bluuebunny/crossref_metadata_2025 huggingface dataset:
Myasthenia gravis in pregnancy and birth: identifying risk factors, optimising care
Authors: Hoff J. M. , Daltveit A. K. , Gilhus N. E.
Published: September 2006

Women with myasthenia gravis (MG) have increased risk of pregnancy complications and an adverse pregnancy outcome. This study examined risk factors for such complications in order to improve the care for pregnant MG women. Through the Medical Birth Registry of Norway, 73 MG mothers with 135 births were identified. Their obstetrical and clinical records were examined. Data on pregnancy, delivery and the newborn were combined with information on mother's disease. The risk for neonatal MG was halved if the mother was thymectomized (P = 0.03). Children with neonatal MG were more likely to display signs of foetal distress during delivery (P = 0.05). Only in one‐third of the pregnancies did the patient see a neurologist during pregnancy. These patients used MG medication more often during pregnancy (P = 0.001), and were more likely to be thymectomized (P = 0.007). They also had a higher rate of elective sections (P = 0.009). Thymectomy may have a protective effect against neonatal MG. Neonatal MG can cause foetal distress during delivery. Most MG women benefit from being examined by a neurologist during pregnancy, to minimize risks and select the best delivery mode in collaboration with obstetricians.
Anosognosia versus unilateral neglect. Coexistence and their relations to age, stroke severity, lesion site and cognition
Authors: Appelros P. , Karlsson G. M. , Hennerdal S.
Published: September 2006

The aim of this study was to examine the association between anosognosia and unilateral neglect (UN), with special focus on age, stroke severity, lesion location and pre‐stroke dementia. The basis of this investigation was a population‐based stroke incidence study. Anosognosia was assessed using a questionnaire, and UN using a three‐item version of the Behaviour Inattention Test, the Baking Tray Task and a test of personal neglect. Stroke severity was assessed using the NIH stroke scale. Patients with anosognosia were older, and they more often had pre‐stroke dementia than patients having UN only. No particular lesion localization was associated with anosognosia, while UN was strongly associated with previously defined lesion sites, often in the parietal lobe. There was a borderline significance regarding stroke severity in patients having anosognosia compared with those with UN only. Patients with anosognosia had higher mortality than patients without, but when controlled for age and stroke severity, this effect was not independent. While UN is closely associated with ‘classical’ lesion sites, anosognosia is a condition that more often occurs in a previously impaired brain. For anosognosia, lesion location appears to be less important. Anosognosia also tends to occur with larger strokes.
Progression of dysautonomia in multiple system atrophy: a prospective study of self‐perceived impairment
Authors: Köllensperger M. , Stampfer‐Kountchev M. , Seppi K. , Geser F. , Frick C. , Del Sorbo F. , Albanese A. , Gurevich T. , Giladi N. , Djaldetti R. , Schrag A. , Low P. A. , Mathias C. J. , Poewe W. , Wenning G. K.
Published: September 2006

To assess severity and progression of self‐perceived dysautonomia and their impact on health‐related quality of life (Hr‐QoL) in multiple system atrophy (MSA), twenty‐seven patients were recruited by the European MSA Study Group (EMSA‐SG). At baseline, all patients completed the Composite Autonomic Symptom Scale (COMPASS) and the 36 item Short Form Health Survey (SF‐36), and they were assessed using the 3‐point global disease severity scale (SS‐3) and the Unified MSA Rating Scale (UMSARS). After 6 months follow‐up, the self completed COMPASS Change Scale (CCS), the SF‐36, SS‐3, and UMSARS were obtained. MSA patients showed marked self‐perceived dysautonomia at baseline visit and pronounced worsening of dysautonomia severity on the CCS at follow‐up. Severity and progression of dysautonomia did not correlate with age, disease duration, motor impairment and overall disease severity at baseline. There were no significant differences between genders and motor subtypes. Baseline COMPASS scores were, however, inversely correlated with SF‐36 scores. Progression of self‐perceived dysautonomia did not correlate with global disease progression. Hr‐QoL scores were stable during follow‐up. This is the first study to investigate self‐perceived dysautonomia severity in MSA and its evolution over time. Our data suggest that dysautonomia should be recognized as a key target for therapeutic intervention in MSA.
Student Finance and Widening Participation in the British Isles: Common Problems, Different Solutions
Authors: Adnett Nick
Published: September 2006

Across the British Isles there are common forces encouraging an expansion of higher education (HE) while constraining the ability and willingness of governments to finance it. We examine the nature of these forces and conclude that together they are likely to lead over time to the general taxpayer funding a declining share of HE costs. While there are some potential efficiency and social equity benefits from reforms of student finance motivated by switching more of the costs towards students and their parents, the likely impact of these reforms on widening participation is unclear. We examine the current student finance systems in the British Isles and assess whether or not a system based upon income‐contingent student loans, means‐tested grants and targeted bursaries can deliver both the desired expansion and widening access.
A Review of Evidence-Based Medicine and Meta-Analytic Reviews in Migraine
Authors: Tfelt-Hansen P
Published: September 2006

The following systematic reviews and meta-analyses are presented and the results discussed: the evidence-based American guidelines, five systematic reviews on naratriptan, rizatriptan, eletriptan, sumatriptan and propranolol; a meta-analysis of sumatriptan, a meta-analysis of acute migraine therapy, a meta-analysis of triptans available in Canada and a large meta-analysis of oral triptans. The systematic reviews of several randomized trials of one drug overcome random effects in estimating treatment effect of the reviewed drug. The results from the large meta-analysis of several drugs are compared with head-to-head comparative trials. Results are generally the same in the meta-analysis and in the comparative trials, with some exceptions. Head-to-head comparisons should remain the ‘gold standard’ and meta-analyses are a useful supplement in cases when comparative trials are relatively small and when no comparative trials exist.
Plasma Changes of Calcitonin Gene-Related Peptide and Substance P in Patients with Dialysis Headache
Authors: Alessandri M , Massanti L , Geppetti P , Bellucci G , Cipriani M , Fanciullacci M
Published: September 2006

Little is known of mechanism of dialysis headache (DH). As suggested for migraine, a role for neuropeptides has been investigated. Twenty-four patients under haemodialysis were studied. Twelve of them suffered from DH. The remaining patients were headache free. Blood samples for radioimmunoassay of calcitonin gene-related peptide (CGRP) and substance P (SP) were collected from the arteriovenous fistula before and after dialysis treatment. Basal plasma concentrations of CGRP were found to be higher in headache patients. Dialysis significantly decreased CGRP concentrations in both groups. No difference in basal plasma concentrations of SP was observed between groups. At the end of the treatment plasma SP concentrations were reduced in headache-free patients but increased in headache patients. Elevated plasma concentrations of CGRP in patients with DH could represent a biochemical factor contributing to susceptibility to headache. Because of the disputable role of SP in migraine, the significance of the increase of the peptide in plasma during DH remains to be elucidated.
Increased lipolysis in non‐obese pregnant women studied in the third trimester
Authors: Diderholm Barbro , Stridsberg Mats , Ewald Uwe , Lindeberg‐Nordén Solveig , Gustafsson Jan
Published: September 2006

Background  During pregnancy, metabolic adaptation takes place in the mother to provide for the supply of substrates to the growing fetus.

Objective  To determine rates and endocrine regulation of lipolysis and glucose production (GPR) in late pregnancy.

Design  Energy substrate production was measured in healthy pregnant women by use of stable isotope‐labelled compounds.

Setting  University Hospital, Uppsala, Sweden.

Sample  Eight healthy non‐obese, non‐smoking women with normal pregnancies were studied at 33–36 weeks of gestation after an overnight (12–14 hours) fast.

Methods  Rates of glycerol and glucose production were analysed by gas chromatography/mass spectrometry following constant rate infusion of [1,1,2,3,3‐2H5]‐glycerol and [6,6‐2H2]‐glucose.

Main outcome measure  Glycerol and glucose production in the third trimester.

Results  The mean rate of glycerol production, reflecting lipolysis, was 3.06 (0.66) and the mean GPR was 13.2 (1.5) μmol kg−1 minute−1 [2.38 (0.27) mg kg−1 minute−1]. There was a correlation between rate of glycerol production and GPR (r= 0.75, P= 0.033). Fasting insulin levels correlated inversely with both the rate of glycerol production (r=−0.85, P= 0.008) and GPR (r=−0.78, P= 0.021).

Conclusions  Our results show that lipolysis is markedly increased during late pregnancy compared with reported data for non‐pregnant women. The data also confirm the occurrence of an increased GPR in pregnant women. The finding of a correlation between rate of glycerol production and GPR corroborates the view that lipolysis promotes gluconeogenesis. Although late gestation is associated with insulin resistance, the results show that insulin plays a regulatory role both in lipolysis and glucose production.
Rising rates, changing relationships: caesarean section and its correlates in South Korea, 1988–2000
Authors: Lee Sang‐Il , Khang Young‐Ho , Yun Sungcheol , Jo Min‐Woo
Published: September 2006

Objective To examine the trends in the relationship between caesarean section rates in South Korea and its correlates.

Design Five rounds (1988, 1991, 1994, 1997 and 2000) of population‐based National Fertility and Family Health Survey of South Korea.

Setting South Korea.

Sample Mothers (N= 9184) aged 15–44 years.

Methods Caesarean rates were calculated according to correlates and then directly adjusted to five‐year age and parity groups. Distribution of all samples (9184 mothers) was standard, producing age‐ and parity‐adjusted caesarean rates. Linear trends of correlates with caesarean rates were examined for ordinal variables such as education, income, urbanisation level (area of residence) and level of prenatal visits.

Main outcome measure Age‐ and parity‐adjusted caesarean section rates.

Results As caesarean rates rose by year, the relationship of caesarean section with education, occupation and area of residence has been reversed. Associations between caesarean rates, income level, place of delivery and level of prenatal visit were found in 1988 but disappeared by 2000. In 2000, relatively low caesarean rates were found in variables that will be more prevalent in the future, such as higher maternal education, higher maternal occupation and residence in big cities.

Conclusion Caesarean rates may have reached a plateau in South Korea. No maternal or health service factors were detected to further increase the proportion of caesarean deliveries.
Preterm delivery predicted by soluble CD163 and CRP in women with symptoms of preterm delivery
Authors: Vogel Ida , Grove Jakob , Thorsen Poul , Moestrup Søren K. , Uldbjerg Niels , Møller Holger Jon
Published: September 2006

Objective  To evaluate whether soluble CD163 (sCD163) and C‐reactive protein (CRP) can predict spontaneous preterm delivery in women with symptoms of preterm delivery.

Design  Prospective cohort study.

Setting  Labour ward at a tertiary university hospital.

Population  Ninety‐three women with symptoms of preterm delivery before 34 weeks of gestation.

Methods  sCD163 and CRP were individually examined as predictors of preterm delivery. A model for prediction of preterm delivery was established using exact logistic regression for risk factors individually associated with preterm delivery.

Main outcome measures  Gestational age at delivery.

Results  In women with symptoms of preterm delivery, median sCD163 and CRP levels were significantly higher statistically in women delivering preterm (3.4 mg/L, and 62 nmol/L) compared with the women delivering at term (2.7 mg/L, and <48 nmol/L, Mann–Whitney U test, P < 0.01 and P < 0.001) for sCD163 and CRP, respectively. sCD163 above 5 mg/L was associated with an increased risk of preterm delivery (crude OR = 10, [95% CI 1.3–466], adjusted OR = 27, [0.7–∞]). CRP above 47 mg/L was associated with an increased risk of preterm delivery (crude OR = 5 [1.8–14], adjusted OR = 5 [1.04–31]). Likelihood ratio of a positive test was 8.6 [2.8–14] and 2.8 [0–6.2] for sCD163 and CRP, respectively. The logistic regression model was able to predict 85% of preterm deliveries with 13% false positive, giving a likelihood ratio of 8 [2.2–13.5].

Conclusion  High levels of sCD163 or CRP are associated with an increased risk of preterm delivery in women with symptoms of delivery. Good prediction of preterm delivery before 34 weeks of gestation was obtained by a combination of preterm prelabour rupture of membranes (PPROM), overweight, relaxin, CRP and sCD163.
Alterations in dopaminergic modulation of prefrontal cortical acetylcholine release in post‐pubertal rats with neonatal ventral hippocampal lesions
Authors: Laplante François , Srivastava Lalit K. , Quirion Rémi
Published: September 2006

Excitotoxic lesion of the ventral hippocampus in neonatal rats is a putative animal model of schizophrenia with characteristic developmental abnormalities in dopaminergic neurotransmission and prefrontal cortical functions. Converging evidence also points to the involvement of the central cholinergic system in neuropsychiatric disorders. These two neurotransmitter systems are interlinked in the prefrontal cortex (PFC) where dopamine stimulates acetylcholine (ACh) release. In the present study, we investigated the role of dopamine in the developmental regulation of prefrontal cortical ACh release and the expression of nicotinic and muscarinic receptors in pre‐ and post‐pubertal rats with neonatal ibotenic acid‐induced lesions of the ventral hippocampus (NVH). In vivo microdialysis in the PFC revealed that systemic injections of the D1‐like receptor agonist (±)‐6‐chloro‐7,8‐dihydroxy‐1‐phenyl2,3,4,5‐tetrahydro‐1H‐3‐benzazepine hydrobromide (SKF 81297) (2.5 and 5.0 mg/kg i.p.) caused significantly higher ACh release in post‐pubertal NVH‐lesioned animals (250 and 300% baseline for 2.5 and 5.0 mg/kg, respectively) compared with post‐pubertal shams (150 and 220% baseline for 2.5 and 5.0 mg/kg, respectively). Most interestingly, while prefrontal cortical perfusion of SKF 81297 (100 and 250 µm) had no significant effect on ACh release in post‐pubertal sham‐operated animals, it significantly stimulated ACh release to approximately 250% baseline at both doses in post‐pubertal NVH‐lesioned animals. Receptor autoradiography demonstrated a significant and selective increase in M1‐like receptor binding sites in the infralimbic area of the PFC in the post‐pubertal NVH‐lesioned animals. For all experiments, significant differences between sham and NVH‐lesioned animals were observed only in post‐pubertal rats. These results suggest a developmentally specific reorganization of the prefrontal cortical cholinergic system involving D1‐like receptors in the NVH model.
Attenuation of chronic neuroinflammation by a nitric oxide‐releasing derivative of the antioxidant ferulic acid
Authors: Wenk Gary L. , McGann‐Gramling Kristin , Hauss‐Wegrzyniak Beatrice , Ronchetti Daniela , Maucci Raffaella , Rosi Susanna , Gasparini Laura , Ongini Ennio
Published: September 2006

Chronic neuroinflammation and oxidative stress contribute to the neurodegeneration associated with Alzheimer's disease and represent targets for therapy. Ferulic acid is a natural compound that expresses antioxidant and anti‐inflammatory activities. Nitric oxide is also a key modulator of inflammatory responses. Grafting a nitric oxide‐releasing moiety onto anti‐inflammatory drugs results in enhanced anti‐inflammatory activity. We compared the effectiveness of ferulic acid with a novel nitric oxide‐releasing derivative of ferulic acid in an animal model of chronic neuroinflammation that reproduces many interesting features of Alzheimer's disease. Lipopolysaccharide was infused into the 4th ventricle of young rats for 14 days. Various doses of ferulic acid or its nitric oxide‐releasing derivative were administered daily. Both drugs produced a dose‐dependent reduction in microglia activation within the temporal lobe. However, the nitric oxide‐releasing ferulic acid derivative was significantly more potent. If we delayed the initiation of therapy for 14 days, we found no reduction in microglial activation. In addition, both drugs demonstrated antioxidant and hydroxyl radical scavenging abilities in in vitro studies. Overall, our results predict that a treatment using nitric oxide‐releasing ferulic acid may attenuate the processes that drive the pathology associated with Alzheimer's disease if the treatment is initiated before the neuroinflammatory processes can develop.
Kinetics of glial glutamine efflux and the mechanism of neuronal uptake studiedin vivoin mildly hyperammonemic rat brain
Authors: Kanamori Keiko , Ross Brian D.
Published: September 2006

Kinetics of glial glutamine (GLN) transport to the extracellular fluid (ECF) and the mechanism of GLNECFtransport into the neuron – crucial pathways in the glutamine–glutamate cycle – were studiedin vivoin mildly hyperammonemic rat brain, by NMR and microdialysis to monitor intra‐ and extracellular GLN. The minimum rate of glial GLN efflux, determined from the rate of GLNECFincrease during perfusion of α‐(methylamino)isobutyrate (MeAIB), which inhibits neuronal GLNECFuptake by sodium‐coupled amino‐acid transporter (SAT), was 2.88 ± 0.22 μmol/g/h at steady‐state brain [GLN] of 8.5 ± 0.8 μmol/g. Our previous study showed that the rate of glutamine synthesis under identical experimental conditions was 3.3 ± 0.3 μmol/g/h. At steady‐state glial [GLN], this is equal to its efflux rate to the ECF. Comparison of the two rates suggests that SAT mediates at least 87 ± 8% (= 2.88/3.3 × 100%) of neuronal GLNECFuptake. While MeAIB induced > 2‐fold elevation of GLNECF, no sustained elevation was observed during perfusion of the selective inhibitor of LAT, 2‐amino‐bicyclo[1,1,2]heptane‐2‐carboxylic acid (BCH), or ofd‐threonine, a putative selective inhibitor of ASCT2‐mediated GLN uptake. The results strongly suggest that SAT is the predominant mediator of neuronal GLNECFuptake in adult rat brainin vivo.
Isolation and characterization of microsatellite markers from Pacific white shrimp (Litopenaeus vannamei)
Authors: ZHI‐YING JIA , XIAO‐WEN SUN , LI‐QUN LIANG , DA‐YU LI , QING‐QUAN LEI
Published: September 2006

We report the development of 11 polymorphic microsatellite loci in pacific white shrimp (Litopenaeus vannamei) using an unenriched genomic library. The number of the alleles ranged from two to 18 and observed hererozygosity ranged from 0.0286 to 0.9429, indicating that these markers will be useful for population studies and mapping in pacific white shrimp. Seven loci were detected deviated from Hardy–Weinberg, caused by deficiency of heterozygote, suggesting population genetic structure across the sampled population. No evidence for linkage disequilibrium was found.
Characterization of 36 polymorphic microsatellite loci in the Kentish plover (Charadrius alexandrinus) including two sex‐linked loci and their amplification in four other Charadrius species
Authors: KÜPPER CLEMENS , HORSBURGH GAVIN J. , DAWSON DEBORAH A. , FFRENCH‐CONSTANT RICHARD , SZÉKELY TAMÁS , BURKE TERRY
Published: September 2006

We isolated 45 new Kentish plover (Charadrius alexandrinus) microsatellite loci. These were tested for polymorphism in 42 Kentish plovers breeding in the Çukurova Delta, Turkey. Thirty‐six of the 45 loci were polymorphic with observed heterozygosity varying between 0.22 and 0.93. Genotypes of individuals of known sex indicated that two loci were sex‐linked (Calex‐26 is located on the Z chromosome and Calex‐31 on the W chromosome). Additionally, we tested all loci for amplification in four other species of Charadridae (Kittlitz's plover, Madagascar plover, three‐banded plover and white‐fronted plover). On average 34 loci amplified per species (range 29–36).
Ten novel dinucleotide microsatellite loci cloned from the Galápagos sea lion (Zalophus californianus wollebaeki) are polymorphic in other pinniped species
Authors: HOFFMAN JOSEPH I. , STEINFARTZ SEBASTIAN , WOLF JOCHEN B. W.
Published: September 2006

We isolated and characterized 10 novel dinucleotide microsatellite loci from the Galápagos sea lion (Zalophus californianus wollebaeki) and tested their amplification utility in four further otariid species (Zalophus californianus californianus, Arctocephalus gazella, Arctocephalus australis and Eumetopias jubatus) and three phocid species (Hydrurga leptonyx, Halichoerus grypus and Phoca vitulina). All of the loci amplified polymorphic polymerase chain reaction (PCR) products in at least three species other than the Galápagos sea lion. These markers will be useful for studies of pinniped mating systems, genetic structure and genetic diversity.
VICISSITUDES OF BENEFIT SHARING OF CROP GENETIC RESOURCES: DOWNSTREAM AND UPSTREAM
Authors: DE JONGE BRAM , KORTHALS MICHIEL
Published: September 2006

In this article, we will first give a historic overview of the concept of benefit sharing and its appearance in official agreements, particularly with respect to crop genetic resources. It will become clear that, at present, benefit sharing is primarily considered as an instrument of compensation or exchange, and thus refers to commutative justice. However, we believe that such a narrow interpretation of benefit sharing disregards, and even undermines, much of its (historical) content and potency, especially where crop genetic resources are concerned. We argue that benefit sharing should not be based merely on commutative justice but rather on a broader model that is also grounded in the concept of distributive justice. This has repercussions for the application of benefit sharing, which we try to clarify by distinguishing between downstream and upstream benefit sharing. Upstream benefit sharing is not so much inspired by compensation for actions done, or the distribution downstream of benefits developed, but by the idea of shared decision‐making on the research and development of resources fundamental to human welfare. Going upstream in the research process of crop genetic resources, and determining research agendas and improving crops according to the needs of the poor, benefit sharing may well be a tool to contribute to world food security and global justice. We concretize our ideas on upstream benefit sharing by introducing a set of criteria that determine the success of consultations on agricultural research agenda setting.
Environmental psychology and the geographies of ethical and sustainable consumption: aligning, triangulating, challenging?
Authors: Hobson Kersty
Published: September 2006

Human geographers’ research into lay responses to burgeoning environmental issues has highlighted their mediated and contingent constitution. Situated within the discipline's cultural turn, this work has challenged prevailing informational and cognitive approaches to sustainability. In doing so, however, potentially informative concepts and findings from environmental psychology have been sidelined. In this paper I attempt a modest allying of the two sub‐disciplines, outlining their differences and similarities, and arguing that environmental psychology can triangulate with human geography, as well as challenge tendencies within human geography literatures to simplify the ‘psychological’ subject.
‘Gluttony or sloth’: critical geographies of bodies and morality in (anti)obesity policy
Authors: Evans Bethan
Published: September 2006

In many countries, obesity is high on public health policy agendas, and geographical research has begun to engage with obesity. However, obesity is a highly contested term, and recent debates about geographers’ engagement with policy, and critical discussions of the presence of bodies in medical geography, bear great relevance for developing a critical perspective on dominant ‘obesity discourse’. Through a critical reading of a recent UK policy document, this paper considers the presence of bodies in (anti)obesity campaigns, calling for a more critical approach to the medicalization of body size to be central to future geographical work on obesity.
Learning and earning: relational scales of children's work
Authors: Jennings Joel , Aitken Stuart , Estrada Silvia López , Fernandez Adriana
Published: September 2006

There is an important dissonance in recent studies of children's work between the global efforts to eradicate abusive forms of child labour on the one hand and, on the other hand, local settings where children's work plays an important role in social reproduction, socialization and skill acquisition. This research explores the reasons for this dissonance by eliding both the global perspectives of children's rights and the local realities of children's daily geographies. By closing the gap between global knowledge about children (from above) and children's knowledge and agency in their own environments (from below), we seek to present a relational account of children's work within the context of their daily geographies. We draw on data collected with child workers in Tijuana, Mexico to demonstrate the complex role that children's work often plays in the daily geographies of young people.
Why rehabilitate urban river systems?
Authors: Findlay Sophia Jane , Taylor Mark Patrick
Published: September 2006

This paper addresses the philosophical question: ‘why rehabilitate urban river systems?’ within an Australian context. Rehabilitation of river systems has become an important objective of many local, state and national governments around the world, who allocate substantial investment into various river projects. An understanding of the various factors influencing stream condition and potential rehabilitation options is essential in order to determine how the process is undertaken, and how success is measured. This paper examines the triple bottom line (economic, social and environmental) factors that influence decisionmaking with respect to urban stream rehabilitation and management and considers their relative value and importance.
THE ROLE OF PHYTOPLANKTON SIZE ON PHOTOCHEMICAL RECOVERY DURING THE SOUTHERN OCEAN IRON EXPERIMENT1
Authors: Peloquin Jill A. , Smith Walker O.
Published: September 2006

Phytoplankton primary productivity in the Southern Ocean is controlled by complex interactions among iron, light, and grazing. This project interfaced with the Southern Ocean iron experiment (SOFeX) that created two iron‐enriched patches north and south of the Polar Front each with distinct silicic acid concentrations. We used pulse amplitude modulated fluorometry and measured the recovery of the maximum quantum yield of photochemistry (Fv/Fm) for three size fractions (whole, <5, <20 μm) and light adapted quantum yield (ΔF/F′m) for single phytoplankton cells. The rates of recovery from iron stress were found to be unrelated to average cell size for both size‐fractioned and single‐celled measurements. The smallest cells appeared to exhibit more severe iron stress at the onset of the experiment than the larger taxa. The largest response detected in regression parameters was that of the pennate diatoms, which took only ∼3.4 days to reach the maximum quantum yield, whereas the centric diatom Asteromphalus sp. reached maximum ΔF/F′m after ∼10.4 days. The north patch measurements showed a different response; the smallest cells never reached maximum ΔF/F′m, whereas the size fraction containing the largest cells did. Single‐celled measurements made nearly 30 days after the initial iron enrichment suggested that diatoms were experiencing either silicic acid or iron limitation, whereas measurements of Phaeocystis sp. did not. These data represent the first study of in situ recovery rates of PSII for groups of diatoms, and may help elucidate the mechanisms of species change in response to environmental perturbation.
Diversity and origin of hepatitis C virus infection among unpaid blood donors in the Netherlands
Authors: Van De Laar Thijs J.W. , Koppelman Marco H.G.M. , Van Der Bij Akke K. , Zaaijer Hans L. , Cuijpers H. Theo M. , Van Der Poel Cees L. , Coutinho Roel A. , Bruisten Sylvia M.
Published: September 2006

BACKGROUND: To improve transfusion policy and to increase understanding of the spread of hepatitis C virus (HCV) in the general population, HCV infections among voluntary Dutch blood donors were examined with molecular epidemiologic techniques.

STUDY DESIGN AND METHODS: During 6 years, 1997 through 2002, confirmed anti‐HCV–positive donors were interviewed on HCV‐associated risk behavior with a standardized questionnaire. Additionally, HCV isolates were genotyped, partially sequenced, and compared to sequences obtained from Dutch injecting drug users (IDUs).

RESULTS: HCV prevalence and incidence rates among Dutch donors were extremely low; the residual risk of transmitting HCV was calculated to be 1 in 30 million donations. Former IDUs (21%), transfusion recipients (30%), and immigrants (>12%) were identified as major HCV risk groups. Cryptogenic transmission caused 18 percent of infections among new donors and all infections among repeat donors. Compared to IDUs, genotype distribution among donors was highly diverse; major subtypes were 3a (27%), 1a (24%), 1b (24%), 2a/b (10%), and 4 (9%). Half of the donors were infected with IDU‐related subtypes 1a and 3a, whereas subtype 1b mainly spread via blood transfusion and various other nosocomial modes of transmission in the past. HCV infections acquired in endemic countries could be clearly identified based on genotype.

CONCLUSION: Different modes of transmission are linked to infections with certain HCV subtypes, suggesting separate HCV epidemics, but spillover between different risk groups underlines the value of molecular epidemiologic techniques to gain insight into the origin and dynamics of HCV infections on a population level.
ABO blood group determines plasma von Willebrand factor levels: a biologic function after all?
Authors: Jenkins P. Vince , O’Donnell James S.
Published: September 2006

For many years, an association between ABO histo‐blood group and risk of thrombosis has been recognized. Blood group non‐O (A, B, and AB) individuals have consistently been found to demonstrate increased incidence of both arterial and venous thrombotic disease, compared to group O individuals. This increased risk is attributable to the fact that ABO blood group influences plasma levels of a coagulation glycoprotein named von Willebrand factor (VWF). VWF levels are 25 percent higher in non‐O compared to group O individuals. The mechanism by which ABO group determines plasma VWF levels has not been determined. ABO(H) carbohydrate antigenic determinants, however, are expressed on the N‐linked glycan chains of circulating plasma VWF. This review will focus on the carbohydrate structures of VWF and recent studies suggesting that subtle variations in these structures (particularly differences in ABO blood group antigen expression) may have clinically significant effects on VWF proteolysis and clearance.
A KEL gene encoding serine at position 193 of the Kell glycoprotein results in expression of KEL1 antigen
Authors: Poole Joyce , Warke Nicole , Hustinx Hein , Taleghani Behrouz Mansouri , Martin Peter , Finning Kirstin , Crew Vanja Karamatic , Green Carole , Bromilow Imelda , Daniels Geoff
Published: September 2006

BACKGROUND: The KEL2/KEL1 (k/K) blood group polymorphism represents 578C>T in the KEL gene and Thr193Met in the Kell glycoprotein. Anti‐KEL1 can cause severe hemolytic disease of the fetus and newborn. Molecular genotyping for KEL*1 is routinely used for assessing whether a fetus is at risk. Red blood cells (RBCs) from a KEL:1 blood donor (D1) were found to have abnormal KEL1 expression during evaluation of anti‐KEL1 reagents.

STUDY DESIGN AND METHODS: Kell genotyping methods, including KEL exon 6 direct sequencing, were applied. KEL cDNA from D1 was sequenced. Flow cytometry was used to assess KEL1 and KEL2 RBC expression.

RESULTS: RBCs from the donor, her mother, and an unrelated donor gave weak or negative reactions with some anti‐KEL1 reagents. Other Kell‐system antigens appeared normal. The three individuals were homozygous for KEL C578 (KEL*2) but heterozygous for a 577A>T transversion, encoding Ser193. They appeared to be KEL*2 homozygotes by routine genotyping methods. Flow cytometry revealed weak KEL1 expression and normal KEL2, similar to that of KEL*2 homozygotes.

CONCLUSION: Ser193 in the Kell glycoprotein appears to result in expression of abnormal KEL1, in addition to KEL2. The mutation is not detected by routine Kell genotyping methods and, because of unpredicted KEL1 expression, could lead to a misdiagnosis.
Safety and efficacy of therapeutic early onset granulocyte transfusions in pediatric patients with neutropenia and severe infections
Authors: Sachs Ulrich J.H. , Reiter Alfred , Walter Tobias , Bein Gregor , Woessmann Wilhelm
Published: September 2006

BACKGROUND: Bacterial and fungal infections in profound neutropenia after chemotherapy are associated with high mortality despite appropriate antibacterial and antifungal treatment. Granulocyte transfusions are used as a therapeutic addendum, but concern regarding pulmonary reactions often results in delayed use in clinical practice. Accordingly, many patients are already at advanced stages of their infectious disease once granulocytes are transfused. Thus, a prospective Phase II trial was conducted to test the safety and efficacy of therapeutic early‐onset granulocyte transfusions in immunocompromised children with neutropenia and severe infections.

STUDY DESIGN AND METHODS: Twenty‐seven children with hematologic disorder or malignancy and severe neutropenia with clinically and/or microbiologically documented severe infection unresponsive to standard treatment were included. They received granulocyte colony‐stimulating factor (G‐CSF)–elicited, crossmatched granulocyte concentrates every other day until complete recovery from infection was documented.

RESULTS: A median of two granulocyte transfusions with a median of 8 × 108 granulocytes per kilogram of body weight were administered. All transfusions were well tolerated, and no pulmonary symptoms were observed. A total of 92.6 percent of our patients were able to clear their initial infection, and 81.5 percent were alive and without signs or symptoms of their infection 1 month later. All six children with aspergillosis cleared their infection.

CONCLUSIONS: G‐CSF–elicited, crossmatched granulocyte concentrates are a safe and efficient therapeutic addendum in immunocompromised children with prolonged neutropenia and severe infections. Early transfusion of granulocyte concentrates can lead to an overall response rate of 92.6 percent without adverse events. Randomized clinical trials with an early‐onset design are required to determine appropriate clinical applications.
Phases of Earthquake Experience: A Case Study of the June 2000 South Iceland Earthquakes
Authors: Akason Jon Börkur , Ólafsson Stefan , Sigbjörnsson Ragnar
Published: September 2006

A case study of the impact factors of stress and relief in the wake of the south Iceland earthquakes in 2000 is presented. By applying axial coding analysis, the isolated concurrent and interplaying sociostructural impact factors were added sequentially to a time axis based on interviews with sufferers, as well as observations and a survey analysis. The data were obtained through a field survey using standardized questionnaires as well as numerous personal in‐depth interviews, photographs, and field notes. An exposition of the different phases of the earthquake experience is presented, reflecting the victims' conscious and/or unconscious efforts to bring life back to “normal,” though constantly burdened by a perceived lack of understanding of their experiences by “outsiders.” The process was characterized by six main stress factors and three noteworthy mitigating factors. The findings are important for vulnerability and risk assessment as well as for planning pre‐, pro‐, and postearthquake reactions in the affected areas.
Government Risk Management Priorities: A Comparison of the Preferences of Asian Indian Americans and Other Americans
Authors: Greenberg Michael R. , Sinha Reya
Published: September 2006

A survey was conducted of approximately 200 Asian Indian Americans and 200 other residents of New Jersey in order to understand the risk management priorities that they want government to have. We found that Asian Indian Americans, especially younger women, focused on personal/family risks, such as alcohol and drug abuse, sexual abuse, and domestic violence. The New Jersey comparison group, in contrast, placed war/terrorism and loss of health care services and insurance at the top of their priorities for government. These results suggest stressful acculturation‐related issues within the Asian Indian community. Both populations want more risk management from government than they believe government is currently providing. Respondents who wanted more from government tended to dread the risk, be fearful of the consequences, trust government, and have a feeling of personal efficacy. Within the Asian Indian American sample, wide variations were observed by language spoken at home and religious affiliation. Notably, Muslims and Hindi‐language speakers tended not to trust government and hence wanted less government involvement. This study supports our call for studies of recent migrant populations and Johnson's(1)for testing ethnic identity and acculturation as factors in risk judgments.
Preventing the Importation of Illicit Nuclear Materials in Shipping Containers
Authors: Wein Lawrence M. , Wilkins Alex H. , Baveja Manas , Flynn Stephen E.
Published: September 2006

We develop a mathematical model to find the optimal inspection strategy for detecting a nuclear weapon (or nuclear material to make a weapon) from being smuggled into the United States in a shipping container, subject to constraints of port congestion and an overall budget. We consider an 11‐layer security system consisting of shipper certification, container seals, and a targeting software system, followed by passive (neutron and gamma), active (gamma radiography), and manual testing at overseas and domestic ports. Currently implemented policies achieve a low detection probability, and improved security requires passive and active testing of trusted containers and manually opening containers that cannot be penetrated by radiography. The annual cost of achieving a high detection probability of a plutonium weapon using existing equipment in traditional ways is roughly several billion dollars if testing is done domestically, and is approximately five times higher if testing is performed overseas. Our results suggest that employing high‐energy x‐ray radiography and elongating the passive neutron tests at overseas ports may provide significant cost savings, and several developing technologies, radiation sensors inside containers and tamper‐resistant electronic seals, should be pursued aggressively. Further effort is critically needed to develop a practical neutron interrogation scheme that reliably detects moderately shielded, highly enriched uranium.
Achievement of Pulmonary Vein Isolation in Patients Undergoing Circumferential Pulmonary Vein Ablation: A Randomized Comparison Between Two Different Isolation Approaches
Authors: LIU XINGPENG , DONG JIANZENG , MAVRAKIS HERCULES E. , HU FULI , LONG DEYONG , FANG DONGPING , YU RONGHUI , TANG RIBO , HAO PENG , LU CHUNSHAN , HE XIAOKUI , LIU XIAOHUI , VARDAS PANOS E. , MA CHANGSHENG
Published: September 2006

Introduction: Circumferential pulmonary vein ablation (CPVA) with the endpoint of pulmonary vein (PV) isolation has been developed as an effective therapy for atrial fibrillation (AF). This endpoint can be achieved either by closing gaps along circular lines or by segmental PV isolation inside the circular lines after creation of initial CPVA lesions. We investigated whether the clinical outcome depends on the PV isolation approach used during the first‐time CPVA procedure.

Methods and Results: One hundred consecutive patients (69 male; age, 56.7 ± 11.6 years) who underwent first‐time CPVA for treatment of symptomatic AF were enrolled. PV isolation was randomly achieved either by CPVA alone (aggressive CPVA [A‐CPVA] group, n = 50) or by a combination of CPVA with segmental PV ostia ablation (modified CPVA [M‐CPVA] group, n = 50). Recurrence of atrial tachyarrhythmias (ATa) within 3 months after the initial procedure occurred in 30 patients (60%) in the M‐CPVA group and in only 15 patients (30%) in the A‐CPVA group (P < 0.01). ATa relapse after the first 3 months was detected in 21 patients (42%) in the M‐CPVA group, compared with 9 patients (18%) in the A‐CPVA group (P = 0.01). At 13 ± 4 months, patients treated by the A‐CPVA approach had greater freedom from ATa recurrence than patients who underwent M‐CPVA (P = 0.01). The M‐CPVA approach was the only independent predictor associated with procedural failure (RR 0.318; 95% CI 0.123–0.821; P = 0.02).

Conclusions: When PV isolation is the endpoint of CPVA, the efficacy of the A‐CPVA approach is better than that of M‐CPVA.
Transesophageal Echocardiography Through Nasal Way as a Guide to Percutaneous Closure of Patent Foramen Ovale
Authors: Tallarico Demetrio , Chiavari Pier Andrea , Mollo Pasquale , Campolongo Giuseppe , Greco Cesare , Gaudio Carlo
Published: September 2006

Percutaneous device closure of patent foramen ovale (PFO) has become an effective and safe alternative to medical or surgery treatment. Transesophageal echocardiography (TEE), as commonly used to guide this procedure, has the limitation to require general anesthesia. Recently, intracardiac echocardiography (ICE) with AcuNav probe was used to guide percutaneous PFO closure. We report a 42 year‐old man with two previous cryptogenetic strokes in whom both diagnosis and guidance of PFO closure were performed by means of TEE using the AcuNav catheter introduced through nasal way (TEENW). This technique, that does not require general anesthesia, provided adequate and complete view of the Amplatzer procedure. TEENW might offer a feasible and equivalent echocardiographic alternative either to standard TEE or ICE as a guide to percutaneous PFO closure
Real Time Three‐Dimensional Transthoracic Echocardiography for Guiding Amplatzer Septal Occluder Device Deployment in Patients with Atrial Septal Defect
Authors: Chen Fong L. , Hsiung Ming C. , Hsieh Kai S. , Li Yi C. , Chou Ming C.
Published: September 2006

Background: Transcatheter Amplatzer septal occluder (ASO) device closure of atrial septal defects (ASDs) has traditionally been guided by two‐dimensional transesophageal echocardiography (2D‐TEE) and intracardiac echocardiography (ICE) modalities. Real time three‐dimensional transthoracic echocardiography (RT3D‐TTE) provides rotating images to define ASD and adjacent structures with potential as an alternative to 2D‐TEE or ICE for guiding the device closure of ASD. Our aim was to assess the feasibility and effectiveness of RT3D‐TTE in parasternal four‐chamber views to guide ASO device closure of ASD. Methods and Results: From July 2004 to August 2005, 59 patients underwent transcatheter ASO device closure of ASD. The first 30 patients underwent 2D‐TEE guidance under general anesthesia and the remaining 29 patients underwent RT3D‐TTE guidance with local anesthesia. All interventions were successfully completed without complications. The clinical characteristics and transcatheter closure variables of RT3D‐TTE and 2D‐TEE were compared. Echocardiographic visualization of ASD and ASO deployment was found to be adequate when using either methods. Catheterization laboratory time (39.1 ± 5.4 vs 78.8 ± 14.1 minutes, P < 0.001) and interventional procedure length (7.6 ± 4.2 vs 15.3 ± 2.9 minutes, P < 0.001) were shortened by using RT3D‐TTE as compared with 2DE‐TEE. There was no difference in the rate of closure following either method, assessed after a 6‐month follow‐up. The maximal diameter measured by RT3D‐TTE and 2D‐TEE was correlated well with a balloon‐stretched ASD size (y = 0.985x + 0.628, r = 0.924 vs y = 0.93x + 2.08, r = 0.885, respectively). Conclusion: RT3D‐TTE may be a feasible, safe, and effective alternative to the standard practice of using 2D‐TEE to guide ASO deployment.
Artemia is Capable of Spreading Oocysts of Cryptosporidium and the Cysts of Giardia
Authors: MÉNDEZ‐HERMIDA FERNANDO , GÓMEZ‐COUSO HIPÓLITO , ARES‐MAZÁS ELVIRA
Published: September 2006

ABSTRACT. The capability for ingesting and spreading the fixed oocysts of Cryptosporidium and fixed cysts of Giardia, two waterborne protozoan parasites, by Artemia franciscana, a microcrustacean widely used as live diet in fish and shellfish larviculture, was demonstrated using differential interference contrast and immunofluorescence microscopy. Our findings suggest the possibility that this microcrustacean could serve as a disseminating vehicle of both parasites in aquatic environments.
Ubiquinone Synthesis and its Regulation in Pneumocystis carinii
Authors: KANESHIRO EDNA S. , BASSELIN MIREILLE , MERALI SALIM , KAYSER OLIVER
Published: September 2006

ABSTRACT. The opportunistic pathogen Pneumocystis causes a type of pneumonia in individuals with defective immune systems such as AIDS patients. Atovaquone, an analog of ubiquinone (coenzyme Q [CoQ]), is effective in clearing mild to moderate cases of the infection. Rat‐derived Pneumocystis carinii was the first organism in which CoQ synthesis was clearly demonstrated to occur in both mitochondrial and microsomal subcellular fractions. Atovaquone inhibits microsomal CoQ synthesis with no effect on mitochondrial CoQ synthesis. We here report on additional studies evaluating CoQ synthesis and its regulation in the organism. Buparvaquone also inhibited CoQ synthesis and it reduced the synthesis of all four CoQ homologs in the microsomal but not the mitochondrial fraction. Glyphosate, which inhibits a reaction in the de novo synthesis of the benzoquinone moiety of CoQ reduced cellular ATP levels. Bacterial and plant quinones, and several chemically synthesized phenolics, flavanoids, and naphthoquinones that inhibit electron transport in other organisms were shown to reduce CoQ synthesis in P. carinii. The inhibitory action of naphthoquinone compounds appeared to depend on their molecular size and structural flexibility rather than redox potential. Results of experiments examining the synthesis of the polyprenyl chain of CoQ were consistent with negative feedback control of CoQ synthesis. These studies on P. carinii suggest that cellular sites and the control of CoQ synthesis in different organisms and cell types might be more diverse than previously thought.