bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in the diet of the Lataste's viper Vipera latastei in the Iberian Peninsula: seasonal, sexual and size-related effects
Authors: Santos Xavier , Llorente Gustavo , Pleguezuelos Juan , Brito José , Fahd Soumia , Parellada Xavier
Published: February 2007

Several life-history traits may increase vulnerability of species to extinction. Among snakes, ambush predation and dietary specialisation are factors that increase this vulnerability. European viper species, genus Vipera, display such traits and are categorised as endangered in several parts of its range. For their conservation management, a deeper knowledge of their ecology and habitat use is highly relevant. One of the species with less ecological data is the Lataste's viper Vipera latastei, a species which lives in the Iberian Peninsula and northwestern Africa. Here, we describe its diet based on the analysis of gut content of 435 museum specimens plus nine bibliographic data from the entire Iberian range. The species showed seasonal and ontogenetic shift in diet but no sexual variations. Feeding activity (percentage of vipers with prey) was low in accordance with its ambush predation tactics, being lower in spring than in summer and autumn. Prey spectrum included two main (reptiles and small mammals), and three sporadic, types of prey (arthropods, amphibians and birds). The consumption of reptiles and mammals was seasonal; the former decreased in occurrence from spring to autumn, whereas the latter showed an opposite pattern. There was an ontogenetic shift in the diet: juveniles fed mainly on reptiles and arthropods, whereas adult vipers progressively substitute this prey with insectivores, and the largest vipers primarily foraged on rodents and birds. Our results suggest that the seasonal variation in prey type was related to prey availability, whereas the ontogenetic shift was linked to gape limitation. The apparently wide prey spectrum of V. latastei must therefore be examined, taking into account that there are seasonal and ontogenetic dietary variations as well as geographic differences, the latter probably driven by climatic contrasts into the Iberian Peninsula. This new data of the endangered Iberian V. latastei can aid the effective conservation management of this species.
Factors affecting spider prey selection by Sceliphron mud-dauber wasps (Hymenoptera: Sphecidae) in northern Italy
Authors: Polidori Carlo , Federici Matteo , Pesarini Carlo , Andrietti Francesco
Published: February 2007

Predatory habits of apoid wasps are well documented for many species, revealing a choice of prey ranging from generalist to specialised, but few studies tested the degree of specialisation when compared with the availability of prey in the environment. In a study carried out in northern Italy, nests of the mud-dauber wasps Sceliphron spirifex L. and S. caementarium Drury were collected to obtain the spider prey of the wasps, and a survey of the nesting area was performed to ascertain frequency of the available spider prey species in the environment. Wasps preyed preferably upon spiders of the family Araneidae. Adult preferred spider prey size ranged from 4 to 6 mm in length. The factor which most affected prey selection was the ecology of the spiders, with orb-web spiders being the preferred prey despite the fact that terricolous, non-web groups were the most abundant in the locality. Sex (female, male or juvenile) of prey was also important in prey selection: juvenile spiders were the most preferred even though males and females were equally and most abundant (respectively). Sceliphron spp. seem almost to be specialised rather than generalist predators. These results suggest that the terms 'generalist' or 'specialised' should not be applied to predators solely on the basis of prey collected from wasp nests, but should also be related to local prey availability.
Silvering of European eel (Anguilla anguilla L.): seasonal changes of morphological and metabolic parameters
Authors: van Ginneken Vincent , Durif Caroline , Balm S. Paul , Boot Ron , Verstegen Martin , Antonissen Erik , van Den Thillart Guido
Published: February 2007

The transformation of yellow eel into silver eel is called 'silvering', and takes place prior to migration. We found the sedentary yellow phase in spring, the migratory silver phase in autumn, while August was a cross-over month. We used principal component analysis (PCA) to characterise the morphological and physiological changes that accompany silvering in the European eel (Anguilla anguilla L.). Silvering is positively related to external parameters such as eye size, internal maturation parameters like GSI, vitellogenine (VIT), and blood-substrates such as phospholipids, Free Fatty Acids (FFA), and cholesterol. The Hepatosomatic Index was not significantly different between yellow and silver groups. In contrast, a significant difference was observed for parameters of body constitution (fat, protein, dry matter) between yellow and silver stages. Furthermore, the process of silvering is accompanied with increased levels of cortisol in autumn, which plays a role in mobilisation of metabolic energy from body stores towards migratory activity and gonadal growth. Based on Principal Component Analysis (PCA) with physiological, morphological and endocrinological parameters, it is concluded that during the process of silvering, several developmental stages can be recognised, with a timeframe of the premigratory sedentary yellow phase from April until July, August is a cross-over month, and the migratory silver phase is found from September until November.
Pheromones inhibit the hatching of diapausing Anostraca (Crustacea: Branchiopoda)
Authors: Beladjal Lynda , Dierckens Kristof , Mertens Johan
Published: February 2007

Hatching of resting eggs of Streptocephalus torvicornis (Waga, 1942) and Branchipus schaefferi Fischer, 1834, two sympatric fairy shrimps, was tested using medium in which these two species and Chirocephalus diaphanus (Prévost, 1803) had been raised. The medium of adults inhibited the hatching of conspecific nauplii, even when diluted by 50% using distilled water. Streptocephalus torvicornis resting eggs hatch in the medium of C. diaphanus but not in the medium of B. schaefferi. Resting eggs of B. schaefferi hatched in low numbers in S. torvicornis medium, and in high numbers in that of C. diaphanus.There appears to be one or more substances associated with the presence of adults of conspecifics and sympatrics which exceed the influences of abiotic factors, such as light, pH, conductivity and osmotic pressure in fresh media. We propose that this substance(s) functions as a pheromone to inhibit further hatching once a population of adults is present.
Kinetics of primary antibody responses to sheep red blood cells in birds: a literature review and new data from great tits and European starlings
Authors: Snoeijs Tinne , Eens Marcel , Van Den Steen Evi , Pinxten Rianne
Published: February 2007

Measuring the primary antibody immune response to an injection with sheep red blood cells (SRBC) is a routine application in poultry science. Recently, this technique is also becoming an increasingly popular tool to investigate humoral immunocompetence in free-living birds in studies of ecological immunology and immunotoxicology. However, an extensive search of the literature revealed that many of these studies have been measuring the primary immune response to SRBC without verifying first when maximum levels of antibodies are reached in the bird species under study. In addition, most studies assessed antibody titres to SRBC approximately 6 days after their inoculation assuming a similar pattern as found in poultry. We tested this assumption of a uniform pattern of kinetics of the primary humoral immune response to SRBC across bird species and investigated it in detail in two important model species, namely the great tit Parus major and the European starling Sturnus vulgaris. In general, the pattern was found to be the same in both passerine species and strongly resembled the pattern observed in chickens. Maximum antibody levels (the plateau phase) were reached on, respectively, day 5 and day 6 (with day of inoculation = day 0) of the immune response in the great tit and the starling and lasted for 3 days in both species. We found no effects of age, sex or time spent in captivity. Furthermore, our findings suggest that antibody levels to SRBC should not be obligatory assessed during the plateau phase of maximum antibody levels although it still remains most accurate to do so or at least shortly before or after it. Overall, we conclude that antibody levels have been reliably assessed in most avian studies using this technique.
Thermal dependence of food assimilation and locomotor performance in juvenile blue-tailed skinks, Eumeces elegans
Authors: Du Wei-Guo , Lu Yi-Wei , Shu Lin , Bao Yi-Xin
Published: February 2007

Variation in the physiological performance and behaviour of ectotherms as a result of changes in body temperature can affect important life-history traits. Studies investigating the effects of temperature on physiological performance and behaviour have thus clear ecological significance. We captured juvenile blue-tailed skinks, Eumeces elegans, from a population in Zhejiang, eastern China, and determined the effects of temperature on their food assimilation and locomotor performance. Food intake of the juveniles generally increased with increase in temperatures within the range of 24-30°C and decreased at higher temperatures. The temperature significantly affected the apparent digestive coefficient (ADC) and the assimilation efficiency (AE) of juveniles; the ADC and AE of the skinks at 32°C were higher than those of skinks at other temperatures. The sprint speed increased with increase in temperature within the range of 12-32°C and decreased at higher temperatures. These results suggest the patterns of thermal sensitivity may differ in various functional performances, and hence support the 'multiple optima hypothesis', which suggests that no specific temperature maximises all functional performance. In addition, this study indicates significant between-age difference in thermal physiology by comparing our data with those on adult skinks, including different thermal sensitivity of AE, and different ranges of thermal-performance breadth for food intake and locomotor performance between juvenile and adult E. elegans.
Evolutionary origin of Lake Tana's (Ethiopia) small Barbus species: indications of rapid ecological divergence and speciation
Authors: De Graaf Martin , Megens Hendrik-Jan , Samallo Johannis , Sibbing Ferdinand
Published: February 2007

Lake Tana, located in the north-western highlands of Ethiopia, contains a unique assemblage of cyprinid fishes. In addition to the only known intact species flock of large (max. 100 cm forklength (FL)) Labeobarbus species, the lake harbours three small (<10 cm FL) Barbus species: B. humilis Boulenger, 1902, B. pleurogramma Boulenger, 1902 and B. tanapelagius de Graaf, Dejen, Sibbing and Osse, 2000. Phylogenetic relationships of the small Barbus species of Lake Tana were investigated using the mtDNA cytochrome b gene. All small Barbus species occurring in Lake Tana are part of the 'small African diploid' groups identified by Tsigenopoulos et al. (2002). Barbus pleurogramma, only reported in Lake Tana, and populations of the morphologically similar species, B. paludinosus Peters, 1852, collected in rivers and lakes throughout Ethiopia, comprised a monophyletic group with separate clades congruent with drainage basins. Barbus pleurogramma could well be a cryptic species rather than synonymous to B. paludinosus as previously suggested. The genetic divergence between B. humilis and B. tanapelagius was very low, and without lineage sorting of haplotypes. This is probably due to recent (<16 000 years ago) evolution of the pelagic, zooplanktivorous B. tanapelagius from the benthic, omnivorous B. humilis after the formation of Lake Tana.
Reading the Bible Together with Muslims: David as Sinner King and Repentant Prophet
Authors: Steenbrink Karel
Published: February 2007

The Jewish, Christian and Muslim traditions share many stories. The narratives about Adam, Abraham, Moses, Solomon and many others are modelled one after the other. During the last decades much attention has been given to the 'three religions of Abraham' as sharing the heritage of that great biblical figure. This contribution concentrates on the stories of David in the three religions as expression of the one hermeneutic family. It pleads that Jews and Christians take the Muslim reinterpretation of their heritage serious.
The Awakening of a New Form of Christianity? Catholicism in the Cariri Region (Brazil)
Authors: Rietveld Jan Joris
Published: February 2007

The Cariri region is the most isolated and poor part of the rural zone of the diocese of Campina Grande in the Paraiba state of Brazil. The Catholic Church has been present here for a relatively short time: 335 years. Moreover the region has an isolated context and this favors conservatism so that only fundamental changes have an impact. These facts make the Cariri an interesting region for a case study about how Catholicism develops. I distinguish five periods, which are described with religious key words and situated in the socio-cultural context. This classification is a schematization: different types of Catholicism often exist together. It is obvious that the dominant features of Catholicism change with time, but in the mainstream of the fifth period we see a small revolution. Now there are not only influences in the socio cultural context and factors in the Church itself that cause changes, but there are also influences of powerful newcomers, the evangelical churches. Their main impact is that many people have left the Catholic Church and are going to live their old faith in a new form. The Catholic Church is searching for adequate ways to respond to this phenomenon.
Ecumenical Relations in Hungary Since 1990
Authors: Vogelaar Huub
Published: February 2007

Hungary has a Catholic majority, but a substantial number of Protestants (about 20%), most of them Reformed. There are also several smaller Orthodox communities. Many ethnic Hungarians live outside the boundaries of the present Republic of Hungary. During the Communist period ecumenical events were used by the state to control and use religion. In the period after 1989 the first concern of all denominations was the re-establishment their own communities, including roles in education, social and political life. Ecumenical relations also developed and have led to several new institutions, councils and activities. These new developments are described in this contribution.
International Human Rights, Religious Pluralism and the Future of Chieftaincy in Ghana
Authors: Atiemo Abamfo
Published: February 2007

A revolutionary development that resulted from Africa's experience of colonialism was the emergence of the nation-state made up of previously separate ethnic states. By the end of the colonial period the rulers of these ethnic states — the chiefs — had lost most of their real political and judicial powers to the political leaders of the new nation-states. But in spite of the loss of effective political power the chiefs continued to wield moral influence over members of their ethnic groups. The limited reach of the nation-state in the post-colonial era has also meant a dependence on the chiefs, in many cases, for aspects of local governance. This, for example, is the case of Ghana. However, in the modern context of religious pluralism the intimate bond between the chiefs and the traditional religion exacerbates tension in situations of conflict between people's loyalty to the traditional state and their religious commitment. In some cases, chiefs invoke customary laws in attempt to enforce sanctions against individuals who refuse to observe certain customary practices for religious reasons. But this has implications for the human rights of citizens. This article discusses the implications of this situation for the future of chieftaincy as well as prospects for the protection of the human rights of citizens who for religious reasons choose to stay away from certain communal customary practices.
A Collocation Method for Global Approximation of General Second Order BVPs
Authors: Costabile F. , Napoli A.
Published: February 2007

For the numerical solution of the second order nonlinear two-point boundary value problems a family of polynomial global methods is derived.

Numerical examples provide favorable comparisons with other existing methods.
INVITED PAPER
Authors: Oliva María Moreno , Delgado Mari Carmen Ruiz , Casado Juan , M. Raposo M. Manuela , C. Fonseca A. Maurício , Hartmann Horst , Hernández Víctor , López Navarrete Juan T.
Published: February 2007

series of push-pull chromophores built around thiophene-based . π-conjugating spacers and bearing various types of amino-donors and cyanovinyl-acceptors have been analyzed by means of UV-Vis- NIR spectroscopic measurements. Density functional theory (DFT) calculations have also been performed to help the assignment of the most relevant electronic features and to derive useful information about the molecular structure of these NLO-phores. The effects of the donor/acceptor substitution in the electronic and molecular properties of the .π -conjugated spacer have been addressed. The effectiveness of the intramolecular charge transfer (ICT) has also been tested as a function of the nature of the end groups (i.e., electron-donating or electron-withdrawing capabilities).
Excitation Energies from a Partially Spin-Restricted Wave Function
Authors: Glushkov V.N.
Published: February 2007

A singe Slater determinant consisting of restricted and unrestricted, in spins, parts is proposed to construct a reference configuration for singlet excited states having the same symmetry as the ground one. A partially restricted Hartree-Fock approach is developed to derive amended equations determining the spatial molecular orbitals for singlet excited states. They present the natural base to describe the electron correlation in excited states using the wellestablished spin-annihilated perturbation theories. The efficiency of the proposed method is demonstrated by calculations of electronic excitation energies for the Be atom and LiH molecule.
Two Linear Programming Models for Deriving the Priority Vector of Fuzzy Preference Relation
Authors: Xu Zeshui
Published: February 2007

We are mainly concerned with the decision-making problem with fuzzy preference relation. The key of this issue is how to derive the priority vector of fuzzy preference relation. In this paper, we establish two linear programming models. By solving the model, we can get the priority vector of fuzzy preference relation. The effectiveness and practicality of the developed two models are illustrated with a numerical example.
Error Control in Terms of Linear Functionals Based on Gradient Averaging Techniques
Authors: Korotov S.
Published: February 2007

We show how commonly used gradient averaging techniques can be successfully applied to estimation of computational errors evaluated by linear (goal-oriented) functionals for linear elliptic type problems. General scheme for construction of corresponding estimators is described and effectivity of the proposed approach is demonstrated in numerical tests.
Assessment of the Negentropy Based Stopping Time Criterion in the Diffusive Restoration of Digital Images
Authors: Rodenas F. , Mayo P. , Ginestar D. , Verdú G.
Published: February 2007

One method successfully employed to denoise digital images is the diffusive iterative filtering. An important point of this technique is the estimation of the stopping time of the diffusion process. In this paper, we propose a stopping time criterion based on the evolution of the negentropy of the ’noise signal’ with the diffusion parameter. The nonlinear diffusive filter implemented with this stopping criterion is evaluated by using several noisy test images with different statistics. Assuming that images are corrupted by additive Gaussian noise, a statistical measure of the Gaussianity can be used to estimate the amount of noise removed from noisy images. In particular, the differential entropy function or, equivalently, the negentropy are robust measures of the Gaussianity. Because of computational complexity of the negentropy function, it is estimated by using an approximation of the negentropy introduced by Hyv¨arinen in the context of independent component analysis.
Closed Newton-Cotes Trigonometrically-Fitted Formulae for Numerical Integration of the Schrödinger Equation
Authors: Simos T.E.
Published: February 2007

In this paper we investigate the connection between closed Newton-Cotes formulae, trigonometrically-fitted differential methods, symplectic integrators and efficient solution of the Schr¨odinger equation. Several one step symplectic integrators have been produced based on symplectic geometry, as one can see from the literature. However, the study of multistep symplectic integrators is very poor. Zhu et. al. [1] has studied the symplectic integrators and the well known open Newton-Cotes differential methods and as a result has presented the open Newton-Cotes differential methods as multilayer symplectic integrators. The construction of multistep symplectic integrators based on the open Newton-Cotes integration methods was investigated by Chiou and Wu [2]. In this paper we investigate the closed Newton-Cotes formulae and we write them as symplectic multilayer structures. We also develop trigonometrically-fitted symplectic methods which are based on the closed Newton-Cotes formulae. We apply the symplectic schemes to the well known one-dimensional Schr¨odinger equation in order to investigate the efficiency of the proposed method to these type of problems.
Sexualities, Gender and Ageing
Authors: Heaphy Brian
Published: February 2007

The issue of sexuality is under-studied in the sociology of ageing. This article advocates placing sexuality at the centre of our analyses of ageing and later life in late modernity, by illustrating the issue of non-heterosexual ageing. The article employs personal narratives of lesbians and gay men aged between their fifties and eighties to demonstrate the importance of material, social and cultural resources in shaping their negotiations of ageing and later life. It indicates how sexuality, gender and age interact in influencing these, and argues that non-heterosexual experience illuminates possibilities that exist for both the reconfiguration and resilience of ‘given’ meanings and practices in relation to gender and ageing. It therefore provides insights into the uneven possibilities of reworking and/or undoing cultural meanings and social practices that shape gendered experiences of ageing and later life.
Changing Intergenerational Solidarities within Families in a Mediterranean Welfare State
Authors: Da Roit Barbara
Published: February 2007

Intergenerational solidarity within families is the traditional source of support for dependent elderly people in southern European countries, where care needs have been mainly fulfilled by the unpaid work of women. Recently, the decline of informal care and the persistent lack of supply of formal services have been accompanied by the growth of commercial services mostly provided by migrant women hired by families in the grey market. The article is based on a qualitative study and explores the social processes underlying these changes. It suggests that although intergenerational solidarity is still crucial, it is expressed less through the direct provision of care and more through the supervision of paid services. This shift, which results mainly from a strategy adopted by middle-class women, challenges traditional gender relations and divisions of work. Moreover, it produces employment relations characterized by low pay and underprotection and reflecting conflicts over time and space typically present in informal care relations.
Simulation in University Education:The Artificial Agent PSI as a Teaching Tool
Authors: Künzel Johanna , Hämmer Viola
Published: February 2007

One weakness of undergraduate psychology education in Germany is that students do not have many opportunities to practice their theoretical knowledge. To fill this gap, a new teaching approach has been introduced to the curriculum at the University of Bamberg, Germany.The students conduct experiments with an artificial agent, a computer simulation originating from a cognitive modeling approach. The agent, called “PSI” (see http://web.uni-bamberg.de/ppp/insttheopsy/software for various versions), is the implementation of the PSI theory (see Dörner, D., 1999, Bauplan für eine Seele, Rowohlt, Reinbek).The PSI theory integrates approaches to cognition, emotions, motivation, human action regulation, and perception. One major benefit of the work with the simulation (besides the students gaining practical experience) is that it is possible to convey knowledge about psychological processes and that interaction of different processes difficult to isolate in natural agents become clearly visible to students. In the evaluation of the course, students rated the course as a valuable addendum to the traditional education in psychology.
Antipsychotic prescribing quality and ethnicity — a study of hospitalized patients in south east London
Authors: Connolly Anne , Rogers Paul , Taylor David
Published: February 2007

A number of studies have shown qualitative and quantitative differences in prescribing of antipsychotics according to patient ethnicity. Black patients tend, for example, to be prescribed higher doses of antipsychotics than whites. Few studies have controlled for other factors which may influence prescribing practice and confound results. This study sought to determine whether or not ethnicity was associated with antipsychotic polypharmacy, high dosage and antipsychotic costs before and after adjustment for potential confounding.

We approached inpatients on acute general psychiatry wards at the Maudsley, Bethlem and Lambeth hospitals in south east London. Prescription details were noted. Subjects were interviewed and social and clinical details were recorded. In all, data on 23 potential confounders were collected.

A total of 210 patients were approached of whom 153 agreed to take part. Of the 23 potential confounders, only use of English as a first language and duration of illness differed significantly between blacks and whites. Categorical findings were adjusted for these factors and other potential confounders such as age and gender. Total antipsychotic daily dose was 82.2% of licensed maximum in blacks, and 77.2% in whites ( p=0.48). Antipsychotic polypharmacy was seen in 23.2% of blacks and 16.9% of whites (adjusted odds ratio (OR) 1.11; 95% CI, 0.45-2.75). High dose (> 100% of maximum dose) antipsychotic regimens were prescribed to 15.9% of blacks and 16.9% of whites (adjusted OR, 0.71: 95% CI, 0.27–1.90). Mean monthly cost of treatment was significantly higher in blacks than whites (£182.79 vs £143.08; p=0.02; adjusted OR (> £150/month), 2.45: 95% CI, 1.19–5.08).

Prescribing quality was similar for blacks and whites. Black ethnicity was associated with significantly higher mean monthly medication costs.
The rhetoric of the consumer and customer control in China
Authors: Gamble Jos
Published: February 2007

This article explores the extent to which the rhetoric of the sovereign consumer and the use of the customer as a device of managerial control have been transferred to the subsidiaries of multinational retail firms operating in China. Based upon data drawn from over 200 interviews conducted at UK and Japanese multi-nationals' stores, in this rapidly internationalizing context it was evident that the notion of the sovereign consumer was ubiquitous and procedures designed to inculcate management by customers or consumer control had been implemented. However, it was equally apparent that the rhetoric of the consumer not only served managerial ends, but also provided a rich and fertile resource for shopfloor workers. Meaningful, socially embedded relationships could also play a crucial role in transactions. Moreover, with respect to discipline and control, employees were fully aware that power lay with their managers, rather than disembodied consumers or even actual customers.
The Corporeal Generosity of Maternity
Authors: Hird Myra J.
Published: February 2007

Feminist analyses have made important contributions to the sociocultural experiences of pregnancy, birth and breastfeeding. This article draws upon recent theorizing within science studies to focus on the mattering of these processes. Specifically, the article expands upon Mauss's notion of the ‘gift’, which Diprose develops through the idea of ‘corporeal generosity’. I am interested in corporeal generosity insofar as it circumvents descriptions of relationships in terms of a closed economy in which resources are exchanged without excess or remainder. Corporeal generosity refers to the often missed but nevertheless inescapable debt that a body owes to other bodies. At the same time, this embodied ‘gifting’ is both unpredictable and intrusive – there is as much possibility of threatening the integrity of bodies as there is of opening new possibilities.
Feminism and the Invisible Fat Man
Authors: Bell Kirsten , McNaughton Darlene
Published: February 2007

In this article we argue that the complex connections between gender and fatness have not been fully examined, particularly in so far as they relate to men. We consider the role of early feminist literature in establishing the idea that the fear of fatness is fundamentally tied up with patriarchy and the ways this also underwrites more recent examinations of fatness and gender. Moreover, we assert that popular feminist scholarship has actively produced the assumption that weight is not only a women's issue, but that it is tied up with the very construction of femininity. Through an examination of the cultural history of fatness we show that men have also been caught up in the drive to reshape the body over the last century. However, their concerns have remained largely hidden, framed as they often are in the lexicon of ‘fitness’ and ‘muscularity’. An examination of the limited published material on male concerns with fat reveals that for many men fatness is feminizing – and undermines normative forms of masculinity in threatening ways. We call for further research that considers both female and male experiences of fatness, given the limitations of approaches that focus merely on one or the other.
Clinical and Instrumental (Magnetic Resonance Imaging [MRI] and Multimodal Evoked Potentials) Follow-Up of Brain Lesions in Three Young Patients With Neurofibromatosis 1
Authors: Margari Lucia , Presicci Anna , Ventura Patrizia , Bacca Simona Maria , Iliceto Gianni , Medicamento Nicola , Buttiglione Maura , Perniola Tommaso
Published: February 2007

Diagnosis of neurofibromatosis 1 is based on clinical criteria. In a large number of children with neurofibromatosis 1, magnetic resonance imaging (MRI) reveals high-signal T2-weighted intensities in different brain regions, defined as unidentified bright objects. These lesions are asymptomatic; most of them regress spontaneously with age, but the presence of contrast enhancement or mass effect in them usually strongly suggests an increased risk of proliferative changes. To date, few studies have focused on evoked potentials in patients with neurofibromatosis 1, and the reported abnormalities did not have significant clinical correlations. We describe the clinical and instrumental (MRI and evoked potentials) follow-up of three patients with neurofibromatosis 1. MRI and evoked potentials showed subclinical involvement of the central nervous system. Some MRI T2-weighted hyperintensities showed enhancement and mass effect of uncertain significance. During follow-up, the MRI lesions spontaneously decreased in size or enhancement, allowing us to exclude the hypothesis of proliferative lesions; in the same way, some asymptomatic evoked potential abnormalities disappeared. These findings suggest that both MRI and evoked potentials could be useful in the detection and monitoring of cerebral complications of neurofibromatosis 1.
Oral Baclofen and Clonidine for Treatment of Spasticity in Children
Authors: Lubsch Lisa , Habersang Rolf , Haase Mark , Luedtke Sherry
Published: February 2007

Few data exist in the literature to support the use of high dosages of oral baclofen and clonidine that are frequently required to treat children with spasticity. This study was a retrospective chart review of baclofen and clonidine dosages used in children diagnosed with cerebral palsy or traumatic brain injury. The primary objective was to calculate the mean dosages of baclofen and clonidine based on the duration of spasticity postinjury. Secondary objectives included determining correlations between dosage and age, injury type, location of spasticity, comorbid seizures, or concomitant antispasticity medications. Eighty-seven children receiving baclofen and/or clonidine were included in this study. Mean dosages of 40 mg/day ( n = 86) and 0.4 mg/day ( n = 31) were required for baclofen and clonidine, respectively. The maximum dosage was 240 mg/day for baclofen and 3.6 mg/day for clonidine. Duration postinjury, age, and concomitant antispasticity medications were the most predictive variables for baclofen dosage as a model ( r = .522; P = .000). Duration postinjury and location of spasticity were the most predictive variables for clonidine dosage as a model ( r = .523; P = .000). The average dosages of baclofen and clonidine used in this population of children with cerebral palsy or traumatic brain injury were similar to those reported in the literature, with higher maximum dosages found in this investigation.
Effectiveness of Intermittent Diazepam Prophylaxis in Febrile Seizures: Long-Term Prospective Controlled Study
Authors: Pavlidou Efterpi , Tzitiridou Maria , Panteliadis Christos
Published: February 2007

The efficacy of intermittent rectal diazepam prophylaxis is assessed in the prevention of febrile seizures. In a prospective randomized cohort trial, 139 children (77 girls, 62 boys) who experienced a first febrile seizure were allocated to two groups: group A, which received intermittent diazepam ( n = 68), and group B, which received no prophylaxis ( n = 71). All children had a 3-year follow-up. The inclusion criteria were no personal history of afebrile seizures, normal neurodevelopment, no previous anticonvulsant therapy, and age between 6 months and 3 years. Each group was stratified to low, intermediate, and high risk according to the available clinical data. The 36-month recurrence rates in the no-prophylaxis group were 83% in high-risk patients, 55% in intermediate-risk patients, and 46% in low-risk patients. In the prophylaxis group, the recurrence rates were reduced in all risk groups: 38%, 35%, and 33%, respectively. Intermittent diazepam prophylaxis reduces the recurrence rate mainly in high-risk children provided that sufficient doses are given on time and adequately.
Head Cooling for Exercise-Induced Headache
Authors: Singh Rajeeva Kumar , Martinez Adelaida , Baxter Peter
Published: February 2007

Three normal children with headache occurring only with exertion were advised to try “head cooling” (eg, immersion of the head in cold water, cold water poured over the head, application of a cold, wet towel or ice pack) at the onset of headache. The patients were followed up quarterly as outpatients, and the effectiveness of head cooling in terms of the frequency of headaches, intensity (interference with play), duration, and side effects was assessed over 18 months.
Epilepsy, Parkinsonism, and Neuroleptic Malignant Syndrome in a Child
Authors: Martínez Héctor R. , Cantú-Martínez Leonel , González Humberto C. , Flores Laura de León , Villarreal Héctor J. , Onofre-Castillo Javier
Published: February 2007

A 9-year-old girl with akinetic-rigid parkinsonism with tremor is described. She was hospitalized with neuroleptic malignant syndrome that started 3 days after anticonvulsant drug treatment owing to epileptic seizures. Cranial magnetic resonance imaging (MRI) was normal, and during the follow-up, magnetic resonance spectroscopy revealed a decrement on N-acetylaspartate in the basal ganglia, suggesting neuronal dysfunction. The basal ganglia and dopamine are involved in the pathophysiology of parkinsonism and neuroleptic malignant syndrome and have been recognized in seizure propagation and seizure threshold. Parkinsonism in children is considered an acquired, secondary, and reversible disorder with a dramatic improvement to treatment. However, our patient still has parkinsonism 2 years after diagnosis. This case represents the unusual presentation of epilepsy, parkinsonism, and neuroleptic malignant syndrome, which might have a common pathophysiologic pathway (dopaminergic dysfunction) involving the basal ganglia and the hypothalamus.
The adaptor protein Lad associates with the G protein β subunit and mediates chemokine-dependent T-cell migration
Authors: Park Dongsu , Park Inyoung , Lee Deogwon , Choi Young Bong , Lee Hyunsook , Yun Yungdae
Published: February 2007

Lck-interacting adaptor protein/Rlk/Itk-binding protein (Lad/RIBP) was previously identified as an adaptor protein involved in TCR-mediated T-cell activation. To elucidate the functions of Lad further, we here performed yeast 2-hybrid screening using Lad as bait and discovered that the G protein β subunit (Gβ) is a Lad-binding partner. Since the most well-known G protein–coupled receptor in T cells is the chemokine receptor, we investigated whether Lad is involved in chemokine signaling. We found that, upon chemokine treatment, Lad associated with Gβ in Jurkat T cells. Furthermore, ectopic expression of dominant-negative Lad or the reduction of endogenous Lad expression by siRNA impaired the chemokine-induced migration of T cells, indicating that Lad is required for chemokine-induced T-cell migration. Subsequent investigation of the signaling pathways revealed that, in response to chemokine, Lad associated with the tyrosine kinases Lck and Zap-70 and that Lad was essential for the activation of Zap-70. Moreover, Lad was required for the chemokine-dependent tyrosine phosphorylation of focal adhesion molecules that included Pyk2 and paxillin. Taken together, these data show that, upon chemokine stimulation, Lad acts as an adaptor protein that links the G protein β subunit to the tyrosine kinases Lck and Zap-70, thereby mediating T-cell migration.
The role of antigen-presenting cells in triggering graft-versus-host disease and graft-versus-leukemia
Authors: Chakraverty Ronjon , Sykes Megan
Published: February 2007

After allogeneic blood or bone marrow transplantation, donor T cells interact with a distorted antigen-presenting cell (APC) environment in which some, but not all, host APCs are replaced by APCs from the donor. Significantly, host APCs are required for the priming of acute graft-versus-host disease (GVHD). Donor APCs play a lesser role in the induction of acute GVHD despite their predicted capacity to cross-present host antigens. In contrast, donor APCs may play a role in perpetuating the tissue injury observed in chronic GVHD. Host APCs are also required for maximal graft-versus-leukemia responses. Recent studies have suggested potential strategies by which the continued presence of host APCs can be exploited to prime strong donor immunity to tumors without the induction of GVHD.
Fatal hemorrhage in mice lacking γ-glutamyl carboxylase
Authors: Zhu Aihua , Sun Hongmin , Raymond Richard M. , Furie Barbara C. , Furie Bruce , Bronstein Mila , Kaufman Randal J. , Westrick Randal , Ginsburg David
Published: February 2007

The carboxylation of glutamic acid residues to γ-carboxyglutamic acid (Gla) by the vitamin K–dependent γ-glutamyl carboxylase (γ-carboxylase) is an essential posttranslational modification required for the biological activity of a number of proteins, including proteins involved in blood coagulation and its regulation. Heterozygous mice carrying a null mutation at the γ-carboxylase (Ggcx) gene exhibit normal development and survival with no evidence of hemorrhage and normal functional activity of the vitamin K–dependent clotting factors IX, X, and prothrombin. Analysis of a Ggcx+/− intercross revealed a partial developmental block with only 50% of expected Ggcx−/− offspring surviving to term, with the latter animals dying uniformly at birth of massive intra-abdominal hemorrhage. This phenotype closely resembles the partial midembryonic loss and postnatal hemorrhage previously reported for both prothrombin- and factor V (F5)–deficient mice. These data exclude the existence of a redundant carboxylase pathway and suggest that functionally critical substrates for γ-carboxylation, at least in the developing embryo and neonate, are primarily restricted to components of the blood coagulation cascade.
The Women's international study of long-duration oestrogen after menopause (WISDOM): a randomised controlled trial
Authors: Vickers Madge R , Martin Jeannett , Meade Tom W ,   the WISDOM study team
Published: February 2007

Background

At the time of feasibility work and final design of the trial there was no randomised control trial evidence for the long-term risks and benefits of hormone replacement therapy. Observational studies had suggested that long term use of estrogen was likely to be associated, amongst other things, with reduced risks of osteoporosis and ischaemic heart disease and increased risks of breast and endometrial cancer. Concomitant use of progestogens had been shown to protect against endometrial cancer, but there were few data showing how progestogen might affect estrogen actions on other conditions. Disease specific risks from observational studies suggested that, overall, long-term HRT was likely to be beneficial. Several studies showed that mortality from all causes was lower in HRT users than in non-users. Some secondary cardiovascular prevention trials were ongoing but evidence was also required for a range of outcomes in healthy women. The WISDOM trial was designed to compare combined estrogen and progestogen versus placebo, and estrogen alone versus combined estrogen and progestogen. During the development of WISDOM the Women's Health Initiative trial was designed, funded and started in the US.

Design

Randomised, placebo, controlled, trial.

Methods

The trial was set in general practices in the UK (384), Australia (94), and New Zealand (24). In these practices 284175 women aged 50–69 years were registered with 226282 potentially eligible. We sought to randomise 22300 postmenopausal women aged 50 – 69 and treat for ten years. The interventions were: conjugated equine estrogens, 0.625 mg orally daily; conjugated equine estrogens plus medroxyprogesterone acetate 2.5/5.0 mg orally daily; matched placebo. Primary outcome measures were: major cardiovascular disease, osteoporotic fractures, breast cancer and dementia. Secondary outcomes were: other cancers, all cause death, venous thromboembolism and cerebro-vascular disease.

Results

The trial was prematurely closed during recruitment following publication of early results from the Women's Health Initiative. At the time of closure, 56583 had been screened, 8980 entered run-in, and 5694 (26% of target of 22,300) randomised. Those women randomised had received a mean of one year of therapy, mean age was 62.8 years and total follow-up time was 6491 person years.

Discussion

The WISDOM experience leads to some simple messages. The larger a trial is the more simple it needs to be to ensure cost effective and timely delivery. When a trial is very costly and beyond the resources of one country, funders and investigators should make every effort to develop international collaboration with joint funding.
Willing to wait?: The influence of patient wait time on satisfaction with primary care
Authors: Anderson Roger T , Camacho Fabian T , Balkrishnan Rajesh
Published: February 2007

Background

This study examined the relationship between patient waiting time and willingness to return for care and patient satisfaction ratings with primary care physicians.

Methods

Cross-sectional survey data on a convenience sample of 5,030 patients who rated their physicians on a web-based survey developed to collect detailed information on patient experiences with health care. The survey included self-reported information on wait times, time spent with doctor, and patient satisfaction.

Results

Longer waiting times were associated with lower patient satisfaction (p < 0.05), however, time spent with the physician was the strongest predictor of patient satisfaction. The decrement in satisfaction associated with long waiting times is substantially reduced with increased time spent with the physician (5 minutes or more). Importantly, the combination of long waiting time to see the doctor and having a short doctor visit is associated with very low overall patient satisfaction.

Conclusion

The time spent with the physician is a stronger predictor of patient satisfaction than is the time spent in the waiting room. These results suggest that shortening patient waiting times at the expense of time spent with the patient to improve patient satisfaction scores would be counter-productive.
What did the public think of health services reform in Bangladesh? Three national community-based surveys 1999–2003
Authors: Cockcroft Anne , Andersson Neil , Milne Deborah , Hossain Md Zakir , Karim Enamul
Published: February 2007

Background

Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP). They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP.

Methods

We carried out three household surveys (1999, 2000 and 2003) of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers.

Results

Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition.

Conclusion

Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically helped the poorest people. User satisfaction could be increased if government doctors improved their interaction with patients and if waiting times were reduced by better management of facilities.