bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of dynamic sentinel lymph node biopsy in patients with squamous cell carcinoma of the penis and palpable inguinal nodes
Authors: Heyns Chris F. , Theron Pieter D.
Published: April 2008

OBJECTIVE

To evaluate dynamic sentinel lymph node biopsy (DSLNB) in patients with squamous cell carcinoma (SCC) of the penis and palpable inguinal lymph nodes, using inguinal lymph node dissection (ILND) as the reference standard to assess the reliability of DSLNB, as using radioscintigraphy and colloidal blue‐dye injection to locate the SLN was reported to be a useful technique to avoid ILND in men with SCC of the penis and clinically impalpable nodes.

PATIENTS AND METHODS

The study included 23 consecutive men with SCC of the penis and clinically palpable inguinal nodes treated between August 1999 and July 2006. On the day before surgery the patient had the SLN located by subcutaneous injection of 60 MBq 99mTc‐nanocolloid 2 cm proximal to the penile tumour. The following day the patient was taken to the operating room for DSLNB, resection of the penile tumour and simultaneous ILND, if considered indicated (G2‐3 and/or T3‐4 primary tumour). During surgery 2 mL of colloidal blue dye was injected in the same area as the previous 99mTc‐nanocolloid injection. The SLNs were located during surgery using a γ‐probe and visualization of blue dye in the node(s), which were then surgically removed. After partial or total penectomy, selected patients had ILND through a 10‐cm subinguinal incision. The primary tumour, SLNs and ILND specimens were assessed histopathologically, using haematoxylin and eosin staining only.

RESULTS

Biopsy of the primary tumour showed SCC grade 1 in six, grade 2 in 13 and grade 3 in two patients. The clinical T stage was T1 in two, T2 in seven, T3 in 13 and T4 in one. There were clinically palpable inguinal lymph nodes bilaterally in 19 and unilaterally in four men. Scintigraphy before surgery showed inguinal nodes bilaterally in 12 and unilaterally in eight patients, while there were no nodes in three. Surgery comprised partial penectomy in 14, radical penectomy in eight and circumcision alone in one patient. Simultaneous bilateral ILND was done in 15 patients. Inguinal node metastases were present in four of the 23 (17%) patients; the SLN was falsely negative in three (13%), one of whom had a small focus of cancer in the SLN that was missed on initial histopathological examination, and in two the dynamically located SLN contained no cancer, but node metastases were found in the ILND specimen.

CONCLUSION

The relatively high false‐negative rate of DSLNB indicates that it is not sufficiently reliable to replace complete ILND in men with a high suspicion of nodal metastases, i.e. a high‐grade or high‐stage primary lesion with clinically palpable inguinal nodes.
Changes to the contractile function of ureter smooth muscle after partial infravesical obstruction in fetal sheep
Authors: Nyirády Peter , Cuckow Peter M. , Fry Christopher H.
Published: April 2008

OBJECTIVE

To measure spontaneous contractile activity, and the responses to agonists using in vitro preparations of sheep ureter after a period of bladder outlet obstruction (BOO) initiated at mid‐gestation.

MATERIAL AND METHODS

Date‐mated Romney Marsh ewes, bearing fetuses of 70–75 days of gestation (term in this breed is 145 days) were used. Five fetuses underwent urachal obstruction and partial urethral constriction for 30 days. Six fetuses at the same gestational time underwent a sham operation (control group). Small strips of mid‐ureter were cut in the longitudinal axis, and in the cross‐sectional (transverse) plane of the ureter. Spontaneous contractile activity and the response to carbachol, high‐K+ (120 mm) solution and α,β‐methylene ATP (ABMA) were characterized by measuring the magnitude of evoked responses and the magnitude and frequency of spontaneous activity.

RESULTS

The ureters from fetuses with BOO were significantly larger in diameter and had expanded lumens. The proportion of smooth muscle was not significantly different between the BOO and control groups. Spontaneous contractile activity in all preparations was resistant to atropine and the neurotoxin, tetrodotoxin. With transverse sections, the magnitude of spontaneous contractions was smaller in the BOO group, but the frequency was greater. The response to carbachol was also smaller in the BOO group, but the response to high‐K+ solution was similar to that of the control group. ABMA did not generate a response in any preparation. With longitudinal ureteric preparations, spontaneous or agonist‐induced activity was negligible in the control group, while preparations from the BOO sheep had spontaneous activity and responded to carbachol and high‐K+ solutions.

CONCLUSION

These results show that in fetuses with BOO and dilated ureters absolute ureteric contractile activity is diminished. However, there is functional reorganization of the muscle layers that generates more force in the longitudinal rather than the transverse axis. This would contribute to a reduced ability of the ureter to propel urine and contribute to the development of raised upper tract pressures.
The opiorphin gene (ProL1) and its homologues function in erectile physiology
Authors: Tong Yuehong , Tar Moses , Melman Arnold , Davies Kelvin
Published: April 2008

OBJECTIVE

To determine ifProL1, a member of the opiorphin family of genes, can modulate erectile physiology, as it encodes a peptide which acts as a neutral endopeptidase inhibitor, other examples of which (Vcsa1,hSMR3A) modulate erectile physiology.

MATERIALS AND METHODS

We cloned members of the opiorphin family of genes into the same mammalian expression backbone (pVAX); 100 µg of these plasmids (pVAX‐Vcsa1, ‐hSMR3A, ‐hSMR3B and ‐ProL1) were injected intracorporally into retired breeder rats and the affect on erectile physiology assessed visually, by histology and by measuring the intracavernous pressure (ICP) and blood pressure (BP). As a positive control, rats were treated with pVAX‐hSlo (expressing the MaxiK potassium channel) and as a negative control the empty backbone plasmid was injected (pVAX). We also compared the level of expression ofProL1in corporal tissue of patients not reporting erectile dysfunction (ED), ED associated with diabetes and ED not caused by diabetes.

RESULTS

Gene transfer of plasmids expressing all members of the opiorphin family had a similar and significant effect on erectile physiology. At the concentration used in these experiments (100 µg) they resulted in higher resting ICP, and histological and visual analysis showed evidence of a priapic‐like condition. After electrostimulation of the cavernous nerve, rats had significantly better ICP/BP than the negative control (pVAX). Gene transfer of pVAX‐hSlo increased the ICP/BP ratio to a similar extent to the opiorphin homologues, but with no evidence for a priapic‐like condition. Corpora cavernosa tissue samples obtained from men with ED, regardless of underlying causes, had significant down‐regulation of bothhSMR3AandProL1.

CONCLUSION

All members of the human opiorphin family of genes can potentially modulate erectile physiology. BothhSMR3andProL1are down‐regulated in the corpora of men with ED, and therefore both genes can potentially act as markers of ED.
Cystectomy in the elderly: does the survival benefit in younger patients translate to the octogenarians?
Authors: Chamie Karim , Hu Brian , DeVere White Ralph W. , Ellison Lars M.
Published: April 2008

OBJECTIVE

To determine whether the survival benefit achieved with radical cystectomy (RC, the reference standard for treating muscle‐invasive bladder cancer) in younger patients justifies its use in octogenarians.

PATIENTS AND METHODS

We used the Surveillance Epidemiology and End Results data of the National Cancer Institute and identified 10 807 patients from 1992–2004 who were diagnosed with muscle‐invasive bladder cancer, and were treated with either RC or radiotherapy. The data were analysed for age, gender, race, extent of lymphadenectomy and cause of death. We stratified the patients by age groups (<60, 60–69, 70–79 and >79 years), and used Kaplan‐Meier survival analysis to compare treatment strategies by age group.

RESULTS

In all, 8034 patients had RC and 2773 radiotherapy; RC was the primary method of treatment in all age groups except for octogenarians. Those who had RC had a sizeable overall survival advantage in all age groups, except for the octogenarians (18 vs 15 months). This small survival advantage improved only slightly (23 vs 15 months) when excluding patients having nodal or distant metastasis. The octogenarians who have RC with a limited pelvic lymph node dissection or RC alone receive little (16 vs 15 months) or no survival benefit. However, cancer‐specific survival was significantly higher in those who had RC, including octogenarians.

CONCLUSIONS

Octogenarians have some benefit to cancer‐specific survival from RC if it includes a standard lymphadenectomy. The issue is how to better select the patients, as the overall survival advantage in these patients over radiotherapy is negligible.
Urinary fibronectin as a predictor of a residual tumour load after transurethral resection of bladder transitional cell carcinoma
Authors: Li Liao‐Yuan , Yang Ming , Zhang Hai‐Bin , Su Xi‐Kang , Xu Wen‐Feng , Chen Yong , Shen Zhou‐Jun , Gao Xin
Published: April 2008

OBJECTIVE

To determine whether the level of urinary fibronectin predicts the residual tumour load after transurethral resection (TUR) of bladder transitional cell carcinoma (TCC).

PATIENTS AND METHODS

Urine samples were collected from 167 consecutive patients with suspected bladder cancer admitted for TUR. Samples were taken both before and after surgery. Bladder tumour fibronectin (BTF) was analysed using a solid‐phase chemiluminescent immunometric test. Creatinine in urine was also determined and the BTF/creatinine ratio calculated.

RESULTS

Patients were divided into a control group of 41 whose previous diagnosis was negative for BT and another of 126 with a positive diagnosis for BT, which was further subdivided into those with and without residual tumour, according to findings from specimens obtained during the second procedure (repeat TUR or cystectomy). After the second procedure, 68 patients (56%) had no residual tumour, whereas 54 (44%) did. Four patients with BT who did not have the second procedure were excluded from the study. The median BTF and BTF/creatinine value in the control group was 33.2 µg/L and 51.4 µg/g, respectively, before the first TUR, and 29.6 µg/L and 46.7 µg/g, respectively, after the first TUR. There were no statistically significant changes in BTF and BTF/creatinine ratio (P = 0.61 and 0.79, respectively). In the group with TCC, the BTF decreased from 211.9 to 97.3 µg/L (P = 0.02) and the BTF/creatinine ratio from 281.6 to 146.5 µg/g (P = 0.009) for those with residual tumour, while it decreased from 195.1 to 34.0 µg/L (P = 0.007) and the BTF/creatinine ratio decreased from 249.1 to 53.7 µg/g (P = 0.003) for those with no residual tumour. After initial TUR, the patients with residual tumour had significantly greater levels of BTF and BTF/creatinine than did those with no residual tumour (P = 0.004 and 0.006, respectively). The receiver operating characteristic curves showed an optimum threshold of 67.8 µg/L and 81.3 µg/g for BTF and the BTF/creatinine in detecting residual tumour, respectively, with a sensitivity of 91.4% and 89.0%, respectively, and a specificity of 87.8% and 85.6%, respectively.

CONCLUSION

Urinary fibronectin, in addition to being one of the best markers for diagnosing bladder carcinoma, can be used to determine the presence of residual tumour load after TUR of bladder TCC.
Neoadjuvant targeted therapy and advanced kidney cancer: observations and implications for a new treatment paradigm
Authors: Shuch Brian , Riggs Stephen B. , LaRochelle Jeff C. , Kabbinavar Fairooz F. , Avakian Raffi , Pantuck Allan J. , Patard Jean‐Jacques , Belldegrun Arie S.
Published: April 2008

OBJECTIVE

To evaluate our early experience with neoadjuvant therapy (sunitinib or sorafenib) in advanced renal cell carcinoma (RCC), to explore the effect on both tumour biology and potential for downstaging advanced tumours, as systemic therapy for RCC has historically resulted in little if any primary tumour response, but recent experience with targeted therapy suggests otherwise.

PATIENTS AND METHODS

The preliminary experience with neoadjuvant therapy for the surgical management of RCC was reviewed at two large referral centres. Several unique patients were identified who had a novel response to systemic therapy that altered the surgical strategy.

RESULTS

Four patients who had targeted therapy before surgery are described and in whom there were effects on tumour biology not seen previously with chemotherapy and cytokine therapy. The selected patients who had neoadjuvant targeted therapy had shrinkage of a tumour thrombus in the inferior vena cava, nodal involvement, renal fossa recurrence and tumour within a solitary kidney.

CONCLUSIONS

The introduction of new molecular agents has revolutionized the treatment of patients with metastatic RCC. Responses to targeted therapy within the primary tumour, tumour thrombus, renal fossa recurrence, and lymph node metastases are novel findings not seen during treatment with immunotherapeutic‐based strategies. This might be a signal for urological surgeons to re‐evaluate the paradigm for the surgical management of advanced RCC. Potential applications are presented to encourage further investigations with targeted therapy in the neoadjuvant setting.
How long is too long? The effect of the duration of anaesthesia on the incidence of non‐urological complications after surgery
Authors: Routh Jonathan C. , Bacon Douglas R. , Leibovich Bradley C. , Zincke Horst , Blute Michael L. , Frank Igor
Published: April 2008

OBJECTIVE

To examine the association between the duration of anaesthesia and non‐urological complication (NUC) rates after surgery, as the increasing complexity of minimally invasive and laparoscopic procedures in urology has resulted in longer surgery and anaesthesia, and information on the effect of this on NUC rates is limited.

PATIENTS AND METHODS

We identified 2196 patients who had open radical nephrectomy or nephron‐sparing surgery at our institution between 1989 and 2002. Patients were subdivided into groups I, II, and III according to the duration of general anaesthesia (<4, 4–6 and ≥6 h, respectively). NUCs after surgery, and mortality during and after surgery, were evaluated.

RESULTS

There were 1340, 723, and 133 patients in groups I, II and III, respectively. The incidences of any NUC were 3.1%, 5.8% and 13.5%, respectively. The odds ratios for the likelihood of a NUC were 1.91 (P = 0.004) and 4.84 (P < 0.001) for groups II and III, respectively. These differences remained significant even after adjusting for patient and tumour characteristics. Perioperative mortality was highest in group III, at 2.3%, vs 0.4% in groups I and II.

CONCLUSIONS

Longer anaesthesia is associated with an increase in the incidence of perioperative complications and mortality, especially when the duration of anaesthesia is >6 h. This increase appears to be independent of patient’s preoperative health status, tumour extent and blood loss.
BUDGET CONSTRAINTS AND DEMAND REDUCTION IN SIMULTANEOUS ASCENDING‐BID AUCTIONS*
Authors: BRUSCO SANDRO , LOPOMO GIUSEPPE
Published: April 2008

The possibility, even if arbitrarily small, of binding budget constraints in simultaneous ascending bid auctions induces strategic demand reduction and generates significant inefficiencies. Under mild conditions on the distributions of the bidders' values, unconstrained bidders behave as if they were liquidity constrained, even as the probability that bidders are budget constrained goes to zero.
THE EFFECT OF SERVICE QUALITY AND EXPECTATIONS ON CUSTOMER COMPLAINTS*
Authors: FORBES SILKE J.
Published: April 2008

Customer complaints measure consumers' dissatisfaction with the quality of a product or service. If product quality is unobservable ex ante, customer complaints may be driven by expectations as well as by the actually experienced quality level. I test whether the level of quality that could be expected prior to consumption affects the number of customer complaints after controlling for–ex post observable–actual quality, using data from the U.S. airline industry. I find that there are fewer complaints when actual quality is higher. Controlling for actual quality, a higher level of expected quality leads to more complaints.
WATCHING WOMEN WATCHING WARRIORS: NICOLAS POUSSIN'S TANCRED AND ERMINIA AND THE VISUALITY OF PAPAL COURT TOURNAMENTS
Authors: PLOCK PHILLIPPA
Published: April 2008

Nicolas Poussin's Tancred and Erminia centres on a woman's gaze. In its reference to noblewomen watching jousting knights, a motif present in the source poem, I argue that the format of the painting drew on ritualized practices of viewing. Contemporary depictions of a tournament reveal the specificities of this visuality for Poussin's patrons. In its replication of the classed and gendered spectatorship of papal court jousts, Tancred and Erminia was able to encourage aspiring papal courtiers to empathize with a coveted viewpoint gendered feminine. In so doing, I believe it offered viewers the possibility to identify with a standpoint, a cultural position of viewing constituted through representation.
On the Exportability of Korean Movies
Authors: Lee Shi Young , Kim Eun‐mee , Jun Sung Hee
Published: April 2008

The authors investigate factors that may affect the exportability of Korean films released from 1996 to 2002. They employ a binary probit model to test the exportability. The findings indicate that the number of screens, action genre, and year dummies of 2000 and 2001 are important determinants of exportability in the overall model. The authors tried to capture the dynamic aspect of exportability by holding outside factors constant. Over the previous years (1996–99), they found that factors that reduce the asymmetric information problem are important predictors of exportability. On the other hand, the star power and number of screens exhibited in the domestic market are strong predictors of exportability during the recent period. This result confirms that the recent expansion and success of the Korean movie industry (such as the effect of Hallyu) serves as an effective signal to the international film market. Their analysis of cultural discount is inconclusive.
Genetic variability in the mitochondrial DNA of the Danish Pine marten
Authors: Pertoldi C. , Muñoz J. , Madsen A. B. , Barker J. S. F. , Andersen D. H. , Baagøe H. J. , Birch M. , Loeschcke V.
Published: April 2008

Here we study genetic differentiation and changes over time in genetic variability in the rare pine marten Martes martes. Samples from three isolated geographic regions: Jutland and Sealand (Denmark) and southern Scania (southernmost Sweden), were genotyped by sequencing the hypervariable domain of the mitochondria control region. Both recent and museum samples were analysed in order to evaluate any temporal loss of genetic variability. Eight haplotypes were found. Two were main haplotypes shared by individuals from all three regions, and in all localities unique haplotypes were found. When comparing the data with previous haplotype analysis, our results suggest that at least three different haplotype groups exist in central and Northern Europe, with the samples from southern Scania being differentiated from samples previously analysed from central Sweden, and the genotypic data for Jutland and Sealand suggest a recent independent evolutionary history for the Danish pine marten.
Does gliding when pregnant select for larger females?
Authors: Fokidis H. B. , Risch T. S.
Published: April 2008

For terrestrial vertebrates, gliding imposes unique constraints on the interaction of body mass and structural size, particularly with reference to minimizing wing loading. Females of gliding animals experience increases in wing loading during pregnancy or gravidity, and selection may favour increased structural size to compensate for the added mass. We tested whether pregnant southern flying squirrelsGlaucomys volanshad similar wing loading as males, and whether females with lower wing loading bore heavier litters, than those with greater wing loading. Males had greater wing loading than females, regardless of the latter's reproductive state (males: 38.4±3.62 N m−2, pregnant females: 30.7±4.21 N m−2and non‐pregnant females: 26.8±5.13 N m−2). The slope of the linear relationship between planar surface area and body mass was similar between pregnant females and males, however (F=0.383,P=0.322). Thus female flying squirrels may optimize their litter mass to minimize wing loading during pregnancy. Contrary to our prediction, females with greater wing loading had heavier litters than those with lower wing loading, which suggests reproductive output may be influenced by other ecological factors.
Consumer credit and monetary policy in Malaysia
Authors: Kassim Salina Hj. , Manap Turkhan Ali Abdul
Published: April 2008

What is the impact of monetary policy on the Malaysian consumer? The study addresses this issue by empirically investigating the consequences of interest rate shocks on consumer credit in Malaysia. The study relies on the impulse response functions and the variance decomposition analysis based on the structural Vector Auto‐regression methodology. Apart from analysing the responses of aggregate consumer loans (ACL) to interest rate changes, further disaggregation is made in efforts to arrive at more detailed findings. In particular, the ACL data are categorized into loans for purchase of residential property, loans for personal uses, loans for credit cards, loans for purchase of consumer durables, loans for purchase of passenger cars and loans for purchase of securities. Through this disaggregation, the study shows the relative sensitivity of the various types of consumer loans to interest rate shocks.
Effectiveness of Nonpharmacological Interventions in Delaying the Institutionalization of Patients with Dementia: A Meta‐Analysis
Authors: Spijker Anouk , Vernooij‐Dassen Myrra , Vasse Emmelyne , Adang Eddy , Wollersheim Hub , Grol Richard , Verhey Frans
Published: April 2008

Contemporary healthcare policies are designed to shape the conditions that can help delay the institutionalization of patients with dementia. This can be done by developing support programs that minimize healthcare risks for the patients with dementia and their informal caregivers. Many support programs have been developed, and some of them are effective, but there has been no systematic review with a meta‐analysis of all types of nonpharmacological support programs with odds of institutionalization or time to institutionalization as an outcome measure. A systematic review with a meta‐analysis was therefore conducted to estimate the overall effectiveness of nonpharmacological support programs for caregivers and patients with dementia that are intended to delay institutionalization. Thirteen support programs with a total of 9,043 patients were included in the meta‐analyses. The estimated overall effectiveness suggests that these programs significantly decrease the odds of institutionalization (odds ratio (OR)=0.66, 95% confidence interval (CI)=0.43–0.99, P=.05) and significantly increase the time to institutionalization (standardized mean difference (SMD)=1.44, 95% CI=0.07–2.81, P=.04). A meta‐analysis of the best‐quality studies still showed a positive significant result for the odds of institutionalization (OR=0.60, 95% CI=0.43–0.85, P=.004), although the time to institutionalization was no longer significant (SMD=1.55, 95% CI=–0.35– 3.45, P=.11). The analysis of the intervention characteristics showed that actively involving caregivers in making choices about treatments distinguishes effective from ineffective support programs. Further investigation should be directed toward calculating the potential efficiency of these support programs by applying net‐benefit or cost‐effectiveness analysis.
Hospital Charges Attributable to a Primary Diagnosis of Infectious Diseases in Older Adults in the United States, 1998 to 2004
Authors: Curns Aaron T. , Steiner Claudia A. , Sejvar James J. , Schonberger Lawrence B.
Published: April 2008

OBJECTIVES: To describe total and average hospital charges associated with infectious disease (ID) hospitalizations and specific ID categories and to estimate ID hospitalization rates in adults aged 65 and older in the United States from 1998 through 2004.

DESIGN: Retrospective analysis of hospital discharge data obtained from the Nationwide Inpatient Sample for 1998 through 2004.

SETTING: United States.

PATIENTS: Older adults hospitalized in the United States from 1998 through 2004.

MEASUREMENTS: Hospital charges and hospitalization rates for IDs described according to year, age group, sex, U.S. Census region, and ID category. Charges for non‐ID hospitalizations were also described. Hospital charges were adjusted for inflation.

RESULTS: From 1998 through 2004, total charges for ID hospitalizations exceeded $261 billion and accounted for 13% of all hospital charges for older adults. Total charges for ID hospitalizations increased from $31.4 billion in 1998 to $45.7 billion in 2004. The average annual ID hospital charge was lower than the average annual non‐ID hospital charge during the study period ($21,342 vs $22,787, P<.001). The average annual rate for ID hospitalizations was 503 per 10,000 older adults, which remained stable during the study period.

CONCLUSION: The total charges for ID hospitalizations and for all hospitalizations in older adults in the United States increased 45% and nearly 40%, respectively, during the 7‐year study period, whereas the population of older adults grew by only 5%. Sustained increases of such magnitude will have major implications for the U.S. healthcare system as it prepares for the more than doubling of the older U.S. adult population during the first 30 years of this century.
A Quality Improvement Program to Enhance After‐Hours Telephone Communication Between Nurses and Physicians in a Long‐Term Care Facility
Authors: Whitson Heather E. , Hastings S. Nicole , Lekan Deborah A. , Sloane Richard , White Heidi K. , McConnell Eleanor S.
Published: April 2008

OBJECTIVES: To determine whether satisfaction of on‐site nurses with after‐hours telephone communication with off‐site physicians improved in one long‐term care (LTC) facility after a nurse‐oriented intervention.

DESIGN: Longitudinal quality improvement study.

SETTING: Extended Care and Rehabilitation Center (ECRC), Durham Veterans Affairs Medical Center.

PARTICIPANTS: Eighteen registered nurses.

INTERVENTION: Communicating Health Assessments by Telephone (Project CHAT), a program of individualized training sessions and decision support tools to aid LTC nurses with symptom assessment and communication of health information over the telephone.

MEASUREMENTS: Nurses completed six satisfaction surveys (three surveys in the 3 months before Project CHAT and three surveys in the 3 months after Project CHAT).

RESULTS: The nurses' average satisfaction scores increased on several items, including those that assessed whether the nurse was pretty sure what pieces of information the physician was going to ask for (P=.04), felt that the amount of patient information the physician asked for seemed reasonable (P=.03), felt prepared to answer the questions the physician asked (P=.01), and felt that the process of gathering patient information for the physician was easy (P=.01). The percentage of calls that resulted in immediate evaluation by a physician (on‐site or in the emergency department) increased from 2.0% in the period before Project CHAT to 8.6% in the period after Project CHAT (P=.01).

CONCLUSION: Nurses' satisfaction with several aspects of after‐hours telephone medicine improved after an inexpensive, education‐based intervention in one LTC facility. Further research is needed to determine how similar interventions might affect other quality measures, including patient outcomes.
Reading Comprehension in Adolescents with LD: What We Know; What We Need to Learn
Authors: Faggella‐Luby Michael N. , Deshler Donald D.
Published: April 2008

The changing job market requires a sophisticated array of literacy skills that adolescents with learning disabilities reading below grade level have not yet acquired. This summary of the research on reading comprehension highlights emerging findings and related instructional conditions necessary to achieve optimal student outcomes with limited instructional time. Limitations in the existing evidence base are addressed via four factors for future research and development agendas: (a) use theory to inform research and practice, (b) study the role that dosage plays as an independent variable, (c) study tiered models of instruction that are applicable for use in middle and high school settings, and (d) study factors that can enhance scaling of reading comprehension interventions.
Intervention Provided to Linguistically Diverse Middle School Students with Severe Reading Difficulties
Authors: Denton Carolyn A. , Wexler Jade , Vaughn Sharon , Bryan Deanna
Published: April 2008

This study investigated the effectiveness of a multicomponent reading intervention implemented with middle school students with severe reading difficulties, all of whom had received remedial and/or special education for several years with minimal response to intervention. Participants were 38 students in grades 6–8 who had severe deficits in word reading, reading fluency, and reading comprehension. Most were Spanish‐speaking English language learners (ELLs) with identified disabilities. Nearly all demonstrated severely limited oral vocabularies in English and, for ELLs, in both English and Spanish. Students were randomly assigned to receive the research intervention (n= 20) or typical instruction provided in their school's remedial reading or special education classes (n= 18). Students in the treatment group received daily explicit and systematic small‐group intervention for 40 minutes over 13 weeks, consisting of a modified version of a phonics‐based remedial program augmented with English as a Second Language practices and instruction in vocabulary, fluency, and comprehension strategies. Results indicated that treatment students did not demonstrate significantly higher outcomes in word recognition, comprehension, or fluency than students who received the school's typical instruction and that neither group demonstrated significant growth over the course of the study. Significant correlations were found between scores on teachers' ratings of students' social skills and problem behaviors and posttest decoding and spelling scores, and between English oral vocabulary scores and scores in word identification and comprehension. The researchers hypothesize that middle school students with the most severe reading difficulties, particularly those who are ELLs and those with limited oral vocabularies, may require intervention of considerably greater intensity than that provided in this study. Further research directly addressing features of effective remediation for these students is needed.
Making a Policy Problem of Water Export in Canada: 1960–2002
Authors: Bakenova Saule
Published: April 2008

The article explores how political tensions developed around the issue of Canadian water export, how policy solutions and alternatives to the problem were offered, and how finally it came to be recognized by the national government. The water export issue reached the formal agenda after a lengthy period of being denied serious consideration. However, it is arguable that agendas are set if an issue receives attention from policy decision makers. This is because an issue's ascension to agenda status is not an indication of how it is actually going to be decided upon. The case of water export demonstrates that the government adopted a policy solution consistent with assumptions prevalent at the time and acceptable among elected decision makers. Yet, the solution was contrary to the expectations of those who demanded a complete water export ban in Canada.
Efectos del ausentismo en la productividad de los maestros
Authors: MILLER Raegen T. , MURNANE Richard J. , WILLETT John B.
Published: April 2008

Los autores estudian los efectos del ausentismo de los maestros en la instrucción, basándose en datos de tres cursos académicos que abarcan a 285 maestros y a 8.631 alumnos —la mayoría pertenecientes a familias modestas— de un distrito escolar urbano de los Estados Unidos. Comprueban la hipótesis de que las ausencias de los maestros son en gran parte injustificadas y reducen el aprovechamiento de los estudiantes. Dado que los suplentes suelen tener menos preparación, la enseñanza pierde intensidad y coherencia: diez días de ausencia del maestro se traducen en un descenso de las notas de los alumnos en matemáticas de alrededor del 3,3 por ciento de la desviación estándar. Para algunos estudiantes, ello supone bajar a una catego‐ría de nivel académico inferior, lo cual reduce su voluntad de salir adelante.
Antibody levels to single bacteria or in combination evaluated against myocardial infarction
Authors: Lund Håheim Lise , Olsen Ingar , Nafstad Per , Schwarze Per , Rønningen Kjersti S.
Published: April 2008

Background: Evidence is accumulating that oral bacteria are associated with myocardial infarctions (MI). We were interested in studying the differences in the association between single bacteria or bacteria in combination and the relation to C‐reactive protein (CRP).

Material and Methods: We examined the levels of antibodies against four major periodontal pathogens Porphyromonas gingivalis (PG), Aggregatibacter actinomycetemcomitans (AA), Tannerella forsythia (TF) and Treponema denticola (TD) and CRP in 548 men with a self‐reported history of MI to 625 controls who took part in the Oslo II study in 2000.

Results: The mean levels of bacterial antibodies were higher for the cases than the controls, but not significant as standard deviations were large. The level of CRP was higher in the cases than the controls (p=0.010). Logistic regression analyses comparing the upper quartile value with the lower value of one of either four antibodies (anti‐AA, anti‐TF, anti‐TD and anti‐PG) were significantly associated (p=0.032) with MI. Equivalent analyses of either three bacteria showed significant associations for anti‐AA, anti‐TD and anti‐PG (p=0.036) and anti‐AA, anti‐PG and anti‐TF (p=0.040). CRP showed an increased relative risk with increasing quartile value; trend, p=0.016, but not in multivariate analysis including the oral antigens.

Conclusions: No single bacterium but rather combinations were related to increasing relative risk for MI independent of known cardiovascular risk factors.
Lamprey (Lampetra fluviatilis and Lampetra planeri) ammocoete habitat associations at regional, catchment and microhabitat scales in Northern Ireland
Authors: Goodwin C. E. , Dick J. T. A. , Rogowski D. L. , Elwood R. W.
Published: April 2008

Abstract –  Habitat characteristics associated with lamprey ammocoetes (Lampetra spp.) were investigated at three different spatial scales: regional (Northern Ireland), catchment (Ballinderry River) and microhabitat. At the regional scale, ammocoetes were more abundant in rivers with a pH ≥8.2, while within a catchment, abundance was negatively related to the number of potential lamprey barriers and distance upstream. At the microhabitat scale, at sites where ammocoetes were present, ammocoetes were more abundant where median phi ≥1.94 (very coarse sand), where sediment depth ≥11.5 cm, and where kurtosis was >1.71. This study provides information on habitat associations of lamprey in the UK which may be of use in their conservation, in particular it highlights the negative association of migration barriers with lamprey abundance.
Malaria and oral health
Authors: Owotade FJ , Greenspan JS
Published: April 2008

Half of the world population resides in malaria‐prone areas, and the disease is responsible for more than a million deaths annually. This is apart from the economic impact of the disease through resources expended towards treatment and prevention and the loss of manpower. In addition to the overt clinical signs and symptoms, the association of malaria with other diseases such as tuberculosis and HIV infection has been described. However few studies have attempted to investigate its relationship to oral diseases. This review provides an overview of the relevance of malaria to the mouth and adjacent structures. The need for further research is also emphasized.
Identification of a novel matrix protein contained in a protein aggregate associated with collagen in fish otoliths
Authors: Tohse Hidekazu , Takagi Yasuaki , Nagasawa Hiromichi
Published: April 2008

In the biomineralization processes, proteins are thought to control the polymorphism and morphology of the crystals by forming complexes of structural and mineral‐associated proteins. To identify such proteins, we have searched for proteins that may form high‐molecular‐weight (HMW) aggregates in the matrix of fish otoliths that have aragonite and vaterite as their crystal polymorphs. By screening a cDNA library of the trout inner ear using an antiserum raised against whole otolith matrix, a novel protein, named otolith matrix macromolecule‐64 (OMM‐64), was identified. The protein was found to have a molecular mass of 64 kDa, and to contain two tandem repeats and a Glu‐rich region. The structure of the protein and that of its DNA are similar to those of starmaker, a protein involved in the polymorphism control in the zebrafish otoliths [Söllner C, Burghammer M, Busch‐Nentwich E, Berger J, Schwarz H, Riekel C & Nicolson T (2003) Science302, 282–286]. 45Ca overlay analysis revealed that the Glu‐rich region has calcium‐binding activity. Combined analysis by western blotting and deglycosylation suggested that OMM‐64 is present in an HMW aggregate with heparan sulfate chains. Histological observations revealed that OMM‐64 is expressed specifically in otolith matrix‐producing cells and deposited onto the otolith. Moreover, the HMW aggregate binds to the inner ear‐specific short‐chain collagen otolin‐1, and the resulting complex forms ring‐like structures in the otolith matrix. Overall, OMM‐64, by forming a calcium‐binding aggregate that binds to otolin‐1 and forming matrix protein architectures, may be involved in the control of crystal morphology during otolith biomineralization.
Magnetic Resonance Imaging and the Female Sexual Response: Overview of Techniques, Results, and Future Directions
Authors: Maravilla Kenneth R. , Yang Claire C.
Published: April 2008

Introduction

Magnetic resonance imaging (MRI) is becoming a frequently used tool in the study of sexual physiology and neurophysiology.

Aim

This report reviews various MRI methods used to study the female sexual arousal response.

Methods

Retrospective review of pertinent literature.

Results

Dynamic genital MRI studies enable the visualization of the physiologic arousal response that provides the direct observation of the time course and magnitude of this response, along with the variability that appears to occur in women with sexual arousal disorder. Functional brain MR studies are described and summarized along with an overview of what we have learned. Finally, the speculation on how we may be able to use MRI technology to better understand the female sexual response and to help in validating new drug treatments or in devising new treatment strategies for sexual dysfunction is also presented.

Conclusions

Neuroimaging has already been proven as an invaluable research tool to study the sexual response in women both in the pelvis as well as within the brain. Using these techniques, major inroads are being made to improve the understanding of the sexual arousal process in women.
Sexual Satisfaction among Patients with Erectile Dysfunction Treated with Counseling, Sildenafil, or Both
Authors: Abdo Carmita H.N. , Afif-Abdo João , Otani Fabio , Machado Albangela Ceschin
Published: April 2008

Introduction

Sexual satisfaction is linked to life satisfaction, and erectile dysfunction (ED) may lead to an impaired quality of life (QOL).

Aim

Our goal was to evaluate the QOL among Brazilian patients with ED, before and after three kinds of treatment.

Methods

Men aged 25–55 years, with a diagnosis of psychogenic or mixed ED, according to the Classification of Mental and Behavioral Disorders of the International Classification of Diseases, 10th edition, and the Standard Practice in Sexual Medicine, were randomly assigned to three treatment groups: counseling, sildenafil, and sildenafil plus counseling. At baseline each group had 40 patients. Sildenafil was provided in 50 mg that could be adjusted to 100 mg. The patients could initially take one to two tablets per week and the entire treatment lasted for 3 months. Counseling was provided in group sessions that took place once a week. They were evaluated at baseline and after 3 months of treatment with the Male Sexual Quotient (MSQ) and the Sexual Health Inventory for Men (SHIM).

Main Outcome Measures

The correlation between the patients' MSQ score and scores on the SHIM.

Results

One hundred seventeen patients were enrolled. The three groups were similar according to age, marital status, mean time of ED, and ED severity and etiology. At baseline, MSQ and SHIM total scores were not different among the three groups. MSQ scores increased from 41.2 ± 15.3, 38.7 ± 18.0, and 46.8 ± 17.0 to 48.5 ± 15.3, 63.8 ± 21.6, and 70.0 ± 17.3 after counseling, sildenafil, and sildenafil plus counseling, respectively (P < 0.05). SHIM scores also increased significantly (9.6 ± 4.1, 9.7 ± 4.1, and 10.2 ± 3.9 to 12.1 ± 3.9, 16.7 ± 5.6, and 17.7 ± 4.5 after counseling, sildenafil, and sildenafil plus counseling, respectively) (P < 0.05). There were no serious adverse events related to sildenafil, and no patient was withdrawn from the study because of an adverse event.

Conclusions

The three treatments were significantly efficient, and the best treatment was sildenafil associated with counseling.
Household willingness‐to‐engage in water quality projects in western Newfoundland and Labrador: a demand‐side management approach
Authors: Sabau Gabriela , Haghiri Morteza
Published: April 2008

This paper aims to measure household willingness‐to‐engage (WTE) in municipal water quality projects. A cross‐sectional logit model is specified as a function of socio‐demographic, socio‐economic, water consumption and conservation, and public awareness in western Newfoundland and Labrador. WTE is a new provision of the demand‐side management approach that incorporates an ecological economics dimension to water use. The results show that the levels of education and annual family income have positively affected households' decisions to get involved in the municipal water quality projects. In addition, the degree of public awareness has a significant impact on shaping the households' decisions.
Uncertainties in the prediction of flow in a long reach of the Sacramento River
Authors: Ercan A. , Younis B. A.
Published: April 2008

The accurate prediction of the flow field in a long reach of a complex waterway is prerequisite to the evaluation to acceptable engineering accuracy of strategies for the restoration, resource management and hazard assessment. In this study, we consider some aspects of the numerical prediction of flow in a long reach of the Sacramento River in California with view to gaining a better understanding the sources and the extent of the uncertainties that are present in the predictions. The predictions were obtained using a finite‐volume method to solve the time‐averaged forms of the equations governing the conservation of mass and momentum. Body‐fitted coordinates were used to define the complex river bathymetry. Both depth‐averaged and fully three‐dimensional (3D) computations were performed. The results were compared with data obtained from a large‐scale physical model of the same reach. The outcome of the comparisons served to provide the basis for the assessment of the sensitivity of the solutions to assumptions made regarding the conditions at inlet to the solution domain, the choice of turbulence model used to close the time‐averaged equations and, for the depth‐averaged calculations, the choice of method used for prescribing the bed friction. The influence of other parameters such as the density of the computational grid, the method used to define the channel bathymetry, and the unsteadiness of the mean flow that results from vortex shedding from a bridge pier and abutments were also assessed. The results obtained form a useful addition to the growing literature on the computational modelling of flows in natural waterways.
Exploring Africa's Economic Recovery
Authors: Carmody Pádraig
Published: April 2008

For much of the last 30 years, Africa has commonly been considered the world's greatest developmental failure – plagued by economic decline, corruption, AIDS, environmental degradation and conflict. While the overgeneralised nature of this ‘Afro‐pessisimist’ discourse was problematic, the extent of economic decline of much of the continent cannot be denied. However, more recently, the number of conflicts on the continent has declined, rates of economic growth have dramatically improved and poverty may be reducing for the first time in decades. This article investigates the depth, structure and significance of Africa's current economic recovery. While recent academic work has been paid much attention to the rising role of Chinese trade and investment in the continent, it argues that this is only one among other significant trends explaining the current conjuncture. While investigating the environmental and economic impacts of recent Chinese trade and investment, the article seeks explores whether or not the re‐alignment of differently scaled social processes opens up the possibility of a poverty‐reducing ‘developmental regime’ for the continent.
Re‐Regulating Offshore Finance?
Authors: Maurer B.
Published: April 2008

This article explores global efforts to regulate offshore finance in the wake of international concern about the effects of so‐called harmful tax competition, as well as money laundering and terrorist financing (the latter a relatively new category since September 11, 2001). In the mid‐1990s, a number of multilateral organizations, from the Organization for Economic Cooperation and Development (OECD) to the Financial Action Task Force, as well as non‐governmental organizations like Oxfam, attempted to curtail offshore finance and tax haven abuses by ‘naming and shaming’ small jurisdictions into compliance with an emerging set of international financial norms. These efforts left themselves open to charges of hypocrisy, however, because many OECD countries themselves failed – and indeed, still fail – to adhere to the standards required of offshore havens. Tax havens responded by calling for a ‘level playing field’. Nevertheless, this effort at global regulation of offshore finance has had tangible effects. This essay explores those effects and argues that the attention to offshore finance missed an opportunity by going after the jurisdictions that provided services rather than addressing the market for such services. Understanding that missed opportunity requires analytical attention to payments, as opposed to exchanges, in international finance and in the social study of finance.