bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling the cost‐effectiveness and capacity impact of changes to colposcopy referral guidelines for women with mild dyskaryosis in the UK Cervical Screening Programme
Authors: Hadwin R , Eggington S , Brennan A , Walker P , Patnick J , Pilgrim H
Published: April 2008

Objective  To evaluate the capacity implications and health economic impact of new guidelines recommending referral to colposcopy after one mild result during cervical screening rather than after two consecutive mild results.

Design  A mathematical model of the country’s colposcopy services and the clinical pathways from smear result through to treatment is constructed. The model incorporates national questionnaire data on referral numbers and management practices, routine data and published research results.

Setting  All English NHS colposcopy services.

Population  Women aged 25 to 64 years.

Methods  The national average workload impact of the change in referral guidelines is predicted, and the impact in differing local circumstances is evaluated within the model. A long‐term health economic model examines the resulting costs and predicted change in quality‐adjusted life years (QALYs).

Main outcome measures  Colposcopy workload implications for single mild dyskaryosis referral and cost per QALY analysis.

Results  We found that single mild dyskaryosis referral implies, on average, a 21% increase in colposcopy workload for services not currently operating this policy. The health economic model predicted a cost per QALY gained as a result of the implementation of the new referral guidelines of around £7,500.

Conclusions  Referral after one mild result will increase workload at colposcopy; however, it may be possible to counterbalance the additional workload by altering other clinical practice. The change to referral guidelines would be considered cost‐effective in comparison with many interventions routinely available on the NHS.
Efficacy of laparoscopic subtotal hysterectomy in the management of menorrhagia: 400 consecutive cases
Authors: Erian J , Hassan M , Pachydakis A , Chandakas S , Wissa I , Hill N
Published: April 2008

Study objective  To assess the safety and patient satisfaction of laparoscopic subtotal hysterectomy (LSH) using a standardised surgical technique.

Design  Prospective observational study.

Setting  Princess Royal University Hospital, Chelsfield Park Hospital and Sloane Hospital, Kent, UK.

Patients and materials  Four hundred consecutive women with menorrhagia underwent LSH. The procedure was performed using the Plasma Kinetic Bipolar Diathermy (Gyrus International Ltd, Berkshire, UK) for pedicle ligation and the Lap Loop system (Roberts Surgical Healthcare Ltd, Kidderminster, UK) to detach the cervix. An electromechanical morcellator (Morcellex; Ethicon Women’s Health and Urology, Cincinnati, OH, USA) was used to remove the uterus from the abdominal cavity.

Main outcome measures  Patient satisfaction, morbidity rates and readmission rates.

Results  A total of 400 LSH were performed between February 2003 and November 2006. The principal clinical indication for hysterectomy was menorrhagia. The mean duration of surgery was 46.4 minutes. The mean operative blood loss was 126 ml. Concurrent surgery was performed in 141 women. Minor and major perioperative complications were encountered in 5% (n= 20) of women. The major complication rate was 1.2% (n= 5): three women (0.75%) with bladder perforation, two women (0.5%) with bowel injury and one woman (0.25%) with a vesicocervical fistula. Eight women (2%) suffered from cyclical vaginal bleeding postoperatively.

Conclusions  LSH is a safe and effective treatment for menorrhagia and other menstrual disorders when hysterectomy is indicated. Women appreciate the quick recovery period, reduced time off work and faster return to normal activity. Our data suggest that LSH can replace abdominal hysterectomy in selected cases.
Maternal depression and medication exposure during pregnancy: comparison of maternal retrospective recall to prospective documentation
Authors: Newport DJ , Brennan PA , Green P , Ilardi D , Whitfield TH , Morris N , Knight BT , Stowe ZN
Published: April 2008

Objective  Outcome investigations of prenatal maternal depression and psychotropic exposure rely extensively on maternal retrospective recall. This study compared postnatal recall to prospective documentation of illness and medication exposures.

Design  Prospective cohort and retrospective case–control studies.

Setting  Emory Women’s Mental Health Program (prospective study) and Emory University Department of Psychology (retrospective study).

Sample  A total of 164 women who participated in both the prospective and retrospective studies.

Methods  Women with a history of mental illness were followed during pregnancy for prospective prenatal assessments of depression and medication exposures. At 6 months postpartum, some of these women also participated in a retrospective study during which they were asked to recall prenatal depression and medication use. Agreement between prospective and retrospective documentation of exposures was analysed.

Main outcome measures  Occurrence of maternal depression during pregnancy and maternal use of pharmacological agents during pregnancy.

Results  There was only moderate agreement (k = 0.42) in prospective versus retrospective reporting of prenatal depression. Positive predictive value for recalling depression was 90.4%; however, negative predictive value for denying depression was only 53.8%. Participants accurately recalled psychotropic use but significantly underreported use of nonpsychotropic medications.

Conclusions  Studies using retrospective data collection may be susceptible to systematic recall bias with underreporting of maternal depression and use of nonpsychotropic agents during pregnancy.
Inferior vena cava filter use in pregnancy: preliminary experience
Authors: Gupta S , Ettles DF , Robinson GJ , Lindow SW
Published: April 2008

Thromboembolism is the most common direct cause of maternal mortality in the UK. Inferior vena cava (IVC) filter placement is indicated in conditions where recurrent thromboembolism occurs despite adequate anticoagulation or when anticoagulation is contraindicated. The safety of IVC filter use in pregnancy is uncertain, as there are limited data available. In this study, we have reviewed pregnancy outcome in women with IVC filter use. Twelve pregnancies in six women, delivered in our hospital in the past 11 years, were identified from obstetric and radiology databases to have an IVC filter in situ. In four pregnancies, an IVC filter was placed during pregnancy. In eight pregnancies, an IVC filter was already in situ before pregnancy and continued for the entire duration of pregnancy. There were no antenatal complications noted due to IVC filter placement and no recurrent thromboembolism noted in pregnancies with an IVC filter in situ before conception. The mode of delivery was based on obstetric reasons in all cases. The mean birthweight was 2982 g, and all babies were born in good condition with Apgar scores within normal range. In conclusion, this case series did not identify any problems associated with IVC filter placement or continuation in pregnancy.
Expression of microRNAs and their precursors in synaptic fractions of adult mouse forebrain
Authors: Lugli Giovanni , Torvik Vetle I. , Larson John , Smalheiser Neil R.
Published: April 2008

We have characterized the expression of microRNAs and selected microRNA precursors within several synaptic fractions of adult mouse forebrain, including synaptoneurosomes, synaptosomes and isolated post‐synaptic densities (PSDs), using methods of microRNA microarray, real time qRT‐PCR, Northern blotting and immunopurification using anti‐PSD95 antibody. The majority of brain microRNAs (especially microRNAs known to be expressed in pyramidal neurons) are detectably expressed in synaptic fractions, and a subset of microRNAs is significantly enriched in synaptic fractions relative to total forebrain homogenate. MicroRNA precursors are also detectable in synaptic fractions at levels that are comparable to whole tissue. Whereas mature microRNAs are predominantly associated with soluble components of the synaptic fractions, microRNA precursors are predominantly associated with PSDs. For seven microRNAs examined, there was a significant correlation between the relative synaptic enrichment of the precursor and the relative synaptic enrichment of the corresponding mature microRNA. These findings support the proposal that microRNAs are formed, at least in part, via processing of microRNA precursors locally within dendritic spines. Dicer is expressed in PSDs but is enzymatically inactive until conditions that activate calpain cause its liberation; thus, we propose that synaptic stimulation may lead to local processing of microRNA precursors in proximity to the synapse.
Shareholder Value and the Performance of a Large Nursing Home Chain
Authors: Kitchener Martin , O'Meara Janis , Brody Ab , Lee Hyang Yuol , Harrington Charlene
Published: April 2008

Objective. To analyze corporate governance arrangements and quality and financial performance outcomes among large multi‐facility nursing home corporations (chains) that pursue stakeholder value (profit maximization) strategies.

Study Design. To establish a foundation of knowledge about the focal phenomenon and processes, we conducted an historical (1993–2005) case study of one of the largest chains (Sun Helathcare Inc.) that triangulated qualitative and quantitative data sources.

Data Sources. Two main sets of information were compared: (1) corporate sources including Sun's Security Exchange Commission (SEC) Form 10‐K annual reports, industry financial reports, and the business press; and (2) external sources including, legal documents, press reports, and publicly available California facility cost reports and quality data.

Principal Findings. Shareholder value was pursued at Sun through three inter‐linked strategies: (1) rapid growth through debt‐financed mergers; (2) labor cost constraint through low nurse staffing levels; and (3) a model of corporate governance that views sanctions for fraud and poor quality as a cost of business.

Conclusions. Study findings and evidence from other large nursing home chains underscore calls from the Institute of Medicine and other bodies for extended oversight of the corporate governance and performance of large nursing home chains.
Economic Growth and Marine Biodiversity: Influence of Human Social Structure on Decline of Marine Trophic Levels
Authors: CLAUSEN REBECCA , YORK RICHARD
Published: April 2008

Abstract:  We assessed the effects of economic growth, urbanization, and human population size on marine biodiversity. We used the mean trophic level (MTL) of marine catch as an indicator of marine biodiversity and conducted cross‐national time‐series analyses (1960–2003) of 102 nations to investigate human social influences on fish catch and trends in MTL. We constructed path models to examine direct and indirect effects relating to marine catch and MTL. Nations' MTLs declined with increased economic growth, increased urbanization, and increased population size, in part because of associated increased catch. These findings contradict the environmental Kuznets curve hypothesis, which claims that economic modernization will reduce human impact on the environment. To make informed decisions on issues of marine resource management, policy makers, nonprofit entities, and professional societies must recognize the need to include social analyses in overall conservation‐research strategies. The challenge is to utilize the socioeconomic and ecological research in the service of a comprehensive marine‐conservation movement.
Assessing the Ecological and Social Benefits of Private Land Conservation in Colorado
Authors: WALLACE GEORGE N. , THEOBALD DAVID M. , ERNST TAWNYA , KING KATHERINE
Published: April 2008

Abstract:  Conservation of private land through conservation easements, development agreements, and clustered housing has increased greatly as have criticisms of the laws, public programs, and incentives that motivate landowners to use them. Rapid land‐use change at the urban–rural interface in Larimer County, Colorado, has given rise to programs that provide a variety of land‐conservation options for landowners. As of January 2005, roughly 60% of Larimer County was publicly owned, and 3% or 16,200 ha was privately owned with some form of protection. We used document analysis, a landowner survey, targeted interviews, and a landscape‐level spatial analysis to analyze the patterns, quantities, and qualities of private land conservation. We created a jurisdiction‐specific typology of desired benefits from local government‐planning documents to help evaluate conservation parcels. Most easements and other conservation documents used general terms and did not describe the site‐specific values of the land being conserved. Landowners were able to describe some benefits not included in parcel‐specific documents, and our spatial analysis revealed parcel‐specific and cumulative conservation benefits such as the amount of buffering, infill, connectivity, protected agricultural land, riparian protection, and other benefits not referenced by either documents or landowners. Conservation benefits provided by a parcel varied depending on its geographic location, the specific institution such as a land trust or open space program that a landowner worked with, and the conservation mechanism used, such as voluntary easement or residential clustering requirements. The methods we used provide a template for jurisdictions wishing to undertake a similar analysis. Our findings may assist other jurisdictions and institutions interested in improving how land‐conservation benefits are described; justify and inform future investments in private land conservation; assist local governments and other institutions with the assessment of program effectiveness; and be useful for conservation planners who wish to become more involved in on‐the‐ground implementation of conservation actions.
Cost‐Effective Management Alternatives for Snake River Chinook Salmon: a Biological‐Economic Synthesis
Authors: HALSING DAVID L. , MOORE MICHAEL R.
Published: April 2008

Abstract:  The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource‐management issue. We constructed an integrated assessment model as a tool for analyzing biological‐economic trade‐offs in recovery of Snake River spring‐ and summer‐run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon‐passage model to predict migration and survival of smolts; an age‐structured matrix model to predict long‐term population growth rates of salmon stocks; and a cost‐effectiveness analysis to determine a set of least‐cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon‐management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost‐effective and generally increased long‐term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost‐effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost‐effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80–90% of management alternatives from the cost‐effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can provide valuable tools for science‐based policy and management.
Modification of ZnAl2O4‐Based Low‐Permittivity Microwave Dielectric Ceramics by Adding 2MO–TiO2 (M=Co, Mg, and Mn)
Authors: Lei Wen , Lu Wen‐Zhong , Zhu Jian‐Hua , Liang Fei , Liu Dan
Published: April 2008

ZnAl2O4‐based microwave dielectric ceramics with added 2MO–TiO2 (M=Co, Mg, and Mn) were synthesized using the solid‐state reaction. The effects of 2MO–TiO2 additions on the microstructures, phase compositions, and microwave dielectric properties of the 0.79ZnAl2O4–0.21M2TiO4 ceramics has been investigated. It can be observed from X‐ray diffraction results that the single‐phase solid solution in the 0.79ZnAl2O4–0.21Co2TiO4 ceramics, and second‐phase rutile, MgTi2O5, and ZnMn3O7 in the 0.79ZnAl2O4–0.21TiO2, 0.79ZnAl2O4–0.21Mg2TiO4, and 0.79ZnAl2O4–0.21Mn2TiO4 ceramics, respectively, appear. The ɛr and τf values of the 0.79ZnAl2O4–0.21M2TiO4 ceramics are weakly dependent on the M element (Co, Mg, and Mn). The ɛr values of the 0.79ZnAl2O4–0.21M2TiO4 ceramics (about 9.7) are lower than that of the 0.79ZnAl2O4–0.21TiO2 ceramics (ɛr=11.6), whereas the τf values of the former (about −65 ppm/°C) are higher than those of the latter (τf=−0.4 ppm/°C). However, in contrast to the Q×f value of the 0.79ZnAl2O4–0.21TiO2 ceramics (Q×f=74 000 GHz), the magnitude of the 0.79ZnAl2O4–0.21Co2TiO4 ceramics increases to 94 000 GHz and that of the 0.79ZnAl2O4–0.21Mg2TiO4 ceramics improves more than twice, whereas the value of the 0.79ZnAl2O4–0.21Mn2TiO4 ceramics undergoes a sharp decline and reaches a minimum of 23 530 GHz at about 6.5 GHz.
Stress Required to Densify a Low‐Fire NiCuZn Ferrite Under Constrained Sintering
Authors: Hsu Rung‐Tsung , Jean Jau‐Ho , Hung Yao‐Yi
Published: April 2008

The effect of uniaxial stress on the densification behavior of a low‐fire NiCuZn ferrite during constrained sintering of a multilayer structure of a ferrite tape and a pure alumina tape has been investigated. Compared with free sintering, the densification of ferrite becomes significantly reduced and slowed down under pressure‐less constrained sintering. To enhance the constrained densification of ferrite in the temperature range required for free sintering, uniaxial stress applied in the thickness direction is needed. The required uniaxial stress to densify ferrite under constrained sintering to reach a relative sintered density of >95% decreases from 1100–1300 kPa at 900°C to 250–450 kPa at 1000°C. Moreover, no significant grain growth is found when the ferrite is densified under pressure‐assisted constrained sintering.
Effect of Electrode Microstructure on the Sensitivity and Response Time of Potentiometric NOX Sensors
Authors: White Briggs , Chatterjee Suman , Macam Eric , Wachsman Eric
Published: April 2008

Nanometric La2CuO4 was synthesized with the Pechini method, co‐precipitation, and two variations of the auto‐ignition technique for fabricating NOX sensor electrodes. The auto‐ignition technique produced the most phase‐pure powder with the smallest particle size and the largest specific surface area. The sensor electrodes were subjected to various thermal treatments resulting in a variety of electrode grain sizes and distributions. The response times of the sensors were exponentially dependent on electrode grain size. Sensors with fine‐grained electrodes were able to produce a steady‐state and consistent voltage at lower temperatures; improving their response sensitivity. Sensors fabricated with powders synthesized through the auto‐ignition route responded quickly, sensitively, and reproducibility to NO.
Could glucose be a proaging factor?
Authors: Kassi Eva , Papavassiliou Athanasios G.
Published: April 2008

There is an ever‐increasing scientific interest for the interplay between cell's environment and the aging process. Although it is known that calorie restriction affects longevity, the exact molecular mechanisms through which nutrients influence various cell signalling/modulators of lifespan remain a largely unresolved issue. Among nutrients, glucose constitutes an evolutionarily stable, precious metabolic fuel, which is catabolized through glycolytic pathway providing energy in the form of ATP and consuming NAD. Accumulating evidence shows that among the important regulators of aging process are autophagy, sirtuin activity and oxidative stress. In light of recent work indicating that glucose availability decreases lifespan whilst impaired glucose metabolism extends life expectancy, the present article deals with the potential role of glucose in the aging process by regulating – directly through its metabolism or indirectly through insulin secretion – autophagy, sirtuins as well as other modulators of aging like oxidative stress and advanced glycation end‐products (AGEs).
The novel adipocytokine visfatin exerts direct cardioprotective effects
Authors: Lim Shiang Y. , Davidson Sean M. , Paramanathan Ajeev J. , Smith Christopher C. T. , Yellon Derek M. , Hausenloy Derek J.
Published: April 2008

Visfatin is an adipocytokine capable of mimicking the glucose‐lowering effects of insulin and activating the pro‐survival kinases phosphatidylinositol‐3‐OH kinase (PI3K)‐protein kinase B (Akt) and mitogen‐activated protein kinase kinase 1 and 2 (MEK1/2)‐extracellular signal‐regulated kinase 1 and 2 (Erk 1/2). Experimental studies have demonstrated that the activation of these kinases confers cardioprotection through the inhibition of the mitochondrial permeability transition pore (mPTP). Whether visfatin is capable of exerting direct cardioprotective effects through these mechanisms is unknown and is the subject of the current study. Anaesthetized C57BL/6 male mice were subjected to in situ 30 min. of regional myocardial ischaemia and 120 min. of reperfusion. The administration of an intravenous bolus of visfatin (5 × 10−6μmol) at the time of myocardial reperfusion reduced the myocardial infarct size from 46.1 ± 4.1% in control hearts to 27.3 ± 4.0% (n≥ 6/group, P < 0.05), an effect that was blocked by the PI3K inhibitor, wortmannin, and the MEK1/2 inhibitor, U0126 (48.8 ± 5.5% and 45.9 ± 8.4%, respectively, versus 27.3 ± 4.0% with visfatin; n≥ 6/group, P < 0.05). In murine ventricular cardiomyocytes subjected to 30 min. of hypoxia followed by 30 min. of reoxygenation, visfatin (100 ng/ml), administered at the time of reoxygenation, reduced the cell death from 65.2 ± 4.6% in control to 49.2 ± 3.7%(n > 200 cells/group, P < 0.05), an effect that was abrogated by wortmannin and U0126 (68.1 ± 5.2% and 59.7 ± 6.2%, respectively; n > 200 cells/group, P > 0.05). Finally, the treatment of murine ventricular cardiomyocytes with visfatin (100 ng/ml) delayed the opening of the mPTP induced by oxidative stress from 81.2 ± 4 sec. in control to 120 ± 7 sec. (n > 20 cells/group, P < 0.05) in a PI3K‐ and MEK1/2‐dependent manner. We report that the adipocytokine, visfatin, is capable of reducing myocardial injury when administered at the time of myocardial reperfusion in both the in situ murine heart and the isolated murine cardiomyocytes. The mechanism appears to involve the PI3K and MEK1/2 pathways and the mPTP.
Porosome in astrocytes
Authors: Lee Jin‐Sook , Cho Won Jin , Jeftinija Ksenija , Jeftinija Srdija , Jena Bhanu P.
Published: April 2008

Secretion is a universal cellular process occurring in bakers yeast, to the complex multicellular organisms, to humans beings. Neurotransmission, digestion, immune response or the release of hormones occur as a result of cell secretion. Secretory defects result in numerous diseases and hence a molecular understanding of the process is critical. Cell secretion involves the transport of vesicular products from within cells to the outside. Porosomes are permanent cup‐shaped supramolecular structures at the cell plasma membrane, where secretory vesicles transiently dock and transiently fuse to release intravesicular contents to the outside. In the past decade, porosomes have been determined to be the universal secretory machinery in cells, present in the exocrine pancreas, endocrine and neuroendocrine cells, and in neurons. In this study, we report for the first time the presence of porosomes in rat brain astrocytes. Using atomic force microscopy on live astrocytes, cup‐shaped porosomes measuring 10–15 nm are observed at the cell plasma membrane. Further studies using electron microscopy confirm the presence of porosomes in astrocytes. Analogous to neuronal porosomes, there is a central plug in the astrocyte porosome complex. Immunoisolation and reconstitution of the astrocyte porosome in lipid membrane, demonstrates a structure similar to what is observed in live cells. These studies demonstrate that in astrocytes, the secretory apparatus at the cell plasma membrane is similar to what is found in neurons.
Smooth muscle NOS, colocalized with caveolin‐1, modulates contraction in mouse small intestine
Authors: El‐Yazbi Ahmed F. , Cho Woo Jung , Cena Jonathan , Schulz Richard , Daniel Edwin E.
Published: April 2008

Neuronal nitric oxide synthase (nNOS) in myenteric neurons is activated during peristalsis to produce nitric oxide which relaxes intestinal smooth muscle. A putative nNOS is also found in the membrane of intestinal smooth muscle cells in mouse and dog. In this study we studied the possible functions of this nNOS expressed in mouse small intestinal smooth muscle colocalized with caveolin‐1(Cav‐1). Cav‐1 knockout mice lacked nNOS in smooth muscle and provided control tissues. 60 mM KCl was used to increase intracellular [Ca2+] through L‐type Ca2+ channel opening and stimulate smooth muscle NOS activity in intestinal tissue segments. An additional contractile response to LNNA (100 μM, NOS inhibitor) was observed in KCl‐contracted tissues from control mice and was almost absent in tissues from Cav‐1 knockout mice. Disruption of caveolae with 40 mM methyl‐β cyclodextrin in tissues from control mice led to the loss of Cav‐1 and nNOS immunoreactivity from smooth muscle as shown by immunohistochemistry and a reduction in the response of these tissues to N‐ω‐nitro‐L‐arginine (LNNA). Reconstitution of membrane cholesterol using water soluble cholesterol in the depleted segments restored the immunoreactivity and the response to LNNA added after KCl. Nicardipine (1 μM) blocked the responses to KCl and LNNA confirming the role of L‐type Ca2+ channels. ODQ (1 μM, soluble guanylate cyclase inhibitor) had the same effect as inhibition of NOS following KCl. We conclude that the activation of nNOS, localized in smooth muscle caveolae, by calcium entering through L‐type calcium channels triggers nitric oxide production which modulates muscle contraction by a cGMP‐dependent mechanism.
Smoking‐attributable periodontal disease in the Australian adult population
Authors: Do Loc G. , Slade Gary D. , Roberts‐Thomson Kaye F. , Sanders Anne E.
Published: April 2008

Background: The extent to which periodontitis is attributable to smoking in Australia has not been examined.

Objectives: To investigate the smoking–periodontitis relationship and to estimate the public health impact of smoking on periodontitis in Australia.

Material and Methods: The National Survey of Adult Oral Health 2004–2006 collected nationally representative oral epidemiologic data for the Australian adult population. Examiners measured probing pocket depth (PPD) and gingival recession at three sites per tooth to compute clinical attachment level (CAL). Moderate‐severe cases were defined as having: 2 interproximal sites (not on same tooth) with 4 mm CAL or with 5 mm PPD. Smoking status was defined as never‐, former‐ or current‐smoker. Current‐smokers were further classified into light‐, moderate‐ or heavy‐smoker using calculated pack‐years. Age, sex and socioeconomic position were examined as potential confounders.

Results: Twenty‐three per cent were former‐smokers and 15% were current‐smokers. Prevalence of periodontitis was 23%. In unadjusted analyses, former‐ and current‐smokers had significantly higher periodontitis prevalence than never‐smokers. Relative to non‐smokers, adjusted prevalence ratios (95% confidence interval) for periodontitis were as follows: former‐smokers: 1.22 (1.03–1.46), moderate‐smokers: 1.63 (1.16–2.30); and heavy‐smokers: 1.64 (1.27–2.12). The population attributable fraction of smoking for moderate‐severe periodontitis was 32% (equivalent to 700,000 adults).

Conclusion: Smoking has a significant impact on periodontal health of the Australian adults.
Prevalence of periodontitis and DMFT index in patients with Crohn's disease and ulcerative colitis
Authors: Brito Fernanda , Barros Fabiana Cervo de , Zaltman Cyrla , Pugas Carvalho Ana Teresa , De Vasconcellos Carneiro Antonio Jose , Fischer Ricardo Guimarães , Gustafsson Anders , De Silva Figueredo Carlos Marcelo
Published: April 2008

Aim: To compare the prevalence of periodontal disease and the decayed, missing and filled teeth (DMFT) index in patients with Crohn's disease (CD) and ulcerative colitis (UC) with those without these diseases.

Material and Methods: Ninety‐nine CD (39.0 SD±12.9 years), 80 UC (43.3 SD±13.2) and 74 healthy controls (40.3 SD±12.9) were compared for DMFT index and presence of periodontitis. Probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), plaque and DMFT index were measured on all subjects. The presence of periodontitis was defined as having CAL 3 mm in at least four sites in different teeth.

Results: Significantly more patients with UC (90.0%; p<0.001) and CD (81.8%; p=0.03) had periodontitis than controls (67.6%). Among smokers, UC patients had significantly more periodontitis. CD had a greater mean DMFT score (18.7 versus 13.9; p=0.031) compared with controls and UC had greater median PPD (2.2 versus 1.7 mm; p<0.0001) than controls. Among non‐smokers, CD (2.4 mm; p<0.0001) and UC showed deeper pockets (2.3 mm; p<0.0001) compared with controls (1.5 mm). UC had a greater mean DMFT score (15.3 versus 12.1; p=0.037) compared with controls.

Conclusions: CD and UC patients had higher DMFT and prevalence of periodontitis than controls, but smoking was an effect modifier.
Bleeding on probing differentially relates to bacterial profiles: the Oral Infections and Vascular Disease Epidemiology Study
Authors: Demmer Ryan T. , Papapanou Panos N. , Jacobs Jr. David R. , Desvarieux Moïse
Published: April 2008

Aim: Various bacterial species are differentially prevalent in periodontal health, gingivitis or periodontitis. We tested the independent associations between three bacterial groupings and gingival inflammation in an epidemiological study.

Material and Methods: In 706 Oral Infections and Vascular Disease Epidemiology Study (INVEST) participants 55 years, bleeding on probing (BoP), pocket depth (PD) and subgingival plaque samples (n=4866) were assessed in eight sites per mouth. Eleven bacterial species were quantitatively assayed and grouped as follows: (i) aetiologic burden (EB, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia); (ii) putative burden (PB, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Micromonas micros, Prevotella intermedia); (iii) health‐associated burden (HAB, Actinomyces naeslundii, Veillonella parvula).

Results: After mutual adjustment for EB, PB and HAB, the BoP prevalence increased by 45% ( p<0.0001) across increasing quartiles of EB while BoP decreased by 13% ( p<0.0001) across increasing quartiles of HAB. Mean PD increased 0.8 mm and decreased 0.3 mm from the first to fourth quartiles of EB (p<0.0001) and HAB ( p<0.0001), respectively. Among 1214 plaque samples with fourth quartile EB, 60% were collected from sites with PD 3 mm.

Conclusion: Bacterial species believed to be aetiologically related to periodontitis were associated with BoP in sites with minimal PD and/or attachment level (AL). Species presumed to be associated with periodontal health demonstrated inverse associations with BoP.
REVIEW ARTICLE: Secreted Heat Shock Protein gp96‐Ig: An Innovative Vaccine Approach
Authors: Strbo Natasa , Podack Eckhard R.
Published: April 2008

Heat shock proteins (HSPs) are a large family of proteins with different molecular weights and different intracellular localizations. These proteins undertake crucial functions in maintaining cell homeostasis, and therefore they have been conserved during evolution. HSP gp96 also known as glucose‐regulated protein grp94, is the primary chaperone of the endoplasmatic reticulum. Gp96/grp94, because of its peptide chaperone capacity and its ability to interact actively with professional antigen‐presenting cells (APCs), is also endowed with crucial immunological functions such as natural adjuvant for priming innate and adaptive immunity. To make gp96 accessible to the immune system without biochemical purification and without cell lysis, we generated a secreted form of gp96. The immunological properties of secreted gp96 and its implications for vaccine in human cancer and infectious diseases will be discussed.
REVIEW ARTICLE: Evolution of Non‐Cytotoxic Uterine Natural Killer Cells
Authors: Kalkunte Satyan , Chichester Clinton O. , Gotsch Francesca , Sentman Charles L. , Romero Roberto , Sharma Surendra
Published: April 2008

The immune tolerance and de novo vascularization are two highly intriguing processes at the maternal–fetal interface that appear to be central to normal pregnancy outcome. Immune tolerance occurs despite the local presence of an active maternal immune system including macrophages, dendritic cells and specialized CD56brightCD16− uterine natural killer (uNK) cells (65–70%). Recent observations indicate that the phenotypic and functional repertoire of uNK cells is distinct from peripheral blood NK and endometrial NK cells, challenging the understanding of their temporal occurrence and function. Origin and specialized programming of uNK cells continue to be debated. uNK cells, replete with an armamentarium to kill the foreign, tolerate the conceptus and facilitate pregnancy. Why do these uNK cells remain non‐cytotoxic? Are these NK cells ‘multitasking’ in nature harboring beneficial and detrimental roles in pregnancy? Are there distinct subpopulations of NK cells that may populate the decidua? We propose that the endometrium/decidua functions as an ‘inducible tertiary lymphoid tissue’ that supports the recruitment and expansion of CD56brightCD16− NK cells and induces transcriptional up‐regulation of angiogenic machinery in response to exposure to local hormonal factors, cytokine milieu and perhaps hypoxia. The angiogenic features of uNK cells could further result in a ‘multitasking’ phenotype that still remains to be characterized. This article discusses the factors and pathways that bridge the angiogenic and non‐cytotoxic response machineries at the maternal–fetal interface.
REVIEW ARTICLE: Clinical Implication of Natural Killer Cells and Reproduction
Authors: Kwak‐Kim Joanne , Gilman‐Sachs Alice
Published: April 2008

The regulation of natural killer (NK) cells in the peripheral blood and endometrial layers has been associated with reproductive immunopathology such as recurrent spontaneous abortions (RSA), infertility of implantation failures, or pre‐eclampsia. The placenta has a complex anatomical structure and different subsets of NK cells with various functional roles can directly interact with trophoblasts. NK cell subpopulations and their functions, putative roles of NK cells in peripheral blood and endometrium are reviewed in relation to RSA and infertility. An increase in NK cell numbers and /or activity in pre‐ or post‐conceptional period in women with RSA or infertility with multiple implantation failures are a significant clinical concern. In addition, immuno‐phenotypic characteristics of NK cells in these women support the changes for their increased activity status. Further studies are needed to explore underlying mechanism of NK cells in RSA, infertility, and other reproductive immunopathologies. Possible neurological and hormonal control of NK cells and NK cell interaction with various leukocyte populations need further investigation in women with reproductive failures.
REVIEW ARTICLE: Mechanisms Underlying Recruitment and Accumulation of Decidual NK Cells in Uterus During Pregnancy
Authors: Santoni Angela , Carlino Claudia , Stabile Helena , Gismondi Angela
Published: April 2008

Natural killer (NK) cells represent the most prominent immune cell type found in the uterus in the first trimester of human pregnancy and in the secretory phase of menstrual cycle. The role of NK cells in pregnancy has been largely discussed over the past years and it is now becoming increasingly clear that they may influence pregnancy outcome at several levels. In normal pregnancy, it appears that the major function of NK cells is to provide benefit by secreting a number of cytokines, chemokines and angiogenic factors rather than to exert a cytotoxic activity. However, the origin of decidual NK cells is still debated and it remains unclear whether they can derive from NK cell populations recruited from peripheral blood and/or other tissues or from self renewal of NK cell progenitors present in the uterus prior to pregnancy or recruited from other tissues. Here, we review the molecular mechanisms underlying peripheral blood NK cell recruitment and its role in the accumulation of NK cells in the decidua during early pregnancy.
ORIGINAL ARTICLE: Decidual Natural Killer Cell Tuning by Autologous Dendritic Cells
Authors: Laškarin Gordana , Redžović Arnela , Rubeša Željka , Mantovani Alberto , Allavena Paola , Haller Herman , Vlastelić Ivan , Rukavina Daniel
Published: April 2008

Problem  Dendritic cells (DC)/natural killer (NK) cells interactions in the deciduas of early human pregnancies were analyzed in vitro.

Method of study  Phenotype, cytokine expression and/or cytolytic mediators’ expression were measured by flow cytometry in NK and DC from the freshly isolated decidual mononuclear cells or after their purification and co‐culture in vitro. Proliferation of 5(6)‐Carboxyfluorescein diacetate N‐succinimidyl ester (CFSE)‐labeled CD56+ cells was analyzed by flow cytometry after the co‐culture with CD1a+ or CD83+ DC.

Results  Decidual CD1a+ cells show less mature phenotype with no expression of CD197, lower expression of CD80 and CD86 and higher expression of CD206 and CD195 in comparison to CD83+ cells. Interleukin (IL)‐15, interferon‐γ and tumor necrosis factor‐α productions were higher in immature than mature DC, whereas IL‐10 and IL‐18 were equally produced in both subpopulations. Immature DC increase perforin, FasL and TRAIL protein expression and proliferation of NK cells, but decrease their intracellular IL‐15 production. Mature DC caused less efficient proliferation of NK cells, and did not affect cytokine and cytolytic mediator expression.

Conclusion These results suggest that decidual CD1a+ cells regulate and shape NK cell function more profoundly than CD83+ cells in decidua.
Light chain multiple myeloma with cutaneous AL amyloidosis
Authors: Becker Maria Rita , Rompel Rainer , Plum Jörg , Gaiser Timo
Published: April 2008

Cutaneous AL amyloidosis is one complication of multiple myeloma. In our patient, painful sclerotic skin changes on the extremities and macroglossia were the presenting features which led to a more detailed investigation and the diagnosis of multiple myeloma. Histological examination revealed cutaneous deposits of amyloid which were positive with Congo red stain and had an apple green color in polarized light.
Photodynamic Therapy in Dermatology – an Update 2008
Authors: Klein Annette , Babilas Philipp , Karrer Sigrid , Landthaler Michael , Szeimies Rolf‐Markus
Published: April 2008

Photodynamic therapy (PDT) is used for the prevention and treatment of non‐melanoma skin cancer. Until recently, clinically approved indications have been restricted to actinic keratoses, nodular and superficial basal cell carcinoma, and – since 2006 – Bowen disease. However, the range of indications has been expanding continuously. PDT is also used for the treatment of non‐malignant conditions such as acne vulgaris and leishmaniasis, as well as for treating premature skin aging due to sun exposure. Here, PDT is used for the stimulation of immunomodulatory effects in contrast to the induction of necrosis and apoptosis as produced in the treatment of skin tumors. The porphyrin precursor 5‐aminolevulinic acid (ALA) or its methyl ester (MAL, so far the only approved formulation in Europe) is applied topically as photosensitizer to exclude systemic reactions. Possible light sources include lasers as well as incoherent light sources; irradiation with incoherent light sources is cheaper and more appropriate for large treatment areas. The main advantages of PDT in comparison to other treatment modalities are its excellent cosmetic results and its high remission rates despite low invasiveness.This article provides up‐to‐date information about PDT with focus on recently published studies.
Hemispheric American Studies: Preliminary Thoughts on Research and Pedagogical Challenges
Authors: Levander Caroline
Published: April 2008

Over the past two decades, important work in many academic disciplines has increasingly begun to break down many of the regional and national boundaries that have long characterized the study of the Americas. Future research and curriculum on the hemisphere will, no doubt, continue to emphasize comparative and cross regional studies. What happens to U.S. and Americas literary and cultural studies if we recognize the asymmetry and interdependency of nation‐state development throughout the hemisphere? This is the question the following article addresses.
‘This Diabolical Generation’– The Ranters and the Devil
Authors: Labuzetta Evan
Published: April 2008

This essay won the 2007 Literature Compass Graduate Essay Prize, Seventeenth Century Section.

This paper argues that the case of the Ranters can help illuminate how attitudes about authority and rebellion were changing in mid‐seventeenth‐century England, and how that process was influenced by printed pamphlets. The Ranters themselves were a print phenomenon – a group largely defined by oppositional writers. These writers applied the traditionally pejorative figure of Satan to the Ranters as a means of denunciation and literal demonization. However, this process was pursued haphazardly and applied to a wide variety of actual beliefs, resulting in a newly complicated meaning of what it meant to be an outsider, a rebel, or a devil. Satan became associated more with an impulse for tearing down and negating established categories of moral behavior, and this mitigated his traditional pejorative associations precisely because it challenged the ability of an observer to say that something was ‘immoral’. The association of Satan with the Ranters figures into a much broader seventeenth‐century re‐evaluation of authority, rebellion, and the figure of the Grand Rebel himself.
Re‐Envisioning the Sublime: L.E.L.'sValley of Linmouth
Authors: Svampa Maria Paola
Published: April 2008

This essay won the 2007Literature CompassGraduate Essay Prize, Romanticism Section.

The English romantic poetess Letitia Elizabeth Landon (1802–38), better known as L.E.L., publishedValley of Linmouthin Fisher'sDrawing Room Scrap‐Bookin 1836. This article examines this single poem and reconsiders the interaction between the message of form and the logic of content. Predicated on the belief that Landon's re‐envisioning of the myths of the sublime and of the solitary genius may be most fully appreciated only through greater attention to language, form, and style, this analysis examines her work in relation to Immanuel Kant'sAnalytic of the Sublime, showing how she attempted to escape the Burkean gendered dichotomy of the beautifulversusthe sublime. Additionally, it highlights the dialogue Landon established with some texts of other English romantic poets. Understanding of Landon's form is critical to avoiding relegation of her work to ‘formlessness’, thus endorsing the traditional prejudice against women's poetry.Valley of Linmouth's combination of clear structure and subtle ambiguities demands a closer reading; comparison of the poem to other texts, and consideration of the same within the entire context of production of Landon's works, underscores both the bold individuality and peculiarity of the poet's discourse.
Mayors rule
Authors: Kenny Michael , Lodge Guy
Published: April 2008

Michael Kenny and Guy Lodge consider the case for introducing more elected mayors in England
Lying back and thinking of England
Authors: Edelstein Jean
Published: April 2008

The UK's approach to tackling teen pregnancy and underage sex is both regressive and lazy, claims Jean Edelstein, who argues that we need a huge culture shift if we genuinely want to protect our young.
Senselessness and sensibility: suicide and university culture
Authors: Benton Meghan
Published: April 2008

In the wake of yet another young suicide in the Welsh town of Bridgend, and in the context of rising emotional problems among young people in Britain, Meghan Benton reflects on the suicide of her ex‐boyfriend at the age of 18, and asks what can be done to better protect at‐risk young people, particularly pressurised students.
The Effect of Past Performance on Expected Control and Risk Attitudes in Integrative Negotiations
Authors: Kray Laura J. , Layne Paddock E. , Galinsky Adam D.
Published: April 2008

Three experiments examine the relationship between past performance and strategies and risk attitudes in integrative negotiations. We hypothesized that past performance would affect negotiators’ willingness to embrace two types of risk: strategic (i.e., information sharing in the present) versus contractual (i.e., uncertainty about the future). Consistent with the hypothesis that past success promotes strategic risk taking, dyads with a history of success were more integrative than dyads with a history of failure in Experiment 1. In Experiment 2, we demonstrated that past performance impacts intentions regarding these two types of risk. Specifically, due to lower expected control over the negotiation process, past failure led negotiators to prefer a contractual risk strategy over a strategic risk strategy. In Experiment 3, we explored one implication of this tendency by showing a greater willingness of past failure negotiators to enter into a contingent agreement, which delays the outcome of the deal until a future point in time. Together these findings indicate that past performance influences not only the amount of risk negotiators assume but also the type of risk they are willing to embrace.
Making a Positive Impression in a Negotiation: Gender Differences in Response to Impression Motivation
Authors: Curhan Jared R. , Overbeck Jennifer R.
Published: April 2008

Prior research has demonstrated the phenomenon ofstereotype reactance, whereby men and women behave in contrast to gender stereotypes, when those stereotypes are activated explicitly (Kray, Thompson, & Galinsky, 2001). The authors propose and present an experiment demonstrating a new mechanism for stereotype reactance—namely,impression motivation, or the degree to which people are motivated to control how others see them (Leary & Kowalski, 1990). Participants randomly assigned to represent either a high‐status recruiter or a low‐status job candidate engaged in a standard employment negotiation simulation. Half the participants were offered an additional incentive to make a positive impression on their negotiation counterparts. As hypothesized, men and women in the high‐status role responded to impression motivation in a manner that contradicted gender stereotypes. Men responded to impression motivation by yielding value to their subordinates, whereas women responded by claiming value for themselves.