bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of screening for cardio‐renal risk factors on drug use in the general population
Authors: Atthobari Jarir , Gansevoort Ron T. , Visser Sipke T. , De Jong Paul E. , De Jong‐van den Berg Lolkje T. W. ,   PREVEND study group
Published: August 2007

What is already know about this subject

• Screening of the population may result in medicalization.

• There is no report about the effect of a health screening programme on drug prescribing.

What this study adds

• Screening of the general population for cardiovascular risk factors does not lead to more drug prescribing, for either screening‐related or screening‐unrelated drugs.

• The incidence of drug use increases in screened subjects with high risk, but only for drugs related to the purpose of screening.

• For screening to be successful, i.e. increased drug use in the detected diseased subjects, it has to be performed in a population expected to be at increased risk.

Aim To evaluate the effect of a cardio‐renal screening programme on desired and undue drug use.

Methods Data from the PREVEND cohort (Prevention of REnal and Vascular ENd‐stage Disease) were used. The drug use of screened (randomly) selected subjects (n = 2650) was compared with unscreened subjects, matched for age and sex (n = 10 434). Drug use in the overall PREVEND cohort, enriched for albuminuria (n = 6751), was also studied. Screening‐related drugs (antihypertensive, antilipidaemic, antidiabetic and antithrombotic) were selected, as well as screening‐unrelated drugs (benzodiazepines, drugs for acid‐related disorders and painkillers). Time to first prescription after screening is presented as Kaplan–Meier curves.

Results After 6.5 years of follow‐up, the incidence of drug use was not significantly different between the screened, randomly selected and unscreened cohorts. Antihypertensives were used by 21.5 and 20.8%, respectively; antilipidaemic 12.8 and 10.2%, antidiabetics 4.0 and 3.9%, and antithrombotic 11.4 and 12.0%. Screening‐unrelated drugs were used at comparable frequencies. Compared with the unscreened cohort, screening‐related drugs were prescribed more frequently for subjects in the enriched cohort (25.8, 15.5, 5.5 and 13.5% for antihypertensive, antilipidaemic, antidiabetic and antithrombotic, respectively), whereas screening‐unrelated drugs were used at comparable frequencies.

Conclusions The incidence of drug use did not differ between the screened, randomly selected and unscreened cohorts. Screening does not lead to more drug prescription, thus arguing against the fear of undue medicalization after screening. The data also show that, for screening to be successful, it should be performed in a targeted population, such as one enriched for albuminuria.
A comparison of serum antivenom concentrations after intravenous and intramuscular administration of redback (widow) spider antivenom
Authors: Isbister Geoffrey K. , O'Leary Margaret , Miller Mark , Brown Simon G. A. , Ramasamy Sharmaine , James Rosemary , Schneider Jennifer S.
Published: August 2007

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Widow spider antivenoms, including redback spider antivenom, are often given by the intramuscular route.

• No studies have measured widow spider antivenom following intramuscular or intravenous antivenom.

WHAT THIS STUDY ADDS

• Intramuscular redback spider antivenom is not detectable in serum for at least 3–5 h after treatment. Intravenous antivenom is detectable 30 min after intravenous infusion.

• Intramuscular antivenom may not be an effective administration route.

AIMSThere are no studies measuring antivenom concentrations following intramuscular administration. This study aimed to compare antivenom concentrations following intravenous and intramuscular administration of redback spider antivenom (RBSAV).

METHODSTwenty patients recruited to a controlled trial comparing intramuscular and intravenous administration of antivenom had serial blood samples collected at 30 min intervals for 2 h after the administration of one or two doses of antivenom. Antivenom concentration was measured using an enzyme immunoassay.

RESULTSTen patients received intramuscular antivenom but antivenom could not be detected in serum after either one or two vials, at any time point. The median time of the final sample after commencement of antivenom treatment in these patients was 3.2 h (1.8–5 h). Ten patients received intravenous antivenom (three one vial and seven two or more vials) and antivenom was detected in all patients.

CONCLUSIONSRBS AV given by the intramuscular route is unlikely to be effective in the treatment of redback (widow) spider bite.
Compressive properties of some Swedish and Danish structured agricultural soils measured in uniaxial compression tests
Authors: Keller T. , Arvidsson J.
Published: August 2007

Soil compaction is recognized as a threat to long‐term productivity of agricultural soils and as a cause of environmental problems such as flooding. The use of models to establish strategies for prevention of soil compaction is hampered by lack of model input parameters describing soil mechanical properties. This paper presents the compressive properties N (specific volume at σ = 1 kPa on the virgin compression line), Cc (compression index) and Cr (recompression index) obtained from uniaxial compression testing of 69 individual soil layers and investigates the relationships between these properties and readily quantifiable soil parameters. No correlation was found between compressive properties and soil texture. Instead, N, Cc and Cr were positively correlated to the initial specific volume (v0). This suggests that compressive properties are more strongly affected by soil structure than by soil texture. Dependency of compressive properties on v0 could not be expected from classical soil compressive behaviour theory but suggests modifications to the theory of soil unloading‐reloading behaviour. We suggest that the latter is dependent on time between unloading and reloading.
Effects of endotoxaemia on markers of permeability, metabolism and inflammation in the large bowel of healthy subjects
Authors: Jørgensen V. L. , Ibsen M. , Andresen L. , Schulzke J. D. , Perner A.
Published: August 2007

Background:  Increased permeability and increased luminal concentrations of l‐lactate have previously been shown in the large bowel in septic patients. To advance these observations, a human model of colorectal barrier failure in sepsis is desirable. Therefore, we assessed the effects of endotoxaemia on markers of permeability, metabolism and inflammation in the large bowel in healthy subjects.

Methods:  Twelve healthy male subjects received intravenous endotoxin (2 ng/kg body weight) or saline in a paired cross‐over design. Colorectal permeability was assessed after 3, 6, 9 and 12 h by the systemic recovery of luminally instilled 99mTc‐diethylenetriaminepentaacetate. Luminal concentrations of l‐lactate were assessed by equilibrium dialysis. Mucosal biopsies from the large bowel were sampled after 6 and 12 h, and the apoptotic ratio of the epithelium was assessed by terminal deoxynucleotidyl transferase‐mediated desoxyuridinetriphosphate nick end‐labelling (TUNEL) assay and the expression of inducible nitric oxide synthase (iNOS) mRNA by reverse transcriptase‐polymerase chain reaction.

Results:  Systemic effects of endotoxaemia were observed, including fever, tachycardia and strongly increased plasma values of tumour necrosis factor‐α. By contrast, the colorectal permeability, luminal lactate concentrations, mucosal infiltration of inflammatory cells, epithelial apoptotic ratio and expression of iNOS were all unaffected by endotoxin.

Conclusions:  No effect of a single intravenous dose of endotoxin was observed on markers of large bowel permeability, metabolism and inflammation in healthy subjects. This suggests that this part of the gut is relatively resistant to the systemic inflammation induced by experimental endotoxaemia in humans.
Anaesthesiological considerations in small‐incision and laparoscopic cholecystectomy in symptomatic cholecystolithiasis: implications for pulmonary function. A randomized clinical trial*
Authors: Keus F. , Ahmed Ali U. , Noordergraaf G. J. , Roukema J. A. , Gooszen H. G. , Van Laarhoven C. J. H. M.
Published: August 2007

Background:  Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post‐operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. Small‐incision cholecystectomy (SIC), a procedure that does not require a pneumoperitoneum, threatens to be lost to clinical practice, even though there is evidence of equality. We hypothesized that the SIC technique should be equal, and might even be superior, to LC when considering post‐operative pulmonary function because of the short incision length.

Methods:  A single‐centre randomized clinical trial was performed including patients scheduled for elective cholecystectomy. Pulmonary flow‐volume curves were measured pre‐operatively, post‐operatively and at follow‐up. Blood gas analyses were measured pre‐operatively, in the recovery phase and on post‐operative day 1. Anaesthesia, analgesics and peri‐operative care were standardized by protocol. Post‐operatively, patients and caregivers were blind to the procedure.

Results:  Two hundred and fifty‐seven patients were analysed. There was one pulmonary complication (pneumonia) in the LC group. In both groups, similar reductions of approximately 20% in pulmonary function parameters occurred, with complete recovery to pre‐operative values. Patients in the SIC group consumed more analgesia when compared with the LC group, without any impact on blood gas analysis. Patients converted to a conventional open technique showed significant differences in six of the eight parameters in pulmonary function tests.

Conclusion:  When evaluated with strict methodology and standardization of care, no clinically relevant differences were found between SIC and LC with regard to pulmonary function. Our results suggest that the popularity of the laparoscopic technique cannot be attributed to pulmonary preservation.
Management of nerves during leg amputation – a neglected area in our understanding of the pathogenesis of phantom limb pain
Authors: Rasmussen S. , Kehlet H.
Published: August 2007

Background:  Chronic neuropathic pain after leg amputation is a significant problem, with a reported incidence during the first year as high as 70%. Intra‐operative handling of the nerves during amputation has not been discussed in the literature on post‐amputation pain and, in major textbooks, it is recommended that the ischial nerve be ligated, despite the fact that the experimental literature uses nerve ligations to produce neuropathic pain. The purpose of this study was to investigate the clinical practice of nerve handling during leg amputation.

Methods:  Trainees with at least 2 years of practice received a questionnaire regarding handling of the nerves during leg amputation; 128 of 149 questionnaires sent (86%) were returned.

Results:  Ligation of the nerves was used by 31% of surgeons.

Conclusion:  There is no consistency in the management of the large nerves during lower leg amputation. The recommendations in major textbooks may not be appropriate when compared with the experimental literature on nerve ligature models to produce neuropathic pain. Future studies on post‐amputation pain should consider intra‐operative nerve management.
Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross‐over, clinical trial
Authors: Wilson K. E. , Welbury R. R. , Girdler N. M.
Published: August 2007

Background:  The transmucosal route for conscious sedation in children has been reported widely in the field of medicine, but less so in dental patients. The aim of this study was to evaluate the efficacy and safety profile of midazolam (0.2 mg/kg) administered by the buccal transmucosal route, in comparison with nitrous oxide/oxygen inhalation sedation, for orthodontic extractions in 10–16‐year‐old dental patients.

Methods:  Each patient attended for two visits and was randomly allocated to receive buccal midazolam (0.2 mg/kg) or nitrous oxide/oxygen titrated to 30%/70% at the first visit, the alternative being used at the second visit. The patients’ vital signs, sedation levels and behavioural scores were recorded throughout. Post‐operatively, side‐effects, recall of the visit and satisfaction levels were recorded via questionnaire.

Results:  Thirty‐six patients, with a mean age of 12.9 years, completed both arms of the trial. The maximum level of sedation was achieved with buccal midazolam in a mean time of 14.42 min, compared with 7.05 min with inhalation sedation. The vital signs with both types of sedation remained within acceptable limits and the reported side‐effects were of no clinical significance. Buccal midazolam was found to be acceptable by 65.7%. Only 28.6% of cases preferred this technique, the main disadvantage being the taste of the solution.

Conclusion:  Buccal midazolam sedation (0.2 mg/kg) seems to be equally as safe and effective as nitrous oxide/oxygen for the extraction of premolar teeth in anxious children. However, further research is required to refine the midazolam vehicle to improve acceptability.
Norepinephrine in low to moderate doses may not increase luminal concentrations of l‐lactate in the gut in patients with septic shock*
Authors: Ibsen M. , Jørgensen V. L. , Perner A.
Published: August 2007

Aim:  To investigate the effect of different doses of norepinephrine (noradrenaline) on luminal concentrations of l‐lactate in the rectum and stomach in patients with fluid‐resuscitated septic shock.

Methods:  This was a paired cross‐over study in which the dose of norepinephrine was titrated to mean arterial blood pressures (MAPs) of 65 and 85 mmHg in random sequence. It was performed in a mixed intensive care unit at a university hospital. Eight patients with fluid‐resuscitated septic shock requiring norepinephrine (>0.1 μg/kg/min) were included. Patients were treated with norepinephrine to a MAP of either 65 or 85 mmHg for 2 h. After a ‘washout’ period of 2 h, the dose of norepinephrine was titrated to the other endpoint of MAP for another 2 h. The concentrations of l‐lactate in the rectal and gastric lumen were estimated by 1‐h equilibrium dialysis during the second hour of the treatment periods.

Results:  MAP and central venous oxygen saturation were increased by increasing the dose of norepinephrine [median (range) (μg/kg/min): 0.07 (0.00–0.60) and 0.18 (0.11–1.00) at MAPs of 65 and 85 mmHg, respectively], whereas the metabolic markers were unaffected [luminal concentrations (mmol/l) of l‐lactate in the rectum of 1.9 (0.8–6.4) and 1.8 (0.9–5.7) (P =0.94) and in the stomach of 1.1 (0.1–10.0) and 1.3 (0.3–9.7) (P =0.88) at MAPs of 65 and 85 mmHg, respectively].

Conclusion:  In this small study, luminal concentrations of l‐lactate in the rectum and stomach were unaffected by norepinephrine at low to moderate doses. These data suggest that norepinephrine may not increase luminal concentrations of l‐lactate in the gut in patients with fluid‐resuscitated septic shock.
Acta Anaesthesiologica Scandinavica– the first years (from lead to electrons)
Authors: Eklund J.
Published: August 2007

Acta Anaesthesiologica Scandinavia is the official scientific journal of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine. It was founded in 1957 and we are thus now celebrating its 50th anniversary. This paper relates the history behind the start of the journal and describes its development until 1993.
Recreation Nonparticipation as Choice Behavior Rather Than Statistical Outcome
Authors: English Eric
Published: August 2007

In recreation demand models nonparticipation is usually estimated as the probability mass on zero demand given a positive level of expected demand and a discrete distribution of demand outcomes. Researchers have attempted to improve predictions of nonparticipation by modifying the parameters of the demand distribution. This study departs from previous approaches by explicitly incorporating nonparticipation into the behavioral model. The choice to participate is described by a distribution of preferences combined with a choke price on individual demands to distinguish participants from nonparticipants. The model is found to accurately predict nonparticipation and the size of the user group.
Voting for Environmental Policy Under Income and Preference Heterogeneity
Authors: Eerola Essi , Huhtala Anni
Published: August 2007

We examine the design of policies for promoting the consumption of green products under preference and income heterogeneity using organic food as an example. Two instruments are considered: a price subsidy for organic food products and a tax on conventional products. When the income differences and social benefits of organic farming are large, these factors dominate in shaping the policy preferences of the majority. In this case, the environmental policies preferred by the majority tend to be stricter than socially optimal policies. However, when income differences are small, policy preferences are more directly determined by tastes for organic products and the majority may prefer no intervention.
Cross‐subsidization Due to Inframarginal Support in Agriculture: A General Theory and Empirical Evidence
Authors: de Gorter Harry , Just David R. , Kropp Jaclyn D.
Published: August 2007

A general theory of cross‐subsidization due to inframarginal support is developed. Two sources of output distortion are identified: exit deterrence and extramarginal output. Some firms would not be in business without the subsidy. Cost savings due to declining average costs are always greater than the losses incurred where price equals marginal cost. Moreover, it is theoretically possible for inframarginal subsidies to expand output more than equivalent fully coupled subsidies. Empirical analysis of U.S. dairy subsidies isolates these components of cross‐subsidization and finds distortions from inframarginal support to be substantial, with implications for trade negotiations, dispute settlement, and policy formulation.
Food Stamp Program Participation and Food Insecurity: An Instrumental Variables Approach
Authors: Yen Steven T. , Andrews Margaret , Chen Zhuo , Eastwood David B.
Published: August 2007

The relationship between Food Stamp Program (FSP) participation and household food insecurity (FI) is investigated using data from the 1996–1997 National Food Stamp Program Survey. Endogeneity of FSP participation is accommodated with an instrumental variables approach. In contrast to other findings reported in the literature, results suggest participation in the FSP reduces the severity of FI. Sociodemographic variables play important roles in FSP participation and FI. Underreporting of FSP participation and limited observations of food‐insecure households in previous studies may have also been factors.
The Role of Patent Rights in Mergers: Consolidation in Plant Biotechnology
Authors: Marco Alan C. , Rausser Gordon C.
Published: August 2007

Few empirical studies have addressed the impact of the patent system on industry structure. Using firm‐level patent data for firms in plant biotechnology, we develop a measure of patent enforceability. Duration models show that patent statistics are useful predictors of the timing of consolidation and that patent enforceability is an important factor influencing the likelihood of consolidation. Acquisitions in plant biotechnology may be motivated by the enforcement of patent rights when firms have overlapping technologies; some merger activity may be explained by attempts to avoid mutually blocking technology, as exemplified by the case of Roundup Ready corn.
THEOLOGICAL ETHICS, THE CHURCHES, AND GLOBAL POLITICS
Authors: Cahill Lisa Sowle
Published: August 2007

Several discourses about theology, church, and politics are occurring among Christian theologians in the United States. One influential strand centers on the communitarian theology of Stanley Hauerwas, who calls on Christians to witness faithfully against liberalism in general and war in particular. Jeffrey Stout, in his widely discussed Democracy and Tradition (2004), responds that religious people ought precisely to endorse those democratic and liberal American traditions that join religious and secular counterparts to battle injustice. Hauerwas, Stout, and many of their interlocutors envision liberal U.S. culture as the context of Christian social ethics. The ensuing debate rarely incorporates Catholic scholars, feminist scholars, scholars of color, or international and liberationist voices. Their inclusion could enhance an understanding of the role of the church in society, and support a common morality in the face of global pluralism. More importantly, it could broaden the scope of discourse on religion and politics to envision global Christian social ethics.
AQUINAS ON ATTACHMENT, ENVY, AND HATRED IN THE SUMMA THEOLOGICA
Authors: Green Keith
Published: August 2007

This essay examines Aquinas's discussions of hatred in Summa Theologica I‐II, Q. 29 and II‐II, Q. 34, in order to retrieve an account of what contemporary theorists of the emotions call its cognitive contents. In Aquinas's view, hatred is constituted as a passion by a narrative pattern that includes its intentional object, beliefs, perceptions of changes in bodily states, and motivated desires. This essay endorses Aquinas's broadly “cognitivist” account of passional hatred, in line with his way of treating passions in general. I suggest that Aquinas's account of hatred's arising out of attachment is compelling. However, I also argue that if Aquinas's treatment of hatred is to help us understand the phenomenon of hate, where classes of people are abominated for an identity they bear, and to avoid equating an oppressor's hatred with that of the oppressed for the oppressor, the cognitive pathway to hatred must be broader than through envy.
GOD, WAR, AND CONSCIENCE
Authors: Eberle Christopher J.
Published: August 2007

Many military officers believe that they morally ought to obey legal orders to fight even in unjust wars: they have a moral obligation to exercise indiscriminate obedience to legal orders to fight. I argue that officers should not be required to exercise indiscriminate obedience: certain theistic commitments to which many citizens and officers adhere prohibit indiscriminate obedience to legal orders to fight. This theistic argument constitutes adequate reason not to require officers to exercise indiscriminate obedience. However, this raises a further question: namely, whether it is appropriate to rely on such a theistic argument when shaping the moral requirements of military officership. I argue that citizens and officers have good reason to make public decisions solely on religious grounds and so are free to follow my theistic argument when shaping the requirements of military officership.
UNJUST WAR AND THE CATHOLIC SOLDIER
Authors: Thomas Ward
Published: August 2007

Roman Catholic teaching holds both that wars must conform to certain criteria in order to be considered morally justifiable, and that individuals are accountable for the moral content of their actions. Are Catholics serving in the armed forces therefore required to refuse to serve in unjust wars? Are they entitled—or obligated—to defer to the judgments of others as to whether a war is just? If so, whose judgment? I suggest that there are exceptional characteristics of military service that may factor in the formation of conscience as it is described in Catholic teaching. Specifically, just as the Church sees the indispensable role of the armed forces in protecting society as reconciling the use of force with the Catholic injunction to seek peace, so too may the indispensable role of obedience and deference to authority in the armed forces—while never supplanting the responsibilities of individual discernment—reconcile fighting in an unjust war with the obligations of conscience.
RECURRING THEMES IN THE DEBATE ABOUT EUTHANASIA AND ASSISTED SUICIDE
Authors: Boer Theo A.
Published: August 2007

During the past four decades, the Netherlands played a leading role in the debate about euthanasia and assisted suicide. Despite the claim that other countries would soon follow the Dutch legalization of euthanasia, only Belgium and the American state of Oregon did. In many countries, intense discussions took place. This article discusses some major contributions to the discussion about euthanasia and assisted suicide as written by Nigel Biggar (2004), Arthur J. Dyck (2002), Neil M. Gorsuch (2006), and John Keown (2002). They share a concern that legalization will undermine a society's respect for the inviolability and sanctity of life. Moreover, the Report of the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill (2005) is analyzed. All studies use ethical, theological, philosophical, and legal sources. All these documents include references to experiences from the Netherlands. In addition, two recent Dutch documents are analyzed which advocate further liberalization of the Dutch euthanasia practice, so as to include infants (Groningen Protocol, NVK 2005) and elderly people “suffering from life” (Dijkhuis Report, KNMG 2004).
Between a ROC and a hard place: decision making and making decisions about using the SCQ
Authors: Corsello Christina , Hus Vanessa , Pickles Andrew , Risi Susan , Cook Edwin H. , Leventhal Bennett L. , Lord Catherine
Published: August 2007

Background:  The Social Communication Questionnaire (SCQ), formerly the Autism Screening Questionnaire (ASQ), is based on a well‐validated parent interview, the Autism Diagnostic Interview (ADI). It has shown promise as a screening measure for autism spectrum disorders (ASDs) in a research‐referred older sample, though recent studies with younger children reported lower sensitivities when using the suggested cutoff of ≥15 to differentiate ASDs from children with nonspectrum disorders (NS).

Methods:  Diagnostic discrimination of the SCQ was evaluated alone and in combination with the ADOS (Autism Diagnostic Observation Schedule) in a clinical and research‐referred sample of 590 children and adolescents (2 to 16 years), with best estimate consensus diagnoses of autism, pervasive developmental disorder, not otherwise specified (PDD‐NOS) and non‐ASD disorders. The SCQ was completed before the evaluation in most cases. Performance of the SCQ was also compared with the Autism Diagnostic Interview – Revised (ADI‐R).

Results:  Absolute scores and sensitivity in the younger children and specificity for all groups were lower than reported in the original study. Using receiver operating curves (ROC) to examine the area under the curve (AUC), the SCQ was more similar to the ADI‐R total score in differentiating ASD from NS disorders in the older (8–10, >11) than younger age groups (<5, 5–7). Lowering the cutoff score in the 2 younger groups improved sensitivity, with specificity remaining relatively low in all groups. Using the SCQ in combination with the ADOS resulted in improved specificity. Diagnostic discrimination was best using the ADI‐R and ADOS in combination.

Conclusions:  Those interested in using the SCQ should consider adjusting cutoff scores according to age and purpose, and using it in combination with another measure. Sensitivity or specificity may be prioritized for research or screening depending on goals.
Prevalence and correlates of psychopathology in a sample of deaf adolescents
Authors: Van Gent Tiejo , Goedhart Arnold W. , Hindley Peter A. , Treffers Philip D.A.
Published: August 2007

Aims:  To examine prevalence and correlates of psychopathology in deaf adolescents using a multi‐method multi‐informant approach.

Methods:  Data for the study came from checklist assessments by parents (Child Behavior Checklist (CBCL)) and teachers (Teacher's Report Form (TRF)) of 70 deaf adolescents aged 13 to 21 years, from semi‐structured clinical interviews of the adolescents (Semi‐structured Clinical Interview for Children and Adolescents (SCICA)), and from expert ratings of dossier data.

Results:  The percentages of Total Problems scores in the borderline clinical range in this population as found with the CBCL, TRF and SCICA are 28%, 32% and 49–63% respectively. Expert dossier ratings identified psychiatric caseness in 49% and DSM‐classifications in 46% of the adolescents (primary classifications: emotional disorder 27%, behavioral disorder 11%, other disorder 7%). Cross‐informant agreement between single ratings and expert dossier ratings was better than agreement between single ratings. Logistic regression analyses revealed that low IQ, a signing mode of communication and a history of three or more physical disorders were associated with psychiatric caseness.

Conclusions:  Findings suggest a high prevalence of psychopathology in the population studied and argue for a special focus on the early detection of significant emotional and behavioral problems as well as a multi‐informant approach to the assessment of disorder in deaf children and adolescents. The correlational findings support the view that it is not deafness per se that contributes to psychiatric problems.
Imaginary companions and young children's responses to ambiguous auditory stimuli: implications for typical and atypical development
Authors: Fernyhough Charles , Bland Kirsten , Meins Elizabeth , Coltheart Max
Published: August 2007

Background: Previous research has reported a link between imaginary companions (ICs) in middle childhood and the perception of verbal material in ambiguous auditory stimuli. These findings have been interpreted in terms of commonalities in the cognitive processes underlying children's engagement with ICs and adults’ reporting of imaginary verbal experiences such as auditory verbal hallucinations. The aim of the present study was to examine these relations using improved methodology and a younger sample of children for whom engagement with ICs would be expected to be particularly salient.

Method: Data on young children's (age range: 4–8 years) reporting of ICs were gathered in two studies (totalN = 80). Responses to ambiguous auditory stimuli were investigated using the new Jumbled Speech task, which measures participants’ likelihood of perceiving words in meaningless but speech‐like auditory stimuli.

Results: Reporting hearing words in the Jumbled Speech task was associated with having a parentally corroborated IC. Hearing words on the task and having an IC were unrelated to age, gender, verbal ability, and understanding of the stream of consciousness.

Conclusions: Findings are consistent with the hypothesis that engaging with ICs is one aspect of a general susceptibility to imaginary verbal experiences. We consider the implications for the assumption of continuity in psychopathological experiences between childhood and adulthood.
Nitroparacetamol (NCX‐701) and Pain: First in a Series of Novel Analgesics
Authors: Romero‐Sandoval E. Alfonso , Curros‐Criado M. Mar , Gaitan Gema , Molina Carlos , Herrero Juan F.
Published: August 2007

The combination of numerous classic drugs with nitric oxide donors has led to the development of new compounds with promising therapeutic activities in a great variety of situations, including cardiovascular and respiratory systems, ocular pressure, inflammation, and pain. One of the first compounds developed was NCX‐701 or nitroparacetamol, resulting from the combination of paracetamol, a classic and popular analgesic used in a great number of over‐the‐counter medications because of its antipyretic and analgesic properties, and a nitrooxybutyroyl moiety, which releases nitric oxide at a low but steady level. Although paracetamol is devoid of most of the gastrointestinal toxicity associated with aspirin‐like drugs, this type of compounds was first designed to take advantage of the cytoprotective properties of nitric oxide when released at low concentrations. However, the combination of these molecules also resulted in an unexpected enhancement of the analgesic activity of paracetamol. In fact, NCX‐701 has been shown to be effective in acute nociception as well as in neuropathic pain, situations in which paracetamol and other COX inhibitors are devoid of any effect. In addition, NCX‐701 is more potent and, in some circumstances, more effective than its parent compound in different models of inflammatory pain. Furthermore, whereas paracetamol lacks any effective antiinflammatory action, NCX‐701 might reduce inflammation. All these results taken together imply that the mechanism of action of NCX‐701 is different from that of paracetamol, although it is not yet established for either molecule. NCX‐701 appears to be a promising compound in the treatment of different types of pain, with a likely better profile of side effects than its parent molecule, paracetamol. Although recent clinical trials provided data consistent with the preclinical profile of NCX‐701, further studies are needed to support its clinical use.
Pharmacological Properties of BN82451: A Novel Multitargeting Neuroprotective Agent
Authors: Chabrier Pierre Etienne , Auguet Michel
Published: August 2007

BN82451 belongs to a new family of small molecules designated as multitargeting or hybrid molecules. BN82451 is orally active, has good central nervous system penetration, and elicits potent neuronal protection and antiinflammatory properties. Neuronal protection is due to Na+ channel blockade, antioxidant properties, and mitochondria‐protecting activity, whereas inhibition of cyclooxygenases is mostly responsible for its antiinflammatory activity. BN82451 has been shown to exert a potent neuroprotective effect in various in vitro and in vivo animal models. BN82451 was found to exert a significant protection in experimental animal models mimicking aspects of cerebral ischemia, Parkinson disease, Huntington disease, and more particularly amyotrophic lateral sclerosis. Collectively, its pharmacological properties designate BN82451 as a promising neuroprotective agent.
Variability and predictability of large‐volume red blood cell transfusion in cardiac surgery: a multicenter study
Authors: Karkouti Keyvan , Wijeysundera Duminda N. , Beattie W. Scott , Callum Jeannie L. , Cheng Davy , Dupuis Jean‐Yves , Kent Blaine , Mazer David , Rubens Fraser D. , Sawchuk Corey , Yau Terrence M. ,   the Reducing Bleeding in Cardiac Surgery (RBC) Research Group
Published: August 2007

BACKGROUND: In cardiac surgery, excessive blood loss requiring large‐volume red blood cell (RBC) transfusion is a common occurrence that is associated with significant morbidity and mortality. The objectives of this study were to measure the interinstitution variation and predictability of large‐volume RBC transfusion.

STUDY DESIGN AND METHODS: Data were retrospectively collected on 3500 consecutive cardiac surgical patients at seven Canadian hospitals during 2004. The crude and risk‐adjusted institutional odds ratios (ORs) for large‐volume (≥5 U) RBC transfusion were calculated with logistic regression. The predictive accuracy of an existing prediction rule for large‐volume RBC transfusion was calculated for each institution.

RESULTS: Large‐volume RBC transfusion occurred in 538 (15%) patients. When compared to the reference hospital (median crude rate), the institutional unadjusted and adjusted ORs for large‐volume RBC transfusion ranged from 0.29 to 1.26 and 0.14 to 1.15, respectively (p  < 0.0001 for interinstitution variation). The variation was lower, but still considerable, for excessive blood loss, defined as at least 5‐U RBC transfusion or reexploration; the ORs ranged from 0.42 to 1.22 (p  < 0.0001). The prediction rule performed well at most sites; its pooled positive predictive value for excessive blood loss was 71 percent (range, 63%‐89%), and its negative predictive value was 90 percent (range, 87%‐93%).

CONCLUSIONS: There is marked interinstitution variation in large‐volume RBC transfusion in cardiac surgery that is not explained by patient‐ or surgery‐related factors. Despite this variation, patients at high or low risk for large‐volume RBC transfusion can be accurately identified by a prediction rule composed of readily available clinical variables.
Celebrating Peggy Papp and Olga Silverstein
Authors: IMBER‐BLACK EVAN
Published: August 2007

Editor's Note: On May 18, 2007, the Ackerman Institute for the Family and the Hunter School of Social Work held a historic conference in honor of the multidecade contributions to family therapy theory and practice of Peggy Papp and Olga Silverstein.1 As chair of this notable event, I opened the conference with a retrospective of the work of Papp and Silverstein, placing their ideas in the larger context of our field. My remarks follow.
Money: A Therapeutic Tool for Couples Therapy
Authors: SHAPIRO MARGARET
Published: August 2007

This article addresses the therapeutic importance of discussing money at every stage of a couple's relationship, both as a concrete reality and as a metaphor for security, adequacy, competence, commitment, acceptance, and acknowledgment in a relationship. I will present a developmental schema looking at financial issues that couples confront at various stages in the adult life cycle and how these affect and reflect relationship problems. The article also presents a money questionnaire as a useful tool for exploring family‐of‐origin financial history, affect, and behavior.
The Clinical Representativeness of Couple Therapy Outcome Research
Authors: WRIGHT JOHN , SABOURIN STÉPHANE , MONDOR JOSIANNE , MCDUFF PIERRE , MAMODHOUSSEN SALIMA
Published: August 2007

The clinical representativeness of outcome studies is defined as the generalizability of recruitment processes, assessment/diagnostic procedures, treatment protocols, and therapeutic results from research settings to naturalistic treatment settings. The main goal of the present study was to examine the clinical representativeness of couple therapy in outcome studies. The data set was formed by 50 published clinical trials, including 34 couple therapy outcome studies for marital distress (CTMD) and 16 couple therapy outcome studies for comorbid relational and mental disorders (CTMD+C). The present findings showed that, overall, the clinical representativeness of couple therapy outcome studies is only fair (i.e., the mean global score is slightly lower than the midpoint of the rating scale used to assess representativeness). CTMD+C studies fared better than CTMD studies on many dimensions of clinical relevance. Studies in which pretherapy training was less intensive (for CTMD studies only), treatment was less structured, and therapists were more experienced showed larger effect sizes than those in which such was not the case.
The Effect of Security‐Related Stress on Dyadic Closeness Among Jews and Arabs in Israel: A Daily Diary Study
Authors: BEN‐ARI ADITAL , LAVEE YOAV
Published: August 2007

An important aspect of Israeli life is its continuous state of conflict with the neighboring Palestinian people and Arab countries. Given that security‐related stress is so intensely experienced by all Israeli residents, we examined the effects of daily fluctuations in security‐related stress on dyadic closeness among Jewish and Arab couples. Time sampling approach was used to study repeated sequences of associations between stress and dyadic closeness. Data were collected from 188 Jewish and 93 Arab couples by means of daily diaries. Hierarchical multivariate linear modeling was used to analyze the data. The findings indicate that stress results in increasing distance between intimate partners, but the effect varies with the level of marital quality and socioethnic affiliation.
Interconnected Hydroxyapatite Nanofibers in the Biomimetic Coating of a Bioinert Ceramic Substrate
Authors: Chakraborty Jui , Sinha Mithlesh Kumar , Basu Debabrata
Published: August 2007

A bioinert ceramic substrate, α‐Al2O3, has been coated with hydroxyapatite (HAp) by the biomimetic route using simulated body fluid (SBF) solution at room temperature. The substrate was incubated at 37°C in SBF for 6 days with a periodic replacement with freshly prepared SBF at 48‐h intervals. After 6 days, continuous nanofiber‐like structures of HAp (5–35 μm in length, 0.05 μm diameter) were obtained, connecting the intra‐ and interglobular clusters, within the coated mineral layer on the substrate surface. This is a unique and new observation, and this phenomenon has been demonstrated by a simple fractal growth model.
Properties and Performances of Concrete Tiles Containing Waste Fired Clay Materials
Authors: Sánchez De Rojas M. I. , Marín F. P. , Frías M. , Rivera J.
Published: August 2007

Industrial waste fired clay materials, which are good pozzolans, can be used in place of cement in the manufacture of precast concrete products. This paper analyzes the use of industrial waste fired clay as pozzolanic materials for the manufacture of concrete roofing tiles, exploring the microstructure and morphology of the resulting concrete and their impact on product properties and performance. All trials and measurements were taken on an industrial ceramic product subsequently used in a second industrial process to manufacture concrete tiles, which were found to meet market standards. Porosity was observed to be greater in the waste fired clay product in only one trial, while the proportion of pores with larger diameters was found to decline. The microstructural studies revealed the existence of pozzolanic reaction products and an incomplete cement reaction, as in the control specimens, due to the processing conditions. This effect caused an increase in flexural strength after 28 days.
Antibiotic susceptibility of blood culture isolates of anaerobic bacteria at a Norwegian university hospital
Authors: KOMMEDAL ØYVIND , NYSTAD TONE WIKENE , BØLSTAD BENTE , DIGRANES ASBJØRN
Published: August 2007

In the present study the susceptibility of 200 blood culture isolates of anaerobic bacteria to benzylpenicillin, clindamycin, metronidazole, imipenem and piperacillin‐tazobactam was examined. Metronidazole, imipenem, and piperacillin‐tazobactam showed the highest activity, with 98.5% of the isolates being fully susceptible to either agent. A high rate of reduced susceptibility to clindamycin among both Bacteroides spp. (37%) and Clostridium spp. (28%) was found. Almost all Bacteroides isolates were resistant to penicillin, and only 60% of Prevotella spp. were susceptible to this agent. The antibiotic susceptibility of anaerobic bacteria in Norway should be surveyed regularly.
Silver against Pseudomonas aeruginosa biofilms
Authors: BJARNSHOLT THOMAS , KIRKETERP‐MØLLER KLAUS , KRISTIANSEN SØREN , PHIPPS RICHARD , NIELSEN ANNE KIRSTINE , JENSEN PETER ØSTRUP , HØIBY NIELS , GIVSKOV MICHAEL
Published: August 2007

Silver has been recognized for its antimicrobial properties for centuries. Most studies on the antibacterial efficacy of silver, with particular emphasis on wound healing, have been performed on planktonic bacteria. Our recent studies, however, strongly suggest that colonization of wounds involves bacteria in both the planktonic and biofilm modes of growth. The action of silver on mature in vitro biofilms of Pseudomonas aeruginosa, a primary pathogen of chronic infected wounds, was investigated. The results show that silver is very effective against mature biofilms of P. aeruginosa, but that the silver concentration is important. A concentration of 5–10 μg/mL silver sulfadiazine eradicated the biofilm whereas a lower concentration (1 μg/mL) had no effect. The bactericidal concentration of silver required to eradicate the bacterial biofilm was 10–100 times higher than that used to eradicate planktonic bacteria. These observations strongly indicate that the concentration of silver in currently available wound dressings is much too low for treatment of chronic biofilm wounds. It is suggested that clinicians and manufacturers of the said wound dressings consider whether they are treating wounds primarily colonized either by biofilm‐forming or planktonic bacteria.
Expression of D2‐40 in adjunct diagnosis of papillary thyroid carcinoma
Authors: WANG SHENG‐LAN , LI SHAU‐HSUAN , CHEN WAN‐TZU , CHAI CHEE‐YIN
Published: August 2007

The clinical pathologic criteria for nuclear features of papillary thyroid carcinoma are subjective and sometimes cannot distinguish carcinoma from adenomatous goiter and follicular neoplasms. No single antibody has demonstrated high sensitivity or specificity in making these distinctions. Using quantitative analysis of immunohistochemical staining with D2‐40, a recently available monoclonal antibody used as a lymphatic endothelial marker, we examined 72 cases of papillary carcinoma. Controls included 36 follicular adenomas, 36 follicular carcinomas, and 20 adenomatous goiters with papillary hyperplasia. Cytoplasmic D2‐40 immunoreactivity was present in 60 of 72 papillary carcinomas, 2 cases of follicular adenoma and 2 cases of follicular carcinoma, whereas no adenomatous goiter or normal thyroid glands contained positive epithelial cells. Overexpression of D2‐40 in papillary thyroid carcinomas thus has potential diagnostic utility in differentiating these tumors from their potential histologic mimics.
Calcium channel antagonist (nifedipine) attenuates Plasmodium berghei‐specific T cell immune responses in Balb/C mice
Authors: MOSHAL KARNI S. , ADHIKARI JAWAHAR S. , BIST KAMANA , NAIR UNNIKRISHNAN , DWARAKANATH B. S. , KATYAL ANJU , CHANDRA RAMESH
Published: August 2007

Nifedipine and verapamil (Martin et al. Science 1987;235:899–901) are a class of calcium channel blockers involved in the reversal of chloroquine (CQ) drug resistance in CQ‐sensitive Plasmodium spp. Nifedipine alters calcium‐dependent functions of macrophages and neutrophils during Plasmodium berghei malaria. However, knowledge of nifedipine‐induced immunomodulation of T cell functions during P. berghei malaria is still limited. We investigated the effect of nifedipine on the immune status of splenic T cells during P. berghei malaria. The intracellular calcium levels were determined in the FURA‐2A/M loaded T cells by spectrofluorometry. Splenic T cell proliferation, phosphatidylserine (PS) externalization, Fas expression and Bcl2/Bax expression were determined by flow cytometry. We report a significant increase in mean percent parasitemia in nifedipine‐treated and P. berghei‐infected mice. Although nifedipine treatment alone did not affect the resting state free calcium levels in splenic T cells, the rise in intracellular calcium levels of T cells following P. berghei infection was significantly less in nifedipine‐treated mice compared to untreated groups at various parasitemia levels. Antigen‐specific splenic T cell proliferation and apoptosis was ablated in nifedipine‐treated and untreated groups at various parasitemia levels. The study unequivocally reflects the suppression of P. berghei‐specific T cell immune responses by nifedipine.
Cytokine gene polymorphisms in hepatitis C virus‐related oral lichen planus
Authors: Carrozzo Marco , Dametto Ennia , Fasano Maria Edvige , Arduino Paolo , Bertolusso Giorgio , Uboldi de Capei Federica , Rendine Sabina , Amoroso Antonio
Published: August 2007

Abstract:  Cytokine polymorphisms may influence both the risk of developing oral lichen planus (OLP) and the outcome of hepatitis C virus (HCV)‐infected patients and OLP has been frequently associated with HCV infection. The aim of the present study was to analyse whether cytokine polymorphisms may influence the susceptibility to HCV‐related OLP. Thirty‐five patients with OLP and chronic HCV infection (OLP–HCV+ve) took part in the study. As controls, 44 patients with OLP but without HCV (OLP–HCV−ve) infection and 140 healthy donors were studied. Thirteen cytokine genes with 22 single nucleotide polymorphisms (SNP) were studied. IFN‐γ UTR 5644 genotype frequencies showed an increase in number of A/T heterozygote in OLP–HCV+ve patients compared with OLP–HCV−ve that approached the statistical significance [P = 0.03, P‐corrected (PC) = 0.66]. Contrarily, in OLP–HCV+ve patients, the frequency of genotype −308 G/A of the TNF‐α was decreased, whereas the genotype −308 G/G was increased compared with OLP–HCV−ve (P = 0.0005, PC = 0.011 and P = 0.0016, PC = 0.0352, respectively). OLP patients with and without HCV infection showed a different genetic cytokine background suggesting distinct pathogenetic mechanisms.