bluuebunny/crossref_metadata_2025 huggingface dataset:
Deconstructing Agnes – externalization in systemic supervision
Authors: Lee Linnet , Littlejohns Sophie
Published: July 2007

Externalization is seen in this paper as a valid and useful part of the process of clinical supervision in systemic family therapy training. We offer a discussion on the use of externalization based on an example from a supervision group on a London M.Sc. in Family Therapy. Externalizing practices are located in the context of a postmodern perspective and narrative ideas within systemic family therapy. We explore the use of narrative ideas and the recursive relationship between theory, practice and the subjective experience of the trainee, within the practice of systemic supervision.
Welcoming Design – Hosting a Hospitable Online Course
Authors: Ascough Richard S.
Published: July 2007

Abstract.  A discussion about how instructors can host a hospitable online learning environment can address one of the fundamental philosophical and theological concerns frequently expressed about online learning – the loss of face‐to‐face interaction and, with it, the loss of community building (cf. Delamarter 2005, 138). This perceived link between physical presence and community creation, sometimes articulated, frequently assumed, often stands in the way of instructors, administrators, and even institutions fully embracing online learning. This article will argue that when one gives due attention to hospitality, the potential for building online community is greatly enhanced, and with it comes a more effective pedagogical strategy for deep learning. It will conclude with some general recommendations for employing hospitality for building online learning communities.
Welcoming the Stranger
Authors: Gallagher Eugene V.
Published: July 2007

Abstract.  Thinking about teaching as an act of intellectual hospitality has the potential to shape productively how teachers conceive of their own roles in the classroom, their interactions with students, and their execution of crucial tasks. It also offers a path to helpful reflection about a persistent issue that arises particularly for the many faculty members who teach in small departments of religion and are therefore called upon to address a wide range of topics in their teaching. In addition, adopting an ethos of hospitality in the classroom provides a salutary counterpoint to the pervasive and often corrosive academic practices of critique, refutation, and dispute.
What do Twins Share? A Joint Probit Estimation of Banking and Currency Crises
Authors: FALCETTI ELISABETTA , TUDELA MERXE
Published: July 2007

We study the determinants of twin crises and investigate the direction of causality between banking and currency crises in emerging markets. We model banking and currency crises as dynamic events, correlated over time, and jointly estimate their probability using panel data simulation techniques. We show that banking and currency crises are closely intertwined and are driven by common fundamentals. Banking crises exhibit strong state dependence, suggesting that countries that have experienced a banking crisis in the past are more prone to experience another crisis. Finally, we find evidence of unobserved heterogeneity and autocorrelation in the error term structure.
Methotrexate and liver function: a study of 13 psoriasis cases treated with different cumulative dosages
Authors: Carneiro SC , Cássia FF , Lamy F , Chagas VLA , Ramos‐e‐Silva M
Published: July 2007

Background  The need and frequency of hepatic biopsies during methotrexate (MTX) therapy are still controversial.

Objectives  The purpose of this investigation is to assess MTX liver toxicity in patients with psoriasis through percutaneous liver biopsy, and compare liver morphology changes with increasing cumulative dosages (1, 2, 3 and 4 g) of MTX.

Results  Cumulative dosages of 1 to 2 g MTX did not cause significant liver toxicity. From a cumulative dosage of 3 to 4 g, there is fibrosis formation, inflammation enhancement in the portal area and fibrous septa, configuring regenerative nodes.

Conclusion  In patients with no risk factors for liver disease, with normal physical examination and liver tests, biopsy can be done after a cumulative MTX dosage of approximately 1 to 1.5 g and repeated for each gram. In patients with risk factors, liver biopsy should be done before use of MTX, or within the first 2 months of treatment at the most, and repeated for each gram of cumulative dosage.
CEO Ownership and Discretionary Investments
Authors: Ghosh Aloke , Moon Doocheol , Tandon Kishore
Published: July 2007

Abstract:  This study investigates empirically the relationship between CEO ownership and discretionary investments such as R&D and capital expenditures. We assert that the under‐investment problem is high for R&D‐intensive projects, while the over‐investment problem is high for capital expenditures because of differences in risk between the two types of investments. Building on the linkages between investments and investment‐related agency problems, we hypothesize that the relationship between CEO ownership and investments depends on whether increasing ownership mitigates or exacerbates the under‐ or over‐investment problem. We find a non‐linear association between CEO stock ownership and R&D investments; R&D investments increase and then decline across increasing levels of ownership. Further, we find that R&D investments and CEO stock options are positively associated at high levels of option holdings. In contrast, capital expenditures do not vary with CEO ownership (stock or options). Finally, consistent with our underlying assumption, we find that the influence of R&D investments on future firm risk is significantly larger than that of capital expenditures. Our findings indicate that managerial risk aversion affects discretionary investments.
Hues of a dragon's belly: morphological correlates of ventral coloration in water dragons
Authors: Cuervo J. J. , Shine R.
Published: July 2007

Sexual dichromatism is common in lizards, and may play an important role in sex recognition and mating systems. Nonetheless, relatively few published papers provide quantitative analyses of colour, deal with Australian taxa or are based on large‐bodied species. Water dragons Physignathus lesueurii (Agamidae) from eastern Australia are very large (upto 1 m total length) and sexually dichromatic, with conspicuous red ventral coloration in adult males. We quantified coloration in three ventral regions (throat, chest and abdomen) of males and females using a spectroradiometer and looked for associations of colour with sex and with morphological traits predicted to correlate with fitness (body size, body condition, relative head size and asymmetry of femoral pores). Among adult males, larger individuals showed less red on the abdomen than did smaller animals, and males with relatively large heads had darker, less red abdomens than did males with smaller heads. Among adult females, larger animals had darker chests, and less red on the abdomen and chest, than did smaller females. The similarity in these trends between the sexes, and the location of the sexually dichromatic and size‐sensitive colours in an area (under the abdomen) where they presumably are not visible to other lizards cast doubt on their utility as sexual or dominance signals. Hence, although we documented significant sex and body‐size effects on ventral coloration, our results suggest that ventral colours in water dragons do not function in sex‐specific displays.
Reproductive success and helper effects in the cooperatively breeding grey‐crowned babbler
Authors: Blackmore C. J. , Heinsohn R.
Published: July 2007

Cooperative breeding, where some individuals help to raise offspring that are not their own, is a relatively rare social system in birds. We studied the breeding biology of a declining cooperative breeder, the grey‐crowned babblerPomatostomus temporalis, with the aim of isolating the social factors that affect its reproductive success. Most breeding pairs were assisted by philopatric offspring, although pairs could breed successfully without helpers. Females laid up to four clutches (usually three eggs per clutch) per season. Male (but not female) helpers increased the number of young fledged from individual nests and the likelihood of re‐nesting, resulting in higher seasonal fledgling production. Helper effects on brood size and fledgling production were greater in the second year of the study, which was also characterized by higher nest failure. This suggests that helpers enhance reproduction more in poor conditions. Our study demonstrates the interacting effects of social and ecological factors on reproductive success, and that retention of offspring is not always beneficial for the breeders in cooperative species.
Effects of food and fire on the demography of a nectar‐feeding marsupial: a field experiment
Authors: Tulloch A. I. , Dickman C. R.
Published: July 2007

Animals that specialize on nectar can be expected to face shortages of energy at times or in places where floral resources fade. Using a nectar‐feeding marsupial, the eastern pygmy‐possum Cercartetus nanus as a model, we predicted that animals would respond rapidly to an artificial energy supplement by showing improved body condition and increased local abundance. We also tested the hypothesis that responses would be more pronounced in burnt than in unburnt habitats due to the expectation that food would be limiting after fire. Energy was added in the form of sugar solution to two burnt and two unburnt woodland sites on the New South Wales coast, but not to two sets of equivalent control sites. The responses of pygmy‐possums were compared between sites a month before and a month after supplementation during early autumn when flowers were diminishing. The energy supplement increased on‐site immigration and a tail‐fat index of body condition, but had no overall effect on the abundance or mean body mass of pygmy‐possums. There was no effect of habitat; floral abundance was equal across sites. The results show that C. nanus responded rapidly to the energy supplement, and indicate that animals monitor shifts in the resource base continuously. Similar resource tracking abilities have been demonstrated previously in more mobile nectar‐feeders, such as honeyeaters and bats. We suggest that such abilities should be generally advantageous in any species that depend on ephemeral resources.
Understanding the population dynamics of a rare, polyvoltine butterfly
Authors: Pickens B. A.
Published: July 2007

Understanding the effects of endogenous and exogenous factors on population dynamics is essential for assessing the viability of populations, setting recovery goals for endangered species, and evaluating management options. Invertebrates are particularly difficult to monitor and few long‐term datasets are available for these species. Additionally, limited resources make it necessary to perform monitoring as efficiently as possible. Here, I use the bivoltine Karner blue butterflyLycaeides melissa samuelisto demonstrate how analyzing the effects of density‐dependent factors and weather on separate life stages can be utilized to understand monitoring data, assess populations and identify critical life‐history parameters. My first step was to compare the use of peak numbers as an index of population size with estimates obtained from a more data intensive methodology. Peak numbers proved to be an effective index, and so I utilized this index to analyze 10 and 13 years of monitoring data at two Karner blue butterfly sites in New York, USA. I modeled the effects of weather and density dependence on two distinct population growth rates (λ) per year. Analysis with Akaike's Information Criteria indicated that both sites were primarily influenced by density dependence during the summer period and by weather conditions during the winter period. Large population declines occurred in the winter period and were a result of the previous year's dry summer and cool spring weather. I conclude that recovery goals for this endangered species should include a second brood‐carrying capacity, mean winter growth rate and multiple sites with independent populations. This study represents a rare, long‐term study on the population dynamics of a polyvoltine species. Understanding the population dynamics of polyvoltine species, such as the Karner blue butterfly, will assist in the conservation of many invertebrate and small mammal species.
Osteoporosis and the general dental practitioner: reliability of some digital dental radiological measures
Authors: Geraets W. G. M. , Verheij J. G. C. , Van Der Stelt P. F. , Horner K. , Lindh C. , Nicopoulou‐Karayianni K. , Jacobs R. , Devlin H.
Published: July 2007

Objectives:  Dental radiographs are relatively inexpensive and are regularly made of a large fraction of the adult population; therefore, they represent an enormous potential as a screening tool for osteoporosis. Monitoring the population by means of dual X‐ray absorptiometry (DXA), which is currently the most accepted method for diagnosing osteoporosis, involves enormous costs and facilities. In previous studies, it was shown that the radiographic trabecular pattern shows correlations with the bone mineral density (BMD) as measured by DXA. The objective of this study was to assess the reproducibility of the quantitative analysis of the trabecular pattern on dental radiographs.

Methods:  Six regions of interest were selected manually on three digital radiographic images of 20 women. This process was performed 10 times resulting in 1200 image samples. For each image sample 26 parameters were measured. The reliability of the parameters was evaluated by means of Cronbach's alpha.

Results:  Of the values of Cronbach's alpha 83% is at least 0.9 and 99% is at least 0.8.

Conclusions:  The measurements of the parameters used in this study are very reproducible. Therefore, the manual selection of the regions of interest does not introduce large amounts of noise. The imaging parameters potentially offer an accurate tool for the prediction of BMD values.
Socio‐economic inequality in the self‐reported number of natural teeth among Norwegian adults – an analytical study
Authors: Haugejorden Ola , Klock Kristin S. , Åstrøm Anne N. , Skaret Erik , Trovik Tordis A.
Published: July 2007

Abstract –  Objective:  To assess inequality in dental status associated with educational level, gross personal and family income among Norwegian adults.

Methods:  Data were collected by Norway's Central Bureau of Statistics in November–December 2003. A two‐stage, proportional random sample comprising 2000 persons aged 16–79 years was drawn from the national population register. Information became available for 1309 subjects by interview. The present analyses pertain to 1092 subjects aged 25–79 years (response rate 66%, mean age 47.9 years).

Results:  Of the respondents, 3% were edentulous and 9% had fewer than 20 teeth. The mean number of teeth was 27.1 (SD 7.0). In multiple logistic regression analysis, low gross personal and adjusted family income were associated with increased likelihood of having fewer than 20 natural teeth (OR = 2.84, 95% CI 1.58, 5.10; OR = 3.63, 95% CI 1.99, 6.62, respectively). Educational level was significantly associated with dental status in bivariate but not in multivariate analyses, except once among males. The predictors of socio‐economic inequality in dental status accounted for a limited proportion of explained variance (Nagelkerke's R2) when controlling for age, place of residence, perceived oral health compared with others, perceived importance of oral health, dental attendance and smoking.

Conclusion:  Socio‐economic inequality in dental status persists among Norwegians aged 25–79 years but absolute differences have decreased during the last 30 years. The findings are encouraging but challenging as far as choice of strategy for further reduction of differences in tooth loss.
Tonic B‐cell and viral ITAM signaling: context is everything
Authors: Grande Shannon M. , Bannish Gregory , Fuentes‐Panana Ezequiel M. , Katz Elad , Monroe John G.
Published: July 2007

Summary:  The presence of an immunoreceptor tyrosine‐based activation motif (ITAM) makes immunoreceptors different from other signaling receptors, like integrins, G‐coupled protein receptors, chemokine receptors, and growth factor receptors. This unique motif has the canonical sequence D/Ex0–2YxxL/Ix6–8YxxL/I, where x represents any amino acid and is present at least once in all immunoreceptor complexes. Immunoreceptors can promote survival, activation, and differentiation by transducing signals through these highly conserved motifs. Traditionally, ITAM signaling is thought to occur in response to ligand‐induced aggregation, although evidence indicates that ligand‐independent tonic signaling also provides functionally relevant signals. The majority of proteins containing ITAMs are transmembrane proteins that exist as part of immunoreceptor complexes. However, oncogenic viruses also have ITAM‐containing proteins. In this review, we discuss what is known about tonic signaling by both cellular and viral ITAM‐containing proteins and speculate what we might learn from each context.
The role of integrins and coreceptors in refining thresholds for B‐cell responses
Authors: Batista Facundo D. , Arana Eloisa , Barral Patricia , Carrasco Yolanda R. , Depoil David , Eckl‐Dorna Julia , Fleire Sebastian , Howe Kathy , Vehlow Anne , Weber Michele , Treanor Bebhinn
Published: July 2007

Summary:  Despite compelling evidence that a large proportion of antigens encountered in vivo by B cells are membrane bound, the general view is that B cells are mainly activated by soluble antigens. This notion may have been biased somewhat over the years because the high affinity of the B‐cell receptor (BCR) for soluble intact ligands allows efficient B‐cell stimulation in vitro. In vivo, however, even soluble antigens are likely to be deposited on the surface of antigen‐presenting cells, either by complement or Fc receptors in the form of immune complexes, thus becoming more potent stimulators of B‐cell activation. In this framework, the BCR works in a complex environment of integrins and coreceptors, as well as the B‐cell cytoskeleton. Over the last few years, we have focused on B‐cell membrane‐bound antigen recognition. Here, we discuss some of our findings in the context of what is currently known in this exciting new field.
The efficacy of orally dosed ketamine and ketamine/medetomidine compared with intramuscular ketamine in rhesus macaques (Macaca mulatta) and the effects of dosing route on haematological stress markers
Authors: Winterborn Andrew N , Bates Wendy A , Feng Changyong , Wyatt Jeffrey D
Published: July 2007

Background This study compared the efficacy of two orally‐dosed (PO) anaesthetic regimens for chemical immobilization in rhesus macaques (Macaca mulatta), versus the standard protocol of intramuscular (TM) ketamine. In addition, the effects of dosing route on haematological stress markers were evaluated.

Methods Testing was conducted on 18 chronically housed animals. Animals were trained to accept oral dosing and then randomly assigned to one of three drug regimens: (1) ketamine IM, (2) ketamine PO, (3) Ketamine/medetomidine PO. Sedation levels for each regimen were evaluated.

Results Oral dosing alone was not sufficient to achieve a plane of sedation that allowed for safe handling. Serum cortisol and glucose levels were unchanged across groups, although differences were observed in the leukogram profiles.

Conclusion The oral dosages used in this study fell short in providing adequate sedation for safe handling for routine veterinary procedures. Leukogram profiles indicated that orally dosed animals experienced a higher level of stress.
Application of tropical legumes for pig feed
Authors: MEKBUNGWAN Apichai
Published: July 2007

Raw legume seeds are important source of protein and other nutrients for monogastric animals. However, these legume seeds include many kinds of anti‐nutritive factors (ANF) such as trypsin and chymotrypsin inhibitors, lectins and tannins. Although these ANF vary by species, cultivation areas and harvesting methods, they play a role in decreasing the utilization of nutrients. The pig is a monogastric animal which is slightly tolerant to the ANF in raw legume seed. Nevertheless, the optimal use of legume seed as a pig feed necessitates a lowering of the toxicity in the raw seed until it is appropriate for incorporation in the feed. There are many methods to improve the utilization of nutrients in legume seed, such as breeding improvement, physical treatments (decortications, dehulling, milling and others), heat treatments (toasting, boiling, extrusion, streaming or autoclave), chelating substances for binding toxics, radiation and soaking. The choice of the treatment depends on the availability of facilities and economic considerations. This article reviews and discusses the nutrients in legume seeds and might offer an important information on legume seeds for pig feed to nutritionists.
Review of a histological intestinal approach to assessing the intestinal function in chickens and pigs
Authors: YAMAUCHI Koh‐en
Published: July 2007

The general histological features of the small intestine are well known. However, histological intestinal alterations induced by ingested feeds have not been established. To demonstrate such a relationship; (i) the post‐hatching development of intestinal villi in chickens was observed; (ii) histological intestinal differences were compared in White Leghorns and broilers; and (iii) histological intestinal alteration was investigated in fasting and refeeding treatments, using chickens and piglets. Histological intestinal recovery responses; (iv) to luminal nutrient absorption, intraluminal physical stimulation, or intravenous parenteral alimentation in fasted chickens, as well as; (v) to particle size and nutritional level of refed diets in fasted chickens and piglets were also compared. To induce compensatory enlargement of ileal villi; (vi) the jejunum was surgically resected. To reconfirm the histological intestinal alterations induced artificially; (vii) conventional feeding experiments were enforced in chickens and piglets. These fundamental investigations demonstrate that the high values of villus height, cell area and cell mitosis numbers as well as protuberated epithelial cells are hypertrophied by ingested feeds. Finally, as examples of practical use in the animal production field; (viii) useful feed resources to improve the growth performance by activating the intestinal function in chickens and piglets; and (ix) an effective forced molting method are introduced. Based on the histological intestinal alterations related with growth performance in chickens and piglets, this article reviews progress in the establishment of a histological intestinal index to assess the intestinal function.
The influence of Pueraria mirifica herb containing phytoestrogens on the urinary gonadotropin and estradiol levels in aged menopausal monkeys
Authors: TRISOMBOON Hataitip , MALAIVIJITNOND Suchinda , CHERDSHEWASART Wichai , WATANABE Gen , TAYA Kazuyoshi
Published: July 2007

We investigated a non‐invasive method of specimen collection for determining the changes of reproductive hormones in aged menopausal monkeys after a long‐term feeding of the Thai herb Pueraria mirifica (PM) containing phytoestrogens. Three groups of aged menopausal monkeys (n = three in each group) were fed daily with 10, 100, or 1000 mg of PM for a 90 day treatment period, and fed with distilled water for 30 and 60 days of the pre‐ and post‐treatment periods, respectively. Urine samples were collected for 14 h daily every 5 days and assayed for follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels. The result showed that monkeys fed with PM 10, PM 100, and PM 1000 had a decrease in urinary FSH levels during the treatment period, followed by a rebound increase during the post‐treatment period. Urinary estradiol levels tended to decrease and fluctuated between 4.28 and 266.71, 2.85–42.27, and 6.24–203.50% of the pre‐treatment levels in those three groups, respectively. Decreases in urinary LH levels could not be observed in all the three groups. These results suggest that FSH could be a candidate marker to detect the estrogenic effects of phytoestrogens in aged menopausal monkeys when changes of urinary hormones need to be used as an indicator.
Predicting urinary nitrogen excretion by milk urea nitrogen in lactating Chinese Holstein cows
Authors: ZHAI Shaowei , LIU Jianxin , WU Yueming , YE Junan
Published: July 2007

The objective of this study was to assess the relationship between milk urea nitrogen (MUN, mg/dL) and urinary nitrogen (UN) excretion (UN, g/day) in lactating Chinese Holstein cows. Twelve mature lactating cows were divided into four groups by their days in milk and milk yield and fed four different crude protein levels diets (13.2, 14.1, 15.0 and 16.2%, dry matter (DM) basis) with a similar net energy content. The experiment was conducted according to a multiple 4 × 4 Latin square design. The entire length of the experimental periods was 56 days, each period consisting of 14 days with days 1–9 for adjustment and days 10–14 for the collection of urine and data. The crude protein content had significant effects on the MUN content and UN excretion (P < 0.01), but little effect on milk yield and composition (P > 0.05). There was a close relationship between MUN and UN excretion (P < 0.001). The following equations were established to predict UN (g/day) excretion based on MUN (mg/dL) in the lactating Chinese Holstein cows: UN = 10.07 × MUN + 47.29. The results obtained in this study suggested that MUN could be used as a parameter to estimate UN excretion, while the equations to predict UN based on MUN might be somewhat different due to the differences in breeds of cow.
Seasonal variations in sexual behavior, testosterone, testicular size and semen characteristics, as affected by social dominance, of tropical hair rams (Ovis aries)
Authors: AGUIRRE Virginio , ORIHUELA Agustín , VÁZQUEZ Reyes
Published: July 2007

The purpose of this study was to examine the effect of day length on seminal characteristics, testicular size, sexual behavior and testosterone concentration (T4) in dominant and subordinate Pelibuey rams. Six groups of three animals were evaluated every 2 weeks over a 12 month period. Dominant (D), medium (M) and subordinate (S) animals in each group were identified through a food competition test every 15 days. All rams ejaculated and produced semen throughout the year. A linear hierarchy was clearly established and maintained during the year. S rams had lower levels (P < 0.05) of semen volume, sperm concentration and testicular volume than D rams, regardless of season. Scrotal circumference was not influenced (P > 0.05) by their social position. D rams were more affected by the photoperiod, decreasing (P < 0.05) reaction times, increasing (P < 0.05) T4and producing more (P < 0.05) sperm per ejaculation than S rams during short days (14.65 ± 1.22vs26.92 ± 1.65 s; 8.68 ± 0.44vs7.37 ± 0.40 ng/mL and 3.37 ± 0.17vs2.04 ± 0.16 sperm/109, respectively). Semen volume and sperm concentration were significantly (P < 0.05) greater during short days in all rams, regardless of their social status, with the exception of sperm concentration in D rams where no variation was found. M rams displayed variable values in the range between the D and S rams. It was concluded that the magnitude of the seasonal effects was not sufficient to prevent the rams being used for breeding throughout the year and that seasonal variation within the variables affected the social ranks differently.
Interactions of HIPPI, a molecular partner of Huntingtin interacting protein HIP1, with the specific motif present at the putative promoter sequence of the caspase‐1, caspase‐8 and caspase‐10 genes
Authors: Majumder P. , Choudhury A. , Banerjee M. , Lahiri A. , Bhattacharyya N. P.
Published: July 2007

To investigate the mechanism of increased expression of caspase‐1 caused by exogenous Hippi, observed earlier in HeLa and Neuro2A cells, in this work we identified a specific motif AAAGACATG (− 101 to − 93) at the caspase‐1 gene upstream sequence where HIPPI could bind. Various mutations in this specific sequence compromised the interaction, showing the specificity of the interactions. In the luciferase reporter assay, when the reporter gene was driven by caspase‐1 gene upstream sequences (− 151 to − 92) with the mutation G to T at position − 98, luciferase activity was decreased significantly in green fluorescent protein–Hippi‐expressing HeLa cells in comparison to that obtained with the wild‐type caspase‐1 gene 60 bp upstream sequence, indicating the biological significance of such binding. It was observed that the C‐terminal ‘pseudo’ death effector domain of HIPPI interacted with the 60 bp (− 151 to − 92) upstream sequence of the caspase‐1 gene containing the motif. We further observed that expression of caspase‐8 and caspase‐10 was increased in green fluorescent protein–Hippi‐expressing HeLa cells. In addition, HIPPI interacted in vitro with putative promoter sequences of these genes, containing a similar motif. In summary, we identified a novel function of HIPPI; it binds to specific upstream sequences of the caspase‐1, caspase‐8 and caspase‐10 genes and alters the expression of the genes. This result showed the motif‐specific interaction of HIPPI with DNA, and indicates that it could act as transcription regulator.
How Reliable is a Self-administered Questionnaire in Detecting Sexual Abuse: A Retrospective Study in Patients with Pelvic-Floor Complaints and a Review of Literature
Authors: Elzevier Henk W. , Voorham-van der Zalm Petra J. , Pelger Rob C.M.
Published: July 2007

Introdution

Sexual abuse and sexual functioning are topics that health professionals find difficult to discuss. Women who present with pelvic-floor complaints often experience sexual difficulties; therefore, questions regarding sexual function should be a routine part of screening. Furthermore, pelvic-floor complaints are correlated with sexual abuse and asking about abuse should be a routine part of screening as well. Considering the fact that many practitioners have difficulty enquiring about abuse, we have suggested that a questionnaire may be helpful in improving the recognition and management of patients who have a history of sexual abuse.

Aim

The efficiency of detecting sexual abuse by a self-administered questionnaire.

Methods

Report of sexual abuse in a self-administered pelvic-floor questionnaire before visiting our outpatient pelvic-floor department was evaluated with the Pelvic Floor Leiden Inventories (PelFIs) administered by a pelvic- floor clinician in a later stage.

Main Outcome Measures

The percentage of sexual abuse detected by a taken questionnaire administered by a pelvic-floor clinician not confessed during a previous self-administered questionnaire.

Results

Sexual abuse was reported in 20 patients with pelvic-floor dysfunction during administration of the PelFIs and were also evaluated on our pelvic-floor department. Only six of the patients (30%) did not note in the self-administered questionnaire that they had a history of sexual abuse.

Conclusion

A self-administered questionnaire for pelvic-floor complaints is reliable in detecting sexual abuse and can be helpful in daily practice.
A Survey of Primary-Care Physicians and Urologists Regarding Peyronie's Disease
Authors: LaRochelle Jeffrey C. , Levine Laurence A.
Published: July 2007

Introduction

Peyronie's disease (PD) is a connective tissue disorder with an uncertain etiology that causes penile deformity. The interest in PD and our understanding of the disorder has grown significantly in recent years. Data have shown that several previous beliefs regarding the prevalence, natural history, and treatment of PD were incorrect. The prevalence is significantly higher than the previously reported 1%, and most cases of PD do not spontaneously resolve.

Aim

To determine the extent to which newer information about PD has reached physicians who are likely to encounter men with PD and to determine practice patterns regarding this disorder.

Methods

We created a survey of 20 questions and mailed it to primary-care physicians (PCPs) and urologists (UROs) in Illinois and Wisconsin.

Main Outcome Measures

Responses to individual survey items were totaled.

Results

We received 152 responses from PCPs and 98 from UROs for response rates of 43% and 44%, respectively. Survey results revealed the following: 63% of PCPs and 41% of UROs thought the prevalence is less than 1%; 17% of PCPs and 38% of UROs believed PD spontaneously resolves in greater than 50% of cases; 17% of PCPs and 9% of UROs did not think PD occurs in men younger than 40 years of age; 48% of PCPs and 37% of UROs did not believe that PD is frequently associated with ED; 51% of PCPs and 1% of UROs were unsure if any effective medical or surgical treatment for PD existed.

Conclusion

These data suggest that many physicians who are very likely to encounter men with PD have incorrect assumptions about the disease, and this can negatively affect diagnosis and treatment of men with PD.
Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes
Authors: Kramvis Anna , Kew Michael C.
Published: July 2007

Of approximately 360 million people in the world chronically infected with hepatitis B virus (HBV), 65 million reside in Africa. Thus, Africa, with 12% of the world's population, carries approximately 18% of the global burden of HBV infection, with hepatocellular carcinoma and cirrhosis accounting for 2% of the continent's annual deaths. Despite HBV being endemic or hyperendemic in Africa, there is a paucity of data on the genotypes and their distribution. Genotype A is found mainly in southern, eastern and central Africa. Most African genotype A strains belong to subgenotype A1, with subgenotype A3 found in western Africa. Genotype D prevails in northern countries and genotype E in western and central Africa. Ithas become increasingly evident that heterogeneity in the global distribution of HBV genotypes may be responsible for differences in the clinical outcomes of HBV infections and the response to antiviral treatment and vaccination. A limited number of studies have been published relating genotypes to clinical outcomes in African countries. Because observations from other regions of the world can not be extrapolated from one locale to another, the HBV strains circulating in Africa should be studied and related to clinical outcomes.
Hepatitis B virus genotypes in Europe
Authors: Schaefer Stephan
Published: July 2007

There are eight genotypes of hepatitis B virus (HBV). Most genotypes can be further divided into subgenotypes. HBV genotypes influence the course of disease and treatment, and show geographic preferences. In Europe, A and D are the main genotypes found. Genotype A is more prevalent in northern Europe, where genotype D is mainly found in countries surrounding the Mediterranean Sea and in Eastern Europe. Subgenotype A2 is the dominant subgenotype in Europe, but the geographic prevalence of the four subgenotypes found in genotype D is not yet clear. On treatment with interferon HBV, genotype A, compared to genotype D, showsbetter virological response and in a large proportion of patients, even development of anti‐HBs. However, in the first year of treatment with lamivudine, higher rates of emergence of YMDD variants are observed in genotype A. This work summarizes the current knowledge on HBV genotypes in countries with low and intermediate HBV carriership from Europe.
Hepatitis B virus genotypes and subgenotypes in China
Authors: Wang Zhanhui , Huang Yuehua , Wen Shujuan , Zhou Bin , Hou Jinlin
Published: July 2007

Eight Hepatitis B virus (HBV) genotypes (A to H) have been identified based on an intergenotype divergence of 8% or more in the entire nucleotide sequence. Subgenotypes have also been identified in different HBV genotypes. As a highly endemic area for HBV infection, the prevalence of chronic HBV infection in China is between 8 and 20% of the general population. Genotypes B and C were identified as the most common HBV strains and account for approximately 95% of Chinese patients. Further study confirmed all genotype B strains belong to subgenotype Ba. Two of genotype C subgenotypes, C1 (Cs) and C2 (Ce), were found in China and they showed different geographic distributions. Genotype A was very rarely found, while genotypes E, F, G and H have not beenreported until now. Two types of HBV C/Drecombinant viruses have been identified in west China and distinct geographic and ethnic distributions were observed. Significant differences were observed (P < 0.001) in the prevalence of A1896 and T1762/A1764 mutations among HBV Ba, C1 and C2 subgenotypes in Chinese patients. Accumulating evidence showed the response rate to antiviral therapy in Chinese patients is higher in genotype B than genotype C patients on interferon treatment, but no difference was observed on nucleoside/nucleotide analog treatment.
Improving outcomes for patients with chronic hepatitis B
Authors: Gish Robert G.
Published: July 2007

A focused meeting on hepatitis B virus (HBV) infection was held at the United States National Institutes of Health in Washington, DC, in April 2006. This meeting focused on new and historical data and served as a review for basic scientists and clinicians, as well as representatives from the pharmaceutical industry. Understanding HBV disease must include up‐to‐date information concerning virology, immunology, animal models, natural history, prevalence, and transmission risk, as well as an understanding of the evolving therapies for this life‐threatening infection. Serious outcomes such as advanced fibrosis, cirrhosis, liver failure and hepatocellular carcinoma from hepatitis B infection appear to be closely tied to both historical and current serum levels of HBV DNA, and elevated serum levels of liver enzymes. Decreasing risk events and vaccinating susceptible individuals are key steps in managing this global scourge. New oral treatments for patients withchronic hepatitis B infection characterized by more potent antiviral effects, less toxicity, and minimal or no risk of resistance were reviewed and emphasized. Entecavir and pegylated interferons have recently been approved for treatment of chronic hepatitis B. Further expansion of our information about lamivudine and adefovir were highlighted. Several other new anti‐HBV agents are also in phase II or III clinical trials or have been submitted for licensing including LdT (telbivudine). The NIH review meeting is summarized in this review and new and emerging areas of information are highlighted.
Role of a
qnr
-Like Gene in the Intrinsic Resistance of
Enterococcus faecalis
to Fluoroquinolones
Authors: Arsène Stéphanie , Leclercq Roland
Published: July 2007

Fluoroquinolones are poorly active against enterococci. Recently, plasmid-borne resistance to fluoroquinolones due to the
qnr
gene was reported in members of the
Enterobacteriaceae
family. The gene encodes a pentapeptide repeat protein that protects DNA gyrase from inhibition by fluoroquinolones. We have identified in the genome of
Enterococcus faecalis
V583 a
qnr
-like gene, named
E. faecalis qnr
(
qnr

E. faecalis

), encoding a putative pentapeptide repeat protein that shares 25% identity with Qnr. To assess its potential role in the intrinsic resistance of
E. faecalis
to fluoroquinolones,
qnr

E. faecalis

was inactivated in
E. faecalis
JH2-2 by insertion of the thermosensitive vector pG1KT. This strain was then complemented with
qnr

E. faecalis

cloned in the multicopy plasmid pORI23. The effects of its overexpression were also studied. Inactivation of the
qnr

E. faecalis

gene resulted in twofold decreases in the MICs of ofloxacin and ciprofloxacin. When the gene was complemented or overexpressed, MICs of fluoroquinolones increased four- to nine-fold, leading to MICs of ofloxacin and ciprofloxacin equal to 32 μg/ml and 8 μg/ml, respectively. The
E. faecalis
Qnr (Qnr

E. faecalis

) protein was produced and purified. Qnr

E. faecalis

protein protected
Escherichia coli
DNA gyrase from inhibition by ofloxacin. The
qnr

E. faecalis

gene was then introduced into
E. coli
DH10B,
Staphylococcus aureus
RN4220, and
Lactococcus lactis
IL-1419 to study its heterologous expression. MICs of the various fluoroquinolones tested increased 4- to 16-fold, showing that Qnr

E. faecalis

conferred resistance to fluoroquinolones in various bacterial backgrounds. Overexpression of
qnr

E. faecalis

in enterococci or mobilization of the gene to other bacterial species may be anticipated as a possible new mechanism for fluoroquinolone resistance.
First Characterization of Heterogeneous Resistance to Imipenem in Invasive Nontypeable
Haemophilus influenzae
Isolates
Authors: Cerquetti Marina , Giufrè Maria , Cardines Rita , Mastrantonio Paola
Published: July 2007

This study describes the first two reported invasive nontypeable
Haemophilus influenzae
(NTHI) isolates (strains 183 and 184) with heterogeneous resistance to imipenem. For both isolates, Etest showed imipenem MICs of ≥32 μg/ml. When the two strains were examined by the quantitative method of population analysis, both strain populations were heterogeneously resistant to imipenem and contained subpopulations growing in the presence of up to 32 μg of imipenem/ml at frequencies of 1.7 × 10
−5
and 1.5 × 10
−7
, respectively. By pulsed-field gel electrophoresis analysis, the two isolates appeared to be genetically closely related. The sequencing of the
ftsI
gene encoding penicillin-binding protein 3 (PBP 3) and comparison with the sequence of the imipenem-susceptible
H. influenzae
strain Rd identified a pattern of six amino acid substitutions shared between strains 183 and 184; an additional change was unique to strain 183. No relationship between mutations in the
dacB
gene encoding PBP 4 and imipenem resistance was found. The replacement of the
ftsI
gene in the imipenem-susceptible strain Rd (for which the MIC of imipenem is 0.38 to 1 μg/ml) with
ftsI
from strain 183 resulted in a transformant for which the MIC of imipenem ranged from 4 to 8 μg/ml as determined by Etest. The Rd/183 transformant population showed heterogeneous resistance to imipenem; it contained subpopulations growing in the presence of up to 32 μg of imipenem/ml at a frequency of 3.3 ×10
−8
. The presence of additional resistance mechanisms, such as the overexpression of the AcrAB efflux pump, was investigated and does not seem to be involved. These data indicate that the heterogeneous imipenem resistance phenotype of our NTHI clone depends largely on the PBP 3 amino acid substitutions. We speculated that bacterial regulatory networks may play a role in the control of the heterogeneous expression of the resistance phenotype.
Population Pharmacokinetics and Pharmacodynamics of Continuous versus Short-Term Infusion of Imipenem-Cilastatin in Critically Ill Patients in a Randomized, Controlled Trial
Authors: Sakka Samir G. , Glauner Anna K. , Bulitta Jürgen B. , Kinzig-Schippers Martina , Pfister Wolfgang , Drusano George L. , Sörgel Fritz
Published: July 2007

Beta-lactams are regularly administered in intermittent short-term infusions. The percentage of the dosing interval during which free drug concentrations exceed the MIC (fT>MIC) is the measure of drug exposure that best correlates with clinical outcome for beta-lactams. Therefore, administration by continuous infusion has gained increasing interest recently. We studied 20 critically ill patients with nosocomial pneumonia and investigated whether continuous infusion with a reduced total dose, compared to the standard regimen of intermittent short-term infusion, results in a superior probability of target attainment as assessed by thefT>MICvalue of imipenem. In this prospective, randomized, controlled clinical study, patients received either a loading dose of 1 g/1 g imipenem and cilastatin (as a short-term infusion) at time zero, followed by 2 g/2 g imipenem-cilastatin per 24 h as a continuous infusion for 3 days (n= 10), or 1 g/1 g imipenem-cilastatin three times per day as a short-term infusion for 3 days (total daily dose, 3 g/3 g;n= 10). Imipenem concentrations in plasma were determined by using a validated liquid chromatography-tandem mass spectrometry assay. A two-compartment open model was employed for population pharmacokinetic modeling. We simulated 10,000 intensive-care-unit patients via Monte Carlo simulations for pharmacodynamic evaluation using the target 40%fT>MIC. The probability of target attainment by MIC for intermittent infusion was robust (>90%) up to MICs of 1 to 2 mg/liter. The corresponding value for continuous infusion was 2 to 4 mg/liter. Although all 20 patients had anfT>MICof 100%, 3 patients died. Patient survival was best described by employing a sepsis-related organ failure assessment score as a covariate in a logistic regression analysis. Larger clinical trials are warranted for evaluation of continuous infusions at a reduced dose of imipenem for critically ill patients.
Effect of Delayed Pulsed-Wave Ultrasound on Local Pharmacokinetics and Pharmacodynamics of Vancomycin-Loaded Acrylic Bone Cement In Vivo
Authors: Cai Xun-Zi , Yan Shi-Gui , Wu Hao-Bo , He Rong-Xin , Dai Xue-Song , Chen Hai-Xiang , Yan Rui-Jian , Zhao Xin-Hua
Published: July 2007

This study sought to investigate the effect of delayed pulsed-wave ultrasound with low frequency on drug release from and the antimicrobial efficacy of vancomycin-loaded acrylic bone cement in vivo and the possible mechanism of this effect. After the implantation of cement and the inoculation of
Staphylococcus aureus
into the bilateral hips of rabbits, ultrasound (average intensity, 300 mW/cm
2
; frequency, 46.5 kHz; on/off ratio, 20 min/10 min) was applied to animals in the normal ultrasound group (UG
0-12
) from 0 through 12 h after surgery and to those in the delayed-ultrasound group (UG
12-24
) from 12 through 24 h after surgery. The control group (CG) was not exposed to ultrasound. Based on vancomycin concentrations in left hip cavities at projected time intervals, the amount of time during which the local drug concentration exceeded the MIC (
T
>MIC
) in UG
12-24
was significantly prolonged compared with that in either CG or UG
0-12
, and the ratios between the areas under the concentration-time curves over 24 h and the MIC for UG
0-12
and UG
12-24
were both increased compared with that for CG. The greatest reductions in bacterial densities in both right hip aspirates and right femoral tissues at 48 h were achieved with UG
12-24
. Local hemorrhage in rabbits of UG
0-12
during the 12-h insonation was more severe than that in rabbits of UG
12-24
. Of four variables, the
T
>MIC
and the bioacoustic effect were both identified as parameters predictive of the enhancement of the antimicrobial efficacy of cement by ultrasound. Sustained concentrations above the MIC replaced early high maximum concentrations and long-term subtherapeutic release of the drug, provided that ultrasound was not applied until local hemorrhage was relieved. The enhancement of the antimicrobial efficacy of cement by ultrasound may be attributed to the prolonged
T
>MIC
and the bioacoustic effect caused by ultrasound.
Activity of Colistin against Heteroresistant
Acinetobacter baumannii
and Emergence of Resistance in an In Vitro Pharmacokinetic/Pharmacodynamic Model
Authors: Tan Chun-Hong , Li Jian , Nation Roger L.
Published: July 2007

Three clinically relevant intermittent regimens, and a continuous infusion, of colistin were simulated in an in vitro pharmacokinetic/pharmacodynamic model against two colistin-heteroresistant strains of
Acinetobacter baumannii
. Extensive initial killing was followed by regrowth as early as 6 h later; bacterial density in the 24- to 72-h period was within 1 log
10
CFU/ml of growth control. Population analysis profiles revealed extensive emergence of resistant subpopulations regardless of the colistin regimen.