bluuebunny/crossref_metadata_2025 huggingface dataset:
EARLY SILURIAN SULCIPENTAMERUS AND RELATED PENTAMERID BRACHIOPODS FROM SOUTH CHINA
Authors: RONG JIAYU , JIN JISUO , ZHAN RENBIN
Published: January 2007

Abstract:  Sixteen species from the Lower Silurian (mostly Aeronian and rarely Telychian) of South China have been assigned previously to the brachiopod family Pentameridae, mainly to the genus Pentamerus. Study of intrapopulation variation suggests that 13 species from the upper Aeronian Lojoping Formation of the Yichang area, western Hubei Province, can be synonymized with Sulcipentamerus dorsoplanus, the most abundant pentamerid species of South China but confined to the Yichang area. The conspicuously high and obtuse ventral umbo, strong ventribiconvexity and a sulcate anterior commissure warrant genus status for Sulcipentamerus, independent of Pentamerus. True Pentamerus is rare in South China, known only from upper Aeronian rocks of Guizhou Province. Multivariate analyses indicate that Aeronian pentameride brachiopods of South China are characterized by a high level of provincialism, distinct from those of Laurentia. Also, the Aeronian pentamerides of South China or Laurentia have a low degree of similarity to those of Baltica, Siberia, Avalonia, Kazakhstan and other palaeotropically located plates or terranes. Besides South China and Laurentia, the pentamerides of other palaeotropical regions constituted a relatively tight cluster. This suggests that the palaeogeographical positions of South China and Laurentia only allowed limited or periodic faunal exchange of these generally large‐shelled brachiopods adapted to living in relatively shallow, warm waters.
HIGHER SYSTEMATICS OF SCORPIONS FROM THE CRATO FORMATION, LOWER CRETACEOUS OF BRAZIL
Authors: MENON FEDERICA
Published: January 2007

Abstract:  Several new specimens of Protoischnurus axelrodorum Carvalho and Lourenço and Araripescorpius ligabuei Campos from the Crato Formation, Brazil, are described. The preservation and recognition of new morphological features allows a re‐diagnosis of both species and a modification of their familial placement. Protoischnurus axelrodorum is the oldest species belonging to the scorpionoid family Hemiscorpiidae Pocock (= Ischnuridae Simon; = Liochelidae Fet and Bechly) and the first Cretaceous record. It was originally placed in the extinct family Protoischnuridae Carvalho and Lourenço, which is here synonymized with Hemiscorpiidae. Araripescorpius ligabuei, now assigned to Chactidae Pocock, is the first chactoid recorded for the Cretaceous of Brazil. These findings confirm that the lineages of two modern families date back at least to the Early Cretaceous and, considering their current distribution, were probably present before the break‐up of the supercontinent Gondwana. Palaeoecological inferences indicate the presence of tropical habitats in the vicinity of the Crato lake/lagoon.
NEW PERMINERALIZED FLORA AND TRILOBITES FROM THE MID TOURNAISIAN (EARLY CARBONIFEROUS) RUXTON FORMATION, CLARKE RIVER BASIN, NORTH‐EAST AUSTRALIA
Authors: GALTIER JEAN , FEIST RAIMUND , TALENT JOHN A. , MEYER‐BERTHAUD BRIGITTE
Published: January 2007

Abstract:  An association of a new permineralized flora with preserved anatomy and decalcified trilobite remains is described from early crenulata Zone (mid Tournaisian; Early Carboniferous) calcareous siltstones in a predominantly shale and minor limestone sequence low in the Ruxton Formation of the eastern Clarke River Basin, north‐east Queensland. Whereas the trilobites belong to Linguaphillipsia, a common and diversified taxon in eastern Australia, the plants (with the exception of Stauropteris that was earlier identified from the Burdekin Basin) were known previously only from the Mississipian (Lower Carboniferous) of Western Europe. The plants represent a diverse assemblage comprising lycopsids, cladoxylaleans, a variety of fern rachises and seed plants, including stems (Tristichia‐type), Lyginorachis petioles and a new cupule, Ruxtonia minuta gen. et sp. nov., containing Hydrasperma ovules.
THE MIDDLE MIOCENE (LAVENTAN) QUEBRADA HONDA FAUNA, SOUTHERN BOLIVIA and A DESCRIPTION OF ITS NOTOUNGULATES
Authors: Croft Darin A.
Published: January 2007

Abstract: The Laventan Quebrada Honda Fauna of southern Bolivia is one of the best sampled middle Miocene South American faunas. The present study describes the toxodontid, interatheriid and mesotheriid notoungulates from Quebrada Honda and summarizes the present state of knowledge of the fauna. Toxodontid specimens from Quebrada Honda include two isolated molars, one upper and one lower. The upper molar compares favourably withParatrigodonand may represent a new species, but too little material is known to make an adequate diagnosis. The lower molar may pertain to the same taxon, or to a distinct species that is even more poorly represented. A new species of the interatheriidMiocochiliusis described,M.federicoi, on the basis of a partial skull. It differs fromM.anomopodusin its significantly smaller size (at least 20 per cent smaller based on linear upper molar dimensions); relatively wider P4 with deeper lingual sulcus; more prominent middle lobes on upper molars; and M3 with deeper lingual sulcus and more prominent metastyle (distal lobe). The generic allocation of this new species is considered tentative, pending a better understanding of the phylogenetic relationships among currently recognized species ofMiocochiliusandProtypotherium. Mesotheriids are represented at Quebrada Honda by a pair of poorly preserved mandibles that are referred toPlesiotypotherium minor, a species previously recorded from slightly older deposits near Cerdas, Bolivia. A newly revised faunal list for Quebrada Honda is compiled that includes 30 species of non‐volant mammals, 27 of which have been identified to at least genus level. This revised faunal list is used to compare Quebrada Honda to other well‐sampled middle–late Miocene faunas (including La Venta, Columbia; Collón‐Curá, Argentina; and Arroyo Chasicó, Argentina) using the Simpson Index of faunal similarity. In order to compensate for inadequately identified specimens (i.e. those not identified to genus level), minimum and maximum values of faunal similarly were estimated using two different sets of assumptions. The analysis indicates that the middle‐latitude Quebrada Honda Fauna is more similar to the slightly older high‐latitude fauna of Collón‐Curá than to the contemporaneous low‐latitude fauna of La Venta, suggesting that isolating mechanisms between the low and middle latitudes were in place during the early and/or middle Miocene. The relative paucity of taxa shared between Quebrada Honda and La Venta, despite their contemporaneity, suggests that the system of South American Land Mammal ‘Ages’ (SALMAs) may not be useful for biocorrelation between low‐latitude faunas and those from elsewhere in South America.
MACROEVOLUTION AND MACROECOLOGY THROUGH DEEP TIME
Authors: BUTTERFIELD NICHOLAS J.
Published: January 2007

Abstract:  The fossil record documents two mutually exclusive macroevolutionary modes separated by the transitional Ediacaran Period. Despite the early appearance of crown eukaryotes and an at least partially oxygenated atmosphere, the pre‐Ediacaran biosphere was populated almost exclusively by microscopic organisms exhibiting low diversity, no biogeographical partitioning and profound morphological/evolutionary stasis. By contrast, the post‐Ediacaran biosphere is characterized by large diverse organisms, bioprovinciality and conspicuously dynamic macroevolution. The difference can be understood in terms of the unique escalatory coevolution accompanying the early Ediacaran introduction of eumetazoans, followed by their early Cambrian (Tommotian) expansion into the pelagic realm. Eumetazoans reinvented the rules of macroecology through their invention of multitrophic food webs, large body size, life‐history trade‐offs, ecological succession, biogeography, major increases in standing biomass, eukaryote‐dominated phytoplankton and the potential for mass extinction. Both the pre‐Ediacaran and the post‐Ediacaran biospheres were inherently stable, but the former derived from the simplicity of superabundant microbes exposed to essentially static, physical environments, whereas the latter is based on eumetazoan‐induced diversity and dynamic, biological environments. The c. 100‐myr Ediacaran transition (extending to the base of the Tommotian) can be defined on evolutionary criteria, and might usefully be incorporated into the Phanerozoic.
DISPARITY: MORPHOLOGICAL PATTERN AND DEVELOPMENTAL CONTEXT
Authors: ERWIN DOUGLAS H.
Published: January 2007

Abstract: The distribution of organic forms is clumpy at any scale from populations to the highest taxonomic categories, and whether considered within clades or within ecosystems. The fossil record provides little support for expectations that the morphological gaps between species or groups of species have increased through time as it might if the gaps were created by extinction of a more homogeneous distribution of morphologies. As the quantitative assessments of morphology have replaced counts of higher taxa as a metric of morphological disparity, numerous studies have demonstrated the rapid construction of morphospace early in evolutionary radiations, and have emphasized the difference between taxonomic measures of morphological diversity and quantitative assessments of disparity. Other studies have evaluated changing patterns of disparity across mass extinctions, ecomorphological patterns and the patterns of convergence within ecological communities, while the development of theoretical morphology has greatly aided efforts to understand why some forms do not occur. A parallel, and until recently, largely separate research effort in evolutionary developmental biology has established that the developmental toolkit underlying the remarkable breadth of metazoan form is largely identical among Bilateria, and many components are shared among all metazoa. Underlying this concern with disparity is a question about temporal variation in the production of morphological innovations, a debate over the relative significance of the generation of new morphologies vs. differential probabilities of their successful introduction, and the relative importance of constraint, convergence and contingency in the evolution of form.
Clinical Aspects of the Ketogenic Diet
Authors: Hartman Adam L. , Vining Eileen P. G.
Published: January 2007

Summary: The ketogenic diet remains a valuable therapeutic option for patients with intractable epilepsy. Clinical aspects of the diet's success may provide insights into epileptogenesis and anticonvulsant action. The diet's efficacy has been established primarily through large case series. The diet has been used successfully in patients with many different epilepsy syndromes in countries around the world. Potential adverse effects can be avoided with careful attention during the diet's initiation and maintenance phases. In the last decade, variations to the classical ketogenic diet have been utilized. Ketogenic diets now are being used for diseases other than epilepsy. This critical analysis of the diet should provide the impetus for further clinical and basic research into the diet's application and mechanisms of action.
Effects of Acute Ethanol Exposure on the Early Inflammatory Response After Excisional Injury
Authors: Fitzgerald Daniel J. , Radek Katherine A. , Chaar Mitchell , Faunce Douglas E. , DiPietro Luisa A. , Kovacs Elizabeth J.
Published: January 2007

Background: Alcohol consumption is involved in over half of all trauma‐related injuries. These patients are known to exhibit a higher incidence of mortality and morbidity following injury compared with patients not exposed to ethanol. As studies from our laboratory demonstrated that ethanol exposure impairs re‐epithelialization and angiogenesis after dermal wounding and because the earlier inflammatory phase of wound healing is likely to influence later responses, we chose to examine neutrophil infiltration and chemokine and proinflammatory cytokine levels in the skin following administration of a dermal excisional wound.

Methods: BALB/c mice were given ethanol at a dose designed to increase blood alcohol concentration to 100 to 120 mg/dL at 30 minutes after treatment. Mice were then subjected to a full‐thickness excisional wound. Wounds from ethanol and saline‐treated mice were collected within the first 24 hours postinjury to assess neutrophil infiltration and myeloperoxidase (MPO) activity, neutrophil chemoattractant macrophage inflammatory protein‐2 (MIP‐2) and KC levels, and proinflammatory cytokine interleukin‐1 β (IL‐1β) and tumor necrosis factor α (TNFα) levels.

Results: At 12 and 24 hours after injury, MPO in wounds from ethanol‐exposed mice was significantly reduced compared with wounds from vehicle‐treated animals. Despite this, histological examination of wounds did not reveal a difference in neutrophil infiltration between the 2 groups. Peak levels of MIP‐2 and KC observed at 12 hours postinjury were decreased in wounds from ethanol‐treated mice by 32 and 45%, respectively, relative to wounds from control mice. Levels of TNFα and IL‐1β (potent inducers of MIP‐2 and KC, as well as neutrophil activation) were also assessed. Levels of TNFα were not elevated in either group after injury. However, IL‐1β demonstrated significantly lower peak levels at 6 hours postinjury in wounds from ethanol‐treated mice, 58% less than wounds from controls.

Conclusion: These studies reveal that early dermal inflammatory responses including MPO activity, production of MIP‐2, KC, and IL‐1β are impaired in mice given ethanol before injury, which may also have detrimental affects on later stages of wound healing.
Ethanol Regulates Angiogenic Cytokines During Neural Development: Evidence From an in Vitro Model of Mitogen‐Withdrawal–Induced Cerebral Cortical Neuroepithelial Differentiation
Authors: Camarillo Cynthia , Kumar Leena S. , Bake Shameena , Sohrabji Farida , Miranda Rajesh C.
Published: January 2007

Background: Heavy alcohol consumption during pregnancy can cause significant mental retardation and brain damage. We recently showed that ethanol depletes reserve cerebral cortical stem cell capacity. Moreover, proliferating neuroepithelial cells exposed to ethanol were resistant to subsequent retinoic acid‐induced differentiation. Emerging evidence suggests that cytokines play a crucial growth‐promoting role in the developing neural tube.

Methods: We cultured murine cortical neurosphere cultures in control or ethanol‐supplemented mitogenic medium, to mimic alcohol exposure during the period of neuroepithelial proliferation. Cultures were then treated with a step‐wise mitogen‐withdrawal, integrin‐activation model to mimic subsequent phases of neuronal migration and early differentiation. We examined the impact of alcohol exposure during neurogenesis on the secretion of inflammatory and growth‐promoting cytokines.

Results: Cortical neurosphere cultures exhibit increasingly complex differentiation phenotypes in response to step‐wise mitogen‐withdrawal and laminin exposure. Some inflammation‐modulating cytokines were secreted independent of differentiation state. However, chemotactic cytokines were specifically secreted at high levels, as a function of differentiation stage. monocyte chemotactic protein‐1, vascular endothelial growth factor‐A, and interleukin (IL)‐10 were coordinately decreased during differentiation compared with neuroepithelial proliferation, while granulocyte macrophage‐colony stimulating factor (GM‐CSF) was induced during differentiation, compared with the neuroepithelial proliferation period. Ethanol exposure during the period of neuroepithelial proliferation prevented the early differentiation‐induced increase in GM‐CSF while inducing differentiation‐associated increase in IL‐12 secretion.

Conclusion: Embryonic cerebral cortical neuroepithelial‐derived precursors secrete high levels of several angiogenic and neural‐growth–promoting cytokines as they differentiate into neurons. Our data collectively suggest that ethanol exposure during the period of neuroepithelial proliferation significantly disrupts cytokine signals that are required for the support of emerging neurovascular networks, and the maintenance of neural stem cell beds.
Ethanol Inhibits the Sensory Responses of Cerebellar Granule Cells in Anesthetized Cats
Authors: Huang Chi‐ming , Huang Rosa H.
Published: January 2007

Background:Granule cells occupy a strategic position in the transmission of afferent information to the cerebellar cortex. They are also the most abundant type of neurons in the cerebellum. The functions of the cerebellum are thought to be sensitive to acute alcohol intoxication. The effects of acute alcohol intoxication on the in vivo physiology of cerebellar granule cells are, however, not completely known.

Methods:We studied chloralose‐anesthetized cats at ethanol doses relevant to human drinking (0.3–1.2 g/kg). We recorded the electrophysiological responses of granule cell clusters to auditory and visual stimulation, and simultaneously monitored the concentration of ethanol in the cerebrospinal fluid (CSF).

Results:At an intravenous ethanol dose of 0.3 g/kg, CSF ethanol concentration peaked in 10 minutes at 17 mM, equivalent to a blood alcohol concentration (BAC) of about 0.08 g/dL. Ethanol quickly and almost completely abolished both auditory and visual responses from granule cells. Complete or near‐complete inhibition lasted 15 to 20 minutes; ∼50% recovery required an additional 15 minutes, and a full recovery yet another 15 minutes. A higher ethanol dose at 1.2 g/kg resulted in a more severe inhibition and required longer time for recovery. The relationship between ethanol dose, CSF ethanol concentration, and granule cell responses was dynamic and nonlinear, critically depending upon the elapsed time.

Conclusions:Cerebellar granule cell sensory responses are highly sensitive to ethanol inhibition. A rapid development of acute tolerance appears to be a major factor contributing to the dynamic and nonlinear relationship among ethanol dosage, CSF ethanol concentration, and granule cell responses. It is likely that a generalized de‐afferentation of the cerebellum from its mossy fiber afferents, followed by the subsequent development of acute tolerance may play major roles by which alcohol intoxication affects cerebellar functions.
Effect of Ethanol on Hypothalamic Opioid Peptides, Enkephalin, and Dynorphin: Relationship With Circulating Triglycerides
Authors: Chang Guo‐Qing , Karatayev Olga , Ahsan Rashedul , Avena Nicole M. , Lee Caroline , Lewis Michael J. , Hoebel Bartley G. , Leibowitz Sarah F.
Published: January 2007

Background:Recent evidence has demonstrated that ethanol intake can stimulate the expression and production of the feeding‐stimulatory peptide, galanin (GAL), in the hypothalamic paraventricular nucleus (PVN), and that PVN injection of this peptide, in turn, can increase the consumption of ethanol. To test the hypothesis that other feeding‐related systems are involved in ethanol intake, this study examined the effect of ethanol on the hypothalamic opioid peptides, enkephalin (ENK), and dynorphin (DYN).

Method:Adult, male Sprague–Dawley rats were trained to voluntarily drink increasing concentrations of ethanol, up to 9% v/v, on a 12‐hour access schedule or were given a single injection of ethanol (10% v/v) versus saline vehicle. The effect of ethanol on GAL, ENK, and DYN mRNA was measured using real‐time quantitative polymerase chain reaction and radiolabeled in situ hybridization, while radioimmunoassay was used to measure peptide levels. In addition to blood alcohol, circulating levels of triglycerides (TG), leptin, and insulin were also measured.

Results:The data demonstrated that: (1) rats voluntarily drinking 9% v/v ethanol (approximately 2.0 g/kg/d) show a significant increase in GAL, ENK, and DYN mRNA in the PVN compared with water‐drinking rats; (2) voluntary consumption of ethanol also increases peptide levels of ENK and DYN in the PVN; (3) acute injection of 10% ethanol (1.0 g/kg of 10% v/v) similarly increases the expression of GAL, ENK, and DYN in the PVN; and (4) ethanol consumption and injection, while having little effect on leptin and insulin, consistently increase circulating levels of TG as well as alcohol, both of which are strongly, positively correlated with peptide expression in the PVN.

Conclusions:These findings, together with published studies, suggest a possible role for hypothalamic opioid peptides in the drinking of ethanol. Based on evidence that dietary fat and lipid injections stimulate the PVN peptides and injection of the opiates and GAL increase ethanol intake, it is proposed that both TG and alcohol in the circulation, which are elevated by the ingestion or injection of ethanol, are involved in stimulating these peptides in the PVN, which in turn promote further consumption of ethanol.
Impaired Response Inhibition Scale for Alcoholism (IRISA): Development and Psychometric Properties of a New Scale for Abstinence‐Oriented Treatment of Alcoholism
Authors: Guardia José , Trujols Joan , Burguete Teresa , Luquero Elena , Cardús Maria
Published: January 2007

Background: Impaired inhibition of conditioned response plays a significant role in relapse in addictive behaviors. Although patients and their relatives frequently discuss this behavioral deficit when seeking treatment, no instrument is yet available to measure its severity. The aim of this study was to develop the Impaired Response Inhibition Scale for Alcoholism (IRISA) to assess this impairment in alcohol‐dependent patients.

Methods: A preliminary version of the IRISA was administered to a group of 151 patients under treatment at our center. Exploratory factor analysis was conducted using principal component analysis. The validity and reliability of the IRISA were examined.

Results: Factor analysis and item refinement led to a definitive 16‐item IRISA that accounted for 61.6% of the total variance and revealed Impaired Response Inhibition as a single factor. Psychometric properties of this version of the IRISA scale showed excellent internal consistency (Cronbach's α: 0.96), good test–retest reliability (intraclass correlation coefficient: 0.81), and satisfactory convergent, discriminant, and predictive validity. The IRISA has a good correlation with alcohol craving, the severity of alcoholism, and alcohol consumption during the recovery process.

Conclusions: Our initial results with the IRISA suggest that it is a reliable and valid tool to measure impairment in response inhibition to drinking behavior. The IRISA assesses a potentially important aspect of treatment process and outcome.
Alcohol Use in Pregnant and Nonpregnant Russian Women
Authors: Kristjanson Arlinda F. , Wilsnack Sharon C. , Zvartau Edwin , Tsoy Marina , Novikov Boris
Published: January 2007

Background: Alcohol consumption in Russia is reportedly high for both men and women; most studies of Russian drinking have used questionnaires not designed specifically to measure alcohol consumption or to interview women. This study was designed specifically to measure drinking patterns among pregnant and nonpregnant Russian women.

Methods: Eight hundred ninety‐nine women of child‐bearing age in St. Petersburg, Russia, were interviewed in employment centers, educational centers, and at obstetric and gynecologic (OB/GYN) clinics and hospitals. Measurement of drinking used several types of drinking questions and time frames.

Results: Nearly all nonpregnant Russian women (95.9%) reported consuming alcohol in the last 12 months. Among nonpregnant women drinkers, 7.6% reported drinking heavily (29.58 mL or more ethanol/d), and 18.4% reported drinking ≥5 on at least 1 occasion. Contrary to expectations of Russian obstetricians, pregnant Russian women readily answered detailed questions about their drinking behavior during pregnancy. Nearly all pregnant women drank in the year before they became pregnant; of these, 60.0% reported drinking when they knew they were pregnant, and 34.9% drank in the past 30 days. Among pregnant women who drank in the past 30 days, 7.4% reporting having ≥5 drinks on at least 1 occasion. Nevertheless, more than 90% of pregnant and nonpregnant Russian women believed that alcohol has a detrimental effect on pregnancy outcomes.

Conclusions: Pregnant and nonpregnant Russian women were willing to answer detailed questions about their drinking behavior. Although most pregnant women studied reduced their drinking during pregnancy, one‐third of the pregnant women did not stop drinking. It is important to find out what enabled two‐thirds of the pregnant women to stop drinking before or during their pregnancy.
Hypothalamic–Pituitary–Adrenal Responses to 5‐HT1A and 5‐HT2A/C Agonists Are Differentially Altered in Female and Male Rats Prenatally Exposed to Ethanol
Authors: Hofmann Candace E. , Ellis Linda , Yu Wayne K. , Weinberg Joanne
Published: January 2007

Background: Prenatal ethanol exposure alters the development of the hypothalamic–pituitary–adrenal (HPA) axis, resulting in HPA hyper‐responsiveness to stressors in adulthood. Prenatal ethanol exposure also alters the development and activity of the serotoninergic (5‐HT) system. We have previously shown that 5‐HT1A and 5‐HT2A/C receptor‐mediated behavioral and physiological function are altered in fetal ethanol‐exposed offspring. As there are extensive interactions between the HPA axis and the 5‐HT system, the present study tested the hypothesis that prenatal ethanol exposure would alter 5‐HT1A and 5‐HT2A/C receptor‐mediated HPA function.

Methods: The 5‐HT1A agonist, 8‐hydroxy‐2‐(di‐n‐propylamino)tetralin (8‐OH‐DPAT; 0.2 mg/kg), and the 5‐HT2A/C agonist, (+)‐1‐(2,5‐dimethoxy‐4‐iodophenyl)‐2‐aminopropane hydrochloride (DOI; 0.3 mg/kg), or vehicle (1 mL/kg) were administered to adult female and male offspring from prenatal ethanol‐exposed (E), pair‐fed control (PF), and ad libitum‐fed control (C) dams. The plasma concentration of adrenocorticotropin (ACTH) and corticosterone (CORT) were determined at 0, 15, 30, 60, and 120 minutes postinjection. In addition, corticotropin releasing hormone (CRH) mRNA expression in the paraventricular nucleus of the hypothalamus, and 5‐HT1A and 5‐HT2A/C receptor mRNA expression in the hippocampus and prefrontal cortex, respectively, were determined by in situ hybridization.

Results: Ethanol‐exposed females showed a blunted ACTH response to 8‐OH‐DPAT at 15 and 30 minutes, and conversely, an increased ACTH response to DOI at all time points postinjection, compared with PF and C females. Differences among E, PF, and C males failed to reach significance. Centrally, however, DOI resulted in a trend toward lower CRH mRNA levels in E and PF compared with C females, but higher CRH mRNA levels in E compared with control males. There were no differences among prenatal groups in 5‐HT2A receptor expression in the prefrontal cortex following either 8‐OH‐DPAT or DOI treatment. However, following 8‐OH‐DPAT, hippocampal 5‐HT1A receptor expression was higher in E than in PF females in CA1, with a trend toward higher expression in E than in C females in CA2, whereas following DOI, a prenatal group by subfield interaction suggests lower 5‐HT1A mRNA levels in E and PF compared with C females in CA1 and the dentate gyrus.

Conclusions: These data are the first to demonstrate that prenatal ethanol exposure has differential long‐term effects on 5‐HT1A‐mediated and 5‐HT2A‐mediated neuroendocrine function in females and males, and suggest a sex‐specific ethanol‐induced alteration in the interaction between the HPA axis and the serotonin system.
Prevalence of Alcohol Dependence Among Excessive Drinkers in New Mexico
Authors: Woerle Sandra , Roeber Jim , Landen Michael G.
Published: January 2007

Background:Excessive alcohol consumption claims more than 75,000 lives in the United States each year. The prevalence of alcohol dependence among excessive drinkers is not well known.

Methods:Data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS) in New Mexico were used to assess the prevalence of excessive drinking, including binge drinking, heavy drinking, alcohol‐impaired driving, and alcohol dependence.

Results:Of 4,761 respondents, 16.5% were excessive drinkers; 14.4% binge drank and 1.8% were alcohol dependent. While the rates of alcohol dependence were higher among the youngest age group, males, those with some college education, and those of race/ethnicity other than White, non‐Hispanic, only differences by age were statistically significant. The prevalence of alcohol dependence was the highest among those who reported alcohol‐impaired driving in the past 30 days (15.9%), and was lower among those who reported heavy drinking (13.4%) and binge drinking (8.1%).

Conclusions:Although 16.5% of New Mexico adults had at least 1 type of excessive drinking, only 1.8% of all adults met the criteria for alcohol dependence. Furthermore, only a minority of those who reported binge drinking, heavy drinking, or alcohol‐impaired driving met the criteria for alcohol dependence. This suggests that most alcohol problems in New Mexico are likely due to excessive drinking among persons who are not alcohol dependent. The adverse health and social consequences associated with excessive drinking are not limited to those who are alcohol dependent, but extend to a broader range of problem drinkers across the population.
Adverse Drug Events Resulting from Patient Errors in Older Adults
Authors: Field Terry S. , Mazor Kathleen M. , Briesacher Becky , DeBellis Kristin R. , Gurwitz Jerry H.
Published: January 2007

OBJECTIVES: To characterize the types of patient‐related errors that lead to adverse drug events (ADEs) and identify patients at high risk of such errors.

DESIGN: A subanalysis within a cohort study of Medicare enrollees.

SETTING: A large multispecialty group practice.

PARTICIPANTS: Thirty thousand Medicare enrollees followed over a 12‐month period.

MEASUREMENTS: Primary outcomes were ADEs, defined as injuries due to a medication, and potential ADEs, defined as medication errors with the potential to cause an injury. The subset of these events that were related to patient errors was identified.

RESULTS: The majority of patient errors leading to adverse events (n=129) occurred in administering the medication (31.8%), modifying the medication regimen (41.9%), or not following clinical advice about medication use (21.7%). Patient‐related errors most often involved hypoglycemic medications (28.7%), cardiovascular medications (21.7%), anticoagulants (18.6%), or diuretics (10.1%). Patients with medication errors did not differ from a comparison group in age or sex but were taking more regularly scheduled medications (compared with 0–2 medications, odds ratio (OR) for 3–4 medications=2.0, 95% confidence interval (CI)=0.9–4.2; OR for 5–6 medications=3.1, 95% CI=1.5–7.0; OR for ≥7 medications=3.3, 95% CI=1.5–7.0). The strongest association was with the Charlson Comorbidity Index (compared with a score of 0, OR for a score of 1–2=3.8, 95% CI=2.1–7.0; OR for a score of 3–4=8.6, 95% CI=4.3–17.0; OR for a score of ≥5=15.0, 95% CI=6.5–34.5).

CONCLUSION: The medication regimens of older adults present a range of difficulties with the potential for harm. Strategies are needed that specifically address the management of complex drug regimens.
Professional Development in Geriatrics for Community‐Based Generalist Faculty
Authors: Willett Rita M. , Boling Peter A. , Meyers M. Elizabeth , Hoban J. Dennis , Lawson Sonya R. , Schlesinger Jeanne B.
Published: January 2007

Generalist physicians provide most primary care for older people. Increasingly, undergraduate clinical education occurs in community sites. Hence, community‐based generalist faculty members need continuing education in geriatrics to support clinical practice and teaching. The Geriatrics Scholars Program provided continuing medical education (CME) in geriatrics over a 3‐year period to 88 participants. Sixty physicians completed 30 or more hours of education and were designated Geriatrics Scholars. On an anonymous exit survey, Scholars reported being better equipped to care for elderly patients and to teach geriatrics and improved patient care in specific aspects of geriatrics, including medication use, cognition, and functional assessment. In summary, community‐based generalist faculty who participated in a substantial, 3‐year program of geriatrics CME reported that their care of older people and their teaching of geriatrics were enhanced.
Completing an Advance Directive in the Primary Care Setting: What Do We Need for Success?
Authors: Ramsaroop Sharda D. , Reid M. C. , Adelman Ronald D.
Published: January 2007

OBJECTIVES: To systematically review studies designed to increase advance directive completion in the primary care setting and employ meta‐analytic techniques to quantify their effects.

DESIGN: Extensive bibliographic searches of English‐language literature published from January 1991 through July 2005 were conducted. Investigators abstracted prespecified information (e.g., design, study duration, types of interventions employed) and advance directive completion rates for intervention and control arms in each investigation and calculated absolute rate differences (i.e., difference in completion rates between the two groups) for each study. Individual study and pooled‐effect sizes were also calculated, along with 95% confidence intervals (CIs).

SETTING: Literature review.

RESULTS: Eighteen studies were retained in the final sample. Most studies employed multimodal interventions. The most common approach consisted of educational materials directed at patients (through mailing or at visit) coupled with a patient–healthcare provider interaction in a group or individual setting (n=7). Absolute differences in completion rates varied from a high of 44% (favors intervention) to a low of –2% (favors control). Effect sizes could be calculated for 15 of the 18 studies. The pooled effect size was 0.50 (95% CI=0.17–0.83), indicating a moderate overall effect in favor of the intervention.

CONCLUSION: The majority of studies demonstrated statistically significant effects associated with the advance directive intervention. The most successful interventions incorporated direct patient–healthcare professional interactions over multiple visits. Passive education of patients using written materials (without direct counseling) was a relatively ineffective method for increasing advance directive completion rates in the primary care setting.
Stroke‐Independent Association Between Metabolic Syndrome and Functional Dependence, Depression, and Low Quality of Life in Elderly Community‐Dwelling Brazilian People
Authors: Roriz‐Cruz Matheus , Rosset Idiane , Wada Taizo , Sakagami Teiji , Ishine Masayuki , Roriz‐Filho Jarbas S. , Cruz Thadeu R. S. , Rodrigues Rosalina P. , Resmini Isvania , Sudoh Shinji , Wakatsuki Yoshio , Nakagawa Masanori , Souza Antonio C. , Kita Toru , Matsubayashi Kozo
Published: January 2007

OBJECTIVES: Metabolic syndrome (Met.S) is a risk factor for stroke, dementia, and ischemic heart disease (IHD). It is unclear whether Met.S is an independent risk factor for functional dependence, depression, cognitive impairment, and low health‐related quality of life (HRQoL) in a population free of clinical stroke.

DESIGN: Cross‐sectional.

SETTING: Two communities in southern Brazil.

PARTICIPANTS: Four hundred twenty people aged 60 and older.

MEASUREMENTS: An adapted (body mass index ≥30 kg/m2 and blood pressure ≥140/90) Adult Treatment Panel III definition was used in diagnosing Met.S. Depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised) and Mini‐Mental State Examination were evaluated along with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). HRQoL was measured using a visual analogue scale (0–10). All values were adjusted for age, sex, and presence of IHD.

RESULTS: Forty (9.5%) subjects had a stroke and were excluded from the final analysis. Met.S was present in 37.4% of the stroke‐free population. Met.S was significantly and independently associated with 2.24 times as much ADL dependence, 2.39 times as much IADL dependence, a 2.12 times higher risk of depression, a 2.27 times higher likelihood of cognitive impairment, and a 1.62 times higher chance of low self‐perceived HRQoL (all P<0.05). Adjustment for its own components reduced the strength of the above associations but did not eliminate their statistical significance. If Met.S were removed from this population, dependence, depression, cognitive impairment, and low QoL would be reduced 15.0% to 21.4%.

CONCLUSION: Met.S was significantly associated with functional dependence, depression, cognitive impairment, and low HRQoL, and its effects were independent of clinical stroke, IHD, and its own individual components.
Pneumonia and Lower Respiratory Infections in Nursing Home Residents: Predictors of Hospitalization and Mortality
Authors: Chan Carusone Soo B. , Walter Stephen D. , Brazil Kevin , Loeb Mark B.
Published: January 2007

OBJECTIVES: To compare predictors of hospitalization and death in nursing home residents with pneumonia and other lower respiratory infections (LRIs).

DESIGN: A nested cohort study.

SETTING: Nine nursing homes in southern Ontario.

PARTICIPANTS: Three hundred fifty‐three nursing home residents with LRIs (enrolled in the control arm of a clinical trial).

MEASUREMENTS: Comorbidities, vaccination status, age, health‐related quality of life, functional status, and vital statistics were evaluated as potential predictors of hospitalization and mortality at 30 days.

RESULTS: Moderate to high disease severity score on a practical severity scale was a strong independent predictor of hospitalization (odds ratio (OR)=7.12, P<.001) and mortality (OR=5.04, P=.003). Diagnosis of pneumonia, established using chest radiograph, was also associated with hospitalization (OR=2.43, P=.008) and mortality (OR=2.35, P=.02). Oxygen saturation (<90%) was a strong independent predictor of hospitalization (OR=3.02, P=.004) but was not a significant predictor of mortality in multivariable analyses. Diagnosis of congestive heart failure (OR=2.26, P=.02) was an independent predictor of hospitalization, whereas receipt of pneumococcal vaccine (OR=0.36, P=.01) and greater functional independence (OR=0.92, P=.02) were negatively associated with hospitalization.

CONCLUSION: In nursing home residents with LRI, severity of illness and radiographically confirmed pneumonia are predictive of death and hospitalization.
Canadian experience with detection of bacterial contamination in apheresis platelets
Authors: Ramírez‐Arcos Sandra , Jenkins Craig , Dion Jocelyne , Bernier France , Delage Gilles , Goldman Mindy
Published: January 2007

BACKGROUND: In Canada, both blood suppliers, Héma‐Québec (HQ) and Canadian Blood Services (CBS), implemented bacterial testing in apheresis platelets (PLTs) with an automated microbial detection system (BacT/ALERT, bioMérieux).

STUDY DESIGN AND METHODS: Validation of the BacT/ALERT Classic and 3D systems involved apheresis PLT spiking with different bacteria at concentrations of 10 and 102 colony‐forming units per mL. As of February 2006, more than 95 percent of apheresis PLTs were screened for bacterial contamination at HQ and CBS. Between 3.5 and 10 mL of PLTs is inoculated into BacT/ALERT aerobic culture bottles followed by incubation for a maximum of 7 days.

RESULTS: During the validation studies, all bacteria were detected at all concentrations and volumes tested. Upon implementation of bacterial screening, the percentage of initial positive samples at CBS and HQ was 0.09 and 0.07 percent, respectively. The rate of indeterminate cultures was significantly higher at CBS than at HQ, whereas the rates for true‐positive, false‐positive, and false‐negative results did not differ significantly. Six confirmed‐positive cultures, including three coagulase‐negative staphylococci and three Enterobacteriaceae species, were detected and PLT units contaminated with these bacteria were not transfused. The rate of true‐positive cultures was significantly lower than that reported by other blood operators. Unfortunately, failed detection of two contaminated units resulted in septic transfusion reactions.

CONCLUSION: Bacterial screening of apheresis PLTs in Canada was successfully implemented, and transfusion of contaminated units was prevented. Rapid bacterial detection systems that could be used before transfusion, however, may further reduce the risk of transfusion reactions.
The efficacy of photochemical treatment with amotosalen HCl and ultraviolet A (INTERCEPT) for inactivation ofTrypanosoma cruziin pooled buffy‐coat platelets
Authors: Castro Emma , Gironés Nuria , Bueno José Luis , Carrión Javier , Lin Lily , Fresno Manuel
Published: January 2007

BACKGROUND:This study evaluated the efficacy of photochemical treatment (PCT) with amotosalen and ultraviolet A (UVA) light to inactivateTrypanosoma cruziin contaminated platelet (PLT) components.

STUDY DESIGN AND METHODS:Fifteen pools of buffy‐coat PLTs (BC‐PLTs) were inoculated with approximately 5 × 103to 5 × 105per mL of viableT. cruziof the G, Tulahuen (T), or Y strains. Samples from BC‐PLTs were assayed for infectivity before and after PCT with 150 µmol per L amotosalen and 3 J per cm2UVA light. Infectivity was determined with three different methods: 1) in vitro culture to detect viable epimastigotes, 2) [3H]thymidine incorporation in culture, and 3) in vivo inoculation into interferon‐γ receptor (IFN‐γR)‐deficient mice.

RESULTS:The in vitro assay yielded viable parasite titers of 3.9 × 105, 2.8 × 104, and 5.6 × 103per mL (corresponding to 5.6, 4.4, and 3.8 logs/mL) for the Y, T, and G strains, respectively. PCT was able to inactivate all three strains ofT. cruzito below the limit of detection (10 parasites/mL) in the sensitive in vivo assay. Because 10‐mL samples, each concentrated into a 1‐mL sample for inoculation, were tested in the in vivo assay, log reductions achieved were greater than 5.6, greater than 4.4, and greater than 3.8 for the Y, T, and G strains ofT. cruzi, respectively.

CONCLUSIONS:The pathogen reduction system with amotosalen HCl and UVA demonstrated robust efficacy for inactivation of high doses of three different strains ofT. cruziand offers the potential to make the PLT supply safer.
H5N1 influenza virus and the safety of plasma products
Authors: Kreil T.R. , Unger U. , Orth S.M. , Petutschnig G. , Kistner O. , Poelsler G. , Berting A.
Published: January 2007

BACKGROUND: The ever‐increasing number of human H5N1 influenza virus infections may enable these viruses to acquire the ability to spread effectively among humans and potentially to cause a pandemic. Recently, more systemic virus dissemination was reported during H5N1 virus infection of humans, resulting in significant virus concentrations also in the blood. The observation has raised concerns about the safety of labile blood products for transfusion and consequentially also for plasma derivatives. To confirm the safety margins of plasma products, dedicated virus inactivation processes used during their production were investigated for their effectiveness in inactivating this virus of recent concern.

STUDY DESIGN AND METHODS: Virus inactivation by steps commonly used during the manufacture of plasma derivatives, such as pasteurization for human albumin, solvent/detergent treatment for intravenous immunoglobulin (IVIG), vapor heating for factor VIII inhibitor bypassing activity, and incubation at low pH for IVIG, were investigated with a reassortant strain of H5N1 influenza virus.

RESULTS: The results show that H5N1 influenza behaves as expected for lipid‐enveloped viruses; that is, the virus is effectively inactivated by all the commonly used virus inactivation procedures tested.

CONCLUSION: The safety margins of plasma derivatives against the theoretical transmission of H5N1 influenza virus are very substantial.
Coagulation parameters in apheresis and leukodepleted whole‐blood plasma during storage
Authors: Boström F. , Sjödahl M. , Wehlin L. , Egberg N. , Lundahl J.
Published: January 2007

BACKGROUND: Thawing fresh‐frozen plasma (FFP) may cause delay in delivery, and one approach to circumvent this is to store plasma at +4°C. Thawed plasma is commonly discarded after a few days of storage, owing to the assumption that coagulation factor activity decreases to clinically unacceptable levels.

STUDY DESIGN AND METHODS: Eighteen apheresis plasma (AP) units were collected from blood donors. The collected plasma was divided into two equal parts: one part frozen at −74°C as FFP and one part stored at +4°C as fresh liquid plasma (FLP). Thirty‐nine units of whole blood (WB) were collected from blood donors and leukodepleted by inline filtration, followed by plasma separation. Twenty plasma units were frozen at −74°C as FFP and 19 plasma units were stored at +4°C as FLP for 28 days. Plasma aliquots were collected before freezing and immediately after thawing FFP and before and during storage of FLP at Days 14 and 28. Factor (F)V, FVIII, D‐dimers, and C1‐esterase inhibitor levels were assessed.

RESULTS: No significant differences in coagulation factor levels were assessed between FLP prepared from AP and FLP prepared from WB. FV and FVIII levels decreased on average 25 and 50 percent, respectively, at Day 14 of storage. C1‐esterase inhibitor and D‐dimers levels were not affected.

CONCLUSION: Leukodepleted apheresis and WB plasma stored for 14 days retain sufficient levels of FV and FVIII activity for maintenance of normal hemostasis and could therefore be considered useful in selected clinical situations.
Influence of Reciprocating Tachycardia on the Development of Atrial Fibrillation in Patients with Preexcitation Syndrome
Authors: KALARUS ZBIGNIEW , LENARCZYK RADOSŁAW , KOWALSKI OSKAR , PRUSZKOWSKA‐SKRZEP PATRYCJA , KRUPA HUBERT , ŚREDNIAWA BEATA , SOKAL ADAM , ZIELIŃSKA TERESA
Published: January 2007

Background: We sought to evaluate the influence of atrio‐ventricular reentrant tachycardia (AVRT) on atrial pressures during tachycardia and the presence of atrial fibrillation (AF) in patients with preexcitation syndrome.

Methods: The study population consisted of 88 patients (37 females, mean age 37.3 years) with left‐sided accessory pathway and AVRT induced during electrophysiologic study. The AF‐inducible group consisted of 32 patients with sustained episodes of AF provoked during electrophysiologic study, whereas the noninducible group comprised 56 patients without AF.

Results: We found significantly higher values of maximal and mean left (LAP) and right (RAP) atrial pressures in the AF group compared with noninducible group: LAP max 32.0 versus 20.8, LAP mean 21.6 versus 13.2, RAP max 15.2 versus 11.5, RAP mean 8.2 versus 6.2 respectively (P < 0.001). When analyzing the effect of AVRT on atrial pressures, we found a significant (P < 0.001) negative correlation between anterograde conduction times during tachycardia and LAP max and LAP mean in the whole population, but a significant positive correlation between retrograde conduction time and left atrial pressures. Similar effects of AVRT on the right atrial pressures were found.

Conclusions: Atrial pressures during AVRT, which depend on the electrophysiological features of tachycardia, play an important role in the genesis of atrial fibrillation in patients with preexcitation syndrome.