bluuebunny/crossref_metadata_2025 huggingface dataset:
Terminalia belliricastimulates the secretion and action of insulin and inhibits starch digestion and protein glycationin vitro
Authors: Kasabri Violet , Flatt Peter R. , Abdel-Wahab Yasser H. A.
Published: September 2009

Traditional plant treatments have been used throughout the world for the therapy of diabetes mellitus. The aim of the present study was to investigate the efficacy and mode of action ofTerminalia belliricaused traditionally for the treatment of diabetes in India.T. belliricaaqueous extract stimulated basal insulin output and potentiated glucose-stimulated insulin secretion concentration-dependently in the clonal pancreatic β-cell line, BRIN-BD11 (P < 0·001). The insulin-secretory activity of the plant extract was abolished in the absence of extracellular Ca2+and by inhibitors of cellular Ca2+uptake, diazoxide and verapamil (P < 0·001;n8). Furthermore, the extract did not increase insulin secretion in depolarised cells and did not further augment insulin secretion triggered by tolbutamide or glibenclamide.T. belliricaextract also displayed insulin-mimetic activity and enhanced insulin-stimulated glucose uptake in 3T3-L1 adipocytes by 300 %. At higher concentrations, the extract also produced a 10–50 % (P < 0·001) decrease in starch digestionin vitroand inhibited protein glycation (P < 0·001). The present study has revealed that components inT. belliricaextract stimulate insulin secretion, enhance insulin action and inhibit both protein glycation and starch digestion. The former actions are dependent on the active principle(s) in the plant being absorbed intact. Future work assessing the use ofT. belliricaas a dietary adjunct or as a source of active anti-diabetic agents may provide new opportunities for the treatment of diabetes.
Image-guided, endoscopic removal of migrated titanium dental implants from maxillary sinus: two cases
Authors: Ramotar H , Jaberoo M-C , Koo Ng N K F , Pulido M A , Saleh H A
Published: September 2009

Objective:

We present two cases of dental implant migration into the maxillary sinus, with subsequent removal via image-guided, transnasal endoscopy.

Method:

Presentation of clinical cases, together with a literature review of alternative surgical techniques, the theories behind implant migration, and the benefits of an image-guided, endoscopic approach.

Results:

One patient was asymptomatic, and the other had begun to experience sinogenic symptoms after implant displacement. Both patients presented to the ENT clinic, and both underwent the BrainLab protocol to generate computed tomography images for navigational reconstruction. Transnasal endoscopy was carried out with this guidance, and the implants were removed successfully in both cases. Previously used surgical techniques such as the Caldwell-Luc procedure or extraction through the tooth socket have higher rates of conversion to open procedures, more damage to the nasal sinuses and higher post-operative complication rates compared with the transnasal endoscopic approach.

Conclusion:

Both patients underwent successful removal of their migrated dental implants with no complications, and neither required any follow-up intervention.
The Cold War in Indonesia, 1948
Authors: Poeze Harry A.
Published: September 2009

Existing accounts of the Madiun incident or revolt of September 1948 suggest that it was a mainly domestic incident, with little direct link to international communism, whether through instructions or the international communist line. This paper argues that there were in fact strong links to both. The revolt was closely linked to the return of veteran communist Muso, who arrived from Europe after discussions with communists there, and with a mandate to help the PKI to reform its policies.
‘It's time for the Indochinese Revolution to show its true colours’: The radical turn of Vietnamese politics in 1948
Authors: Vu Tuong
Published: September 2009

Cold War historians have neglected the significance of the year 1948 for Indochina. Based on new sources, this paper shows critical shifts in politics within the Vietnamese nationalist movement in 1948. These were the result of converging developments during late 1947 and early 1948, including changes in international politics, in French–Vietnamese relations, and in the relationship between non-communist and communist leaders within the Việt Minh state. By late 1948, Party ideologues were already looking beyond national independence towards building a new socialist regime. The nationalist coalition that had led the Democratic Republic of Vietnam (DRV) was seriously damaged in 1948, even though civil war would only break out several years later. As elsewhere in Southeast Asia, 1948 thus marked a new period: the beginning of the end of the ‘united front’ period and cooperation with bourgeois nationalists.
‘Strangers’ and ‘stranger-kings’: Thesayyidin eighteenth-century maritime Southeast Asia
Authors: Kathirithamby-Wells Jeyamalar
Published: September 2009

Sayyidi‘strangers’ and ‘stranger-kings’, borne on the eighteenth-century wave of Hadhrami migration to the Malay-Indonesian region, boosted indigenous traditions of charismatic leadership at a time of intense political challenge posed by Western expansion. The extemporary credentials and personal talents which made forsādaexceptionalism and lent continuity to Southeast Asian state-making traditions are discussed with particular reference to Perak, Siak and Pontianak. These case studies, representative of discretesādaresponses to specific circumstances, mark them out as lead actors in guiding the transition from ‘the last stand of autonomies’ to a new era of pragmatic collaboration with the West.
The impact of diet during early life and its contribution to later disease: critical checkpoints in development and their long-term consequences for metabolic health
Authors: Symonds Michael E. , Sebert Sylvain P. , Budge Helen
Published: September 2009

Changes in maternal diet at different stages of reproduction can have pronounced influences on the health and well-being of the resulting offspring, especially following exposure to an obesogenic environment. The mechanisms mediating adaptations in development of the embryo, placenta, fetus and newborn include changes in the maternal metabolic environment. These changes include reductions in a range of maternal counter-regulatory hormones such as cortisol, leptin and insulin. In the sheep, for example, targeted maternal nutrient restriction coincident with the period of maximal placental growth has pronounced effects on the development of the kidney and adipose tissue. As a consequence, the response of these tissues varies greatly following adolescent-onset obesity and ultimately results in these offspring exhibiting all the symptoms of the metabolic syndrome earlier in young adult life. Leptin administration to the offspring after birth can have some long-term differential effects, although much higher amounts are required to cause a response in small compared with large animal models. At the same time, the responsiveness of the offspring is gender dependent, which may relate to the differences in leptin sensitivity around the time of birth. Increasing maternal food intake during pregnancy, either globally or of individual nutrients, has little positive impact on birth weight but does impact on liver development. The challenge now is to establish which components of the maternal diet can be sustainably modified in order to optimise the maternal endocrine environment through pregnancy, thus ensuring feto–placental growth is appropriate in relation to an individual's gender and body composition.
New insights into adipose tissue atrophy in cancer cachexia
Authors: Bing Chen , Trayhurn Paul
Published: September 2009

Profound loss of adipose and other tissues is a hallmark of cancer cachexia, a debilitating condition associated with increased morbidity and mortality. Fat loss cannot be attributable to reduced appetite alone as it precedes the onset of anorexia and is much more severe in experimental models of cachexia than in food restriction. Morphological examination has shown marked remodelling of adipose tissue in cancer cachexia. It is characterised by the tissue containing shrunken adipocytes with a major reduction in cell size and increased fibrosis in the tissue matrix. The ultrastructure of ‘slimmed’ adipocytes has revealed severe delipidation and modifications in cell membrane conformation. Although the molecular mechanisms remain to be established, evidence suggests that altered adipocyte metabolism may lead to adipose atrophy in cancer cachexia. Increased lipolysis appears to be a key factor underlying fat loss, while inhibition of adipocyte development and lipid deposition may also contribute. Both tumour and host-derived factors are implicated in adipose atrophy. Zinc-α2-glycoprotein (ZAG), which is overexpressed by certain malignant tumours, has been identified as a novel adipokine. ZAG transcripts and protein expression in adipose tissue are up regulated in cancer cachexia but reduced with adipose tissue expansion in obesity. Studiesin vitrodemonstrate that recombinant ZAG stimulates lipolysis. ZAG may therefore act locally, as well as systemically, to promote lipid mobilisation in cancer cachexia. Further elucidation of ZAG function in adipose tissue may lead to novel targets for preventing adipose atrophy in malignancy.
Evaluation of speech misattribution bias in schizophrenia
Authors: Stephane M. , Kuskowski M. , McClannahan K. , Surerus C. , Nelson K.
Published: September 2009

Background

The attribution of self-generated speech to others could explain the experience of verbal hallucinations. To test this hypothesis, we developed a task to simultaneously evaluate (A) operations of self-other distinction and (B) operations that have the same cognitive demands as in A apart from self-other distinction. By adjusting A to B, operations of self-other distinction were specifically evaluated.

Method

Thirty-nine schizophrenia patients and 26 matched healthy controls were required to distinguish between self-generated, other-generated and non-generated (self or other) sentences. The sentences were in the first, second or third person and were read in a male or female voice in equal proportions. Mixed multi-level logistic regression models were used to investigate the effect of group, sentence source, pronoun and gender of the heard sentences on response accuracy.

Results

Patients differed from controls in the recognition of self-generated and other-generated sentences but not in general recognition ability. Pronoun was a significant predictor of response accuracy but without any significant interaction with group. Differences in the gender of heard sentences were not significant. Misattribution bias differentiated groups only in the self-other direction.

Conclusions

These data support the theory that misattribution of self-generated speech to others could result in verbal hallucinations. The syntactic (pronoun) factor could impact self-other distinction in subtypes of verbal hallucinations that are phenomenologically defined whereas the acoustic factor (gender of heard speech) is unlikely to affect self-other distinction.
Specificity of cognitive biases in patients with current depression and remitted depression and in patients with asthma
Authors: Fritzsche A. , Dahme B. , Gotlib I. H. , Joormann J. , Magnussen H. , Watz H. , Nutzinger D. O. , von Leupoldt A.
Published: September 2009

Background

Previous studies have demonstrated a specific cognitive bias for sad stimuli in currently depressed patients; little is known, however, about whether this bias persists after recovery from the depressive episode. Depression is frequently observed in patients with asthma and is associated with a worse course of the disease. Given these high rates of co-morbidity, we could expect to observe a similar bias towards sad stimuli in patients with asthma.

Method

We therefore examined cognitive biases in memory and attention in 20 currently and 20 formerly depressed participants, 20 never-depressed patients diagnosed with asthma, and 20 healthy control participants. All participants completed three cognitive tasks: the self-referential encoding and incidental recall task, the emotion face dot-probe task and the emotional Stroop task.

Results

Compared with healthy participants, currently and formerly depressed participants, but not patients with asthma, exhibited specific biases for sad stimuli.

Conclusions

These results suggest that cognitive biases are evident in depression even after recovery from an acute episode but are not found in never-depressed patients with asthma.
The association of cognitive performance with mental health and physical functioning strengthens with age: the Whitehall II cohort study
Authors: Jokela M. , Singh-Manoux A. , Ferrie J. E. , Gimeno D. , Akbaraly T. N. , Shipley M. J. , Head J. , Elovainio M. , Marmot M. G. , Kivimäki M.
Published: September 2009

Background

Cognitive performance has been associated with mental and physical health, but it is unknown whether the strength of these associations changes with ageing and with age-related social transitions, such as retirement. We examined whether cognitive performance predicted mental and physical health from midlife to early old age.

Method

Participants were 5414 men and 2278 women from the Whitehall II cohort study followed for 15 years between 1991 and 2006. The age range included over the follow-up was from 40 to 75 years. Mental health and physical functioning were measured six times using SF-36 subscales. Cognitive performance was assessed three times using five cognitive tests assessing verbal and numerical reasoning, verbal memory, and phonemic and semantic fluency. Socio-economic status (SES) and retirement were included as covariates.

Results

High cognitive performance was associated with better mental health and physical functioning. Mental health differences associated with cognitive performance widened with age from 39 to 76 years of age, whereas physical functioning differences widened only between 39 and 60 years and not after 60 years of age. SES explained part of the widening differences in mental health and physical functioning before age 60. Cognitive performance was more strongly associated with mental health in retired than non-retired participants, which contributed to the widening differences after 60 years of age.

Conclusions

The strength of cognitive performance in predicting mental and physical health may increase from midlife to early old age, and these changes may be related to SES and age-related transitions, such as retirement.
Suicide in recently released prisoners: a case-control study
Authors: Pratt D. , Appleby L. , Piper M. , Webb R. , Shaw J.
Published: September 2009

Background

Recently released prisoners are at markedly higher risk of suicide than the general population. The aim of this study was to identify key risk factors for suicide by offenders released from prisons in England and Wales.

Method

All suicides committed by offenders within 12 months of their release from prison in England and Wales, between 2000 and 2002, were identified. One control matched on gender and date of release from prison was recruited for each case. Univariate and multivariate logistic regression modelling identified key independent risk factors for suicide.

Results

Of 256 920 released prisoners, 384 suicides occurred within a year of release. Factors significantly associated with post-release suicide were increasing age over 25 years, released from a local prison, a history of alcohol misuse or self-harm, a psychiatric diagnosis, and requiring Community Mental Health Services (CMHS) follow-up after release from prison. Non-white ethnicity and a history of previous imprisonment were protective factors.

Conclusions

There is a need to improve the continuity of care for people who are released from prison and for community health, offender and social care agencies to coordinate care for these vulnerable individuals.
Sensitivity to conversational maxims in deaf and hearing children
Authors: SURIAN LUCA , TEDOLDI MARIANTONIA , SIEGAL MICHAEL
Published: September 2009

We investigated whether access to a sign language affects the development of pragmatic competence in three groups of deaf children aged 6 to 11 years: native signers from deaf families receiving bimodal/bilingual instruction, native signers from deaf families receiving oralist instruction and late signers from hearing families receiving oralist instruction. The performance of these children was compared to a group of hearing children aged 6 to 7 years on a test designed to assess sensitivity to violations of conversational maxims. Native signers with bimodal/bilingual instruction were as able as the hearing children to detect violations that concern truthfulness (Maxim of Quality) and relevance (Maxim of Relation). On items involving these maxims, they outperformed both the late signers and native signers attending oralist schools. These results dovetail with previous findings on mindreading in deaf children and underscore the role of early conversational experience and instructional setting in the development of pragmatics.
Associations of plasma IL-8 levels withHelicobacter pyloriseropositivity, gastric atrophy, andIL-8T-251A genotypes
Authors: NAITO M. , EGUCHI H. , GOTO Y. , KONDO T. , NISHIO K. , ISHIDA Y. , KAWAI S. , OKADA R. , HISHIDA A. , WAKAI K. , HAMAJIMA N.
Published: September 2009

There are few data on circulatory pro-inflammatory cytokine levels and cytokine gene polymorphisms inH. pylori-positive patients. A cross-sectional study was conducted to examine the effects ofH. pyloriinfection, gastric atrophy, and theIL-8T-251A polymorphism on plasma IL-8 levels in 98 Japanese adults. Seventy-one subjects were positive forH. pyloriinfection. The geometric mean of plasma IL-8 concentration was significantly higher in subjects withH. pyloriinfection than in those without (P=0·001). The development of atrophy was negatively associated with IL-8 levels in theH. pylori-positive subjects, although not significantly. Plasma IL-8 levels in the T/T genotype were associated withH. pyloriinfection and atrophy status (P=0·016). Our findings suggested that circulating IL-8 levels were associated withH. pyloriinfection. The effect ofH. pyloriinfection on plasma IL-8 levels was not clearly modified by theIL-8T-251A polymorphism.
The utility of seroepidemiology for tracking trends in pertussis infection
Authors: QUINN H. E. , McINTYRE P. B. , BACKHOUSE J. L. , GIDDING H. F. , BROTHERTON J. , GILBERT G. L.
Published: September 2009

Comparing pertussis epidemiology over time and between countries is confounded by differences in diagnostic and notification practices. Standardized serological methods applied to population-based samples enhance comparability. Population prevalence of different levels of pertussis toxin IgG (PT IgG) antibody, measured by standardized methods, were compared by age group and region of Australia between 1997/1998 and 2002. The proportion of 5- to 9-year-olds with presumptive recent pertussis infection (based on IgG levels ⩾62·5 ELISA units/ml) significantly decreased in 2002, consistent with notification data for the same period and improved uptake of booster vaccines following the schedule change from whole-cell to acellular vaccine. In contrast, recent presumptive infection significantly increased in adults aged 35–49 years. Population-based serosurveillance using standardized PT IgG antibody assays has the potential to aid interpretation of trends in pertussis incidence in relation to vaccine programmes and between countries.
Quality of attachment and home environments in children prenatally exposed to PCP and cocaine
Authors: Rodning Carol , Beckwith Leila , Howard Judy
Published: September 2009

Quality of attachment, disorganization in attachment, and the contribution of caregiver interactions in the home were investigated for infants prenatally exposed to PCP and cocaine and their caregivers. The drug-exposed infants were compared with infants of similar ethnicity, socioeconomic status (SES), and living in the same geographical area of the city with non-substance-abusing mothers. The majority of drug-exposed infants were insecurely attached to their caregivers and did not differ in the percentage of security in the three caregiving environments in which the infants were growing up: biologic mother care, kinship care, or foster mother care. The majority of drug-exposed children were disorganized. Change in caregivers during the first year was not found to be related to the rate of insecurity in any of the caregiving environments. The majority of the non-drug-exposed comparison infants were securely attached, and only a small percentage were disorganized. The high incidence of insecurity in the drug-exposed group is discussed in relation to maternal and environmental circumstances that can alter the assumption of security in attachment for the majority of children and caregivers toward insecurity in attachment.
Attachment security in preschoolers with and without externalizing behavior problems: A replication
Authors: Greenberg Mark T. , Speltz Matthew L. , DeKlyen Michelle , Endriga Marya C.
Published: September 2009

This study attempted to replicate previous findings that indicated that preschool-aged children with significant externalizing problems are more likely to have insecure attachment relations than nonproblem peers (Speltz, Greenberg, & DeKlyen, 1990). Fifty children (ages 3–6) and their mothers participated; 25 referred to a child psychiatry clinic for one of the DSM-IIIR Disruptive Behavior Disorders, and 25 matched comparisons without externalizing behavior problems. Attachment was measured at the time of referral using two separation and reunion sequences in a clinic context. We found that 80% of the clinic-referred children were classified as insecure, whereas only 28% of the comparisons were so classified (p <.001). Further, a high percentage of clinic insecure children showed a controlling pattern of attachment. Thus, the present study, with improved methodological rigor, provided an almost exact replication to previous results. The discussion focuses on what contribution attachment research can provide to a developmental psychopathology perspective on early externalizing disorders.
Patterns of individual adaptation across childhood
Authors: Urban Joan , Carlson Elizabeth , Egeland Byron , Sroufe L. Alan
Published: September 2009

Continuity in individual patterns of adaptation and maladaptation was examined across the years from infancy to preadolescence. Forty-seven preadolescent subjects from a 15-year longitudinal study of children at risk for developmental problems participated. Subjects were intensively observed in a 4-week summer daycamp at age 10. Children were then rated on scales of agency, social skill, dependency, positive and negative affect, and ranked on emotional health. In addition, Q-sorts were performed to obtain an overall description of the child's personality, and observations were made of child-adult interactions. Significant differences were found between secure and insecure attachment groups on molar measures of adaptation including social competence and ego resiliency. Children with anxious histories were also rated higher on dependency and were found to be more frequently involved in interactions with adults than children with secure histories. In addition, differences were found in the patterns of adaptation exhibited by children with the two types of anxious attachment history. Children with resistant histories were found to be more often the recipients of adult-initiated contact, specifically support and nurturance, than were children with avoidant attachment histories. Comparison of overall personality style through correlations of composite counselor Q-sorts identified children with secure and resistant attachment histories as most like other children with the same attachment history. Results for avoidant children did not achieve significance. Patterns of contemporary child behavior revealed through counselor Q-sorts were also found to be related to theoretically derived predictions from patterns observed in infancy.
Attachment and depressive symptoms during adolescence: A developmental pathways analysis
Authors: Kobak R. Rogers , Sudler Nanette , Gamble Wendy
Published: September 2009

This article uses a developmental pathway model to consider the role of attachment processes in adolescents' reports of depressive symptoms. Teen attachments were assessed with both interview and observational methods. Assessments of teens' strategies in the Adult Attachment Interview (AAI) indicated that insecure and preoccupied strategies were associated with increased reports of depressive symptoms. Observations of mother-teen problem-solving revealed that depressed teens engaged in interactions characterized by high levels of maternal dominance and dysfunctional anger. Maternal reports of teens' negative life events contributed additional variance to a regression model for depressive symptoms. Gender differences further specified pathways to depressive symptoms. Females reported more depressive symptoms, while depressed males engaged in problem-solving interactions characterized by high levels of dysfunctional anger. Competency-based treatments of depressive symptoms designed to improve parent-teen communication and meta-monitoring skills are discussed.
Family patterns of relationship in normative and dysfunctional families
Authors: Crittenden Patricia M. , Partridge Mary F. , Claussen Angelika H.
Published: September 2009

The relation among family relationships was explored for (a) couple pairings and (b) parent-child dyads. In S3 maltreating and adequate families, mothers' and male partners' quality of attachment (drawn from interviews) was compared with each other and with child quality of attachment (drawn from the Strange Situation). The notion of internal representational models, drawn from attachment theory, provided the basis for seeking continuity, that is, matches and meshes between partners and coherence from parent to child. Both concordance and discordance were found; in particular, a hypothesis of meshed adult relationships and parent-child transformations was supported. The conditions leading to meshed partnerships and transformed parent-to-child patterns require further study. In addition, the results suggest the need for greater incorporation of regulation of affect in assessment procedures, greater theory development, and precision in validation and application of assessment procedures. Finally, this study highlights the advantages of using atypical samples to explore aspects of normative development that are obscured in normative samples.
Marketing foods to children and adolescents: licensed characters and other promotions on packaged foods in the supermarket
Authors: Harris Jennifer L , Schwartz Marlene B , Brownell Kelly D
Published: September 2009

Objective

To analyse cross-promotions targeted to children and adolescents on packaging in the supermarket.

Design

On three occasions from 2006 to 2008, researchers purchased all foods in a large supermarket that included a cross-promotion on the package. A total of 397 products were categorized by promotional partner, food category, targeted age group, promotion type, product nutrition, and company policies on marketing to children.

Results

The number of products with youth-oriented cross-promotions increased by 78 % during the period examined. Overall, 71 % of cross-promotions involved third-party licensed characters and 57 % appealed primarily to children under 12 years of age; however, the use of other forms of promotions increased from 5 % of the total in 2006 to 53 % in 2008, and promotions targeting pre-school and general audiences increased from 23 % to 54 % of the total. Only 18 % of products met accepted nutrition standards for foods sold to youth, and nutritional quality declined during the period examined. Food manufacturers with policies limiting marketing to children represented 65 % of all youth-oriented cross-promotions, their use of cross-promotions increased significantly, and the nutritional quality of their products did not improve. Some media companies did reduce the use of their properties on food promotions.

Conclusions

Overall, the supermarket environment worsened due to an increase in cross-promotions targeted to children and adolescents and a decline in the nutritional quality of these products. This analysis failed to find improvements in food marketing to youth and highlights the need to expand current industry self-regulatory pledges.
Weight retention within the puerperium in adolescents: a risk factor for obesity?
Authors: Thame Minerva M , Jackson Maria D , Manswell Inger P , Osmond Clive , Antoine Matthias G
Published: September 2009

Objective

The present study aimed to investigate weight retention and body composition in the postpartum period between adolescent girls and older women.

Design

A prospective cohort study. Anthropometry and skinfold thickness measurements were performed at the first antenatal visit and at 6 weeks postpartum. An FFQ was administered at 6 weeks postpartum to explore the relationship between diet and postpartum weight retention.

Setting

Clinics at the University of the West Indies, Kingston, Jamaica.

Subjects

Recruitment included women aged 19 years and younger (adolescent girls) and 20 years and older (older women).

Results

Three hundred and forty women were studied. Adolescent girls had significantly lower measurements compared with the older women at the first antenatal visit and at 6 weeks postpartum. Dietary intakes of energy and macronutrients were similar in both groups. Postnatal assessments showed that adolescent girls retained more weight (P= 0·003) and a greater percentage of body fat (P< 0·002) than older women. In multiple regression analyses, 0·982 kg more fat mass was retained postpartum in the adolescent group compared with the older women, while there was no significant difference in lean body mass retained between the two groups.

Conclusions

Adolescent girls retained more weight postpartum and this was predominantly fat mass as opposed to lean body mass.
Slow ion irradiation of sugar: astrobiological implications
Authors: Tuleta M. , Gabla L. , Wickramasinghe N.C.
Published: September 2009

As a result of irradiation by slow hydrogen and argon ions of saccharose, humic films having a fractal nature were produced. The use of hydrogen ions simulated roughly the interaction of low-energy solar wind protons with interplanetary dust grains which, in addition to organic and mineral dust, may include clumps of viable bacteria. The type of film generated by this experimental procedure could play a role in shielding the interior of micron-sized clumps from damaging ultraviolet and low-energy cosmic ray irradiation. We argue that such films may have played a role in processes that led to the initial origin of life, and following the emergence of life the same types of films (as, for instance, in biofilms surrounding cells) may have been modified by irradiation to offer protection to viable cells in the interior.
User choice in European health systems: towards a systematic framework for analysis
Authors: Kreisz Florian P. , Gericke Christian
Published: September 2009

This article proposes a systematic framework for analysis of the increasingly popular concept of user choice in European health systems. The development of such a framework is exemplified using one category of potential choice: the choice of health service provider. In the first part, the paper summarises the conceptual background of the user choice debate. Subsequently, the paper theoretically analyses the concept of user choice alongside a stringent set of standard dimensions embracing technical, administrative and allocative efficiency, as well as equity in access and finance. Reference to available evidence is made where applicable. The employed dimensions are critically discussed and finally mapped against the identified determinants within a systematic matrix framework for analysis. Furthermore, the paper underlines that user choice is by no means a panacea but rather a highly complex and ambiguous political strategy. Extended choice in some sectors and levels of health systems may lead to inefficiencies and may therefore lead to loss of benefits, including choice, for individuals and society.
Co-payments in the NHS: an analysis of the normative arguments
Authors: Weale Albert , Clark Sarah
Published: September 2009

During 2008, some forms of patient co-payments – in particular, patients paying privately for additional medicines as part of an episode of care in the National Health Service – became controversial in political and policy terms in the UK. In response, the UK Government published a report, the Richards’ Review, examining the issues. Richards offered a particular policy solution, but also touched on fundamental principles of social value. Using the methods of normative policy analysis, we seek to understand these principles of social value, accepting the Richards’ framework according to which the relevant arguments can be grouped under the broad headings of equity and autonomy. None of the arguments on either side are decisive, and, in part, the policy decision turns on uncertain empirical conjectures.
Dyspnoe-Algorithmen für Praxis und Notfallstation
Authors: Bingisser Roland
Published: September 2009

Die Abklärung der Dyspnoe in Notfallsituationen ist ein kritischer Teil der Patientenevaluation, speziell wenn kardiopulmonale Krankheiten vermutet werden. Weil Dyspnoe ein Symptom ist, das wie Hunger oder Durst verschiedensten afferenten Mechanismen unterliegt, kommt eine Vielzahl von Ursachen, alleine oder in Kombination in Frage. Qualitative und quantitative Aspekte von mühsamer oder erschwerter Atmung variieren stark zwischen den einzelnen Patienten. Deshalb ist es unter Zeitdruck enorm wichtig, einerseits differentialdiagnostisch breit zu denken, andererseits aber auch standardisiert vorzugehen.
From dyspnea to pulmonary embolism
Authors: Perrier Arnaud
Published: September 2009

Pulmonary embolism (PE) is often evoked in patients with new-onset or worsening dyspnea, especially when it is associated with pleuritic chest pain. However, the prevalence of PE in patients with a clinical suspicion ranges from 20 % to as low as 5 %. Unfortunately, what exactly constitutes a clinical suspicion of PE in a patient with dyspnea can not be accurately standardized. The presence of risk factors for venous thromboembolism should prompt the search for PE. However, their absence does not rule out PE as the cause of the patient’s symptoms, since around 30 % of patients with a first episode of PE have no risk or precipitating factors. Once PE is suspected, the diagnostic workup can be standardized and based on a large body of evidence, combining clinical assessment by a prediction rule, D-dimer measurement and CT angiography in patients with an elevated D-dimer level or a high clinical probability of PE. Patients with obvious alternative diagnoses such as acute left heart failure, pneumonia or acute coronary syndrome should not be investigated for PE.
Der COPD-Patient mit akuter Atemnot
Authors: Christ Michael , Heppner Hans Jürgen
Published: September 2009

Das Vorhandensein einer chronisch obstruktiven Lungenerkrankung (COPD) gilt als wichtiger Risikofaktor für kardiovaskuläre Begleiterkrankungen. Deshalb ist die hohe Sterblichkeit bei COPD-Patienten zum einen auf maligne Tumorerkrankungen aber auch auf die kardiovaskuläre Komorbidität zurückzuführen. Patienten mit COPD weisen in etwa 20 – 30 % der Fälle eine akute Herzinsuffizienz auf. Sie wird jedoch häufig unter- oder verspätet diagnostiziert und damit nicht adäquat therapiert. Das diagnostische Dilemma lässt sich durch das vergleichbare Beschwerdebild und die Ähnlichkeit der klinischen Untersuchungsbefunde erklären. Deshalb ist es wichtig, dass bei COPD-Patienten mit akuter Atemnot die wichtige Differentialdiagnose einer akuten Herzinsuffizienz berücksichtigt wird. Die Bestimmung natriuretischer Peptide ist hervorragend geeignet, auch bei Patienten mit bekannter COPD und akuter Atemnot zwischen pulmonaler und kardialer Ursache der Atemnot zu differenzieren. Bei BNP Werten unter 100 pg/mL bzw. NT-proBNP Werten unter 300 pg/mL (1000 pg/mL bei Intensivpatienten) lässt sich eine kardiale Ursache der Atemnot mit hoher Sicherheit ausschließen. Die Diagnose einer akuten Herzinsuffizienz („rule in“) kann jedoch nicht durch alleinige Interpretation der Plasmaspiegel natriuretischer Peptide erfolgen, sondern sollte anamnestische Angaben sowie klinische und technische Untersuchungsbefunde (z. B. Echokardiographie) mit einbeziehen. Die Bestimmung natriuretischer Peptide ermöglicht bei Patienten mit pulmonalen Vorerkrankungen und akuter Atemnot eine kosteneffektivere Betreuung betroffener Patienten.
Joint Passive/Controlled Source Seismic Experiment Across Taiwan
Authors: Okaya David , Wu Francis , Wang Chien‐Ying , Yen Horng‐Yuan , Huang Bor‐Shouh , Brown Larry , Liang Wen‐Tzong
Published: September 2009

Scientists who study Earth structures and interactions at tectonic plate boundaries illuminate the three‐dimensional (3‐D) subsurface primarily through passive or active source seismic studies. In passive source studies, natural earthquakes are observed through arrays of seismic stations, allowing seismologists to image structures at depth and infer physical properties of the Earth. In active (controlled) source studies, scientists provide an artificial seismic source to be recorded by seismic networks, allowing more detailed views of fine‐scale structures buried within plate boundaries.

The use of “continuous” modes on large‐storage‐capacity seismic recording systems enables seismologists to blur traditional lines between active and passive source seismology in regions of high earthquake activity. In addition to generating seismograms from controlled sources, a deployed dense array can record local and teleseismic earthquakes with exceptionally coherent signals across its aperture. As a result of such joint recording, the scientific value of the collected data increases. Moreover, whether or not the seismic sources are natural or engineered becomes less of a factor for data storage, sorting, and analysis methods. Local earthquakes can supplement controlled sources, multichannel processing and imaging methods traditionally used in active seismic studies become amenable to dense sets of passive source data, and active source data with known source origin times and locations are easily incorporated into regional seismic 3‐D tomography and earthquake location studies.
Origins of the Word “Phenology”
Authors: Demarée Gaston R. , Rutishauser This
Published: September 2009

Observing and documenting life cycle stages of plants and animals have been tradition and necessity for humans throughout history. Phenological observations—as called by their modern scientific name—were key to successful hunting and farming because the precise knowledge of animal behavior and plant growth, as well as their timing with changing seasons, was critical for survival.

In today's context of environmental awareness and climate change research, phenological observations have become prime indicators of documenting altered life cycles due to environmental change in disciplines from biology to climatology, geography, and environmental history. Observations on the ground, from space, and from models of different complexity describe intra‐annual and interannual changes of life cycles at individual, pixel, or grid box scale.
Carbon Cycle Observations: Gaps Threaten Climate Mitigation Policies
Authors: Birdsey Richard , Bates Nick , Behrenfeld Mike , Davis Kenneth , Doney Scott C. , Feely Richard , Hansell Dennis , Heath Linda , Kasischke Eric , Kheshgi Haroon , Law Beverly , Lee Cindy , McGuire A. David , Raymond Peter , Tucker Compton J.
Published: September 2009

Successful management of carbon dioxide (CO2) requires robust and sustained carbon cycle observations. Yet key elements of a national observation network are lacking or at risk. A U.S. National Research Council review of the U.S. Climate Change Science Program earlier this year highlighted the critical need for a U.S. climate observing system to meet requirements of mitigation policies for improved carbon cycle observations. This Forum highlights the most significant gaps and threats to carbon cycle observations—including observations from satellites; in situ observations of land, ocean, and aquatic systems; and direct atmospheric measurements—and suggests ways to improve the U.S. national effort.
Comment on “On AGU's Position Statement, ‘Human Impacts on Climate’”
Authors: Evans Rob
Published: September 2009

Regarding the Forum by Cyril Galvin (Eos, 89(46), 459, 2008), while I understand AGU's willingness to present both sides of the coin, as it were, I am disappointed that this Forum appeared in Eos.

One major point in question is the assertion by Galvin that “nowhere on the sandy ocean shores of the world is there a beach whose erosion has been documented to be caused by sea level rise.” This point disregards the fact that coastal barrier systems have been moving landward for the last several thousand years, driven by rising sea level. Yes, the picture is complex, and yes, wave action and storms, in addition to constraints on sediment supply—many of them heavily influenced in the present day by societal actions—are also important: Some beaches will erode without rising sea level if they are starved of new sediment to replace that removed by wave‐driven, alongshore currents, and it is of course the waves that move the sediment around.
Spatial distribution of average vorticity in the high‐latitude ionosphere and its variation with interplanetary magnetic field direction and season
Authors: Chisham G. , Freeman M. P. , Abel G. A. , Bristow W. A. , Marchaudon A. , Ruohoniemi J. M. , Sofko G. J.
Published: September 2009

We present a technique to measure the magnetic field‐aligned vorticity of mesoscale plasma flows in the F region ionosphere using line‐of‐sight velocity measurements made by the Super Dual Auroral Radar Network (SuperDARN). Vorticity is often used as a proxy for magnetic field‐aligned current (FAC) intensity in the ionosphere but also provides information about turbulent processes in the ionosphere and magnetosphere. Using 6 years (2000–2005 inclusive) of vorticity measurements made by six SuperDARN radars in the Northern Hemisphere, we have compiled, for the first time, maps of average vorticity across the northern polar ionosphere. These maps have been subdivided according to different seasonal and interplanetary magnetic field (IMF) conditions. The variations in the morphology of the vorticity maps with IMF direction match very closely those seen in maps of average FAC intensity (determined using different methods and instrumentation), suggesting that vorticity is a good proxy for FAC in an averaged sense. The variations in the morphology of the vorticity maps with season show differences from those seen in the FAC maps, illustrating that ionospheric conductance plays a major role in determining the differences between measurements of vorticity and FAC.
Mouse strains with point mutations in TAP1 and TAP2
Authors: Theodoratos Angelo , Whittle Belinda , Enders Anselm , Tscharke David C , Roots Carla M , Goodnow Christopher C , Fahrer Aude M
Published: September 2009

We report two new mouse strains: Jasmine (C57BL/6J/Apb‐Tap2jas/Apb), with a point mutation in the transporter associated with antigen processing (TAP)2 ; and Rose, (C57BL/6J/Apb‐Tap1rose/Apb), with a point mutation in TAP1. These strains were detected as the result of ethyl nitroso urea (ENU) screens for recessive point mutations affecting the immune system. As expected in cases of defective TAP expression, the mice have very low major histocompatibility complex (MHC)‐I cell‐surface expression, and few CD8+ T cells. The Rose strain has an A to T substitution in exon 10 of TAP1, resulting in an asparagine to valine substitution at position 643. Jasmine has an A to C transversion in exon 5 of TAP2, resulting in a threonine to proline substitution at position 293 of the protein. The mutation does not affect mRNA levels, but results in a very severe reduction in TAP2 protein. TAP1 protein levels are also decreased in Jasmine mice, demonstrating a new role for mouse TAP2 in stabilizing TAP1 protein expression. Jasmine is the first strain available with defective TAP2. The two mouse strains provide additional animal models for the human condition Bare Lymphocyte syndrome type 1, and identify new residues important for TAP function.
Physicians' Views on Generic Medicines: A Narrative Review
Authors: Hassali Mohamed Azmi , Shafie Asrul Akmal , Awaisu Ahmed , Ibrahim Mohamed Izham , Ping Chong Chee , Jamshed Shazia
Published: September 2009

Most countries are facing escalating health-care expenditures. A recent trend to control these staggering increases in costs is to encourage the use of generic medicines. Physicians are at the centerpiece of the medication use process as they are the dominant prescribers in all clinical settings. It is therefore prudent to examine what they perceive about generic medicines. The current study attempts to identify and review the literature on physicians' perceptions and practices on the use of generic medicines. Using subject-related keywords, an extensive literature search was undertaken through indexing services available in the authors' institution's library. Full text papers written in English language between 1980 and 2008 were retrieved and reviewed. Fourteen studies, majority ( n = 5) from the United States were reviewed and included. Most of the studies used quantitative methodology. Generally, physicians were neutral to slightly supportive on the use of generic medications. Most of the studies reviewed highlighted the factors that can influence physicians' views as policy-related issues, patient-related variables, drug characteristics and physician-related variables. Although physicians accept generic substitution under policy and economic pressures, they still have concerns about the overall quality and reliability of generic drugs as well as generic interchange of certain drug categories.
US electricity grid still vulnerable to electromagnetic pulses
Authors: Kramer David
Published: September 2009

Experts warn lawmakers that an intense solar storm or an attack by a single nuclear weapon could knock out power in an entire region for months.
Spatial Linear Regression from Census Microdata: Combining Microdata and Small Area Data
Authors: Nagle Nicholas N
Published: September 2009

Census microdata have become an extremely valuable source of information in social sciences research. These data, however, must have very coarse geographic resolution in order to protect respondent anonymity. Thus the geographic scale of these microdata sources is drastically different from the scale of many spatial processes—particularly neighborhood-scale processes. It is suggested that this difference in geographic scales creates a problem of conclusion validity for regression models which use anonymized microdata: measures of statistical significance are biased in these models. A correction to this problem in which small area data and population-density maps are used to estimate the effects of spatial dependence is presented. Monte Carlo evidence is presented which demonstrates that the conclusion-validity problem may be severe in practice. Further, this evidence shows that the suggested correction with small area data restores conclusion validity to statistical tests.