bluuebunny/crossref_metadata_2025 huggingface dataset:
Focal Dermal Hypoplasia with Exuberant Fat Herniations and Skeletal Deformities
Authors: Mianda Sandra Bitencourt , Delmaestro Delio , Bertoli Renildes , Marinho Tânia , Lucas Elton
Published: September 2005

Abstract:  Focal dermal hypoplasia or Goltz syndrome is a rare congenital and mesoectodermal dysplasia with multisystemic involvement. Although the genetic alterations responsible for focal dermal hypoplasia are not fully known, there is predominance in affected females, suggesting dominant X‐linked inheritance. Besides the skin, other structures frequently involved are the skeletal system, eyes, teeth, hair, and nails. Skeletal abnormalities are predominantly observed in the hands and feet. We report a 9‐year‐old girl who had typical linear skin atrophy on the trunk, exuberant “fat herniations,” several skeletal abnormalities, and exuberant “lobster claw” deformity. In addition, she had the typical longitudinal striations in femur metaphyses. With regard to family history, her mother had one male stillbirth with several deformities. This typical focal dermal hypoplasia patient is considered valuable in light of the affected male stillbirth and parents with nonaffected phenotypes that together provides evidence for mother‐to‐daughter spontaneous transmission.
Juvenile Xanthogranuloma Associated with Contralateral Lymphadenopathy
Authors: Kirke Sandra , Windebank Kevin , Wood Katrina , Taylor Aileen E. M.
Published: September 2005

Abstract:  Juvenile xanthogranuloma is an uncommon, benign histiocytic condition, primarily affecting children less than 1 year of age. Although usually only cutaneous lesions are found, systemic manifestations of the disease have been reported. We present a child with juvenile xanthogranuloma of the right cheek associated with contralateral cervical lymph node histiocytic infiltration.
Acquired Ichthyosis and Hypertrichosis due to Autoimmune Thyroiditis: Therapeutic Response to Thyroxine Replacement
Authors: Brazzelli Valeria , Prestinari Francesca , Barbagallo Tania , Bellani Eleonora , Calcaterra Valeria , Larizza Daniella , Lauriola Maria M. , Borroni Giovanni
Published: September 2005

Abstract:  Thyroid diseases may be associated with a wide variety of dermatologic disorders. We report a 15‐year‐old girl with acquired ichthyosis and hypertrichosis associated with hypothyroidism resulting from autoimmune thyroiditis. Her skin lesions progressively resolved after 8 months of replacement therapy with L‐thyroxine. This result supports the hypothesis that hypothyroidism in our patient can be directly related to the pathogenesis of acquired ichthyosis and hypertrichosis.
Obesity is Associated with Genetic Variants That Alter Dopamine Availability
Authors: Need A. C. , Ahmadi K. R. , Spector T. D. , Goldstein D. B.
Published: September 2005

Human and animal studies have implicated dopamine in appetite regulation, and family studies have shown that BMI has a strong genetic component. Dopamine availability is controlled largely by three enzymes: COMT, MAOA and MAOB, and by the dopamine transporter SLC6A3, and each gene has a well‐characterized functional variant. Here we look at these four functional polymorphisms together, to investigate how heritable variation in dopamine levels influences the risk of obesity in a cohort of 1150, including 240 defined as obese (BMI ≥ 30). The COMT and SLC6A3 polymorphisms showed no association with either weight, BMI or obesity risk. We found, however, that both MAOA and MAOB show an excess of the low‐activity genotypes in obese individuals (MAOA:χ2= 15.45, p = 0.004; MAOB:χ2= 8.05, p = 0.018). Additionally, the MAOA genotype was significantly associated with both weight (p = 0.0005) and BMI (p = 0.001). When considered together, the ‘at risk genotype’ ‐ low activity genotypes at both the MAOA and MAOB loci ‐ shows a relative risk for obesity of 5.01. These results have not been replicated and, given the experience of complex trait genetics, warrant caution in interpretation. In implicating both the MAOA and MOAB variants, however, this study provides the first indication that dopamine availability (as opposed to other effects of MAOA) is involved in human obesity. It is therefore a priority to assess the associations in replication datasets.
Detecting linkage disequilibrium in the presence of locus heterogeneity
Authors: Wang D. , Huang J.
Published: September 2005

Locus heterogeneity is a common phenomenon in complex diseases and is one of the most important factors that affect the power of either linkage or linkage disequilibrium (LD) analysis. In linkage analysis, the heterogeneity LOD score (HLOD) rather than LOD itself is often used. However, the existing methods for detecting linkage disequilibrium, such as the TDT and many of its variants, do not take into account locus heterogeneity. We propose two novel likelihood‐based methods, an LD‐Het likelihood and an LD‐multinomial likelihood, to test linkage disequilibrium (LD) that explicitly incorporate locus heterogeneity in the analysis. The LD‐Het is applicable to general nuclear family data but requires a working penetrance model. The LD‐multinomial is only applicable to affected sib‐pair data but does not require specification of a trait model. For affected sib‐pair data, both methods have similar power to detect LD under the recessive model, but the LD‐multinomial model has greater power when the underlying model is dominant or additive.
Cardiovascular Risk Factors Predictive for Survival and Morbidity‐Free Survival in the Oldest‐Old Framingham Heart Study Participants
Authors: Terry Dellara F. , Pencina Michael J. , Vasan Ramachandran S. , Murabito Joanne M. , Wolf Philip A. , Hayes Margaret Kelly , Levy Daniel , D'Agostino Ralph B. , Benjamin Emelia J.
Published: September 2005

Objectives:To examine whether midlife cardiovascular risk factors predict survival and survival free of major comorbidities to the age of 85.

Design:Prospective community‐based cohort study.

Setting:Framingham Heart Study, Massachusetts.

Participants:Two thousand five hundred thirty‐one individuals (1,422 women) who attended at least two examinations between the ages of 40 and 50.

Measurements:Risk factors were classified at routine examinations performed between the ages of 40 and 50. Stepwise sex‐adjusted logistic regression models predicting the outcomes of survival and survival free of morbidity to age 85 were selected from the following risk factors: systolic and diastolic blood pressure, total serum cholesterol, glucose intolerance, cigarette smoking, education, body mass index, physical activity index, pulse pressure, antihypertensive medication, and electrocardiographic left ventricular hypertrophy.

Results:More than one‐third of the study sample survived to age 85, and 22% of the original study sample survived free of morbidity. Lower midlife blood pressure and total cholesterol levels, absence of glucose intolerance, nonsmoking status, higher educational attainment, and female sex predicted overall and morbidity‐free survival. The predicted probability of survival to age 85 fell in the presence of accumulating risk factors: 37% for men with no risk factors to 2% with all five risk factors and 65% for women with no risk factors to 14% with all five risk factors.

Conclusion:Lower levels of key cardiovascular risk factors in middle age predicted overall survival and major morbidity‐free survival to age 85. Recognizing and modifying these factors may delay, if not prevent, age‐related morbidity and mortality.
The Role of Abutment‐Attachment Selection in Resolving Inadequate Interarch Distance: A Clinical Report
Authors: Alsiyabi Abdullah S. , Felton David A. , Cooper Lyndon F.
Published: September 2005

A critical factor that needs to be evaluated during the diagnosis and treatment planning phase for patients seeking an implant‐tissue‐supported overdenture or metal‐resin implant fixed denture is the presence of adequate interarch distance. The amount of interarch distance is critical to the selection of appropriate implant abutments and attachments for both implant‐tissue‐supported overdentures and metal‐resin implant fixed complete dentures. This clinical report describes a patient with complications related to the failure to diagnose inadequate interarch distance, and the methods used to resolve the patient's chief complaint. A guide for abutment‐attachment selection using one commercially available implant system is given.
Effect of Heat Treatment on Joint Properties of Laser‐Welded Ag‐Au‐Cu‐Pd and Co‐Cr Alloys
Authors: Watanabe Ikuya , Benson Andrew P. , Nguyen Khoi
Published: September 2005

Purpose: This study investigated the effect of heat treatment on the strengths of laser‐welded cast Ag‐Au‐Cu‐Pd and Co‐Cr alloys.

Materials and Methods: Cast plates of Ag‐Au‐Cu‐Pd (Ag) and Co‐Cr (Co) alloys were prepared. After polishing the surfaces to be welded, the plates were matched and butted Ag to Ag (Ag/Ag), Co to Co (Co/Co), and Ag to Co (Ag/Co) and welded using Nd:YAG laser at a pulse duration of 10 ms, spot diameter of 1 mm, and voltage of 200 V. Five specimens were prepared for each experimental condition by bilaterally welding them with five spots. The Ag/Ag, Ag/Co, and control Ag underwent two heat treatments—softening (ST) and hardening (AH). A group of as‐cast specimens serving as controls was not given either heat treatment. The failure load and percent elongation were measured at a crosshead speed of 1.0 mm/min.

Results: The fracture resistance of Co/Co was similar to that of the control Co, while the fracture resistance of Co/Ag was significantly lower than that of both like alloy pairings for all heat‐treating conditions. The control Ag had greater fracture resistance after AH and lower fracture resistance after ST. The AH treatment increased the fracture resistance, and the ST treatment decreased the fracture resistance of both Ag/Ag and Co/Ag, although not significantly. The percentage of elongation appeared to positively correlate with the fracture resistance results.

Conclusions: The results obtained in this study indicated that the age‐hardening heat treatment increased the weld strength between the paired Au‐Ag‐Cu‐Pd alloys and between the Au‐Ag‐Cu‐Pd and Co‐Cr alloys.
Assessing the Electoral Connection: Evidence from the Early United States
Authors: Carson Jamie L. , Engstrom Erik J.
Published: September 2005

Students of legislative behavior are divided over the extent to which an electoral connection existed in the early United States. In this article, we offer a test of the electoral connection in early American politics by investigating the electoral aftershocks of the disputed presidential election of 1824. Using newly available county‐level presidential voting data, along with the unique circumstances associated with the presidential contest, we examine the connection between representative behavior, district public opinion, and electoral outcomes. We find that representatives who voted for John Quincy Adams in the House contest, yet were from districts supporting Andrew Jackson, were targeted for ouster and suffered a substantial vote‐loss in the subsequent midterm election. We also find that the entry of a quality challenger had a sizeable impact on the fortunes of incumbent legislators. These results serve to confirm that representatives could be held accountable for their behavior in office during the antebellum era.
Who Wants to Globalize? Consumer Tastes and Labor Markets in a Theory of Trade Policy Beliefs
Authors: Baker Andy
Published: September 2005

Although the allure of consumption is the engine of globalization, political economists have tended to ignore varying consumer tastes as a potential source of beliefs about trade policy. This article develops a theory of trade policy preferences that adds the notion of varying consumer tastes to the standard labor‐market application of the Heckscher‐Ohlin trade model. The theory, which can explain trade preferences both across individuals and countries, is supported by an empirical analysis of survey data from 41 nations. Heavy consumers of exportables are found to be more protectionist than heavy consumers of imports and import‐competing goods. Moreover, citizens in countries with expensive tradable goods see trade liberalization as a remedy to the rents they pay for protectionism. Other findings also support the more conventional labor‐market side of the Heckscher‐Ohlin model.
Mixed Protonic–Electronic Conduction in “α‐Al2O3”: An Alternative Hypothesis
Authors: Näfe Helfried
Published: September 2005

As an alternative, the voltage data of Kurita et al. recently published on galvanic cells with commercial α‐Al2O3 as a solid electrolyte and with O2, H2O/α‐Al2O3 as well as H2, H2O/α‐Al2O3 as electrodes can be quantitatively described by assuming that α‐Al2O3 represents a mixed sodium ionic–electronic conductor rather than a protonic–electronic conductor. From the evaluation of the experimental data, numerical values for the p‐type electronic conduction parameter are obtained that agree sufficiently well with the data known to date for the sodium ion conductor Na‐beta‐Al2O3.
Ophthalmological adverse effects of (chiropractic) upper spinal manipulation: evidence from recent case reports
Authors: Ernst Edzard
Published: September 2005

Objective:  Upper spinal manipulation (USM) is frequently used by chiropractors and other health care professionals to treat minor complaints. This systematic review aimed to summarize ophthalmological adverse effects of USM recently reported in the medical literature.

Methods:  Five electronic databases were searched for all case reports of ophthalmological adverse effects after USM published between January 1995 and April 2003. No language restrictions were applied. Key data from the primary publications thus located were extracted and critically evaluated.

Results:  Fourteen case reports were found. Clinical symptoms and signs were diverse and included loss of vision, ophthalmoplegia, diplopia and Horner's syndrome. The underlying mechanism was arterial wall dissection in most cases. The eventual outcome varied and often included permanent deficits. Causality was frequently deemed likely or certain.

Conclusion:  Upper spinal manipulation is associated with ophthalmological adverse effects of unknown frequency. Ophthalmologists should be aware of its risks. Rigorous investigations must be conducted to establish reliable incidence figures.
Intraocular pressure control after clear corneal phacoemulsification in eyes with previous trabeculectomy: a controlled study
Authors: Inal Asli , Bayraktar Sükrü , Inal Berkay , Bayraktar Zerrin , Yilmaz Ömer Faruk
Published: September 2005

Purpose:  To compare intraocular pressure (IOP) control in eyes with or without clear corneal phacoemulsification following trabeculectomy.

Methods:  The study group included 30 eyes that underwent uneventful clear corneal phacoemulsification and foldable intraocular lens implantation following trabeculectomy without antimetabolites. Thirty eyes that had undergone filtering surgery without cataract extraction were selected as controls. Case and control groups were matched with respect to age, gender, IOP, number of glaucoma medications, glaucoma type (primary open‐angle glaucoma/ pseudoexfoliative glaucoma), trabeculectomy time and follow‐up. Comparisons between the study and control groups (intergroup) and within the same group at different time‐points (intragroup) were performed for IOP, glaucoma medications and bleb morphology. Success rates were investigated by Kaplan−Meier survival analysis and the factors influencing final success by logistic regression.

Results:  Intraocular pressure (p = 0.04) and glaucoma medications (p = 0.001) increased during an average follow‐up of 26.1 ± 9.9 months in both groups. Intragroup differences became statistically significant after the 6‐month visit, but intergroup differences remained insignificant. Bleb height decreased significantly following phacoemulsification in the study group (p = 0.017). Success rates decreased with time in both groups, with no intergroup difference (p = 0.46). The final success rate was negatively correlated with IOP and number of glaucoma medications used at the study entry, while there was a positive correlation between the baseline and final success rates.

Conclusion:  Trabeculectomy success decreased in a time‐dependent manner in eyes with and without subsequent phacoemulsification. Uncomplicated clear corneal phacoemulsification was not found to have any additional unfavorable influence on IOP control in eyes with filtering blebs.
Can the prevalence of open‐angle glaucoma be estimated from a retrospective clinical material? A study on the west coast of Iceland
Authors: Jóhannesson Gauti , Guðmundsdóttir Guðrún J. , Lindén Christina
Published: September 2005

Purpose: To explore the possibility of estimating the prevalence of open‐angle glaucoma (OAG) on the west coast of Iceland using a clinical retrospective material, and to compare that estimate with the results from a recent prospective Icelandic study.

Methods: The compulsory ophthalmological examination for the prescription of eye glasses in combination with information obtained from Statistics Iceland were used to establish the prevalence of glaucoma in Akranes and to estimate the minimum prevalence for the greater west coast area. A recent prospective study from Iceland was used as reference.

Results: In all, 79% of 1443 Akranes inhabitants aged 50 years or more had visited the eye clinic at least once between 1996 and 2001. The prevalence of OAG was 4.8% (95% CI 3.6–6.1). The minimum prevalence for the west coast was 3.8% (95% CI 3.2–4.4). The prevalence increased with age (p < 0.001). The overall prevalence was similar to that of recently published prospective data but the prevalence of normal tension glaucoma (NTG) was lower.

Conclusion: The results from the two studies are similar in many respects, which indicates that retrospective data may supply meaningful information on glaucoma prevalence. Important sources of error are the selection and attendance of patients, screening methods and diagnostic criteria. If routine examination does not include fundus photography and/or perimetry, the prevalence of NTG will be underestimated.
The effects of structures on decision‐making policies in health care
Authors: Tuulonen Anja
Published: September 2005

Background:  There is plenty of evidence in the literature indicating how difficult it is to recognize, question and eventually change our current mental models of the structures and decision‐making processes in health care. The citizens of western countries are offered more health care services than ever and report themselves to be somatically healthier than ever. Paradoxically, many health care systems claim to be in a state of crisis, for which the cure is believed to more services and more money. Growth is a major feature of modern medicine and most people assume that more medical care must lead to improved health and wellbeing. However, adding more resources and more health care may also have counterintuitive effects.

Objective:  This perspective describes common phenomena seen in our health care structures and searches for reports and results that may challenge some of the ‘self‐evident’ solutions to these problems.

Results and Discussion:  Most organizations and systems learn poorly and it is difficult to recognize how we contribute to our own problems and crisis. Even if the evidence has been apparent for decades, it may simply be ignored or rejected when it is inconsistent with the underlying beliefs. Learning seems to be associated more with attitudes and mental models than with evidence. As we are part of the health care structure, we share responsibility for problems generated by the system. It is time for health care professionals to study and question the efficacy of our current paradigms and practices.
Neuronal versus glial cell swelling in the ischaemic retina
Authors: Bringmann Andreas , Uckermann Ortrud , Pannicke Thomas , Iandiev Ianors , Reichenbach Andreas , Wiedemann Peter
Published: September 2005

Under normal conditions, the pigment epithelium dehydrates the outer retina while Müller glial cells mediate the rapid water transport within the inner retina. Gliotic alterations of Müller cells may be implicated in the development of oedema in the post‐ischaemic retina. Here, we suggest a mechanism of Müller cell‐supported neuronal cell swelling and apoptosis in the ischaemic retina. During ischaemia, over‐excitation of ionotropic glutamate receptors leads to neuronal cell depolarization that causes excess Ca2+influx into the cells, and to activation of the apoptosis machinery. The ion fluxes into the retinal neurons are associated with water movements that are mediated by aquaporin‐4 water channels expressed by Müller cells and result in neuronal cell swelling. After reperfusion, the glial cells may swell due to the down‐regulation of their K+conductance, which results in intracellular K+overload and water movements from the blood and vitreous into the cells. An inhibition of the glial cell‐mediated water movements during ischaemic episodes should reduce the ion shifts at the neuronal synapses, resulting in decreased neuronal cell swelling and apoptosis. An inhibition of the water movements in the post‐ischaemic phase may prevent cytotoxic Müller cell swelling but may impair the fluid clearance from retinal tissue in the presence of vasogenic oedema. Thus, pharmacological modification of the ion and fluid clearance functions of Müller cells may become a novel way to resolve both cytotoxic and vasogenic oedema in the retina.
A comparison of habitat use and habitat‐specific feeding efficiency by Eurasian ruffe (Gymnocephalus cernuus) and yellow perch (Perca flavescens)
Authors: Fullerton A. H. , Lamberti G. A.
Published: September 2005

Abstract –  Eurasian ruffe are invading habitats in the North American Great Lakes watershed occupied by commercially important native yellow perch. We conducted laboratory experiments to evaluate potential overlap in habitat (macrophytes, mud, cobble) and food (benthic invertebrates) use. Ruffe and yellow perch both preferred macrophytes > cobble > mud in the light, but only ruffe increased their use of mud in the dark. Neither fish density nor food availability affected habitat preferences, and competition for habitat was not evident. For both species, feeding rates were marginally lower in macrophytes but did not differ between species. Our experiments suggest that if ruffe and yellow perch share a habitat (e.g., during invasion or because of predation risk), competition for space will be weak or absent. However, within a shared habitat, competition for food may occur when food is limiting because neither species has a clear advantage in its ability to consume invertebrates in any habitat.
A human‐specific TNF‐responsive promoter for Goodpasture antigen‐binding protein
Authors: Granero Froilán , Revert Fernando , Revert‐Ros Francisco , Lainez Sergio , Martínez‐Martínez Pilar , Saus Juan
Published: September 2005

The Goodpasture antigen‐binding protein, GPBP, is a serine/threonine kinase whose relative expression increases in autoimmune processes. Tumor necrosis factor (TNF) is a pro‐inflammatory cytokine implicated in autoimmune pathogenesis. Here we show that COL4A3BP, the gene encoding GPBP, maps head‐to‐head with POLK, the gene encoding for DNA polymerase kappa (pol κ), and shares with it a 140‐bp promoter containing a Sp1 site, a TATA‐like element, and a nuclear factor kappa B (NFκB)‐like site. These three elements cooperate in the assembly of a bidirectional transcription complex containing abundant Sp1 and little NFκB that is more efficient in the POLK direction. Tumour necrosis factor cell induction is associated with Sp1 release, NFκB recruitment and assembly of a complex comparatively more efficient in the COL4A3BP direction. This is accomplished by competitive binding of Sp1 and NFκB to a DNA element encompassing a NFκB‐like site that is pivotal for the 140‐bp promoter to function. Consistently, a murine homologous DNA region, which contains the Sp1 site and the TATA‐like element but is devoid of the NFκB‐like site, does not show transcriptional activity in transient gene expression assays. Our findings identify a human‐specific TNF‐responsive transcriptional unit that locates GPBP in the signalling cascade of TNF and substantiates previous observations, which independently related TNF and GPBP with human autoimmunity.
The stellar halo metallicity—luminosity relationship for spiral galaxies
Authors: Renda Agostino , Gibson Brad K. , Mouhcine Mustapha , Ibata Rodrigo A. , Kawata Daisuke , Flynn Chris , Brook Chris B.
Published: September 2005

The stellar haloes of spiral galaxies bear important chemodynamical signatures of galaxy formation. We present here the analysis of 89 semi-cosmological spiral galaxy simulations, spanning ∼4 mag in total galactic luminosity. These simulations sample a wide variety of merging histories and show significant dispersion in halo metallicity at a given total luminosity — more than a factor of 10 in metallicity. Our preliminary analysis suggests that galaxies with a more extended merging history possess haloes which have younger and more metal-rich stellar populations than the stellar haloes associated with galaxies with a more abbreviated assembly. A correlation between a halo's metallicity and its surface brightness has also been found, reflecting the correlation between halo metallicity and its stellar mass. Our simulations are compared with recent Hubble Space Telescope observations of resolved stellar haloes in nearby spirals.
Potential for Satellite Remote Sensing of Ground Water
Authors: Becker Matthew W.
Published: September 2005

Predicting hydrologic behavior at regional scales requires heterogeneous data that are often prohibitively expensive to acquire on the ground. As a result, satellite‐based remote sensing has become a powerful tool for surface hydrology. Subsurface hydrology has yet to realize the benefits of remote sensing, even though surface expressions of ground water can be monitored from space. Remotely sensed indicators of ground water may provide important data where practical alternatives are not available. The potential for remote sensing of ground water is explored here in the context of active and planned satellite‐based sensors. Satellite technology is reviewed with respect to its ability to measure ground water potential, storage, and fluxes. It is argued here that satellite data can be used if ancillary analysis is used to infer ground water behavior from surface expressions. Remotely sensed data are most useful where they are combined with numerical modeling, geographic information systems, and ground‐based information.
Determination of Transverse Dispersion Coefficients from Reactive Plume Lengths
Authors: Cirpka Olaf A. , Olsson Åsa , Ju Qingsong , Rahman Md. Arifur , Grathwohl Peter
Published: September 2005

With most existing methods, transverse dispersion coefficients are difficult to determine. We present a new, simple, and robust approach based on steady‐state transport of a reacting agent, introduced over a certain height into the porous medium of interest. The agent reacts with compounds in the ambient water. In our application, we use an alkaline solution injected into acidic ambient water. Threshold values of pH are visualized by adding standard pH indicators. Since aqueous‐phase acid‐base reactions can be considered practically instantaneous and the only process leading to mixing of the reactants is transverse dispersion, the length of the plume is controlled by the ratio of transverse dispersion to advection. We use existing closed‐form expressions for multidimensional steady‐state transport of conservative compounds in order to evaluate the concentration distributions of the reacting compounds. Based on these results, we derive an easy‐to‐use expression for the length of the reactive plume; it is proportional to the injection height squared, times the velocity, and inversely proportional to the transverse dispersion coefficient. Solving this expression for the transverse dispersion coefficient, we can estimate its value from the length of the alkaline plume. We apply the method to two experimental setups of different dimension. The computed transverse dispersion coefficients are rather small. We conclude that at slow but realistic ground water velocities, the contribution of effective molecular diffusion to transverse dispersion cannot be neglected. This results in plume lengths that increase with increasing velocity.
Dementia and Driving: Autonomy Versus Safety
Authors: Snyder Charlene Hoffman
Published: September 2005

Purpose

This article reviews the effects of various types of dementia on driving skills, the available assessment measures, legal considerations, and the important role played by the nurse practitioner (NP) in the process of recommending driving cessation. It provides strategies and resources that may offer guidance to NPs who are attempting to balance the continued independence of patients with dementia, as represented by driving, with the safety not only of such patients but also of the public at large.

Data sources

A review of the biomedical literature, resources available on the World Wide Web, and illustrative case studies were used.

Conclusions

The diagnosis of dementia alone is often insufficient to determine driver competence because the topographic losses of dementia are complex. Recognizing when cessation should occur is made more difficult because objective assessment tools do not exist to predict impaired driving skills. Recommending driving cessation at the appropriate time can be a challenge for NPs, who must balance such a significant impact on the driver's autonomy with concerns about public safety if the patient continues to drive despite progressive impairment.

Implications for practice

The progressive loss of cognitive abilities in dementia presents a series of ongoing challenges for the patient throughout the disease continuum. Unfortunately, the recommendation to stop driving can present one of the more immediate issues confronting the patient, the family, and the healthcare provider. Failure to assess diminished driving skill can lead either to premature or to delayed driving cessation. Either outcome can have adverse effects on the patient, the patient's family, and public safety.
The Development of Health Care–Seeking Behaviors in Traditional‐Age Undergraduate College Students
Authors: Nicoteri Jo Ann , Arnold Elizabeth C.
Published: September 2005

Purpose

Traditional‐age undergraduate college students are embarking into the world of autonomous decision making. These decisions encompass not only academics but also lifestyle and lifeskills. One of the lifeskill areas in which students have difficulty is seeking health care independently. The aim of this pilot study is to gather qualitative data to help illuminate the process of the development of health care–seeking behaviors in traditional‐age undergraduate college students (18–23 years).

Data source

A purposive focus group sample of eight traditional‐age undergraduate college students was recruited from a private university in the northeastern United States.

Conclusions

Five major themes emerged: needing help or care, expectations, decision making, healthcare accessibility, and future needs. Health care for these student participants is expected upon demand by them in this “age of convenience.”

Implications for Practice

The findings indicate these traditional‐age undergraduate college students view themselves as independent but still rely on parental supervision of health care. Implications for providing primary health care for this generation may include marketing strategies to meet this perspective of “24‐7” care based upon this limited focus group, but further expanded studies are needed for generalizations.
Factors Contributing to Low Weight in Community‐Living Older Adults
Authors: Martin Carolyn T. , Kayser‐Jones Jeanie , Stotts Nancy A. , Porter Carol , Froelicher Erika Sivarajan
Published: September 2005

Purpose

To investigate the factors that influence the dietary practices and eating patterns of low‐weight, community‐living older adults (aged 65 and older) and to examine the nutritional advice given to them by healthcare providers (HCPs) (e.g., nurse practitioner, medical doctor).

Data sources

A qualitative approach was used to study a convenience sample of older women. Semistructured interviews were conducted. Thematic analysis and open coding were used to analyze data.

Conclusions

Eating alone, social isolation, and stressors are the main reasons reported by participants for low weight. Data gathered in this study provide important insights into possible reasons for low weight in community‐living older adults.

Implication for practice

As HCPs, it is important to bring low weight to the attention of older adults and educate them regarding appropriate weight for their age (body mass index [BMI] range >21 to <27 kg/m2 for age 65 and older), to understand that older adults with a BMI of <24 may be at increased risk for poor nutritional status, and to weigh older adults at each office visit to assess change in BMI. Small changes in eating patterns and food intake can potentially play an important role in stabilizing weight. Strategies that address eating alone, social isolation, and stressors need to be pursued.
Aggregation and species coexistence in fleas parasitic on small mammals
Authors: Krasnov Boris R. , Stanko Michal , Khokhlova Irina S. , Mošanský Ladislav , Shenbrot Georgy I. , Hawlena Hadas , Morand Serge
Published: September 2005

The aggregation model of coexistence states that species coexistence is facilitated if interspecific aggregation is reduced relative to intraspecific aggregation. We investigated the relationship between intraspecific and interspecific aggregation in 17 component communities (the flea assemblage of a host population) of fleas parasitic on small mammals and hypothesized that interspecific interactions should be reduced relative to intraspecific interactions, facilitating species coexistence. We predicted that the reduction of the level of interspecific aggregation in relation to the level of intraspecific aggregation would be positively correlated with total flea abundance and species richness of flea assemblages. We also expected that the higher degree of facilitation of flea coexistence would be affected by host parameters such as body mass, basal metabolic rate (BMR) and depth and complexity of burrows. Results of this study supported the aggregation model of coexistence and demonstrated that, in general, a) conspecific fleas were aggregated across their hosts; b) flea assemblages were not dominated by negative interspecific interactions; and c) the level of interspecific aggregation in flea assemblages was reduced in relation to the level of intraspecific aggregation. Intraspecific aggregation tended to be correlated positively to body mass, burrow complexity and mass‐independent BMR of a host. Positive interspecific associations of fleas tended to occur more frequently in species‐rich flea assemblages and/or in larger hosts possessing deep complex burrows. Intraspecific aggregation increased relative to interspecific aggregation when species richness of flea infracommunities (the flea assemblage of a host individual) and component communities increased. We conclude that the pattern of flea coexistence is related both to the structure of flea communities and affinities of host species.
Protein kinase C shifts the voltage dependence of KCNQ/M channels expressed in Xenopus oocytes
Authors: Nakajo Koichi , Kubo Yoshihiro
Published: September 2005

It is well established that stimulation of Gq‐coupled receptors such as the M1 muscarinic acetylcholine receptor inhibits KCNQ/M currents. While it is generally accepted that this muscarinic inhibition is mainly caused by the breakdown of PIP2, the role of the subsequent activation of protein kinase C (PKC) is not well understood. By reconstituting M currents in Xenopus oocytes, we observed that stimulation of coexpressed M1 receptors with 10 μm oxotremorine M (oxo‐M) induces a positive shift (4–30 mV, depending on which KCNQ channels are expressed) in the conductance–voltage relationship (G–V) of KCNQ channels. When we applied phorbol 12‐myristate 13‐acetate (PMA), a potent PKC activator, we observed a large positive shift (17.8 ± 1.6 mV) in the G–V curve for KCNQ2, while chelerythrine, a PKC inhibitor, attenuated the shift caused by the stimulation of M1 receptors. By contrast, reducing PIP2 had little effect on the G–V curve for KCNQ2 channels; although pretreating cells with 10 μm wortmannin for 30 min reduced KCNQ2 current amplitude by 80%, the G–V curve was shifted only slightly (5 mV). Apparently, the shift induced by muscarinic stimulation in Xenopus oocytes was mainly caused by PKC activation. When KCNQ2/3 channels were expressed in HEK 293T cells, the G–V curve seemed already to be shifted in a positive direction, even before activation of PKC, and PMA failed to shift the curve any further. That alkaline phosphatase in the patch pipette shifted the G–V curve in a negative direction suggests KCNQ2/3 channels are constitutively phosphorylated in HEK 293T cells.
Activation of KATP channels by H2S in rat insulin‐secreting cells and the underlying mechanisms
Authors: Yang Wei , Yang Guangdong , Jia Xuming , Wu Lingyun , Wang Rui
Published: September 2005

H2S is an important gasotransmitter, generated in mammalian cells from l‐cysteine metabolism. As it stimulates KATP channels in vascular smooth muscle cells, H2S may also function as an endogenous opener of KATP channels in INS‐1E cells, an insulin‐secreting cell line. In the present study, KATP channel currents in INS‐1E cells were recorded using the whole‐cell and single‐channel recording configurations of the patch‐clamp technique. KATP channels in INS‐1E cells have a single‐channel conductance of 78 pS. These channels were activated by diazoxide and inhibited by gliclazide. ATP (3 mm) in the pipette solution inhibited KATP channels in INS‐1E cells. Significant amount of H2S was produced from INS‐1E cells in which the expression of cystathinonie gamma‐lyase (CSE) was confirmed. After INS‐1E cells were transfected with CSE‐targeted short interfering RNA (CSE‐siRNA) or treated with dl‐propargylglycine (PPG; 1–5 mm) to inhibit CSE, endogenous production of H2S was abolished. Increase in extracellular glucose concentration significantly decreased endogenous production of H2S in INS‐1E cells, and increased insulin secretion. After transfection of INS‐1E cells with adenovirus containing the CSE gene (Ad‐CSE) to overexpress CSE, high glucose‐stimulated insulin secretion was virtually abolished. Basal KATP channel currents were significantly reduced after incubating INS‐1E cells with a high glucose concentration (16 mm) or lowering endogenous H2S level by CSE‐siRNA transfection. Under these conditions, exogenously applied H2S significantly increased whole‐cell KATP channel currents at concentrations equal to or lower than 100 μm. H2S (100 μm) markedly increased open probability by more than 2‐fold of single KATP channels (inside‐out recording) in native INS‐1E cells (n= 4, P < 0.05). Single‐channel conductance and ATP sensitivity of KATP channels were not changed by H2S. In conclusion, endogenous H2S production from INS‐1E cells varies with in vivo conditions, which significantly affects insulin secretion from INS‐1E cells. H2S stimulates KATP channels in INS‐1E cells, independent of activation of cytosolic second messengers, which may underlie H2S‐inhibited insulin secretion from these cells. Interaction among H2S, glucose and the KATP channel may constitute an important and novel mechanism for the fine control of insulin secretion from pancreatic β‐cells.
Ca2+/calmodulin protein kinase II and memory: learning‐related changes in a localized region of the domestic chick brain
Authors: Solomonia Revaz O. , Kotorashvili Adam , Kiguradze Tamar , McCabe Brian J. , Horn Gabriel
Published: September 2005

The role of calcium/calmodulin‐dependent protein kinase II (CaMKII) in the recognition memory of visual imprinting was investigated. Domestic chicks were exposed to a training stimulus and learning strength measured. Trained chicks, together with untrained chicks, were killed either 1 h or 24 h after training. The intermediate and medial hyperstriatum ventrale/mesopallium (IMHV/IMM), a forebrain memory storage site, was removed together with a control brain region, the posterior pole of the neostriatum/nidopallium (PPN). Amounts of membrane total αCaMKII (tCaMKII) and Thr286‐autophosphorylated αCaMKII (apCAMKII) were measured. For the IMHV/IMM 1 h group, apCaMKII amount and apCAMKII/tCaMKII increased as chicks learned. The magnitude of the molecular changes were positively correlated with learning strength. No learning‐related effects were observed in PPN, or in either region at 24 h. These results suggest that CaMKII is involved in the formation of memory but not in its maintenance.
Good Timing
Authors: Davenport R. John
Published: September 2005

Television commercials implore viewers to drink milk every day for strong bones, but new research provides a different connection between daily activities and a robust skeleton. An appetite-dampening hormone impinges on cogs in the body's internal clock to slow bone growth, the findings show. The work reveals a new body process controlled by the clock and bolsters connections between circadian rhythms and metabolism.
Novel, Single-Dose Microsphere Formulation of Azithromycin versus 7-Day Levofloxacin Therapy for Treatment of Mild to Moderate Community-Acquired Pneumonia in Adults
Authors: D'Ignazio Joseph , Camere Marco A. , Lewis Drew E. , Jorgensen Daniel , Breen Jeanne D.
Published: September 2005

This randomized, double-blind, noninferiority study was designed to demonstrate that a single 2.0-g oral dose of a novel microsphere formulation of azithromycin was at least as effective as 7 days of levofloxacin, 500 mg/day, in the treatment of adult patients with mild to moderate community-acquired pneumonia (Fine classes I, II, and III). In total, 427 subjects were randomly assigned to receive either a single 2.0-g dose of azithromycin microspheres (
n
= 213) or a 7-day regimen of levofloxacin (
n
= 214). At baseline, 219 of 423 (51.8%) treated subjects had at least one pathogen identified by culture, PCR, or serology. The primary end point was the clinical response (cure or failure) in the “clinical per protocol” population at test of cure (days 13 to 24). Clinical cure rates were 89.7% (156 of 174) for azithromycin microspheres and 93.7% (177 of 189) for levofloxacin (treatment difference, −4.0%; 95% confidence interval, −9.7%, 1.7%). Bacteriologic success at test of cure in the “bacteriologic per protocol” population was 90.7% (97 of 107) for azithromycin microspheres and 92.3% (120 of 130) for levofloxacin (treatment difference, −1.7%; 95% confidence interval, −8.8%, 5.5%). Both treatment regimens were well tolerated; the incidence of treatment-related adverse events was 19.9% and 12.3% for azithromycin and levofloxacin, respectively. A single 2.0-g dose of azithromycin microspheres was at least as effective as a 7-day course of levofloxacin in the treatment of mild to moderate community-acquired pneumonia in adult outpatients.
Molecular Characterization of Isoniazid-Resistant
Mycobacterium tuberculosis
Isolates Collected in Australia
Authors: Lavender Caroline , Globan Maria , Sievers Aina , Billman-Jacobe Helen , Fyfe Janet
Published: September 2005

Elucidation of the molecular basis of isoniazid (INH) resistance in
Mycobacterium tuberculosis
has led to the development of different genotypic approaches for the rapid detection of INH resistance in clinical isolates. Mutations in
katG
, in particular the S315T substitution, are responsible for INH resistance in a large proportion of tuberculosis cases. However, the frequency of the
katG
S315T substitution varies with population samples. In this study, 52 epidemiologically unrelated clinical INH-resistant
M. tuberculosis
isolates collected in Australia were screened for mutations at
katG
codon 315 and the
fabG1
-
inhA
regulatory region. Importantly, 52 INH-sensitive isolates, selected to reflect the geographic and genotypic diversity of the isolates, were also included for comparison. The
katG
S315T substitution and
fabG1
-
inhA
−15 C-to-T mutation were identified in 34 and 13 of the 52 INH-resistant isolates, respectively, and none of the INH-sensitive isolates. Three novel
katG
mutations, D117A, M257I, and G491C, were identified in three INH-resistant strains with a wild-type
katG
codon 315,
fabG1
-
inhA
regulatory region, and
inhA
structural gene. When analyzed for possible associations between resistance mechanisms, resistance phenotype, and genotypic groups, it was found that neither the
katG
S315T nor
fabG1
-
inhA
−15 C-to-T mutation clustered with any one genotypic group, but that the −15 C-to-T substitution was associated with isolates with intermediate INH resistance and isolates coresistant to ethionamide. In total, 90.4% of unrelated INH-resistant isolates could be identified by analysis of just two loci:
katG315
and the
fabG1
-
inh
A regulatory region.
Newly Designed Six-Membered Azasugar Nucleotide-Containing Phosphorothioate Oligonucleotides as Potent Human Immunodeficiency Virus Type 1 Inhibitors
Authors: Lee Dong-Seong , Jung Kyeong-Eun , Yoon Cheol-Hee , Lim Hong , Bae Yong-Soo
Published: September 2005

A series of modified oligonucleotides (ONs), characterized by a phosphorothioate (P═S) backbone and a six-membered azasugar (6-AZS) as a sugar substitute in a nucleotide, were newly synthesized and assessed for their ability to inhibit human immunodeficiency virus type 1 (HIV-1) via simple treatment of HIV-1-infected cultures, without any transfection process. While unmodified P═S ONs exhibited only minor anti-HIV-1 activity, the six-membered azasugar nucleotide (6-AZN)-containing P═S oligonucleotides (AZPSONs) exhibited remarkable antiviral activity against HIV-1/simian-human immunodeficiency virus (SHIV) replication and syncytium formation (50% effective concentration = 0.02 to 0.2 μM). The AZPSONs exhibited little cytotoxicity at concentrations of up to 100 μM. DBM 2198, one of the most effective AZPSONs, exhibited antiviral activity against a broad spectrum of HIV-1, including T-cell-tropic, monotropic, and even drug-resistant HIV-1 variants. The anti-HIV-1 activities of DBM 2198 were similarly maintained in HIV-1-infected cultures of peripheral blood mononuclear cells. When we treated severely infected cultures with DBM 2198, syncytia disappeared completely within 2 days. Taken together, our results indicate that DBM 2198 and other AZPSONs may prove useful in the further development of safe and effective AIDS-therapeutic drugs against a broad spectrum of HIV-1 variants.