bluuebunny/crossref_metadata_2025 huggingface dataset:
Metformin, pre‐eclampsia, and pregnancy outcomes in women with polycystic ovary syndrome
Authors: Glueck C. J. , Bornovali S. , Pranikoff J. , Goldenberg N. , Dharashivkar S. , Wang P.
Published: July 2004

Aims  Was metformin during pregnancy in women with polycystic ovary syndrome (PCOS) associated with pre‐eclampsia, and was it safe for mother and neonate?

Methods  In the current study, pre‐eclampsia and other pregnancy outcomes were prospectively studied in 90 women with PCOS who conceived on metformin 1.5–2.55 g/day, and had ≥ 1 live birth (97 pregnancies, 100 live births) compared with 252 healthy women (not known to have PCOS) with ≥ 1 live birth, consecutively delivered in a community obstetrics practice.

Results  Women with PCOS were older than controls (33 ± 5 vs. 29 ± 6 years, P < 0.0001), more likely to be > 35 years old at conception (23 vs. 13%, P = 0.028), much heavier (93 ± 23 vs. 72 ± 18 kg, P < 0.0001, BMI 33.8 ± 7.8 kg/m2 vs. 25.6 ± 5.9, P < 0.0001), and more likely to be Caucasian (97 vs. 90%, P = 0.05), but there were similar numbers with preconception Type 2 diabetes mellitus [2/90 (2.2%) vs. 1/252 (0.4%), P = 0.17]. Pre‐eclampsia in PCOS (5/97 pregnancies, 5.2%), did not differ (P = 0.5) from controls (9/252, 3.6%), nor did it differ (P = 1.0) in PCOS vs. control primigravidas [2/45 (4.4%) vs. 4/91 (4.4%)]. Development of gestational diabetes in PCOS did not differ from controls [9/95 pregnancies (9.5%) vs. 40/251 (15.9%), P = 0.12]. Of the 100 live births to 90 women with PCOS, there were no major birth defects. Mean ± sd birth weight of the 80 live births ≥ 37 weeks gestation in women with PCOS (3414 ± 486 g) did not differ from controls’ 206 live births ≥ 37 weeks (3481 ± 555 g), P = 0.34, nor did the percentage of ≥ 37 week gestation neonates ≥ 4000 g (12.5 vs. 17.5%, P = 0.3) or ≥ 4500 g (1.3 vs. 2.9%, P = 0.7).

Conclusions  Metformin is not associated with pre‐eclampsia in pregnancy in women with PCOS, and appears to be safe for mother and fetus.
Paraoxonase 1 192Gln/Arg polymorphism is associated with the risk of microangiopathy in Type 2 diabetes mellitus
Authors: Murata M. , Maruyama T. , Suzuki Y. , Saruta T. , Ikeda Y.
Published: July 2004

Aims  To investigate possible associations between diabetic microangiopathy and genetic polymorphisms in factors relevant to arterial thrombosis.

Methods  We conducted a case‐control study on a total of 280 patients with Type 2 diabetes, comparing those without retinopathy or nephropathy (n = 92) and those with microangiopathies (n = 188), for the association of polymorphisms in four candidate genes, paraoxonase 1 (PON1), plasminogen activator inhibitor‐1, fibrinogen, and platelet glycoprotein Ibα.

Results  There were no differences between the two study groups in gender distribution, age at diagnosis of diabetes (47.9 ± 8.4 and 49.0 ± 11.4 years, respectively), or duration of diabetes (14.9 ± 4.5 and 14.5 ± 8.4 years, respectively). Among the gene polymorphisms tested, the 192Gln/Arg polymorphism of PON1 was associated with the prevalence of retinopathy [odds ratio (OR) = 3.13, 95% confidence interval (CI) = 1.42–6.89, P = 0.0046, Gln/Gln vs. Gln/Arg and Arg/Arg]. This polymorphism was also associated with nephropathy (OR = 3.01, 95% CI = 1.30–6.98, P = 0.0103). There were no differences between the three PON1 genotypes (Gln/Gln, Gln/Arg, and Arg/Arg) with regard to the present disease status. Logistic regression analysis for the adjustment of other risk factors revealed that genotypes with PON1 192Arg were an independent predictor of retinopathy. No associations were found between microangiopathies and the other polymorphisms evaluated (plasminogen activator inhibitor‐1, fibrinogen, and platelet glycoprotein Ibα).

Conclusions  This study suggests that the presence of the 192Arg‐allele in the PON1 gene is a genetic risk factor for microangiopathy in Type 2 diabetes mellitus.

Diabet. Med. (2004)
Mortality of South Asian patients with insulin‐treated diabetes mellitus in the United Kingdom: a cohort study
Authors: Swerdlow A. J. , Laing S. P. , Dos Santos Silva I. , Slater S. D. , Burden A. C. , Botha J. L. , Waugh N. R. , Morris A. D. , Gatling W. , Bingley P. J. , Patterson C. C. , Qiao Z. , Keen H.
Published: July 2004

Aims  To investigate mortality in South Asian patients with insulin‐treated diabetes and compare it with mortality in non South Asian patients and in the general population.

Methods  A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin‐treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population.

Results  SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95% CI 2.0–6.9) in men and 10.1 (5.6–16.6) in women, and in the corresponding non South Asians were 2.7 (2.6–2.9) and 4.0 (3.6–4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young‐onset patients was due to several causes, while that in the patients diagnosed at ages 30–49 was largely due to cardiovascular disease, which accounted for 70% of deaths in South Asian males and 73% in females.

Conclusions  South Asian patients with insulin‐treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients.
Sustained effects of pioglitazone vs. glibenclamide on insulin sensitivity, glycaemic control, and lipid profiles in patients with Type 2 diabetes
Authors: Tan M. H. , Johns D. , Strand J. , Halse J. , Madsbad S. , Eriksson J. W. , Clausen J. , Konkoy C. S. , Herz M. ,   for the GLAC Study Group
Published: July 2004

Aims  This study compared the effects of 52 weeks’ treatment with pioglitazone, a thiazolidinedione that reduces insulin resistance, and glibenclamide, on insulin sensitivity, glycaemic control, and lipids in patients with Type 2 diabetes.

Methods  Patients with Type 2 diabetes were randomized to receive either pioglitazone (initially 30 mg QD, n = 91) or micronized glibenclamide (initially 1.75 mg QD, n = 109) as monotherapy. Doses were titrated (to 45 mg for pioglitazone and 10.5 mg for glibenclamide) to achieve glycaemic targets during the next 12 weeks: fasting blood glucose of ≤ 7 mmol/l and 1‐h postprandial blood glucose of ≤ 10 mmol/l. Patients were maintained on the titrated dose for 40 weeks.

Results  Pioglitazone significantly increased insulin sensitivity compared with glibenclamide, as assessed by homeostasis model assessment (17.0% vs. −13.0%; P < 0.001), quantitative insulin sensitivity check index (0.011 vs. −0.007; P < 0.001) and fasting serum insulin (−1.3 pmol/l vs. 23.8 pmol/l; P = 0.007). The glibenclamide group had significantly lower HbA1c than the pioglitazone group after 12 weeks of therapy (7.8% vs. 8.3%, P = 0.015), but significantly higher HbA1c after 52 weeks of therapy (7.8% vs. 7.2%, P = 0.001). Pioglitazone significantly (vs. glibenclamide) increased mean HDL‐C (P < 0.001), decreased mean triglycerides (P = 0.019), and decreased mean atherogenic index of plasma (AIP; P = 0.001) and mean total cholesterol/HDL‐C (P = 0.004), without significantly elevating mean total cholesterol or mean LDL‐C compared with glibenclamide.

Conclusions  These data suggest that the effects of pioglitazone are more sustained than those of glibenclamide for improving insulin sensitivity in patients with Type 2 diabetes, and that 52 weeks’ treatment with pioglitazone has favourable effects on glycaemic control and lipoprotein profile.
Targeted screening for undiagnosed diabetes reduces the number of diagnostic tests. Inter99(8)
Authors: Glümer C. , Jørgensen T. , Borch‐Johnsen K.
Published: July 2004

Aims  To determine the cost and performance of a Danish risk score, fasting plasma glucose (FPG), and HbA1c as single screening tests and in combination with targeted screening.

Subjects and methods  In the Inter99 study, 12 934 inhabitants of Copenhagen County were invited to participate. All participants underwent anthropometric measurements, blood samples, and a 75‐g standardized oral glucose tolerance test [N = 6784 (52.5%)].

Results  Of the 6117 individuals included in the analysis, 252 (4.1%) had previously undiagnosed diabetes. As a stand‐alone test, the FPG had the highest performance expressed by a significantly higher area under the receiver–operating curve [0.89; 95% confidence interval (CI) 0.86, 0.99] compared with the Danish risk score (0.78; 95% CI 0.76, 0.81) and HbA1c (0.76; 95% CI 0.72, 0.80). Targeted screening where the initial test was a risk score reduced the FPG measurements by 72% (100% vs. 27.8%). Using FPG in population‐based screening, the cost per newly diagnosed diabetic individual was 583 euro compared with 270 euro if screened by questionnaire followed by FPG. The sensitivity and specificity were 78.6% and 87.7% for FPG, and 61.5% and 89.2% for the combination of the questionnaire and FPG, respectively.

Conclusions  The performance of FPG was superior to a questionnaire and HbA1c used as single tests. However taking into account workload, the burden on the population and the cost per identified person with undiagnosed diabetes, targeted screening using a questionnaire followed by FPG appears to be the strategy of choice.

Diabet. Med. (2004)
Effects of cardiac rehabilitation on exercise capacity in Type 2 diabetic patients with coronary artery disease
Authors: Vergès B. , Patois‐Vergès B. , Cohen M. , Lucas B. , Galland‐Jos C. , Casillas J. M.
Published: July 2004

Aim  To determine whether Type 2 diabetic patients with coronary disease can obtain, after cardiac rehabilitation, a similar benefit on exercise capacity to non‐diabetic coronary individuals.

Research design and methods  Fifty‐nine Type 2 diabetic patients and 36 age‐matched non‐diabetic patients were enrolled in a 2‐month cardiac rehabilitation programme, after an acute coronary event. At the beginning and at the end of the cardiac rehabilitation programme, each subject underwent a cardiopulmonary exercise test to assess exercise capacity as measured by peak workload, duration of test, maximal heart rate, peak VO2 and anaerobic threshold. The two groups of patients were not different in age, sex ratio, type of coronary event or left ventricular ejection fraction.

Results  The baseline exercise capacity parameters were not different between diabetic and non‐diabetic subjects. After cardiac rehabilitation, improvement of exercise capacity was significantly less in patients with diabetes compared with those without diabetes: peak workload (19% vs. 29%, P = 0.022), peak VO2 (13% vs. 30%, P = 0.002), anaerobic threshold (12% vs. 31%, P = 0.017). In the diabetic patients, a significant inverse relation between fasting blood glucose and change in peak VO2 was observed on both univariate (r = −0.40, P = 0.002) and multivariate (P = 0.001) analyses.

Conclusions  The benefit of cardiac rehabilitation, after an acute ischaemic heart event, in exercise capacity is significantly lower in Type 2 diabetic patients. The response to cardiac rehabilitation in those with diabetes appears to be influenced by blood glucose levels.
Baseline characteristics in the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with Type 2 diabetes
Authors: Thomason M. J. , Colhoun H. M. , Livingstone S. J. , Mackness M. I. , Betteridge D. J. , Durrington P. N. , Hitman G. A. , Neil H. A. W. , Fuller J. H. ,   the CARDS Investigators
Published: July 2004

Aim  To describe baseline characteristics of patients in the Collaborative AtoRvastatin Diabetes Study (CARDS), a randomized, placebo‐controlled trial of lipid lowering with atorvastatin 10 mg daily for the primary prevention of major cardiovascular events in patients with Type 2 diabetes.

Methods  The main eligibility criteria were Type 2 diabetes, age 40–75 years, no previous history of coronary heart disease, stroke or other major cardiovascular events, a documented history of at least one of retinopathy, micro‐ or macroalbuminuria, hypertension or current smoking, LDL‐cholesterol ≤ 4.14 mmol/l and triglycerides ≤ 6.78 mmol/l.

Results  Randomization of 2838 persons (909 women) into CARDS was completed in June 2001. At entry, mean age was 62 years, 12% were over 70 years old and median duration of diabetes was 6 years. Median fasting lipid levels were total cholesterol 5.4 mmol/l, LDL‐cholesterol 3.1 mmol/l, HDL‐cholesterol 1.4 mmol/l and triglyceride 1.7 mmol/l. There was a documented history of retinopathy in 30% of patients, micro/macroalbuminuria in 11% (additionally 17% had micro/macroalbuminuria based on two elevated pretreatment measurements of albumin–creatinine ratios), hypertension in 79% and 23% were current smokers.

Conclusion  CARDS will contribute importantly to the evidence for the macrovascular and microvascular benefits of lipid lowering with atorvastatin in patients with Type 2 diabetes. The results are likely to have important implications for the management of patients.
Social Support Networks of African‐American Children Attending Head Start: A Longitudinal Investigation of Structural and Supportive Network Characteristics
Authors: Bost Kelly K. , Vaughn Brian E. , Boston Ada L. , Kazura Kerry L. , O'Neal Colleen
Published: July 2004

This study examined the stability and coherence of African‐American children's social support networks. Participants included a total of 106 3‐ to 4‐year‐old children attending Head Start centers located in the southeast. Children completed a social network interview in two consecutive years at the Head Start centers. These interviews tapped multiple dimensions of the support network including social embeddedness, proportion of the network providing support, and perceived support. Analyses focused on both the rank‐order stability of children with respect to network characteristics as well as stability of network relationships (the same individuals included in the network at both time periods). Results indicated age‐related increases in network size for adult and child categories, network size across three support domains, proportion of support scores, and perceived support from adults. In addition to age‐related changes, analyses revealed considerable rank‐order stability with respect to structural network dimensions, but very little rank‐order stability in proportion of support and perceived support scores. In contrast, both structural and supportive components of the children's networks were shown to be coherent over a one‐year period when specific network member relationships were examined. Discussion highlights both continuities and discontinuities in young children's social networks, and how data obtained in this study contribute to theory building and the systematic examination of African‐American children's emerging social networks.
Perceptions of Achievement and Achieving Peers in U.S. and Chinese Kindergartners
Authors: Li Jin , Wang Qi
Published: July 2004

Two studies were conducted to examine perceptions about achievement and achiev‐ing peers in 190 U.S. and Chinese kindergartners. Children provided free‐narrative responses to story beginnings about an achieving protagonist in school settings. We found marked cultural differences. For achievement, U.S. children perceived more intellectual development, positive affects of the protagonist, and adult praise, where Chinese children perceived more social respect and their ability to help others. For lack of achievement in non‐achieving peers, U.S. children identified more negative affects, and Chinese children anticipated more negative reactions from adults. Moreover, although children in both cultures used non‐ability factors to explain achievement, Chinese children did so more consistently. Most strikingly, whereas Chinese children often expressed peer respect and desire to emulate the achieving protagonist, U.S. children frequently attributed peer negative reactions toward him or her. We interpret these differences as reflecting U.S. and Chinese cultural values regarding learning, achievement, and related self‐other perceptions.
Emotion Socialization as a Framework for Understanding the Development of Disorganized Attachment
Authors: DeOliveira Carey Anne , Bailey Heidi Neufeld , Moran Greg , Pederson David R.
Published: July 2004

Recent years have seen the emergence of accounts of the origins of the Disorganized attachment relationship in early mother–infant interaction, each building on the pioneering work of Main and Hesse—dysfunctional emotional processes figure prominently in all these accounts. This paper applies a framework based on two complementary theories of emotion socialization, Gianino and Tronick's (1992) Mutual Regulation Model and Gergely and Watson's (1996) Social Biofeedback Theory, to suggest an emotion‐based mechanism consistent with recently proposed models of the development of Disorganized attachment. The framework is used to generate hypothetical accounts of the role of dysfunctional emotional processes and maladaptive emotion socialization in early mother–infant interaction in the development of Disorganized attachment along two distinct pathways, one associated with actual abuse of the infant and the other associated with maternal unresolved trauma.
Positively charged porphyrins: a new series of photosensitizers for sterilization of RBCs
Authors: Trannoy Laurence L. , Lagerberg Johan W.M. , Dubbelman Tom M.A.R. , Schuitmaker Hans J. , Brand Anneke
Published: July 2004

BACKGROUND:  Photodynamic treatment could be a way to inactivate pathogens in RBCs. The objective of this study was to characterize the virucidal activity and RBC‐damaging activity of a series of cationic porphyrins. Using the most efficacious photosensitizer, various in‐vitro human RBC quality variables and in‐vivo RBC survival in Rhesus monkeys were evaluated.

STUDY DESIGN AND METHODS:  RBCs, spiked with 5 log of extracellular VSV, were treated with porphyrins (25 µmol/L) and red light (100 W/m2) and essayed for virucidal activity. In‐vitro RBC quality variables were assessed during 5 weeks of storage in various ASs. In‐vivo survival was investigated with autologous RBCs in Rhesus monkeys.

RESULTS:  Tri‐P(4) was by far the best sensitizer of a series tested, giving the least hemolysis under conditions that resulted in 5 log‐kill of extracellular VSV. Under our experimental conditions, the percentage hemolysis in treated cells was 5.1 ± 1.1 percent after 5 weeks of storage in SAG‐M compared to 1.9 ± 1.1 percent in the untreated control. Storage in AS‐3 resulted hemolysis of 2.3 ± 1.9 percent. With the exception of IgG binding and potassium leakage, RBC quality variables remained unchanged after photodynamic treatment. Addition of reduced glutathione (GSH) during treatment reduced IgG binding. The 24‐hour recovery and T50 of treated RBCs in Rhesus monkeys were satisfactory.

CONCLUSION:  Porphyrin Tri‐P(4) may be a suitable photosensitizer for sterilization of RBCs. However, further exploration to optimize the method is necessary to reach clinically acceptable goals.
Multicenter evaluation of a whole‐blood filter that saves platelets
Authors: Paunovic Dragica , Van Der Meer Pieter , Kjeldsen‐Kragh Jens , Kekomaki Riitta , Larsson Stella , Greppi Noemi , Porretti Laura , Balint Bela , Trkuljic Miroljub , Nedeljkovic Ninoslav , Simonovic Ruzica , Massaro Anna , Labanca Luciana , Kora Shinichi , Riggert Joachim
Published: July 2004

BACKGROUND:  Whole‐blood (WB) leukoreduction filters in current use retain the majority of PLTs. A new whole‐blood filter, which retains significantly fewer of the PLTs (or saves PLTs [WB‐SP]), has been developed. The performance characteristics of the WB‐SP filter have been evaluated in a multicenter study.

STUDY DESIGN AND METHODS:  A total of 617 units of WB was collected into quadruple bag sets with an integrated WB‐SP filter, leukoreduced, and processed into leukoreduced RBCs (LR‐RBC), plasma (LR‐PL), and buffy coats (LR‐BC) from which, pooled, leukoreduced, PLT concentrates (LR‐PCs) were produced. Recovery, yield, and residual WBCs were assessed in prepared blood components.

RESULTS:  The median residual WBC number in the LR‐RBCs was 0.05 × 106 (range, <0.05‐3.8), exceeding 1 × 106 in 0.6 percent of the units. Median Hb content in LR‐RBC was 50 g (range, 34‐72), reflecting a final RBC recovery of 81 ± 6 percent. The median WBC content of the LR‐PC was 0.05 × 106 (range, <0.05‐0.28), with none exceeding 1 × 106. The median PLT content of the LR‐PC, per individual donation, was 6.4 × 1010 (range, 4.1‐10.7), representing a final recovery of 62 ± 10 percent. The mean FVIII activity was 104 ± 25 percent and 83 ± 11 percent in plasma separated from fresh or overnight stored WB, respectively.

CONCLUSION:  Use of the WB‐SP filter makes it possible to obtain three leukoreduced blood components with only one filtration step. The WB‐SP filter showed good leukoreduction performance and recovery of all blood components including PLTs.
Photochemical treatment of platelet concentrates with amotosalen hydrochloride and ultraviolet A light inactivates free and latent cytomegalovirus in a murine transfusion model
Authors: Jordan Catherine T. , Saakadze Natia , Newman James L. , Lezhava Levan J. , Maiers Tanya T. , Hillyer Whitney M. , Roback John D. , Hillyer Christopher D.
Published: July 2004

BACKGROUND:  A photochemical treatment (PCT) process utilizing amotosalen hydrochloride and long wavelength UVA light has been developed to inactivate pathogens in PLTs. This study investigated the effects of amotosalen/UVA treatment on free and latent murine CMV (MCMV) in PLT preparations using a murine model of transfusion‐transmitted CMV (TT‐CMV).

STUDY DESIGN AND METHODS:  In a model of latent MCMV infection, “donor” mice received 1 × 106 plaque‐forming units (PFUs) MCMV and were rested 14 days. Subsequently harvested, pooled, and washed WBCs were PCR positive for MCMV. Murine WBC doses of 1 × 104, 1 × 105, and 1 × 106 were added to human apheresis PLTs in 35 percent autologous plasma and 65 percent PLT AS (PAS). The WBC‐PLT products were treated with 150 µmol/L amotosalen and 0.6 J per cm2 UVA and transfused via tail vein injection into recipient mice. Recipients were killed on Day 14. Blood and spleens were collected and assayed for MCMV by PCR. In a parallel model of active infection with free virus, human PLT in 35 percent autologous plasma and 65 percent PAS were dosed with 1 × 105 and 1 × 106 PFUs of MCMV. All other procedures were as described above.

RESULTS:  In the absence of amotosalen/UVA‐pretreatment, transfusion of PLT latently or actively infected with MCMV produced TT‐CMV in a dose‐dependent fashion. In contrast, all transfusion recipients of identical PLT preparations pretreated with amotosalen/UVA were uniformly PCR negative for MCMV (abrogation of TT‐CMV; p < 0.05).

CONCLUSIONS:  PCT of PLT preparations with the specified doses of amotosalen hydrochloride and UVA light prevents transfusion transmission of free and latent MCMV in a murine model. These results suggest that PCT of human PLTs with amotosalen/UVA should also effectively abrogate TT‐CMV in the clinical setting.
Pregnancy outcomes after recovery from thrombotic thrombocytopenic purpura–hemolytic uremic syndrome
Authors: Vesely Sara K. , Li Xiaoning , McMinn J.R. , Terrell Deirdra R. , George James N.
Published: July 2004

BACKGROUND:  Recurrent thrombotic thrombocytopenic purpura–hemolytic uremic syndrome (TTP‐HUS) during a subsequent pregnancy is an important concern because pregnancy may increase the risk for relapse.

STUDY DESIGN AND METHODS:  Outcomes of all pregnancies after recovery from TTP‐HUS in the Oklahoma TTP‐HUS Registry, a cohort of 301 consecutive patients during the period of 1989 through 2003, were assessed and compared to the total published experience.

RESULTS:  In the Oklahoma Registry, 3 of 7 (43%) women with idiopathic TTP‐HUS, 2 of 11 (18%) women who were pregnant/postpartum, and 0 of 1 (0%) woman with a bloody diarrhea prodrome at their initial presentation were diagnosed with TTP‐HUS during a subsequent pregnancy; all 5 women recovered. In published reports, 10 of 11 (91%) women with idiopathic TTP‐HUS and 11 of 18 (61%) women who were pregnant/postpartum at their initial presentation, and all 11 (100%) women with congenital TTP‐HUS were diagnosed with TTP‐HUS during a subsequent pregnancy. Rates of recurrence in the Oklahoma Registry may be less because of case report bias for exceptional patients. Recurrent TTP‐HUS was difficult to diagnose because other pregnancy‐related complications were frequent.

CONCLUSIONS:  Although pregnancies in these women were often complicated, a future pregnancy may be a safe and appropriate decision for women who have recovered from TTP‐HUS.
Prestorage pooled whole‐blood–derived leukoreduced platelets stored for seven days, preserve acceptable quality and do not show evidence of a mixed lymphocyte reaction
Authors: Sweeney Joseph D. , Kouttab Nicola M. , Holme Stein , Kurtis Jonathan D. , Cheves Tracey A. , Nelson Edward J.
Published: July 2004

BACKGROUND: Prestorage pooling of whole‐blood–derived PCs (WBD‐PCs) would be advantageous to transfusion services in that it would make the product available in a more timely manner, reduce wastage of untransfused pools, and simplify bacterial screening by allowing testing of the pool rather than each single PLT concentrate (PC).

STUDY DESIGN AND METHODS: Four to six individual leukoreduced PCs were pooled into a 1.5‐L CLX‐HP PLT storage bag using a sterile connecting device. Controls were individual prestorage leukoreduced PCs that were stored as single products. Products were sampled on Days 5 and 7 for measures of PLT quality; coagulation, fibrinolytic and complement activation; and for evidence of a mixed lymphocyte reaction.

RESULTS: The pH level was well maintained to Day 7 with no prestorage pool having a pH below 6.7. Day 7 studies showed no evidence of coagulation or difference in complement activation. F1.2 levels did not differ between Days 5 and 7, but a 10‐ to 15‐percent increase in C3a des‐Arg was observed between these days in all product types. Day 7 activated lymphocyte surface markers (CD69, CD71, HLA‐DR) were all at lower limits of detection in the prestorage pooled products, and levels of supernatant cytokines were either not different between product types on either study day or, if different, were lower in the prestorage pooled products.

CONCLUSION: There is no evidence of a deterioration in quality, activation of coagulation or complement, or a mixed lymphocyte reaction attributable to the prestorage pooling process with up to 7 days of storage.
Decreased deformability of donor red blood cells after intrauterine transfusion in the human fetus: possible reason for their reduced life span?
Authors: Egberts J. , Hardeman M.R. , Luykx L.M.
Published: July 2004

BACKGROUND:  The life span of donor red blood cells (RBCs) is reduced in the fetus with Rh hemolytic disease. This may have resulted from donor or recipient factors.

STUDY DESIGN AND METHODS:  Studied in vitro was the effect of gamma irradiation on hemolysis, methemo‐globin (metHb), and lipid peroxidation of donor RBCs and the ability of fetal and adult plasma to protect irradiated RBCs from induced lipid peroxidation. Also studied in vivo were the effects after the time that donor RBCs reside in the fetus by measuring its lipid peroxidation, cholesterol‐to‐phospholipid ratios, and deformability of RBCs.

RESULTS:  Irradiation barely increased hemolysis and metHb formation and did not increase lipid peroxidation. Plasma samples of D+ fetuses inhibited induced oxidative stress less than plasma samples of adults. Nevertheless, in vivo lipid peroxidation of the donor RBC membrane had not increased, whereas the molar cholesterol‐to‐phospholipid ratio increased from 1.08 ± 0.11 to 1.38 ± 0.12. It became identical to that of the fetal RBCs (1.44 ± 0.12). Before transfusion, the deformability of the adult RBCs (elongation index, 0.578 ± 0.013) was better than that of the fetal cells (elongation index, 0.494 ± 0.027), but decreased to fetal levels after transfusion (elongation index, 0.518 ± 0.039).

CONCLUSION:  Irradiation of the RBCs and a reduced fetal antioxidant capacity do not lead to in vivo lipid peroxidation. The shorter life span of donor cells in the fetus probably results from a decreased deformability of the RBCs after transfusion, most likely owing to an increased cholesterol‐to‐phospholipid ratio.
Diclofenac‐induced antibodies against red blood cells are heterogeneous and recognize different epitopes
Authors: Sachs Ulrich J.H. , Santoso Sentot , Röder Lida , Smart Elizabeth , Bein Gregor , Kroll Hartmut
Published: July 2004

BACKGROUND:  Diclofenac (DCF) is a widely used nonsteroidal anti‐inflammatory drug implicated as a cause of immune hemolytic anemia. Drug derivatives have been suggested to be an important—or probably the primary—immunizing agent in drug‐induced immune reactions. A systematic evaluation of 12 patients with DCF‐induced immune hemolysis is reported.

STUDY DESIGN AND METHODS:  All sera samples were evaluated with standard serologic tests for the detection of red blood cells (RBCs) and platelet (PLT) antibodies in the presence of DCF, DCF‐urine (DCF‐U), and five chemically defined metabolites.

RESULTS:  Twelve patients’ sera samples reacted with DCF‐U, but only 9 reacted with DCF. When derivatives were tested, no metabolite was recognized by all sera samples (although 4′‐OH‐DCF was recognized by 11/12), and no metabolite remained unrecognized. As demonstrated with Rhnull cells, the Rh complex may represent an important, but not the only, target protein for which drug‐dependent antibodies are specific. PLT‐reactive antibodies were not detectable.

CONCLUSION:  There is evidence that patients with DCF‐induced immune hemolysis produce a broad spectrum of anti‐DCF/RBC antibodies. 4′‐OH‐DCF seems to represent the most immunogenic metabolite. Nevertheless, all patients’ sera samples contain a mixture of antibodies that recognize several and distinguishable epitopes. These epitopes consist of different drug metabolites and a target protein on the RBC surface, which appears to be the Rh complex in many, but not in all, cases. Additional target proteins remain to be identified.
Human platelet antigen‐specific alloantibodies implicated in 1162 cases of neonatal alloimmune thrombocytopenia
Authors: Davoren Anne , Curtis Brian R. , Aster Richard H. , McFarland Jarice G.
Published: July 2004

BACKGROUND:  Neonatal alloimmune thrombocytopenia (NATP) caused by fetomaternal mismatch for human platelet (PLT) alloantigens (HPAs) complicates approximately 1 in 1000 to 1 in 2000 pregnancies and can lead to a serious bleeding diathesis, intracranial hemorrhage, and sometimes death of the fetus or neonate. As a national reference center for NATP investigations, our experience with this entity over a 12‐year period was reviewed.

STUDY DESIGN AND METHODS:  The laboratory records of all cases of suspected NATP referred for evaluation from January 1, 1990, to December 31, 2002, were analyzed. The spectrum of PLT alloantibody specificities identified was compared with an earlier reported series of serologically verified NATP cases.

RESULTS:  HPA‐specific alloantibodies were identified in 1162 (31%) of 3743 sera of mothers of infants with clinically suspected NATP. Maternal HPA‐1a (PlA1) alloimmunization accounted for the majority (79%) of confirmed NATP cases, with HPA‐5b (Bra), HPA‐3a (Baka), and HPA‐1b (PLA2) alloantibodies accounting for 9, 2, and 4 percent of cases, respectively. In addition, an increase in the number of cases in which multiple HPA‐specific alloantibodies were present in maternal sera was observed during the study period.

CONCLUSION:  Although, as with the earlier series, maternal HPA‐1a alloimmunization was the dominant cause of NATP, the identification of an increasing number of cases due to alternative HPA polymorphisms suggests that investigation for HPA‐1 incompatibility alone is no longer sufficient to fully evaluate clinically suspect NATP cases.
Policymaking in the Parallelogram of Forces: Common Agency and Human Service Provision
Authors: Bertelli Anthony M. , Lynn Laurence E.
Published: July 2004

The “congressional dominance” literature in political science provides valuable insights into the legislative control of administrative agencies. However, this literature tends to be conceptualized with respect to regulatory agencies, and it is not especially helpful in understanding the dynamics of policymaking in the provision of human services. After distinguishing the tasks of regulation and human services provision, we present an alternative: a common agency model of human service policy as the outcome of interest group bargaining. We illustrate its implications with an analytic narrative of service provision for the seriously mentally ill.
Matching Rates and Mandates: Federalism and Children's Medicaid Enrollment
Authors: Kronebusch Karl
Published: July 2004

An important focus of the federalism literature has been on analyzing the responses of lower levels of government to the financial incentives of intergovernmental grant programs. But grant conditions and mandates are also important features of grant programs, and these have received considerably less attention in the literature. This article examines the implementation of federal Medicaid mandates during the 1980s and 1990s to explicitly compare the relative responses of the states to matching rate incentives and statutory mandates. Using individual‐level information on program enrollment to measure policy implementation, the results indicate that the federal mandates led to large changes in children's Medicaid enrollment. In contrast, the effects of the federal matching rate were much more limited. Moreover, the statutory mandates not only raised the average level of enrollment but also reduced the degree of policy variation across the states. While the current pattern of federal Medicaid matching payments reduces policy variation to some extent, these effects are modest compared to the impacts of the mandates. Mandates are a more powerful instrument for national policymakers than the comparatively weak fiscal incentives provided by matching rates.
Evaluating the Effectiveness of Nonprofit Fundraising
Authors: Brooks Arthur C.
Published: July 2004

In this article, I apply and discuss two alterative approaches for evaluating nonprofit fundraising practices. First, I introduce simple financial ratios, using a sample of New York state social welfare nonprofits. Then, I construct Adjusted Performance Measures, which attempt to neutralize the uncontrollable outside forces that nonprofits face in their fundraising. I compare the two types of measures statistically, and examine their respective strengths and weaknesses.
State Implementation of Federal Environmental Policy: Explaining Leveraging in the Clean Water State Revolving Fund
Authors: Travis Rick , Morris John C. , Morris Elizabeth D.
Published: July 2004

The Clean Water State Revolving fund (CWSRF) program provides states with significant discretion to design, implement, and administer the program to meet their water quality needs. An important aspect of the program is the decision whether to leverage existing funds to generate additional capital for loans. This article seeks to explain the leveraging decision process, using three models as explanators. We conceive leveraging as a two‐stage process—(1) the decision to leverage and (2) the decision of how much to leverage. By employing regression techniques, we find that the Environmental Protection Agency's (EPA’s) stated reasons for leveraging—environmental needs and demand for loans—are not significant in the decision to leverage, although needs are significant at the second stage. Likewise, there is limited support for Lester's (1994) “capacity/commitment” model of environmental implementation. A third model employing a larger range of independent variables is the best predictor of both the decision to leverage and the amount of leveraging. Furthermore, the factors important at each stage of the decision process differ substantially, reinforcing our conception of a two‐stage decision process.
DIRECT BONDING OF GaN AND SiC: A NOVEL TECHNIQUE FOR ELECTRONIC DEVICE FABRICATION
Authors: LEE JAESEOB , DAVIS R. F. , NEMANICH R. J.
Published: July 2004

The direct bonding method is applied to the GaN / SiC system, and the processing conditions for successful direct bonding are clarified. Direct bonding of GaN / SiC is achieved at 900°C. The direct bonding of GaN to Si -face SiC is very dependent on the choice of chemical treatments but the bonding of GaN to C -face SiC is less dependent on surface preparation. It is found that an oxide-cleaned surface is essential to achieve good reproducibility of bonding. The electrical properties of the bonded interfaces are also characterized. If a native oxide is present when the bonded interface is prepared, the current through the interface is decreased, which is attributed to an energy barrier due to the presence of charged interface states. Cross section transmission electron microscopy indicates 10nm spaced dislocations at the interface, which form to accommodate the lattice mismatch and twist misfit. In some regions an amorphous oxide layer forms at the interface, which is attributed to inadequate surface preparation prior to bonding. Directly bonded GaN / SiC heterojunction diodes have been fabricated and characterized. The Ga -face (0001) n-type 2H GaN films were directly bonded to the Si -face or C -face (0001, 000-1) p-type 6H SiC . The I-V characteristics display diode ideality factors, saturation currents and energy barrier heights of 1.5±0.1, 10-13 A / cm 2, 0.75±0.10 eV for the Ga / Si interface and 1.2±0.1, 10-16 A / cm 2, 0.56±0.10 eV for the Ga / C interface. The built-in potential was determined from capacitance-voltage measurements to be 2.11±0.10 eV and 2.52±0.10 eV for the Ga / Si interface and the Ga / C interface, respectively. From the built-in potential the energy band offsets are determined to be ΔEC=0.87±0.10 eV and ΔEV=1.24±0.10 eV for the Ga / Si interface and ΔEC=0.46±0.10 eV and ΔEV=0.83±0.10 eV for the Ga / C interface.
QUASI-BALLISTIC AND OVERSHOOT TRANSPORT IN GROUP III-NITRIDES
Authors: KIM K. W. , KOCHELAP V. A. , SOKOLOV V. N. , KOMIRENKO S. M.
Published: July 2004

We analyze steady-state and transient electron transport in the group III-nitride materials at high and ultra-high electric fields for different electron concentration regimes. At high electron concentrations where the electron distribution function assumes a shifted Maxwellian, we investigate different time-dependent transient transport regimes through the phase-plane anyalysis. Unexpected electron heating pattern is observed during the velocity overshoot process with a moderate electron temperature near the peak velocity followed by rapid increase in the deceleration period. For short nitride diodes, space-charge limited transport is considered by taking into account the self-consistent field. In this case, the overshoot is weaker and the electron heating in the region of the peak velocity is greater than that found for time-dependent problem. The transient processes are extended to sufficiently larger distances as well. When the electron concentration is small, we propose a model which accounts the main features of injected electrons in a short device with high fields. The electron velocity distribution over the device is found as a function of the field. It is demonstrated that in high fields the electrons are characterized by the extreme distribution function with the population inversion.
GENERATION-RECOMBINATION NOISE IN GaN-BASED DEVICES
Authors: RUMYANTSEV SERGEY L. , PALA NEZIH , SHUR MICHAEL. S. , LEVINSHTEIN MICHAEL E. , GASKA REMIS , ASIF KHAN M. , SIMIN GRIGORY
Published: July 2004

AlGaN thin films and Schottky barrier Al 0.4 Ga 0.6 N diodes exhibit generation-recombination (GR) noise with activation energies of 0.8 - 1 eV. GR noise in AlGaN / GaN Heterostructure Field Effect transistors (HFETs) corresponds to activation energies in the range from 1 - 3 meV to 1 eV. No GR noise is observed in thin doped GaN films and GaN MESFETs. GR noise with the largest reported activation energy of 1.6 eV was measured in AlGaN / InGaN / GaN Double Heterostructure Field Effect Transistors (DHFETs). Local levels responsible for the GR noise in HFETs and DHFETs might be located in AlGaN barrier layers.
High Voltage AlGaN/GaN Heterojunction Transistors
Authors: McCarthy L. S. , Zhang N-Q. , Xing H. , Moran B. , DenBaars S. , Mishra U. K.
Published: July 2004

The use of AlGaN / GaN HEMTs and HBTs for switching power supplies is explored. With its high electron velocities and breakdown fields, GaN has great potential for power switching. The field-plate HEMT increased breakdown voltages by 20% to 570V by reducing the peak field at the drain-side edge of the gate. The use of a gate insulator is also investigated, using both JVD SiO 2 and e-beam evaporated SiO 2 to reduce gate leakage, increasing breakdown voltages to 1050V and 1300V respectively. The power device figure of merit (FOM) for these devices: [Formula: see text], is the highest reported for switching devices. To reduce trapping effects, reactively sputtered SiN x, is used as a passivant, resulting in a switching time of less than 30 ns for devices blocking over 110V with a drain current of 1.4A under resistive load conditions. Dynamic load results are also presented.

The development of HBTs for switching applications included the development of an etched emitter HBT with a selectively regrown extrinsic base. This was later improved upon with the selectively regrown emitter devices with current gains as high as 15. To improve breakdown in these devices, thick GaN layers were grown, reducing threading dislocation densities in the active layers. A further improvement included the use of a bevelled shallow etch and a lateral collector design to maximize device breakdown.
n-AlGaAs/p-GaAs/n-GaN HETEROJUNCTION BIPOLAR TRANSISTOR: THE FIRST TRANSISTOR FORMED VIA WAFER FUSION
Authors: ESTRADA SARAH , HU EVELYN , MISHRA UMESH
Published: July 2004

We discuss the first reported device characteristics of a wafer-fused heterojunction bipolar transistor (HBT), demonstrating the potential of wafer fusion for the production of electrically active heterostructures between lattice-mismatched materials. n-GaAs / n-GaN ("n-n") and p-GaAs / n-GaN ("p-n") heterojunctions were successfully fused and processed into current-voltage (I-V) test structures. The fusion and characterization of these simple structures provided insight for the fabrication of the more complicated HBT structures. Initial HBT devices performed with promising dc common-emitter I-V characteristics and Gummel plots. n-n, p-n, and HBT electrical performance was correlated with systematically varied fusion conditions, and with the quality of the fused interface, given both chemical information provided by secondary ion mass spectroscopy (SIMS) and structural information from high resolution transmission electron microscopy (HRTEM) analysis.
500 MeV PROTON ELASTIC SCATTERING ON 13C NUCLEI
Authors: BEREZHNOY Yu. A. , MIKHAILYUK V. P.
Published: July 2004

The polarization observables for 500 MeV proton elastic scattering on 13 C nuclei are calculated on the basis of the multiple diffraction scattering theory and the α-cluster model with dispersion. It is shown that the model assuming that 13 C nucleus consists of a deformed core and an additional neutron most probably situated inside the core allows us to agree with calculated and measured observables.
TESTING 6,8He DENSITY DISTRIBUTIONS BY CALCULATIONS OF TOTAL REACTION CROSS-SECTIONS OF 6,8He+28Si
Authors: LUKYANOV V. K. , ZEMLYANAYA E. V. , MASSEN S. E. , MOUSTAKIDIS Ch. C. , ANTONOV A. N. , KRUMOVA G. Z.
Published: July 2004

Calculations of the 6,8 He +28 Si total reaction cross-sections at intermediate energies are performed on the basis of the Glauber–Sitenko microscopic optical-limit model. The target-nucleus density distribution is taken from the electron-nucleus scattering data, and the 6,8 He densities are used as they are derived in different models. The results of the calculations are compared with existing experimental data. The effects of the density tails of the projectile nuclei as well as the role of shell admixtures and short-range correlations are analyzed.
RELATIVISTIC DIRECT INTERACTION BETWEEN NUCLEONS DERIVED FROM CLASSICAL FIELD THEORY
Authors: NAZARENKO A. V.
Published: July 2004

In order to achieve a realistic description of nuclear matter properties, the nonlinear interactions between nucleons can be introduced into the quantum model on the basis of nonlinear coupling constants solutions to the classical equations for meson fields. In this connection, the quantization of the classical theory is firstly considered in the case of linear solutions. The obtained model is applied to reproduce the "liquid–gas" phase transition in nuclear matter.
EXCITATION FUNCTIONS OF α-INDUCED REACTIONS IN COBALT AND PRE-EQUILIBRIUM EFFECTS
Authors: ANSARI M. AFZAL , Abd. ALSLAM MOUNER A. , SATHIK N. P. M. , ISMAIL M. , RASHID M. H.
Published: July 2004

Excitation functions for the reactions (α,2n), (α,αn), (α,α2n), (α,α3n) and (α,2pn) have been measured using 57 Co as a target up to 50 MeV α-particle energy. The stacked foil activation technique and γ-ray spectroscopy method has been employed. Measured excitation functions are compared with the geometry dependent hybrid (GDH) model. A comparison shows that the pure equilibrium (EQ) compound reaction mechanism is incapable of reproducing the experimental data while the pre-equilibrium (PE) reaction mechanism along with equilibrium (EQ) decay, where it is considered that pre-equilibrium emission of particles take place prior to the establishment of the thermodynamical equilibrium of the system, is able to reproduce the experimental data. The GDH model code ALICE-91 has been used for theoretical calculations. A value of initial exciton number n0=4 with configuration (2 neutron + 2 proton + 0 hole) has been found to give the satisfactory reproduction of experimental excitation functions.
Premium usability
Authors: Sauro Jeff
Published: July 2004

The debate rages. "Formal usability testing costs too much," says one side. "We need methodological rigor," maintains the other. "You can find the important problems with just five users," insists the first. "Such a small number doesn't give us reliable results," counters the second.

And never the twain shall meet.

Or will they? In this
Whiteboard
, Jeff Sauro explores the issues and gives us some ideas for maintaining the statistical validity of our usability testing as we reduce its costs.---
Elizabeth Buie
In pursuit of desktop evolution
Authors: Ravasio Pamela , Schär Sissel Guttormsen , Krueger Helmut
Published: July 2004

This study deals with the problems users encounter in their daily work with computers and the typical practices that they employ. Sixteen daily computer users were interviewed about their habits and problems that they encountered during document classification and retrieval. For both these areas, we provide an overview of identified user practices and a citation-based analysis of the problems users encountered, including those related to the use of the screen real estate (the actual desktop). Two types of problems were identified: (1) Problems that concern the actual use of the system installed on the computer. (2) Problems that arise when people realise that they are using a system that does not allow for the desired work or organizational functions sought. We were able to show that skill continues to be an important factor with respect to the ease of using today's systems. We suggest the following necessary improvements for the evolution of personal information systems: A storage facility that represents the user's view of information; replacing pure technical file metadata with more user-friendly attributes; and introduction of annotations as a new information type.