bluuebunny/crossref_metadata_2025 huggingface dataset:
Azathioprine treatment during lactation
Authors: CHRISTENSEN L. A. , DAHLERUP J. F. , NIELSEN M. J. , FALLINGBORG J. F. , SCHMIEGELOW K.
Published: August 2008

Background  Thiopurines are widely used to maintain remission in inflammatory bowel disease. Treatment during pregnancy is generally recommended to improve the chance of a normal birth outcome, but advice concerning breastfeeding is conflicting.

Aim  To estimate the exposure of breastfed infants to 6‐mercaptopurine, as a metabolite of azathioprine, from maternal milk.

Methods  Eight lactating women with inflammatory bowel disease receiving maintenance therapy with azathioprine 75–200 mg daily were studied. Milk and plasma samples were obtained 30 and 60 min after drug administration and hourly for the following 5 h.

Results  The variation in the bioavailability of the drug was reflected in a wide range of peak plasma values of 6‐mercaptopurine within the first 3 h. A similar curve, but with an hour’s delay and at significantly lower concentrations varying from 2–50 μg/L, was seen in maternal milk. After 6 h an average of 10% of the peak values were measured.

Conclusions  The major part of 6‐mercaptopurine in breast milk is excreted within the first 4 h after drug intake. On the basis of maximum concentration measured, the infant ingests mercaptopurine of <0.008 mg/kg bodyweight/24 h. The findings confirm that breastfeeding during treatment with azathioprine seems safe and should be recommended, considering the extensive beneficial effects.
Identification of Helicobacter pylori infected patients, using administrative data
Authors: THIRUMURTHI S. , DESILVA R. , CASTILLO D. L. , RICHARDSON P. , ABRAHAM N. S.
Published: August 2008

Background  Helicobacter pylori is a prevalent organism implicated in peptic ulcer disease.

Aim  To validate administrative data for diagnosis of H. pylori‐infected patients.

Methods  Administrative data identified patients with ICD‐9 code for H. pylori (041.86) or prescription of eradication therapy; diagnosis was confirmed by chart abstraction. Multivariable regression assessed predictors of infection considering drug therapy, ICD‐9 code 041.86, procedure code, in‐patient or out‐patient diagnostic code, age, gender and race to generate an algorithm for validation.

Results  The test cohort of 531 patients (361 potential cases; 170 random controls) was primarily male (94%), Caucasian (59%) and elderly [67 years (s.d. 10)]. The positive predictive value (PPV) of ICD‐9 code 041.86 was 100% and 97.4% if from an in‐patient or out‐patient encounter, respectively. Eradication drug therapy had a PPV of 73.7% (triple therapy) and 97.7% (quadruple therapy). The strongest predictors were out‐patient ICD‐9 code 041.86 (OR 8.1; 95% CI: 7.0–9.1); eradication drug therapy (OR 7.4; 95% CI: 6.6–8.3); oesophagogastroduodenoscopy (OR 3.5; 95% CI: 3.3–3.6); and age ≥70 (OR 1.2; 95% CI: 1.1–1.4). An algorithm including these data elements yielded a c‐statistic of 0.93 and PPV of 97.9%.

Conclusions  Administrative data can diagnose H. pylori‐infected patients. The diagnostic algorithm includes presence of eradication drug therapy overlapping with an out‐patient ICD‐9 code 041.86 among elderly adults.
Alluvial fan development and morpho‐tectonic evolution in response to contractional fault reactivation (Late Cretaceous–Palaeocene), Provence, France
Authors: Leleu S. , Ghienne J.‐F. , Manatschal G.
Published: September 2008

Along‐strike variability within a Late Cretaceous to early Palaeocene contractional growth structure and associated alluvial fan deposits is documented at the northern margin of the Arc Basin (Provence, SE France). This contribution shows that alluvial fans can be used as high‐resolution proxies to reconstruct structural segmentation and palaeo‐geomorphological evolution of a source/basin margin system. Facies‐based reconstruction allows the spatial and temporal distribution of alluvial fan bodies to be mapped. Relationships between fan area and catchment size from modern alluvial fan systems were used to estimate palaeo‐catchment size. Combining alluvial fan morphologies with catchment area, pebble provenance analysis and growth structure reconstruction, we show that: (1) fan distribution and related depositional processes were strongly influenced by intrinsic parameters such as drainage basin evolution, local structural inheritance and lateral facies changes in source area lithologies; (2) Inherited structures trending N100 effectively controlled the first‐order location of the fold and thrust structures (Montagne Sainte‐Victoire Range) and adjacent depositional areas (Arc Basin); (3) Syn‐sedimentary faults trending N010‐030 influenced the source/basin margin development and interacted with developing growth structures; (4) Facies changes in Jurassic carbonates controlled fold development and consequently the structural evolution of the source area; and (5) the N010‐030 faults and along‐strike variability of the source/basin margin system were ultimately controlled by basement structures that controlled where Late Cretaceous deformation nucleated. The overall architecture of the source/basin margin system reflects segmentation and strain partitioning along strike, as demonstrated by diachronous alluvial fan distribution.
Women’s stories of their experiences as overweight patients
Authors: Merrill Emily , Grassley Jane
Published: September 2008

Title.  Women’s stories of their experiences as overweight patients.

Aim.  This paper is a report of a study to illuminate the meaning of women’s experiences as overweight patients in their encounters with healthcare services and healthcare providers.

Background.  Overweight and obesity are increasingly important issues for women’s health internationally. Overweight or obese women may delay or avoid health care if care providers have previously reacted negatively to them based on weight. However, studies focusing on the meaning of women’s experiences as overweight patients and as recipients of healthcare services are lacking.

Method.  A hermeneutic phenomenological approach was used. Face‐to‐face interviews were conducted in the United States of America in 2007 with eight women volunteers who self‐identified as being overweight patients. The framework of van Manen’s lifeworld existentials of lived space, lived body, lived time and lived relation‐guided reflection for data analysis.

Findings.  The essence of women’s experiences was a battle to fit into the world of healthcare services. Four major themes were identified. ‘Struggling to fit in’ consisted of trying to fit into limited physical space (examination rooms, equipment), limited time, and limited satisfaction and support in relationships with healthcare providers. ‘Being dismissed’ consisted of demeaning and embarrassing interactions with providers. ‘Feeling not quite human’ involved the stigma of being different because of body size. ‘Refusing to give up’ consisted of persistence in seeking support and advice from professionals despite negative past experiences.

Conclusion.  Awareness of these findings could reform understanding of women’s experiences as overweight patients and raise the consciousness of nurses worldwide to develop sensitive communication strategies and healthcare environments that support holistic care.
Validation of the Italian version of the Discomfort Scale – Dementia of Alzheimer Type
Authors: Dello Russo Carolina , Di Giulio Paola , Brunelli Cinzia , Dimonte Valerio , Villani Daniele , Renga Giovanni , Toscani Franco
Published: September 2008

Title.  Validation of the Italian version of the Discomfort Scale – Dementia of Alzheimer Type.

Aim.  This paper is a report of a study to validate the Discomfort Scale – Dementia of Alzheimer Type in Italian.

Background.  Dementia is a long and highly debilitating illness with a slow course and a steadily rising prevalence. Improving the quality of life of patients with dementia requires instruments to measure their problems and symptoms, because they are unable to communicate and interact with others. In Italy, there are no validated scales to assess discomfort for this population. The Discomfort Scale – Dementia of Alzheimer Type was developed in the USA and has been further tested there as well as in Germany.

Methods.  The data were collected by 21 nurses during 2006 in five nursing homes with 71 patients with severe dementia. Face and content validity were evaluated in a focus group. Discriminant validity was assessed with the opposite‐group approach and internal consistency and inter‐rater reliability were measured.

Results.  The discriminant validity of the Italian Discomfort Scale – Dementia of Alzheimer Type showed its ability to detect patients with high and low levels of discomfort. Reliability testing gave positive results: the internal consistency level was satisfactory (0·814) and comparisons of overall discomfort scores across nurses show good reliability.

Conclusion.  These findings support the use of Discomfort Scale – Dementia of Alzheimer Type in a clinical setting for people with severe dementia for both research and practice. Its ease of use and comprehensibility, and the limited time required to observe patients renders the Discomfort Scale – Dementia of Alzheimer Type a practical instrument for assessment and choosing care interventions.
Proteomic identification of non‐Gal antibody targets after pig‐to‐primate cardiac xenotransplantation
Authors: Byrne Guerard W. , Stalboerger Paul G. , Davila Eduardo , Heppelmann Carrie J. , Gazi Mozammel H. , McGregor Hugh C. J. , LaBreche Peter T. , Davies William R. , Rao Vinay P. , Oi Keiji , Tazelaar Henry D. , Logan John S. , McGregor Christopher G. A.
Published: September 2008

Abstract:  Background:  Experience with non‐antigenic galactose α1,3 galactose (αGal) polymers and development of αGal deficient pigs has reduced or eliminated the significance of this antigen in xenograft rejection. Despite these advances, delayed xenograft rejection (DXR) continues to occur most likely due to antibody responses to non‐Gal endothelial cell (EC) antigens.

Methods:  To gauge the diversity of the non‐Gal antibody response we used antibody derived from CD46 transgenic heterotopic cardiac xenografts performed without T‐cell immunosuppression, Group A (n = 4) and Gal knockout (GT‐KO) heart transplants under tacrolimus and sirolimus immunosuppression, Group B (n = 8). Non‐Gal antibody was measured by flow cytometry and by western blots using GT‐KO EC membrane antigens. A nanoLC/MS/MS analysis of proteins recovered from 2D gels was used to identify target antigens.

Results:  Group A recipients exhibited a mixed cellular and humoral rejection. Group B recipients mainly exhibited classical DXR. Western blot analysis showed a non‐Gal antibody response induced by GT+ and GT‐KO hearts to an overlapping set of pig aortic EC membrane antigens. Proteomic analysis identified 14 potential target antigens but failed to define several immunodominant targets.

Conclusions:  These experiments indicate that the non‐Gal antibody response is directed to a number of stress response and inflammation related pig EC antigens and a few undefined targets. Further analysis of these antibody specificities using alternative methods is required to more fully define the repertoire of non‐Gal antibody responses.
Self‐rated health, psychosocial functioning, and health‐related behavior among Thai adolescents
Authors: Page Randy M. , Suwanteerangkul Jiraporn
Published: September 2008

Background:  Despite the popularity of self‐rated health (SRH) in Western countries as a useful public health tool, it has only rarely been used in Asian countries. The purpose of the current study was to determine whether measures of psychosocial functioning and health‐related factors differ according to SRH in a school‐based sample of Thai adolescents.

Methods:  The survey was given to 2519 adolescents attending 10 coeducational secondary high schools in Chiang Mai Province, Thailand and included measures of psychosocial functioning (loneliness, hopelessness, shyness, perceptions of social status, self‐rated happiness, and perception of physical attractiveness) and certain health‐related factors (height/weight, physical activity, eating breakfast, sleep).

Results:  The proportion of boys (5.1%) reporting that they were not healthy was similar to the proportion of girls (4.6%) making the same rating. These adolescents showed a pattern of overall poor health risk. Compared to adolescent peers who rated their health as healthy or very healthy, they were less physically active, got less sleep, were more likely to be overweight, and scored lower on loneliness, shyness, hopelessness, and self‐rated happiness.

Conclusions:  The present pattern of poor health risk warrants attention and supports the merit of using SRH in adolescent health assessment. SRH is easy to obtain and simple to assess and single‐item assessments of SRH appear to be valid measures of health status in adults and adolescent. Interventions, such as health counseling, mental health counseling, and health education, can target adolescents who rate themselves as ‘not healthy’ or report poor health status.
Anti‐oxidant enzymes and related elements in term and preterm newborns
Authors: Nassi Niccolò , Ponziani Vanessa , Becatti Matteo , Galvan Paola , Donzelli Gianpaolo
Published: September 2008

Background:  Although oxidative stress‐related diseases mostly affect neonates with extremely low birthweight, healthy preterm newborns might also be at risk of oxidative damages. The aim of the present study was to verify this possibility.

Methods:  Urinary 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG), erythrocyte glutathione peroxidase (GSHPx) and superoxide dismutase (SOD), plasma and erythrocyte concentrations of selenium, zinc and copper were measured until 100 days of life in 30 preterm infants with mean ± SD birthweight and gestational age of 1605 ± 122 g and 34.5 ± 0.5 weeks. The control group included 30 term infants with birthweight 3123 158 g and gestational age 39.6 0.7 weeks.

Results:  Throughout the study period urinary 8‐OHdG, taken as a marker of oxidative stress, was significantly higher in the preterm than in the term group. Up until 20 days of life, GSHPx activity was significantly lower in the preterm than in the term infants but this was not associated with any apparent selenium deficiency. Conversely, up until 100 days, preterm infants had significantly reduced SOD levels that appeared to reflect a shortage of the elements needed for this enzyme’s activity, notably copper, the plasma concentrations of which were constantly and significantly below the control values.

Conclusion:  The nutritional status of the elements related to the anti‐oxidant enzymes, especially zinc and copper, should be carefully assessed in preterm infants, even if their birthweight is not extremely low.
High incidence of meropenem resistance among α‐hemolytic streptococci in children with cancer
Authors: Abe Masako , Kamijo Takehiko , Matsuzawa Shigeyuki , Miki Jun , Nakazawa Yozo , Sakashita Kazuo , Okabe Tadashi , Honda Takayuki , Mitsuyama Jun‐ichi , Koike Kenichi
Published: September 2008

Background:  Infections caused by antibiotics‐resistant Gram‐positive bacteria have been reported from many pediatric hematology–oncology centers.

Methods:  The susceptibility profiles to meropenem, piperacillin, and vancomycin among oral flora isolates of α‐hemolytic streptococci (AHS) obtained from six children with cancer who received several empirical therapies (ET) against febrile neutropenia, were investigated.

Results:  Meropenem minimum inhibitory concentration (MIC) of AHS isolated from ET patients was 2.167 ± 0.258 μg/mL (mean ± SD), which was significantly higher than the MIC of AHS isolated from control groups. Intriguingly, AHS isolated approximately 6 months after hospital discharge indicated recovery of susceptibility to meropenem.

Conclusions:  AHS isolates from neutropenic children with cancer should be checked for antibiotic susceptibility, even against carbapenems.
Metagenomic and stable isotopic analyses of modern freshwater microbialites in Cuatro Ciénegas, Mexico
Authors: Breitbart Mya , Hoare Ana , Nitti Anthony , Siefert Janet , Haynes Matthew , Dinsdale Elizabeth , Edwards Robert , Souza Valeria , Rohwer Forest , Hollander David
Published: September 2008

Ancient biologically mediated sedimentary carbonate deposits, including stromatolites and other microbialites, provide insight into environmental conditions on early Earth. The primary limitation to interpreting these records is our lack of understanding regarding microbial processes and the preservation of geochemical signatures in contemporary microbialite systems. Using a combination of metagenomic sequencing and isotopic analyses, this study describes the identity, metabolic potential and chemical processes of microbial communities from living microbialites from Cuatro Ciénegas, Mexico. Metagenomic sequencing revealed a diverse, redox‐dependent microbial community associated with the microbialites. The microbialite community is distinct from other marine and freshwater microbial communities, and demonstrates extensive environmental adaptation. The microbialite metagenomes contain a large number of genes involved in the production of exopolymeric substances and the formation of biofilms, creating a complex, spatially structured environment. In addition to the spatial complexity of the biofilm, microbial activity is tightly controlled by sensory and regulatory systems, which allow for coordination of autotrophic and heterotrophic processes. Isotopic measurements of the intracrystalline organic matter demonstrate the importance of heterotrophic respiration of photoautotrophic biomass in the precipitation of calcium carbonate. The genomic and stable isotopic data presented here significantly enhance our evolving knowledge of contemporary biomineralization processes, and are directly applicable to studies of ancient microbialites.
Multiple bacterial symbionts in two species of co‐occurring gutless oligochaete worms from Mediterranean sea grass sediments
Authors: Ruehland Caroline , Blazejak Anna , Lott Christian , Loy Alexander , Erséus Christer , Dubilier Nicole
Published: September 2008

Gutless oligochaete worms are found worldwide in the pore waters of marine sediments and live in symbiosis with chemoautotrophic sulfur‐oxidizing bacteria. In the Mediterranean, two species of gutless oligochaete worms, Olavius algarvensis and O. ilvae, co‐occur in sediments around sea grass beds. These sediments have extremely low sulfide concentrations (< 1 μM), raising the question if O. ilvae, as shown previously for O. algarvensis, also harbours sulfate‐reducing symbionts that provide its sulfur‐oxidizing symbionts with reduced sulfur compounds. In this study, we used fluorescence in situ hybridization (FISH) and comparative sequence analysis of genes for 16S rRNA, sulfur metabolism (aprA and dsrAB), and autotrophic carbon fixation (cbbL) to examine the microbial community of O. ilvae and re‐examine the O. algarvensis symbiosis. In addition to the four previously described symbionts of O. algarvensis, in this study a fifth symbiont belonging to the Spirochaetes was found in these hosts. The symbiotic community of O. ilvae was similar to that of O. algarvensis and also included two gammaproteobacterial sulfur oxidizers and two deltaproteobacterial sulfate reducers, but not a spirochete. The phylogenetic and metabolic similarity of the symbiotic communities in these two co‐occurring host species that are not closely related to each other indicates that syntrophic sulfur cycling provides a strong selective advantage to these worms in their sulfide‐poor environment.
An association between Type 2 diabetes and α1‐antitrypsin deficiency
Authors: Sandström C. S. , Ohlsson B. , Melander O. , Westin U. , Mahadeva R. , Janciauskiene S.
Published: September 2008

Aims  α1‐Antitrypsin (AAT) is a serine protease inhibitor which recently has been shown to prevent Type 1 diabetes development, to prolong islet allograft survival and to inhibit pancreatic B‐cell apoptosis in vivo. It has also been reported that Type 1 diabetic patients have significantly lower plasma concentrations of AAT, suggesting the potential role of AAT in the pathogenesis of Type 1 diabetes. We have investigated whether plasma AAT levels are altered in Type 2 diabetes.

Methods  The study included patients with Type 2 diabetes (n = 163) and non‐diabetic control subjects matched for age, sex and smoking habits (n = 158) derived from the population‐based Malmö Diet and Cancer study. Plasma samples were analysed for AAT concentration and phenotype and serum glucose, insulin, C‐reactive protein and lipid levels were measured. Glycated haemoglobin was also measured.

Results  In the diabetic group, the women had higher mean plasma AAT levels than men (P < 0.05). The mean plasma AAT levels did not differ between diabetic and control subjects. However, the number of individuals with low AAT levels (< 1.0 mg/ml) was 50% higher in the diabetic group (P < 0.05) and the frequency of AAT deficiency genotypes was 50% higher (NS) in diabetic compared with control subjects. In the group of diabetic patients with AAT < 1 mg/ml, AAT directly correlated with systolic blood pressure (P = 0.048) and inversely correlated with waist–hip ratio (P = 0.031).

Conclusions  Our results provide evidence that deficiency of AAT may be associated with an increased risk of developing Type 2 diabetes.
Are symptoms of depression more common in diabetes? Results from the Heinz Nixdorf Recall study
Authors: Icks A. , Kruse J. , Dragano N. , Broecker‐Preuss M. , Slomiany U. , Mann K. , Jöckel K. H. , Erbel R. , Giani G. , Moebus S. ,   on behalf of the Heinz Nixdorf Recall Study Investigator Group
Published: September 2008

Aims  To estimate the association between depressive symptoms and Type 2 diabetes, as well as previously undetected diabetes, in a large population‐based sample in Germany and to determine associated variables.

Methods  We used baseline data on 4595 participants (age 45–75 years, 50.2% women) from the German Heinz Nixdorf Recall study, a population‐based, prospective cohort study which started in 2000. Diabetes mellitus was assessed by self report (physician diagnosis or medication), undiagnosed diabetes based on blood glucose levels. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES‐D) scale short form (cut‐off ≥ 15 points). We fitted multiple logistic regression models.

Results  The prevalence of diagnosed and previously undetected diabetes was 9.3% (95% confidence interval 8.2–11.6) and 7.6% (6.6–8.8) in men and 6.0% (5.1–7.1) and 3.2% (2.5–4.0) in women, respectively. Compared with non‐diabetic women, the prevalence of depressive symptoms was not significantly different in diabetic women (age‐adjusted odds ratio, 95% confidence interval 1.48; 0.98–2.24) and women with undiagnosed diabetes (0.67; 0.33–1.36). In men, the prevalence of depressive symptoms tended to be lower in diabetic than in non‐diabetic subjects (0.62; 0.35–1.09), but the depressive symptoms were significantly less frequent in men with undiagnosed diabetes (0.30; 0.13–0.70). The pattern remained after further adjustment. Significant associations with depressive symptoms were found for co‐morbidities and living without a partner in both women and in men, and for body mass index and activity level in women only.

Conclusions  After adjustment for relevant covariates, the association between depressive symptoms and Type 2 diabetes was heterogenous in our population‐based study. In subjects with undiagnosed diabetes, however, depressive symptoms were less frequent in men. Co‐morbidities and psychosocial conditions are strongly associated with depressive symptoms.
Charcot neuroarthropathy triggered by osteomyelitis and/or surgery
Authors: Ndip A. , Jude E. B. , Whitehouse R. , Prescott M. , Boulton A. J.
Published: September 2008

Introduction  Charcot neuroarthropathy (CN) is a rare but devastating complication of diabetic neuropathy. Osteomyelitis is also a complication of the diabetic foot and it may be difficult to differentiate from CN.

Patients and methods  A patient with Type 1 diabetes and peripheral neuropathy developed a foot ulcer complicated by osteomyelitis of the first proximal phalanx. He was successfully treated with antibiotics and surgical excision of the infected bone. Six months later, he developed a hot, swollen, red foot and X‐ray showed destruction of the second and third metatarsal heads. At the second presentation, it was difficult to determine whether this was a recurrence of osteomyelitis or a new onset of CN. Thus, to obtain a definitive diagnosis, recourse was made to more sophisticated imaging techniques.

Results  99mTc methylenediphosphonate (MDP) bone scans and magnetic resonance imaging proved inconclusive to differentiate between osteomyelitis and CN. Subsequently, an indium‐labelled white cell scan confirmed the absence of osteomyelitis and the patient was successfully treated for CN.

Discussion  Infection and/or surgery may be predisposing factors in the development of diabetic CN but the combination of the two could accelerate the onset of the Charcot process in people with diabetes and neuropathy.
Effect of cranberry extracts on lipid profiles in subjects with Type 2 diabetes
Authors: Lee I. T. , Chan Y. C. , Lin C. W. , Lee W. J. , Sheu W. H‐H.
Published: September 2008

Aim  To examine the effect of cranberry ingestion on lipid profiles in Type 2 diabetic patients taking oral glucose‐lowering drugs.

Methods  Thirty Type 2 diabetic subjects (16 males and 14 females; mean age 65 ± 1 years) who were taking oral glucose‐lowering medication regularly were enrolled in this randomized, placebo‐controlled, double‐blind study. Changes in lipid profiles, oxidized low‐density lipoprotein (ox‐LDL), glycaemic control, components of the metabolic syndrome, C‐reactive protein (CRP) and urinary albumin excretion (UAE) were assessed after cranberry or placebo treatment for 12 weeks.

Results  Low‐density lipoprotein (LDL) cholesterol decreased significantly in the cranberry group (from 3.3 ± 0.2 to 2.9 ± 0.2 mmol/l, P = 0.005) and the decrease was significantly greater than that in the placebo group (–0.4 ± 0.1 vs. 0.2 ± 0.1 mmol/l, P < 0.001). Total cholesterol and total : high‐density lipoprotein (HDL) cholesterol ratio also decreased significantly (P = 0.020 and 0.044, respectively) in the cranberry group and the reductions were significantly different from those in the placebo group (P < 0.001 and P = 0.032, respectively). However, ox‐LDL levels did not change significantly in response to cranberry consumption. Neither fasting glucose nor glycated haemoglobin improved in either group. Changes in components of the metabolic syndrome, UAE and CRP were not significantly different between groups.

Conclusions  Cranberry supplements are effective in reducing atherosclerotic cholesterol profiles, including LDL cholesterol and total cholesterol levels, as well as total : HDL cholesterol ratio, and have a neutral effect on glycaemic control in Type 2 diabetic subjects taking oral glucose‐lowering agents.
Liberalization without Retrenchment: Understanding the Consensus on Swedish Welfare State Reforms
Authors: Bergh Andreas , Erlingsson Gissur Ó.
Published: September 2008

In 1980, Sweden was a highly regulated economy with several state monopolies and low levels of economic freedom. Less than twenty years later, liberal reforms turned Sweden into one of the world's most open economies with a remarkable increase in economic freedom. While there is resilience when it comes to high levels of taxes and expenditure shares of GDP, there has been a profound restructuring of Sweden's economy in the 1980s and 1990s that previous studies have under‐estimated. Furthermore, the degree of political consensus is striking, both regarding the welfare state expansions that characterized Sweden up to 1980, as well as the subsequent liberalizations. Since established theories have difficulties explaining institutional change, this article seeks to understand how the Swedish style of policy making produced this surprising political consensus on liberal reforms. It highlights the importance of three complementary factors: policy making in Sweden has always been influenced by, and intimately connected to, social science; government commissions have functioned as ‘early warning systems’, pointing out future challenges and creating a common way to perceive problems; and, as a consequence, political consensus has evolved as a feature of Swedish style of policy making. The approach to policy making has been rationalistic, technocratic and pragmatic. The article concludes that the Swedish style of policy making not only explains the period of welfare state expansion – it is also applicable to the intense reform period of the 1980s and 1990s.
Income Inequality and Demand for Redistribution: A Multilevel Analysis of European Public Opinion
Authors: Finseraas Henning
Published: September 2008

This article employs multilevel modeling to assess the importance of income inequality on the demand for redistribution in a sample of 22 European countries. According to standard political economy models of redistribution – notably the Meltzer‐Richard model – inequality and demand for redistribution should be positively linked. However, existing empirical research has disputed this claim. The main advantages of this article is that demand for redistribution is measured at the individual level, and that the relevant interaction between inequality and own income is considered. The main findings are that inequality is positively associated with demand for redistribution, and that the median income person is sensitive to the level of inequality. These findings are robust to the inclusion of a range of relevant control variables. The results are relevant in relation to the increase in inequalities in many European countries, and especially relevant to the current debate about the importance of directly observable differences in public preferences for social policy outcomes.
Ethnic Diversity and Social Capital in Europe: Tests of Putnam's Thesis in European Countries
Authors: Gesthuizen Maurice , Van Der Meer Tom , Scheepers Peer
Published: September 2008

This article focuses on the core theory recently proposed by Putnam on the relationship between ethnic diversity and dimensions of social capital. Hypotheses are derived from this theory, but also from other theories that propose competing hypotheses on relationships between national characteristics and dimensions of social capital. Essentially, the authors propose more rigorous empirical tests of Putnam's hypotheses by including these competing hypotheses: tests of these hypotheses provide possibilities to evaluate Putnam's and these other theories in terms of general (i.e. cross‐national) tenability for the European continent. The general question is: To what extent do national‐level characteristics like ethnic diversity, next to other national characteristics, actually affect dimensions of social capital of individual citizens in European countries? The authors set out to answer this question by testing hypotheses on cross‐national data from 28 European countries. These data contain valid measurements of a number of dimensions of social capital. The individual‐level data are enriched with contextual‐ (i.e. national‐) level characteristics to be included in more advanced multilevel analyses. The main finding is that Putnam's hypothesis on ethnic diversity must be refuted in European societies. Instead, it is found that economic inequality and the national history of continuous democracy in European societies turn out to be more important for explaining cross‐national differences in social capital in Europe.
Water Expansions in Shantytowns: Health and Savings
Authors: GALIANI SEBASTIAN , GONZALEZ‐ROZADA MARTIN , SCHARGRODSKY ERNESTO
Published: September 2008

This paper examines the effects of the expansion of the water network in urban shantytowns in Argentina. We find large reductions in the presence, frequency and severity of diarrhoea episodes among children reached by network expansions relative to a control group. Moreover, expanded connections induce savings in water expenditures, as these families are able to substitute piped water for more expensive and distant sources of water provision. These health and savings effects are also important for households that previously had clandestine self‐connections to the water network, which were free but of low quality.
Constitutive histamine H2receptor activity regulates serotonin release in the substantia nigra
Authors: Threlfell Sarah , Exley Richard , Cragg Stephanie J. , Greenfield Susan A.
Published: August 2008

The substantia nigra pars reticulata (SNr) forms a principal output from the basal ganglia. It also receives significant histamine (HA) input from the tuberomammillary nucleus whose functions in SNr remain poorly understood. One identified role is the regulation of serotonin (5‐HT) neurotransmission via the HA‐H3receptor. Here we have explored regulation by another HA receptor expressed in SNr, the H2‐receptor (H2R), by monitoring electrically evoked 5‐HT release with fast‐scan cyclic voltammetry at carbon‐fiber microelectrodes in SNr in rat brain slices. Selective H2R antagonists (inverse agonists) ranitidine and tiotidine enhanced 5‐HT release while the agonist amthamine suppressed release. The ‘neutral’ competitive antagonist burimamide alone was without effect but prevented ranitidine actions indicating that inverse agonist effects result from constitutive H2R activity independent of HA tone. H2R control of 5‐HT release was most apparent (from inverse agonist effects) at lower frequencies of depolarization (≤ 20 Hz), and prevailed in the presence of antagonists of GABA, glutamate or H3‐HA receptors. These data reveal that H2Rs in SNr are constitutively active and inhibit 5‐HT release through H2Rs on 5‐HT axons. These data may have therapeutic implications for Parkinson’s disease, when SNr HA levels increase, and for neuropsychiatric disorders in which 5‐HT is pivotal.
Induction of sulfiredoxin expression and reduction of peroxiredoxin hyperoxidation by the neuroprotective Nrf2 activator 3H‐1,2‐dithiole‐3‐thione
Authors: Soriano Francesc X. , Léveillé Frédéric , Papadia Sofia , Higgins Larry G. , Varley James , Baxter Paul , Hayes John D. , Hardingham Giles E.
Published: August 2008

Peroxiredoxins are an important family of cysteine‐based antioxidant enzymes that exert a neuroprotective effect in several models of neurodegeneration. However, under oxidative stress they are vulnerable to inactivation through hyperoxidation of their active site cysteine residues. We show that in cortical neurons, the chemopreventive inducer 3H‐1,2‐dithiole‐3‐thione (D3T), that activates the transcription factor Nuclear factor erythroid 2‐related factor (Nrf2), inhibits the formation of inactivated, hyperoxidized peroxiredoxins following oxidative trauma, and protects neurons against oxidative stress. In both neurons and glia, Nrf2 expression and treatment with chemopreventive Nrf2 activators, including D3T and sulforaphane, up‐regulates sulfiredoxin, an enzyme responsible for reducing hyperoxidized peroxiredoxins. Induction of sulfiredoxin expression is mediated by Nrf2, acting via a cis‐acting antioxidant response element (ARE) in its promoter. The ARE element in Srxn1 contains an embedded activator protein‐1 (AP‐1) site which directs induction of Srxn1 by synaptic activity. Thus, raising Nrf2 activity in neurons prevents peroxiredoxin hyperoxidation and induces a new member of the ARE‐gene family, whose enzymatic function of reducing hyperoxidized peroxiredoxins may contribute to the neuroprotective effects of Nrf2 activators.
Serotonin 1A receptors in human and monkey prefrontal cortex are mainly expressed in pyramidal neurons and in a GABAergic interneuron subpopulation: implications for schizophrenia and its treatment
Authors: de Almeida Julián , Mengod Guadalupe
Published: August 2008

Serotonin 1A (5‐HT1A) receptors are found in high densities in prefrontal cortex. However, their distribution within cortical cell populations is unknown in both humans and primates. We used double in situ hybridization histochemistry to quantify the percentage of glutamatergic and GABAergic neurons expressing 5‐HT1A receptors in human and monkey prefrontal cortex. Moreover, in the case of the monkey, we also quantified the parvalbumin and calbindin GABAergic subpopulations expressing this receptor. 5‐HT1A receptor mRNAs were expressed in about 80% of glutamatergic neurons in external layers II and upper III, and in around 50% in layer VI; they were also present in approximately 20% of GABAergic neurons in both species. Although they were found in up to 43% of the calbindin cell subpopulation they were rarely present in parvalbumin cells in monkey prefrontal cortex. The knowledge of the phenotype of the prefrontal cortex (PFC) cells expressing 5‐HT1A will help understanding serotonin actions in PFC.
Basal and stimulated lactate fluxes in primary cultures of astrocytes are differentially controlled by distinct proteins
Authors: Maekawa Fumihiko , Minehira Kaori , Kadomatsu Kenji , Pellerin Luc
Published: August 2008

Lactate release by astrocytes is postulated to be of importance for neuroenergetics but its regulation is poorly understood. Basigin, a chaperone protein for specific monocarboxylate transporters (MCTs), represents a putatively important regulatory element for lactate fluxes. Indeed, basigin knockdown by RNA interference in primary cultures of astrocytes partially reduced both proton‐driven lactate influx and efflux. But more strikingly, enhancement of lactate efflux induced by glutamate was prevented while the effect of sodium azide was significantly reduced by treatment of cultured astrocytes with anti‐basigin small interfering RNA. Enhancement of glucose utilization was unaffected under the same conditions. Basal lactate uptake and release were significantly reduced by MCT1 knockdown, even more so than with basigin knockdown, whereas glutamate‐driven or sodium azide‐induced enhancement of lactate release was not inhibited by either MCT1, 2, or 4 small interfering RNAs. In conclusion, MCT1 plays a pivotal role in the control of basal proton‐driven lactate flux in astrocytes while basigin is only partly involved, most likely via its interaction with MCT1. In contrast, basigin appears to critically regulate the enhancement of lactate release caused by glutamate (or sodium azide) but via an effect on another unidentified transporter at least present in astrocytes in vitro.
Modelling Parkinson‐like neurodegeneration via osmotic minipump delivery of MPTP and probenecid
Authors: Alvarez‐Fischer Daniel , Guerreiro Serge , Hunot Stéphane , Saurini Françoise , Marien Marc , Sokoloff Pierre , Hirsch Etienne C. , Hartmann Andreas , Michel Patrick P.
Published: August 2008

Mouse models of MPTP intoxication have been used extensively to explore the molecular mechanisms of Parkinson’s disease. However, these models present some limitations since; (i) Dopaminergic (DA) cell death occurs rapidly in contrast to the presumably slow evolution of the disease process. (ii) Some of the key histological features of the disease such as Lewy body like inclusions and long‐term inflammatory changes are lacking. Fornai et al. [Proc. Natl Acad. Sci. USA 102 (2005), 3413] suggested that continuous delivery of MPTP with Alzet osmotic minipumps may possibly circumvent these problems. Our results show, however, that MPTP infusion via Alzet osmotic minipumps (40 mg/kg/day) produces only a transient depletion in striatal dopamine (DA) without causing dopaminergic cell loss in the substantia nigra. Neuronal cell loss occurred, however, if MPTP was infused concomitantly with probenecid, an uricosuric agent which potentiates the effects of the toxin injected via the i.p. route. Even under these conditions, dopaminergic cell loss was moderate (−25%) and other neurodegenerative changes characteristic of Parkinson’s disease remained undetectable.
Expression and possible role of creatine transporter in the brain and at the blood‐cerebrospinal fluid barrier as a transporting protein of guanidinoacetate, an endogenous convulsant
Authors: Tachikawa Masanori , Fujinawa Jun , Takahashi Masato , Kasai Yasuyuki , Fukaya Masahiro , Sakai Kazuhisa , Yamazaki Maya , Tomi Masatoshi , Watanabe Masahiko , Sakimura Kenji , Terasaki Tetsuya , Hosoya Ken‐ichi
Published: August 2008

Little is known about the cerebral distribution and clearance of guanidinoacetate (GAA), the accumulation of which induces convulsions. The purpose of the present study was to identify creatine transporter (CRT)‐mediated GAA transport and to clarify its cerebral expression and role in GAA efflux transport at the blood‐cerebrospinal fluid barrier (BCSFB). CRT mediated GAA transport with aKmvalue of 269 μM/412 μM which was approximately 10‐fold greater than that of CRT for creatine. There was wide and distinct cerebral expression of CRT and localization of CRT on the brush‐border membrane of choroid plexus epithelial cells. Thein vivoelimination clearance of GAA from the CSF was 13‐fold greater than that ofd‐mannitol reflecting bulk flow of the CSF. This process was partially inhibited by creatine. The characteristics of GAA uptake by isolated choroid plexus and an immortalized rat choroid plexus epithelial cell line (TR‐CSFB cells) used as anin vitromodel of BCSFB are partially consistent with those of CRT. These results suggest that CRT plays a role in the cerebral distribution of GAA and GAA uptake by the choroid plexus. However, in the presence of endogenous creatine in the CSF, CRT may make only a limited contribution to the GAA efflux transport at the BCSFB.
Triptolide inhibits COX‐2 expression and PGE2 release by suppressing the activity of NF‐κB and JNK in LPS‐treated microglia
Authors: Gong Yuntao , Xue Bing , Jiao Jian , Jing Liming , Wang Xiaomin
Published: August 2008

Activated microglia participate in neuroinflammation which contributes to neuronal damage in neurodegenerative diseases. Inhibition of microglial activation may have potential anti‐inflammatory effects. Our laboratory has previously reported that triptolide, a natural biologically active compound extracted from Tripterygium wilfordii, could protect dopaminergic neurons from inflammation‐mediated damage. However, the mechanism by which triptolide inhibits inflammation remains unknown. We reported here that inhibition of prostaglandin E2 (PGE2) production could be a potential mechanism of triptolide to suppress inflammation. Triptolide suppressed c‐jun NH2‐terminal kinase (JNK) phosphorylation, cyclooxygenase 2 (COX‐2) expression and PGE2 production in microglial cultures treated with lipopolysaccharide (LPS). Triptolide also greatly inhibited the transcriptional activity, but not the DNA‐binding activity of nuclear factor‐κB (NF‐κB) in microglia following LPS stimulation. These results indicate that triptolide might suppress NF‐κB activity to down‐regulate COX‐2 expression. The LPS‐stimulated transcriptional activity of NF‐κB was suppressed by inhibition of p38MAPK, but not by that of JNK and extracellular signal‐regulated kinase. Furthermore, the LPS‐induced PGE2 production was reduced by inhibiting these kinases. Taken together, these results suggest that triptolide may suppress neuroinflammation via a mechanism that involves inactivation of two parallel signaling pathways: p38‐NF‐κB‐COX‐2‐PGE2 and JNK‐PGE2.
A descriptive study of basic stimulation in Danish ICUs in 2006
Authors: Egerod Ingrid , Almer Glennie Marie , Thomsen Rasmus Risager
Published: September 2008

Basic stimulation (BS) is a multimodal approach used in the intensive care unit (ICU) to help patients to perceive, move, communicate and learn. The concept was developed in Germany in the 1970s to help multi‐handicapped children. It was adapted to nursing in the 1980s, and to critical care nursing in the 1990s. Little is known about the use of BS outside of Germany although it has been gaining momentum in German‐speaking countries as well as Scandinavia. The aim of the present study is to describe the extent and application of BS at Danish ICUs in 2006. The study had a prospective, descriptive, qualitative, multicentre design. Data were generated from key‐informant telephone interviews (n = 10). This study has shown that BS is dependent upon the personal interest of individual nurses. At most units the concept is rarely used, or used by only few practitioners, for only few patients, or only few of the elements of the technique are applied. The tenets of BS are similar to those of conventional nursing, and in some cases to health care in general. The concept shows promising potential for critical care nursing. It has, however, been introduced unsystematically at Danish ICUs and needs more management support, systematic implementation and clinical research.
Primary school children: access to toilets
Authors: Upadhyay Vipul , Mathai John , Reed Peter W.
Published: September 2008

Aim: Most children are continent of urine by the time they are in primary school. Balanced micturition and paradoxically dysfunctional voiding (DV) are acquired behaviour. Children need easy access to toilets at school, to comply with timed voiding which is part of the treatment for DV. This study investigated children's access to primary school toilets in Auckland.

Methods: A questionnaire was sent to 97 primary schools listed on the New Zealand ministry of education (MoE) website for the Auckland region. Information regarding the school decile rating, population, rota, toilet facilities and toilet policy was requested. Six randomly selected schools were visited to verify the facilities available there.

Results: Eighty‐four percent of the schools in our sample complied with the prescribed statutory minimum for both boys and girls toilets. There was a median ratio of 11 children per facility. The median duration to use a facility during the first recess was 2 min.

Conclusion: In general, the toilet facilities and utilization ratios in primary schools in the Auckland region appear to provide a healthy environment for urination. Schools must be encouraged to draft and adhere to a toilet policy to ensure a uniform toilet environment.
Total serum bilirubin levels during cyclooxygenase inhibitor treatment for patent ductus arteriosus in preterm infants
Authors: Rheinlaender C , Helfenstein D , Walch E , Berns M , Obladen M , Koehne P
Published: September 2008

Aim: To determine whether ibuprofen use in VLBW infants is associated with increased serum bilirubin levels and impaired neurodevelopmental outcome at 2 years of age compared to indomethacin.

Methods: We retrospectively evaluated bilirubin data and outcome parameters of 178 VLBW infants treated with COX inhibitors for a haemodynamically relevant patent ductus arteriosus (PDA) between 1998 and 2003 in a single institution. In our department ibuprofen replaced indomethacin for PDA treatment in 2001, while clinical and echocardiagraphic criteria for the indication of PDA invention have remained unchanged.

Results: Ibuprofen and indomethacin therapy groups did not differ in their baseline clinical profile. Peak serum bilirubin concentration was 10.2 mg/dL in the ibuprofen group and 8.6 mg/dL in the indomethacin group (p < 0.01), while phototherapy duration did not differ. At 2 years of age neurodevelopmental outcome was similar in both groups. In a single case analysis, four cases of adverse neurodevelopmental outcome despite inconspicuous clinical course were identified in the ibuprofen group.

Conclusion: In VLBW infants with PDA, ibuprofen treatment was associated with higher bilirubin levels than indomethacin.