than obesityper se.
The hormonal induction of cervical remodeling in the common marmoset monkey (Callithrix jacchus)
Authors: Simon Christina , Einspanier Almuth
Published: December 2008

Controversy still exists regarding the involvement of relaxin (RLX) in cervical reorganization throughout parturition in the human, despite its well-known role in facilitating extensive extracellular matrix (ECM) remodeling in diverse organs. Therefore, the aim of the present study was to examine the influence of RLX and estrogen (E2) on the cervical tissue of the common marmoset monkey. Two experimental designs were used: 1)in vivoanalysis of the intracervical diameter under locally applied RLX and 2) ovariectomized (ov) marmosets were treated systemically with either recombinant human (rh) RLX, E2 or rhRLX+E2 to examine their action on the cervix.In vivo-locally applied rhRLX induced a distinct and significant widening of the cervix (before: 4.8±1.1 mm versus after: 5.7±0.9 mm in diameter;P<0.030, MV±s.e.m.). This widening effect was most pronounced in animals without previous pregnancies.In vitroinvestigation of cervical tissue showed significantly increased wet weights after all three hormone treatments (E2: 0.27±0.07 g, RLX: 0.25±0.04 g, E2+RLX: 0.30±0.11 g; allP<0.05; MV±s.e.m.) versus controls (0.10±0.04 g). Furthermore, morphological changes such as loosening of the connective tissue structure and decline in collagen content, an increase in the number of eosinophils, increased the expression of matrix metalloproteinases (MMP1) and MMP2, as well as gene and protein expression of the RLX receptor RXFP1 could be detected in the cervical tissue after all hormone treatments, compared with controls. In summary, RLX has a potent widening effect on the cervix of the common marmoset monkey. Although E2 is not required for this RLX effect, a combined application of E2 and RLX induced the most prominent cervical ripening.
Severe Snoring in a Child with Pycnodysostosis Treated with a Bilateral Rib Graft
Authors: Teissier Natacha , Jacquemont Marie-Line , Blancal Jean-Philippe , Elmaleh-Bergès Monique , Van Den Abbeele Thierry , Bennaceur Selim
Published: December 2008

Pycnodysostosis is a rare osteopetrotic disorder. This report describes a case of a 3½-year-old boy with pycnodysostosis who presented with severe snoring. The snoring was the result of a pharyngeal narrowing due to a hypoplastic mandible. Surgery consisted of a bilateral rib graft, which allowed an enlargement of the pharynx by acting both on an anterior projection of the chin and a decrease of the glossoptosis. A significant reduction of the snoring and an excellent mouth aperture were obtained. This technique is ideal for such patients presenting a high risk of infection, nonunion, and secondary fracture.
Temporary Tongue-Lip Traction during the Initial Period of Mandibular Distraction in Pierre Robin Sequence
Authors: Lee Jun-Ho , Kim Yong-Ha
Published: December 2008

Objective:

Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomy in patients with Pierre Robin sequence. However, the airway must be maintained during the distraction period. The purpose of this study was to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedures.

Patients:

Three Pierre Robin sequence patients between 4 months and 3 years of age requiring surgical procedures to correct recurrent and severe pulmonary complications.

Method:

All patients underwent distraction osteogenesis of the mandible. During surgery, a deep one-tension suture was used to apply traction to the tongue. When the patient gained control of the upper airway during the initial period of distraction and micrognathia was corrected, the traction suture was removed.

Results:

The patients were followed for a mean of 5.4 years. No patients complained of severe pulmonary complications, and tracheostomy was avoided. The lower face area was increased in all three patients.

Conclusion:

In severe Pierre Robin sequence cases, temporary tongue-lip traction was a good adjunct to distraction osteogenesis because this method avoided tracheostomy.
Effects of Altered Fundamental Frequency on Nasalance during Vowel Production by Adult Speakers at Targeted Sound Pressure Levels
Authors: Mandulak Kerry C. , Zajac David J.
Published: December 2008

Objective:

This study investigated the effects of altered fundamental frequency (F0) on nasalance levels of the vowels /i/ and /a/ produced by adults without cleft palate within a controlled sound pressure level (SPL) range.

Design:

A prospective group design with convenience sampling from the University of North Carolina at Chapel Hill was used.

Participants:

20 men and 20 women participated, aged 18 to 55 years. All were native English speakers with normal speech and language skills and adequate velopharyngeal function.

Main Outcome Measures:

The outcome measures were percentage nasalance obtained from the Nasometer 6200 (KayPentax) headset and the Computerized Speech Lab Model 4400 (CSL, KayPentax) during vowel production while speakers (1) targeted an SPL range of 75 to 85 dB and (2) targeted the SPL plus F0 range of 165 to 175 Hz.

Results:

A significant univariate effect was found for the vowels /i/ and /a/ in the targeted SPL condition such that /i/ was produced with higher nasalance than /a/. A significant univariate effect was also found during production of /a/ in the targeted SPL plus F0 condition such that men produced /a/ with higher nasalance than women did.

Conclusions:

SPL appears to largely account for percentage nasalance differences between the vowels /i/ and /a/ produced by adult male and female speakers. Increased F0 by male speakers appears to influence percentage nasalance during production of the vowel /a/. Clinical implications in regard to assessment of hypernasality are discussed.
Alveolar Bone Grafting for Patients with Unilateral Complete Alveolar and Palatal Clefts Improves the Bony Structure of the Nose
Authors: Nagasao Tomohisa , Ogata Hisao , Miyamoto Junpei , Jiang Hua , Kaneko Tsuyoshi , Isshiki Yasushige , Nakajima Tatsuo
Published: December 2008

Objective:

This is a retrospective study regarding the effect of alveolar bone grafting (ABG) on morphological changes in the bony structure of the nose in alveolar and palatal cleft patients.

Methods:

Sixty-five randomly selected adults were included in the present study. Of the 65 subjects, 21 had no congenital anomaly and were designated as the control group (n  =  21; mean age 22.4 ± 4.3 years). Forty-four had unilateral complete clefts of the alveolus and palate on the left side. The patients with clefts were further divided into two subgroups based on presence or absence of ABG in their histories. These groups were termed the ABG(+) group (n  =  24; mean age 20.3 ± 2.5 years) and the ABG(−) group (n  =  20; mean age 32 ± 4.5 years), respectively. An anatomical structure that constitutes the bony component of the nose was defined. This structure, composed of the nasal bones and part of the frontal process of the maxilla, was termed the BSEN (bony structure of the external nose). The symmetry of the BSEN was assessed quantitatively by performing morphological measurements on computerized tomographic images of each patient's skull, and these measurements were compared among the control, ABG(+), and ABG(−) groups.

Results:

The BSEN presented more symmetric features in the ABG(+) group patients than in the ABG(−) group patients.

Conclusion:

ABG improves symmetry of the BSEN. This finding justifies ABG in terms of cosmetic improvement of the external nose in patients with unilateral complete alveolar and palatal clefts.
Evaluation of Hypernasality in Vowels Using Voice Low Tone to High Tone Ratio
Authors: Lee Guo-She , Wang Ching-Ping , Fu Sherry
Published: December 2008

Objective:

The voice low tone to high tone ratio (VLHR) is defined as the power ratio of low frequency to high frequency energy obtained by dividing the voice spectrum with a specific cutoff frequency. In a previous study, VLHR correlated significantly with nasalance and perceptual rating of hypernasality for a single vowel. The methodology was optimized in this study by investigating the correlations among other vowels.

Design:

Voice signals of six sustained vowels vocalized by subjects with hypernasality were collected. Vowel nasalance was obtained with a nasometer, and hypernasality rating scores were provided by two speech-language pathologists. The VLHRs calculated using different cutoff frequencies were correlated with nasalance and hypernasality rating scores.

Participants:

Eight subjects with hypernasality caused by palatal fistula or velopharyngeal insufficiency.

Main Outcome Measures:

VLHR, nasalance, and hypernasality rating score.

Results:

The correlation of VLHR with nasalance and hypernasality rating was most significant using a cutoff frequency of 600 Hz. The correlation of VLHR with nasalance was significant (r  =  .62, p < .01, Pearson's correlation), as was the correlation of VLHR with hypernasality score (Spearman's rank correlation coefficient  =  .62, p < .01).

Conclusions:

VLHR correlated significantly with nasalance and hypernasality in the six sustained vowels and may provide another quantitative index for the evaluation of hypernasality in sustained vowels.
Prolonged oestrogen treatment does not correlate with a sustained increase in anterior pituitary mitotic index in ovariectomized Wistar rats
Authors: Nolan L A , Levy A
Published: December 2008

Oestrogen is a powerful mitogen that is believed to exert a continuous, dose-dependent trophic stimulus at the anterior pituitary. This persistent mitotic effect contrasts with corticosterone and testosterone, changes in the levels of which induce only transient, self-limiting fluctuations in pituitary mitotic activity. To further define the putative long-term trophic effects of oestrogen, we have accurately analysed the effects of 7 and 28 days oestrogen treatment on anterior pituitary mitotic activity in ovariectomized 10-week-old Wistar rats using both bromodeoxyuridine (BrdU) and timed colchicine-induced mitotic arrest. An oestrogen dose-dependent increase in mitotic index was seen 7 days after the start of treatment as expected, representing an acceleration in gross mitotic activity from 1.7%/day in ovariectomized animals in the absence of any oestrogen replacement to 3.7%/day in the presence of a pharmacological dose of oestrogen (50 mcg/rat per day: ∼230 mcg/kg per day). Despite continued exposure to high-dose oestrogen and persistence of the increase in pituitary wet weight, the increase in mitotic index was unexpectedly not sustained. After 28 days of high-dose oestrogen treatment, anterior pituitary mitotic index and BrdU-labelling index were not significantly different from baseline. Although a powerful pituitary mitogen in the short term, responsible, presumably, for increased trophic variability in oestrus cycling females, these data indicate that in keeping with other trophic stimuli to the pituitary and in contrast to a much established dogma, the mitotic response to longer-term high-dose oestrogen exposure is transient and is not the driver of persistent pituitary growth, at least in female Wistar rats.
Correlates of Improvement in Walking Ability in Older Persons in the United States
Authors: Feinglass Joe , Song Jing , Manheim Larry M. , Semanik Pamela , Chang Rowland W. , Dunlop Dorothy D.
Published: December 2008

Objectives. We analyzed factors associated with improvement in walking ability among respondents to the nationally representative Health and Retirement Study.

Methods. We analyzed data from 6574 respondents aged 53 years or older who reported difficulty walking several blocks, 1 block, or across the room in 2000 or 2002. We examined associations between improvement (versus no change, deterioration, or death) and baseline health status, chronic conditions, baseline walking difficulty, demographic characteristics, socioeconomic status, and behavioral risk factors.

Results. Among the 25% of the study population with baseline walking limitations, 29% experienced improved walking ability, 40% experienced no change in walking ability, and 31% experienced deteriorated walking ability or died. In a multivariate analysis, we found positive associations between walking improvement and more recent onset and more severe walking difficulty, being overweight, and engaging in vigorous physical activity. A history of diabetes, having any difficulty with activities of daily living, and being a current smoker were all negatively associated with improvement in walking ability. After we controlled for baseline health, improvement in walking ability was equally likely among racial and ethnic minorities and those with lower socioeconomic status.

Conclusions. Interventions to reduce smoking and to increase physical activity may help improve walking ability in older Americans.
Cardioprotective Activity of Polyherbal Extracts in Experimental Myocardial Necrosis in Rodents: An Evidence of Antioxidant Activity
Authors: Naik Suresh R. , Panda Vandana S
Published: December 2008

The present study investigates the antioxidant activity of A.V. Circulo (AVC), a polyherbal formulation in isoproterenol(ISO)-induced oxidative stress in rats and attempts to correlate its cardioprotective activity with antioxidant activity. Myocardial necrosis was produced in rats with ISO (85 mg/kg, s.c.), injected twice at an interval of 24 h. AVC (500 mg/kg, p.o.) was administered to rats for 21 days and 45 days and its effect was evaluated on ISO-induced cardiac injury. The marker enzymes - AST, LDH & CPK were assayed in serum and heart, and antioxidant parameters, viz., reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) & glutathione reductase (GR), and malondialdehyde (MDA), were determined in heart homogenate. Significant myocardial necrosis, depletion of endogenous antioxidants and an increase in serum levels of marker enzymes were observed in ISO-treated rats when compared with normal rats. Daily pretreatment of AVC (500 mg/kg) for 21 & 45 days to rats which were treated with ISO on the last 2 days, resulted in a significant cardioprotective and antioxidant activity, reflected by decreased levels of serum marker enzymes & MDA, and restored activities of marker enzymes, GSH, and antioxidant enzymes in the heart. AVC (500 mg/kg) administration for 45 days showed greater cardiac protection than for 21 days. It is concluded that AVC (500 mg/kg) oral treatment for 21 & 45 days to ISO-challenged rats augments endogenous antioxidant enzymes in the rat heart and prevents lipid peroxidation of the membrane, thereby salvaging the myocardium from the deleterious effects of ISO.
Primary Defects in β-Cell Function Further Exacerbated by Worsening of Insulin Resistance Mark the Development of Impaired Glucose Tolerance in Obese Adolescents
Authors: Cali Anna M.G. , Man Chiara Dalla , Cobelli Claudio , Dziura James , Seyal Aisha , Shaw Melissa , Allen Karin , Chen Shu , Caprio Sonia
Published: December 2008

OBJECTIVE—Impaired glucose tolerance (IGT) is a pre-diabetic state of increasing prevalence among obese adolescents. The purpose of this study was to determine the natural history of progression from normal glucose tolerance (NGT) to IGT in obese adolescents.

RESEARCH DESIGN AND METHODS—We determined the evolution of β-cell function, insulin sensitivity (SI), and glucose tolerance in a multiethnic group of 60 obese adolescents over the course of approximately 30 months. Each subject underwent three serial 3-h oral glucose tolerance tests. Dynamic, static, and total β-cell responsivity (Φd, Φs, and Φtot, respectively) and Si were assessed by oral C-peptide and glucose minimal models. The disposition index (DI), which adjusts insulin secretion for Si, was calculated.

RESULTS—At baseline, all 60 subjects had NGT. Seventy-seven percent (46 subjects) maintained NGT over the three testing periods (nonprogressors), whereas 23% (14 subjects) developed IGT over time (progressors). At baseline, percent fat and BMI Z score were comparable between the groups. Fasting plasma glucose, 2-h glucose, glucose area under the curve at 180 min, and Φd were significantly different between the two groups at baseline, whereas Si was comparable between the two groups. Over time, although Si remained unchanged in nonprogressors, it steadily worsened by ∼45% (P > 0.04) in progressors. β-Cell responsivity decreased by 20% in progressors, whereas it remained stable in nonprogressors. The DI showed a progressive decline in progressors compared with a modest improvement in nonprogressors (P = 0.02).

CONCLUSIONS—Obese adolescents who progress to IGT may manifest primary defects in β-cell function. In addition, progressive decline in Si further aggravates β-cell function, contributing to the worsening of glucose intolerance.
Managing severe hoof pain in a horse using multimodal analgesia and a modified composite pain score
Authors: Dutton D. W. , Lashnits K. J. , Wegner K.
Published: December 2008

This report describes a clinically useful modified composite pain score (MCPS) for horses with hoof pain. The horse in this report initially suffered from acute pain from a subsolar seroma as well as suspected pain from chronic laminitis. Following surgical debridement, corium prolapsed through the wound and it became infected. During the course of conventional hoof and wound management, the pain experienced by the patient was refractory to nonsteroidal anti‐inflammatory drugs. Using the MCPS as a guide, inflammatory and neuropathic pain states were identified and multimodal analgesia was employed in response to the varying pain states. Drugs used for the anti‐inflammatory pain management protocol included firocoxib, butorphanol, phenylbutazone, aspirin and fish oil. Neuropathic pain modulators included parenteral and local anaesthetics, pentoxifylline, ketamine and gabapentin. Composite pain scoring in horses, which includes observational, physiological and interactive components, may have greater sensitivity for demonstrating response to therapy when multiple types and stages of pain exist.
Editorial
Authors: Welch Penny ,   Wright Susan
Published: December 2008

Welcome to the third issue of Learning and Teaching: The International Journal of Higher Education in the Social Sciences. This issue completes the 2008 volume. Our thanks go to the authors of articles and reviews, the anonymous referees who read the articles, the publishers who provided review copies of the books, our own publisher, Berghahn, and the editorial board.
Book Reviews
Authors: Sandle Mark , Taylor Gary , Welch Penny
Published: December 2008

Geoff Timmins, Keith Vernon and Christine Kinealy (2005) Teaching and Learning History

Review by Mark Sandle

Lorraine McIlrath and Iain Mac Labhrainn (eds) (2007) Higher Education and Civic Engagement: International Perspectives

Review by Gary Taylor

Joanna Bull and Colleen McKenna (2004) Blueprint for Computer-Assisted Assessment

Review by Penny Welch

Peter Redman (2006) Good Essay Writing

Review by Penny Welch
MULTICRITERIA GRAPHICAL‐ANALYTICAL EVALUATION OF THE FINANCIAL STATE OF CONSTRUCTION ENTERPRISES / STATYBOS ĮMONIŲ FINANSINĖS VEIKLOS GRAFINIS ANALITINIS DAUGIAKRITERINIS VERTINIMAS
Authors: Ginevičius Romualdas , Podvezko Valentinas
Published: December 2008

Complex evaluation of the effectiveness of financial activities of construction enterprises may be made by multicriteria methods. As a result of calculations, the priority order of the considered objects can be established. A more thorough analysis reveals that the above methods do not take into consideration the effect of the components of a particular evaluation method on the result obtained. This can be achieved only if multicriteria evaluation is based on graphical‐analytical approach. In this case, the reasons why some of the compared alternatives get lower ranks than others can be clearly demonstrated and some effective measures can be provided for improving the situation. Santrauka Statybos įmonių finansinės veiklos efektyvumą kompleksiškai galima įvertinti taikant daugiakriterinius metodus. Tokių skaičiavimų rezultatas – prioritetinė nagrinėjamų objektų eilė. Išsamesnė analizė rodo, kad šie metodai neišryškina sudėtinių vertinimo būdo komponentų įtakos bendram vertinimo rezultatui. Ši galimybė atsiveria tada, kai daugiakriterinis vertinimas remiasi grafine ir analitine interpretacija. Tokiu atveju galima akivaizdžiau nustatyti lyginamų variantų žemesnio reitingo priežastis ir numatyti veiksmingesnę padėties gerinimo priemonę.
FLEXIBILITY APPROACH IN CONSTRUCTION PROCESS ENGINEERING / LANKSTUMAS STATYBOS PROCESO INŽINERIJOJE
Authors: Paslawski Jerzy
Published: December 2008

The issues of environmental impact on building processes constitute a permanent aspect of the building industry, irrespective of various preventive actions (prefabrication, robotics etc.). The proposed method was developed in the course of tracking problems that arise during performance of building processes exposed to weather impact (as an example of interruptions) on construction sites of airports, highways, logistic centres, or installation of tall building facades. The proposed approach is based on creating multiple variants for process realization options, thus enabling adaptation to current realization conditions at particular stages. The studies that have been carried out confirm the advantage of this method over the traditional planning based on a single realization variant. Santrauka Aplinkos poveikis statybos procesui yra būdingas statybos pramonei nepaisant prevencinių veiksmų (surenkamųjų elementų gamyba, robotizacija). Pasiūlytas metodas buvo sukurtas stebint problemas, atsirandančias vykdant oro sąlygų veikiamus statybos procesus (pavyzdžiui, trikdžius) oro uostų, magistralinių kelių, logistikos centrų, aukštų pastatų fasado įrengimo darbų, statybos aikštelėse. Sukurtojo metodo esmė – pasiūlyti daug variantų konkrečiam procesui įvykdyti. Tai leidžia parinkti tam tikras konkrečių darbų etapų įvykdymo sąlygas. Tyrimas patvirtino, kad šis metodas pranašesnis už tradicinį planavimą, teturintį vienintelį darbų įvykdymo variantą.
STRATEGIC ADAPTATION AND THE VALUE OF FORECASTS: THE DEVELOPMENT OF A CONCEPTUAL FRAMEWORK
Authors: Yusof Faizal Mohamed , Aziz Rozainun Abdul
Published: December 2008

This paper examines the lack of emphasis on the value of forecasts in strategic adaptation frameworks. The objective of this paper is to offer a conceptual framework of strategic adaptation that incorporates and emphasizes the value of forecasts. In developing the framework, we incorporate three different studies. Eunni's model (2003) purports to rank companies with high strategic adaptation ability in an industry. Further, in developing our framework, we specifically link the contributions of Lawrence et al. (2006) and Mentzer et al.(1996, 1999). Our study highlights that companies with high strategic adaptation ability need to be examined further in order to understand and take on board how they withstand the volatile market. It is intended that the conceptual framework, driven by previous studies and the current scenario, will offer a better direction for companies to adapt towards an objective indicator of the value of forecasts for strategic purposes.
RUSSIAN PUBLIC SECTOR REFORM: THE IMPACT ON UNIVERSITY ACCOUNTING
Authors: Timoshenko Konstantin
Published: December 2008

The last few decades have witnessed substantial efforts to reinvent the state worldwide. The Russian state is no exception to this global trend. At the outset of a new millennium, the need for renewal of the post‐Soviet model of the state has been acknowledged, and an up‐to‐date reform package has been promoted by the central government. This has encompassed the reconstruction of public sector accounting. Given the paucity of consistent research efforts on the topic, this article seeks to describe and analyze, and by so doing, contribute to knowledge about Russian public sector accounting in times of change. To tackle the general purpose, two levels are incorporated in this study to link reform initiatives for the government as a whole with those endeavours to implement them in one state‐sponsored university of Russian tertiary education. The major questions to be addressed are of whether, why, and how changes at the central government level have penetrated down to the university and extended to its accounting system. The evidence gathered in this paper reveals that a new Russian public sector ideology has markedly been affected by overseas developments in the shape of large international organizations. However, no compelling evidence has been documented in this research as unveiling that changes at the macro‐level have penetrated down to the university to any significant extent. This study concludes that launching a new version of accounting by the Russian state can be regarded as more of a symbol of legitimacy for the university rather than of an actual financial management tool.
DAILY VARIATION AND PREDICTING STOCK MARKET RETURNS FOR THE FRANKFURTER BÖRSE (STOCK MARKET)
Authors: Jarrett Jeffrey E. , Schilling Janne
Published: December 2008

In this article we test the random walk hypothesis in the German daily stock prices by means of a unit root test and the development of an ARIMA model for prediction. The results show that the time series of daily stock returns for a stratified random sample of German firms listed on the stock exchange of Frankfurt exhibit unit roots. Also, we find that one may predict changes in the returns to these listed stocks. These time series exhibit properties which are forecast able and provide the intelligent data analysts’ methods to better predict the directive of individual stock returns for listed German firms. The results of this study, though different from most other studies of other stock markets, indicate the Frankfurt stock market behaves in similar ways to North American, other European and Asian markets previously studied in the same manner.
BOOK REVIEWS
Authors: Zavadskas Edmundas Kazimieras , Podvezko Valentinas
Published: December 2008

DESIGN AND APPLICATION OF INTELLIGENT INFORMATION SYSTEMS Reviewed book: Dalé Dzemydiené. Intelektualizuotų informacinių sistemų projektavimas ir taikymas: monografija. Vilnius: Mykolo Romerio universiteto leidybos centras, 2006. 352 p. [Design and Application of Intelligent Information Systems, ISBN: 9955-19-051-5 in Lithuanian]. GAME THEORY IN BUILDING TECHNOLOGY AND MANAGEMENT Reviewed book: E. K. Zavadskas, F. Peldschus, L. Ustinovičius, Z. Turskis. Lošimų teorija statybos technologijoje ir vadyboje. Vilnius: Technika, 2004 [Game Theory in Building Technology and Management, ISBN: 9986-05-700-0 in Lithuanian]. METHODS AND MODELS OF RESEARCH IN CONSTRUCTION PROJECT ENGINEERING Reviewed book: Oleg Kapliński (Eds.). Methody i modele badań w inžynierii przedsięwzięć budowlanych. Polska akademia nauk, komitet inžynierii lądowej i wodnej, Warszawa, 2007 [Methods and Models of Research in Construction Project Engineering, ISBN: 978-83-89687-22-7, ISSN: 0137-5393 in Polish].
ESTIMATION OF MOTIVATION USING ENTROPY
Authors: Srivastava Sachin Kumar , Kakkar Dhruve Narain
Published: December 2008

Motivation has been in practices since the life of mankind. It is such an effort, which requires to be quantified for better management technique. The present paper deals with estimation of motivation efforts using entropy and ability of manpower involved in certain organization.
INTEGRAL SPACES IN THE EUROPEAN UNION: POSSIBLE TRENDS OF THE SOCIAL, ECONOMIC AND TECHNOLOGICAL INTEGRATION IN THE BALTIC REGION
Authors: Melnikas Borisas
Published: December 2008

Regional integration oriented transformations in the Baltic region, as well as the unified social, economic and technological space formation processes are described and analysed. These processes are comprehended as an important factor of further social, economic and technological modernization in the Baltic countries, as a precondition for more intensive and active integration of Baltic economic systems into the European and global economic and technological structures, as well as a knowledge‐based society and knowledge economy creation factor. The arguments determining the idea of the Baltic region community and unity, as well as opposing arguments are evaluated. The main principles of integration in the Baltic region, as well as the possible integration strategies are analysed. The unified social, economic and technological space in the Baltic region as a research area is described.