bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Herbs and Dietary Supplements in Gynecology: An Evidence‐Based Review
Authors: Dennehy Cathi E.
Published: November 2006

Consumers frequently use herbs and dietary supplements to treat chronic conditions that are poorly responsive to prescription drugs or when prescription drugs carry a high side effect burden. Women may use herbs and supplements for chronic gynecologic conditions, such as menopause, premenstrual syndrome, dysmenorrhea, cyclic mastalgia, and infertility. This review is an evidence‐based evaluation of herbs and supplements for these conditions. Therapies that carry a higher level of support from randomized controlled trial evidence include black cohosh for menopause; vitamins B1 and E for dysmenorrhea; calcium, vitamin B6, and chasteberry for premenstrual syndrome; and chasteberry for cyclic mastalgia. There were too few trials involving herbs and supplements in infertility to warrant a solid recommendation, but chasteberry, antioxidants, and Fertility Blend have some preliminary support. Midwives may want to consider these alternatives in addition to more traditional treatment options when meeting with patients.
Polycystic Ovary Syndrome
Authors: King Joyce
Published: November 2006

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, affecting between 4% and 8% of reproductive aged women. This syndrome, a complex disorder with multiple components, including reproductive, metabolic, and cardiovascular manifestations, has long‐term health concerns that cross the life span. The diagnostic criteria for PCOS are ovarian dysfunction evidenced by oligomenorrhea or amenorrhea and clinical evidence of androgen excess (e.g., hirsutism and acne) in the absence of other conditions that can cause these same symptoms. This article reviews current knowledge about the pathophysiology, clinical manifestations, diagnosis, and management of this disorder.
The Intrauterine Device: Rethinking Old Paradigms
Authors: Morgan Katherine W.
Published: November 2006

The United States continues to have one of the highest rates of unintended pregnancy and elective abortion in developed countries. Intrauterine devices (IUDs) available today offer women safe and highly effective contraception along with noncontraceptive benefits, yet IUDs remain underutilized in part because of outdated and biased information about the risks associated with this method of fertility control. New research demonstrates that IUD use does not increase the risk of pelvic infections or subsequent infertility. IUD use decreases the absolute risk of ectopic pregnancies. In light of this data, the IUD should be made available to women at low‐risk for sexually‐transmitted infections and should not be denied to women on the basis of parity or marital status.
Body Image After Bilateral Prophylactic Mastectomy: An Integrative Literature Review
Authors: McGaughey Amy
Published: November 2006

Bilateral prophylactic mastectomy (BPM) can reduce a woman's risk for breast cancer by 80%. Thus, women who are at high risk for familial breast cancer are increasingly opting for BPM as a preventative option. Research indicates that there are psychological benefits to BPM, including a reduction in anxiety about developing breast cancer. The purpose of this integrative review is to summarize the research that has examined the effect of prophylactic mastectomy on women's subsequent body image. Thirteen studies were reviewed. The majority of women were satisfied with their decision. However, the majority of studies indicate that up to one‐half of the women suffer a negative effect on body image and changes in sexuality. Knowledge of these findings can improve the practitioner's ability to counsel women regarding this radical decision. Further research, particularly prospective studies, are needed to examine women's body image prior to BPM so that the impact of prophylactic mastectomy can be examined more thoroughly.
Student-selected components: bringing more ENT into the undergraduate curriculum
Authors: Newbegin R M , Rhodes J C , Flood L M , Richardson H C
Published: November 2006

Exposure to otolaryngology is currently minimal in the UK undergraduate medical curriculum. This may lead to difficulties in attracting graduates into higher ENT surgical training and in ensuring a reasonable standard of ENT knowledge amongst primary care practitioners.

A recent innovation, of which many ENT units may be unaware, is the introduction to the undergraduate curriculum of ‘student-selected components’. Like the traditional elective, this allows students to undertake an attachment to a speciality and department of their choice. Units which do not regularly teach medical students but which have a welcoming and enthusiastic approach to undergraduate training may well be ideal hosts.

This paper introduces the concepts underlying student-selected components, outlines the preparation required and offers a template for such an attachment, for which ENT is ideally suited.
A historical review of head and neck cancer in celebrities
Authors: Folz B J , Ferlito A , Weir N , Pratt L W , Rinaldo A , Werner J A
Published: November 2006

Introduction: The illnesses of celebrity patients always receive more attention from the general public than those of ordinary patients. With regard to cancer, this fact has helped to spread information about the four major malignancies: breast cancer, prostatic cancer, lung cancer and colorectal cancer. Head and neck cancer, on the other hand, is still not well recognised by the lay public, although the risk factors are similar to those of lung cancer. It was the objective of this analysis to identify cases of celebrity patients, the description of which could help to increase awareness of head and neck cancer, its symptoms and risk factors.

Methods: The Internet and medical literature databases were searched for celebrity patients who had suffered from head and neck cancer.

Results: The search revealed numerous famous head and neck cancer patients. However, only seven cases were documented well in the medical literature. Among the identified persons were one emperor, two United States presidents, a legendary composer, a world-renowned medical doctor, an outstanding athlete and an extraordinary entertainer. In spite of their exclusive position in society, these patients did not have a better prognosis compared with ordinary patients of their time. Only two of the group experienced long term survival and only one was cured. None of these influential figures used their influence to fund research or to promote knowledge about their respective diseases.

Conclusion: The identified cases could help increase public awareness of head and neck cancer. Similar to activities in other oncologic fields, current celebrity head and neck cancer patients should be encouraged to discuss their diseases openly, which could have a positive effect on public health.
Intestinale Ischämie – Internistische Sicht
Authors: Geissler
Published: November 2006

Die Prognose bei einem Patienten mit mesenterialer Ischämie ist entscheidend abhängig vom Management des erstuntersuchenden Arztes. Um das hohe Mortalitätsrisiko bei einer akuten mesenterialen Ischämie zu minimieren, ist eine rasche, zielgerichtete und invasiv-aggressive Diagnostik mit unmittelbar anschliessender Therapie unumgänglich. Ein abwartendes, kontrollierendes Verhalten ist beim Verdacht auf eine akute intestinale Ischämie nicht zu rechtfertigen. Diagnostisch problematisch ist die Tatsache, dass frühe klinische Zeichen und diagnostische Parameter wie Leukozytose, erhöhter Laktatwert und eine metabolische Azidose oft unspezifisch sind. Aus diesem Grunde sollte im Verdachtsfall frühzeitig eine mesenteriale Angiographie als Goldstandard bei der Abklärung der arteriellen mesenterialen Ischämie durchgeführt werden. Bei peritonitischen Zeichen sollte, wenn klinisch möglich, umgehend die explorative Laparotomie mit anschliessender Embolektomie und ggf. chirurgischer Revaskularisation erfolgen.
A super bubble detected by dense GPS network at east Asian longitudes
Authors: Ma Guanyi , Maruyama Takashi
Published: November 2006

A post sunset bubble manifested by total electron content depletion was observed at midlatitudes (∼30°–34°N, ∼130°–134°E) during the main phase of a storm on 12 February 2000. With loss of lock and the rate of the total electron content index maps, the bubble was seen to bifurcate at its early growth phase. The upward drift speed was observed ∼300 m/s at ∼2150 km, and decreasing with increasing altitude and time. The bubble had unusually large latitudinal extension reaching midlatitude of 36.5°N (31.5°N magnetic latitude), indicating an apex height of ∼2500 km. In process of the evolution, the bubble drifted eastward at a speed of ∼50 m/s. The F region peak height and density obtained by a meridional ionosonde chain suggested a prompt penetrating magnetospheric electric field helped to trigger the super bubble.
A study of aspect angle effects in the E‐region irregularity velocity using multi‐point electric field measurements
Authors: Makarevich R. A. , Senior A. , Koustov A. V. , Uspensky M. , Honary F. , Dyson P. L.
Published: November 2006

E‐region irregularity velocity measured by the STARE Norway VHF radar is considered as a function of magnetic aspect angle α and EISCAT‐derived electron drift velocity at 7 locations with α between 0.38° and 2.64°. It is shown that the irregularity line‐of‐sight (l‐o‐s) velocity normalized to the electron velocity component Ve0 comp exhibits a decrease with an increasing aspect angle for Ve0 comp exceeding 500 m/s. The rate of velocity decrease is greater than those reported previously and is close to that predicted by the linear theory of electrojet irregularities without assuming anomalously large collision frequencies.
Selection and amplification of modes of an optical frequency comb using a femtosecond laser injection-locking technique
Authors: Moon H. S. , Kim E. B. , Park S. E. , Park C. Y.
Published: November 2006

The authors have demonstrated the selection and the amplification of the components of an optical frequency comb using a femtosecond laser injectionlocking technique. The author used a mode-locked femtosecond Ti:sapphire laser as the master laser and a single-mode diode laser as the slave laser. The femtosecond laser injection-locking technique was applied to a filter for mode selection of the optical frequency comb and an amplifier for amplification of the selected mode. The authors could obtain the laser source selected only the desired mode of the optical frequency comb and amplified the power of the selected modes several thousand times.
Photoluminescence response of ion-implanted silicon
Authors: Harding Ruth E. , Davies Gordon , Hayama S. , Coleman P. G. , Burrows C. P. , Wong-Leung J.
Published: November 2006

The photoluminescence intensity from ion-implanted silicon can be quenched by the radiation damage implicit in the implantation. Annealing is then required before the intensity of the luminescence from a defect center is approximately proportional to the concentration of that center. Data from positron annihilation and photoluminescence experiments establish that severe quenching of the luminescence occurs when the mean separation of the small vacancy clusters is less than ∼30 atomic spacings, and the authors map out where, in the annealing and implantation phase space, the luminescence intensity is expected to be approximately proportional to the concentration of the optical centers.
Transition of field emission to space-charge-limited emission in a nanogap
Authors: Koh W. S. , Ang L. K.
Published: November 2006

This letter presents a quantum model showing the transition of electron field emission at low current to space-charge-limited emission at high current in a nanogap. It is found that the classical transition models are no longer valid when the electron de Broglie wavelength is comparable to the gap spacing. The transition from the Fowler-Nordheim law at low current to the quantum Child-Langmuir law at high current in a nanogap is calculated for various conditions.
Adhesion modulation by quantum size effects in Pb∕Si(111) system
Authors: Han Tie-Zhu , Dong Guo-Cai , Shen Quan-Tong , Zhang Yan-Feng , Jia Jin-Feng , Xue Qi-Kun
Published: November 2006

Ultrahigh vacuum atomic force microscopy is employed to measure the adhesive force of atomically flat (111) oriented Pb island on Si (111) surface at low temperature (∼60K). The experimental results indicate that for the same (111) surface the adhesive force changes and oscillates with the island thickness. This phenomenon is shown to originate from the electron structure modulation by strong quantum size effects along the island surface normal direction, which modifies surface energy and leads to the observed oscillatory adhesive forces.
Stomatal aperture can compensate altered stomatal density in Arabidopsis thaliana at growth light conditions
Authors: Büssis Dirk , von Groll Uritza , Fisahn Joachim , Altmann Thomas
Published: November 2006

Stomatal density of transgenic Arabidopsis thaliana plants over-expressing the SDD1 (stomatal density and distribution) gene was reduced to 40% and in the sdd1-1 mutant increased to 300% of the wild type. CO2 assimilation rate and stomatal conductance of over-expressers and the sdd1-1 mutant were unchanged compared with wild types when measured under the light conditions the plants were exposed to during growth. Lower stomatal density was compensated for by increased stomatal aperture and conversely, increased stomatal density was compensated for by reduced stomatal aperture. At high light intensities the assimilation rates and stomatal conductance of SDD1 over-expressers were reduced to 80% of those in wild type plants. Areas beneath stomata and patches lacking stomata were analysed separately. In areas without stomata, maximum fluorescence yield (Fv / Fm) and quantum yield of photosystem II (Φ PSII) were significantly lower than in areas beneath stomata. In areas beneath stomata, Fv / Fm and Φ PSII were identical to levels measured in wild type leaves. At high light intensities over-expressers showed decreased photochemical quenching (qP) compared with wild types. However, the decrease of qP was significantly stronger in areas without stomata than in mesophyll areas beneath stomata. At high CO2 partial pressures and high light intensities CO2 assimilation rates of SDD1 over-expressers did not reach wild type levels. These results indicate that photosynthesis in SDD1 over-expressers was reduced because of limiting CO2 in areas furthest from stomata at high light.
Growth and photosynthetic down-regulation in Coffea arabica in response to restricted root volume
Authors: Ronchi Cláudio P. , DaMatta Fábio M. , Batista Karine D. , Moraes Gustavo A. B. K. , Loureiro Marcelo E. , Ducatti Carlos
Published: November 2006

Coffee (Coffea arabica L.) plants were grown in small (3-L), medium (10-L) and large (24-L) pots for 115 or 165 d after transplanting (DAT), which allowed different degrees of root restriction. Effects of altered source : sink ratio were evaluated in order to explore possible stomatal and non-stomatal mechanisms of photosynthetic down-regulation. Increasing root restriction brought about large and general reductions in plant growth associated with a rising root : shoot ratio. Treatments did not affect leaf water potential or leaf nutrient status, with the exception of N content, which dropped significantly with increasing root restriction even though an adequate N supply was available. Photosynthesis was severely reduced when plants were grown in small pots; this was largely associated with non-stomatal factors, such as decreased Rubisco activity. At 165 DAT contents of hexose, sucrose, and amino acids decreased in plants grown in smaller pots, while those of starch and hexose-P increased in plants grown in smaller pots. Photosynthetic rates were negatively correlated with the ratio of hexose to free amino acids, but not with hexose content. Activities of acid invertase, sucrose synthase, sucrose-P synthase, fructose-1,6-bisphosphatase, ADP-glucose pyrophosphorylase, starch phosphorylase, glyceraldehyde-3-P dehydrogenase, PPi : fructose-6-P 1-phosphotransferase and NADP : glyceraldehyde-3-P dehydrogenase all decreased with severe root restriction. Glycerate-3-P : Pi and glucose-6-P : fructose-6-P ratios decreased accordingly. Photosynthetic down-regulation was unlikely to have been associated directly with an end-product limitation, but rather with decreases in Rubisco. Such a down-regulation was largely a result of N deficiency caused by growing coffee plants in small pots.
Excess copper induces structural changes in cultured photosynthetic soybean cells
Authors: Bernal María , Sánchez-Testillano Pilar , Risueño María del Carmen , Yruela Inmaculada
Published: November 2006

Soybean [Glycine max (L.) Merr.] cell suspensions have the capacity to develop tolerance to excess copper, constituting a convenient system for studies on the mechanisms of copper tolerance. The functional cell organisation changes observed in these cell cultures after both short-term (stressed cells) and long-term (acclimated cells) exposure to 10 μm CuSO4 are reported from structural, cytochemical and microanalytical approaches. Cells grown in the presence of 10 μm CuSO4 shared some structural features with untreated cells, such as: (i) a large cytoplasmic vacuole, (ii) chloroplasts along the thin layer of cytoplasm, (iii) nucleus in a peripheral location exhibiting circular-shaped nucleolus and a decondensed chromatin pattern, and (iv) presence of Cajal bodies in the cell nuclei. In addition, cells exposed to 10 μm CuSO4 exhibited important differences compared with untreated cells: (i) chloroplasts displayed rounded shape and smaller size with denser-structured internal membranes, especially in copper-acclimated cells; (ii) no starch granules were found within chloroplasts; (iii) the cytoplasmic vacuole was larger, especially after long-term copper exposure; (iv) the levels of citrate and malate increased. Extracellular dark-coloured deposits with high copper content attached at the outer surface of the cell wall were observed only in cells exposed to a short-term copper stress. Structural cell modifications, mainly affecting chloroplasts, accompanied the short-term copper-induced response and were maintained as stable characters during the period of adaptation to excess copper. Vacuolar changes accompanied the long-term copper response. The results indicate that the first response of soybean cells to excess copper prevents its entry into the cell by immobilising it in the cell wall, and after an adaptive period, acclimation to excess copper may be mainly due to vacuolar sequestration.
MyoD expression restores defective myogenic differentiation of human mesoangioblasts from inclusion-body myositis muscle
Authors: Morosetti Roberta , Mirabella Massimiliano , Gliubizzi Carla , Broccolini Aldobrando , De Angelis Luciana , Tagliafico Enrico , Sampaolesi Maurilio , Gidaro Teresa , Papacci Manuela , Roncaglia Enrica , Rutella Sergio , Ferrari Stefano , Tonali Pietro Attilio , Ricci Enzo , Cossu Giulio
Published: November 2006

Inflammatory myopathies (IM) are acquired diseases of skeletal muscle comprising dermatomyositis (DM), polymyositis (PM), and inclusion-body myositis (IBM). Immunosuppressive therapies, usually beneficial for DM and PM, are poorly effective in IBM. We report the isolation and characterization of mesoangioblasts, vessel-associated stem cells, from diagnostic muscle biopsies of IM. The number of cells isolated, proliferation rate and lifespan, markers expression, and ability to differentiate into smooth muscle do not differ among normal and IM mesoangioblasts. At variance with normal, DM and PM mesoangioblasts, cells isolated from IBM, fail to differentiate into skeletal myotubes. These data correlate with lack in connective tissue of IBM muscle of alkaline phosphatase (ALP)-positive cells, conversely dramatically increased in PM and DM. A myogenic inhibitory basic helix–loop–helix factor B3 is highly expressed in IBM mesoangioblasts. Indeed, silencing this gene or overexpressing MyoD rescues the myogenic defect of IBM mesoangioblasts, opening novel cell-based therapeutic strategies for this crippling disorder.
Individuals homozygous for the age-related macular degeneration risk-conferring variant of complement factor H have elevated levels of CRP in the choroid
Authors: Johnson P. T. , Betts K. E. , Radeke M. J. , Hageman G. S. , Anderson D. H. , Johnson L. V.
Published: November 2006

Polymorphisms in the complement factor H gene (CFH) are associated with a significantly increased risk for, or protection against, the development of age-related macular degeneration (AMD). The most documented risk-conferring single-nucleotide polymorphism results in a tyrosine-to-histidine substitution at position 402 (Y402H) of the CFH protein. In this work, we examined the ocular distributions and relative abundance of CFH, several CFH-binding proteins, and abundant serum proteins in the retinal pigmented epithelium (RPE), Bruch's membrane, and choroid (RPE–choroid) inCFHhomozygotes possessing either the “at-risk” 402HH or “normal” 402YY variants. Although CFH immunoreactivity is high in the choroid and in drusen, no differences in CFH-labeling patterns between genotypes are apparent. In contrast, at-risk individuals have significantly higher levels of the CFH-binding protein, C-reactive protein (CRP), in the choroidal stroma. Immunoblots confirm that at-risk individuals have ≈2.5-fold higher levels of CRP in the RPE–choroid; no significant differences in the levels of CFH or other serum proteins are detected. Similarly, we find no differences in CFH transcription levels in the RPE–choroid nor evidence for local ocular CRP transcription. Increased levels of CRP in the choroid may reflect a state of chronic inflammation that is a by-product of attenuated CFH complement-inhibitory activity in those who possess theCFHat-risk allele. Because the CRP-binding site in CFH lies within the domain containing the Y402H polymorphism, it is also possible that the AMD risk-conferring allele alters the binding properties of CFH, thereby leading to choroidal CRP deposition, contributing to AMD pathogenesis.
The Requirement of Sterol Glucoside for Pexophagy in Yeast Is Dependent on the Species and Nature of Peroxisome Inducers
Authors: Nazarko Taras Y. , Polupanov Andriy S. , Manjithaya Ravi R. , Subramani Suresh , Sibirny Andriy A.
Published: November 2006

Sterol glucosyltransferase, Ugt51/Atg26, is essential for both micropexophagy and macropexophagy of methanol-induced peroxisomes in Pichia pastoris. However, the role of this protein in pexophagy in other yeast remained unclear. We show that oleate- and amine-induced peroxisomes in Yarrowia lipolytica are degraded by Atg26-independent macropexophagy. Surprisingly, Atg26 was also not essential for macropexophagy of oleate- and amine-induced peroxisomes in P. pastoris, suggesting that the function of sterol glucoside (SG) in pexophagy is both species and peroxisome inducer specific. However, the rates of degradation of oleate- and amine-induced peroxisomes in P. pastoris were reduced in the absence of SG, indicating that P. pastoris specifically uses sterol conversion by Atg26 to enhance selective degradation of peroxisomes. However, methanol-induced peroxisomes apparently have lost the redundant ability to be degraded without SG. We also show that the P. pastoris Vac8 armadillo repeat protein is not essential for macropexophagy of methanol-, oleate-, or amine-induced peroxisomes, which makes PpVac8 the first known protein required for the micropexophagy, but not for the macropexophagy, machinery. The uniqueness of Atg26 and Vac8 functions under different pexophagy conditions demonstrates that not only pexophagy inducers, such as glucose or ethanol, but also the inducers of peroxisomes, such as methanol, oleate, or primary amines, determine the requirements for subsequent pexophagy in yeast.
Congenital Cytomegalovirus Infection Diagnosed by Polymerase Chain Reaction With the Use of Preserved Umbilical Cord in Sensorineural Hearing Loss Children
Authors: Ogawa Hiroshi , Baba Yoko , Suzutani Tatsuo , Inoue Naoki , Fukushima Eiko , Omori Koichi
Published: November 2006

Objectives/Hypothesis: Congenital cytomegalovirus (CMV) infection is estimated to account for 30% of sensorineural hearing loss (SNHL) cases. Differences in clinical characteristics between CMV‐related and unrelated SNHL cases were scrutinized.

Methods: Using dried umbilical cord, we have recently developed a polymerase chain reaction (PCR)‐based assay for the retrospective detection of congenital CMV infection. Medical records of 7 CMV‐related patients identified from 31 SNHL patients by the assay were evaluated for the following: type and degree of hearing impairment, computed tomographic scan results, mental retardation, cerebral palsy, autism, and other multiple disorders.

Results: Clinical characteristics of the seven CMV‐related SNHL cases were as follows: 1) six of the seven exhibited severe bilateral SNHL, whereas one had severe unilateral SNHL in the right ear. Although the hearing levels of CMV‐related patients were more greatly impaired than those of CMV‐negative patients, there was no hearing impairment pattern specific to the CMV‐related patients; 2) five patients had mental retardation, which was more frequent than in CMV‐negative patients; 3) birth weights of the CMV‐positive cases were relatively lower.

Discussion: Although CMV‐positive cases are clinically indistinguishable from CMV‐negative cases, our PCR system allowed the retrospective diagnosis of CMV‐related SNHL.

Conclusion: CMV‐related SNHL tends to accompany mental retardation and low birth weight more frequently than does CMV‐negative SNHL.
Positional Therapy for Obstructive Sleep Apnea Patients: A 6‐Month Follow‐Up Study
Authors: Oksenberg Arie , Silverberg Donald , Offenbach Dalia , Arons Elena
Published: November 2006

Background: Approximately half of obstructive sleep apnea (OSA) patients are positional (i.e., the majority of their breathing abnormalities during sleep appear in the supine posture). Little information exists as to whether avoiding the supine posture during sleep (positional therapy) is a valuable form of therapy for these patients.

Aim: To assess the use of positional therapy (by the tennis ball technique [TBT]) during a 6 month period in 78 consecutive positional OSA patients.

Methods: Demographic, polysomnographic, and self‐reported questionnaire data on the use of the TBT were analyzed.

Results: Of the 50 patients who returned the questionnaire, 19 (38%) (group A) said they were still using the TBT, and 12 (24%) (group B) said they used it initially and stopped using it within a few months but were still avoiding the supine position during sleep. Nineteen patients (38%) (group C) stopped using the TBT within a few months but did not learn how to avoid the sleep supine posture. Patients still using the TBT showed a significant improvement in their self‐reported sleep quality (P < .005) and daytime alertness (P < .046) and a decrease in snoring loudness (P < .001). Patients of groups A and B were older than patients who did not comply with this therapy (P < .001). The main reason for patients stopping the use of the TBT in group C was that using it was uncomfortable.

Conclusions: Positional therapy appears to be a valuable form of therapy mainly for some older aged positional OSA patients.
The Effects of Debridement After Endoscopic Sinus Surgery
Authors: Bugten Vegard , Nordgård Ståle , Steinsvåg Sverre
Published: November 2006

Objectives/Hypothesis: The aim of this randomized, partly blinded, controlled clinical trial was to evaluate the effects of debridement 6 and 12 days after endoscopic sinus surgery.

Methods: Sixty patients (male/female = 26/34; mean age, 43.5 years; age range, 23–73 years) with chronic or acute recurrent rhinosinusitis were included. The patients were randomized to postoperative debridement or not. Primary outcome variables were adhesions between the middle turbinate and the lateral nasal wall 10 to 14 weeks after surgery judged by blinded evaluation of endoscopic video recordings. Secondary outcome variables were crusts in the nasal cavity 12 days after surgery and pain caused by debridement.

Results: We found a significant reduction in adhesions in the group that underwent debridement (P < .001). At 12 weeks, bilateral adhesions were observed in nine control patients but in only one debridement patient. Unilateral adhesions were found in 11 control patients and in nine debridement patients. Twelve days after surgery, we found significantly less severe crusts in the debridement group (P < .01). Patients with severe crusts in the middle meatus 12 days after surgery had more adhesions 12 weeks postoperatively. The debridement group used more analgesics the days after the first debridement (3.7 days [standard deviation 2.3] vs. 2.3 days [standard deviation 2.6] in the control group, P < .041).

Conclusions: Crusts in the middle meatus after sinus surgery is associated with postoperative adhesions. Debridement of the nasal cavity reduces crusts and postoperative adhesions significantly compared with saline irrigation only. However, the procedure induces more postoperative nasal pain.
DDB1 functions as a linker to recruit receptor WD40 proteins to CUL4–ROC1 ubiquitin ligases
Authors: He Yizhou Joseph , McCall Chad M. , Hu Jian , Zeng Yaxue , Xiong Yue
Published: November 2006

Cullins assemble the largest family of ubiquitin ligases by binding with ROC1 and various substrate receptors. CUL4 function is linked with many cellular processes, but its substrate-recruiting mechanism remains elusive. We identified a protein motif, the DWD box (DDB1-binding WD40 protein), and demonstrated the binding of 15 DWD proteins with DDB1–CUL4A. We provide evidence supporting the critical function of the DWD box and DDB1’s role as the linker mediating DWD protein association with CUL4A. A database search predicts that about one-third of WD40 proteins, 90 in humans, contain the DWD box, suggesting a potentially large number of DWD–DDB1–CUL4–ROC1 E3 ligases.
The order of expression of transcription factors directs hierarchical specification of hematopoietic lineages
Authors: Iwasaki Hiromi , Mizuno Shin-ichi , Arinobu Yojiro , Ozawa Hidetoshi , Mori Yasuo , Shigematsu Hirokazu , Takatsu Kiyoshi , Tenen Daniel G. , Akashi Koichi
Published: November 2006

The mechanism of lineage specification in multipotent stem cells has not been fully understood. We recently isolated progenitors with the eosinophil, basophil, or mast cell lineage potential, all of which originate from granulocyte/monocyte progenitors (GMPs). By using these prospectively purified progenitors, we show here that the expression timing of GATA-2 and CCAAT enhancer-binding protein α (C/EBPα) can differentially control their lineage commitment. The expression of GATA-2 instructed C/EBPα-expressing GMPs to commit exclusively into the eosinophil lineage, while it induced basophil and/or mast cell lineage commitment if C/EBPα was suppressed at the GMP stage. Furthermore, simply by switching the order of C/EBPα and GATA-2 transduction, even lymphoid-committed progenitors recaptured these developmental processes to be reprogrammed into each of these lineages. We propose that the order of expression of key transcription factors is critical for their interplay to selectively drive lineage specification programs, by which stem cells could generate multiple lineage cells in a hierarchical manner.
A review of inherited platelet disorders with guidelines for their management on behalf of the UKHCDO
Authors: Bolton‐Maggs Paula H. B. , Chalmers Elizabeth A. , Collins Peter W. , Harrison Paul , Kitchen Stephen , Liesner Ri J. , Minford Adrian , Mumford Andrew D. , Parapia Liakat A. , Perry David J. , Watson Steve P. , Wilde Jonathan T. , Williams Michael D.
Published: November 2006

The inherited platelet disorders are an uncommon cause of symptomatic bleeding. They may be difficult to diagnose (and are likely to be under‐diagnosed) and pose problems in management. This review discusses the inherited platelet disorders summarising the current state of the art with respect to investigation and diagnosis and suggests how to manage bleeding manifestations with particular attention to surgical interventions and the management of pregnancy.
Globin gene expression in Hb Lepore‐BAC transgenic mice
Authors: Sloane‐Stanley Jackie , Roberts Nigel A. , Olivieri Nancy , Weatherall David J. , Wood William G.
Published: November 2006

We generated five lines of transgenic mice carrying 1–3 copies of the Hb Lepore δβ fusion gene, in the context of a Bacterial Artificial Chromosome containing the whole human β globin gene cluster. Normal developmental regulation of human genes occurred at levels approximating to those of endogenous genes. δβ transgene expression became detectable during fetal life and rose to a mean level of 13·0% in adults, similar to that of humans. Low levels of human γ chains were detectable as F cells in adult mice, but numbers did not increase after treatment with drugs that raise F cells in human subjects, even on a thalassaemic background.
CD2 identifies a monocyte subpopulation with immunoglobulin E‐dependent, high‐level expression of FcɛRI
Authors: Cheng Y. X. , Foster B. , Holland S. M. , Klion A. D. , Nutman T. B. , Casale T. B. , Metcalfe D. D. , Prussin C.
Published: November 2006

Background
FcɛRI expression by monocytes can affect monocyte function via multiple mechanisms, thereby potentially influencing the generation of allergic inflammation. Previous studies on the in vivo regulation of monocyte FcɛRI expression by ambient IgE have yielded conflicting results.

Objective
We hypothesized that monocyte FcɛRI expression is limited to a specific monocyte subset, and that within that subset FcɛRI surface expression is correlated to serum IgE.

Methods
Study 1: Blood was obtained from non‐allergic subjects (n=14) and subjects with allergic asthma (n=18), hypereosinophilic syndrome (n=2), hyper‐IgE syndrome (n=6), and helminth infection (n=4). Study 2: Blood was obtained from allergic subjects in a clinical trial of omalizumab before and during study drug treatment. Monocyte surface FcɛRI expression was measured using flow cytometry.

Results
FcɛRI expression was significantly greater in the CD2high vs. CD2low monocyte subsets (31% vs. 1.9% median FcɛRI+, respectively). In asthmatic and non‐atopic healthy control subjects, CD2low monocytes expressed little or undetectable FcɛRI. In study 1, FcɛRI expression was highly correlated to serum IgE in the CD2high, but not in the CD2low monocyte subpopulation (R values of 0.67 and 0.41, respectively). In study 2, omalizumab, but not placebo, caused a significant and sustained decline in FcɛRI expression within the CD2high monocyte subset.

Conclusions
CD2 defines a monocyte subset with high FcɛRI expression, whose magnitude is highly correlated to serum IgE. As such, this new description of CD2high monocytes as FcɛRI‐bearing cells suggests that they may be potential targets of anti‐IgE immunomodulatory therapies.
Induction of polyphenol gene expression in apple (Malus x domestica) after the application of a dioxygenase inhibitor
Authors: Fischer Thilo C. , Halbwirth Heidrun , Roemmelt Susanne , Sabatini Emidio , Schlangen Karin , Andreotti Carlo , Spinelli Francesco , Costa Guglielmo , Forkmann Gert , Treutter Dieter , Stich Karl
Published: November 2006

A comprehensive study of the complex polyphenol biosynthesis in developing leaves of apple (Malus domestica) was performed comprising gene expression, enzyme activities and polyphenol composition. During leaf development, an early increase in gene expression was observed for phenylalanine ammonia lyase (PAL, EC 4.3.1.5), chalcone synthase (CHS, EC 2.3.1.74), flavanone 3‐hydroxylase (FHT, EC 1.14.11.9) and dihydroflavonol 4‐reductase/flavanone 4‐reductase (DFR/FNR, EC 1.1.1.219). Their enzyme activities showed a corresponding trend during the time course. A parallel set of experiments was carried out with leaves treated with prohexadione‐Ca (ProCa), which is an enzyme inhibitor of 2‐oxoglutarate dependent dioxygenases (2‐ODDs). ProCa is known to induce changes in polyphenol biosynthesis, which are accompanied by a reduced incidence of fire blight and scab, the two major pome fruit diseases. The application of ProCa led to an increase in activities of PAL, CHS, FHT and DFR/FNR, which was based on an enhanced gene expression. In contrast, an inhibition of gene expression was detected for anthocyanidin synthase (EC 1.14.11.19). These effects are interpreted as a feedback regulation by changed polyphenol levels. Because of the inhibition of the 2‐ODDs FHT and flavonol synthase (EC 1.14.11.23), some pronounced changes in polyphenol composition were observed. Eriodictyol, the substrate of FHT, accumulated as eriodictyol‐7‐O‐glucoside and 6″‐O‐trans‐p‐coumaroyleriodictyol 3′‐O‐glucoside. In addition, the 3‐deoxycatechin luteoliflavan was formed which is not present in untreated apple leaves. Hence, beyond the redirection of polyphenol biosynthesis by the enzyme inhibitor, changed polyphenol levels obviously cause a distinct induction of gene expression by feedback regulation.
Analysis of strawberry genes differentially expressed in response to Colletotrichum infection
Authors: Casado‐Díaz Antonio , Encinas‐Villarejo Sonia , Santos Berta de los , Schilirò Elisabetta , Yubero‐Serrano Elena‐María , Amil‐Ruíz Francisco , Pocovi Mariana I. , Pliego‐Alfaro Fernando , Dorado Gabriel , Rey Manuel , Romero Fernando , Muñoz‐Blanco Juan , Caballero José‐Luis
Published: November 2006

Important losses in strawberry production are caused by species of the fungus Colletotrichum, the causal agent of anthracnose. However, very limited studies at molecular level exist of the mechanisms related to strawberry susceptibility against this pathogen. We have analysed a moderately resistant cultivar (cv. Andana) together with a very susceptible one (cv. Camarosa) during the process of infection with Colletotrichum acutatum at a molecular level. To gain insight into this interaction we have identified a large number of strawberry genes involved in signalling, transcriptional control, defence and many genes with unknown function with altered expression in response to C. acutatum infection. Spatial and temporal gene expression profiles after infection showed that the response was dependant on the tissue and cultivar analysed and also quicker and/or stronger in the moderately resistant cultivar (cv. Andana) than in the susceptible one (cv. Camarosa). Interestingly, we found that genes described as being induced during pathogen infection such as γ‐thionins, peroxidases, chitinases and β‐1‐3‐glucanases were downregulated in fruit and/or crown tissues of the very susceptible cultivar. Our results yielded a first insight on some of the genes responding to this plant–pathogen interaction at molecular level and suggest that pathogen progression can be dependent upon a reduction of the active defences of strawberry and this is genotype and tissue dependent.
The international migration of Indian nurses
Authors: Thomas P.
Published: November 2006

Aim:  To identify the factors responsible for the international migration of Indian nurses.

Methods:  The paper is based on the responses of 448 nurse practitioners, nurse educators and nurse administrators to a questionnaire administered to them in December 2004–January 2005. Key factors were identified by the analysis of contingency tables.

Discussion:  Apart from economic factors, dissatisfaction with working conditions and unhappiness with prevalent social attitudes towards nurses were identified as being of crucial importance for the international migration of Indian nurses. It was found that nurses working in the private sector and from some linguistic and religious groups were particularly prone to migration. Nurses working in the government sector seemed to be more worried about being unable to adjust to working conditions abroad, and therefore less keen to migrate. The fact that they enjoyed better pay scales, a more relaxed work atmosphere and more facilities may have also played a part here. What seemed to be vital to the decision to migrate for a large number of government sector nurses belonging to the so‐called ‘Forward’ and ‘Middle’ Castes was that they were being crowded out of promotional avenues as a result of the government’s policy of Reservations in Promotions for Scheduled Castes and Tribes.

Conclusion:  Health policy‐makers in India need to take a serious look at the growing migration of nurses to foreign countries. While such migration leads to inflow of foreign exchange, it also implies the loss of medical personnel vital for the fulfilment of national goals.
Nursing in the United Arab Emirates: an historical background*
Authors: El‐Haddad M.
Published: November 2006

Aim:  To gain a better understanding of some of the factors that may be contributing to the shortage of national nurses in the United Arab Emirates (UAE).

Background:  Approximately 3% of the UAE nursing workforce are currently nationals, which explains the UAE dependency on transient expatriate nurses. Even though Emirati women have been recently empowered to join the national workforce, not many have joined the nursing profession. Several factors may be contributing, in varying degrees, to this predicament.

Method:  The socio‐economic factors as well as the cultural and religious customs that have shaped the country and its people are examined. Hence, the historical background to the establishment of the UAE, women in Islam, the first nurse in Islam, the development of nursing in the UAE and the Emirates Nursing Association are considered.

Conclusion:  Factors contributing to the limited number of UAE nationals in the nursing profession include, but are not limited to: the low status of nursing in the UAE; the variations in basic nursing programmes in the country; the lack of Arabic educational resources; the affluent life style of UAE nationals as well as the strict cultural norms and religious values by which they live. As the need to nationalize the nursing workforce in the UAE is paramount, these issues and other perceived barriers from the perspective of Emirati nurses need to be explored and addressed.
Integration, Fragmentation and the Geography of Welfare
Authors: Dluhosch Barbara
Published: November 2006

The welfare effects of trade integration with endogenous production technology are examined in a monopolistic competition framework. In addition to explaining industry location, trade patterns and accompanying effects on local welfare, the analysis highlights the endogenous change in the costs of supervising fragmented production when economies open up to trade. By regarding fragmentation as a skill‐intensive activity, factor proportions (rather than size) strongly affect the international distribution of gains from trade. Nevertheless, albeit not generally, for a wide range of parameter values, even a skill‐poor country can participate in the gains—despite loss of industry.
Private Passions, the Public Good and Public Service Reform
Authors: Hoggett Paul , Mayo Marjorie , Miller Chris
Published: November 2006

There has been considerable recent discussion of the impact of public service reforms on the work ethics and motivations of public service workers. In this article we draw upon recent research on the ethical dilemmas facing regeneration workers in order to look more closely at the role of values in the working lives of public service professionals. Focusing on the commitment to social justice, we argue that such values find expression in two interlinked ways, as something workers have and as a process of giving value to different goods. Our research reveals that while both aspects of values are rooted in people's life experiences the second dimension is more contingent and relational. While public service reforms appear to have less impact upon workers’ pregiven values, they can and do have an impact on the way in which these values find expression in attachment to different goods. To understand the effect of such reform processes on workers’ motivations we therefore need a more complex conceptual framework than that provided by either simple public sector ethos/private sector ethos distinctions or by models of economic individualism offered by writers such as Julian Le Grand.
HISTORY AND RELIGION IN THE MODERN AGE
Authors: FASOLT CONSTANTIN
Published: November 2006

This essay seeks to clarify the relationship between history and religion in the modern age. It proceeds in three steps. First, it draws attention to the radical asymmetry between first‐person and third‐person statements that Wittgenstein's Philosophical Investigations rescued from the metaphysical exile to which it had been condemned by Descartes's definition of the self as a thing. Second, it argues that religion is designed to alleviate the peculiarly human kind of suffering arising from this asymmetry. Third, it maintains that history relies on the same means as religion in order to achieve the same results. The turn to historical evidence performed by historians and their readers is more than just a path to knowledge. It is a religious ritual designed to make participants at home in their natural and social environments. Quite like the ritual representation of the death and resurrection of Christ in the Mass, the historical representation of the past underwrites the faith in human liberty and the hope in redemption from suffering. It helps human beings to find their bearings in the modern age without having to go to pre‐industrial churches and pray in old agrarian ways. History does not conflict with the historical religions merely because it reveals them to have been founded on beliefs that cannot be supported by the evidence. History conflicts with the historical religions because it is a rival religion.
Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: outcomes and mechanisms of change
Authors: Gardner Frances , Burton Jennifer , Klimes Ivana
Published: November 2006

Background:  To test effectiveness of a parenting intervention, delivered in a community‐based voluntary‐sector organisation, for reducing conduct problems in clinically‐referred children.

Methods:  Randomised controlled trial, follow‐up at 6, 18 months, assessors blind to treatment status. Participants −76 children referred for conduct problems, aged 2–9, primarily low‐income families, randomised to treatment vs. 6‐month wait‐list group. Retention was 93% at 6 months, 90% at 18 months. Interventions – Webster‐Stratton Incredible Years video‐based 14‐week group programme, teaches cognitive‐behavioural principles for managing behaviour, using a collaborative, practical, problem‐solving approach. Primary outcomes – child problem behaviour by parent‐report (Eyberg) and home‐based direct observation; secondary outcomes – observed positive and negative parenting; parent‐reported parenting skill, confidence and depression.

Results:  Post‐treatment improvements were found in child problem behaviour, by parent‐report (effect size (ES) .48, p = .05) and direct observation (ES .78, p = .02); child independent play (ES .77, p = .003); observed negative (ES .74, p = .003) and positive (ES .38, p = .04) parenting; parent‐reported confidence (ES .40, p = .03) and skill (ES .65, p =.01), using ANCOVA to control for baseline scores. Maternal depression did not change. Consumer satisfaction was high. At 18‐month follow‐up, although no randomised comparison was possible, changes appeared to maintain, with no significant change toward baseline level on any measure. Change in observed positive parenting appeared to mediate change in child problem behaviour (p < .025).

Conclusions:  Findings suggest that a group‐based cognitive‐behavioural parenting programme, delivered by well‐trained and supervised staff, can be effective in a community voluntary‐sector setting, for reducing conduct problems and enhancing parenting skills. Change in parenting skill appears to be a key mechanism for change in child behaviour. Findings have implications for feasibility of translating evidence‐based programmes, even for clinically‐referred conduct problems, into less specialised community settings, likely to have lower costs and be more accessible for families.