bluuebunny/crossref_metadata_2025 huggingface dataset:
Obesity and intermediate clinical outcomes in diabetes: evidence of a differential relationship across ethnic groups
Authors: Millett C. , Khunti K. , Gray J. , Saxena S. , Netuveli G. , Majeed A.
Published: June 2008

Aim  To examine associations between obesity, ethnicity and intermediate clinical outcomes in diabetes.

Methods  Population‐based, cross‐sectional study using electronic primary care medical records of 7300 people with diabetes from White, Black and south Asian ethnic groups.

Results  The pattern of obesity differed within ethnic groups, with rates significantly higher in younger when compared to older Black (women, 63% vs. 44%, P = 0.002; men, 37% vs. 20%, P = 0.005) and south Asian (women, 47% vs. 27%, P = 0.01; men, 21% vs. 13%, P = 0.05) people. Obese people with diabetes were significantly less likely to achieve an established target for blood pressure control (adjusted odds ratio 0.50, 95% confidence interval 0.42, 0.59). Differences in mean systolic blood pressure in obese and normal weight persons were significant in the White group but not in the Black groups or south Asian groups (6.9 mmHg, 1.9 mmHg and 2.7 mmHg, respectively). Differences in mean diastolic blood pressure between obese and normal weight persons were 4.8 mmHg, 3.6 mmHg and 3.4 mmHg in the White, Black and south Asian groups. Mean HbA1c and achievement of an established treatment target did not differ significantly with obesity in any ethnic group.

Conclusions  Obesity is more prevalent amongst younger people than older people with diabetes in ethnic minority groups. The relationship between obesity and blood pressure control in diabetes differs markedly across ethnic groups. Major efforts must be implemented, especially in young people, to reduce levels of obesity in diabetes and improve long‐term outcomes.
100 YEARS OF TARIFF PROTECTION IN AUSTRALIA
Authors: Lloyd Peter
Published: June 2008

This paper presents time series of tariff rates in Australia from the time of Federation. As a preliminary to the construction of economy‐wide series, it constructs series for three broadly representative goods throughout the 100 years: passenger motor vehicles, blankets, and beer. It then constructs two economy‐wide series, one for all imports and another for dutiable imports only. It discusses the main events relating to turning points in the series and concludes with some applications.
THE ROLE OF THE HIGH COURT IN FEDERAL ARBITRATION DURING THE GREAT DEPRESSION: PRESERVING A FUTURE FOR ‘REASON AND MORAL SUASION’?
Authors: Price Rohan
Published: June 2008

Between 1929 and 1933 the Australian federal system of conciliation and arbitration came under economic and political strain. This article reveals that arbitration proved to be an adaptable industrial relations framework for dealing with economic depression. While the monetary entitlements of workers were reduced, the legal instrumentality that conferred the wage cuts, the Arbitration Court, itself defied abolition and evolved to be a protective body. There was a subtle and previously unremarked interaction in the regulatory functions of the High Court, the Arbitration Court, and the Commonwealth Parliament characterised by the purposeful abstention of the High Court and Scullin Government and the activism of the Arbitration Court.
INFORMAL CENTRAL BANK INDEPENDENCE: AN ANALYSIS FOR THREE EUROPEAN COUNTRIES
Authors: Cobham David , Cosci Stefania , Mattesini Fabrizio
Published: June 2008

Changes in formal and informal central bank independence (CBI) in France, Italy and the United Kingdom in the period from the mid‐1970s to the 1990s are examined; the major changes occurred in the 1990s, after the disinflations of the 1980s. Broad trends in the informal independence of central banks (CBs), defined as the ability to pursue price stability regardless of the government's preferences, are identified on the basis of a monetary policy narrative and an analysis of a set of qualitative determinants of informal independence. The most important determinants are the social/political acceptance that monetary policy is the sphere of the CB, the existence of anti‐inflationary commitments in the form of intermediate targets for monetary policy, the degree of social consensus on the means and ends of macroeconomic policy, and the relative technical expertise of the CB. These broad trends help to explain some of the inflation experience of the 1980s and 1990s, which cannot be understood in terms of changes to formal CBI.
UNEMPLOYMENT PERSISTENCE AND THE NAIRU: A BAYESIAN APPROACH
Authors: Berger Tino , Everaert Gerdie
Published: June 2008

This paper estimates the United States and euro area NAIRU in a Bayesian framework. We set out a simple structural model explaining unemployment by demand and supply factors, which are treated as unobserved variables that have observable effects on measured unemployment, output and inflation. The model allows for unemployment persistence and a time‐varying core inflation rate. The results show that although cyclical shocks are very persistent, most of the increase in European unemployment is driven by structural factors. The degree of persistence is lower in the United States but demand shocks seem to be more important in explaining variation in unemployment.
THE (IR)RELEVANCE OF THE NRU FOR POLICY MAKING: THE CASE OF DENMARK
Authors: Karanassou Marika , Sala Hector , Salvador Pablo F.
Published: June 2008

We reconsider the central role of the natural rate of unemployment (NRU) in forming policy decisions. We show that the unemployment rate does not gravitate towards the NRU due to frictional growth, a phenomenon that encapsulates the interplay between lagged adjustment processes and growth in dynamic labour market systems. We choose Denmark as the focal point of our empirical analysis and find that the NRU explains only 33% of the unemployment variation, while frictional growth accounts for the remaining 67%. Therefore, our theoretical and empirical findings raise doubts as to whether the NRU should play such a key instrumental role in policy making.
‘You'd Be Good at That’: Gender Patterns in Parent‐Child Talk about Courses
Authors: Tenenbaum Harriet R.
Published: June 2008

This study examined the parent‐child dyad as a context in which children's gender‐stereotyped course selections are reinforced. Fifty four children from two age groups (Ms = 10.67 and 12.71 years) and their mothers and fathers selected courses for when children reached secondary school. Afterwards, children and parents discussed their decisions. Parents of sons selected fewer foreign language courses than mathematics, language arts or science courses, whereas parents of daughters selected fewer science and foreign language than mathematics or language arts courses. Girls selected fewer science than language arts courses, whereas boys selected fewer foreign language than mathematics or science courses. Although parents' course selections followed gender‐stereotyped patterns for language arts and science, their discouraging comments were not confined to cross‐gender‐stereotyped domains. Instead, parents made more discouraging comments in general to daughters than to sons. Counter to the hypotheses, daughters made more encouraging comments about science courses than did sons while talking to mothers. The findings suggest that parents and children may show gender‐differentiated preferences for children before children are old enough to make course decisions.
“Developing Good Taste in Evidence”: Facilitators of and Hindrances to Evidence‐Informed Health Policymaking in State Government
Authors: JEWELL CHRISTOPHER J. , BERO LISA A.
Published: June 2008

Context: Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real‐life context in which policymakers are situated and make decisions also is crucial to the development of evidence‐informed policy.

Methods: This qualitative study expands on other studies of research utilization at the state level through interviews with twenty‐eight state legislators and administrators about their real‐life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances.

Findings: Hindrances to evidence‐informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence‐based skills; and developing research venues and collaborative relationships in order to generate relevant evidence.

Conclusions: Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence‐informed health policymaking are amenable to change. Policymakers could benefit from evidence‐based skills training to help them identify and evaluate high‐quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy.
State Responses to New Flexibility in Medicaid
Authors: COUGHLIN TERESA A. , ZUCKERMAN STEPHEN
Published: June 2008

Context: States have long lobbied to be given more flexibility in designing their Medicaid programs, the nation's health insurance program for the low‐income, the elderly, and individuals with disabilities. The Bush administration and the Deficit Reduction Act of 2005 have put in place policies to make it easier to grant states this flexibility.

Methods: This article explores trends in states' Medicaid flexibility and discusses some of the implications for the program and its beneficiaries. The article uses government databases to identify the policy changes that have been implemented through waivers and state plan amendments.

Findings: Since 2001, more than half the states have changed their Medicaid programs, through either Medicaid waivers or provisions in the Deficit Reduction Act of 2005. These changes are in benefit flexibility, cost sharing, enrollment expansions and caps, privatization, and program financing.

Conclusions: With a few important exceptions, these changes have been fairly circumscribed, but despite their expressed interest, states have not yet fully used this flexibility for their Medicaid programs. However, states may exercise this newly available flexibility if, for example, the nation's health care system is not reformed or an economic downturn creates fiscal pressures on states that must be addressed. If this happens, the policies implemented during the Bush administration could lead to profound changes in Medicaid and could be carried out relatively easily.
Rethinking Medical Professionalism: The Role of Information Technology and Practice Innovations
Authors: MECHANIC DAVID
Published: June 2008

Context:Physician leaders and the public have become increasingly concerned about the erosion of medical professionalism. Changes in the organization, economics, and technology of medical care have made it difficult to maintain competence, meet patients' expectations, escape serious conflicts of interest, and distribute finite resources fairly. Information technology (IT), electronic health records (EHRs), improved models of disease management, and new ways of relating to and sharing responsibility for patients' care can contribute to both professionalism and quality of care.

Methods:The potential of IT, EHRs, and other practice facilitators for professionalism is assessed through diverse but relevant literatures, examination of relevant websites, and experience in working with medical leaders on renewing professionalism.

Findings:IT and EHRs are the basis of needed efforts to reinforce medical competence, improve relationships with patients, implement disease management programs, and, by increasing transparency and accountability, help reduce some conflicts of interest. Barriers include the misalignment of goals with payment incentives and time pressures in meeting patients' expectations and practice demands. Implementing IT and EHRs in small, dispersed medical practices is particularly challenging because of short‐term financial costs, disruptions in practice caused by learning and adaptation, and the lack of confidence in needed support services. Large organized systems like the VA, Kaiser Permanente, and general practice in the United Kingdom have successfully overcome such challenges.

Conclusions:IT and the other tools examined in this article are important adjuncts to professional capacities and aspirations. They have potential to help reverse the decline of primary care and make physicians' practices more effective and rewarding. The cooperation, collaboration, and shared responsibility of government, insurers, medical organizations, and physicians, as well as financial and technical support, are needed to implement these tools in the United States' dispersed and fragmented medical care system.
Birthweights in sickle cell trait pregnancies
Authors: Tan TL , Seed P , Oteng‐Ntim E
Published: June 2008

Objectives  Available evidence on the effect of sickle cell trait (SCT) on birthweight is conflicting, not gestational age specific, and does not account for maternal and infant factors. The objectives of this study are to determine the contemporary mean birthweight, mean customised birthweight centile, and to analyse the risk of small‐for‐gestational‐age (SGA) and large‐for‐gestational‐age (LGA) babies in SCT pregnancies.

Design  Large retrospective cohort study.

Setting  London hospital.

Population  Singleton pregnancies between 24 and 42 completed weeks delivered between 2000 and 2005 in parturient with body mass index between 18.0 and 35.0 kg/m2.

Methods  All qualifying pregnancies were identified on Terra Nova Healthware. Birthweight centiles of these cases were computed with Gardosi customised bulk centile calculator using collected data on maternal height, weight, ethnicity and parity, and the infant’s gender, gestational age and birthweight. Birthweight and birthweight centiles of SCT and pregnancies with no haemoglobinopathy (control) were compared. Statistical analysis was performed using Stata version 9.2.

Main outcome measures  Birthweight and birthweight centiles.

Results  Five hundred and five SCT and 16 320 controls were analysed. The mean birthweight of SCT pregnancies was 3223 g, 57 g lower than controls (P = 0.024). However, its mean birthweight centile was 49.0% similar to that of controls’ 47.5% (P = 0.320). There is an apparent risk of LGA babies in SCT pregnancies, but logistic regression analysis suggests that the odds are related to being an older non‐white parturient and a male infant rather than SCT status.

Conclusions  SCT is not a risk factor for SGA or LGA infants.
Estimates of maternal risks of pregnancy for women with hereditary haemorrhagic telangiectasia (Osler–Weber–Rendu syndrome): suggested approach for obstetric services
Authors: Shovlin CL , Sodhi V , McCarthy A , Lasjaunias P , Jackson JE , Sheppard MN
Published: June 2008

Objectives  Hereditary haemorrhagic telangiectasia (HHT) affects 1 in 5–8000 individuals. Pregnancy outcomes are rarely reported. The major reason is that most women do not have their HHT diagnosed prior to pregnancy. Using a large well‐characterised series, we studied all pregnancies known to have occurred in HHT‐affected women, whether or not their diagnosis was known at the time of pregnancy. Our aim was to estimate rates and types of major complications of HHT in pregnancy, to guide management decisions.

Design  Cohort study, with prospective, retrospective and familial components.

Setting/Population  Tertiary referral centre population.

Methods  All 262 pregnancies in the 111 women with HHT and pulmonary arteriovenous malformations (PAVMs) reviewed between 1999 and 2005 were studied. Eighty‐two women (74%) did not have a diagnosis of HHT/PAVM at the time of pregnancy. 222 pregnancies in their 86 HHT‐affected relatives were also studied.

Main outcome measures  PAVM bleed, stroke and maternal death.

Results  Thirteen women experienced life‐threatening events during pregnancy: 1.0% (95% CI 0.1–1.9) of pregnancies resulted in a major PAVM bleed; 1.2% (0.3–2.2%) in stroke (not all were HHT related); and 1.0% (0.13–1.9%) in maternal death. All deaths occurred in women previously considered well. In women experiencing a life‐threatening event, prior awareness of HHT or PAVM diagnosis was associated with improved survival (P = 0.041, Fisher’s exact test).

Conclusions  Most HHT pregnancies proceed normally. Rare major complications, and improved survival outcome following prior recognition, means that pregnancy in a woman with HHT should be considered high risk. Recommendations for pregnancy management are provided.
The hidden mortality of transposition of the great arteries and survival advantage provided by prenatal diagnosis
Authors: Blyth M , Howe D , Gnanapragasam J , Wellesley D
Published: June 2008

Objective  To describe the sensitivity of fetal anomaly scanning at detecting transposition of the great arteries (TGA) and to investigate whether prenatal detection improves survival.

Design  Retrospective review of survival by comparing those who had an antenatal diagnosis with those who did not.

Setting  Population‐based study in Wessex region over 13 years.

Population  Babies with isolated TGA and an intact ventricular septum.

Methods  Review of outcomes by comparing those who had an antenatal diagnosis with those who did not.

Main outcome measures  Mortality rates in each group.

Results  TGA occurred more commonly in boys than in girls. Using the existing national screening policy, the antenatal detection rate of TGA was only 6.9% over the study period, improving to 25% in the last 4 years. This contrasts with a 40% detection rate when TGA was associated with a ventricular septal defect (VSD). All the babies who had TGA diagnosed antenatally survived through surgery. Of those who were not diagnosed antenatally, two were stillborn, five died before the diagnosis was made and four died after surgery. Although the difference in survival rates between those who were antenatally diagnosed and those who were not is not statistically significant (χ2= 3.9; P = 0.11), some of these deaths could have been prevented if a prenatal diagnosis had been made.

Conclusions  Improved antenatal diagnosis could lead to a significant reduction in the mortality associated with TGA. The current low detection rate of TGA in the UK could be improved by the inclusion of outflow tract views in routine fetal anomaly scans, and we believe that the extra workload is justified.
Thunderclap Headache After Micturition in Bladder Pheochromocytoma
Authors: Im So‐Hyang , Kim Nam‐Hee
Published: June 2008

A thunderclap headache is a sudden and severe headache and is sometimes a sign of a medical emergency such as aneurysmal subarachnoid hemorrhage and pituitary apoplexy. We report a case of pheochromocytoma in the urinary bladder in a 37‐year‐old man who presented with recurrent thunderclap headache after voiding and exercises. Bladder pheochromocytoma should be included in the differential diagnosis of recurrent thunderclap headache after micturition or exercises.
Ophthalmoplegic Migraine: A Case With Recurrent Palsy of the Abducens Nerve
Authors: Vasconcelos Luiz Paulo , Stancioli Felipe Galvão , Leal Juliana Cardoso , Da Silva Ariovaldo , Gómez Rodrigo Santiago , Teixeira Antônio Lúcio
Published: June 2008

Ophthalmoplegic migraine (OM) is a rare disorder characterized by recurrent episodes of migraine‐like headaches associated with extrinsic ocular musculature palsy. In this article, we report a patient with OM that presented recurrent palsy of the abducens nerve and other atypical features. Case reports of OM with abducens nerve palsy were also reviewed.
Rational Combination Therapy in Refractory Migraine
Authors: Peterlin B. Lee , Calhoun Anne H. , Siegel Sherry , Mathew Ninan T.
Published: June 2008

Refractory migraine (RM) headaches pose important treatment challenges to the patients who live with them and the clinicians who try to treat them. Defined based on the lack of response to acute, preventive, and nonpharmacologic treatment, RM is often treated with a combination of treatments. Although combination therapy for RM has not been systematically studied in randomized trials, clinical experience suggests that a rational approach to RM treatment, utilizing a combination of treatments, may be effective where monotherapy has failed. In this article we briefly identify patient populations appropriate for more aggressive migraine prevention with combination therapy. We then discuss modifiable risk factors and comorbidities in migraine and then focus on the use of rational combination therapy, as well as the duration migraine preventatives should be considered for use. Future research is needed to evaluate the full potential of rational combination treatment as a strategy for treating and ultimately preventing RM.
Refractory Migraine and Chronic Migraine: Pathophysiological Mechanisms
Authors: Goadsby Peter J. , Hargreaves Richard
Published: June 2008

Migraine is a complex disorder of the brain whose mechanisms are only now being unravelled. It is common, disabling, and economically costly. Brain imaging has suggested a role for the brainstem. While the disorder is almost certainly inherited, the degree to which this contributes to a treatment refractory state is not clear. Indeed, no specific structural or pharmacological explanation can be seen from the data as they have been generated. It is clear that patients with more frequent headache are very likely to go on to even more frequent headache, but again these data are complex. A challenge going forward is to establish the biology of these very challenging patients who undoubtedly have substantial disability.
Prevalence and Impact of Migraine Among US Army Soldiers Deployed in Support of Operation Iraqi Freedom
Authors: Theeler Brett J. , Mercer Renee , Erickson Jay C.
Published: June 2008

Objectives.— To assess the prevalence and impact of migraine headaches in US Army soldiers deployed in support of Operation Iraqi Freedom.

Methods.— A brigade of US Army soldiers stationed at Ft. Lewis, Washingtion was given a self‐administered headache questionnaire within 10 days of return from a 1‐year combat tour in Iraq. Soldiers who screened positive for migraine were surveyed again by phone 3 months after return from Iraq.

Results.— In total, 19% of soldiers screened positive for migraine and 17% for possible migraine. Soldiers with a positive migraine screen had a mean of 3.1 headache days per month, a mean headache duration of 5.2 hours, and a mean of 2.4 impaired duty days per month due to headache. Soldiers with migraine made a total of 490 sick call visits for headache over a 3‐month period compared with 90 sick call visits among those with possible migraine. In all, 75% of the soldiers with migraine used over‐the‐counter analgesics and only 4% used triptans. Soldiers with migraine contacted 3 months after returning from Iraq had a mean of 5.3 headache days per month and 36% had a Migraine Disability Assessment Scale grade of 3 or 4.

Conclusions.— Migraine headaches are common in deployed US Army soldiers exceeding the expected prevalence. These headaches result in impaired duty performance and are a frequent cause of sick call visits. Migraine headaches tend to persist after deployment in many soldiers.
Implications of decreased hippocampal neurogenesis in chronic temporal lobe epilepsy
Authors: Hattiangady Bharathi , Shetty Ashok K.
Published: June 2008

Summary

Temporal lobe epilepsy (TLE), characterized by spontaneous recurrent motor seizures (SRMS), learning and memory impairments, and depression, is associated with neurodegeneration, abnormal reorganization of the circuitry, and loss of functional inhibition in the hippocampal and extrahippocampal regions. Over the last decade, abnormal neurogenesis in the dentate gyrus (DG) has emerged as another hallmark of TLE. Increased DG neurogenesis and recruitment of newly born neurons into the epileptogenic hippocampal circuitry is a characteristic phenomenon occurring during the early phase after the initial precipitating injury such as status epilepticus. However, the chronic phase of the disease displays substantially declined DG neurogenesis, which is associated with SRMS, learning and memory impairments, and depression. This review focuses on DG neurogenesis in the chronic phase of TLE and first confers the extent and mechanisms of declined DG neurogenesis in chronic TLE. The available data on production, survival and neuronal fate choice decision of newly born cells, stability of hippocampal stem cell numbers, and changes in the hippocampal microenvironment in chronic TLE are considered. The next section discusses the possible contribution of declined DG neurogenesis to the pathophysiology of chronic TLE, which includes its potential effects on spontaneous recurrent seizures, cognitive dysfunction, and depression. The subsequent section considers strategies that may be useful for augmenting DG neurogenesis in chronic TLE, which encompass stem cell grafting, administration of distinct neurotrophic factors, physical exercise, exposure to enriched environment, and antidepressant therapy. The final section suggests possible ramifications of increasing the DG neurogenesis in chronic epilepsy.
Potential consequences of altered neurogenesis on learning and memory in the epileptic brain
Authors: Wojtowicz Jan Martin
Published: June 2008

Summary

Studies of epilepsy and memory are tied by their common dependence on the hippocampal formation and the adjacent brain structures in the temporal lobe. With the discovery of adult neurogenesis and the consequent revisions of our understanding of how the hippocampus works, the role of neurogenesis in epilepsy needs to be addressed. In this article, we outline two theories describing how neurogenesis contributes to the hippocampus‐dependent learning. We speculate that any drastic changes in neurogenesis will negatively impact the hippocampal memory processing.
Neurogenesis and epilepsy in the developing brain
Authors: Porter Brenda E.
Published: June 2008

Summary

Multiple studies have highlighted how seizures induce different molecular, cellular, and physiologic consequences in an immature brain as compared to a mature brain. In keeping with these studies, seizures early in life alter dentate granule cell birth in different, and even opposing, fashion to adult seizure models (see

Table 1

). During the first week of rodent postnatal life, seizures decrease cell birth in the postictal period, but do not alter the maturation of newborn cells. Seizures during the second week of life have varied effects on dentate granule cell birth, either causing no change or increasing birth, and may promote a mild increase in neuronal survival. During the third and fourth weeks of life, seizures begin to increase cell birth similar to that seen in adult seizure models. Interestingly, animals that experienced seizure during the first month of life have an increase in cell birth during adulthood, opposite to the reported decrease in chronic animals experiencing a prolonged seizure as an adult. Children have more ongoing cell birth in the dentate gyrus than adults, and markers of cell division are further increased in children with refractory temporal lobe epilepsy. There are clear age‐dependent differences in how seizures alter cell birth in the dentate gyrus both acutely and chronically. Future studies need to focus on how these changes in neurogenesis influence dentate gyrus function and what they imply for epileptogenesis and learning and memory impairments, so commonly found in children with temporal lobe epilepsy.

Early seizures alter cell birth in rodent dentate gyrus

Age
Seizure model
Acute and subacute changes in cell birth
Chronic changes in cell birth

1st week of life
Flurothyl
Increased ictala and decreased postictalb
ND

Pilocarpine
Decreased postictalc
Increasedc

Kainate
Decreasedd
ND

2nd week of life
Pilocarpine
Increasede
ND

Kainate
Increasedf
ND

Hyperthermia
No changef,g
Slight increase in newborn cell survivalg (female only)

3rd –4th week of life
Pilocarpine
Increasede,h
Increased in those animals that develop spontaneous seizuresj

Kainate
Increasedi(similar to adults)
ND

ND, not determined.

a

Holmes et al., 2008; bMcCabe et al., 2001; cXiu‐Yu et al., 2007; dLiu et al., 2003; eSankar et al., 2000; fBender et al., 2003; gLemmens et al., 2005; hPorter et al., 2004; iGray et al., 2002; jCha et al., 2004.
Are Elderly Hospitalized Patients Getting Enough Protein?
Authors: Gaillard Cathy , Alix Emmanuel , Boirie Yves , Berrut Gilles , Ritz Patrick
Published: June 2008

OBJECTIVES: To determine the protein requirements of elderly hospitalized patients.

DESIGN: Cross‐sectional evaluation of nitrogen balance.

SETTING: Short‐stay geriatric ward or rehabilitation care unit.

PARTICIPANTS: Thirty‐six elderly hospitalized patients (aged 65–99) admitted to short‐stay and rehabilitation care units.

MEASUREMENTS: Resting energy expenditure and nitrogen balance were determined under usual and spontaneous energy and protein intake after subjects were clinically stable (3–5 days after admission). All items consumed over a 3‐day period were weighed to determine energy and protein intake.

RESULTS: Energy (23.5±6.3 kcal/kg per day) and protein (0.99±0.24 g/kg per day) intake were similar in men and women, and nitrogen balance was neutral (0.37±2.6 g/day; P=.41 vs a neutral nitrogen balance, i.e., 0 g/d). Half of the patients had a positive nitrogen balance. Plasma C‐reactive protein, renal function, nutritional status, and initial diagnosis had no influence on nitrogen balance. In contrast, energy and protein intakes correlated positively with nitrogen balance. Linear regression analysis suggested that an elderly hospitalized patient with an energy intake of 1.31 times resting energy expenditure or greater appears to require a minimum protein intake of 1.06±0.28 g/kg per day.

CONCLUSION: Mean protein intake to reach a neutral nitrogen balance in elderly hospitalized patients is 1.06±0.28 g/kg per day, which is higher than current recommendations for healthy elderly people. Safe protein intake (that would be adequate to ensure that 95% of patients remain in positive nitrogen balance) is difficult to establish.
Erythrocyte‐magnetized technology: an original and innovative method for blood group serology
Authors: Bouix Olivier , Ferrera Virginie , Delamaire Maryvonne , Redersdorff Jean Claude , Roubinet Francis
Published: June 2008

BACKGROUND: Erythrocyte‐magnetized technology (EMT) is a new fully automated method for ABO‐RH‐K phenotyping and antibody detection. The magnetization of red cells avoids centrifugation and washing phases. This report describes the results of an evaluation of this new technology on its specific automated system.

STUDY DESIGN AND METHODS: ABO‐RH‐K phenotyping was compared between EMT and a semiautomated routine method (liquid microplate for ABO‐D and microcolumn system for RH‐K) on 311 patients' samples. The overall performance of the new method was further assessed in daily routine on a total of 11,022 samples during 3 months in two different laboratories. Antibody detection was evaluated on 624 consecutive patients' samples and on 118 frozen samples containing specific antibodies in comparison with commercial microcolumn systems.

RESULTS: Eight of 311 ABO‐RH‐K tests (2.6%) were not interpreted by EMT. Seven of them were weak antigen or reverse grouping reactions showing a negative result with the routine method. On a 3‐month follow‐up, 216 of 11,022 tests (1.96%) were not interpreted by the system, 75 percent of them being due to weak or mixed‐field reactions. EMT was better in detecting ABO‐D mixed‐field reaction than routine microplate method. Detection of clinically significant antibodies was similar between EMT and microcolumn. In contrast, EMT detected a markedly lower rate of presumed nonsignificant antibodies. The system presents an overall high reliability.

CONCLUSION: EMT is tailored to meet the needs of the transfusion service and represents an important advance in the field of immunohematology.
Characterization of Dielectric Particles by Impedance Spectroscopy (Part I)
Authors: Petrovsky Vladimir , Petrovsky Tatiana , Kamlapurkar Swetha , Dogan Fatih
Published: June 2008

Impedance spectroscopy is an effective method to investigate physical properties of multicomponent systems so that contributions of individual components can be extracted from different sections of the spectra, which is frequency dependent. Slurries can be considered as 0–3 mixed systems containing a host liquid and dispersed particles. It was shown that low‐frequency part of impedance spectra is sensitive to dielectric properties of dispersed particles. Applicability of this technique was extended using various dielectric powders dispersed in appropriate liquids. Characterization of slurries by impedance spectroscopy through applying of equivalent circuit models allows a reliable measurement of dielectric constant of particulate materials and liquids.
The Brick Layer Model Revisited: Introducing the Nano‐Grain Composite Model
Authors: Kidner Neil J. , Perry Nicola H. , Mason Thomas O. , Garboczi Edward J.
Published: June 2008

Brick layer models (BLMs), although applicable at the microscale, are inappropriate for characterizing electroceramics at the nanoscale. A new construct, the nano‐grain composite model (n‐GCM), has been developed to model/analyze the AC‐impedance response of equiaxed polycrystalline electroceramics. The procedure employs a set of equations, based on the Maxwell–Wagner/Hashin–Shtrikman effective medium model, to calculate local electrical properties (conductivity, dielectric constant) for both “phases” (grain core, grain boundary) from experimental AC‐impedance spectra and also, for the first time, grain core volume fraction. The n‐GCM method was tested on a model system (a 3D‐BLM material) and demonstrated with a test case (nanograined yttria‐stabilized zirconia). The method appears to be applicable only at nanograin sizes, i.e., 10–100 nm. Limitations of the method, in terms of grain size (10–100 nm) and experimental uncertainty, are also discussed.
Thoracic radiography of pet macaques in Sulawesi, Indonesia
Authors: Schillaci Michael A. , Jones‐Engel Lisa , Heidrich John E. , Benamore R. , Pereira Andre , Paul Narinder
Published: June 2008

This report describes the results from a study of thoracic radiographs taken on a sample (n = 20) of pet macaque monkeys (Macaca) on the Indonesian island of Sulawesi. We present findings relating to general thoracic health, as well as describe our field methods and outline some of the challenges of conducting thoracic radiography in remote areas of the developing world. Examination of the radiographic images identified six possible cases of cardiac enlargement, and one case of minor lung consolidation possibly consistent with tuberculosis. The study did not identify major radiographic evidence of significant respiratory illness in the monkeys as might be expected based on the intense exposure to human respiratory diseases. These largely negative findings may be in part a consequence of image quality which seems to be influenced by power output and incomplete inspiration during film exposure.
Concentration compared with total urinary excretion of 11,17‐DOA in cynomolgus monkey urine
Authors: Hau J. , Royo F.
Published: June 2008

Strees sensitive molecules exhibit great variation in concentration in the circulation and it may often be advantageous to quantify these in urine or feces rather than in serum or plasma. We advocate that all urine‐or feces‐should be collected, and that excretion of stress sensitive molecules should be expressed as amounts excreted per time unit per kg body‐weight, rather than being expressed as concentrations in samples. Urine and feces excretion varies significantly within and between animals over time, which may render simple concentration measures of molecules of little biological relevance.
Molecular cloning, gene expression, and tissue distribution of adiponectin and its receptors in the Japanese monkey, Macaca fuscata
Authors: Kang Kyung‐Hwa , Higashino Atsunori , Kim Heui‐Soo , Lee Yong‐Tae , Kageyama Takashi
Published: June 2008

Background  Adiponectin is an adipocyte‐derived hormone that affects regulation of metabolic syndrome such as insulin resistance, type‐2 diabetes, and obesity. It functions via seven transmembrane domain receptors [i.e., adiponectin receptors 1 (AdipoR1) and 2 (AdipoR2)] that have been scarcely investigated in non‐human primates.

Methods  Molecular cloning of cDNAs for adiponectin, AdipoR1, and AdipoR2 that included the whole protein‐coding region in the Japanese monkey, Macaca fuscata, was carried out. Tissue‐specific expression of respective genes was analyzed with Northern blot hybridization.

Results  The essential Cys36 and four lysine residues in adiponectin, and transmembrane‐spanning domains in AdipoR1 and AdipoR2 appear well conserved. While adiponectin mRNA is expressed only in adipose tissues, AdipoR1 mRNA was found to be expressed in various tissues including the brain.

Conclusions  These results significantly add to the understanding of the molecular basis of obesity‐related adipokines and their receptors in non‐human primates.
Genetic susceptibility to heroin addiction: a candidate gene association study
Authors: Levran O. , Londono D. , O’Hara K. , Nielsen D. A. , Peles E. , Rotrosen J. , Casadonte P. , Linzy S. , Randesi M. , Ott J. , Adelson M. , Kreek M. J.
Published: June 2008

Heroin addiction is a chronic complex disease with a substantial genetic contribution. This study was designed to identify genetic variants that are associated with susceptibility to develop heroin addiction by analyzing 1350 variants in 130 candidate genes. All subjects had Caucasian ancestry. The sample consisted of 412 former severe heroin addicts in methadone treatment, and 184 healthy controls with no history of drug abuse. Nine variants, in six genes, showed the lowest nominalPvalues in the association tests (P < 0.01). These variants were in noncoding regions of the genes encoding the mu (OPRM1; rs510769 and rs3778151), kappa (OPRK1; rs6473797) and delta (OPRD1; rs2236861, rs2236857 and rs3766951) opioid receptors; the neuropeptide galanin (GAL; rs694066); the serotonin receptor subtype 3B (HTR3B; rs3758987) and the casein kinase 1 isoform epsilon (CSNK1E; rs1534891). Several haplotypes and multilocus genotype patterns showed nominally significant associations (e.g.OPRM1;P = 0.0006 andCSNK1E;P = 0.0007). Analysis of a combined effect ofOPRM1andOPRD1showed that rs510769 and rs2236861 increase the risk of heroin addiction (P = 0.0005). None of these associations remained significant after adjustment for multiple testing. This study suggests the involvement of several genes and variants in heroin addiction, which is worthy of future study.
Posttraumatic stress among children in Kurdistan
Authors: Ahmad A
Published: June 2008

Aim: To identify a posttraumatic stress disorder profile for the Child Behaviour Checklist.

Method: Checklist item scores for 806 school‐aged children in Iraqi Kurdistan (201 randomly selected from the general population, 241 orphans, 199 primary medical care visitors and 165 hospital in‐patients) were analysed against the Posttraumatic Stress Symptom Scale for Children (PTSS‐C) scores, estimating not only stress diagnoses, but also nonstress‐related, child‐specific posttraumatic symptoms.

Results: Twenty checklist items, which revealed significant correlations with the stress diagnoses, formed the checklist–stress profile with acceptable reliability and validity, and significant correlation to the PTSS‐C estimates.

Conclusion: A child‐specific stress profile for the checklist is recommended for use as a screening instrument.
EFFECTS OF BLEACHING ON TOOTH STRUCTURE AND RESTORATIONS, PART IV: EFFECTS ON RESTORATIVE MATERIALS
Authors: Swift Edward J.
Published: June 2008

Tooth whitening has become a common treatment over the last 15 years, and much research has been reported on the effects of bleaching procedures on enamel, dentin, and restorative materials. We are presenting a series of Critical Appraisals covering recent research in this area. This final installment describes studies regarding the effects of bleaching agents on various types of restorative materials.
Varied routes of entry into secondary care and delays in the management of lung cancer in New Zealand
Authors: STEVENS Wendy , STEVENS Graham , KOLBE John , COX Brian
Published: June 2008

Aim:  To determine secondary care transit times for lung cancer patients, whether these times conformed to international guidelines and the major factors which influenced these times.

Methods:  An audit of secondary care management in Auckland‐Northland of lung cancer patients diagnosed in 2004 (565 patients) provided the opportunity to assess entry routes into and transit times in secondary care.

Results:  The most common entry route was via the emergency department (ED) (35%, 198 patients), especially for those with metastatic disease (P < 0.0005). The median time from entry to diagnosis was 22 days (interquartile range [IQR]: 11; 42) overall, but only 11 days (IQR: 6; 18) when entry occurred via ED. The median time from entry to treatment was 64 days (38; 93); 59 days (36; 87) for palliative treatment and 76 days (50; 111) for curative treatment. Initiation of treatment within British Thoracic Society recommended times occurred for 41% patients undergoing surgical resection, 36% receiving definitive (56% palliative) radiation therapy and 40% receiving chemotherapy. The factors that influenced transit times in multivariate analysis included the entry route, the presenting symptoms, the investigations performed, the tumor type, multidisciplinary discussion and Maori ethnicity.

Conclusion:  A high proportion of lung cancer patients, especially those treated curatively, were not managed within internationally recommended timeframes. Improved access to primary care may facilitate earlier diagnosis and better resource allocation and prioritizing patients in secondary care may improve the timeliness of treatment for those most likely to benefit from it, thereby improving survival outcomes.
The scattered debris of the Magellanic Stream
Authors: Westmeier T. , Koribalski B. S.
Published: June 2008

Searching the H i Parkes All-Sky Survey and its northern extension, we detected a population of very compact high-velocity clouds (HVCs) with similar velocities in the Galactic standard-of-rest frame which appear to be arranged in several filaments aligned with the nearby Magellanic Stream. A comparison with published O vi/Ca ii absorption and H i emission-line measurements suggests that the HVCs are condensations within an extended and mainly ionized component of the Magellanic Stream. They coincide in position with a faint gas stream predicted in numerical simulations of the Magellanic Clouds by Gardiner & Noguchi. Consequently, the Magellanic Stream could be much more extended than generally believed.
ANALYSIS OF NATURALLY OCCURRING PHENOLIC COMPOUNDS IN AROMATIC PLANTS BY RP‐HPLC AND GC‐MS AFTER SILYLATION
Authors: PROESTOS CHARALAMPOS , KAPSOKEFALOU MARIA , KOMAITIS MICHAEL
Published: June 2008

Aromatic plants of Greek origin, Origanum dictamnus (dictamus), Eucalyptus globulus (eucalyptus), Origanum vulgare L. (oregano), Mellisa officinalis L. (balm mint) and Sideritis cretica (mountain tea) were examined for the content of phenolic substances. Reversed phase high performance liquid chromatography was used for the analysis of the plant extracts. Gas chromatography–mass spectrometry method was also used for identification of phenolic compounds after silylation. The most abundant phenolic acids were gallic acid (1.5–2.6 mg 100 g−1 dry sample), ferulic acid (0.34–6.9 mg 100 g−1 dry sample) and caffeic acid (1.0–13.8 mg 100 g−1 dry sample). (+)‐Catechin and (−)‐epicatechin were the main flavonoids identified in oregano and mountain tea. Quercetin was detected only in eucalyptus and mountain tea.

PRACTICAL APPLICATIONS

Plant‐derived polyphenols receive considerable interest because of their potential antioxidant and antimicrobial properties. Undoubtedly, it is very important not only to determine those properties but also to determine each and every phenol in aromatic plants both qualitatively and quantitatively. A number of analytical methods have been proposed for the separation and determination of these compounds. Most of these protocols are based on a high performance liquid chromatography technique with ultraviolet spectrophotometry. Gas chromatography–mass spectrometry after silylation of the phenolic compounds is used in this research together with the aforementioned technique as an alternative and more sensitive method to detect and understand the compositional profile of the extracts as well as the structure and functional relationship of the components in the extracts, based on MS spectra.
A SIMPLE AND RAPID DETECTION BY PCR OF ENTEROPATHOGENIC ESCHERICHIA COLI IN NATURALLY CONTAMINATED VEGETABLES
Authors: IBENYASSINE KHADIJA , AITMHAND RAJAA , KARAMOKO YAHAYA , ENNAJI MOULAY MUSTAPHA
Published: June 2008

Contaminated vegetables have been identified as one of the principal sources of foodborne illnesses. Escherichia coli is one of the bacteria that can contaminate vegetables and cause serious foodborne disease. The development of simple and rapid assays for detection of E. coli would enable official agencies and food industries to identify contaminated foodstuffs in a timelier manner. In this work, we detected E. coli contamination in four types of vegetables using a 24 h procedure. This method is very specific, rapid and simple to use in the laboratory. Indeed, the enrichment, DNA isolation and polymerase chain reaction (PCR) amplification procedures described here can also be used for detection of E. coli in other foods.

PRACTICAL APPLICATIONS

Foodborne disease remains an important public health threat worldwide; one of the most important food safety hazards is associated with raw vegetables. Several studies have found that products can support the growth of enteric bacterial pathogens such as Salmonella, Shigella and Escherichia coli. Culture techniques are universally recognized as the standard method for detecting pathogenic bacteria in foods. Bacteria are detected and subsequently identified by growth on solid selective culture media and by analysis of metabolic properties or serotyping. This process is lengthy and may last 5–10 days or more. In our investigation, the polymerase chain reaction (PCR) detection of E. coli in vegetables was realized within 24 h. The pre‐enrichment step used in this study did not have any inhibiting effect on the PCR. Therefore, it became possible to rapidly and directly detect E. coli in raw vegetables by the PCR technique just by heating samples.