bluuebunny/crossref_metadata_2025 huggingface dataset:
Affective Correlates of Occupational Exposure to Whole-Body Vibration
Authors: Abbate C. , Micali E. , Giorgianni C. , Munaò F. , Brecciaroli R. , Salmaso L. , Germanò D.
Published: October 2004

Background: Exposure to whole-body vibrations (WBV) represents a highly diffuse occupational risk. Some studies report that chronic exposure to WBV induces a significant increment in the modifications of the cognitive and emotional area. The aim of this study was to investigate the long-term effects of WBV exposure on the neuropsychic and behavioural system. Methods: The study population consisted of 137 male subjects, mean age 45.7 years, working as drivers of mechanical trolleys and occupationally exposed to WBV of a frequency below 2 m/s2. The Profile of Mood States was administered to all subjects in a maximum time of 10 min and in the same operative conditions. The results were compared with those of a homogeneous control group by means of an innovative statistical technique. Results: The results show a significant difference in the response to the neurobehavioural test. The exposed group showed, in fact, a higher score compared with the controls for all 6 factors. In particular, the scores for factors F (fatigue-inertia), D (depression-dejection) and T (tension-anxiety) were more elevated, expressing a significant alteration of the psycho-affective status. Moreover, statistical analysis showed a correlation between exposure time and the score obtained for all factors in the exposed group. Conclusion: This study indicates that occupational exposure to WBV is associated with alterations of mood status and that these modifications are directly proportional to exposure time. Furthermore, our results show that psychological tests commonly used in psychopathologic diagnostics can be useful in monitoring alterations of psycho-emotional status determined by physical stressors.
Reasons for Quitting Serotonin Reuptake Inhibitor Therapy: Paradoxical Psychological Side Effects and Patient Satisfaction
Authors: Bolling Madelon Y. , Kohlenberg Robert J.
Published: October 2004

Background: The goal of this study was to document the existence of psychological side effects associated with serotonin reuptake inhibitors (SSRIs) taken for depression and to determine their relationship to patients’ decisions to stop treatment, and attitudes toward taking SSRIs again. Method: We conducted 161 semi-structured telephone interviews of adults who had completed a course of treatment for depression with one of the SSRIs. We identified 29 categories of unwanted psychological effects and analyzed data in terms of responders and non-responders, the former split into those who would, and those who would not take the same drug again if depressed in the future (‘take-again responders’ and ‘not-again responders’, respectively). Results: Psychological side effects were cited just as often as physical side effects as the primary reason for quitting SSRI treatment. Non-responders cited psychological side effects rather than non-response as the primary reason for quitting, and not-again responders cited physical more than psychological side effects. Not-again responders and non-responders did not differ in the number of side effects experienced, and non-responders experienced significantly more unwanted psychological effects than either type of responder (χ2 = 6.767, p = 0.009). Conclusion: Psychological side effects might well be included in measures and discussions of side effects, even though they present no known physical danger to the patient.
The Burden of Anaemia in Patients with Cancer
Authors: Pujade-Lauraine Eric , Gascón Pere
Published: October 2004

Anaemia is highly prevalent in patients with cancer, and its incidence and severity depend on many factors, such as type of anti-cancer therapy. The decreased oxygen capacity of blood resulting from anaemia affects virtually every organ and tissue system in the body, manifesting in numerous signs and symptoms that include fatigue, dyspnoea, palpitations, tachycardia, asthenia, anorexia, cold hypersensitivity and general weakness. Anaemia related to cancer may also cause cognitive dysfunction, leading to decreased mental alertness, poor concentration and memory problems. There is a close association between anaemia and overall quality of life (QoL) variables, and anaemia is an adverse prognostic factor in patients with cancer. Since anaemia can seriously compromise the QoL of cancer patients and is associated with decreased overall survival time, there is a strong need for effective and well-tolerated treatment strategies. Erythropoietic agents have been proven to be safe, well-tolerated and effective in the management of anaemia in patients with cancer. Epoetin therapy reduces transfusion requirements and increases haemoglobin levels in patients with solid tumours and haematological malignancies.
Optimising Anaemia Management with Epoetin Beta
Authors: Reed Nicholas , Morère Jean-François
Published: October 2004

The contribution of epoetin beta to the management of cancer-related anaemia over the past decade has been a significant one; increased haemoglobin (Hb) levels, reduced transfusion need and improved patient quality of life (QoL) have been well documented in patients across a wide range of malignancies. In recent years, concerns have been raised over the inconvenience and costs associated with the conventional three-times weekly (tiw) epoetin dosing regimen. As a result, optimising therapy through less frequent dosing (i.e. once weekly) has become a focus of research. The NeoRecormon Once Weekly (NOW) study compared the efficacy and tolerability of epoetin beta 30,000 IU once weekly with a standard 10,000 IU tiw regimen in patients with lymphoproliferative malignancies. The study showed that the once weekly regimen was equally effective as the tiw regimen in increasing Hb levels and reducing transfusion need. Furthermore, the response to once weekly treatment was rapid, with 1 and 2 g/dl increases in Hb level seen at approximately 4 and 8 weeks, respectively. Studies with other erythropoietic agents have also shown the efficacy of the once weekly dosing strategy. Epoetin beta 30,000 IU is now approved for once weekly administration in patients with lymphoproliferative malignancies receiving antitumour therapy, and can be administered using a new 30,000 IU pre-filled syringe. Once weekly administration of epoetin beta offers greater convenience and should reduce administration costs compared with the tiw regimen.
Can Erythropoietin Therapy Improve Survival?
Authors: Glaspy John , Dunst Juergen
Published: October 2004

The presence of anaemia in patients with cancer is correlated with poor clinical outcome, a reduced tumour response to anticancer therapy and an increased risk of mortality. This observation has led to speculation as to whether treatment of anaemia can enhance survival rates. The majority of studies have suggested that erythropoietic therapy either does not change or improves disease-free and/or overall survival. Only two studies, one in breast cancer and the other in head and neck cancer, both of which used epoetin outside its approved indications, have observed a decrease in survival in epoetin-treated patients compared with controls. Methodological issues and baseline imbalances between groups in prognostic factors for survival that may have favoured placebo treatment have complicated the interpretation of these studies. In contrast, a Cochrane meta-analysis of randomised, controlled trials of epoetin in anaemic patients with cancer that reported survival identified 19 trials up to the end of 2001 with 2,865 patients. This meta-analysis reported a hazard ratio for overall survival of 0.81 (95% CI 0.67–0.99) for adjusted data and a hazard ratio of 0.84 (95% CI 0.69–1.02) for unadjusted data. A recent meta-analysis of nine randomised, controlled trials of epoetin beta (n = 1,413) suggests that use of this therapy is associated with a reduced risk of tumour progression. This meta-analysis also showed that no association existed between the risk of overall mortality or thromboembolic mortality and epoetin beta therapy. These results suggest that treatment of anaemic patients with cancer with epoetin beta is effective and safe.
Diagnosis of Non-Functioning Neuro-Endocrine Gastro-Enteropancreatic Tumours
Authors: Plöckinger Ursula , Wiedenmann B.
Published: October 2004

Non-functioning neuro-endocrine gastro-enteropancreatic tumours are neoplasms of neuro-endocrine differentiation without symptoms of hormonal hypersecretion. In pancreatic tumours, symptoms are related to an expanding tumour mass, while most midgut tumours are small and symptoms of intermittent intestinal entrapment are due to mesenteric fibrosis. Positive somatostatin receptor imaging indicates the neuro-endocrine differentiation of the tumour. The high spatial resolution of MRI/CT improves preoperative planning. In localized pancreatic tumours, curative resection of the primary improves survival. In midgut tumours, resection of the primary should be performed, irrespective of the presence of liver metastases. Palliative surgery and cytoreductive therapy of liver metastases may prolong survival in both, pancreatic and midgut tumours. Combination chemotherapy is effective in pancreatic disease, while in midgut tumours the response rate is only 22%. As the antiproliferative effect of biotherapy is still uncertain, it cannot yet be recommended as a routine treatment in non-functioning neuro-endocrine gastro-enteropancreatic tumours.
When to Look for Von Hippel-Lindau Disease in Gastroenteropancreatic Neuroendocrine Tumors?
Authors: Ling Hao , Cybulla Markus , Schaefer Oliver , Arnold Christian , Schories Marcus , Neumann Hartmut P.H.
Published: October 2004

Von Hippel-Lindau (VHL) disease is a progressive autosomal dominant multisystem disorder that is associated with a germ line mutation of the VHL gene on the short arm of chromosome 3. A variety of benign and malignant diseases, including eye and CNS hemangioblastomas, renal cell carcinoma and pheochromocytoma are the major components. Gastroenteropancreatic neuroendocrine tumors are also listed among the typical complications, although these occur seldom. Virtually all such tumors are pancreatic islet cell tumors. VHL-associated islet cell tumors are mostly hormone-inactive. They can be detected during screening investigations according to the multidisciplinary disorder or by workup of space-occupying lesions. There are no specific predictors for malignancy in VHL-associated islet cell neoplasias, but tumors smaller than 3 cm in diameter are believed to be always benign. Gadolinium-enhanced MRI is currently the imaging method of choice, but contrast-enhanced CT is also a diagnostic option. The spectrum of manifestations is illustrated by selected cases.
Interventional Treatment of the Carcinoid Syndrome
Authors: Ahlman H. , Nilsson O. , Olausson M.
Published: October 2004

Liver metastases imply a major problem in patients with carcinoid tumours and hormone overproduction. Patients with distant metastases can undergo resection for potential cure or for symptom palliation. In patients with bilobar liver metastases other interventions are at hand, e.g. local ablation or hepatic arterial embolization. In selected cases liver transplantation can be a treatment alternative. Prior to all interventions patients with midgut carcinoids are protected with somatostatin analogues to reduce hormone secretion. Patients with foregut carcinoids may present special problems with life-threatening release of histamine during interventions.
Interferon-α: Regulatory Effects on Cell Cycle and Angiogenesis
Authors: Rosewicz Stefan , Detjen Katharina , Scholz Arne , von Marschall Z.
Published: October 2004

In the current study, we investigated the effects of interferon-α (IFN-α) on proliferation and angiogenesis in neuroendocrine tumor disease. Using a panel of human neuroendocrine tumor cell lines, we confirmed functionally active IFN-α signaling by STAT activation and nuclear translocation as well as transactivation. IFN-α results in anchorage-dependent and -independent growth inhibition due to a delayed progression from S-phase to G2 phase of the cell cycle. This was due to substantial reduction in cellular cyclin B levels resulting in the inhibition of Cdc2 kinase activity. In parallel to growth inhibition, we observed a profound inhibition of VEGF gene transcription by IFN-α in human neuroendocrine tumor cells due to an Sp1/Sp3-dependent inhibition of VEGF promoter activity. Treatment of neuroendocrine tumors with IFN-α in nude mice resulted in growth inhibition and inhibition of angiogenesis. Furthermore, treatment of neuroendocrine tumor patients with IFN-α resulted in decreased VEGF expression as well as tumor angiogenesis in liver metastases. In summary, IFN-α acts via direct antiproliferative effects as well as inhibition of tumor angiogenesis mediated by suppression of VEGF gene expression in neuroendocrine tumor disease.
From Basic to Clinical Research in Gastroenteropancreatic Neuroendocrine Tumor Disease – The Clinician-Scientist Perspective
Authors: Wiedenmann Bertram , Pape Ulrich-Frank
Published: October 2004

Patients with rare tumors represent a diagnostic and therapeutic challenge for non-specialized physicians, surgeons and other medical doctors. Whereas several specialized centers have gathered data for an improved diagnosis and therapy of neuroendocrine tumor disease, numerous clinical issues have not been resolved on an evidence-based medicine level. Furthermore, the evaluation of new treatment options has been overshadowed by the low incidence of the disease. In this article, a major medical challenge for the diagnosis and therapy of neuroendocrine tumor disease is addressed. As well, new therapeutic treatment options translated from current findings in the fields of molecular and tumor biology are discussed.
L-Citrulline Immunoreactivity Reveals Nitric Oxide Production in the Electromotor and Electrosensory Systems of the Weakly Electric Fish, Apteronotus leptorhynchus
Authors: Smith G. Troy , Allen Antiño R. , Oestreich Jörg , Gammie Stephen C.
Published: October 2004

Weakly electric fish produce electric organ discharges (EODs) used for electrolocation and communication. In the brown ghost knifefish, Apteronotus leptorhynchus, several neuron types in brain regions that control the EOD or process electrosensory information express nitric oxide synthase (NOS). The present study used immunoreactivity for L-citrulline, a byproduct of the production of nitric oxide (NO) by NOS, to assess NO production in NOS-expressing neurons. A polyclonal antibody against L-citrulline produced specific labeling in most neuronal populations previously identified to express NOS. Specifically, several cell types that precisely encode temporal information and/or fire at high frequencies, including spherical cells in the electrosensory lateral line lobe, giant cells in layer VI of the dorsal torus semicircularis, and pacemaker and relay cells in the pacemaker nucleus, were strongly immunoreactive for L-citrulline. This suggests that these neurons produced high levels of NO. Notably, electromotor neurons, which also strongly express NOS, were not immunoreactive for L-citrulline, suggesting that NOS did not produce high levels of NO in these neurons. No apparent differences in L-citrulline distribution or intensity were observed between socially isolated fish and fish exposed to playback stimuli simulating the presence of a conspecific. This suggests that social stimulation by electrocommunication signals is not necessary for high levels of NO production in many NOS-positive neurons. Future studies focusing on regulation of NO production in these systems, and the effects of NO on electrosensory processing and electromotor pattern generation will help elucidate the function of NO signaling pathways in this system.
Social Signals Regulate Gonadotropin-Releasing Hormone Neurons in the Green Treefrog
Authors: Burmeister Sabrina S. , Wilczynski Walter
Published: October 2004

Animals coordinate their physiological state with external cues to appropriately time reproduction. These external cues exert effects through influences on the gonadotropin-releasing hormone neurons (GnRH), at the apex of the hypothalamus-pituitary-gonad (HPG) axis. In green treefrogs, mating calls are important regulators of reproductive behavior and physiology. Reception of mating calls causes an increase in androgen levels, and androgens promote the production of mating calls, demonstrating a mutual influence between the communication and endocrine systems. In order to investigate the central nervous system correlates of social regulation of the HPG axis in green treefrogs, we exposed males to a mating chorus or a control stimulus (tones), counted the resulting number of septo-preoptic GnRH-immunoreactive cells (GnRH-ir), and measured changes in plasma androgens. We found that reception of the mating chorus caused an increase in the number of GnRH-ir cells. As previously shown, we also found that the reception of the mating chorus resulted in higher androgen levels, suggesting that the higher GnRH-ir cell number represents increased GnRH production and release. We suggest that mating calls are an important supplementary cue that promotes GnRH production and release within the context of GnRH regulation by seasonal cues. Previous studies have proposed a neuroanatomical link between the anuran auditory system and GnRH neurons. Our results demonstrate a functional role for this proposed sensory-endocrine circuit, and show for the first time an influence of acoustic signals on GnRH neurons.
Comparisons of Visual Properties between Tectal and Thalamic Neurons with Overlapping Receptive Fields in the Pigeon
Authors: Yang Jin , Zhang Chuan , Wang Shu-Rong
Published: October 2004

The present study is the first attempt to make comparisons of the visual response properties between tectal and thalamic neurons with spatially overlapping receptive fields by using extracellular recording and computer mapping techniques. The results show that in neuronal pairs about 70% of thalamic cells have excitatory receptive field alone, whereas 85% of tectal cells possess an excitatory receptive field surrounded by an inhibitory receptive field. In 70% of pairs the tectal cells are selective for direction of motion different from that which the thalamic cells prefer. Most thalamic cells prefer high speeds (80–160°/s), whereas tectal cells prefer intermediate (40°/s) or low (10–20°/s) speeds. Photergic and scotergic cells exist in the thalamus but not in the tectum. These results provide evidence that tectal and thalamic cells extract different visual information from the same region of the visual field. The functional significance of these differences is discussed.
Free IGF-I, IGFBP-1, and the Binary Complex of IGFBP-1 and IGF-I Are Increased during Human Pregnancy
Authors: Skjærbæk Christian , Frystyk Jan , Ørskov Hans , Flyvbjerg Allan
Published: October 2004

Background/Aims: To investigate changes in free insulin-like growth factor I (IGF-I) and IGF-binding protein 1 (IGFBP-1) complexed IGF-I during human pregnancy. Methods: Overnight fasting serum was obtained in a longitudinal design from 11 women with non-complicated pregnancy at gestation weeks 6–10, 16–20, 24–28 and 35–38 and, for comparison, 5 weeks post-partum. All samples were analyzed for total and free IGF-I and IGF-II, IGFBP-3 and IGFBP-3 proteolysis, total and non-phosphorylated (np-) IGFBP-1, and IGFBP-1 complexed IGF-I. Results: Total IGF-I was increased in late pregnancy (week 35–38) (p < 0.001), whereas free IGF-I was significantly increased by 77% already at week 6–10 (p = 0.004) and by 140% (p = 0.002) at week 34–38, when compared to post-partum levels. At weeks 16–20 and 24–28, levels of free IGF-I were not significantly different from post-partum levels. Significant IGFBP-3 proteolysis was detectable from week 6–10 and throughout pregnancy (p < 0.05). Total and np-IGFBP-1 were significantly increased from 16–20 weeks of pregnancy (both p < 0.05) and IGFBP-1 complexed IGF-I was increased 2-fold from week 16–20 and throughout pregnancy (p < 0.05). However, the saturation of IGFBP-1 remained constant at 27–29% during the study. Conclusion: We found evidence of increased free IGF-I and increased IGF-I in binary complexes during pregnancy, possibly caused by IGFBP-3 proteolysis and decreased ternary complex formation.
Adrenal Steroid Hormones and Metaphyseal Bone in Children
Authors: Remer Thomas , Boye Kai R. , Hartmann Michaela F. , Neu Christina , Schoenau Eckhard , Manz Friedrich , Wudy Stefan A.
Published: October 2004

Background/Objectives: The responses of metaphyseal bone tissue to physiological variations of endogenous adrenal steroid hormones during childhood are unclear. Therefore, we studied potential hormonal influences in children before the appearance of pubic hair (onset of pubarche). Methods: Excretions of major glucocorticoid metabolites (C21), cortisol, sum of adrenarchal dehydroepiandrosterone and its immediate 16-hydroxylated metabolites (DHEA&M), and 5-androstene-3β,17β-diol (hermaphrodiol) were analyzed in a cross-sectional study in 24-hour urine samples of 109 healthy boys and girls, aged 6–13 years, using steroid profiling by gas chromatography-mass spectrometry. Total and trabecular volumetric bone mineral densities, bone mineral content (BMC) and bone strength strain index were determined with peripheral quantitative computed tomography at the distal forearm. Results: In multiple regression analyses significant associations with the metaphyseal radius were seen for grip force, age, or BMI depending on gender and bone variable analyzed. DHEA&M did not contribute to the explanation of the variance of any bone variable. However, hermaphrodiol positively explained a significant part of variation of bone mineral densities, and BMC (p < 0.01) in girls. Significantly negative associations with all bone variables were seen in boys for cortisol. Conclusions: The steroid hormones, cortisol and hermaphrodiol, in their physiological ranges, but not the adrenarche marker DHEA&M, appear to associate with metaphyseal bone in a sex-dependent manner during childhood.
Predicting Therapeutic Response and Degree of Pituitary Tumour Shrinkage during Treatment of Acromegaly with Octreotide LAR
Authors: Jenkins P.J. , Emery M. , Howling S.J. , Evanson J. , Besser G.M. , Monson J.P.
Published: October 2004

Background/Aims: The efficacy of transsphenoidal surgery in the treatment of patients with acromegaly is largely dependent on tumour size. A reduction in pituitary tumour volume by medical therapy might therefore improve subsequent surgical cure rates. This study prospectively determined the effects of the depot somatostatin analogue octreotide LAR on pituitary tumour size, GH and IGF-I levels and clinical symptoms in a cohort of previously untreated patients with acromegaly. Methods: Six patients newly diagnosed with acromegaly (mean age 53 years; range 42–76 years) received intramuscular octreotide LAR every 28 days for 6 months. The initial dose of LAR was 20 mg, but increased to 30 mg after the initial 3 injections if mean GH levels were >5 mU/l. Prior to commencing LAR therapy, each patient received 3 injections of subcutaneous octreotide (50, 100 and 200 µg) in a randomized order on separate days, and the serum GH response was measured. Pituitary tumour volume was calculated from MRI or computed tomography scans at baseline, then 3 and 6 months after initiation of treatment, and assessed by a ‘blinded’ radiologist in random order. At baseline, 4 patients had a macroadenoma and 2 patients had a microadenoma. For the latter, the whole gland volume was measured. Results: Serum GH levels decreased from 29.6 ± 19.2 mU/l (mean ± SD) at baseline to 12.1 ± 10.5 mU/l at 3 months and 10.4 ± 9.3 mU/l at 6 months. Three patients achieved a mean serum GH level of <5 mU/l. In these patients, the serum GH had declined to <5 mU/l in response to a single 100 µg subcutaneous octreotide injection. Serum IGF-I levels decreased by a mean of 45 ± 7.4%. Tumour volume decreased in all patients: mean baseline volume 2,175 mm3 (range 660–6,998) decreasing to 1,567 mm3 (range 360–4,522) at 3 months (p < 0.05) and 1,293 mm3 (range 280–4,104) at 6 months (p < 0.002). The mean percentage decrease in size was 29% (range –54 to +4%) at 3 months (p < 0.02) and 47% (range 21–97%) at 6 months (p < 0.002). There was no statistically significant correlation between GH response and tumour shrinkage. Conclusions: A single test dose of subcutaneous octreotide may be useful in predicting the subsequent efficacy of octreotide LAR. Octreotide LAR results in significant shrinkage of pituitary tumours of newly diagnosed patients with acromegaly. Whether its administration to such patients for 6–12 months can improve the efficacy of subsequent transsphenoidal surgery will require further study.
Role of Endothelial Mitochondria in Oxidant Production and Modulation of Neutrophil Adherence
Authors: Ichikawa* H. , Kokura* S. , Aw T.Y.
Published: October 2004

This study is designed to test whether the postanoxic endothelial mitochondria is an important source of reactive oxygen species (ROS) using a chemical model of mitochondrial disruption to mimic the loss of mitochondrial integrity after anoxia/reoxygenation (A/R). The current objectives were to (1) determine the adhesion of human neutrophils to human umbilical vein endothelial cells exposed to antimycin A, a specific inhibitor of the mitochondrial cytochrome b–c1 complex, and (2) define the mechanisms responsible for the early and late phases of neutrophil hyperadhesivity. Antimycin A caused a 5-fold increase in ROS generation and induced neutrophil adhesion at 30 min (phase 1) and 4 h (phase 2) that were quantitatively similar to that induced by A/R. Blockade of electron transport in antimycin A and A/R exposed cells with rotenone, amytal or thenoyltrifluoroacetate, but not myxothiazol, prevented neutrophil adhesion, confirming a role for mitochondrial ROS. Catalase inhibited phase 1 adhesion, indicating H2O2 involvement. Anti-ICAM-1 or anti-P-selectin monoclonal antibodies (mAbs) attenuated phase 1 adhesion, while anti-E-selectin mAb attenuated phase 2 adhesion, consistent with roles for constitutive ICAM-1 and preformed P-selectin in early and E-selectin in late phase responses. Actinomycin D and cycloheximide or competing ds-oligonucleotides containing cognate DNA sequences of the nuclear factor ĸB or activator protein-1 attenuated phase 2 adhesion, implicating a role for de novo protein synthesis. Peak surface expression of the endothelial cell adhesion molecules correlated with peak adhesions at phases 1 and 2. These results show that disruption of mitochondrial respiratory chain elicits ROS production that mediates transcription-independent and -dependent surface expression of various adhesion molecules that leads to a two-phase neutrophil-HUVEC interaction similar to that induced by A/R.
Combined Pulse Oximetry/Cutaneous Carbon Dioxide Tension Monitoring during Colonoscopies: Pilot Study with a Smart Ear Clip
Authors: Heuss Ludwig T. , Chhajed Prashant N. , Schnieper Patricia , Hirt Thomas , Beglinger Christoph
Published: October 2004

Background: We compared the accuracy and practicability of a new combined ear sensor device measuring pulse oximetry and transcutaneous carbon dioxide tension. Methods: Validation studies were done by comparing the results of the combined sensor with arterial blood gas measurements. In an observational part, monitoring data were obtained from 25 patients undergoing colonoscopy, sedated with midazolam and alfentanil and from 8 patients without sedation. Results: There was an excellent correlation between the oxygen saturation and carbon dioxide tension measurements comparing the combined sensor with arterial blood gas analysis (R 0.96 and 0.93, respectively). A mean rise in transcutaneous carbon dioxide tension of 7.6 mm Hg was detectable during sedation with midazolam/alfentanil and of 2.3 mm Hg without sedation. Conclusion: Combined POX/PcCO2 monitoring at the ear lobe is a novel approach to improve patient safety during sedation and may be helpful in preventing an unintentional slide into a state of deep sedation with impairment of ventilation.
Improvement of Gastric Motility with Gastric Electrical Stimulation in STZ-Induced Diabetic Rats
Authors: Liu Jinsong , Qiao Xian , Micci Maria-Adelaide , Pasricha Pankaj J. , Chen J.D.Z.
Published: October 2004

Aims: The aims of this study were to observe whether gastric motility was impaired in streptozotocin (STZ)-induced diabetic rats and whether gastric electrical stimulation was able to restore the impaired motility. Methods: Ten control rats and 30 STZ-induced diabetic rats were used in this study. Gastric slow waves were recorded at baseline and 0, 1, 2, 3 and 4 weeks after the injection of STZ or vehicle. Gastric emptying with (long or short pulses) or without gastric electrical stimulation was measured 6 weeks after STZ injection in a group of 10 diabetic rats each. Results: (1) STZ injection resulted in hyperglycemia and weight loss. (2) Gastric motility was impaired in the diabetic rats. The percentage of normal slow waves was progressively reduced 2 weeks after STZ injection. Compared with the control rats, gastric emptying in the diabetic rats was significantly delayed 6 weeks after STZ injection (60 ± 3 vs. 79 ± 2%, p < 0.02). (3) Gastric electrical stimulation with either long or short pulses accelerated gastric emptying in the diabetic rats. (4) Gastric electrical stimulation with long but not short pulses was capable of normalizing gastric dysrhythmia in the diabetic rats. Conclusion: Our data show that gastric motility is impaired in STZ-induced diabetic rats as reflected by a progressive reduction in the percentage of normal gastric slow waves and delayed gastric emptying. Moreover, here we show that gastric electrical stimulation normalizes delayed gastric emptying in diabetic rats and this normalization is not attributed to the effect of gastric electrical stimulation on gastric slow waves.
Clinical Usefulness of Serum Pepsinogen II in the Management of Helicobacter pylori Infection
Authors: Di Mario Francesco , Moussa Ali Mahamat , Cavallaro Lucas Giovanni , Caruana Pietro , Merli Roberta , Bertolini Simone , Iori Veronica , Cavestro Giulia Martina , Dal Bò Nadia , Pilotto Alberto , Franzé Angelo , Leandro Gioacchino
Published: October 2004

Background: Serum pepsinogen II (sPGII) levels are known to increase during Helicobacter pylori infection. Aim: To assess H. pylori infection and success of H. pylori therapy by means of sPGII levels. Methods: sPGII levels were determined in 156 H. pylori-positive and 157 H. pylori-negative consecutive patients with dyspeptic symptoms. Additionally, sPGII determination was performed in 70 H. pylori-positive patients 2 months after H. pylori eradication therapy. In 29 of these 70 patients, gastroscopy was performed to evaluate the effect of H. pylori therapy on gastric activity. Results:H. pylori-positive subjects demonstrated a significantly higher mean of sPGII levels than H. pylori-negative subjects (16.8 ± 7.4 vs. 8.6 ± 3.7 µg/l; p < 0.001). The best sPGII cut-off for predicting H. pylori infection was 9.93 µg/l (sensitivity 83%, specificity 73%). The best cut-off values to evaluate success of therapy were: sPGII of 9.47 µg/l, a sPGII variation level (difference between baseline and after therapy) of 4.54 µg/l, and a sPGII Δvalue (sPGII variation divided by sPGII before therapy) of 25% (sensitivity 93%, specificity 91%). Conclusions: sPGII levels may be used as a reliable marker of H. pylori infection in the initial diagnosis as well as to evaluate H. pylori eradication and subsequent changes in gastric inflammation.
Automated Analysis of the Auditory Brainstem Response Using Derivative Estimation Wavelets
Authors: Bradley Andrew P. , Wilson Wayne J.
Published: October 2004

In this paper, we describe an algorithm that automatically detects and labels peaks I–VII of the normal, suprathreshold auditory brainstem response (ABR). The algorithm proceeds in three stages, with the option of a fourth: (1) all candidate peaks and troughs in the ABR waveform are identified using zero crossings of the first derivative, (2) peaks I–VII are identified from these candidate peaks based on their latency and morphology, (3) if required, peaks II and IV are identified as points of inflection using zero crossings of the second derivative and (4) interpeak troughs are identified before peak latencies and amplitudes are measured. The performance of the algorithm was estimated on a set of 240 normal ABR waveforms recorded using a stimulus intensity of 90 dBnHL. When compared to an expert audiologist, the algorithm correctly identified the major ABR peaks (I, III and V) in 96–98% of the waveforms and the minor ABR peaks (II, IV, VI and VII) in 45–83% of waveforms. Whilst peak II was correctly identified in only 83% and peak IV in 77% of waveforms, it was shown that 5% of the peak II identifications and 31% of the peak IV identifications came as a direct result of allowing these peaks to be found as points of inflection.
Effects of Treatment with Epoetin Beta on Outcomes in Patients with Anaemia and Chronic Heart Failure
Authors: Silverberg Donald S. , Wexler Dov , Blum Miriam , Iaina Adrian , Sheps David , Keren Gad , Scherhag Armin , Schwartz Doron
Published: October 2004

Anaemia is frequently found in patients with chronic heart failure (CHF) and has been associated with an increase in mortality and morbidity, impaired cardiac and renal function and a reduced quality of life (QoL) compared with non-anaemic CHF patients. Correction of anaemia with recombinant human erythropoietin (epoetin) has been associated with an improvement in CHF in both controlled and uncontrolled studies. The present study describes our findings in a series of 78 consecutive patients with symptomatic CHF and anaemia (haemoglobin (Hb) level <12.0 g/dl) treated with epoetin beta and, if necessary, intravenous iron sucrose. Over a mean observation period of 20.7 ± 12.1 months, mean Hb levels increased from 10.2 ± 1.1 to 13.5 ± 1.2 g/dl, p < 0.01. New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) were significantly improved and the number of hospitalizations was significantly reduced with the period before treatment (all p < 0.01). Serum creatinine and creatinine clearance (CCr) were 2.2 ± 0.9 mg/dl and 32.5 ± 26.5 ml/min, respectively, at baseline, and remained stable over the observation period. Interestingly, >90% of the patients had concomitant mild-to-moderate chronic kidney disease at baseline and study end (CKD), as defined by the accepted diagnostic criterion of a CCr <60 ml/min. Conclusions: The correction of the anaemia with epoetin beta together with initial intravenous iron supplementation, resulted in significant improvements in NYHA class and cardiac function, and a reduction in hospitalization rate. Moreover, renal function was maintained stable in most patients.
Use of Stereo Duet Playback to Investigate Traditional Duet Playback Methods and Mechanisms of Cooperative Territorial Defence in Magpie-Larks
Authors: Harrington Helèna , Miller Audrey , Mcdowell Sarah , Rogers Amy , Panagos Joanne , Ferguson Jasmine
Published: October 2004

Duets are precisely coordinated acoustic displays, usually involving members of a mated pair. Studies investigating avian duet function often employ a single speaker playback system to compare response of focal pairs to simulated territorial intrusion by duetting and solo birds. It has recently been suggested that a 'stereo duet playback', in which male and female duet components are separated and broadcast through two different speakers, would provide a more realistic duet stimulus. We conduct the first comparison of a traditional single speaker versus a new stereo duet playback design and provide evidence that Australian magpie-larks, Grallina cyanoleuca, make significantly more flights towards duet playback presented in a more realistic stereo context. Male and female magpie-lark pairs did not split up and attack one 'intruder' each when presented with a stereo duet playback. Instead they moved towards the same speaker together as a united pair, showing a tendency to approach the speaker initiating the duet intrusion. Distance between the two speakers in a stereo duet design did not have a significant effect on the response variables measured. We conclude that magpie-larks can distinguish between use of a single speaker or stereo duet playback to broadcast a duet and suggest that cooperative defence against duetting intruders in magpie-larks is a result of joint territorial defence rather than intraspecific aggression against same-sex intruders.
Behavioral Responses to 'Alarm Odors' In Potentially Invasive and Non-invasive Crayfish Species from Aquaculture Ponds
Authors: Daniels William , Gherardi Francesca , Acquistapace Patrizia
Published: October 2004

Two North American crayfish species, the Eastern white river crayfish, Procambarus acutus acutus, and the red swamp crayfish, P. clarkii, were studied in the laboratory for their responses to food odors and to cues released by injured conspecifics and heterospecifics. The two species differ in that only P. clarkii is known to behave as an invasive species. All the test individuals were collected from aquaculture research ponds, in which they had had no prior contact with the other species and predation risks, excluding cannibalism, were reduced. The experimental design consisted in subjecting 20 crayfish per species to (1) a 3-min control phase after the injection of 20 ml of water and (2) a 3-min test phase after the injection of 20 ml of one of three test solutions (food odor, conspecific odor plus food odor, heterospecific odor plus food odor). We found that the two species differ on one hand for their background behavior and on the other for the intensity and quality of their responses to the three types of cues. Firstly, P. clarkii appeared more active than P. acutus acutus during the control phase and responded in a stronger fashion to the injection of the solutions. Secondly, we recorded an increased locomotion in P. acutus acutus with food and heterospecific cues (by moving crayfish maximize the chance of finding food), but not with conspecific odors (by not moving, crayfish reduce their exposure to visual predators). To the contrary, at the injection of the three test solutions P. clarkii displayed clear feeding-related activities (although less intense with conspecific odors) as opposed to the danger reactions shown in a previous study on individuals from a naturalized population of the same species. This result suggests that crayfish reared in an environment where predation risks are reduced (e. g. in aquaculture ponds) may respond differently to cues that in other, more risky habitats inform of a danger.
Vulnerable Teens, Vulnerable Times
Authors: Slater Michael D. , Henry Kimberly L. , Swaim Randall C. , Cardador Joe M.
Published: October 2004

We hypothesize that the relationship between teen use of violent media and aggressiveness is contingent on personality and situational variables. Concurrent effects are modeled in four waves of data collection using multilevel analyses. Results indicate that the effect of violent media on aggression is more robust among students who report feelings of alienation from school and during times of increased peer victimization. Although overall use of violent media is associated with higher levels of aggression, a robust within individual effect also exists; that is, during times when a student is viewing elevated levels of violent media content relative to the student’s own norms for use of such media, he or she is also more likely to demonstrate heightened levels of aggression. This relationship is more robust among students who are victimized by their peers and experiencing increased sensation seeking.
Psychometric Properties of an Instrument Designed to Measure the Educational Quality of Graduate Training Programs
Authors: Bierer S. Beth , Fishleder Andrew J. , Dannefer Elaine , Farrow Nancy , Hull Alan L.
Published: October 2004

To assess the quality of residency education programs at an academic medical center for purposes of enhancing individual graduate medical education programs, we asked residents and fellows (N = 419) to evaluate their training programs using a Web-based questionnaire (response rate = 70%). Kruskal-Wallis tests, factor analysis, correlations, generalizability/decision studies, and mean plots were used to examine trainee responses and to assess the questionnaire’s measurement properties. Exploratory factor analysis indicated that the instrument had a threefactor structure that correlated highly with overall program rating. Cronbach’s alpha exceeded .80 for all factors, and decision studies revealed that 13 to 23 raters were needed to obtain G-coefficients greater than .70. Mean plots showed that the instrument could discriminate within and among training programs at the item level and the factor level, which should help target improvements across graduate training programs within large institutions.
On Assessing the Quality of Physicians’ Clinical Judgment
Authors: Wainer Howard , Mee Janet
Published: October 2004

A primary question that must be resolved in the development of tasks to assess the quality of physicians’ clinical judgment is, “What is the outcome variable?” One natural choice would seem to be the correctness of the clinical decision. In this article, we use data on the diagnosis of urinary tract infections among young girls to illustrate why, in many clinical situations, this is not a useful variable. We propose instead a judgment weighted by the relative costs of an error. This variable has the disadvantage of requiring expert judgment for scoring, but the advantage of measuring the construct of interest.
Outcomes of Preventive Case Management Among High-Risk Elderly in Three Medical Groups
Authors: Newcomer Robert , Maravilla Vilma , Faculjak Paul , Graves Maria T.
Published: October 2004

Preventive case management was implemented by Sharp Healthcare of San Diego with the intention of complementing primary care for geriatric patients enrolled in PacifiCare’s Secure Horizons Medicare plan. This article presents patient outcomes after 12 months of participation. The program featured an annual screening questionnaire, appointment monitoring, disease education, and self-management support. It used a prospective design, tracking randomly assigned treatment (n= 1,537) and control patient samples (n = 1,542) for 12 months. Outcomes included physical and mental health status; hospital, ER, and nursing home use; hospital days and expenditures among persons having an inpatient stay; and primary care physician visits. Utilization data were obtained from Sharp Healthcare systems and from screening questionnaires. No statistically significant main effects were found, but persons with three or more independent activity of daily living limitations were about half as likely to have a nursing home admission if they were in case management rather than in the control group.
Typologies of Men Who Are Maritally Violent
Authors: Holtzworth-Munroe Amy , Meehan Jeffrey C.
Published: October 2004

Varying levels and types of husband violence may be conceptualized as typologies of maritally violent men. Across studies, batterer subtypes resembling those proposed by Holtzworth-Munroe and Stuart (1994) have been identified and generally found to differ in predicted ways. Longitudinal data from this study suggests that the subgroups continued to differ over three years. Over time, however, the placement of individual men into some subtypes was not stable. Whether to best conceptualize the heterogeneity among maritally violent men as differing subtypes or as variability along dimensions is considered. Clinical issues regarding the typology are discussed, including concern that the use of absolute cut-off points to identify subtypes is premature and consideration of using the typology to predict treatment outcome and to match interventions to subtypes. Regarding future research ideas, it is time to consider more immediate, situational and dyadic, processes leading to violence perpetration within each subtype.
Mobilizing Mothers for War
Authors: de Volo Lorraine Bayard
Published: October 2004

Studies document that in wartime, states often employ maternal imagery and mobilize women as mothers.Yet we know relatively little about when and why states and their opposition do so. This study seeks to build theory for this phenomenon through frame analysis of the Nicaraguan Contra War. The author proposes that maternal framing, aimed at mothers as well as a broader national and international audience, benefits militaries in at least three ways: (1) channeling maternal grievances, (2) disseminating propaganda through “apolitical” mothers, and (3) evoking emotions and sympathy nationally and internationally. This study furthermore explores three underexamined features of both gendered studies of war and frame analysis: (1) It applies frame theory to states, (2) it develops our understanding of crossnational gendered framing strategies, and (3) it introduces gender framing to the study of war.
Internationalisation Outcomes for All Students Using Information and Communication Technologies (ICTs)
Authors: Leask Betty
Published: October 2004

Internationalisation in higher education institutions is often focused on the movement of students—attracting international students to study on campus and in country and encouraging domestic students to study abroad. Information and communication technologies (ICTs) bring a new dimension to the internationalisation of higher education. They are increasingly being used to enhance the quality of learning of all students. ICTs offer many opportunities to internationalise the curriculum and the learning experiences of students, but they also provide challenges because academics teach a more diverse range of students in a more complex and diverse teaching and learning environment. This article explores the intersections between internationalisation outcomes, ICTs and the planned curriculum, and the implications of these for professional development and student support.
Engineering Education in African Universities: A Case for Internationalization
Authors: Kumar A. , Ochieng Aoyi , Onyango Maurice S.
Published: October 2004

Engineering education is getting global. This article assesses the present scenario in engineering education, which is undergoing a paradigm shift because of the Internet, innovation, and internationalization. The influence of information technology, industrial development, national politics, and economic policies on internationalization of engineering education has been discussed. Quality control and accreditation practices in some countries have been reviewed, and a link between technology advancement and engineering curricula has been drawn. A stable political and economic system is necessary to retain the highly qualified African engineers who are the drivers of the engineering education toward achieving this goal.
A Survey of Internationalisation Activities in European Library and Information Science Schools
Authors: Kajberg Leif
Published: October 2004

Findings are presented from a questionnaire-based survey addressing issues in internationalisation and international collaboration of European higher education institutions within Library and Information Science (LIS). Seventy-five percent of the 30 schools in the survey population responded to the questionnaire. Many schools are making special efforts to internationalise their programme curricula. Study-abroad programmes tend to be widespread and exchanges within EU’s mobility scheme for students and staff are a typical vehicle relied on. International student enrolment (degree students) presents a somewhat diverse picture. Quite a few schools have internationally oriented academic specialists on their staff. The fairly new concept of Internationalisation at Home has been slow to impact on internationalisation activities. Overall, there is a clear sense of the obstacles hampering progress in international cooperation. The general picture of the pace of internationalisation within European LIS education appears somewhat uneven. There seems to be a paucity of more ambitiously conceived collaborative initiatives.