bluuebunny/crossref_metadata_2025 huggingface dataset:
Governance, globalism and satellites
Authors: Price Monroe E.
Published: November 2008

Governing and regulating the use of communication satellites and their signals is becoming increasingly difficult for governments and multilateral organizations. This article takes forward the question arising from the characterization of satellites as `trade routes in the sky' (Price, 1999), as to whether it is more appropriate to look for regional themes and models for state intervention rather than a global system of governance.
Satellite industry and the digital age
Authors: Bovet Christian , Këllezi Pranvera
Published: November 2008

This article provides an overview of regulatory and governance challenges faced by policy makers in view of increasingly sophisticated information and communication technologies and the growing commercialization of satellite communication. The authors, with expertise in pan-European legal and regulatory regimes, suggest ways in which public interest can be safeguarded.
`Have you seen Bloomberg?'
Authors: Orgad Shani
Published: November 2008

With the proliferation of transnational television flows, viewers can see their national affairs, traditionally covered predominantly by national news, portrayed by cross-border news channels. This article examines how transnational satellite news coverage of national events enhances nations' global visibility, and influences national public debate over national narratives. An analysis of the public debates in Spain and France over transnational channels' coverage of the March 2004 terror bombings in Madrid and the October 2005 French riots, respectively, provides the basis for discussing the implications of the `new visibility' (Thompson, 2005) of nations, in today's media age. The analysis demonstrates how transnational networks' coverage of these events generated estrangement, de-familiarized and cast doubt on national narratives and commonsensical discourses of us/them, thereby offering viewers an alternative distance from their national unit and encouraging a self-reflexive process of introspection and critical discussion. This process may open up the possibility for a more inclusive national space and strengthen democratic culture, but at the same time it triggers instabilities, which might contribute to citizens' loss of trust in the news media — a dangerous scenario for democracy.
Effect of Foot Orthotics on Single- and Double-Limb Dynamic Balance Tasks in Patients With Chronic Ankle Instability
Authors: Sesma Amelia R. , Mattacola Carl G. , Uhl Tim L. , Nitz Arthur J. , McKeon Patrick O.
Published: November 2008

Deficits have been observed in patients with chronic ankle instability while performing dynamic balance tasks. Foot orthotic intervention has demonstrated improvements in static balance following lateral ankle sprain, but the effect is unknown in patients with chronic ankle instability during dynamic balance tasks. Twenty patients with self-reported unilateral chronic ankle instability volunteered for participation. They completed a familiarization session and 2 test sessions separated by 4 weeks. The familiarization session consisted of practice trials of the Star Excursion Balance Test (SEBT) and Limits of Stability (LOS) test, orthotic fitting, and the Cumberland Ankle Instability Tool (CAIT) questionnaire. Patients were instructed to wear the custom-fitted orthotics for at least 4 hours a day to a preferred 8 hours a day for the 4 weeks between sessions. There was an increase in distance reached in the posterolateral direction over the 4-week period in the orthotic condition. There was an increase in distance reached in the medial direction, demonstrating an improvement on the injured side in the orthotic condition after 4 weeks of orthotic intervention. No consistent, meaningful results were observed in the LOS. The involved leg had a significantly lower CAIT score than the uninvolved leg during both sessions, but the involved leg CAIT scores significantly improved over 4 weeks compared with the baseline measure. Orthotic intervention may prove beneficial for improving dynamic balance as measured by the SEBT in individuals with chronic ankle instability and may be a useful adjunct to clinical and sport interventions.
Effect of elevated levels of coagulation factors on the risk of venous thrombosis in long-distance travelers
Authors: Kuipers Saskia , Cannegieter Suzanne C. , Doggen Carine J. M. , Rosendaal Frits R.
Published: November 2008

Risk of venous thrombosis is increased after long-distance travel. Identifying high-risk groups may provide a basis for targeted prevention. We assessed the effect of increased levels of coagulation factors and combinations of risk factors in travelers in a large case-control study. We calculated odds ratios (ORs) for 334 travelers (200 cases and 134 controls) with coagulation factors II (prothrombin), VII, VIII, and IX; fibrinogen, and von Willebrand factor (VWF) above the 80th percentile; for increasing numbers of risk factors; and for specific combinations. The risk was increased in travelers with high FII (OR, 2.2: 95% CI, 1.3-3.7) and FVIII (OR, 6.2, (95% CI, 3.6-10.5) compared with travelers with normal levels. High FIX and fibrinogen levels increased the risk in air travelers (FIX: OR, 3.2; 95% CI, 0.9-11.0; fibrinogen: OR, 2.0; 95% CI, 0.7-5.5) but not in other travelers. The ORs increased with the number of risk factors, and the risk was increased most in women with the combination of oral contraceptives and high FVIII (OR, 51.7; 95% CI, 5.4-498). We conclude that increased levels of FII and FVIII increase the risk of venous thrombosis in travelers. Furthermore, the risk is greatly increased if other risk factors are present as well.
Classification of lymphoid neoplasms: the microscope as a tool for disease discovery
Authors: Jaffe Elaine S. , Harris Nancy Lee , Stein Harald , Isaacson Peter G.
Published: November 2008

In the past 50 years, we have witnessed explosive growth in the understanding of normal and neoplastic lymphoid cells. B-cell, T-cell, and natural killer (NK)–cell neoplasms in many respects recapitulate normal stages of lymphoid cell differentiation and function, so that they can be to some extent classified according to the corresponding normal stage. Likewise, the molecular mechanisms involved the pathogenesis of lymphomas and lymphoid leukemias are often based on the physiology of the lymphoid cells, capitalizing on deregulated normal physiology by harnessing the promoters of genes essential for lymphocyte function. The clinical manifestations of lymphomas likewise reflect the normal function of lymphoid cells in vivo. The multiparameter approach to classification adopted by the World Health Organization (WHO) classification has been validated in international studies as being highly reproducible, and enhancing the interpretation of clinical and translational studies. In addition, accurate and precise classification of disease entities facilitates the discovery of the molecular basis of lymphoid neoplasms in the basic science laboratory.
A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico
Authors: Philbin Morgan M , Lozada Remedios , Zúñiga María Luisa , Mantsios Andrea , Case Patricia , Magis-Rodriguez Carlos , Latkin Carl A , Strathdee Steffanie A
Published: November 2008

Background

The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions.

Methods

We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes.

Results

Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies.

Conclusion

Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.
End-expiratory lung volume during mechanical ventilation: a comparison with reference values and the effect of positive end-expiratory pressure in intensive care unit patients with different lung conditions
Authors: Bikker Ido G , van Bommel Jasper , Miranda Dinis Reis , Bakker Jan , Gommers Diederik
Published: November 2008

Introduction

Functional residual capacity (FRC) reference values are obtained from spontaneous breathing patients, and are measured in the sitting or standing position. During mechanical ventilation FRC is determined by the level of positive end-expiratory pressure (PEEP), and it is therefore better to speak of end-expiratory lung volume. Application of higher levels of PEEP leads to increased end-expiratory lung volume as a result of recruitment or further distention of already ventilated alveoli. The aim of this study was to measure end-expiratory lung volume in mechanically ventilated intensive care unit (ICU) patients with different types of lung pathology at different PEEP levels, and to compare them with predicted sitting FRC values, arterial oxygenation, and compliance values.

Methods

End-expiratory lung volume measurements were performed at PEEP levels reduced sequentially (15, 10 and then 5 cmH2O) in 45 mechanically ventilated patients divided into three groups according to pulmonary condition: normal lungs (group N), primary lung disorder (group P), and secondary lung disorder (group S).

Results

In all three groups, end-expiratory lung volume decreased significantly (P < 0.001) while PEEP decreased from 15 to 5 cmH2O, whereas the ratio of arterial oxygen tension to inspired oxygen fraction did not change. At 5 cmH2O PEEP, end-expiratory lung volume was 31, 20, and 17 ml/kg predicted body weight in groups N, P, and S, respectively. These measured values were only 66%, 42%, and 34% of the predicted sitting FRC. A correlation between change in end-expiratory lung volume and change in dynamic compliance was found in group S (P < 0.001; R2 = 0.52), but not in the other groups.

Conclusions

End-expiratory lung volume measured at 5 cmH2O PEEP was markedly lower than predicted sitting FRC values in all groups. Only in patients with secondary lung disorders were PEEP-induced changes in end-expiratory lung volume the result of derecruitment. In combination with compliance, end-expiratory lung volume can provide additional information to optimize the ventilator settings.
Reproductive medicine and the concept of ‘quality’
Authors: Wahlberg Ayo
Published: November 2008

Selection in reproductive medicine today relies on normative assessments of what ‘good life’ consists of. This paper explores the terms under which such assessments are made by focusing on three particular concepts of ‘quality’: quality of life, biological quality and population quality. It is suggested that the apparently conflicting hypes, hopes and fears that surround reproductive medicine can co-circulate because of the different forms of normative assessment that these concepts allow. To ensure clarity in bioethical deliberations about selection, it is necessary to highlight how these differing forms of assessment are mobilized and invoked in practices of and debates about reproductive medicine.
The regulation of preimplantation genetic diagnosis (PGD) in the Netherlands and the UK: a comparative study of the regulatory frameworks and outcomes for PGD
Authors: Asscher Eva C A
Published: November 2008

Developments in biotechnology present difficult social and ethical challenges that need to be resolved by regulators among others. One crucial problem for regulators of new technologies is to ensure that regulation is both clear and sufficiently flexible to respond to new developments. This is particularly difficult to achieve in contentious fields such as medical biotechnology. In the European Union there is a divergence in the solutions to this problem which has lead to different regulatory frameworks for medical biotechnology. This paper compares and contrasts the British and Dutch regulatory frameworks for the selection of embryos by preimplantation genetic diagnosis as an example of the regulation of medical biotechnology. Some of the outcomes of the regulatory choices and possible reasons behind the divergent frameworks are discussed, such as the ethical outlooks and political systems in these countries.
Through thick and thin: rationalizing the public bioethical debate over therapeutic cloning
Authors: Jensen Eric
Published: November 2008

Beauchamp and Childress (1994) elaborated an approach to bioethical deliberations based on four universalistic principles. This framework of ‘principlism’ has been criticized from within biomedical ethics as insufficient and problematic. However, this article considers a more radical sociological critique by John Evans (2002) that rejects the entire approach of defining ‘principles’ a priori. This sociological critique is based on classical sociologist Max Weber's (1925) distinction between instrumental (‘thin’) and substantive (‘thick’) rationality. As an exploratory assessment of Evans' critique, his conceptualization of ‘thin’ versus ‘thick’ rationalization is applied to a large sample of Anglo-American press coverage ( n = 5126) of the bioethical controversy surrounding therapeutic cloning. Given the role of mainstream news media as a key arena for the discursive framing of biomedical research and its ethical implications, the findings raise important questions about principlism and the mediation of bioethical debates on issues such as therapeutic cloning.
Death and best interests
Authors: Baines Paul
Published: November 2008

I will consider how we can assess the interests of critically ill children who will survive only while aggressive medical support is continued. If aggressive medical support is withdrawn, the child will die shortly afterwards. This is important because when the courts are asked to decide treatments, the standard is that decisions should be made in the best interests of the child. My claim is that this is not a coherent way to consider how some children in this situation should be treated. I will consider two separate aspects of this problem. First, I will argue that there is no objective best interests test and no immediate prospect that we will be able to develop one. Secondly, I will argue that best interests are not a coherent way to consider the interests of children who will die shortly after treatment is withdrawn. To reinforce this claim, I will describe an example of two children where acting in the child's best interests produces counter-intuitive conclusions.
Mentoring for NHS doctors: perceived benefits across the personal–professional interface
Authors: Steven A , Oxley J , Fleming WG
Published: November 2008

Summary

Objective

To investigate NHS doctors' perceived benefits of being involved in mentoring schemes and to explore the overlaps and relationships between areas of benefit.

Design

Extended qualitative analysis of a multi-site interview study following an interpretivist approach.

Setting

Six NHS mentoring schemes across England.

Main outcome measures

Perceived benefits.

Results

While primary analysis resulted in lists of perceived benefits, the extended analysis revealed three overarching areas: professional practice, personal well-being and development. Benefits appear to go beyond a doctor's professional role to cross the personal–professional interface. Problem solving and change management seem to be key processes underpinning the raft of personal and professional benefits reported. A conceptual map was developed to depict these areas and relationships. In addition secondary analysis suggests that in benefitting one area mentoring may lead to consequential benefits in others.

Conclusions

Prior research into mentoring has mainly taken place in a single health care sector. This multi-site study suggests that the perceived benefits of involvement in mentoring may cross the personal/professional interface and may override organizational differences. Furthermore the map developed highlights the complex relationships which exist between the three areas of professional practice, personal wellbeing and personal and professional development. Given the consistency of findings across several studies it seems probable that organizations would be strengthened by doctors who feel more satisfied and confident in their professional roles as a result of participation in mentoring. Mentoring may have the potential to take us beyond individual limits to greater benefits and the conceptual map may offer a starting point for the development of outcome criteria and evaluation tools for mentoring schemes.
Incidence and prevalence of multiple allergic disorders recorded in a national primary care database
Authors: Simpson Colin R , Newton John , Hippisley-Cox Julia , Sheikh Aziz
Published: November 2008

Summary

Background

The co-existence of allergic conditions, food allergy, eczema, allergic rhinitis, asthma and anaphylaxis is thought to be increasing. Analysis of primary healthcare data-sets offers the possibility to advance understanding about the changing epidemiology of multiple allergic disorders.

Aim

To investigate recent trends in the recorded incidence, lifetime prevalence and consulting behaviour of patients with multiple allergic disorders in England.

Methods

QRESEARCH is one of the world's largest national aggregated health databases containing the records of over nine million patients (including those who have left or died). Data were extracted on all patients with a recorded diagnosis of multiple allergic disorders, and annual age–sex standardized incidence and lifetime period prevalence rates were calculated for each year from 2001 to 2005. We also analysed the consulting behaviour of these patients when compared with the rest of the QRESEARCH database population.

Results

The age–sex standardized incidence of multiple allergic disorders was 4.72 per 1000 person-years in 2001 and increased by 32.9% to 6.28 per 1000 patients in 2005 (p<0.001). Lifetime age–sex standardized prevalence of a recorded diagnosis of multiple allergic disorders increased by 48.9% from 31.00 per 1000 in 2001 to 46.16 in 2005 (p<0.001). Over this period, the mean consultation rate to general practitioners for these patients increased from 4.68 to 4.90 consultations per person per year.

Conclusions

Recorded incidence and lifetime prevalence of multiple allergic disorders in England have increased substantially in recent years.
Concrete and abstract visualizations in history learning tasks
Authors: Prangsma Maaike E. , van Boxtel Carla A. M. , Kanselaar Gellof , Kirschner Paul A.
Published: November 2008

Background History learning requires that students understand historical phenomena, abstract concepts and the relations between them. Students have problems grasping, using and relating complex historical developments and structures.

Aims A study was conducted to determine the effects of tasks with abstract and/or concrete visualizations on the learning of historical developments and structures. The hypothesis was that students receiving visualizations would learn and retain more historical knowledge and concepts than those not receiving visualizations.

Sample First‐year pupils in vocational middle school (N = 104) worked in randomly assigned pairs.

Methods After reading a text, the pairs were given a learning task in one of four conditions: Textual, Concrete visualized, Abstract visualized, and Combined.

Results Post‐test and retention test results showed no significant differences. There were some significant differences on the evaluation questionnaire.

Conclusions Combining text and different types of visualizations in learning tasks does not necessarily enhance history learning. Possible explanations given are the ecological setting, the semiotics of the domain of history – that are not defined clearly – and the difficulty of unequivocally visualizing historical concepts.
Who art thou? Personality predictors of artistic preferences in a large UK sample: The importance of openness
Authors: Chamorro‐Premuzic Tomas , Reimers Stian , Hsu Anne , Ahmetoglu Gorkan
Published: November 2008

The present study examined individual differences in artistic preferences in a sample of 91,692 participants (60% women and 40% men), aged 13–90 years. Participants completed a Big Five personality inventory (Goldberg, 1999) and provided preference ratings for 24 different paintings corresponding to cubism, renaissance, impressionism, and Japanese art, which loaded on to a latent factor of overall art preferences. As expected, the personality trait openness to experience was the strongest and only consistent personality correlate of artistic preferences, affecting both overall and specific preferences, as well as visits to galleries, and artistic (rather than scientific) self‐perception. Overall preferences were also positively influenced by age and visits to art galleries, and to a lesser degree, by artistic self‐perception and conscientiousness (negatively). As for specific styles, after overall preferences were accounted for, more agreeable, more conscientious and less open individuals reported higher preference levels for impressionist, younger and more extraverted participants showed higher levels of preference for cubism (as did males), and younger participants, as well as males, reported higher levels of preferences for renaissance. Limitations and recommendations for future research are discussed.
Intergroup contact, friendship quality and political attitudes in integrated and segregated schools in Northern Ireland
Authors: Stringer Maurice , Irwing P. , Giles M. , McClenahan C. , Wilson R. , Hunter J. A.
Published: November 2008

BackgroundThis study examines the effects of integrated and segregated schooling on Northern Irish children's self‐reported contact and friendship with members of the other denominational group in school and community settings.

AimTo assess the effects of cross group friendships and cross group contacts in school and outside school on children's political attitudes.

SampleA cross‐sectional design was employed with 1732 children being assessed at three age levels 11,12 & 14 years in eight‐matched integrated, maintained (Catholic) and controlled (Protestant) schools.

MethodLisrel modelling was used to investigate the interrelationships among cross group friendship quality, cross group contacts in school and outside school and children's political attitudes.

ResultsIntergroup contact within and outside school was reported frequently in integrated schools but only occasionally in segregated schools. Modelling revealed that cross group contacts in school and outside school were both associated with less extreme political attitudes. Friendship quality with cross group members had no significant effects on political attitudes.

ConclusionsThe results provide support for educating Protestants and Catholics together as a means of moderating attitudes and creating cross‐community friendships in a divided society.
The effect of month of birth on the attainments of primary and secondary school pupils
Authors: McPhillips Martin , Jordan‐Black Julie‐Anne
Published: November 2008

Background Previous research has produced conflicting results regarding the effects of season of birth and age‐position on cognitive attainments. In Northern Ireland the school year divides the summer season into two providing an opportunity to evaluate the relative contribution of season of birth and age‐position effects.

Aims To investigate the relationship between attainment in literacy skills and month of birth for primary and secondary school pupils and to determine the relationship between motor skills and month of birth in primary school pupils.

Sample One thousand one hundred and twenty four primary school pupils participated, and results for key stage 3 (KS3) English and GCSE English Language, for 3,493 Year 10 and 3,697 Year 12 secondary school pupils, respectively, were obtained.

Method Primary school pupils were individually assessed using standardised reading and spelling tests, as well as tests of motor skill. They were also assessed using a standardised group reading test in their class groups. For the secondary school pupils, the results for two year cohorts, in KS3 English and GCSE English language, respectively, were analysed.

Results For the primary school pupils there was evidence of both a season of birth and an age‐position effect on all of the cognitive measures, particularly in the early years of schooling. There was, also, evidence of a significant age‐position effect at both KS3 and GCSE in favour of the older pupils. For the younger primary school pupils there was evidence of significant age‐position effects on both motor measures.

Conclusions The findings from the present study suggest that month of birth may be related to both season of birth and age‐position effects. These effects may be compounded, particularly in the early years of primary school, when summer born children are youngest in their year, as in England. In Northern Ireland, age‐position effects are also evident in secondary school public examination results, which may have implications for long‐term life choices.
Emphatic stress shift in German
Authors: Berg Thomas
Published: November 2008

This paper presents an analysis of a sample of intentional deviations from the typical stress pattern of German words. These deviations are described as stress shifts in which the main stress is in a different position to the norm. This process is optional, mainly found in media speech and used for emphatic purposes. All stress shifts involve an interchange of primary and secondary stress, thereby demonstrating their sensitivity to a prosodic-similarity constraint. Stress retractions by far outnumber stress advancements, which can be jointly explained by a probabilistic association of the main stress and the word-initial position in language structure and an anticipatory bias in the language production system. Stress shifts show a strong overrepresentation of adjectives because this word class codes evaluative aspects most naturally and it is evaluations that speakers prefer to emphasize. From a social-psychological perspective, stress shifts are claimed to be a means by which speakers may boast their knowledge and, from a rhetorical perspective, a strategy of making the event being talked about more spectacular. Stress shifts are minority patterns in the sense that the constraints on them are so strong that only relatively few lexical items are eligible. This raises the issue of what speakers do with those items which they wish to emphasize but which do not lend themselves readily to stress shifting. Whether they turn to alternative means of expression or whether they leave their intentions unexpressed remains to be determined.
The Effect of Radial Crack Locations on Load Resistance in C1550 Panel Tests
Authors: Bernard E. S. , Xu G. G.
Published: November 2008

ASTM C1550 has been used for post-crack performance assessment of fiber reinforced concrete (FRC) and shotcrete (FRS) for several years and has proven to be an excellent tool for quality control testing due to the very low level of within-batch performance variability typically obtained using this test method. Experience in the field indicates that the positions of the three radial cracks generated in a test vary between specimens and concerns have been raised by users of this test that specimen performance may change as a result of this variation in crack location. The significance of this aspect of specimen behavior has been investigated to determine the characteristic range of crack rotations experienced in C1550 specimens as a result of variations in crack location and the magnitude of their corresponding influence on post-crack load resistance.
A Review of Peripheral Vascular Deformations due to Respiration and Musculoskeletal Influences
Authors: Cheng Christopher P.
Published: November 2008

The vascular system is extremely dynamic with motions generated from cardiac pulsatility, respiration, and musculoskeletal influences. This paper reviews in vivo non-pulsatile, non-radial deformations in the abdominal aorta, and iliac, superficial femoral, renal, and carotid arteries. Medical imaging modalities and geometric modeling and quantification techniques are also briefly outlined. The axial strain, twisting, and bending deformations of these arteries are essential for establishing the boundary conditions by which to evaluate, regulate, and design vascular implants.
Truffle Wars
Authors: renowden gareth
Published: November 2008

Chinese truffles, close relatives of the French black truffle, arrived on world markets in the middle of the 1990s. Available in quantity at low prices, they were eagerly snapped up by traders facing a steep decline in European production. Despite having less intense flavour, they have captured a large part of world trade in truffles, and their harvest has brought significant economic benefits to rural communities in Sichuan and Yunnan provinces of southern China. In parallel, the development of artificial truffle flavouring has led to an explosion in ersatz ““truffle”” products, and the practice in many restaurants of boosting the flavour of inferior truffles with artificial truffle oils. However, recent expansion of truffle growing in North America and the arrival of southern hemisphere producers from New Zealand and Australia is extending both the quantity of truffle available and the season.
Nina Katchadourian's Genealogy of the Supermarket
Authors: bernat cory
Published: November 2008

For Genealogy of the Supermarket, the contemporary artist, Nina Katchadourian, has created an elaborate and colorful family tree using recognizable, human advertising icons found on packages lining the shelves of the average American grocery store. This essay describes the artwork generally and in some selective detail. Katchadourian's family tree is appreciated for its ability to draw in the viewer with familiar, friendly icons like Aunt Jemima, Mr. Clean and the Jolly Green Giant. Yet, viewers are enabled to see the icons——and the supermarket culture in which many of us interact regularly——in a new light and with unexpected clarity. How does ““personality advertising”” influence how we relate to products and our experience at the supermarket?
Distribution, Abundance, and Population Trends of Bull Trout in Idaho
Authors: High Brett , Meyer Kevin A. , Schill Daniel J. , Mamer Elizabeth R. J.
Published: November 2008

Broad-scale declines in populations of bull trout Salvelinus confluentus over the past century or more led the Idaho Department of Fish and Game to implement statewide no-harvest regulations on bull trout in 1994 and ultimately led to a threatened listing under the U.S. Endangered Species Act in 1998. Despite this listing, quantitative evaluations of trends in abundance and estimates of population size over most of the species' historical range have not been made. We evaluated bull trout distribution, abundance, and trends in abundance using stratified sampling extrapolations of fish surveys (snorkeling and electrofishing) conducted at 2,521 survey sites (most distributed nonrandomly) across 77,447 km of stream. Bull trout were captured at 887 (35%) of the sites. Within the 262 local populations designated by the U.S. Fish and Wildlife Service within seven Idaho recovery units, the number of 70-mm total length and larger bull trout was estimated at 1.13 million; this estimate was most likely biased low due to sampling limitations. Long-term (>20 years) intrinsic rates of change (r) were negative for 10 of 16 bull trout populations up to 1994 (3 were significantly negative; 1 was significantly positive) and were positive for 14 of 17 populations after 1994 (1 was significantly negative; 5 were significantly positive). Over the entire period of record and all trend data sets, r averaged 0.01 ± 0.01 (mean ± 90% confidence interval), suggesting stability at a broad scale. During these same time periods, trends for other salmonids in much of the study area experienced similar declines through 1994 and increases after 1994, suggesting that environmental factors with influence over large geographical areas produced the recent positive trends. Once bull trout populations were detrended by use of linear regression residuals, there was little evidence of synchrony between populations. Our results suggest that despite declines from historical levels, bull trout in Idaho are presently widely distributed, relatively abundant, and apparently stable.
Field-Based Evaluations of Horizontal Flat-Plate Fish Screens
Authors: Rose Brien P. , Mesa Matthew G. , Barbin-Zydlewski Gayle
Published: November 2008

Diversions from streams are often screened to prevent the loss of or injury to fish. Hydraulic criteria meant to protect fish that encounter screens have been developed, but primarily for screens that are vertical to the water flow rather than horizontal. For this reason, we measured selected hydraulic variables and released wild rainbow trout Oncorhynchus mykiss over two types of horizontal flat-plate fish screens in the field. Our goal was to assess the efficacy of these screens under a variety of conditions in the field and provide information that could be used to develop criteria for safe fish passage. We evaluated three different inverted-weir screens over a range of stream (0.24–1.77 m3/s) and diversion flows (0.10–0.31 m3/s). Approach velocities (AVs) ranged from 3 to 8 cm/s and sweeping velocities (SVs) from 69 to 143 cm/s. We also evaluated a simple backwatered screen over stream flows of 0.23–0.79 m3/s and diversion flows of 0.08–0.32 m3/s. The mean SVs for this screen ranged from 15 to 66 cm/s and the mean AVs from 1 to 5 cm/s. The survival rates of fish held for 24 h after passage over these screens exceeded 98%. Overall, the number of fish–screen contacts was low and the injuries related to passage were infrequent and consisted primarily of minor fin injuries. Our results indicate that screens of this type have great potential as safe and effective fish screens for small diversions. Care must be taken, however, to avoid operating conditions that produce shallow or no water over the screen surface, situations of high AVs and low SVs at backwatered screens, and situations producing a localized high AV with spiraling flow.
Comparison of Opioid Requirements and Analgesic Response in Opioid‐Tolerant versus Opioid‐Naïve Patients After Total Knee Arthroplasty
Authors: Patanwala Asad E. , Jarzyna Donna L. , Miller Michael D. , Erstad Brian L.
Published: November 2008

Study Objectives. To compare opioid requirements in opioid‐tolerant and opioid‐naïve patients after total knee arthroplasty, and to compare pain scores, sedation scores, and adverse effects between the groups.

Design. Prospective, observational study.

Setting. Academic medical center.

Patients. Twenty‐nine patients aged 18 years or older who underwent elective total knee arthroplasty between October 1, 2005, and June 31, 2007.

Measurements and Main Results. Patients were classified on the basis of their daily opioid consumption during the week before surgery: those who required 10 mg or less of oral morphine equivalent were considered opioid naïve (20 patients), and those who required at least 30 mg of oral morphine equivalent were opioid tolerant (nine patients). Postoperative opioid consumption, pain scores, sedation scores, and adverse effects were compared between the two groups up to 48 hours after discharge from the postanesthesia care unit (PACU). Postoperative opioid consumption (in intravenous morphine equivalents) was significantly greater in the opioid‐tolerant group than in the opioid‐naïve group in the PACU (median 56 vs 8.2 mg, p=0.0013), during the first 24 hours after discharge from the PACU (108 vs 20.5 mg, p=0.0004), and 24–48 hours after discharge from the PACU (152.3 vs 25 mg, p=0.0001). Pain scores, assessed by using a verbal numeric scale from 0–10, were significantly greater in the opioid‐tolerant group than in the opioid‐naïve group during the first 24 hours after discharge from the PACU (5.9 vs 4.1, p=0.03). We observed no significant difference in pain scores during the other time periods studied. Sedation scores and adverse effects were similar between groups.

Conclusion. After total knee arthroplasty, patients tolerant to opioids required significantly more opioids in the PACU and up to 48 hours after discharge from the PACU than did opioid‐naïve patients. Opioid‐tolerant patients also experienced greater pain during the first 24 hours after discharge from the PACU; however, sedation scores and adverse effects did not appear to be significantly different at any of the time periods studied. Clinicians need to be aggressive with pain management immediately after surgery and ensure that patients restart any opioid treatment at home as soon as possible.
Pharmacokinetics of Ibutilide in Patients with Heart Failure Due to Left Ventricular Systolic Dysfunction
Authors: Tisdale James E. , Overholser Brian R. , Sowinski Kevin M. , Wroblewski Heather A. , Amankwa Kwadwo , Borzak Steven , Kingery Joanna R. , Coram Rita , Zipes Douglas P. , Flockhart David A. , Kovacs Richard J.
Published: November 2008

Study Objective.To assess whether the increased risk of ibutilide‐induced torsade de pointes in patients with heart failure may be due to increased ibutilide exposure, we sought to determine if the pharmacokinetics of ibutilide are altered in patients with heart failure due to left ventricular systolic dysfunction.

Design.Multicenter, prospective pharmacokinetic study.

Setting.Four academic medical centers in the United States.

Patients.Sixteen adult patients with atrial fibrillation or atrial flutter requiring conversion to normal sinus rhythm: six patients who had New York Heart Association (NYHA) class II or III heart failure due to left ventricular dysfunction (mean ± SD left ventricular ejection fraction [LVEF] 30 ± 9%); 10 patients who did not have left ventricular dysfunction (mean ± SD LVEF 54 ± 5% in six of these 10 patients) served as controls.

Intervention.All patients received a single dose of ibutilide 1.0 mg administered intravenously over 10 minutes. Blood samples were obtained through an indwelling catheter in the contralateral arm before ibutilide administration, at the end of the infusion, and at 5, 15, 30, 45 minutes and 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, and 48 hours after the infusion.

Measurements and Main Results.Serum ibutilide concentrations were determined by using high‐performance liquid chromatography and mass spectrometry. No significant differences were noted between the heart failure and normal left ventricular function groups in the following parameters: maximum serum ibutilide concentration (median [interquartile range] 3.8 [2.3–5.7] vs 5.8 [3.1–14.4] μg/L, p=0.31), area under the serum concentration‐time curve from time zero extrapolated to infinity (mean ± SD 11.0 ± 9.4 vs 13.2 ± 10.6 μg * hr/L, p=0.88), steady‐state volume of distribution (1380 ± 334 vs 1390 ± 964 L, p=0.99), systemic clearance (129 ± 60 vs 125 ± 81 L/hr, p=0.92), or half‐life (12.5 ± 10.7 vs 12.4 ± 8.6 hrs, p=0.99).

Conclusion.The pharmacokinetics of ibutilide do not appear to be altered in patients with NYHA class II or III heart failure due to left ventricular systolic dysfunction. Therefore, the increased risk of ibutilide‐induced torsade de pointes in patients with heart failure does not appear to be due to increased ibutilide exposure.
Cost‐Effectiveness of Telavancin versus Vancomycin for Treatment of Complicated Skin and Skin Structure Infections
Authors: Laohavaleeson Somvadee , Barriere Steven L. , Nicolau David P. , Kuti Joseph L.
Published: November 2008

Study Objective. To determine the cost‐effectiveness of telavancin versus vancomycin for the treatment of complicated skin and skin structure infections (cSSSIs).

Design. Pharmacoeconomic analysis conducted from the hospital's perspective using data from the Assessment of Telavancin in Complicated Skin and Skin Structure Infections (ATLAS) phase III clinical trial.

Setting. One hundred twenty‐nine hospitals in the United States and internationally.

Patients. A total of 1044 clinically evaluable patients who were hospitalized with a cSSSI during the ATLAS trial and who received at least one dose of telavancin or vancomycin in the hospital.

Measurements and Main Results. Diagnosis‐related group‐specific hospital bed costs, antibiotic acquisition prices, and cost of vancomycin monitoring were applied to the resource utilization data collected during the ATLAS trial. Infection‐related length of stay (LOSIR) and hospitalization costs (COSTIR) were compared between the telavancin (514 patients) and vancomycin (530 patients) groups. Incremental cost‐effectiveness ratios (ICERs) were calculated for the total population and a subset of patients infected with methicillin‐resistant Staphylococcus aureus (MRSA) by using a 25,000‐sample bootstrap analysis. During sensitivity analyses, the daily acquisition price for telavancin was increased from the equivalent to vancomycin ($13.44) to $50, $100, $150, or $200, and the rate of MRSA acquisition was varied between 30% and 75%. The median (interquartile range) LOSIR was 8 days (6–12 days) for both telavancin and vancomycin (p=0.742), and median (interquartile range) COSTIR was $8118 ($6291‐11,758) and $8185 ($6474‐11,405), respectively (p=0.560). Similar findings were observed for the MRSA subset. Telavancin cost‐effectiveness was greater for the MRSA population versus the total population. During bootstrap analyses of the MRSA population, the ICER for telavancin ranged from dominant (‐$9560) to $27,889 as acquisition price was increased.

Conclusions. Telavancin LOSIR and total COSTIR were similar to those of vancomycin for the treatment of cSSSIs. Particularly in those infected with MRSA, telavancin may be more cost‐effective than vancomycin over the range of acquisition prices tested.
Association of the HistamineN‐Methyltransferase C314T (Thr105Ile) Polymorphism with Atopic Dermatitis in Caucasian Children
Authors: Kennedy Mary Jayne , Loehle Jennifer A. , Griffin Angela R. , Doll Mark A. , Kearns Gregory L. , Sullivan Janice E. , Hein David W.
Published: November 2008

Study Objective.To investigate potential associations between the histamineN‐methyltransferase (HNMT) gene,HNMT, C314T (Thr105Ile) polymorphism and atopic dermatitis in a cohort of Caucasian children.

Design.Prospective, multicenter, genotype‐association study.

Setting.Four academic, tertiary care medical centers within the Pediatric Pharmacology Research Unit network.

Participants.Two hundred forty‐nine Caucasian children aged 6 months‐5 years with atopic dermatitis (127 patients) or without (122 control subjects).

Intervention.Buccal swabs (one swab/cheek) were performed to obtain epithelial cells for extraction of genomic DNA.

Measurements and Main Results.Data were collected on severity of atopic dermatitis, oral antihistamine treatment, and treatment response through parental report. TheHNMTgenotypes were successfully obtained in 116 control subjects and 122 patients with atopic dermatitis. Frequencies of the T314 variant allele (0.12 vs 0.06, p=0.04) and combined CT/TT genotype (0.24 vs 0.12, p=0.02) were significantly higher in children with atopic dermatitis compared with control subjects. Children with genotypes conferring reduced HNMT activity were 2 times more likely to have atopic dermatitis than those who were homozygous for the C314 reference allele.

Conclusion.Increased histamine levels in patients with atopic dermatitis may result, at least in part, from reduced enzymatic inactivation via HNMT. Genetically associated reduction in histamine biotransformation may therefore contribute to the pathogenesis, persistence, and progression of atopic dermatitis. If confirmed, these data indicate thatHNMTgenotype might represent a common risk factor for development of atopic dermatitis, asthma, and allergic rhinitis and may be useful in identifying individuals who are candidates for early preventive pharmacotherapeutic intervention. Additional longitudinal studies will be required to assess the relationship between genotype, disease severity, and antihistamine response.
Optimal Prevention of Seizures Induced by High‐Dose Busulfan
Authors: Eberly Andrea L. , Anderson Gail D. , Bubalo Joseph S. , McCune Jeannine S.
Published: November 2008

High‐dose busulfan is frequently used in a variety of conditioning regimens for hematopoietic cell transplantation. In this setting, busulfan has marked neurotoxicity, specifically causing seizures that generally are tonic‐clonic in character. Phenytoin has been the preferred drug to treat busulfan‐induced seizures, but this practice should be reexamined in light of newer antiepileptic drugs being preferentially used by neurologists. Characteristics of ideal seizure prophylaxis include lack of overlapping toxicity with the conditioning regimen, lack of interference with engraftment of donor cells, and minimal potential for pharmacokinetic drug interactions. Based on these criteria, phenytoin is suboptimal due to possible toxicities and is especially ill suited because of its ability to induce busulfan metabolism. It is postulated that this induction adversely affects efforts to update methods for targeting busulfan doses to individual patients, based on recent developments in the understanding of the pharmacogenomics of busulfan metabolism. The existing clinical data support the use of benzodiazepines, most notably clonazepam and lorazepam, to prevent busulfan‐induced seizures. The second‐generation antiepileptic drug levetiracetam possesses the characteristics of optimal prophylaxis for busulfan‐induced seizures, and early data of its efficacy are promising, although further study is needed.