bluuebunny/crossref_metadata_2025 huggingface dataset:
Nietzsche and Amor Fati
Authors: Han‐Pile Béatrice
Published: September 2009

Abstract: This paper identifies two central paradoxes threatening the notion of amor fati [love of fate]: it requires us to love a potentially repellent object (as fate entails significant negativity for us) and this, in the knowledge that our love will not modify our fate. Thus such love may seem impossible or pointless. I analyse the distinction between two different sorts of love (eros and agape) and the type of valuation they involve (in the first case, the object is loved because we value it; in the second, we value the object because we love it). I use this as a lens to interpret Nietzsche's cryptic pronouncements on amor fati and show that while an erotic reading is, up to a point, plausible, an agapic interpretation is preferable both for its own sake and because it allows for a resolution of the paradoxes initially identified. In doing so, I clarify the relation of amor fati to the eternal return on the one hand, and to Nietzsche's autobiographical remarks about suffering on the other. Finally, I examine a set of objections pertaining both to the sustainability and limits of amor fati, and to its status as an ideal.
Understanding consumers' perspectives on food labelling in India
Authors: Ali Jabir , Kapoor Sanjeev
Published: September 2009

This study aims at identifying the factors influencing consumers' perception on food labelling and its impact on food purchase decision making, through personal interviews of 631 respondents using a structured questionnaire. To analyse the consumers' perceptions on food labelling, factor analysis has been carried out to identify the underlying dimensions among a set of food labelling attributes using the principal component analysis. Based on factor analysis, four sets of components/factors have emerged, that is, (i) serving method; (ii) quality and nutrition; (iii) production and storage; and (iv) product identification, which explain 66.271% of the variance. Logit regression analysis indicates that among the socio‐demographic indicators, the estimated coefficients for gender, education, income and location of residence are statistically significant. Similarly, information on quality and nutrition, production and storage processes, and basic information of the product is found to be significant, implying that these factors are more likely to influence the use of food labels in making informed purchase decisions by the consumers. The findings of the study give practical insights on food labelling issues for the food processors and policy makers.
Management of infertility in low resource countries
Authors: Sharma S , Mittal S , Aggarwal P
Published: September 2009

Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub‐Saharan Africa where infection‐related tubal damage is the commonest cause. Most infections causing tubal damage are preventable and assisted conception can treat the infertility. However, assisted conception, despite being available for nearly three decades is either unavailable or inaccessible to most residents of resource poor countries. Infertility has social, economic and personal effects, which go beyond childlessness, and women bear the major brunt of the burden. There is urgent need for a comprehensive sexual and reproductive healthcare initiative involving maternal and child health, safe abortions, family planning and infertility prevention and management. The provision of low cost assisted reproduction for couples in poorly resourced countries also needs to be revisited.
Preventing mother‐to‐child transmission of HIV
Authors: Mnyani CN , McIntyre JA
Published: September 2009

HIV transmission from mother‐to‐child remains a major cause of infant morbidity and mortality in resource‐poor settings. There is consensus that women who need antiretroviral treatment should receive this during pregnancy and beyond, and that an appropriate antiretroviral prophylactic regimen should be given to those who do not yet need ongoing therapy. Infant feeding remains a major source of infection and new antiretroviral strategies, for mothers or children, are emerging with the potential to control this. Access to HIV testing and antiretroviral treatment or prophylaxis remain very limited in low resource settings and needs to be expanded.
Newborn survival in low resource settings—are we delivering?
Authors: Lawn JE , Kerber K , Enweronu‐Laryea C , Massee Bateman O
Published: September 2009

The annual toll of losses resulting from poor pregnancy outcomes include half a million maternal deaths, more than three million stillbirths, of whom at least one million die during labour and 3.8 million neonatal deaths—up to half on the first day of life. Neonatal deaths account for an increasing proportion of child deaths (now 41%) and must be reduced to achieve Millennium Development Goal (MDG) 4 for child survival. Newborn survival is also related to MDG 5 for maternal health as the interventions are closely linked. This article reviews current progress for newborn health globally, with a focus on the countries where most deaths occur. Three major causes of neonatal deaths (infections, complications of preterm birth, intrapartum‐related neonatal deaths) account for almost 90% of all neonatal deaths. The highest impact interventions to address these causes of neonatal death are summarised with estimates of potential for lives saved. Two priority opportunities to address newborn deaths through existing maternal health programmes are highlighted. First, antenatal steroids are high impact, feasible and yet under‐used in low resource settings. Second, with increasing investment to scale up skilled attendance and emergency obstetric care, it is important to include skills and equipment for simple immediate newborn care and neonatal resuscitation. A major gap is care during the early postnatal period for mothers and babies. There are promising models that have been tested mainly in research studies in Asia that are now being adapted and evaluated at scale including through a network of African implementation research trials.
Ensuring effective Essential Obstetric Care in resource poor settings
Authors: Kongnyuy EJ , Hofman JJ , van den Broek N
Published: September 2009

Although Emergency Obstetric Care (EOC) is globally accepted as a key strategy to improve maternal health and reduce maternal mortality, there is still a lot of debate surrounding its use – What is EOC? Is it evidence‐based? How can we measure it? How can we improve access to EOC? This paper attempts to answer these questions. Although there are no randomized controlled trials, there is strong evidence from quasi‐experimental, observational and ecological studies that EOC should be a critical component of any programme to reduce maternal mortality. This paper also identifies the barriers to accessing EOC and proposes strategies to overcome them which could contribute to achieving Millennium Development Goal 5.
Quality of care for maternal and newborn health: the neglected agenda
Authors: van den Broek NR , Graham WJ
Published: September 2009

The quality of care received by mothers and babies in developing countries is often reported as poor. Yet efforts to address this contributory factor to maternal and newborn mortality have received less attention compared with barriers of access to care. The current heightened concern to achieve Millennium Development Goals 4 & 5 has illuminated the neglected quality agenda. Whilst there is no universally‐accepted definition of “quality care”, it is widely acknowledged to embrace multiple levels – from patient to health system, and multiple dimensions, including safety as well as efficiency. Quality care should thus lie at the core of all strategies for accelerating progress towards MDG4 &5. Interventions to measure and improve quality need themselves to be evidence‐based. Two promising approaches are maternal and perinatal death reviews and criterion‐based audit. These and other quality improvement tools have a crucial role to play in the implementation of effective maternal and newborn care.
Skilled birth attendance‐lessons learnt
Authors: Adegoke AA , van den Broek N
Published: September 2009

To reduce the horrific maternal mortality figures that we have globally especially in resource poor countries, there was a global commitment to reduce maternal mortality by three‐quarters by 2015 using 1990 as a baseline. To measure the achievement of this goal, two indicators: maternal mortality ratio and proportion of births attended by skilled attendance were selected. To ensure skilled attendance at birth for all women, the international community set a target of 80% by 2005, 85% by 2010 and 90% coverage by 2015. However, in 2008 only 65.7% of all women were attended to by a skilled attendant during pregnancy, childbirth and immediately postpartum globally with some countries having less than 20% coverage. With the global human resource crisis, achieving this target is challenging but possible. This paper provides a narrative review of the literature on the skilled birth attendance strategy identifying key challenges and lessons learnt.
Efficacy of four insect repellents against mosquito bites: a double‐blind randomized placebo‐controlled field study in Senegal
Authors: Uzzan Bernard , Konate Lassana , Diop Abdoulaye , Nicolas Patrick , Dia Ibrahima , Dieng Yémou , Izri Arezki
Published: September 2009

Insect‐borne diseases represent a worldwide threat. In addition to fight against vectors (insecticides) and disease prevention (vaccination against yellow fever, chemoprophylaxis against malaria), insect repellents applied on the skin could help reduce the heavy burden related to these diseases. In a field study performed in Senegal, we compared the efficacy of one skin application between 3 and 4 p.m. of four spray repellents [icaridine 20%, para‐menthane‐diol (PMD) 20% and 50% and DEET 50%] against placebo, among 100 healthy male and female volunteers experienced with mosquito capture. Double‐blind randomized cross‐over placebo‐controlled study (Latin‐square design) during five consecutive nights (7 p.m. to midnight) in two villages was conducted. To avoid residual effect, right or left leg was alternately exposed during consecutive nights and the exposed leg was washed before next night. The statistical model was random and mixed effects anova. All four active repellents provided a significant and similar protection compared with placebo, lasting 8 h. However, there was a non‐significant trend for a higher protection by DEET 50% than by PMD 20% (P = 0.07). Duration of protection was similar for all repellents. Their effects were similar among men and women, and against Anopheles or other species. No serious adverse drug reaction was noticed. Using a rigorous methodology and a large number of volunteers, our well‐controlled study demonstrated an important and similar protective effect of all four repellents compared with placebo. Such field studies should be required before approval of any newly developed repellent.
Ethanol‐induced relaxation of mouse esophagus: subcellular mechanisms
Authors: Döndaş Naciye Yaktubay , Kaya Derya , Kaplan Mahir , Ertuğ Peyman , Şingirik Ergin
Published: September 2009

Ethanol (164 mm) produced reproducible relaxations in isolated mouse esophageal strips. Hexamethonium (10–500 μm), a ganglionic blocking agent, and lidocaine (10–100 μm), a local anesthetic agent, failed to affect the relaxations induced by ethanol in the mouse esophagus. Although verapamil (10–500 μm), a selective blocker of L‐type Ca2+channels, failed to affect the relaxations to ethanol, ruthenium red (10–100 μm), a selective blocker of ryanodine receptors (intracellular Ca2+channels), and cyclopiazonic acid (1–10 μm), a selective blocker of sarcoplasmic reticulum Ca2+ATPase (SERCA), significantly inhibited these relaxations. In addition, tetraethylammonium (10–100 μm), a potassium‐selective ion channel blocker andNω‐nitro‐l‐arginine (l‐NOARG; 10–500 μm), a specific inhibitor of nitric oxide synthase (NOS), neomycin (10–500 μm), a phospholipase C inhibitor and indomethacine (1–10 μm), a non‐selective COX inhibitor, significantly inhibited the relaxations induced by ethanol. In contrast ouabain (10–100 μm), an inhibitor of Na+–K+‐ATPase, failed to cause significant alteration on these relaxations in the same tissue. The results of the present study suggest that the inhibitory effect of ethanol on the mouse esophagus may be direct effect of ethanol on the muscle tissue rather than neuronal effect. In addition, intracellular but not extracellular Ca2+may have a role on ethanol‐induced relaxations in isolated mouse esophageal strips. Potassium channels and nitric oxide may also have a role on these relaxations. Similarly, phospholypase C and arachidonic acid pathways may contribute the relaxations to ethanol. However Na+–K+‐ATPase may not have a role on relaxations induced by ethanol in the mouse esophagus.
Effects of β‐aminoisobutyric acid on leptin production and lipid homeostasis: mechanisms and possible relevance for the prevention of obesity
Authors: Begriche Karima , Massart Julie , Fromenty Bernard
Published: September 2009

β‐Aminoisobutyric acid (BAIBA) is a catabolite of thymine and antiretroviral thymine analogues AZT and d4T. We recently discovered that this β‐amino acid is able to enhance fatty acid oxidation and reduce body weight in mice through an increased production of leptin by the white adipose tissue (WAT). Furthermore, BAIBA could have favourable effects on nonalcoholic steatohepatitis in a leptin‐independent manner. In the present review, we shall recall the circumstances that led us to discover the effects of BAIBA on body fat mass and lipid homeostasis. In addition, we put forward several hypothetical mechanisms whereby BAIBA could enhance leptin secretion by WAT and present some anti‐inflammatory effects in the liver. We also discuss in this review (i) the deleterious impacts caused by the absence of, or low leptin expression on lipid homeostasis and body weight in humans and animals and (ii) recent data from other investigators suggesting that increasing leptin levels and/or responsiveness may be indeed an attractive pharmacological strategy in order to prevent (and/or treat) obesity, at least in some individuals.
Relations between open‐field, elevated plus‐maze, and emergence tests in C57BL/6J and BALB/c mice injected with GABA‐ and 5HT‐anxiolytic agents
Authors: Lalonde Robert , Strazielle Catherine
Published: September 2009

Two 5HT1A receptor agonists and chlordiazepoxide were examined in open‐field, elevated plus maze, and emergence tests. At doses with no effect in the open‐field, chlordiazepoxide increased open and open/total arm visits as well as open arm duration in the elevated plus maze, whereas 5HT1A receptor agonists showed an anxiolytic response on a single measure. The anxiolytic action of chlordiazepoxide was limited to the less active BALB/c strain. Unlike the 5HT1A receptor agonists, chlordiazepoxide was also anxiolytic in the emergence test, once again only in BALB/c and not C57BL/6J mice. Significant correlations were found between emergence latencies and specific indicators of anxiety in the elevated plus‐maze in chlordiazepoxide‐treated but not in mice treated with buspirone and 8‐OH‐DPAT. These results indicate that elevated plus‐maze and emergence tests depend on benzodiazepine receptors. In contrast, 5HT1A receptor agonists were ineffective in the emergence test and no correlation was found between emergence latencies and specific indicators of anxiety in the elevated plus‐maze. Though superficially similar, the emergence test seems to tap into a partially separate facet of anxiety.
Antithrombotic therapy for heart failure in sinus rhythm
Authors: Subramaniam Veeran , Davis Russell C. , Shantsila Eduard , Lip Gregory Y.H.
Published: September 2009

Although the risk of thromboembolism in chronic heart failure is high even in the absence of atrial fibrillation, the risk to benefit ratio of anticoagulation vs. antiplatelet therapy or no antithrombotic therapy is poorly defined in this population. Post hoc analysis of large therapeutic heart failure trials has estimated the risk of thromboembolism to be between 1 and 4.5%. However, most of these studies have included some patients with atrial fibrillation, and thromboembolism was not a predefined endpoint. At present, the evidence for either anticoagulation or antiplatelet therapy is limited and the results from current large‐scale randomized studies are awaited. From the randomized studies carried out thus far, there is a beneficial trend in favour of anticoagulation therapy, with less hospitalization for heart failure compared with patients taking aspirin.
Development and Psychometric Evaluation of the Pain Impact Inventory
Authors: Jakobsson Ulf
Published: September 2009

Objectives:  The aim of this study was to develop and psychometrically evaluate an instrument for measuring the impact of chronic pain on daily life.

Methods:  The study comprised 384 respondents (aged between 18–102 years) who reported chronic pain. The instrument “Pain Impact Inventory” (PII) was evaluated in terms of face, content, construct and criterion validity, as well as two reliability measures. Reliability was measured by means of test–retest (with a 2‐week interval) while Cronbach's alpha was used to measure internal consistency.

Results:  The results showed that the PII had acceptable validity and reliability. The PII contains 20 items and was found to have a nested design with five sub‐scales (Physical impact, Psychological impact, Impact on social life, Social support, and Control) and two overarching dimensions (“Impact” and “Support”).

Conclusions:  The initial tests showed that the PII seems to be a psychometrically sound instrument for measuring the impact of pain on daily life from a multidimensional perspective.
Additional Validation of the Pain Medication Questionnaire in a Heterogeneous Sample of Chronic Pain Patients
Authors: Buelow Amanda K. , Haggard Robbie , Gatchel Robert J.
Published: September 2009

The present study represents the next stage in the development of a psychometrically sound, self‐report screening tool used for assessing the potential pain‐medication‐misuse risk. A revised Pain Medication Questionnaire (PMQ) was initially designed to successfully evaluate such risk. A subsequent series of two additional studies further documented the clinical utility of the PMQ. A new shortened version of the PMQ was developed, and its psychometric properties, along with its predictive accuracy in identifying risk for medication misuse, were evaluated. Results revealed that the new version maintained the strong psychometric properties of the original PMQ. Moreover, its predictive accuracy was found to be high (85.5% accuracy). Thus, this revised, shortened PMQ can aid physicians in assessing for potential medication misuse, allowing them to more closely monitor at‐risk patients during pain management treatment.
Figulla ASD Occluder versus Amplatzer Septal Occluder: A Comparative Study on Validation of a Novel Device for Percutaneous Closure of Atrial Septal Defects
Authors: PAC AYSENUR , POLAT TUGCIN BORA , CETIN ILKER , OFLAZ MEHMET BURHAN , BALLI SEVKET
Published: September 2009

Objectives: Occlutech Figulla ASD Occluder (FSO) is an alternative device to Amplatzer Septal Occluder (ASO) with some structural innovations including increased flexibility, minimizing the amount of material implanted, and absence of the left atrial clamp. We aimed to report our experiences with FSO and compare the outcomes of this novel device versus ASO.

Interventions: Between December 2005 and February 2009, 75 patients diagnosed with secundum atrial septal defects underwent transcatheter closure. The FSO device was used in 33 patients, and the ASO was used in 42.

Results: Patient characteristics, stretch size of the defect, device left disc size, procedure, and fluoroscopy time were similar between the groups. However, the difference between device waist size and stretched diameter of the defect was significantly higher, and device delivery sheath was significantly larger in FSO group and device left disc size was significantly lower in the FSO group. In all subjects, the residual shunt was small to trivial during follow‐up and the reduction in prevalence of residual shunt with time was similar in both groups (P = 0.68). We found no differences in complication rate between the two devices; however, device embolization to the pulmonary bifurcation in one patient was recorded as major complication in FSO device group.

Conclusions: Both devices are clinically safe and effective in ASD closure. FSO device has similar outcomes when compared to ASO device. Difficulties in selecting the correct device size in larger defects and larger venous sheath requirement need to be evaluated in further studies.
The Influence of Identification Decision and DNA Evidence on Juror Decision Making1
Authors: Pozzulo Joanna D. , Lemieux Julie M. T. , Wilson Angela , Crescini Charmagne , Girardi Alberta
Published: September 2009

This study examined the influence of identification decision type and DNA evidence on mock jurors' ratings of evidence reliability, witness credibility, and verdict decisions. Type of identification decision was found to influence jurors' perceptions of the reliability of eyewitnesses' descriptions of various details related to the crime. Specifically, positive identifications resulted in the highest reliability ratings. Type of DNA evidence presented was found to impact on ratings of expert witness reliability. Overall, inconsistent DNA evidence that was statistical in nature resulted in the lowest reliability ratings. DNA‐consistent evidence led to more convictions than did DNA‐inconsistent evidence. Furthermore, jurors rendered more guilty verdicts when witnesses made a non‐identification or a positive identification, as compared to a foil identification.
Workplace Bullying and Intention to Leave Among Schoolteachers in China: The Mediating Effect of Affective Commitment1
Authors: McCormack Darcy , Casimir Gian , Djurkovic Nikola , Yang Li
Published: September 2009

Workplace bullying includes behaviors such as harassing, offending, or socially excluding the target. This study examines whether the relationship between workplace bullying and intention to leave is mediated by affective commitment. Based on data from 142 schoolteachers in China, a partial least squares analysis revealed that affective commitment partially mediates the effect of bullying on intention to leave. Furthermore, the direct effect of bullying on intention to leave is stronger than the indirect effect. Theoretical and practical implications include that awareness needs to be raised about what constitutes bullying behavior and that more emphasis needs to be placed on preventing bullying in the workplace.
Monitoring Online Training Behaviors: Awareness of Electronic Surveillance Hinders E‐Learners1
Authors: Thompson Lori Foster , Sebastianelli Jeffrey D. , Murray Nicholas P.
Published: September 2009

Web‐based training programs commonly capture data reflecting e‐learners' activities, yet little is known about the effects of this practice. Social facilitation theory suggests that it may adversely affect people by heightening distraction and arousal. This experiment examined the issue by asking volunteers to complete a Web‐based training program designed to teach online search skills. Half of participants were told their training activities would be tracked; the others received no information about monitoring. Results supported the hypothesized effects on satisfaction, performance, and mental workload (measured via heart rate variability). Explicit awareness of monitoring appeared to tax e‐learners mentally during training, thereby hindering performance on a later skills test. Additionally, e‐learners reported less satisfaction with the training when monitoring was made salient.
Predicting Transformational Leadership in Naval Cadets: Effects of Personality Hardiness and Training
Authors: Johnsen Bjørn Helge , Eid Jarle , Pallesen Staale , Bartone Paul T. , Nissestad Odd A.
Published: September 2009

The present study investigated whether personality hardiness predicts peer ratings of leadership style in Navy officer cadets. Cadets (n = 71) completed the Dispositional Resiliency (hardiness) Scale, and later rated their peers using the Multifactor Leadership Questionnaire (full range of leadership model). Results show the hardy–commitment facet predicted peer ratings of all leadership styles covered in the model, both before and after and intensive military exercise. The challenge facet was a positive predictor of transformational and transactional leadership and was negatively related to passive‐avoidant leadership. Transformational leadership predicted leader performance, as indexed by military development grades; and a partial mediation effect was found for hardiness on the relation between transformational leadership and leader performance.
Social Exchange in Work Settings: Content, Process, and Mixed Models
Authors: Shore Lynn M. , Coyle-Shapiro Jacqueline A-M. , Chen Xiao-Ping , Tetrick Lois E.
Published: September 2009

Social exchange theory has provided the dominant basis for understanding exchange relationships in organizational settings. Despite its predominance within the management field, there are a number of unaddressed issues. This special issue seeks to further social exchange research in work settings. We differentiate social from economic exchange and highlight the moderating role of cultural and individual differences in explaining the outcomes associated with social exchange relationships. We introduce the ideas of content, process, and mixed models of exchange to reflect the different emphases given to the amount and type of resources exchanged, the quality of the relationship, and a combination of both. The five papers in this special issue illustrate these models. We discuss the applicability of social exchange theory across cultural contexts and present suggestions for future research.
The scale of homogeneity of the galaxy distribution in SDSS DR6
Authors: Sarkar Prakash , Yadav Jaswant , Pandey Biswajit , Bharadwaj Somnath
Published: September 2009

The assumption that the Universe, on sufficiently large scales, is homogeneous and isotropic is crucial to our current understanding of cosmology. In this Letter, we test if the observed galaxy distribution is actually homogeneous on large scales. We have carried out a multifractal analysis of the galaxy distribution in a volume-limited subsample from the Sloan Digital Sky Survey (SDSS) Data Release 6. This considers the scaling properties of different moments of galaxy number counts in spheres of varying radius, r, centred on galaxies. This analysis gives the spectrum of generalized dimension Dq(r), where q > 0 quantifies the scaling properties in overdense regions and q < 0 in underdense regions. We expect Dq(r) = 3 for a homogeneous, random point distribution. In our analysis, we have determined Dq(r) in the range −4 ≤q≤ 4 and 7 ≤r≤ 98 h−1 Mpc. In addition to the SDSS data, we have analysed several random samples which are homogeneous by construction. Simulated galaxy samples generated from dark matter N-body simulations and the Millennium Run were also analysed. The SDSS data is considered to be homogeneous if the measured Dq is consistent with that of the random samples. We find that the galaxy distribution becomes homogeneous at a length-scale between 60 and 70 h−1 Mpc. The galaxy distribution, we find, is homogeneous at length-scales greater than 70 h−1 Mpc. This is consistent with earlier works which find the transition to homogeneity at around 70 h−1 Mpc.
Isokinetic and isometric muscle strength in a healthy population with special reference to age and gender
Authors: Danneskiold‐Samsøe B. , Bartels E. M. , Bülow P. M. , Lund H. , Stockmarr A. , Holm C. C. , Wätjen I. , Appleyard M. , Bliddal H.
Published: September 2009

Aim: Muscle strength is an excellent indicator of general health when based on reliable measurements. Muscle strength data for a healthy population are rare or non‐existent. The aim of the present study was to measure a set of normal values for isometric and isokinetic muscle strength for all the major joint movements of the body and, from these data, to create a basis for comparison of the muscle strength of an individual with the expected value in a normal population.

Methods: A randomly selected group, aged 20–80 years, from the Copenhagen City Heart Study were studied. The group was subgrouped according to age and gender. Isometric and isokinetic muscle strength was measured in each subject across the main joints in the body. A statistical model was developed that encompassed the three main muscle groups: upper limbs, trunk and lower limbs.

Results: Muscle strength in healthy men decreases in a linear fashion from the age of 25 years down to between 54% and 89% at the age of 75 years, and seems not highly dependent on any other parameter than age. For women, the muscle strength is dependent on weight and is only related to age from around 40 years of age. The decrease in muscle strength from the age around 40 to 75 years is 48–92%. For most muscle groups, men are 1.5–2 times stronger than women, with the oldest men having strength similar to that observed among the youngest women.

Conclusion: We developed a model to compare the isometric and isokinetic muscle strength of all the major joint movements of an individual with values for a healthy man or woman at any age in the range of 20–80 years. In all age groups, women have lower muscle strength than men. Men’s muscle strength declines with age, while women’s muscle strength declines from the age of 41 years.
Periodontal disease and systemic health: current status
Authors: Cullinan MP , Ford PJ , Seymour GJ
Published: September 2009

The relationship between poor oral health and systemic diseases has been increasingly recognized over the past two decades. Indeed, the clichés “You cannot have good general health without good oral health”, “The mouth is part of the body” and “Floss or die”, are gaining an increasing momentum. A large number of epidemiological studies have now linked poor oral health with cardiovascular diseases, poor glycaemic control in diabetics, low birthweight preterm babies and a variety of other conditions. The majority have shown an association, although not always strong. As a result, a number of meta‐analyses have been conducted and have confirmed the associations and at the same time cautioned that further studies are required, particularly with regard to the effect of periodontal treatment in reducing risk. A number of biologically plausible mechanisms have been put forward to explain the association and there is accumulating evidence in support of them, although at this stage, insufficient to establish causality. Nevertheless, the relationship between poor oral health and systemic diseases has become a significant issue, such that adult oral health can no longer be ignored in overall health strategies. This review provides an update on current understanding of the contribution of poor oral health to systemic diseases, the possible mechanisms involved and the relevance of this for general dental practitioners.
Strategies for the endodontic management of concurrent endodontic and periodontal diseases
Authors: Abbott PV , Salgado J Castro
Published: September 2009

Endodontic and periodontal diseases can provide many diagnostic and management challenges to clinicians, particularly when they occur concurrently. As with all diseases, a thorough history combined with comprehensive clinical and radiographic examinations are all required so an accurate diagnosis can be made. This is essential since the diagnosis will determine the type and sequence of treatment required. This paper reviews the relevant literature and proposes a new classification for concurrent endodontic and periodontal diseases. This classification is a simple one that will help clinicians to formulate management plans for when these diseases occur concurrently. The key aspects are to determine whether both types of diseases are present, rather than just having manifestations of one disease in the alternate tissue. Once it is established that both diseases are present and that they are as a result of infections of each tissue, then the clinician must determine whether the two diseases communicate via the periodontal pocket so that appropriate management can be provided using the guidelines outlined. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intracanal infection before any cementum is removed. This avoids several complications and provides a more favourable environment for periodontal repair. The endodontic treatment can be completed before periodontal treatment is provided when there is no communication between the disease processes. However, when there is communication between the two disease processes, then the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis of the tooth has been reassessed as being favourable. The use of non‐toxic intracanal therapeutic medicaments is essential to destroy bacteria and to help encourage tissue repair.
Systemic antibiotics in periodontal therapy
Authors: Heitz‐Mayfield LJA
Published: September 2009

Periodontitis is a biofilm infection with a mixed microbial aetiology. Periodontitis is generally treated by non‐surgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface for mechanical debridement. A range of systemic antibiotics for treatment of periodontitis has been documented, with some studies showing superior clinical outcomes following adjunctive antibiotics while others do not. This has resulted in controversy as to the role of systemic antibiotics in the treatment of periodontal diseases. Recent systematic reviews have provided an evidence‐based assessment of the possible benefits of adjunctive antibiotics in periodontal therapy. This review aims to provide an update on clinical issues of when and how to prescribe systemic antibiotics in periodontal therapy.
Democratising Trade Politics in the Americas: Insights from the Women's, Environmental and Labour Movements
Authors: Icaza Rosalba , Newell Peter , Saguier Marcelo
Published: September 2009

This paper explores the extent to which and the ways in which civil society groups are contributing to the democratisation of trade policy and politics in the Americas. It explores the strategies adopted by a range of NGOs and social movements to influence the decision‐making processes and the content of the trade agenda. This includes efforts to open up existing spaces of participation as well as the creation of new ones through forms of citizen engagement, democratic innovation and efforts to change the terms of debate. We concentrate on the cases of the women's, environmental and labour movements in relation to the trade agenda promoted by the NAFTA, MERCOSUR and FTAA initiatives.

The first part of the paper provides a discussion of the constraints that recent trade integration processes in the Americas pose to the possibility of deepening democracy. This is followed by an engagement with existing literatures on democratisation in Latin America to draw parallels and identify insights on the nature of the relationship between trade and democracy. The second part draws on three case studies of the strategies of movements in Latin America in their attempts to influence trade policy processes across political scales. The first case study explores the initiatives of women's and feminist organisations in Mexico to incorporate a gender perspective into the debate about NAFTA. The second case deals with the engagements of the environmental movement at the sub‐regional and hemispheric levels in relation to the NAFTA, MERCOSUR and FTAA initiatives. The third case focuses on the labour movement in the Americas in relation to the FTAA process. The conclusion reflects on what has been achieved and what future challenges remain.
The Politics of Taxation and Implications for Accountability in Ghana 1981–2008
Authors: Prichard Wilson
Published: September 2009

In many ways the raising of tax revenues is the most central activity of any state, but it is only recently that the development field has begun to take questions about taxation and its relationship to the performance of government seriously. This research seeks to investigate the particular hypothesis that a government that relies primarily on tax revenues, as opposed to natural resource rents or foreign aid, is more likely to be accountable to its citizens.

This research seeks to capture the evolution of the Ghanaian central government tax system since 1982. The first goal is to understand the politics behind this evolution, in order to pinpoint the factors influencing the willingness and ability of governments to raise domestic revenue. The research then proceeds to ask whether the evolution of the tax system provides evidence that government efforts to raise taxes have given rise to successful demands for greater accountability.

The research finds that there is significant evidence that taxation has often been a catalyst for demands for greater accountability, but also finds that the nature of this relationship has varied dramatically across time, context and tax types. While generalisations demand further research, initial evidence points to several factors that shape the nature of state‐society bargaining over taxation, among them: the broader state of politics, the role of elites, the mobilising capacity of civil society, the motives for the tax increase and the type of tax in question.
Load Response of Periodontal Ligament: Assessment of Fluid Flow, Compressibility, and Effect of Pore Pressure
Authors: Bergomi Marzio , Wiskott H. W. Anselm , Botsis John , Mellal Aïssa , Belser Urs C.
Published: September 2009

The periodontal ligament (PDL) functions both in tension and in compression. The presence of an extensive vascular network inside the tissue suggests a significant contribution of the fluid phase to the mechanical response. This study examined the load response of bovine PDL under different pore pressure levels. A custom-made pressure chamber was constructed. Rod-shaped specimens comprising portions of dentine, bone, and intervening layer of PDL were extracted from bovine mandibular molars. The dentine ends of the specimens were secured to the actuator while the bone ends were affixed to the load cell. The entire assemblage was surrounded by the pressure chamber, which was then filled with saline. Specimens loaded at 1.0 Hz sinusoidal displacement were subjected to four different environmental fluid pressures (i.e., pressures of 0.0–1.0 MPa). The video images recorded during the tests were analyzed to determine whether or not fluid exchange between the PDL and the surrounding medium took place during mechanical loading. A value for the tissue’s apparent Poisson ratio was also determined. The following observations were made: (1) fluid was squeezed out and pumped into the ligament during the compressive and tensile loading phases, (2) the PDL was highly compressible, and (3) the pore pressure had no influence on the mechanical response of the PDL. The present tests emphasized the biphasic structure of PDL tissue, which should be considered as a porous solid matrix through which fluid can freely flow.
Direction and Magnitude of Blood Flow Shear Stresses on the Leaflets of Aortic Valves: Is There a Link With Valve Calcification?
Authors: Ge Liang , Sotiropoulos Fotis
Published: September 2009

Aortic stenosis caused by valve calcification is a major cause of death around the world. Hemodynamic factors have been suggested to be major players in the development of valve calcification, yet a detailed knowledge of the blood flow dynamics as experienced by endothelial cells on valve surfaces is still lacking. In this study we carry out high-resolution numerical simulations of the blood flow through a polymeric trileaflet valve in order to elucidate the differential flow dynamics on the aortic and ventricular sides of the valve leaflets. Limiting streamlines and surface shear stress contours are used to probe and quantify the blood flows on its side. Complicated flow patterns were only observed on the aortic side of the valve near the region where focalized distribution of valve calcification is typically observed.
Virtual Axis Finder: A New Method to Determine the Two Kinematic Axes of Rotation for the Tibio-Femoral Joint
Authors: Roland Michelle , Hull M. L. , Howell S. M.
Published: September 2009

The tibio-femoral joint has been mechanically approximated with two fixed kinematic axes of rotation, the longitudinal rotational (LR) axis in the tibia and the flexion-extension (FE) axis in the femur. The mechanical axis finder developed by Hollister et al. (1993, “The Axes of Rotation of the Knee,” Clin. Orthop. Relat. Res., 290, pp. 259–268) identified the two fixed axes but the visual-based alignment introduced errors in the method. Therefore, the objectives were to develop and validate a new axis finding method to identify the LR and FE axes which improves on the error of the mechanical axis finder. The virtual axis finder retained the concepts of the mechanical axis finder but utilized a mathematical optimization to identify the axes. Thus, the axes are identified in a two-step process: First, the LR axis is identified from pure internal-external rotation of the tibia and the FE axis is identified after the LR axis is known. The validation used virtual simulations of 3D video-based motion analysis to create relative motion between the femur and tibia during pure internal-external rotation, and flexion-extension with coupled internal-external rotation. The simulations modeled tibio-femoral joint kinematics and incorporated 1 mm of random measurement error. The root mean squared errors (RMSEs) in identifying the position and orientation of the LR and FE axes with the virtual axis finder were 0.45 mm and 0.20 deg, and 0.11 mm and 0.20 deg, respectively. These errors are at least two times better in position and seven times better in orientation than those of the mechanical axis finder. Variables, which were considered a potential source of variation between joints and/or measurement systems, were tested for their sensitivity to the RMSE of identifying the axes. Changes in either the position or orientation of a rotational axis resulted in high sensitivity to translational RMSE (6.8 mm of RMSE per mm of translation) and rotational RMSE (1.38 deg of RMSE per degree of rotation), respectively. Notwithstanding these high sensitivities, corresponding errors can be reduced by segmenting the range of motion into regions where changes in either position or orientation are small. The virtual axis finder successfully increased the accuracy of the mechanical axis finder when the axes of motion are fixed with respect to the bones, but must be used judiciously in applications which do not have fixed axes of rotation.
Age-Dependent Regional Mechanical Properties of the Rat Hippocampus and Cortex
Authors: Elkin Benjamin S. , Ilankovan Ashok , Morrison Barclay
Published: September 2009

Age-dependent outcomes following traumatic brain injury motivate the study of brain injury biomechanics in experimental animal models at different stages of development. Finite element models of the rat brain are used to better understand the mechanical mechanisms behind these age-dependent outcomes; however, age- and region-specific rat brain tissue mechanical properties are required for biofidelity in modeling. Here, we have used the atomic force microscope (AFM) to measure region-dependent mechanical properties for subregions of the cortex and hippocampus in P10, P17, and adult rats. Apparent elastic modulus increased nonlinearly with indentation strain, and a nonlinear Ogden hyperelastic model was used to fit the force-deflection data. Subregional heterogeneous distributions of mechanical properties changed significantly with age. Apparent elastic modulus was also found to increase overall with age, increasing by >100% between P10 and adult rats. Unconfined compression tests (ε=−0.3) were performed on whole slices of the hippocampus and cortex of P10, P17, and adult rats to verify the mechanical properties measured with the AFM. Mean apparent elastic modulus at an indentation strain of 30% from AFM measurements for each region and age correlated well with the long-term elastic modulus measured from 30% unconfined compression tests (slope not significantly different from 1, p>0.05). Protein, lipid, and sulfated glycosaminoglycan content of the brain increased with age and were positively correlated with tissue stiffness, whereas water content decreased with age and was negatively correlated with tissue stiffness. These correlations can be used to hypothesize mechanistic models for describing the mechanical behavior of brain tissue as well as to predict relative differences between brain tissue mechanical properties of other species, at different ages, and for different regions based on differences in tissue composition.
Magnetic Coulomb Phase in the Spin Ice Ho
2
Ti
2
O
7
Authors: Fennell T. , Deen P. P. , Wildes A. R. , Schmalzl K. , Prabhakaran D. , Boothroyd A. T. , Aldus R. J. , McMorrow D. F. , Bramwell S. T.
Published: September 2009

Magnetic Monopoles

Magnets come with a north and a south pole. Despite being predicted to exist, searches in astronomy and in high-energy particle physics experiments for magnetic monopoles (either north or south on their own) have defied observation. Theoretical work in condensed-matter systems has predicted that spin-ice structures may harbor such elusive particles (see the Perspective by

Gingras

).

Fennell
et al.

(p.
415
, published online 3 September) and

Morris
et al.

(p.
411
, published online 3 September) used polarized neutron scattering to probe the spin structure forming in two spin-ice compounds—Ho
2
Ti
2
O
7
and Dy
2
Ti
2
O
7
—and present results in support of the presence of magnetic monopoles in both materials.
Group Acupuncture to Relieve Radiation Induced Xerostomia: A Feasibility Study
Authors: Simcock Richard , Fallowfield Lesley , Jenkins Valerie
Published: September 2009

Background

A distressing complication of radiotherapy treatment for head and neck cancer is xerostomia (chronic oral dryness). Xerostomia is difficult to treat conventionally but there are reports that acupuncture can help. We conducted a feasibility study to examine the acceptability of a standardised group acupuncture technique and adherence to group sessions, together with acceptability of the objective and subjective measurements of xerostomia.

Methods

12 males with established radiation induced xerostomia were treated in three groups of four. Each received eight weekly sessions of acupuncture using four bilateral acupuncture points (Salivary Gland 2; Modified Point Zero; Shen Men and one point in the distal radial aspect of each index finger (LI1)). Sialometry and quality of life assessments were performed at baseline and at the end of treatment. A semi-structured interview was conducted a week after completing the intervention.

Results

Adherence to and acceptability of the treatment and assessments was 100%. There were objective increases in the amounts of saliva produced for 6/12 patients post intervention and the majority also reported subjective improvements. Mean quality of life scores for domains related to salivation and xerostomia also showed improvement. At baseline 92% (11/12) patients reported experiencing a dry mouth “quite a bit/very much” as compared to 42% (5/12) after the treatment. Qualitative data revealed that the patients enjoyed the sessions.

Conclusion

The pilot study shows that a standardised group technique is deliverable and effective. The tools for objective and subjective assessment are appropriate and acceptable. Further examination in a randomised trial is now warranted.