bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards the definition of the best management and prognostic factors of teratoma with malignant transformation: a single‐institution case series and new proposal
Authors: Necchi Andrea , Colecchia Maurizio , Nicolai Nicola , Piva Luigi , Catanzaro Mario , Biasoni Davide , Torelli Tullio , Stagni Silvia , Paolini Biagio , Milani Angelo , Salvioni Roberto
Published: September 2010

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

• To investigate the optimal management and prognostic factors of patients with malignant transformation (MT) in germ‐cell tumour (GCT) by re‐evaluating Institutional series.

PATIENTS AND METHODS

• Patients with an MT within GCT have been identified from the institutional database and all slides have been reviewed by the referral pathologist.

RESULTS

• From June 1982 to October 2009, 48 patients and 13 somatic histologies have been identified. Twelve patients presented with stage I, 12 with stage II and 24 with stage III disease. All stage I patients are alive and disease‐free after a median follow up of 88 months (interquartile range 38–103).

• Of the 36 metastatic cases, 11 underwent GCT‐oriented chemotherapy plus surgery and seven of them are currently disease‐free. Three patients underwent MT‐chemotherapy, one relapsed and is still under treatment. Overall, 17 patients relapsed (35%) and three of them have been rescued by GCT‐chemotherapy. Five‐year overall survival was 100% for stage I, 80% (95% CI 40–94) for stage II and 44% (95% CI 19–67) for stage III patients. Stage III disease at MT, incomplete surgical removal and primitive neuroectodermal tumours plus adenocarcinoma histologies were significant adverse prognostic factors for survival.

CONCLUSIONS

• New insights emerged into the impact of histology and chemotherapy on MT. The development of an adenocarcinoma component as well as the possible efficacy of a GCT‐tailored chemotherapy in a multimodal strategy are addressed for the first time, while disease extent at transformation and extent of radical surgery are confirmed as significant prognosticators.

• An international web database for registration of all cases of MT worldwide is presented.
Implementing Fiscal Decentralization: A Case Study of a Regional Tax Agency in Italy
Authors: ASQUER ALBERTO
Published: September 2010

As a measure to enhance the fiscal autonomy of the region, in 2006 the Regional Government of Sardinia in Italy decided to establish a tax agency for managing regional taxes on holiday houses and boat and aircraft transit. Based on interviews conducted with the tax agency director and staff, this article traces the trajectory and outcome of events included in the implementation of this part of the regional government's fiscal policy. Drawing from this case, this article theorizes the process of implementing fiscal decentralization by addressing the issue of how fiscal policy decisions affect the management of tax agencies in the start‐up stage. Social mechanisms of learning, brokerage, and actor certification provide important linkages between fiscal policy choices and organizational change. On the whole, the research argument made in this article further contributes to institutionalist and processualist research trends in current research on organization studies and public management.
Policymaking in Multiparty Presidential Regimes: A Comparison between Brazil and Ecuador
Authors: PEREIRA CARLOS , ACOSTA ANDRÉS MEJÍA
Published: September 2010

This paper explores why two countries with similar electoral, partisan, and presidential institutions, have produced significantly different policy outcomes in Latin America. Brazil and Ecuador are conventionally known as having highly fragmented party systems, where legislators have great incentives to cultivate a personal vote. Presidents are perceived to be strong and to make large use of government resources in order to advance their agenda. Yet, policies in Brazil are more likely to respond to shocks and to be more stable over time than policies in Ecuador, where policies remain vulnerable to political changes and realignments. We argue that this variation is explained by the different nature of political coalitions formed in each country. We identify three factors that increase the executive's ability to craft governing coalitions in congress: the availability of valuable coalition currencies, the influence of long‐term political horizons, and the extent to which political transactions are credibly and effectively enforced.
Revising Road Safety Policy: The Role of Systematic Evidence in Switzerland
Authors: FREY KATHRIN
Published: September 2010

In recent years, interest has grown in promoting and employing “evidence‐based policymaking.” This has been accompanied by an increase in available information about the performance of public policies. While existing research concludes that evidence about “what works” rarely prevails in democratic politics, it is inconclusive about which conditions affect the relevance of such evidence in decision‐making processes. This article aims first to clarify these conditions, and second, to present empirical findings from two case studies of road safety policy revision. The findings show how the creation and diffusion, as well as the political context, affect the role evidence plays in legislative policy revision in Switzerland.
Physiological performance of an Alaskan shrub (Alnus fruticosa) in response to disease (Valsa melanodiscus) and water stress
Authors: Rohrs‐Richey Jennifer K. , Mulder Christa P. H. , Winton Loretta M. , Stanosz Glen
Published: September 2010

See also the Commentary by Grulke
A fundamental, eco‐hydrological basis for niche segregation in plant communities
Authors: Araya Yoseph N. , Silvertown Jonathan , Gowing David J. , McConway Kevin J. , Peter Linder H. , Midgley Guy
Published: September 2010

See also the Commentary by Peuelas et al
.
Cognitive profile in young adults born preterm at very low birthweight
Authors: LØHAUGEN GRO C C , GRAMSTAD ARNE , EVENSEN KARI ANNE I , MARTINUSSEN MARIT , LINDQVIST SUSANNE , INDREDAVIK MARIT , VIK TORSTEIN , BRUBAKK ANN‐MARI , SKRANES JON
Published: September 2010

Aim  The aim of this study was to assess cognitive function at the age of 19 years in individuals of very low birthweight (VLBW; ≤1500g) and in term‐born comparison individuals.

Method  In this hospital‐based follow‐up study, 55 VLBW participants (30 males, 25 females; mean birthweight 1217g, SD 233g; mean gestational age 29.1wks, SD 2.5wks) and 81 comparison individuals (42 males, 39 females; mean birthweight 3707g, SD 433g; mean gestational age 39.7wks, SD 1.2wks) were examined with a standardized IQ test (Wechsler Adult Intelligence Scale III) to assess general cognitive ability.

Results  Over half (53%) of the VLBW participants achieved a low IQ score (defined as >1SD below the mean in the comparison group; odds ratio 6.4 vs comparison individuals; 95% confidence interval 2.8–14.4; p<0.001). None of the VLBW group, compared with 22% of the comparison individuals, achieved a high IQ score (>1SD above the comparison mean). VLBW participants scored lower than comparison individuals on full, verbal, and performance IQ, as well as on all four indices (p≤0.001). The subtest profile indicated problems on all subtests, but especially on those related to arithmetic and visual–perceptual tasks.

Interpretations  Few studies have undertaken a comprehensive assessment of general cognitive outcome (IQ) among young adults of VLBW. Our results indicate that VLBW seems to have a global and lasting impact on cognitive ability. Full‐scale IQ assessment may reveal important learning problems in young adults of VLBW, and should be performed to inform appropriate assistance to enhance academic achievement and the chances of permanent employment as adults.
Early developmental assessment of children with major non‐cardiac congenital anomalies predicts development at the age of 5 years
Authors: MAZER PETRA , GISCHLER SASKIA J , VAN DER CAMMEN‐VAN ZIJP MONIQUE H M , TIBBOEL DICK , BAX NICOLAAS M A , IJSSELSTIJN HANNEKE , VAN DIJK MONIQUE , DUIVENVOORDEN HUGO J
Published: September 2010

Aim  The aim of this study was to evaluate cognitive and motor development in children with major congenital anomalies and the predictability of development at age 5 years.

Method  A prospective, longitudinal follow‐up study was undertaken. The Dutch version of the Bayley Scales of Infant Development – Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) – were administered at the ages of 6, 12, and 24 months. The Revised Amsterdam Children’s Intelligence Test – IQ and the Movement Assessment Battery for Children – Total impairment score (TIS) were used at age 5 years. A total of 117 children participated in the study. After excluding 12 children who had a major chromosomal or syndromal abnormality, the analysis was limited to 105 children (50 females, 55 males). Seven groups of congenital anomalies were distinguished: (1) small intestinal anomalies; (2) abdominal wall defects, comprising gastroschisis and omphalocele; (3) oesophageal atresia; (4) congenital diaphragmatic hernia; (5) Hirschsprung disease; (6) anorectal malformations; and (7) miscellaneous diagnoses. Logistic regression analyses served to determine the ability of MDI and PDI to predict IQ and TIS at age 5 years.

Results  At age five, 83.7% of 104 children had an IQ of 85 or above and 16.3% an IQ of less than 85. TIS was normal in 71.3% of 87 children, while 17.2% demonstrated a borderline score and 11.5% a definite motor problem. MDI and PDI scores showed equal sensitivity to predict IQ (p=0.004 at 6 and 12mo, p=0.001 at 24mo) and TIS (p<0.001 at 6 and 12mo, p=0.002 at 24mo). MDI and PDI were positively correlated with IQ and TIS; TIS was positively correlated with IQ.

Interpretation  IQ scores at 5 years of age corresponded to Dutch population scores, but TIS scores differed significantly. Early development of children with major congenital anomalies is predictive of development at 5 years, which can guide individualized follow‐up for this vulnerable group of children.
Pathogenesis of gestational urinary tract infection: urinary obstruction versus immune adaptation and microbial virulence
Authors: Nowicki B , Sledzinska A , Samet A , Nowicki S
Published: September 2010

Please cite this paper as: Nowicki B, Sledzinska A, Samet A, Nowicki S. Pathogenesis of gestational urinary tract infection: urinary obstruction versus immune adaptation and microbial virulence. BJOG 2011;118:109–112.
Socio‐economic disparities in maternal mortality in China between 1996 and 2006
Authors: Feng XL , Zhu J , Zhang L , Song L , Hipgrave D , Guo S , Ronsmans C , Guo Y , Yang Q
Published: September 2010

Please cite this paper as: Feng X, Zhu J, Zhang L, Song L, Hipgrave D, Guo S, Ronsmans C, Guo Y, Yang Q. Socio‐economic disparities in maternal mortality in China between 1996 and 2006. BJOG 2010;117:1527–1536.

Objective  China’s economic reforms have raised concerns over rising inequalities in maternal mortality, but it is not known whether the gap across socio‐economic regions has increased over time.

Design  A population‐based, longitudinal, ecological correlation study.

Setting  China.

Sample  Records from the National Maternal and Child Mortality Surveillance System between 1996 and 2006.

Methods  We report levels, causes and timing of maternal deaths, and examine crude and adjusted time trends in the overall and cause‐specific maternal mortality ratio in five socio‐economic regions (using Poisson regression). We examine whether socio‐economic disparities have widened over time using concentration curves.

Main outcome measures  All‐causes and cause‐specific maternal mortality ratios.

Results  Maternal mortality (MMR) declined by 6% per year (yearly rate ratio, RR, 0.94; 95% CI 0.93–0.96). The decline was most pronounced in the wealthiest rural type‐I counties (RR 0.89; 95% CI 0.85–0.93), and in the poorest rural type‐IV counties (RR 0.90; 95% CI 0.82–1.00). There were declines in almost all causes of maternal death. Postpartum haemorrhage (PPH) was by far the leading cause of maternal death (32%, 997/3164). The decline in MMR was largely explained by the increased uptake of institutional births. Concentration curves suggest that wealth‐related regional inequalities did not increase over time.

Conclusions  China’s extraordinary economic growth has not adversely affected disparities in MMR across socio‐economic regions over time, but poor rural women remain at disproportionate risk. Other emerging economies can learn from China’s focus on the supply and quality of maternity services along with more general health systems strengthening.
A study of paediatric and adolescent gynaecology services in a British district general hospital
Authors: McGreal S , Wood PL
Published: September 2010

Please cite this paper as: McGreal S, Wood P. A study of paediatric and adolescent gynaecology services in a British district general hospital. BJOG 2010;117:1643–1650.

Objective  The Paediatric and Adolescent Gynaecology service (PAG) at Kettering General Hospital is a designated service meeting the needs of children with gynaecological problems. National guidelines reinforce the fact that children should be seen within specific paediatric areas in hospital. We aim to review the role of such a service in the context of a British district general hospital.

Design  Retrospective review spanning 15 years.

Setting  The outpatient/inpatient service of a UK district general hospital.

Population  A total of 800 patients were included in the study.

Methods  We identified patients attending the PAG clinic between 1994 and 2009. Medical notes were reviewed individually.

Main outcome measures  Demographics, referral source, presenting symptoms, examination findings, diagnosis, management, admissions and referrals to tertiary centres.

Results  In total, 86% of patients were referred from primary care. The age distribution was bimodal at 4 and 15 years of age: the average age was 10 years. Sixty percent of patients were followed‐up, giving a total of 2023 appointments. The commonest presentations were vulvovaginitis (18%), labial adhesions (14%), abdominal pain (7%) and precocious puberty (6%). A total of 15% of patients were admitted, largely for planned procedures, of which vaginoscopy was the most frequent.

Conclusions  The PAG service has enabled pathways for care that were previously non‐existent, as well as the development of ‘best practice’. The British Society for Paediatric and Adolescent Gynaecology has been seeking to develop a network of similar services at secondary and tertiary level throughout the UK. This approach should be encouraged and promoted by those in charge of healthcare policy and provider trusts in general.
Developing a community‐based maternal obesity intervention: a qualitative study of service providers’ views
Authors: Oteng‐Ntim E , Pheasant H , Khazaezadeh N , Mohidden A , Bewley S , Wong J , Oke B
Published: September 2010

Please cite this paper as: Oteng‐Ntim E, Pheasant H, Khazaezadeh N, Mohidden A, Bewley S, Wong J, Oke B. Developing a community‐based maternal obesity intervention: a qualitative study of service providers’ views. BJOG 2010;117:1651–1655.

The aim of this study was to explore healthcare professionals’ views on the development of multicomponent interventions for obese pregnant women. A cohort of 22 healthcare professionals was interviewed. The interview transcripts were analysed thematically. Three key themes were highlighted by the interviews: (1) the lack of existing services for obese pregnant women in south‐east London; (2) the barriers and challenges that need to be overcome (e.g. ethnic and cultural) when considering the creation of a new service for obese women who are pregnant; (3) the possible components of a new intervention. The findings of this study will inform the design of a programme to combat maternal obesity.
An evaluation of searching the German CCMeddatabase for the production of systematic reviews
Authors: Waffenschmidt Siw , Hausner Elke , Kaiser Thomas
Published: September 2010

Objectives: National databases may be useful sources in the production of a systematic review (SR). The aim of this study was to assess the potential benefit of a systematic search in the German database ‘Current Contents Medizin’ (CCMed).

Methods: The study was conducted on the basis of published SRs that included CCMedas a literature source. Eligible SRs were identified through a systematic search inmedline,embaseand The Cochrane Library. The websites of German Health Technology Assessment agencies were also screened. Citations of primary studies included as relevant in the SRs were extracted and then categorised.

Results: The search yielded 52 eligible SRs. A total of 1505 relevant citations were extracted. Seventy‐seven of these articles were published in journals indexed in CCMed. Thirty‐two of the 77 citations were indexed in CCMed, but only eight of the 32 were unique. Of these eight citations, seven were not identified by a systematic search, but by handsearching. Only one unique citation, an observational study, was identified in CCMedby a systematic search.

Conclusions: In the production of SRs, a systematic search in CCMedidentifies relevant studies only in exceptional cases. Therefore, the routine inclusion of this database in systematic searches does not appear meaningful.
Persistent impairment of mitochondrial and tissue redox status during lithium‐pilocarpine‐induced epileptogenesis
Authors: Waldbaum Simon , Liang Li‐Ping , Patel Manisha
Published: September 2010

J. Neurochem. (2010) 115, 1172–1182.

Mitochondrial dysfunction and oxidative stress are known to occur following acute seizure activity but their contribution during epileptogenesis is largely unknown. The goal of this study was to determine the extent of mitochondrial oxidative stress, changes to redox status, and mitochondrial DNA (mtDNA) damage during epileptogenesis in the lithium‐pilocarpine model of temporal lobe epilepsy. Mitochondrial oxidative stress, changes in tissue and mitochondrial redox status, and mtDNA damage were assessed in the hippocampus and neocortex of Sprague–Dawley rats at time points (24 h to 3 months) following lithium‐pilocarpine administration. A time‐dependent increase in mitochondrial hydrogen peroxide (H2O2) production coincident with increased mtDNA lesion frequency in the hippocampus was observed during epileptogenesis. Acute increases (24–48 h) in H2O2 production and mtDNA lesion frequency were dependent on the severity of convulsive seizure activity during initial status epilepticus. Tissue levels of GSH, GSH/GSSG, coenzyme A (CoASH), and CoASH/CoASSG were persistently impaired at all measured time points throughout epileptogenesis, that is, acutely (24–48 h), during the ‘latent period’ (48 h to 7 days), and chronic epilepsy (21 days to 3 months). Together with our previous work, these results demonstrate the model independence of mitochondrial oxidative stress, genomic instability, and persistent impairment of mitochondrial specific redox status during epileptogenesis. Lasting impairment of mitochondrial and tissue redox status during the latent period, in addition to the acute and chronic phases of epileptogenesis, suggests that redox‐dependent processes may contribute to the progression of epileptogenesis in experimental temporal lobe epilepsy.
The impact of bodily change on social behaviour in patients with Thyroid‐Associated Ophthalmopathy
Authors: Jensen Annesofie L. , Harder Ingegerd
Published: September 2010

Scand J Caring Sci; 2011; 25; 341–349

The impact of bodily change on social behaviour in patients with Thyroid‐Associated Ophthalmopathy

Thyroid‐associated ophthalmopathy (TAO) is characterized by the altered appearance of face and eyes and changed visual function. TAO has been described as alarming and crippling. It is well documented that TAO influences the patient’s quality of life negatively. However, little is known about how the bodily change complicates the patient’s social behaviour in everyday situations. The aim of this study was to explore how social behaviour is influenced by the bodily change and what it means to patients with TAO. An ethnographic study was conducted using in‐depth interviews and participant observation. A total of 13 patients, nine women and four men, diagnosed with moderate to severe TAO were included. Data analysis was performed concurrently using grounded theory technique. The local ethics committee approved the study, and all participants gave written informed consent. The study reveals that the experience of bodily change had considerable consequences for patients’ involvement with people and maintenance of social relations. Uncontrollable eyes were the dominating experience. It contained four sub‐themes; the experience of changed facial communication, the experience of being somebody else, the experience of being clumsy among others and the experience of being cut off from the outside world. The bodily change affected people’s attitude and behaviour towards them and their own ways of being with people. They struggled to change social behaviour and avoid withdrawal. In their struggle, they used seven different coping strategies. The study contributes to clarification of essential aspects of living with TAO. The condition of uncontrollable eyes may have serious consequences for patients’ social behaviour and relationships with others. Early identification of the impact of bodily change and planned support may help prevent serious quality of life change.
Monitoring LCM Process by FBG Sensor Under Birefringence
Authors: Molimard J. , Vacher S. , Vautrin A.
Published: September 2010

Abstract:  Optical fibre Bragg gratings (FBG) provide accurate and non‐intrusive strain and temperature local measurements. FBG sensors can be embedded into fibrous preforms to monitor the flow and the cure of the resin and deliver real‐time information on the ongoing process. The paper concentrates on the utilisation of the strain‐induced birefringence of the FBG to derive information on the effective stress–strain state of the composite at the end of the process cycle (Vacher 2004, Optical fiber sensors to monitor the processing and the mechanical characterization of composites. PhD thesis). During the cooling phase, the reflection spectrum from the FBG splits into two peaks because of the birefringence of the glass fibre owing to the residual stress. The paper shows that this effect can be utilised to estimate the residual stress and strain in composites manufactured by Liquid Composite Moulding technologies. The birefringence effect arising from the cooling of a [06,903]S CFRP laminate is first characterised, and then the determination of the strains along the principal axes inside the laminate is completed by modelling the local stress–strain state because of the interaction of the optical fibre and its environment within the framework of orthotropic thermo‐elasticity and the Classical Laminated Plate Theory.
Towards critical geographies of the university campus: understanding the contested experiences of Muslim students
Authors: Hopkins Peter
Published: September 2010

This paper sets out an agenda for advancing critical geographies of the university campus. Despite the plethora of scholarship that highlights the complexity evident within other social locations, scales and sites, there is a dearth of geographical research about the construction and contestation of social and spatial relations experienced on university campuses. By exploring understandings of the contradictory and contested nature of everyday spaces developed by social and cultural geographers, I suggest that scholarship could usefully be extended to interrogate the complex ways in which different university campuses are constructed, contested and experienced. This paper explores these multiple constructions of the university campus through the narratives of 29 Muslim students attending a British higher education institution. I use these data to explore the multiple and contradictory discourses that students utilise, which simultaneously construct the university campus as tolerant and diverse and as discriminatory and exclusionary. This paper draws attention to the significance of spaces within universities as well as to the management of university space as crucial factors in providing environments suited to an increasingly diverse student body.
America and Amerindians in Sebastian Münster's Cosmographiae universalis libri VI (1550)
Authors: DAVIES SUREKHA
Published: September 2010

Sebastian Münster's Cosmographiae universalis libri VI (1550) was produced in more sixteenth‐century editions that any book apart from the Bible. A descriptive geography prefaced by a series of maps, it offered the reader an overview of the world's peoples, natural history and geography. While German cosmographers had been instrumental in the emergence of the notion of America as the fourth part of the world, Münster considered America as part of Asia in a world with three, rather than four, parts.

This article investigates how Münster conceptualized America and Amerindians in the Cosmographia, and the ways in which he related them to the rest of the world. It shows how Münster's consideration of America as part of an island chain that included the Spice Islands or Moluccas fed into a broader discourse of long‐distance trade and exploration rather than indicating the limits of his ability to reconcile classical geography with contemporary exploration. It explains why Münster's delineation of America as an island was unsuccessful, but also why it consituted a reasonable model in the sixteenth century.
Computational Fluid Dynamics Design and Analysis of a Passively Suspended Tesla Pump Left Ventricular Assist Device
Authors: Medvitz Richard B. , Boger David A. , Izraelev Valentin , Rosenberg Gerson , Paterson Eric G.
Published: September 2010

This article summarizes the use of computational fluid dynamics (CFD) to design a novel suspended Tesla left ventricular assist device. Several design variants were analyzed to study the parameters affecting device performance. CFD was performed at pump speeds of 6500, 6750, and 7000 rpm and at flow rates varying from 3 to 7 liters per minute (LPM). The CFD showed that shortening the plates nearest the pump inlet reduced the separations formed beneath the upper plate leading edges and provided a more uniform flow distribution through the rotor gaps, both of which positively affected the device hydrodynamic performance. The final pump design was found to produce a head rise of 77 mm Hg with a hydraulic efficiency of 16% at the design conditions of 6 LPM throughflow and a 6750 rpm rotation rate. To assess the device hemodynamics the strain rate fields were evaluated. The wall shear stresses demonstrated that the pump wall shear stresses were likely adequate to inhibit thrombus deposition. Finally, an integrated field hemolysis model was applied to the CFD results to assess the effects of design variation and operating conditions on the device hemolytic performance.
Temporal trends in the mortality of people with epilepsy: A review
Authors: Neligan Aidan , Bell Gail S. , Shorvon Simon D. , Sander Josemir W.
Published: September 2010

Purpose:  It is now generally accepted that people with epilepsy are at increased risk of premature death compared with peers in the general population. It has, however, not been clearly established how this risk changes over time, nor whether mortality rates have been changing over time.

Methods:  We carried out a systematic review: (1) To determine the pattern of change of mortality risk relative to the general population in people with epilepsy in the course of their condition as measured by standardized mortality ratios (SMRs), by reviewing longitudinal prospective cohort studies. (2) To establish whether there have been any changes in reported mortality rates for epilepsy in general populations over time. This was complemented by comparison of SMRs in people with epilepsy in the same types of source populations (population‐based, hospital‐based, and institutional studies) in different time periods to ascertain any changes in reported mortality rates.

Results:  The SMR is highest in the initial years after diagnosis and subsequently decreases. There is a suggestion that there may be an increase after 10 years from diagnosis despite the fact that the majority of people in these cohorts are in long‐term remission. There is no evidence that either the overall SMR or the mortality rate of people with epilepsy has changed significantly over time.

Discussion:  Further population and cohort studies are needed to confirm these findings.
A duplication in 1q21.3 in a family with early onset and childhood absence epilepsy
Authors: Muhle Hiltrud , Steinich Ines , Von Spiczak Sarah , Franke Andre , Weber Yvonne , Lerche Holger , Wittig Michael , Heidemann Simone , Suls Arvid , De Jonghe Peter , Marini Carla , Guerrini Renzo , Scheffer Ingrid E. , Berkovic Samuel F. , Stephani Ulrich , Siebert Reiner , Sander Thomas , Helbig Ingo , Tönnies Holger
Published: September 2010

Early onset absence epilepsy (EOAE) starting before the age of 4 years constitutes a rare subgroup of the idiopathic generalized epilepsies (IGEs). A strong genetic component in IGE has been suggested by twin and family studies. We describe a boy with absence seizures starting at the age of 9 months whose parents both had childhood absence epilepsy. A 192‐kb duplication in 1q21.3 was identified in the proband and his father, encompassing the gene CHRNB2 coding for the β‐2 subunit of the nicotinic acetylcholine receptor and the gene ADAR coding for adenosine deaminase, an enzyme responsible for RNA editing. Both are candidate genes for seizure disorders. The duplication was not identified in 191 independent IGE patients (93 EOAE; 98 classical IGE) or in 1,157 population controls.
SUDEP, suspected positional airway obstruction, and hypoventilation in postictal coma
Authors: Tao James X. , Qian Shuo , Baldwin Maria , Chen Xiang‐Jun , Rose Sandra , Ebersole Susan‐Hawes , Ebersole John S.
Published: September 2010

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of mortality in patients with chronic uncontrolled epilepsy. Despite intense interest in SUDEP from the medical and scientific communities in recent years, its etiologies are still largely unresolved. A 35‐year‐old woman had SUDEP after having a generalized seizure in the prone position. The cause of her death was likely asphyxia from the convergence of postictal coma and suspected positional airway obstruction and hypoventilation, rather than the commonly suspected periictal cardiac arrhythmia or central apnea. SUDEP may share a similar etiology with sudden infant death syndrome (SIDS) and is likely preventable, at least in a proportion of cases.
Cognitive outcomes in children who present with a first unprovoked seizure
Authors: Sogawa Yoshimi , Masur David , O’Dell Christine , Moshe Solomon L. , Shinnar Shlomo
Published: September 2010

Purpose: To determine the long‐term cognitive and educational outcomes in children prospectively identified at the time of a first unprovoked seizure.

Methods: A cohort of children with a first unprovoked seizure was enrolled and followed for a mean of 15 years. Cognitive function and educational outcomes were determined 10 or more years after the first seizure via standardized neuropsychological tests, school records, and structured interviews. Children with symptomatic etiology were excluded from the analysis. When available, siblings of study subjects were recruited as normal controls. Primary educational outcome was defined as enrollment into special education services or grade repetition.

Results: Twenty‐eight percent of (43 of 153) of children with a single seizure and 40% (42 of 105) of children with epilepsy received special education service or repeated a grade (p = 0.05). There was a statistically significant trend in which the children with more seizures tended to require special education or repeat a grade more often (28% in single seizure group vs. 34% in 2–9 seizure group vs. 64% in ≥10 seizure group; p = 0.004). Of 163 subjects who completed neuropsychological testing, children with single seizures tended to score higher than children with epilepsy on Wide Range Achievement Test‐3 (WRAT) reading (p = 0.08), Test of Non‐Verbal Intelligence‐II (TONI‐II) (p = 0.02), and Wechsler Intelligence Scale for Children (WISC)/Wechsler Adult Intelligence Scale (WAIS) (p = 0.07). There was no statistically significant difference between children with a single seizure and sibling controls.

Conclusion: The results suggest that children with a single seizure represent a group that is distinctly different from children with epilepsy and are more similar to sibling controls. In contrast, even children with very mild epilepsy have significantly worse educational outcomes.
Egg laying and development of Neotropical trichogrammatid species in artificial eggs
Authors: Dias Nivia da Silva , Parra José Roberto Postali , Cônsoli Fernando Luis
Published: September 2010

The goal of this work was to assess the suitability of two artificial diets for egg laying and development of Trichogramma atopovirilia Oatman & Platner, Trichogrammatoidea annulata De Santis, and Trichogramma bruni Nagaraja (all Hymenoptera: Trichogrammatidae). Additionally, the quality of wasps reared in vitro was compared with those reared in vivo. The ‘standard’ diet consisted of Diatraea saccharalis (Fabricius) (Lepidoptera: Crambidae) pupal holotissues (65%), chicken egg yolk (18%), fetal bovine serum (8.5%), lactalbumin hydrolysate (8.5%), and anticontaminants (0.3%). The ‘modified’ diet differed from the standard one only in the D. saccharalis pupal holotissues, that were replaced with Heliothis virescens (Fabricius) (Lepidoptera: Noctuidae) ones. Females of the three trichogrammatid species laid eggs in artificial eggs containing any artificial medium, but the modified one received more eggs. Although the standard diet was accepted for oviposition by the three wasp species, no development occurred. On the modified diet, only T. atopovirilia was able to develop to adult emergence. Adult F1 were of a quality that was similar to insects reared in vivo.
Comparison of mating disruption and mass trapping with Pyralidae and Sesiidae moths
Authors: Teixeira Luís A.F. , Miller James R. , Epstein David L. , Gut Larry J.
Published: September 2010

Mating disruption and mass trapping for control of lepidopteran pests use synthetic sex pheromone to prevent males from finding and mating with females. Here, we identify the behavioral mechanism underlying mating disruption and mass trapping of American plum borer, Euzophera semifuneralis (Walker) (Lepidoptera: Pyralidae), peachtree borer, Synanthedon exitiosa Say, and lesser peachtree borer, Synanthedon pictipes (Groeten) (Lepidoptera: Sesiidae). In addition, we derive relative dispenser activity (Relative Da) from the competitive attraction equation to compare the disruptive activity of the devices used in mating disruption and mass trapping. Dispensers and traps were deployed in replicated 0.14‐ha cherry or peach plots with E. semifuneralis or the Synanthedon moths, respectively. Dispenser densities were 0, 10, 20, 59, 185, and 371 per ha, whereas trap densities were 0, 10, 20, 40, 79, and 158 per ha. Moth catch in a centrally placed, pheromone‐baited monitoring trap in each plot was used to evaluate the treatments. The profile of moth captures in mating disruption and mass trapping with the three species indicates that competitive attraction is the behavioral mechanism responsible for trap disruption. Relative Da is 0.27, 0.23, and 0.53 with American plum borer, peachtree borer, and lesser peachtree borer, respectively, which indicates that the traps are 1.9–4.4 times more effective in reducing moth catch than the dispensers. Relative Da can be used to compare devices for pheromone‐based behavioral manipulation of these and other species that are competitively attracted to artificial pheromone sources. When the same type of trap is employed for monitoring and mass trapping, Relative Da is the same as dispenser activity Da.
Host use and developmental instability in the cactophilic sibling speciesDrosophila gouveaiandD. antonietae
Authors: Soto I. M. , Carreira V. P. , Corio C. , Soto E. M. , Hasson E.
Published: September 2010

TheDrosophila repletagroup encompasses an ensemble of species that inhabit desertic areas that are inhospitable to other drosophilids. These species have a tractable ecology, as they breed and feed on necrotic tissues of a wide diversity of species of Cactaceae, with a certain degree of host specificity, which makes them suitable models to investigate the role of host plant shifts in diversification. Most species have their own primary host plant, which may be shared with a closely related species. However, the consequences of host plant shifts from primary to secondary hosts have not been thoroughly studied so far. We investigated the effects of the cactus host on developmental instability and performance ofD. gouveaiTidon‐Sklorz & Sene andD. antonietaeTidon‐Sklorz & Sene (Diptera: Drosophilidae), a pair of closely related sibling species, and of their F1 interspecific hybrids reared in primary and secondary host plants. Fluctuating asymmetry (FA) for wing size was significantly greater in flies of both species reared in their respective secondary cactus host than in those grown in the primary host. Interspecific hybrids also exhibited host‐dependent levels of FA. However, hybrids did not show greater FA than the parental species, suggesting that hybridization per se did not affect developmental stability. Even though cactus host shifts affected different measures of fitness (larval viability and adult size) both inD. antonietaeandD. gouveai, we did not detect a consistent relationship between FA and fitness. Our results suggest that FA cannot be used as a sensitive indicator of genetic and phenotypic quality and we discuss its application as a fitness predictor.
Recognition of Intercenter Differences May Help Develop Best Practice
Authors: Norda Rut , Axelsson Claes Göran , Axdorph Ulla , Berlin Gösta , Wikström Björn , Stegmayr Bernd ,   for the Swedish Apheresis Group
Published: September 2010

The Swedish Apheresis Registry is a National Quality Registry and performing intercenter comparisons can be done as one task. The purpose of this study was to evaluate differences in adverse effects (AE) associated with plasma exchange (PE) for the development of best practice. Six hundred and twenty reports of AE related to a total of 12 461 apheresis procedures performed during 1996–2002 were analyzed, and eight Swedish university hospital centers that reported AE every year were compared. About 70% of all PE in Sweden were performed in centers that also reported AE. During this period, there was no change in the proportion of PE procedures with AE, but there was a decrease in the frequency of prematurely interrupted procedures (2.1% to 1.3%, P = 0.003). The mean frequency of moderate and severe AE was 5%. Adverse effects were more common when PE was performed in patients with Guillain–Barré syndrome (GBS; 10%) or thrombotic thrombocytopenic purpura–hemolytic uremic syndrome (TTP–HUS; 8%) than in patients with macroglobulinemia/hyperviscosity syndromes (2%). In the eight centers, there was a four‐fold difference in AE between the centers with the highest and the lowest frequency. The frequency of AE in GBS, TTP–HUS and macroglobulinemia/hyperviscosity syndromes differed four‐fold, while the frequency of specified symptoms differed more than four‐fold. The indications and the choice of substitution fluids could explain some of these differences. The results of the study have initiated changes in practice. The identification of significant intercenter differences in the frequency and symptoms of AE has started improvement in current PE practices.
A Pilot Study of Leukocytapheresis Efficacy With 1.5 Liter Blood Processing Volume in Patients With Ulcerative Colitis
Authors: Shimada Masaaki , Iwase Hiroaki , Tsuzuki Tomoyuki , Hirashima Noboru , Kobayashi Kyoko , Hibino Yusuke , Watanabe Hisanori , Ryuge Nobumitsu , Ando Takafumi , Goto Hidemi , Yagi Yuhki , Tsujikawa Tomoyuki , Andoh Akira
Published: September 2010

Standard leukocytapheresis (LCAP) protocols recommend the processing of a 3 L blood volume. In this study, we evaluated the clinical effects of LCAP with 1.5 L of blood processing (1.5L‐LCAP) in patients with active ulcerative colitis (UC). Ten patients with moderate to severe UC were enrolled. Their clinical and endoscopic responses, the kinetics of the peripheral blood counts and cytokine responses were evaluated. Clinical and endoscopic effects were assessed using the clinical activity index described by Rachmilewitz, and by Matts' endoscopic classification, respectively. The 1.5L‐LCAP induced clinical remission in 8 out of 10 patients (80%). Endoscopic improvement was noted in 6 out of 7 patients (85.7%). Prednisolone (PSL) was used in 8 patients; the PSL dose could be reduced in 6 patients, and weaning was possible in one patient. Adverse effects were not observed during 1.5L‐LCAP therapy. During the 1.5L‐LCAP session, the leukocyte count reached the minimum at 1.0 L of blood processing, but promptly increased after completion of the session, and reached a maximum after 30 min. Interleukin (IL)‐1β‐induced IL‐8 and IL‐6 secretion by peripheral blood mononuclear cells were both significantly reduced by 1.5L‐LCAP therapy. 1.5L‐LCAP was clinically effective for active UC patients. Cellular responses induced by 1.5L‐LCAP were similar to those induced by a standard LCAP session.
Removal of 2‐Arachidonylglycerol by Direct Hemoperfusion Therapy With Polymyxin B Immobilized Fibers Benefits Patients With Septic Shock
Authors: Kase Yoichi , Obata Toru , Okamoto Yasuhisa , Iwai Kenichi , Saito Keita , Yokoyama Keitaro , Takinami Masanori , Tanifuji Yasumasa
Published: September 2010

Arachidonylethanolamide (AEA) and 2‐arachidonylglycerol (2‐AG) are endocannabinoids involved in septic shock, and 8‐epi prostaglandin F2α (F2‐isoprostane) is a biomarker of oxidative stress in biological systems. Because the antibiotic polymyxin B absorbs endocannabinoids as well as endotoxins, direct hemoperfusion therapy with polymyxin B‐immobilized fibers (PMX‐DHP) decreases serum levels of endocannabinoids. To investigate the features of sepsis and determine the proper use of PMX‐DHP, we measured the changes in levels of endocannabinoids and F2‐isoprostane in patients with septic shock. Twenty‐six patients with septic shock, including those with septic shock induced by peritonitis, underwent laparotomy for drainage. Endocannabinoids absorption with PMX‐DHP was examined in two groups of patients: patients whose mean arterial blood pressure (mABP) had increased more than 20 mm Hg (responder group; N = 13); and patients iwhose mABP did not increase or had increased no more than 20 mm Hg (non‐responder group; N = 13). Levels of AEA did not change after PMX‐DHP in either the non‐responder or responder groups, whereas levels of 2‐AG decreased significantly after PMX‐DHP in the responder group, but not in the non‐responder group. F2‐isoprostane gradually increased after PMX‐DHP treatment; on the other hand, levels of F2‐isoprostane remained constant in the responder group. Patients with septic shock are under considerable oxidative stress, and 2‐AG plays an important role in the cardiovascular status of these patients. The removal of 2‐AG by PMX‐DHP benefits patients with septic shock by stabilizing cardiovascular status and decreasing long‐term oxidative stress.
Efficacy of Cytokine Removal by Plasmadiafiltration Using a Selective Plasma Separator: In Vitro Sepsis Model
Authors: Li Mingxin , Xue Jun , Liu Junfeng , Kuang Dingwei , Gu Yong , Lin Shanyan
Published: September 2010

More effective removal of pro‐ and anti‐inflammatory cytokines may play an important role in the treatment of sepsis. Plasmadiafiltration (PDF) with a larger selective plasma separator was performed to study the cytokine and plasma protein permeability profiles of the membrane in an in vitro sepsis model. The in vitro sepsis model was constructed by exposure of human whole blood to bacterial lipopolysaccharide. EVACURE 2A, a selective plasma separator, was placed in the blood circuit of PDF. Sieving coefficients of cytokines and plasma protein were tested in post‐dilution PDF mode at the following operating parameters: blood flow rate 150 mL/min; dialysate flow rate 33.33 mL/min; replacing fluid flow rate 6.67 mL/min; ultrafiltration rate 5 mL/min. An enzyme linked immunoadsorbent assay was used to measure the concentrations of tumor necrosis factor‐α (TNF‐α), high‐mobility group box 1 protein (HMGB1), interleukin‐1β (IL‐1β), interleukin‐1 receptor antagonist (IL‐1ra), interleukin‐2 (IL‐2), interleukin‐2 receptor (IL‐2r), interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), interleukin‐10 (IL‐10) in plasma and ultrafiltrate. Sieving coefficients of different solutes ranged from 0.1 to 1.0 at first, decreased 10%–60% after 1 h of PDF, and then remained stable. Total clearance rates of cytokines ranged from 15 to 80 mL/min. The concentrations of cytokines decreased 20–80% after 1 hour of PDF. The sieving coefficient of albumin was 0.1 at first and then decreased to 0.05 after 1 hour of therapy. Plasmadiafiltration with Evacure 2A plasma separator can effectively remove almost all of the inflammatory mediators with low albumin loss.
Review of Helicobacter pylori Infection and Chronic Renal Failure
Authors: Sugimoto Mitsushige , Yamaoka Yoshio
Published: September 2010

Chronic renal failure patients receiving hemodialysis and continuous ambulatory peritoneal dialysis often encounter gastrointestinal troubles over their long treatment period. Helicobacter pylori infection has close association with development of peptic ulcer, gastric cancer and gastric lymphoma, and is thought to be one of the major risk factors for gastrointestinal troubles in dialysis patients. However, it is unclear whether H. pylori infection is directly associated with progression of renal dysfunction and prognosis of chronic renal failure patients. Recent consensus shows that the prevalence of H. pylori infection in chronic renal failure patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in hemodialysis patients, the prevalence of infection decreases as dialysis periods progressed, in particular within the first four years after the start of treatment. However, the chance of natural eradication becomes rare for patients receiving dialysis treatment for a long time. Moreover, chronic renal failure patients with H. pylori infection have a higher incidence of gastroduodenal diseases, and therefore, are recommended to receive eradication therapies, especially for those receiving treatment for a long time and with higher risks of complication. Intensive endoscopic check‐ups for the prevention of gastrointestinal events and the discovery of peptic ulcer and neoplastic diseases at an early phase may be required.