bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of central nervous system manifestations in mitochondrial disorders
Authors: Finsterer J.
Published: May 2010

Central nervous system (CNS) manifestations of mitochondrial disorders (MIDs) are accessible to therapy. Therapy of CNS abnormalities may be categorized as acting on the pathogenic cascade or on the genetic level, which is experimental. Treatment acting on the pathogenic cascade may be classified as non‐specific, including antioxidants, electron donors/acceptors, lactate‐lowering agents, alternative energy providers, cofactors, avoidance of mitochondrion‐toxic drugs, and physiotherapy, or as specific, including drugs against epilepsy, movement disorders, migraine, spasticity, psychiatric abnormalities, hypopituitarism, or bulbar manifestations, ketogenic diet, deep brain stimulation, or artificial ventilation. Stroke‐like episodes need to be delineated from ischaemic stroke and require special management. Potentially, mitochondrion‐toxic drugs and drug cocktails need to be avoided, seizures should be consequently treated even with mitochondrion‐toxic drugs if necessary, and as few drugs as possible should be given. Effective treatment acting on the pathogenic cascade may increase the quality of life and outcome in patients with MID and may prevent a therapeutic nihilism occasionally upcoming with MIDs.
Genetic variation on chromosome 9p21 shows association with the ischaemic stroke subtype large‐vessel disease in a Swedish sample aged ≤70
Authors: Olsson S. , Jood K. , Blomstrand C. , Jern C.
Published: May 2010

Background:  The aim of this study was to investigate whether we could replicate a recent finding of an association between genetic variants on chromosome 9p21 and the ischaemic stroke (IS) subtype large‐vessel disease (LVD).

Methods:  The Sahlgrenska Academy Study on Ischemic Stroke comprises 844 patients with IS, who suffered IS before reaching the age of 70, and 668 healthy controls. IS subtype was defined according to the TOAST criteria, and 111 patients were categorized as LVD. Seven single‐nucleotide polymorphisms (SNPs) on 9p21 were analyzed. Functional outcome was assessed 3 months after IS using the modified Rankin scale.

Results:  The SNP rs7857345 showed a significant association with the subtype LVD independent of traditional vascular risk factors. In addition, an association between rs7857345 and functional outcome after LVD was observed.

Conclusion:  In this relatively young sample of patients with IS, genetic variation on 9p21 is associated with LVD.
Association of the glucocerebrosidase N370S allele with Parkinson’s disease in two separate Chinese Han populations of mainland China
Authors: Hu F.‐Y. , Xi J. , Guo J. , Yu L.‐H. , Liu L. , He X.‐H. , Liu Z.‐L. , Zou X.‐Y. , Xu Y.‐M.
Published: May 2010

Background and purpose:  Mutations in the glucocerebrosidase (GBA) gene have been implicated in the development of Parkinson’s disease (PD). However, recent screenings for GBA mutations in PD subjects from different ethnic populations have yielded contradictory results.

Methods:  We performed a case–control study to look for a possible association between PD and the GBA N370S allele involving 628 subjects in two separate Chinese Han populations from mainland China. All subjects were successfully genotyped by polymerase chain reaction–restriction fragment length polymorphism analysis.

Results:  A total of six patients with PD and two control subjects carried the N370S allele. Although PD cases (1.8%) had an increased frequency of N370S compared to controls (0.7%), the difference was not statistically significant (P = 0.290). However, when PD cases were stratified by age at onset, a higher frequency of N370S in late‐onset PD (LOPD) cases (3.2%) compared to controls was observed.

Conclusions:  Our results suggest that the N370S allele might be associated with LOPD in Chinese Han population and that this phenomenon should be further examined in a larger study.
Clinical outcome after acute ischaemic stroke: the influence of restless legs syndrome
Authors: Medeiros C. A. M. , de Bruin P. F. C. , Paiva T. R. , Coutinho W. M. , Ponte R. P. , de Bruin V. M. S.
Published: May 2010

Background and purpose:  The objective was to evaluate the presence of Restless Legs Syndrome (RLS) in acute stroke, its association with sleep disturbances and clinical outcome during long‐term follow‐up.

Methods:  This was a longitudinal study (N = 96, 59 men, mean age 64.0 ± 8.9) of cases with acute ischaemic stroke. Patients were asked about the occurrence of RLS symptoms before the cerebrovascular event. RLS was diagnosed using the criteria established by the International RLS Study Group. Stroke outcome was estimated by the Barthel Index and the modified Rankin Scale. Daytime somnolence (Epworth Sleepiness Scale –ESS > 10), poor sleep quality (Pittsburgh Sleep Quality Index –PSQI > 5) and risk of obstructive sleep apnea (OSA) (Berlin questionnaire) were evaluated.

Results:  Twelve patients (12.5%) met the diagnostic criteria for RLS. All cases had symptoms of RLS before stroke. However, none of the cases had a previous medical diagnosis of RLS or were on use of specific medication. In only one case, a family history of RLS was found. In all patients, RLS symptoms started after the age of 40 (mean age 64 ± 6.7). Daytime sleepiness (44.8%) and poor quality sleep (62.8%) were present. Patients with RLS (12.5%) presented greater neck circumference (P = 0.04) and worse sleep quality (P = 0.007). Risk of OSA (56.2%) was associated with hypertension [OR = 0.12; CI=0.03–0.42]. Stroke outcome was significantly worse at three and 12 months (ancova, P < 0.005) in patients with RLS, remaining after adjustment for diabetes and body mass index (P < 0.05).

Conclusions:  Patients with acute stroke and RLS have worse clinical outcome, at three and 12 months of follow‐up.
Plasma brain natriuretic peptide predicts death during hospitalization in acute ischaemic stroke and transient ischaemic attack patients with atrial fibrillation
Authors: Shibazaki K. , Kimura K. , Iguchi Y. , Aoki J. , Sakai K. , Kobayashi K.
Published: May 2010

Background and purpose:  Atrial fibrillation (AF) is the most powerful predictor of early death in patients with acute ischaemic stroke. We investigated whether the plasma brain natriuretic peptide (BNP) level on admission can serve as a biological marker of in‐hospital death in acute ischaemic stroke and transient ischaemic attack (TIA) patients with AF.

Methods:  We prospectively enrolled ischaemic stroke and TIA patients with AF within 24 h of onset and measured plasma BNP on admission. Patients were divided into two groups: the deceased group, who died during hospitalization, and the survival group. The factors associated with in‐hospital death were investigated by multivariate logistic regression analysis.

Results:  A total of 221 patients with AF were enrolled. Death occurred in 24 (10.9%) patients. The mean ± SD of the plasma BNP level of the deceased group was significantly higher than that of the survival group (714.1 ± 716.3 vs. 320.0 ± 380.7 pg/ml, P < 0.0001). The optimal cutoff level, sensitivity, and specificity of BNP levels to distinguish the deceased group from the survival group were 320 pg/ml, 79.2, and 69.0%, respectively. Multivariate logistic regression analysis demonstrated that age per 10 years increase (OR, 3.56; 95% CI, 1.728–7.346, P = 0.0006), internal carotid artery occlusion (OR, 10.20; 95% CI, 2.525–41.177, P = 0.0011), NIHSS score of >17 (OR, 4.68; 95% CI, 1.137–19.286, P = 0.0325), and plasma BNP level of >320 pg/ml (OR, 4.74; 95% CI, 1.260–17.800, P = 0.0213) were independent factors associated with in‐hospital death.

Conclusion:  The plasma BNP level on admission can predict in‐hospital death in acute ischaemic stroke and TIA patients with AF.
Addiction and Self‐Deception: A Method for Self‐Control?
Authors: WALKER MARY JEAN
Published: May 2010

abstract

Neil Levy argues that while addicts who believe they are not addicts are self‐deceived, addicts who believe they are addicts are just as self‐deceived. Such persons accept a false belief that their addictive behaviour involves a loss of control. This paper examines two implications of Levy's discussion: that accurate self‐knowledge may be particularly difficult for addicts; and that an addict's self‐deceived belief that they cannot control themselves may aid their attempts at self‐control. I argue that the self‐deceived beliefs of addicts in denial and of self‐described addicts differ in kind. Unlike the self‐deception of an addict in denial, that of the self‐described addict allows them to acknowledge their behaviour. As such, it may aid an addict to develop more self‐control. A paradoxical implication is that this self‐deception may allow an addict more self‐knowledge.
Pulling the Same Way? A Multi‐Perspectivist Study of Crisis Cooperation in Government
Authors: Ödlund Ann
Published: May 2010

After crises have occurred, limitations in crisis management capacity often cause surprise and frustration. An explanation that frequently recurs in evaluations is a lack of efficient cooperation between organizations. Even though crisis cooperation is anticipated and planned for, it seems to create several problems. How is cooperation possible between organizations with different mandates, cultures and professions? This paper aims to identify factors that strengthen or hamper cooperation in crisis management between Swedish government agencies. A rationalist organizational and a social psychological perspective are applied, respectively, to demonstrate the interdependence of organizational context and human behaviour. One conclusion is that long‐term organizing and exercises could help authorities to identify strengths and weaknesses such as differences in regulations and culture. If carefully addressed and considered, such insights could improve the effectiveness of cooperation during crises.
Expression of intermediate filaments at muscle insertions in human fetuses
Authors: Abe Shinichi , Rhee Sun‐ki , Osonoi Makoto , Nakamura Takuo , Cho Baik Hwan , Murakami Gen , Ide Yoshinobu
Published: May 2010

Desmin and vimentin are intermediate filaments that play crucial roles in the maturation, maintenance and recovery of muscle fibers and mesenchymal cells. The expression of these proteins has not been investigated extensively in human fetuses. In the present study, we examined the immunohistochemical expression of intermediate filaments in skeletal muscles of the head, neck and thorax in 12 mid‐term human fetuses at 9–18 weeks of gestation. We also used immunohistochemistry to localize the expression of the myosin heavy chain and silver impregnation to identify the fetal endomysium. Expression of desmin and vimentin was already detectable in intercostal muscle at 9 weeks, especially at sites of muscle attachment to the perichondrium. At this stage, myosin heavy chain was expressed throughout the muscle fibers and the endomysium had already developed. Beginning with punctate expression, the positive areas became diffusely distributed in the muscle fibers. At 15–18 weeks, intermediate filament proteins were extensively expressed in all of the muscles examined. Expression at the bone–muscle interface was continuous with expression along the intramuscular tendon fibres. These results suggest that the development of intermediate filaments begins in areas of mechanical stress due to early muscle contraction. Their initially punctate distribution, as observed here, probably corresponds to the earliest stage of fetal enthesis formation.
Unbroken mirror neurons in autism spectrum disorders
Authors: Fan Yang‐Teng , Decety Jean , Yang Chia‐Yen , Liu Ji‐Lin , Cheng Yawei
Published: May 2010

Background:  The ‘broken mirror’ theory of autism, which proposes that a dysfunction of the human mirror neuron system (MNS) is responsible for the core social and cognitive deficits in individuals with autism spectrum disorders (ASD), has received considerable attention despite weak empirical evidence.

Methods:  In this electroencephalographic study, we examined mu suppression, as an indicator of sensorimotor resonance, concurrent with oculomotor performance while individuals (n = 20) with ASD and control participants (n = 20) either executed hand actions or observed hand actions or a moving dot. No difference in visual attention between groups was found as indicated by fixation duration and normalized fixation number on the presented stimuli.

Results:  The mu suppression over the sensorimotor cortex was significantly affected by experimental conditions, but not by group membership, nor by the interaction between groups and conditions. Individuals with ASD, similar to the controls, exhibited stronger mu suppression when watching hand actions relative to a moving dot. Notably, participants with ASD failed to imitate the observed actions while their mu suppression indicating the MNS activity was intact. In addition, the mu suppression during the observation of hand actions was positively associated with the communication competence of individuals with ASD.

Conclusion:  Our study clearly challenges the broken mirror theory of autism. The functioning of the mirror neuron system might be preserved in individuals with ASD to a certain degree. Less mu suppression to action observation coupled with more communicational severity can reflect the symptom heterogeneity of ASD. Additional research needs to be done, and more caution should be used when reaching out to the media.
Practitioner Review: Beyond shaken baby syndrome: what influences the outcomes for infants following traumatic brain injury?
Authors: Ashton Rebecca
Published: May 2010

Background: Traumatic brain injury (TBI) in infancy is relatively common, and is likely to lead to poorer outcomes than injuries sustained later in childhood. While the headlines have been grabbed by infant TBI caused by abuse, often known as shaken baby syndrome, the evidence base for how to support children following TBI in infancy is thin. These children are likely to benefit from ongoing assessment and intervention, because brain injuries sustained in the first year of life can influence development in different ways over many years.

Methods: A literature search was conducted and drawn together into a review aimed at informing practitioners working with children who had a brain injury in infancy. As there are so few evidence‐based studies specifically looking at children who have sustained a TBI in infancy, ideas are drawn from a range of studies, including different age ranges and difficulties other than traumatic brain injury.

Results: This paper outlines the issues around measuring outcomes for children following TBI in the first year of life. An explanation of outcomes which are more likely for children following TBI in infancy is provided, in the areas of mortality; convulsions; endocrine problems; sensory and motor skills; cognitive processing; language; academic attainments; executive functions; and psychosocial difficulties. The key factors influencing these outcomes are then set out, including severity of injury; pre‐morbid situation; genetics; family factors and interventions.

Conclusions: Practitioners need to take a long‐term, developmental view when assessing, understanding and supporting children who have sustained a TBI in their first year of life. The literature suggests some interventions which may be useful in prevention, acute care and longer‐term rehabilitation, and further research is needed to assess their effectiveness.
Evidence of validity in a new method for measurement of dexterity in children and adolescents
Authors: VOLLMER BRIGITTE , HOLMSTRÖM LINDA , FORSMAN LEA , KRUMLINDE‐SUNDHOLM LENA , VALERO‐CUEVAS FRANCISCO J , FORSSBERG HANS , ULLÉN FREDRIK
Published: May 2010

Aim  Many everyday activities involve manipulation of objects with the fingertips. Impaired performance in manipulative tasks is common in neurodevelopmental disorders. Thus accurate assessment of an individual’s ability to coordinate fingertip forces is important for planning treatment. We evaluated a recently developed assessment tool (the Strength–Dexterity Test), which is based on manipulation of unstable objects, in a paediatric population.

Method  A Rasch model was used to examine the validity and reliability of the Strength–Dexterity Test in a sample of 56 typically developing children and adolescents (30 males, 26 females; age range 4y 10mo–17y 3mo; mean age 9y 8mo, SD 3y 8mo). In addition, we examined how performance on this test relates to widely used tests for assessment of gross manual dexterity (assessed with the Box and Blocks Test) and finger strength measured with a pinch meter.

Results  The constructs measured with the 78‐item Strength–Dexterity Test include dexterity and strength, and form a unique unidimensional latent trait, named fingertip force coordination, that improves with age. The test has internal scale validity when applied to a typical paediatric population. Positive correlations (significant at p<0.001) were found among all three tests.

Interpretation  We provide preliminary evidence of construct validity in the Strength–Dexterity Test. Our findings suggest that this test has the potential to be developed into a promising tool for assessing dexterity in children.
Prevalence and clinical presentation of constipation in children with severe generalized cerebral palsy
Authors: VEUGELERS REBEKKA , BENNINGA MARC A , CALIS ELSBETH AC , WILLEMSEN STEN P , EVENHUIS HELEEN , TIBBOEL DICK , PENNING CORINE
Published: May 2010

Aim  Our aim was to study the prevalence and characteristics of constipation in children with profound multiple disabilities, as data in this area are scarce.

Method  A cross‐sectional observational study was performed in specialized day‐care centres and schools in the Netherlands. The study included 152 children (81 males, 71 females; mean age 9y 6mo, SD 4y 6mo). Intellectual disability ranged from moderate (7%) to profound (52%) in all participants who also had severe motor disabilities (83% classified at Gross Motor Function Classification System level V). We collected data on defaecation characteristics, food and fluid intake, and laxative consumption using standardized bowel diaries and interviews. Constipation was defined as (1) scybalous, pebble‐like, hard stools in over a quarter of defaecations in combination with a defaecation frequency of less than three times per week during a 2‐week study period; (2) large stools palpable on abdominal examination; or (3) laxative use or manual disimpaction of faeces.

Results  Of the studied population, 57% were constipated and 55% used laxatives, 27% of whom showed symptoms of constipation. Daily intakes of water and fibre were below the required standards in 87% and 53% of participants respectively, without a proven relation to constipation.

Interpretation  Constipation is a common problem in children with severe disabilities. Laxative use is high but dosing is frequently inadequate to prevent symptoms.
The effects of oral‐motor exercises on swallowing in children: an evidence‐based systematic review
Authors: ARVEDSON JOAN , CLARK HEATHER , LAZARUS CATHY , SCHOOLING TRACY , FRYMARK TOBI
Published: May 2010

Aim  The aim of this unregistered evidence‐based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders.

Method  A systematic search of 20 electronic databases was completed to identify relevant peer‐reviewed literature published in English between 1960 and 2007. Experimental or quasi‐experimental design studies examining OME as a treatment for children with swallowing disorders were appraised for methodological quality by two assessors and reviewed by a third.

Results  Sixteen studies of varying methodological quality were included. No study examining the effects of OME on pulmonary health in children was identified. The included studies incorporated a wide variety of OME, and mixed findings were noted across all of the outcomes targeted in this review.

Interpretation  Based on the results of this evidence‐based systematic review, there is insufficient evidence to determine the effects of OME on children with oral sensorimotor deficits and swallowing problems. Well‐designed studies are needed to provide clinicians with evidence that can be incorporated into the preferences of the client and the clinicians’ knowledge of anatomy, physiology, and neurodevelopment in the management of this group of children.
The oft‐neglected role of parietal EEG asymmetry and risk for major depressive disorder
Authors: Stewart Jennifer L. , Towers David N. , Coan James A. , Allen John J. B.
Published: May 2010

Relatively less right parietal activity may reflect reduced arousal and signify risk for major depressive disorder (MDD). Inconsistent findings with parietal electroencephalographic (EEG) asymmetry, however, suggest issues such as anxiety comorbidity and sex differences have yet to be resolved. Resting parietal EEG asymmetry was assessed in 306 individuals (31% male) with (n=143) and without (n=163) a DSM‐IV diagnosis of lifetime MDD and no comorbid anxiety disorders. Past MDD+ women displayed relatively less right parietal activity than current MDD+ and MDD− women, replicating prior work. Recent caffeine intake, an index of arousal, moderated the relationship between depression and EEG asymmetry for women and men. Findings suggest that sex differences and arousal should be examined in studies of depression and regional brain activity.
Effects of concurrent working memory load on distractor and conflict processing in a name‐face Stroop task
Authors: Jongen Ellen M. M. , Jonkman Lisa M.
Published: May 2010

To examine the time course of effects of working memory (WM) load on interference control, ERPs were measured in a combined WM and Stroop task. A WM load of 0, 2, or 4 letters was imposed, and during the maintenance‐interval Stroop trials were presented that required participants to classify names of famous people while ignoring faces that were either congruent or incongruent with the names.

Behavioral interference was not modulated by WM load, but WM load led to an overall reduction of Stroop stimulus encoding as reflected by reduced N170 and N250 amplitudes independent of congruency. Incongruent distractor faces induced interference as shown by a delayed and reduced positivity between 480–600 ms (N450) and an enhanced positivity between 760–1000 ms (P600), indicating longer stimulus evaluation, conflict detection, and conflict resolution, respectively. WM load led to an increase of the P600 at frontal and parietal sites, possibly reflecting PFC‐driven top‐down control of posterior sites, necessary for conflict resolution.
Fashion consumer profiles in the Portuguese market: involvement, innovativeness, self‐expression and impulsiveness as segmentation criteria
Authors: Cardoso Paulo Ribeiro , Costa Helda Sofia , Novais Liliana Andreia
Published: May 2010

This study identified fashion consumer profiles among Portuguese young adults. The work was based on four constructs: fashion involvement, fashion innovativeness, self‐expression through fashion products and impulsiveness. Another purpose of this study was to test these instruments in this cultural context in order to contribute to the generalizability of the scales. A cluster analysis uncovered three groups: Moderates, Apathetic and Enthusiasts. On the whole, this study proposes a new way of segmenting Portuguese fashion consumers and demonstrates that the four constructs employed can be used in different cultural contexts.
Importance of blanket testing in promoting US beef for Japanese consumers
Authors: Ishida Takashi , Ishikawa Noriko , Fukushige Mototsugu
Published: May 2010

We carried out and analysed a questionnaire survey on consumer attitudes to verify the effectiveness of blanket testing of US beef in Japan. Applying an ordered probit model to the data yielded the following findings: blanket testing dramatically increases purchase probabilities, so it is one of the most important tools for reviving Japanese consumers’ meat demand. The effect of blanket testing is especially large in the region where the consumers traditionally ate more beef (the Kansai area). Purchase probability is lower in households with awareness of country‐of‐origin of beef before the BSE crisis than households without it. Purchase probability of the households that had eaten US beef before the BSE outbreak is higher than those that had not. Purchase probability is not affected by family structure.
Representations of the emotions associated with a wine purchasing or consumption experience
Authors: Mora Pierre , Moscarola Jean
Published: May 2010

Wine products possess pronounced cultural and symbolic characteristics. Given how hard it is to differentiate the product's more objective dimensions, it is important to understand the emotions and feelings that accompany wine purchasing, consuming or sharing experiences. The present study uses a writing workshop and literature review to uncover the relationships between the dimensions of the emotions that people feel during an experience of this kind, along with the mode of expression of different consumer groups. It also offers specific analysis of the role played by brands among the different characteristics of emotions. Towards this end, a series of wine‐related experiential narratives has been compiled and treated via a structural text analysis approach followed by lexical contents analysis. One of the findings breaks consumers' involvement down into four categories of emotions. Another comes from a content analysis of the narratives that will differentiate among three separate consumer groups. Lastly, suggestions will be made in terms of wider consequences for the field of wine marketing.
Characterisation of three temperate phages released from the same Lactobacillus paracasei commercial strain
Authors: CAPRA MARIA L. , MERCANTI DIEGO J. , REINHEIMER JORGE A. , QUIBERONI ANDREA L.
Published: May 2010

Lysogeny entails more economical and technological risks in probiotic Lactobacillus casei/paracasei bacteria than in other lactic acid bacteria, due to economic value. Lysogeny is widely spread among L. casei/paracasei strains. Siphophages CL1 and CL2, isolated from noninfected lysed‐cultures of commercial L. paracasei A, are thermoresistant, have identical host spectrum, latent and burst times, whereas burst sizes are 148 and 85, respectively. Mitomycin C induction of L. paracasei A yielded prophage iA2, whose presence was confirmed on the strain genome and whose restriction patterns differed from phages CL1 and CL2. The latter shared several restriction fragments, probably indicating a common origin.
Expedited partner therapy for Chlamydia trachomatis at the community pharmacy
Authors: Cameron ST , Glasier A , Muir A , Scott G , Johnstone A , Quarrell H , Oroz C , McIntyre M , Miranda D , Todd G
Published: May 2010

Please cite this paper as: Cameron S, Glasier A, Muir A, Scott G, Johnstone A, Quarrell H, Oroz C, McIntyre M, Miranda D, Todd G. Expedited partner therapy for Chlamydia trachomatis at the community pharmacy. BJOG 2010;117:1074–1079.

Objective  Expedited partner treatment (EPT) for uncomplicated Chlamydia trachomatis at the pharmacy is an alternative approach to partner notification that has not yet been evaluated within the UK. The aim of this study was to evaluate EPT for partners using pharmacies in Lothian.

Design  A pilot study over 18 months.

Setting  Selected healthcare settings and community pharmacies in Lothian, Scotland, UK.

Population  Sexual partners of index cases with uncomplicated C. trachomatis.

Methods  Index cases with uncomplicated C. trachomatis were given a pharmacy voucher to pass onto sexual partners. Partners could redeem vouchers for free treatment (azithromycin) at one of 90 pharmacies in the area.

Main outcome measures  The main outcome measure was the proportion of vouchers redeemed. Secondary outcomes included patient satisfaction, as determined at a telephone follow‐up of a subgroup of female index cases from one study site, 1 month later.

Results  In total 577 vouchers were issued to chlamydia‐positive index patients of mean age 22.9 years (range 15–47 years). A total of 231 vouchers were redeemed (40%), at a median of 2 days after issue. Only 4% of partners attended a clinic for treatment. Most index patients surveyed reported that partners were satisfied with this method of treatment (48 out of 55; 87%).

Conclusions  Expedited partner treatment for uncomplicated chlamydia at a pharmacy is a popular choice, and increases options on where, when and how partners are treated.
Smoking and pregnancy‐related pelvic pain
Authors: Biering K , Aagaard Nohr E , Olsen J , Hjollund NH , Nybo Andersen A‐M , Juhl M
Published: May 2010

Please cite this paper as: Biering K, Aagaard Nohr E, Olsen J, Hjollund N, Nybo Andersen A‐M, Juhl M. Smoking and pregnancy‐related pelvic pain. BJOG 2010;117:1019–1026.

Objective  To investigate possible associations between smoking and pregnancy‐related pelvic pain.

Design  Nested case–control study.

Setting  Denmark 2000–2001.

Population  The Danish National Birth Cohort.

Methods  The women were interviewed twice in pregnancy and twice after childbirth. The first pregnancy interview provided information on smoking and possible confounding factors, whereas the first interview after birth addressed case identification. Cases (n = 2302) were defined on the basis of self‐reported pelvic pain, and controls were selected among women who did not report pelvic pain (n = 2692). Logistic regression analysis was used to estimate associations between smoking and pelvic pain.

Main outcome mreasue  Pregnancy‐related pelvic pain.

Results  Compared with non‐smokers, women who smoked during pregnancy had an adjusted odds ratio of 1.2 (1.0–1.4) for overall pelvic pain, similar to women who stopped smoking in early pregnancy 1.3 (1.1–1.7). The equivalent adjusted odds ratio for severe pelvic pain was 1.2 (1.0–1.5) for smokers, and 1.5 (1.2–1.9) for women who stopped smoking. Smoking intensity, measured as number of cigarettes smoked per day, was associated with pelvic pain in a dose–response pattern. Information about smoking was collected prospectively, which makes it unlikely that differential recall alone explains the results.

Conclusions  Smoking was associated with pregnancy‐related pelvic pain, with a dose–response pattern between reported smoking intensity and pelvic pain. These findings suggest a possible new risk factor for a common ailment during pregnancy.
Apgar score and perinatal death after one previous caesarean delivery
Authors: Carlsson Wallin M , Ekström P , Maršál K , Källén K
Published: May 2010

Please cite this paper as: Carlsson Wallin M, Ekström P, Maršál K, Källén K. Apgar score and perinatal death after one previous caesarean delivery. BJOG 2010;117:1088–1097.

Objective  To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery.

Design  Population‐based cohort study.

Setting  Sweden.

Population  Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry.

Methods  The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarcharchical system based on information from birth records.

Main outcome measures  Perinatal death, low Apgar score (less than seven at 5 minutes).

Results  Infants of women with one previous caesarean section were at increased risk of low Apgar score compared with infants of women with one previous vaginal delivery (OR, 2.0; 95% CI, 1.9–2.1). The risk estimate was reduced when adjustment for maternal and fetal/infant characteristics was made (OR, 1.6; 95% CI, 1.5–1.8). The corresponding crude and adjusted odds ratios for perinatal death were 1.6 (95% CI, 1.4–1.7) and 1.1 (95% CI, 1.0–1.2), respectively. The infant outcome of the delivery after one caesarean section was mainly dependent on the indication for the first‐delivery caesarean section and, when no medical indication was present, no increase in risk was detected.

Conclusions  Infants of women with one previous caesarean section were at increased risk of low Apgar score and/or perinatal death compared with infants of women with one previous vaginal delivery. The results suggest that medical conditions, not the previous caesarean section per se, contributed to the increase in risk.
Distribution of neuroendocrine regulatory peptide‐1 and ‐2, and proteolytic processing of their precursor VGF protein in the rat
Authors: Mishiro‐Sato Emi , Sasaki Kazuki , Matsuo Takashi , Kageyama Haruaki , Yamaguchi Hideki , Date Yukari , Matsubara Masako , Ishizu Takehiro , Yoshizawa‐Kumagaye Kumiko , Satomi Yoshinori , Takao Toshifumi , Shioda Seiji , Nakazato Masamitsu , Minamino Naoto
Published: May 2010

J. Neurochem. (2010) 114, 1097–1106.

Neuroendocrine regulatory peptide (NERP)‐1 and NERP‐2 are biologically active peptides recently discovered by peptidomic analysis. NERPs are processed out from the 594‐residue VGF protein which contains many prohormone convertase cleavage motifs. VGF‐deficient mice exhibit a hypermetabolic and infertile phenotype, for which VGF protein‐derived peptides including NERPs are presumably responsible. To provide a solid basis for elucidating physiological roles of NERPs, we investigated rat VGF protein processing by chromatographic and mass spectrometric analysis, and immunoblotting, using antibodies against NERPs and the VGF protein C‐terminus (VGF‐C). Cellular and tissue distribution of immunoreactive (ir) NERPs were also analyzed in the rat. Both ir‐NERP‐1 and ir‐NERP‐2, which occur abundantly in the CNS and pituitary, moderately in the gastrointestinal (GI) tract, were mainly localized in neuronal structures. Major endogenous forms of ir‐NERPs in the brain and GI tract were identified as NERP‐1, NERP‐2, and big NERP‐2 (NERP‐1 + NERP‐2), with NERP‐1 and big NERP‐2 being predominant. Regarding ir‐VGF‐C peptides, VGF[588–617], VGF[556–617], and VGF[509–617] were found to be major forms. Immunoblotting with the NERP‐2 and VGF‐C antibodies revealed processing intermediates of 10–37 kDa. Taken together, we deduce that VGF protein is primarily cleaved at 10 sites through the processing pathway common to the brain and GI tract.
Ionic dysregulations typical of ischemia provoke release of glycine and GABA by multiple mechanisms
Authors: Luccini Elisa , Romei Cristina , Di Prisco Silvia , Raiteri Maurizio , Raiteri Luca
Published: May 2010

J. Neurochem. (2010) 114, 1074–1084.

Energy deprivation during ischemia causes dysregulations of ions, particularly sodium, potassium and calcium. Under these conditions, release of neurotransmitters is often enhanced and can occur by multiple mechanisms. The aim of this work was to characterize the modes of exit of glycine and GABA from nerve endings exposed to stimuli known to reproduce some of the ionic changes typical of ischemic conditions. Their approach was chosen instead of application of ischemic conditions because the release evoked during ischemia is mechanistically too heterogeneous. Mouse hippocampus and spinal cord synaptosomes, pre‐labeled with [3H]glycine or [3H]GABA, were exposed in superfusion to 50 mM KCl or to 10 μM veratridine. The evoked overflows differed greatly between the two transmitters and between the two regions examined. Significant portions of the K+‐ and the veratridine‐evoked overflows occurred by classical exocytosis. Carrier‐mediated release of GABA, but not of glycine, was evoked by high K+; GABA and, less so, glycine were released through transporter reversal by veratridine. External calcium‐dependent overflows were only in part sensitive to ω‐conotoxins; significant portions occurred following reversal of the plasmalemmal Na+/Ca2+ exchanger. Finally, a relevant contribution to the overall transmitter overflows came from cytosolic calcium originating through the mitochondrial Na+/Ca2+ exchanger. To conclude, ionic dysregulations typical of ischemia cause neurotransmitter release by heterogeneous mechanisms that differ depending on the transmitters and the CNS regions examined.
Experimental Strain Analysis of the Mast of a 420 Sailboat During Sailing
Authors: Pellicioli G. , Petrone N.
Published: May 2010

Abstract:  Aim of the work was the experimental strain analysis of a 420 sailboat mast during sailing: this type of data is of great interest in the structural design of sailboat masts and hulls as well as in the sail‐making. The work involved the design, calibration and installation of strain gauge bridges at seven sections of an instrumented mast and at the shrouds: this was followed by the collection of strain data during simulated laboratory rigging tests and real sailing sessions with medium/strong wind. Compression loads at the mast step were recorded with a customised load cell calibrated on a force platform. On the basis of laboratory calibration constants, the strain measurements were converted into structural loads and averaged over steady states during rigging and sailing either close to the wind or beam reach: the longitudinal bending moment, the lateral bending moment and the axial loads were analysed and plotted along the 6.20 m mast length. Highest values of lateral bending (146 ± 14.5 Nm) were recorded at the mast head, whereas longitudinal bending showed highest values at the vang connection to the mast (229 ± 29 Nm). Tension loads acting on the shrouds were also measured with highest values of 2887 ± 167 N. The knowledge of loads acting along the mast will support the designers in improving the mast’s cross section profile, the material selection and the validation of numerical structural analysis. Moreover, experimental data about the loads acting on the standing rigging and on the mast‐step during sailing will support the optimised design of the boat shell.
Shear Characterisation of Woven Carbon/Epoxy Composite Under Various Adverse Environments
Authors: Dash P. K. , Singh D.
Published: May 2010

Abstract:  In this article, an investigation into the shear properties of bi‐directional carbon fibre reinforced composite has been carried out by ‘rail‐shear’ test method (D4255). The specimens were tested under various adverse environmental conditions after subjecting them to different durations of exposure. A comparison between time‐dependent degradation of the shear properties of the material with respect to virgin shear properties is made, and the results have been analysed with emphasis on material weight gain or loss under those adverse environments.
Multi‐actor systems and ethics
Authors: Pruyt Erik
Published: May 2010

This paper looks at implicit and explicit ethical aspects of research and decision making in complex issues that are characterized by combined systems and multi‐actor complexities. These social–technical issues, called multi‐actor systems, are so complex that researchers and decision makers need to reduce these complexities. This is mostly achieved by means of implicit assumptions of the research paradigms/methods chosen and explicit omission of multi‐actor and/or system aspects. Many of these paradigmatic assumptions and boundary choices are in fact implicit and explicit ethical choices. The goals of this paper are to draw attention to these ethical choices, to reveal their underlying ethical theories and to reflect on appropriate locations and functions of ethics in different strands of multi‐actor systems research and decision making.
Chronic and Temporary Poverty in Australia: Targeting Public Transfers*
Authors: RODGERS JOAN R.
Published: May 2010

This study investigates the efficacy of Australian public transfers in alleviating poverty, particularly chronic poverty. The larger the proportion of transfers received by people who would be poor in their absence, the better targeted the transfers. From 2001 to 2007, 64 per cent of all public transfers were received by people who would have been in chronic poverty according to their pre‐transfer incomes. Another 22 per cent went to people in pre‐transfer temporary poverty, whereas 14 per cent were received by people who were not poor based on their pre‐transfer incomes. Family payments were less well‐targeted than other public transfers.
Validating a Detailed, Dynamic CGE Model of the USA*
Authors: DIXON PETER B. , RIMMER MAUREEN T.
Published: May 2010

Computable general equilibrium (CGE) models can be used to generate detailed forecasts of output growth for commodities/industries and thereby provide baselines from which to calculate the effects of policy changes. In this article, we assess a CGE forecasting method that has been applied in policy analyses in the USA and Australia. Using data available up to 1998, we apply the method with the USAGE model to generate ‘genuine forecasts’ for 500 US commodities/industries for the period 1998–2005. We then compare these forecasts with actual outcomes and with alternate forecasts derived as extrapolated trends from 1992 to 1998.
Cost Sharing, Family Health Care Burden, and the Use of Specialty Drugs for Rheumatoid Arthritis
Authors: Karaca‐Mandic Pinar , Joyce Geoffrey F. , Goldman Dana P. , Laouri Marianne
Published: May 2010

Objectives.To examine the impact of benefit generosity and household health care financial burden on the demand for specialty drugs in the treatment of rheumatoid arthritis (RA).

Data Sources/Study Setting.Enrollment, claims, and benefit design information for 35 large private employers during 2000–2005.

Study Design.We estimated multivariate models of the effects of benefit generosity and household financial burden on initiation and continuation of biologic therapies.

Data Extraction Methods.We defined initiation of biologic therapy as first‐time use of etanercept, adalimumab, or infliximab, and we constructed an index of plan generosity based on coverage of biologic therapies in each plan. We estimated the household's burden by summing up the annual out‐of‐pocket (OOP) expenses of other family members.

Principal Findings.Benefit generosity affected both the likelihood of initiating a biologic and continuing drug therapy, although the effects were stronger for initiation. Initiation of a biologic was lower in households where other family members incurred high OOP expenses.

Conclusions.The use of biologic therapy for RA is sensitive to benefit generosity and household financial burden. The increasing use of coinsurance rates for specialty drugs (as under Medicare Part D) raises concern about adverse health consequences.
New insights into the molecular mechanisms of general anaesthetics
Authors: Chau P‐L
Published: May 2010

This paper provides new insights of how general anaesthetic research should be carried out in the future by an analysis of what we know, what we do not know and what we would like to know. I describe previous hypotheses on the mechanism of action of general anaesthetics (GAs) involving membranes and protein receptors. I provide the reasons why the GABA type A receptor, the NMDA receptor and the glycine receptor are strong candidates for the sites of action of GAs. I follow with a review on attempts to provide a mechanism of action, and how future research should be conducted with the help of physical and chemical methods.
Neuroprotection by donepezil against glutamate excitotoxicity involves stimulation of α7 nicotinic receptors and internalization of NMDA receptors
Authors: Shen H , Kihara T , Hongo H , Wu X , Kem WR , Shimohama S , Akaike A , Niidome T , Sugimoto H
Published: May 2010

BACKGROUND AND PURPOSEGlutamate excitotoxicity may be involved in ischaemic injury to the CNS and some neurodegenerative diseases, such as Alzheimer's disease. Donepezil, an acetylcholinesterase (AChE) inhibitor, exerts neuroprotective effects. Here we demonstrated a novel mechanism underlying the neuroprotection induced by donepezil.

EXPERIMENTAL APPROACHCell damage in primary rat neuron cultures was quantified by lactate dehydrogenase release. Morphological changes associated with neuroprotective effects of nicotine and AChE inhibitors were assessed by immunostaining. Cell surface levels of the glutamate receptor sub‐units, NR1 and NR2A, were analyzed using biotinylation. Immunoblot was used to measure protein levels of cleaved caspase‐3, total NR1, total NR2A and phosphorylated NR1. Immunoprecipitation was used to measure association of NR1 with the post‐synaptic protein, PSD‐95. Intracellular Ca2+concentrations were measured with fura 2‐acetoxymethylester. Caspase 3‐like activity was measured using enzyme substrate, 7‐amino‐4‐methylcoumarin (AMC)‐DEVD.

KEY RESULTSLevels of NR1, a core subunit of the NMDA receptor, on the cell surface were significantly reduced by donepezil. In addition, glutamate‐mediated Ca2+entry was significantly attenuated by donepezil. Methyllycaconitine, an inhibitor of α7 nicotinic acetylcholine receptors (nAChR), inhibited the donepezil‐induced attenuation of glutamate‐mediated Ca2+entry. LY294002, a phosphatidyl inositol 3‐kinase (PI3K) inhibitor, had no effect on attenuation of glutamate‐mediated Ca2+entry induced by donepezil.

CONCLUSIONS AND IMPLICATIONSDecreased glutamate toxicity through down‐regulation of NMDA receptors, following stimulation of α7 nAChRs, could be another mechanism underlying neuroprotection by donepezil, in addition to up‐regulating the PI3K‐Akt cascade or defensive system.
Methylenedioxymethamphetamine (‘Ecstasy’)‐induced immunosuppression: a cause for concern?
Authors: Boyle Noreen T , Connor Thomas J
Published: May 2010

Methylenedioxymethamphetamine (MDMA; ‘Ecstasy’) is a ring‐substituted amphetamine and a popular drug of abuse. In addition to ability to induce euphoria, MDMA abuse is associated with a range of acute and long‐term hazardous effects. This paper is focused on once such adverse effect: its ability to negatively impact on functioning of the immune system. Research demonstrates that MDMA has immunosuppressive properties, with both innate and adaptive arms of the immune system being affected. The ability of MDMA to suppress innate immunity is indicated by impaired neutrophil phagocytosis and reduced production of dendritic cell/macrophage‐derived pro‐inflammatory cytokines including tumour necrosis factor‐alpha, interleukin (IL)‐1β, IL‐12 and IL‐15. MDMA also suppresses innate IFN‐γ production, and considering the role of IFN‐γ in priming antigen‐presenting cells, it is not surprising that MDMA reduces MHC class II expression on dendritic cells and macrophages, and inhibits co‐stimulatory molecule expression. Paradoxically, studies demonstrate that MDMA elicits pro‐inflammatory actions in the CNS by activating microglia, the resident innate immune cells in the brain. In terms of adaptive immunity, MDMA reduces circulating lymphocyte numbers, particularly CD4+T‐cells; suppresses T‐cell proliferation; and skews cytokine production in a Th2direction. For the most part, the immunosuppressive effects of MDMA cannot be attributed to a direct action of the drug on immune cells, but rather due to the release of endogenous immunomodulatory substances. In this regard, peripheral β‐adrenoceptors and cholinergic receptors have been shown to mediate some immunosuppressive effects of MDMA. Finally, we discuss emerging evidence indicating that MDMA‐induced immunosuppression can translate into significant health risks for abusers.