bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic bone disorders in HIV‐infected patients: incidence in the Aquitaine cohort (1999–2002)
Authors: Martin K , Lawson‐Ayayi S , Miremont‐Salamé G , Blaizeau MJ , Balestre E , Lacoste D , Ragnaud JM , Malvy D , Dupon M , Mercié P , Schaeverbeke T , Haramburu F , Dabis F ,   for the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)
Published: November 2004

Background

Since the inception of highly active antiretroviral therapy (HAART), mortality among HIV‐infected patients has decreased, but this has been accompanied by the appearance of several complications.

Objectives

To estimate the incidence of symptomatic bone disorders in HIV‐infected patients of the Aquitaine cohort (from south‐west France) for the period 1999–2002, and to describe cases.

Methods

We retrospectively studied the records of 2700 patients of the Aquitaine cohort, which was derived from a hospital‐based surveillance system of HIV infection in France. All cases of symptomatic bone disorders diagnosed from 1 January 1999 to 30 June 2002 were reviewed.

Results

Fourteen cases of bone disorders were diagnosed, eight cases of aseptic osteonecrosis and six cases of severe osteoporosis, representing incidences of 0.3/1000 patient‐years [95% confidence interval (CI): 0.14–0.62] and 0.22/1000 patient‐years (95% CI: 0.09–0.52), respectively. All patients with aseptic osteonecrosis were male, while all but one with osteoporosis were female. The ages of patients ranged from 36 to 54 years for osteonecrosis and from 39 to 50 for severe osteoporosis. At the time of clinical diagnosis, all patients were treated with nucleoside reverse transcriptase inhibitors (duration of treatment ranging from 19 to 123 months for osteonecrosis and from 46 to 132 months for severe osteoporosis). Ten patients were treated with nonnucleoside reverse transcriptase inhibitors [duration of treatment ranging from 6 to 31 months for osteonecrosis (n=6) and from 4 to 29 months for severe osteoporosis (n=4)]. Thirteen patients were treated with protease inhibitors [duration of treatment ranging from 12 to 62 months for osteonecrosis (n=8) and from 3 to 44 months for severe osteoporosis (n=5)]. All osteonecrosis and five osteoporosis patients had at least one known risk factor or comorbidity associated with the bone disorder occurrence.

Conclusions

In our study, the aetiology of clinical bone disorders seemed to be multifactorial, as almost all the patients had at least one possible risk factor in addition to HAART exposure.
Ethics and Method
Authors: ERMARTH ELIZABETH DEEDS
Published: November 2004

It is possible for historians to mislead a nation in respect of what it might regard as its historic mission.

Herbert Butterfield

History as we knew it was a lie, a deceit.

Slavenka Drakuliç

Historical method rests on the common‐denominator values that characterize modernity. Postmodernity challenges those values across the range of practice and with them the very foundations of historical explanation. Responding to this challenge is central to the ethics of history at the present time. An adequate response requires at least three things summarized here: a clear understanding of the cultural function of history as one of the representational methods characterizing modernity; a definition of postmodernity and its challenges that is less trivial than those currently prevailing in North America; and even some experimental effort to explore some of the positive possibilities of the postmodern challenge, including alternative uses for “the past.”
The ups and downs of European gender equality policy
Authors: Rubery Jill , Figueiredo Hugo , Smith Mark , Grimshaw Damian , Fagan Colette
Published: November 2004

In 2003, equal opportunities policy in the European Union suffered both ups and downs. New opportunities came in the guise of the hotly contested new directive on gender equality outside the field of employment, in the invitation to present the first of an annual report on equality between women and men to the Spring Council, in the consolidation of gender mainstreaming within the second round of the National Action Plans on social inclusion and in the new commitments to ‘substantial reductions by 2010’ in gender gaps in employment, unemployment and pay that were included in the new employment guidelines in 2003. These new guidelines presented, however, a major challenge to gender equality as the new phase of the European Employment Strategy dispensed with the four pillars, and therefore the equal opportunities pillar. Instead gender equality became just one of 10 new guidelines. In December the launch of the Employment Taskforce report appeared to push employment policy back more to a ‘full employment with flexibility’ approach and away from concerns with job quality. The focus was therefore more on the integration of women into employment rather than on closing the equality gap.
Wettbewerbsorientierte Reformen im Gesundheitssystem der Schweiz – Vorbild für regulierten Wettbewerb in der deutschen GKV?
Authors: Greß Stefan , Kocher Ralf , Wasem Jürgen
Published: November 2004

Recent reforms of the Swiss health care system to introduce regulated competition have raised expectations about the possible combination of more efficient services, while at same time maintaining or even increasing the level of solidarity in health care systems. In this article we examine expected behavioral changes of the market actors, the way incentives for market actors have been changed and analyze the way market actors in fact changed their behavior. We conclude that so far only some of the targets of the reforms have been met. For a reasonable assessment of the Swiss experience in regulating competition in health care it is paramount to distinguish expected effects from actual effects.
Purohit technique of vaginal hysterectomy: a new approach
Authors: Purohit Ram Krishna
Published: November 2004

To ease intra‐operative access to laterally at vaginal hysterectomy, we have developed the ‘Purohit technique of vaginal hysterectomy’ using a right angle forceps, electrocautery and 10 mm telescope with light source. A prospective study on consecutive 214 women with benign disease of the uterus without prolapse, including cases with relative contraindications (excluding endometriosis and uteri above 20 weeks size), demonstrated it to be easy, safe and effective. Vaginal hysterectomy was successfully completed in 213 (99.53%) cases, with one failure (0.46%) which needed laparoscopic assistance. Vaginal salpingo‐oophorectomy was completed in all indicated cases. We believe that many abdominal and laparoscopic hysterectomies could be avoided by this technique. Details of the technique can be seen on the following website http://www.purohittechnique.com
Teachers’ personal epistemological beliefs about students with disabilities as indicators of effective teaching practices
Authors: Jordan Anne , Stanovich Paula
Published: November 2004

Teachers’ epistemological beliefs, that is, their beliefs about the nature of knowledge and how it is learned, appear to be highly influential in their classroom practices. To date, the exploration of teachers’ epistemological beliefs has been complicated by philosophical and methodological disputes. A method is presented here for inferring the epistemological beliefs of elementary school general education teachers through their descriptions of their work with students with disabilities. Evidence to support the reliability of this method is also presented. Differences in teacher belief constructs are related to differences in instructional practices – a relationship which holds for instructional interactions with both individual students and the whole class, and which predicts instructional practices for students both with and without disabilities. We therefore speculate that differences in teachers’ beliefs about students with disabilities might be related to their larger epistemological theories about knowledge and learning. In speculating about the source of differences in beliefs and practice, it is notable that the normative school beliefs, that is, the prevailing beliefs in a school about teachers’ roles and responsibilities for students with disabilities, appear to influence the beliefs of individual teachers. The potential for differences in teachers’ beliefs and practices to influence student outcomes is also considered, with some preliminary evidence from student self‐concept data.
Actions of R‐ and S‐verapamil and nifedipine on rat vascular and intestinal smooth muscle
Authors: Cleary L. , Vandeputte C. , Kelly J. G. , Docherty J. R.
Published: November 2004

1 We have investigated the actions of the calcium entry blockers nifedipine, R‐verapamil and S‐verapamil in rat aorta, colon and vas deferens.

2 In aorta and colon, these agents produced concentration‐dependent relaxations of KCl (80 mm)‐induced contractions. In both tissues, the order of potency was nifedipine > S‐verapamil > R‐verapamil. However, nifedipine showed selectivity for aorta (potency ratio, colon/aorta: 4.36), S‐verapamil showed no selectivity (0.62), but R‐verapamil showed selectivity for colon (0.19).

3 In prostatic portions of rat vas deferens, nifedipine (10 μm) abolished the contraction to a single electrical stimulus, but R‐ and S‐verapamil were without effect. In epididymal portions of rat vas deferens, R‐ and S‐verapamil inhibitedα1‐adrenoceptor‐mediated contractions to a single electrical stimulus at concentrations of 10 μmand above.

4 In conclusion, R‐verapamil may prove useful as an intestinal selective calcium entry blocker in the treatment of intestinal disease with a hypermotility component, e.g. irritable bowel syndrome.
Remarks on the terminology used to describe developmental behaviour among the auks (Alcidae), with particular reference to that of the Great AukPinguinus impennis
Authors: Gaskell Jeremy
Published: November 2004

Much of the historical record relating to the breeding biology of the Great AukPinguinus impennisconsists of statements on which it is not safe to rely without corroboration. There is, nevertheless, sufficient evidence for a strong case to be argued for the species having evolved a precocial chick‐rearing strategy, together with an incubation period that is remarkably brief for a bird of its size. In this way, the species would have minimized the time for which it had to remain ashore to raise its young. Before the evidence for this proposition is evaluated, a review is undertaken of the history and usage of the terminology most frequently used to describe the developmental condition of young birds on hatching. Modifications to the terminology have been suggested where there is a potential for confusion, and an entirely new term, ‘hypoprecocial’, introduced for downy young that require an appreciable period of brooding before quitting the breeding site. Regarding the species itself, it is suggested that the Great Auk had evolved a strategy that was more fully precocial than that of any seabird whose breeding biology is known to science.
Measurement of Molecular Orientation in Retrieved Ultra‐high‐molecular‐weight Polyethylene (UHMWPE) Hip Sockets using Fourier‐transform Infrared Spectroscopy
Authors: Davey S. M. , Orr J. F. , Buchanan F. J. , Nixon J. R. , Bennett D.
Published: November 2004

Abstract:  This paper describes the use of Fourier‐transform infrared spectroscopy (FTIR) to measure the degree of orientation in retrieved ultra‐high‐molecular‐weight polyethylene (UHMWPE) acetabular components of prosthetic hip joints quantitatively. Multidirectional shearing has been found to result in a wear rate that is several orders of magnitude higher than that for linear shear. This is because linear wear of UHMWPE is believed to induce orientation of the polymer lamellae. The FTIR technique described in this paper enables a direct comparison to be made between patient biomechanics and the molecular orientation of UHMWPE hip sockets. Patients were identified prior to revision surgery of the hip for loosening of components. Individual patient's hip‐joint kinematics were quantified by the aspect ratio of movement loci developed from clinical gait analysis. It was found that patients with high aspect ratios and therefore more linear wear paths, exhibited measurable orientation of the UHMWPE polymer lamellae in their retrieved hip sockets. An aspect ratio of 5.36 resulted in 67% of the polymer lamellae being oriented in the a‐axis direction. The technique was qualitatively validated by the use of transmission electron microscopy and it was found that an aspect ratio of 4.46 or greater resulted in the observed orientation of the polymer lamellae.
A policy mechanism for housing construction activity to achieve social and environmental goals: a case for India
Authors: Tiwari Piyush
Published: November 2004

Adequate shelter for all is one of the most pressing challenges faced by developing countries. India is currently facing a shortage of 17.6 million houses. Construction sector represents the most pressing need, viz. shelter. Technologies, which are sustainable environmentally, are another important issue in developing countries, who are on their path to development. Earlier researchers have indicated that construction activity contributes 17% to the carbon dioxide emission in India. In this paper, we have tried to interweave various issues and propose a construction strategy for the Indian housing sector. Affordability of a house and availability of building materials for its construction are the main determinants of access to shelter. This demands efficient use of resources at low cost. This paper analyzes whether it is possible to provide a housing solution at affordable cost by adopting technologies which are less emitting. A policy instrument, energy tax, is designed in this paper that would enforce a switch in technology and promote those technologies, which are well known as least cost but less adopted. An optimization framework developed by Tiwari et al. (1999) and Tiwari (2001) for technology evaluation in house construction based on design codes for India, is used in this paper. Recent government housing policy statements have indicated that an annual supply of two million new houses would be required to meet the current shortage of housing in India. This model is applied to the construction of two million houses. The construction technologies that we evaluate are the commonly used construction technologies as well as the low‐cost techniques. It is asserted that by a proper selection of such techniques and material, the costs and emissions can be reduced substantially and at the same time employment can be generated.
School location methodology in urban areas of developing countries
Authors: Pizzolato Nelio D. , Barcelos Fabricio Broseghini , Nogueira Lorena Luiz Antonio
Published: November 2004

This study is concerned with the location of primary public schools. The public system should have the capacity to satisfy all the demand, although students may choose between public and private schools if they can afford the corresponding costs. A number of factors, such as questionable education quality, limited capacity, poor location and social preferences, secure a participation of about 30% to the private school system. The purpose of this study is both the evaluation of the existing public school network and a relocation proposal. The result of the former was the identification of areas with shortage and excess in school offer. The latter suggests school relocation using capacitated and uncapacitated models. ArcView, a software of the geographic information system (GIS) family, was employed, allowing the efficient handling of large problems and improving the presentation and evaluation of the findings. This methodology was applied to the primary public school network in the area of Vitoria, a state capital located in the southeast region of Brazil with about 300,000 inhabitants. Finally, the practical use of this study and its importance for planning purposes are discussed.
The Effect of Area HMO Market Share on Cancer Screening
Authors: Baker Laurence C. , Phillips Kathryn A. , Haas Jennifer S. , Liang Su‐Ying , Sonneborn Dean
Published: November 2004

Objective. Managed care may have widespread impacts on health care delivery for all patients in the areas where they operate. We examine the relationship between area managed care activity and screening for breast, cervical, and prostate cancer among patients enrolled in more managed care plans and patients who are enrolled in less managed plans.

Data and Methods. Data on cancer screening from the 1996 Medical Expenditure Panel Survey (MEPS) were linked to data on health maintenance organization (HMO) and preferred provider organization (PPO) market share and HMO competition at the metropolitan statistical area (MSA) level. Logistic regression analysis was used to examine the relationship between area managed care prevalence and the use of mammography, clinical breast examination, Pap smear, and prostate cancer screening in the past two years, controlling for important covariates.

Results. Among all patients, increases in area‐level HMO market share are associated with increases in the appropriate use of mammography, clinical breast exam, and Pap smear (OR for high relative to low managed care areas are 1.75, p<.01, for mammography, 1.58, p<.05, for clinical breast exam, and 1.71, p<.01, for Pap smear). In analyses of subgroups, the relationship is significant only for individuals who are enrolled in the nonmanaged plans; there is no relationship for individuals in more managed plans. No relationship is observed between area HMO market share and prostate cancer screening in any analysis. Neither the level of competition between area HMOs nor area PPO market share is associated with screening rates.

Conclusions. Area‐level managed care activity can influence preventive care treatment patterns.
Globalization and National Identity in Japan
Authors: Sasaki Masamichi
Published: November 2004

Abstract:  Globalization and national identity are two separate but important concepts in contemporary sociology; however, neither is well grounded. There is little consensus. Yet we need to establish a foundation for talking about globalization and national identity and the relationship between them. By reviewing literature, this paper presents many sides of the related controversies.

 Globalization can be interpreted from many different perspectives: economic, social, psychological, political, even philosophical. There is little argument that globalization is now a major characteristic of our daily lives. Identity had its beginnings in psychology and was then superimposed upon social systems, thereby explicating local, regional and national identities: Who are we? We are like those people, but unlike those other people.

 When considering complex concepts, we need to ask appropriate questions of both parents and their children (due to socialization). In the research study described in this paper, two sample data sets from Japan were used (N = 2,164), both employing an identical questionnaire: (a) a nationwide survey of parents and their children aged 15 through 17; and (b) a nationwide survey of adults. The two stage stratified sampling method was used.

 The study revealed that Japanese children had more positive and open‐minded attitudes toward “others” than did their parents and older adult groups. One's generation has an important impact on national identity among the Japanese. The findings also indicate that Japan is not a nation‐state in which national identity plays a particularly significant role. The study also suggested numerous opportunities for future research.
Making It Happen: Beyond Theories of the Firm to Theories of Firm Design
Authors: Sarasvathy Saras D.
Published: November 2004

Current theories of the firm provide no explanation for entrepreneurial success except in terms of firm success. Even when the focus is on the entrepreneur, s/he is entirely cast as a bundle of traits/behaviors or heuristics/biases that serves to explain firm performance. In this article, I suggest putting the entrepreneur center stage, adopting an instrumental view of the firm. Drawing upon the work of Simon in symbolic cognition and Lakoff in semantic cognition, I explore how we can go beyond explanations based on economic forces and evolutionary adaptation to entrepreneurial effectuation; I end with specific research questions pertaining to firm design.
The Role of Mental Simulations and Counterfactual Thinking in the Opportunity Identification Process
Authors: Gaglio Connie Marie
Published: November 2004

The process of identifying, shaping, and pursuing market opportunities is emerging as a focal point in the field of entrepreneurship. Scholarly efforts to date have considered what happens during this process; it is time to turn attention to how and why. This article examines one such “how” question: how do entrepreneurs think and reason such that they identify innovative opportunities? Specifically, the cognitive processes of mental simulation and counterfactual thinking are proposed as mechanisms by which entrepreneurs identify and develop innovative opportunities. Propositions regarding the application of these cognitive processes to opportunity identification are presented and discussed.
Direct Comparison of a Contractility and Activity Pacemaker Sensor During Treadmill Exercise Testing
Authors: EROL‐YILMAZ AYTEN , TUKKIE RAYMOND , DE BOO JOB , SCHRAMA TIM , WILDE ARTHUR
Published: November 2004

There are limited data about the chronotropic capacity of the peak endocardial acceleration (PEA) sensor. This study directly compared the chronotropic function from the PEA and the activity (ACT) sensor. The study included 18 patients (age 73 ± 7 years) with ≥ 75% pacemaker‐driven heart rate (HR) and a PEA sensor and 11 healthy controls (age 67 ± 7 years) underwent a chronotropic assessment exercise protocol (CAEP) exercise test with the pacemaker patients in VVIR mode after programming the sensors in the default setting with adjustment of the upper sensor rate as an age related maximum value (220‐age). The ACT sensor was externally strapped on the thorax. Achieved exercise duration for the patients and controls was, respectively, 9.2 ± 3 vs 18.4 ± 4 minutes (P < 0.001). The maximal achieved HR with the PEA sensor was 124 ± 25 beats/min, versus the ACT with 140 ± 23, versus the controls with 153 ± 26 beats/min (P < 0.001 between the groups). For the PEA, ACT, and controls, the time to peak HR was, respectively, 11 ± 3, 7 ± 3.6, and 18 ± 4 (P < 0.001 between groups) and HR after 10 minutes recovery was, respectively, 80 ± 20, 65 ± 15, and 82 ± 4 beats/min (P < 0.001 between groups). The PEA sensor functions hypochonotroop during exercise programmed as a single sensor system. It is, therefore, preferable to combine the PEA sensor with an activity‐based sensor in a dual sensor system. Although both groups had normal left ventricular functions, the exercise capacity of pacemaker patients is significantly lower than in the controls.
Different Clinical Courses and Predictors of Atrial Fibrillation Occurrence After Transisthmic Ablation in Patients with Preablation Lone Atrial Flutter, Coexistent Atrial Fibrillation, and Drug Induced Atrial Flutter
Authors: BERTAGLIA EMANUELE , BONSO ALDO , ZOPPO FRANCO , PROCLEMER ALESSANDRO , VERLATO ROBERTO , CORÒ LEONARDO , MANTOVAN ROBERTO , THEMISTOCLAKIS SAKIS , RAVIELE ANTONIO , PASCOTTO PIETRO ,   North‐Eastern Italian Study on Atrial Flutter Ablation Investigators
Published: November 2004

The aim of this prospective study was to compare the long‐term follow‐up after transisthmic ablation of patients with preablation lone atrial flutter, coexistent AF, and drug induced atrial flutter to determine if postablation AF followed a different clinical course and displayed different predictors in these groups. The study evaluated 357 patients who underwent transisthmic ablation for typical atrial flutter. These were divided into four groups according to their preablation history. Group A included patients with typical atrial flutter and without preablation AF (n = 120, 33.6%). Group B included patients with preablation AF and spontaneous atrial flutter (n = 132, 37.0%). Group C patients had preablation AF and atrial flutter induced by treatment with IC drugs (propafenone or flecainide) (n = 63, 17.6%) Group D included patients with preablation AF and atrial flutter induced by treatment with amiodarone (n = 42, 11.8%). During a mean follow‐up of 15.2 ‡ 10.6 months (range 6–55 months) AF occurred more frequently in groups B (56.1%) and C (57.1%) patients than in groups A (20.8%, P < 0.0001) and D (31.0%, P < 0.0001) patients. The results of multivariate analysis revealed that different clinical and echocardiographical variables were correlated with postablation AF occurrence in the different groups. Patients with atrial flutter induced by amiodarone have a significantly lower risk of postablation AF than patients with spontaneous atrial flutter and AF, and those with atrial flutter induced by IC drugs. Different clinical and echocardiographical variables predict postablation AF occurrence in different subgroups of patients.
Pulmonary Veins:
Authors: FYNN SIMON P. , KALMAN JONATHAN M.
Published: November 2004

Recent years have seen an enormous amount of experimental and clinical research into role of the pulmonary veins (PVs) in atrial fibrillation (AF). Advanced imaging techniques have confirmed the findings of earlier postmortem studies and added further dimension to our knowledge of PV anatomy. Such work is vital for an effective approach to successful ablation of AF. Detailed mapping studies suggest that reentry within the PVs is most likely responsible for their arrhythmogenicity, although focal or triggered activity cannot be excluded. Further work also implicates the posterior left atrium in the genesis of AF. Investigation into the interplay between the PVs and left atrium has led to a reevaluation of the mechanisms underlying AF and suggests that the PVs may play a role in both the initiation and maintenance of this arrhythmia. In order for electrophysiologists to further develop the technical approach to ablation of AF and improve the clinical outcomes, these crucial issues must be resolved.
Subtotal Innominate Vein Occlusion After Unsuccessful Pacemaker Implantation for Resynchronization Therapy
Authors: VAN PUTTE BART P. , BAKKER PATRICIA F.A.
Published: November 2004

Cardiac resynchronization therapy is increasingly used to treat patients with poor left ventricular function and asynchronous left ventricular contraction. Generally, a transvenous approach is used for implantation of pacing leads. However, coronary sinus lead implantation may be associated with various problems that may result in abandoning of the procedure. In this report a patient is described with subtotal innominate vein occlusion after such a procedure who underwent video‐assisted thoracoscopic surgery (VATS) for implantation of epicardial left ventricular pacemaker leads for resynchronization therapy.
Novel Approaches for the Treatment of Chronic Total Coronary Occlusions
Authors: SEGEV AMIT , STRAUSS BRADLEY H.
Published: November 2004

Despite major advancements in the technology used for the percutaneous treatment of coronary artery disease, chronic total occlusions (CTOs) persist as a major challenge to the interventional cardiologist with relatively low success rates. CTOs are evident in 20% of patients undergoing cardiac catheterization and are responsible for the majority of cases that are referred to bypass surgery. There is growing evidence that patients may benefit from recanalization of a CTO by alleviation of angina, improving left ventricular function, and potentially long‐term survival. The major obstacle to percutaneous recanalization of CTOs is the inability to cross the occlusion with coronary guidewires. Even when crossed, the operator has to deal with the exact location of the distal wire (e.g., dissection or true lumen) and the existence of relatively long lesion requiring multiple stents with high restenosis rates. New technologies for CTO revascularization have been focused mainly on a mechanical approach including specialized guidewires and more recently, specific devices using highly sophisticated technology such as laser guidewire, optical coherence reflectometry, and a blunt microdissection catheter. An alternate biological approach involves the local administration of enzymes such as plasminogen activators (urokinase) or collagenase, which can act locally to specifically degrade the collagen content of the CTO, thereby “softening” the occlusion and allowing easier guidewire crossing. In conclusion, CTOs emerge as a great technical challenge and are the focus of novel series of mechanical and biological approaches.
Off‐label and non‐classical prescriptions of antipsychotic agents in ordinary in‐patient practice
Authors: Barbui C. , Ciuna A. , Nosé M. , Patten S. B. , Stegagno M. , Burti L. , Amaddeo F. , Tansella M.
Published: November 2004

Objective:  To estimate the proportion of off‐label prescriptions of antipsychotics (APs) in ordinary in‐patient practice.

Method:  From the South‐Verona Psychiatric Case Register all admissions to the in‐patient unit during 2001–02 were extracted. Prescriptions of APs were defined off‐label when dispensed outside the licensed indications. In addition, the proportion of ‘non‐classical prescriptions’ was calculated.

Results:  During the 2 years surveyed AP agents were prescribed in 311 cases. Nearly 50% of second‐generation AP prescriptions were for an off‐label indication. In contrast, <15% of first‐generation AP prescriptions were for an off‐label indication. About 30% of first‐ and second‐generation agents were prescribed for a non‐classical indication.

Conclusion:  Approved labels for second‐generation AP agents cover a much narrower range of indications than any of the first‐generation agents, and this explains the higher proportion of off‐label prescriptions. In contrast, the everyday use of first‐ and second‐generation APs cover a similar range of clinical indications.
Sinus floor augmentation with simultaneous placement of dental implants in the presence of platelet‐rich plasma or recombinant human bone morphogenetic protein‐7
Authors: Roldán J. Camilo , Jepsen Søren , Schmidt Christian , Knüppel Helge , Rueger David C. , Açil Yahya , Terheyden Hendrik
Published: November 2004

Abstract: The aim of the present study was to evaluate the possible benefit of platelet‐rich plasma (PRP) in sinus grafting as compared with recombinant human bone morphogenetic protein‐7 (rhBMP‐7). For this purpose, we performed a bilateral sinus augmentation with anorganic bovine bone and simultaneous insertion of a titanium screw implant in five miniature pigs. Six hundred microliters of PRP and 15%‐vol. autologous bone, which was collected with a trap during preparation of the implant recipient site, were added to the right sinus and 420 μl rhBMP‐7 to the left sinus. A polychrome sequential labeling was performed. The animals were sacrificed 6 weeks after surgery. Undecalcified ground sections were evaluated by microradiography, digitized histomorphometry and under fluorescent light. The mean bone–implant contact using rhBMP‐7 was 45.8% and 5.7% under PRP (P=0.002). The mean height of newly mineralized bone in the augmented area using rhBMP‐7 amounted to 8.3 mm as opposed to 3.6 mm under PRP (P=0.013). Using PRP, the mean area of the newly formed bone was enhanced (51.3%) as compared with rhBMP‐7 (33.1%); however, this difference was not statistically significant (P=0.081). In conclusion, under the selected experimental conditions the use of rhBMP‐7 led to superior outcomes with regard to the osseointegration of dental implants and the height of new bone as compared with the use of PRP.
A comparison of a computer‐based questionnaire and personal interviews in determining oral health‐related behaviours
Authors: Chestnutt Ivor G. , Morgan Maria Z. , Hoddell Ceri , Playle Rebecca
Published: November 2004

Abstract –  Background:  A major challenge for survey‐based research is to reduce bias. In an interview, subjects may claim more favourable behaviour to please the interviewer or comply with accepted norms.

Objectives:  This study aimed to: (i) determine if adolescents give different answers when using a self‐completed computer‐administered oral health questionnaire compared with a personal interview, (ii) ascertain if responses to a face‐to‐face interview are dependant on whether a dentist or nonclinical researcher administered the questionnaire and (iii) examine if responses were influenced by whether they undertook the computer questionnaire first or second.

Methods:  A randomized crossover design was used to investigate the responses to 15 closed questions on oral health‐related practices. These were administered to 453, 12‐year olds attending school dental inspections in South Wales.

Results:  A total of 449 valid pairings of computer/interview responses were available for analysis. Responses to the questionnaire variables demonstrated good to very good levels of agreement (κ 0.68–0.90) when comparing the face‐to‐face and computer‐administered questionnaire. With the exception of questions on dental attendance, responses were not influenced by whether the questions were posed by the research officer or the dentist. A minimal order effect could be detected when undertaking the computer‐administered questionnaire first.

Conclusions:  Whilst a study such as this cannot determine the true validity of the responses achieved, it is concluded that a computer‐administered questionnaire, comprising closed questions, can be utilized to determine oral health‐related behaviours in oral health surveys.
Assessment of different methods for diagnosing dental caries in epidemiological surveys
Authors: Assaf Andréa Videira , Meneghim Marcelo de Castro , Zanin Luciane , Mialhe Fábio Luiz , Pereira Antonio Carlos , Ambrosano Gláucia Maria Bovi
Published: November 2004

Abstract – Aims:  The aims of the study were: (i) to assess different clinical diagnostic methods of dental caries during epidemiological surveys; (ii) to determine which combinations of methods and diagnostic adjuncts show the best performances in epidemiological surveys when compared with examinations performed in a traditional dental setting (standard); (iii) to evaluate the influence of including noncavitated (NC) lesions in dental caries estimation.

Methods:  Forty 12‐year‐old children were divided into low and moderate caries prevalence groups. The individuals were submitted to 12 epidemiological examinations (in an outdoor setting), which combined three methods (blade, mirror and mirror + CPI (Community Periodontal Index) dental probe) with or without diagnostic adjuncts (previous dental brushing and dental drying). The last examination was performed in a traditional dental setting (standard examination). The unit of measure was the DMFS (decayed, missing and filled surfaces) index according to WHO criteria. The variance analysis, Dunnet's and Tukey's tests were applied.

Results:  For the DMFS analysis, the visual/tactile method, with or without diagnostic adjuncts, was the best method for both groups, presenting a performance higher than 90% when compared with the standard examination, except for the examinations without previous dental brushing for the low caries prevalence group. Previous dental brushing was more relevant than dental drying (P = 0.0054). All of the epidemiological examinations underestimated the NC diagnosis even with the association of diagnostic adjuncts when compared with the standard examination.

Conclusion:  The visual–tactile (for both groups) and the visual (mirror) methods plus dental brushing (for the moderate group) are appropriate for diagnosing cavitated lesions, but not NC lesions.
Chronic thrombocytopenia of childhood: use of non‐invasive methods in clinical evaluation
Authors: Rajantie J. , Javela K. , Joutsi‐Korhonen L. , Kekomäki R.
Published: November 2004

Objectives : An unselected group of 21 children with chronic thrombocytopenia was investigated to understand the patients’ platelet abnormality better.

Methods : Platelet counts, mean platelet volumes (MPV), membrane glycoproteins and Fcγ receptor type IIA (FcγRIIA) polymorphism H131R, reticulated platelets (%RP), antiplatelet antibodies and plasma thrombopoietin (TPO) were measured.

Results : Sixteen patients had idiopathic thrombocytopenic purpura (ITP) (group 1: platelets <50 × 109/L, n = 6; group 2: 50–99 × 109/L, n = 4; group 3: 100–149 × 109/L, n = 4; group 4: splenectomised patients with normal platelet counts, n = 2). Five patients had familial thrombocytopenia. Six healthy children were studied as a reference. In the 19 thrombocytopenic patients, the platelets were significantly larger and %RP and TPO levels were significantly higher than those in the controls. Increased megakaryocytosis at diagnosis was associated with larger MPV and higher %RP but not with platelet level or TPO. The %RP was remarkably high in all ITP patients of group 1 indicating a brisk production of platelets despite low peripheral count. In all patients with familial thrombocytopenia, TPO was increased suggesting that the syndrome was not because of defective TPO production. The distribution of FcγRIIA alleles in the patients was similar to that in the controls.

Conclusions : A combined application of %RP and TPO could be helpful in classifying patients with chronic thrombocytopenia into different categories. The observations may be of value in the clinical evaluation of ITP patients and lead to avoidance of invasive examinations at least in some patients.
Yellow fever vaccine: a successful vaccination of an immunocompromised patient
Authors: Gowda R. , Cartwright K. , Bremner J. A. G. , Green S. T.
Published: November 2004

We report on the successful vaccination of a patient, 21/2 yr after bone marrow transplantation for myeloma. He was not severely immunosupressed and responded to the yellow fever vaccine (17D, a live attenuated vaccine) without any adverse affects.
The predictive value of megakaryocytic and erythroid colony formation and platelet function tests on the risk of thromboembolic and bleeding complications in essential thrombocythaemia
Authors: Niittyvuopio Riitta , Juvonen Eeva , Kekomäki Riitta , Oksanen Kalevi , Anttila Pekka , Ruutu Tapani
Published: November 2004

The predictive value of spontaneous in vitro colony formation of megakaryocytic and erythroid progenitors (154 patients), and defective platelet aggregation responses (55 patients) on the risk of thrombohaemorrhagic complications in patients with essential thrombocythaemia (ET) was evaluated retrospectively. In the in vitro cultures of haematopoietic progenitors, 114/154 patients (74%) showed either spontaneous megakaryocytic or erythroid colony formation or both. Forty‐three per cent of patients with any spontaneous colony growth and only 20% of those without this phenomenon had an arterial thrombosis at diagnosis or during the follow‐up (P = 0.02). In the whole patient group neither spontaneous megakaryocytic nor spontaneous erythroid colony formation alone predicted the risk of arterial thrombosis. In patients younger than 45 yr of age, the prognostic value of spontaneous megakaryocytic growth was statistically significant: 44% of the patients with spontaneous megakaryocytic colony formation, but only 14% of those without it, experienced arterial thrombosis (P = 0.04). The presence of spontaneous colony formation had no effect on the risk of bleeding complications. Forty‐one of the 55 patients (75%) showed abnormalities in the platelet aggregation responses. There was no statistically significant correlation between the platelet function response and the risk of bleeding or thrombotic complications. No correlation was found between the platelet aggregation responses and the presence of spontaneous colony growth. In conclusion, spontaneous colony formation indicated an increased risk of thrombohaemorragic events but the platelet function test had no predictive value for these complications.
Seasonal changes of liver glycogen content and condition factor of wild Atlantic salmon parr in a sub‐arctic river
Authors: Heinimaa S.
Published: November 2004

Abstract –  Mean liver glycogen content of 1–4‐year‐old Atlantic salmon parr varied from 0.5 to 9.5% (of fresh liver mass) and condition factor (CF) from 0.66 to 0.85 in the sub‐arctic River Teno system in northern Finland during 2 years of study. There were no significant differences in liver glycogen contents of different age groups as there were in CF. However, there were seasonal differences in liver glycogen content and CF of the wild parr. The lowest liver glycogen contents were observed in July and the highest in September and December whereas the lowest CFs were observed in May and the highest in July.
Modelling the life‐history variation of Arctic charr
Authors: Rikardsen A. H. , Thorpe J. E. , Dempson J. B.
Published: November 2004

Abstract – A model based on proximate considerations of life histories of Atlantic salmon,Salmo salar, was examined for its applicability to fit the variation in life‐history of wild Arctic charr,Salvelinus alpinus, based on a qualitative assessment of information related to growth and lipid dynamics of Arctic charr. The original salmon model is discussed in context of modifications required to account for added complexities in the life history of Arctic charr in relation to anadromy versus residency. A study from North Norway shows that individual charr that emigrate from the lakes to the sea, maintain a high growth rate in the lake in late summer and early autumn compared with resident fish. Their relatively low lipid level in autumn combined with a high rate of change of lipid during winter was associated with postponement of maturation in the anadromous individuals. Individuals that remain resident in the lake arrested growth in autumn. Their high lipid level in autumn combined with a low rate of change of lipid during winter was associated with maturation the following summer, without emigration from freshwater. Results from this and other related studies show similarities with the model derived from lipid and growth dynamics of Atlantic salmon. The adjusted charr model illustrates possible proximate explanations for the high variation in life‐history strategies of Arctic charr. However, the model does not account for the characteristic return migration of immature charr into freshwater several weeks after their entry to the sea. The proximate physiological stimulus for this movement of immature fish is not entirely clear.
The Melanocortin Receptor‐1 Gene but not the Proopiomelanocortin Gene is Expressed in Melanoblasts and Contributes their Differentiation in the Mouse Skin
Authors: Hirobe Tomohisa , Takeuchi Sakae , Hotta Eri
Published: November 2004

Alpha‐melanocyte stimulating hormone (α‐MSH) added to serum‐free primary culture of melanoblasts derived from epidermal cell suspensions of 0.5 d old C57BL/10JHir mice induced their differentiation. Analysis using the reverse transcription‐polymerase chain reaction showed that the expression of the melanocyte‐specific α‐MSH receptor gene, melanocortin receptor‐1 (MC1‐R), had already been initiated before addition of α‐MSH, and, in addition, no up‐regulation of the MC1‐R gene was observed after addition of α‐MSH. However, no expression of the proopiomelanocortin (POMC) gene was observed before or after the addition of α‐MSH. The expression of the MC1‐R and POMC genes in the epidermis and dermis of the dorsal skin was surveyed from 13 d old embryos to 5.5 d old neonates. The expression of the MC1‐R gene was first observed in the epidermis of 13 d old embryos, and gradually increased up to 0.5 d after birth, and thereafter remained constant. By contrast, the expression of the MC1‐R gene in the dermis was first observed in 16 d old embryos, and gradually increased up to 3.5 d after birth, and thereafter remained constant. However, no expression of the POMC gene was observed in the epidermis or dermis of the dorsal skin at any age of mice tested. These results suggest that the expression of the MC1‐R gene, but not of the POMC gene, plays an important role in the regulation of melanocyte differentiation in mouse skin.
Pigmentation in Intrinsically Aged Skin of A1 Guinea Pigs
Authors: Tobiishi Megumi , Haratake Akinori , Kaminaga Hiroko , Nakahara Michio , Komiya Aya , Koishikawa Hisa , Uchiwa Hideyo , Kawa Yoko , Mizoguchi Masako
Published: November 2004

It is known that skin often shows irregular pigmentation during aging which is frequently associated with hyperpigmentation. Many studies have utilized brownish A1 guinea pigs to investigate the pathogenesis of ultraviolet (UV)‐induced skin pigmentation, however, changes associated with intrinsic aging in A1 guinea pig skin have not been documented. To characterize such changes, skin from the dorsal and neck areas of 20‐week, 1‐, 2‐, 3‐ and 5‐yr‐old guinea pigs was examined. Skin color was measured using a colorimeter, and biopsy specimens were stained with Masson‐Fontana, l‐3,4‐dihydroxyphenylalanine (DOPA), and antibodies against KIT (ACK‐45), gp100 (HMB‐45) and S‐100 proteins. The L* value of skin color decreased with aging and melanin deposits increased in the epidermis. Further, DOPA+, gp100+ and S‐100+ melanocytes increased, indicating that the number of melanocytes had increased with age, whereas KIT+ melanocytes did not increase in dorsal skin and actually decreased in neck skin with aging. Further, rippled pigmented areas appeared in the neck skin of the 3‐yr‐old animals, and in the dorsal and neck skin of 5‐yr‐old guinea pigs in the absence of UV irradiation. Melanocytes were distributed uniformly in younger skin, whereas they were clustered in older skin. UV irradiation caused an increase in the number of melanocytes, although they were not clustered. These results are the first to provide evidence that pigmentation is induced in the skin of intrinsically aged A1 guinea pigs in the absence of UV irradiation, a process that differs from that elicited by UV irradiation.
Establishment by an Original Single‐cell Cloning Method and Characterization of an Immortal Mouse Melanoblast Cell Line (NCCmelb4)
Authors: Ito Masaru , Kawa Yoko , Watabe Hidenori , Ono Hirotake , Ooka Shiho , Nakamura Masayuki , Soma Yoshinao , Mizoguchi Masako
Published: November 2004

We devised a unique new single‐cell cloning method which uses microscope cover glasses and established a melanoblast cell line derived from mouse neural crest cells. A microscope cover glass was nicked and broken into small pieces and put on a dish. Culture medium and a suspension of 20–30 cells/ml were dropped in the dish. After 1–3 d, a piece of glass to which only one cell was adhered was picked up and transferred to another dish containing culture medium. The greatest advantage of this method is that the derivation of a colony from a single cell can be directly confirmed by microscopy and there is no risk of migratory cells being contaminated by other colonies. Using this single‐cell cloning method, in this study we established a cell line derived from a neural crest cell line (NCC‐S4.1) and designated it as NCCmelb4. When the culture medium was supplemented with stem cell factor (SCF) alone, NCCmelb4 cells were KIT‐positive and tyrosinase‐negative melanocyte precursors; they remained at an immature and undifferentiated stage. When the medium was supplemented with phorbol 12‐o‐tetradecanoyl‐13‐acetate (TPA) + cholera toxin (CT), the cell morphology changed and became l‐3,4‐dihydroxyphenylalanine (DOPA)‐positive. This observation indicates that the NCCmelb4 cells are capable of further differentiation with suitable stimulation. NCCmelb4 cells derived from the mouse neural crest has characteristics of melanocyte precursors (melanoblasts), and is a cell line which can be utilized to study differentiation‐inducing factors and growth factors without the effects of feeder cells.