bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of intermediate‐fidelity simulation training technology in undergraduate nursing education
Authors: Alinier Guillaume , Hunt Barry , Gordon Ray , Harwood Colin
Published: April 2006

Aim.  The aim of this paper is to present the results of a study designed to determine the effect of scenario‐based simulation training on nursing students’ clinical skills and competence.

Background.  Using full‐scale, realistic, medical simulation for training healthcare professionals is becoming more and more common. Access to this technology is easier than ever before with the opening of several simulation centres throughout the world and the availability on the market of more sophisticated and affordable patient simulators. However, there is little scientific evidence proving that such technology is better than more traditional techniques in the education of, for example, undergraduate nursing students.

Methods.  A pretest/post‐test design was employed with volunteer undergraduate students (n = 99) from second year Diploma of Higher Education in Nursing programme in United Kingdom using a 15‐station Objective Structured Clinical Examination. Students were randomly allocated to either a control or an experimental group. The experimental group, as well as following their normal curriculum, were exposed to simulation training. Subsequently, all students were re‐tested and completed a questionnaire. The data were collected between 2001 and 2003.

Results.  The control and experimental groups improved their performance on the second Objective Structured Clinical Examination. Mean test scores, respectively, increased by 7·18 and 14·18 percentage points. The difference between the means was statistically significant (P < 0·001). However, students’ perceptions of stress and confidence, measured on a 5‐point Likert scale, was very similar between groups at 2·9 (1, not stressful; 5, very stressful) and 3·5 (1, very confident; 5, not confident) for the control group, and 3·0 and 3·4 for the experimental group.

Conclusions.  Intermediate‐fidelity simulation is a useful training technique. It enables small groups of students to practise in a safe and controlled environment how to react adequately in a critical patient care situation. This type of training is very valuable to equip students with a minimum of technical and non‐technical skills before they use them in practice settings.
Nursing and midwifery students’ approaches to study and learning
Authors: Mansouri Parisa , Soltani Fahimeh , Rahemi Shamsi , Nasab Masood Moosavi , Ayatollahi Ali Reza , Nekooeian Ali Akbar
Published: April 2006

Aim.  This paper reports an investigation of the approaches to study and learning of nursing and midwifery students at a school of nursing and midwifery in Iran.

Background.  Current knowledge suggests that students approach their studies in surface, deep or strategic manners. Students’ approaches to study have an important impact on their academic success. Awareness of their approaches to study and factors that affect their choices is important for curriculum planners as well as nurse and midwife educators.

Methods.  A cross‐sectional design was used with a convenience sample of nursing and midwifery students in all 3 years of study at one university in Iran. The validated Persian translation of Entwistle and Ramsden's Approaches and Study Skills Inventory was administered in a classroom context in 2003.

Results.  Sixty‐four per cent (95% CI; 57–72%) of nursing and 63% (95%; CI 50–75%) of midwifery students adopted a deep approach. The use of a surface approach was negatively correlated to the stage of study for midwifery but not nursing students. There was also a statistically significant positive correlation between level of interest in the field of study and use of strategic approach for both nursing and midwifery students. Grade point average for the nursing students adopting the strategic approach was statistically significantly higher than for those adopting deep or surface approach. The grade point average for midwifery students adopting strategic approach was statistically significantly higher than that for those adopting deep approach, but not different from the grade point average of those adopting surface approach.

Conclusion.  Our findings suggest that adoption of strategic or deep approaches to learning was associated with better educational outcome, as indicated by higher grade point averages. Moreover, the findings emphasize the impact of students’ interest in their field on their academic success. Therefore, the adoption of factors which foster deep or strategic approaches and activities which increase students’ interest should lead to improved academic outcomes.
Health promotion for frail older home care clients
Authors: Markle‐Reid Maureen , Weir Robin , Browne Gina , Roberts Jacqueline , Gafni Amiram , Henderson Sandra
Published: April 2006

Aim. This paper reports a study evaluating the comparative effects and costs of a proactive nursing health promotion intervention in addition to usual home care for older people compared with usual home care services alone.

Background. An ageing population, budget constraints and technological advances in many countries have increased the pressure on home care resources. The result is a shift in nursing services from health promotion to meet the more pressing need for postacute care. For frail older people with long‐term needs, these changes combine to create a fragmented system of health service delivery, characterized by providing nursing on demand rather than proactively.

Methods. A two‐armed, single‐blind, randomized controlled trial was carried out with older people ≥75 years and eligible for personal support services through a home care programme in Ontario, Canada. Participants were randomly allocated either to usual home care (control) or to a nursing (experimental) group. In addition to usual home care, the nursing group received a health assessment combined with regular home visits or telephone contacts, health education about management of illness, coordination of community services, and use of empowerment strategies to enhance independence. The data were collected in 2001–2002.

Results. Of the 288 older people who were randomly allocated at baseline, 242 (84%) completed the study (120 nursing group; 122 control group). Proactively providing older people with nursing health promotion, compared with providing nursing services on‐demand, resulted in better mental health functioning (P = 0·009), a reduction in depression (P = 0·009), and enhanced perceptions of social support (P = 0·009) at no additional cost from a societal perspective.

Conclusions. Home based nursing health promotion, proactively provided to frail older people with chronic health needs, enhances quality of life while not increasing the overall costs of health care. The results underscore the need to re‐invest in nursing services for health promotion for older clients receiving home care.
Exploring the experience of weight loss in people with advanced cancer
Authors: Hopkinson Jane , Wright David , Corner Jessica
Published: April 2006

Aim. This paper reports a study of the experience of and concerns about weight loss described by patients with advanced cancer, their caregivers and nurse specialists.

Background. Weight loss is reported to be one of the commonest symptoms experienced by patients with advanced cancer. There is evidence that it can be of concern to patients and their caregivers. However, little is known about why this is the case or how people might be helped to live with the symptom.

Method. An exploratory study with a purposive sample of 30 patients, 23 caregivers, and 14 specialist nurses from the South of England was conducted in 2003. The in‐depth interviews focused on the experience of weight loss and its management. Interviews were transcribed verbatim, then analysed using an approach informed by Wolcott's framework for qualitative data analysis and Miles and Huberman's ‘mixed strategy for cross‐case analysis’.

Findings. Concern was experienced when advanced cancer became visible through weight loss. Visible weight loss symbolized proximity to death, loss of control and both physical and emotional weakness. Despite this, weight loss was not routinely assessed by palliative care nurse specialists, who, like others in the patient's social network, respected a weight loss taboo in the belief that little could be done to help people live with the symptom.

Conclusion. Weight loss‐related concern might be mitigated if clinicians adopted a systematic and proactive approach to the management of the symptom that breaks through the weight loss taboo.
Serum lipid levels in relation to serum thyroid‐stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: the Tromsø Study
Authors: IQBAL A. , JORDE R. , FIGENSCHAU Y.
Published: April 2006

Objective.  To evaluate the relation between serum thyroid‐stimulating hormone (TSH) and lipids.

Design.  Cross‐sectional epidemiological study, nested case–control study, and a placebo‐controlled double‐blind intervention study.

Methods.  In the 5th Tromsø study serum TSH, total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), and low‐density lipoprotein cholesterol (LDL‐C) were measured. Subjects with subclinical hypothyroidism (SHT) and a matching control group were re‐examined and apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were also measured. Subjects with SHT were included in an intervention study with thyroxine supplementation for 1 year.

Results.  A total of 5143 subjects from the 5th Tromsø study were included. A significant and positive correlation between serum TSH levels and serum TC and LDL‐C levels were found in both genders. However, in the females this did not reach statistical significance after adjusting for age and BMI. The serum LDL‐C were significantly higher and the Apo A1 levels significantly lower in 84 SHT subjects compared with 145 controls, and in the SHT females the TC levels were also significantly elevated. In the intervention study (32 subjects given thyroxine and 32 subjects given placebo), we observed a significant reduction in the Apo B levels after thyroxine medication. In those that at the end of the study had serum TSH levels in the range 0.2–2.0 mIU L−1, the serum TC and LDL‐C levels were also significantly reduced.

Conclusions.  There is a positive association between serum TSH levels and TC and LDL‐C levels. These lipid levels are reduced with thyroxine treatment in subjects with SHT.
Role of the methylcitrate cycle in Mycobacterium tuberculosis metabolism, intracellular growth, and virulence
Authors: Muñoz‐Elías Ernesto J. , Upton Anna M. , Cherian Joseph , McKinney John D.
Published: April 2006

Growth of bacteria and fungi on fatty acid substrates requires the catabolic β‐oxidation cycle and the anaplerotic glyoxylate cycle. Propionyl‐CoA generated by β‐oxidation of odd‐chain fatty acids is metabolized via the methylcitrate cycle. Mycobacterium tuberculosis possesses homologues of methylcitrate synthase (MCS) and methylcitrate dehydratase (MCD) but not 2‐methylisocitrate lyase (MCL). Although MCLs share limited homology with isocitrate lyases (ICLs) of the glyoxylate cycle, these enzymes are thought to be functionally non‐overlapping. Previously we reported that the M. tuberculosis ICL isoforms 1 and 2 are jointly required for growth on fatty acids, in macrophages, and in mice. ICL‐deficient bacteria could not grow on propionate, suggesting that in M. tuberculosis ICL1 and ICL2 might function as ICLs in the glyoxylate cycle and as MCLs in the methylcitrate cycle. Here we provide biochemical and genetic evidence supporting this interpretation. The role of the methylcitrate cycle in M. tuberculosis metabolism was further evaluated by constructing a mutant strain in which prpC (encoding MCS) and prpD (encoding MCD) were deleted. The ΔprpDC strain could not grow on propionate media in vitro or in murine bone marrow‐derived macrophages infected ex vivo; growth under these conditions was restored by complementation with a plasmid containing prpDC. Paradoxically, bacterial growth and persistence, and tissue pathology, were indistinguishable in mice infected with wild‐type or ΔprpDC bacteria.
Novel smooth muscle markers reveal abnormalities of the intestinal musculature in severe colorectal motility disorders
Authors: Wedel T. , Van Eys G. J. J. M. , Waltregny D. , Glénisson W. , Castronovo V. , Vanderwinden J‐m.
Published: April 2006

Abstract  Histopathological studies of gastrointestinal motility disorders have mainly focused on enteric nerves and interstitial cells of Cajal, but rarely considered the enteric musculature. Here we used both classical and novel smooth muscle markers and transmission electron microscopy (TEM) to investigate muscular alterations in severe colorectal motility disorders. Full‐thickness specimens from Hirschsprung's disease, idiopathic megacolon, slow‐transit constipation and controls were stained with haematoxylin/eosin (HE) and Masson's trichrome (MT), incubated with antibodies against smooth muscle α‐actin (α‐SMA), smooth muscle myosin heavy chain (SMMHC), smoothelin (SM) and histone deacetylase 8 (HDAC8) and processed for TEM. Control specimens exhibited homogeneous immunoreactivity for all antibodies. Diseased specimens showed normal smooth muscle morphology by HE and MT. While anti‐α‐SMA staining was generally normal, immunoreactivity for SMMHC, HDAC8 and/or SM was either absent or focally lacking in Hirschsprung's disease (80%), idiopathic megacolon (75%) and slow‐transit constipation (70%). Ultrastructurally, clusters of myocytes with noticeably decreased myofilaments were observed in all diseases. SMMHC and the novel smooth muscle markers SM and HDAC8 often display striking abnormalities linked to the smooth muscle contractile apparatus unnoticed by both routine stainings and α‐SMA, suggesting specific defects of smooth muscle cells involved in the pathogenesis of gastrointestinal motility disorders.
Metabolic consequences of susceptibility and resistance (race‐specific and broad‐spectrum) in barley leaves challenged with powdery mildew
Authors: SWARBRICK PHILIP J. , SCHULZE‐LEFERT PAUL , SCHOLES JULIE D.
Published: April 2006

In a compatible interaction biotrophic fungi often lower the yield of their hosts by reducing photosynthesis and altering the fluxes of carbon within the infected leaf. In contrast, comparatively little is known about the metabolic consequences of activating resistance responses. In this study we investigated the hypothesis that the activation of both race‐specific (Mla12) and broad‐spectrum (mlo) resistance pathways in barley leaves infected with Blumeria graminis represents a cost to the plant in terms of carbon production and utilization. We have shown, using quantitative imaging of chlorophyll fluorescence, that during a susceptible interaction, photosynthesis was progressively reduced both in cells directly below fungal colonies and in adjacent cells when compared with uninoculated leaves. The lower rate of photosynthesis was associated with an increase in invertase activity, an accumulation of hexoses and a down‐regulation of photosynthetic gene expression. During both Mla12‐ and mlo‐mediated resistance, photosynthesis was also reduced, most severely inhibited in cells directly associated with attempted penetration of the fungus but also in surrounding cells. These cells displayed intense autofluorescence under ultraviolet illumination indicative of the accumulation of phenolic compounds and/or callose deposition. The depression in photosynthesis was not due only to cell death but also to an alteration in source‐sink relations and carbon utilization. Apoplastic (cell wall‐bound) invertase activity increased more rapidly and to a much greater extent than in infected susceptible leaves and was accompanied by an accumulation of hexoses that was localized to areas of the leaf actively exhibiting resistance responses. The accumulation of hexoses was accompanied by a down‐regulation in the expression of Rubisco (rbcS) and chlorophyll a/b binding protein (cab) genes (although to a lesser extent than in a compatible interaction) and with an up‐regulation in the expression of the pathogenesis‐related protein 1 (PR‐1). These results are consistent with a role for invertase in the generation of hexoses, which may supply energy for defence reactions and/or act as signals inducing defence gene expression.
Cell and leaf size plasticity in Arabidopsis: what is the role of endoreduplication?
Authors: COOKSON SARAH JANE , RADZIEJWOSKI AMANDINE , GRANIER CHRISTINE
Published: April 2006

Leaf area expansion is affected by environmental conditions because of differences in cell number and/or cell size. Increases in the DNA content (ploidy) of a cell by endoreduplication are related to its size. The aim of this work was to determine how cell ploidy interacts with the regulation of cell size and with leaf area expansion. The approach used was to grow Arabidopsis thaliana plants performing increased or decreased rounds of endoreduplication under shading and water deficit. The shading and water deficit treatments reduced final leaf area and cell number; however, cell area was increased and decreased, respectively. These differences in cell size were unrelated to alterations of the endocycle, which was reduced by these treatments. The genetic modification of the extent of endoreduplication altered leaf growth responses to shading and water deficit. An increase in the extent of endoreduplication in a leaf rendered it more sensitive to the shade treatment but less sensitive to water deficit conditions. The link between the control of whole organ and individual cell expansion under different environmental conditions was demonstrated by the correlation between the plasticity of cell size and the changes in the duration of leaf expansion.
Multiseismic cycle deformation rates from Holocene normal fault scarps on Crete (Greece)
Authors: Caputo R. , Monaco C. , Tortorici L.
Published: April 2006

Morphotectonic features reveal recent seismic activity on normal faults on Crete allowing slip rates, palaeoearthquake magnitudes and earthquake recurrence intervals to be inferred. The studied faults show major escarpments (100s m high, 10s km long), separating uplifted Mesozoic rocks from Quaternary deposits. During the Holocene, slip rates outpaced erosion/sedimentation rates and 5–15 m high fresh scarps formed at the base of the major escarpments. Based on our field observations and following empirical relationships between magnitude, surface rupture length and maximum co‐seismic vertical displacement, it is possible to infer some important seismotectonic parameter relative to the investigated faults. Taking into account the possible sources of error and the corresponding uncertainties, our preferred long‐term slip rates range between 0.5 and 1.3 mm yr−1, the maximum expected magnitudes between 6.3 and 6.6 (or 6.5 and 6.8, considering worst case scenarios), while the mean recurrence intervals range between 260 andc. 840 years. These estimates are in good agreement with the shallow seismicity thus allowing to improve our knowledge on the seismic potential in Crete. Horizontal extension rates could be also inferred from our geological data and compared with the few available GPS data.
A novel R2R3 MYB transcription factor NtMYBJS1 is a methyl jasmonate‐dependent regulator of phenylpropanoid‐conjugate biosynthesis in tobacco
Authors: Gális Ivan , Šimek Petr , Narisawa Tomoko , Sasaki Mami , Horiguchi Tatsuya , Fukuda Hiroo , Matsuoka Ken
Published: April 2006

Target metabolic and large‐scale transcriptomic analyses of tobacco (Nicotiana tabacum L.) Bright Yellow‐2 (BY‐2) cells were employed to identify novel gene(s) involved in methyl jasmonate (MJ)‐dependent function in plants. At the metabolic level, we describe the specific accumulation of several phenylpropanoid–polyamine conjugates in MJ‐treated BY‐2 cells. Furthermore, global gene expression analysis of MJ‐treated cells using a 16K cDNA microarray containing expressed sequence tags (ESTs) from BY‐2 cells revealed 828 genes that were upregulated by MJ treatment within 48 h. Using time‐course expression data we identified a novel MJ‐inducible R2R3 MYB‐type transcription factor (NtMYBJS1) that was co‐expressed in a close temporal pattern with the core phenylpropanoid genes phenylalanine ammonia‐lyase (PAL) and 4‐coumarate:CoA ligase (4CL). Overexpression of NtMYBJS1 in tobacco BY‐2 cells caused accumulation of specific phenylpropanoid conjugates in the cells. Subsequent microarray analysis of NtMYBJS1 transgenic lines revealed that a limited number of genes, including PAL and 4CL, were specifically induced in the presence of the NtMYBJS1 transgene. These results, together with results of both antisense expression analysis and of gel mobility shift assays, strongly indicate that the NtMYBJS1 protein functions in tobacco MJ signal transduction, inducing phenylpropanoid biosynthetic genes and the accumulation of phenylpropanoid–polyamine conjugates during stress.
Vascular endothelial growth factor secretion from mesenteric adipose tissue and from creeping fat in Crohn’s disease
Authors: Schäffler Andreas , Fürst Alois , Büchler Christa , Paul Gisela , Rogler Gerhard , Schölmerich Jürgen , Herfarth Hans
Published: April 2006

Background:  Creeping fat represents a characteristic feature of Crohn’s disease (CD), and adipose tissue secretes adipocytokines and chemokines/growth factors such as vascular endothelial growth factor (VEGF). Because VEGF serum levels and mucosal VEGF expression is elevated in CD patients, the aim of the present paper was to investigate creeping fat‐derived VEGF secretion in CD.

Material and Methods:  Adipose tissue was obtained from creeping fat of 10 patients with CD. Mesenteric adipose tissue was resected from 13 patients with colon cancer (CC) and from seven patients with diverticulitis (DIV). Three fat tissue specimens per well, and several wells (6–8) per patient were incubated ex vivo for 24 h. The release of VEGF into the supernatant was measured by ELISA.

Results:  There was stable VEGF secretion from mesenteric adipose tissue of patients with CC or DIV and from creeping fat of patients with CD. Whereas the VEGF secretion rate was not different between patients with CD (465 ± 98 pg/g fat per 24 h) and CC (399 ± 48 pg/g fat per 24 h), VEGF secretion was significantly reduced in patients suffering from DIV (115 ± 41 pg/g fat per 24 h; P < 0.0001 and P = 0.001, respectively). The CD patients treated with steroids had significantly lower VEGF secretion rates (294 ± 42 pg/g fat per 24 h) than CD patients not receiving steroids (607 ± 105 pg/g fat per 24 h; P = 0.001).

Conclusions:  Creeping fat is an important source of VEGF secretion. The characteristics of the inflammatory changes in CD might be due to the lack of VEGF downregulation that is seen in DIV.
Characteristics of acute and sub‐acute liver failure in China: nomination, classification and interval
Authors: Liu Qing , Liu Zheng , Wang Tailing , Wang Qingguo , Shi Xiaohong , Dao Wenbin
Published: April 2006

Background and Aims: Unlike most other countries, in China, liver failure is termed as severe hepatitis. However, there are two differences between liver failure and severe hepatitis: the interval of acute and sub‐acute severe hepatitis and the etiology. The aims of this study were to assess the best cutoff time‐point to distinguish between acute and sub‐acute severe hepatitis caused mainly by hepatitis B virus (HBV; 67.5%) in China and to determine whether the Chinese classifications of severe hepatitis can meet the international criteria based on pathological features and clinical characteristics.

Methods: A total of 157 patients with acute, sub‐acute and chronic severe hepatitis were involved in the study. Their clinical findings, laboratory data and liver biopsies were retrospectively analyzed.

Results: The different incidences of complications between acute and sub‐acute severe hepatitis were significant if the cutoff point was set at 15 days or 4 weeks (P < 0.01), but there is no significant differences if the cutoff was 8 weeks. Identifying the better cutoff point with a receiver–operator characteristic curve showed that 28 days was better than 15 days (sensitivity 100%vs92%; specificity 75%vs53%). The major differences in histopathology between acute and sub‐acute severe hepatitis were: (i) there was a single hepatic necrosis in acute severe hepatitis, but repeated and continuous hepatic necrosis in sub‐acute severe hepatitis; and (ii) survivors of acute severe hepatitis had full hepatocyte regeneration in the native liver architecture. Regeneration in survivors with sub‐acute severe hepatitis indicated the destruction of nodular architecture; new and old necrosis appeared at the same time. When the cutoff point for acute and sub‐acute severe hepatitis was set at 15 days, some sub‐acute severe hepatitis cases (full hepatocyte regeneration and one massive necrosis) had an overlap in pathological features with acute severe hepatitis. If the cutoff time‐point was set at 4 weeks, the clinical features between acute and sub‐acute, as well as the pathological changes, were clearly distinguished.

Conclusion: The best cutoff time‐point to distinguish between acute and sub‐acute severe hepatitis is 4 weeks. This classification meets the international criteria based on the present clinical and pathological results.
Effect of hepatitis C virus core shadow protein expressed in human hepatoma cell line on human gene expression profiles
Authors: Dou Jun , Liu Pengbo , Wang Jing , Zhang Xinjian
Published: April 2006

Background and Aims:  The hepatitis C virus (HCV) C region has been reported to have overlapping genes or regions, and may encode a core shadow protein that has a role in HCV self‐replication, pathogenesis and carcinogenesis. The aim of this study was to identify the effect of HCV core shadow protein expressed in a human hepatoma (Huh‐7) cell line on human gene expression profiles.

Methods:  Recombinants for expression of HCV genotype 1b core shadow protein and genotype 1b core protein were constructed, and an Huh‐7 cell line was established that could express the shadow protein and the core protein constitutively. Affymetrix human gene chip, HG‐U133 A and B microarray analysis and semiquantitative RT‐PCR were employed to identify the expression profiles of two kinds of core proteins in the Huh‐7 cell line.

Results:  The microarray analysis showed that the core shadow protein caused expression of more genes to be up/down‐regulation than the core protein, including signal transduction, protease activity, molecular transport and, particularly, immune responses genes. Surprisingly, the core shadow protein could increase/decrease expression of apoptosis and anti‐apoptosis genes simultaneously. The expression profiles of three up‐regulated genes were confirmed by semiquantitative RT‐PCR, with results similar to the microarray analysis.

Conclusions:  Hepatitis C virus core shadow protein may play an important role in inhibiting or stimulating host cells apoptosis processing and carcinogenesis, which is useful for the understanding of HCV core shadow protein biological functions in vivo and in vitro.
Profile of chronic hepatitis B virus in children in India: Experience with 116 children
Authors: Satapathy SK , Garg S , Chauhan R , Malhotra V , Sakhuja P , Sharma B C , Sarin SK
Published: April 2006

Background:  Hepatitis B virus (HBV) infection in children is mostly asymptomatic and therefore the disease burden is likely to be under appreciated. There is limited information on the profile of chronic HBV infection in children from the Indian subcontinent.

Method:  In 116 (male : female 89:27) children, aged <15 years, with persistent HBsAg positivity for more than 6 months, a clinical, biochemical, virological and histological assessment was carried out.

Results:  At presentation, 21.6% of children were symptomatic, with icterus in 12%. Features of decompensation such as ascites (7%) and gastrointestinal (GI) bleed (5%) were noted uncommonly. Five (4.3%) children had hepatocellular carcinoma (HCC) at presentation. Elevated alanine aminotransferase (ALT) was observed in 76% of subjects (median 61; range 14–815). A significantly higher proportion of children with hepatitis B early antigen (HbeAg) positive status had higher histological activity index (HAI) (84%vs 16%, P < 0.001) and fibrosis score (80%vs 20%, P = 0.007). A strong positive correlation was noted between aspartate aminotransferase (AST), ALT, HBV‐DNA and histological severity of the disease (HAI ≥4, fibrosis ≥2). Median HBV‐DNA levels were significantly higher in the HBeAg positive compared to the HBeAg negative group (25.6 vs 0.7 pg/mL, P = 0.004). Seventy‐four percent of the mothers had evidence of past or present HBV infection.

Conclusions:  Majority of the children with chronic HBV infection are asymptomatic at presentation. HBeAg positive status reflects histologically more severe disease, and a higher level of HBV‐DNA. Almost two‐thirds of the children may have acquired their HBV infection perinataly.
Cardiac involvement in Crohn’s disease: Echocardiographic study
Authors: Bragagni Gianpaolo , Brogna Raffaele , Franceschetti Paola , Zoli Giorgio
Published: April 2006

Background:  Crohn’s Disease (CD) commonly presents extra‐intestinal manifestations, but cardiac involvement is considered rare. The aim of the present study was to assess cardiac involvement in CD and its possible correlation with activity, duration, localization and therapy.

Patients and Methods:  A group of 68 patients with CD and a control group of 60 healthy subjects were subjected to a transthoracic echocardiogram with Doppler study.

Results:  The study found overall morphologic alterations in 47/68 CD patients (69.11%) versus 12/60 controls (20.0%; P < 0.01); mitral valve prolapse in 20/68 CD patients (29.4%) versus 4/60 controls (6.6%; P < 0.01); and pericardial effusion in 13/68 CD patients (19.1%)versus 1/60 controls (1.6%; P < 0.01). The following findings were frequent, but without statistical significance: mitral insufficiency, 9/68 CD (13.2%) versus 3/60 controls (5.0%); tricuspidalic insufficiency, 8/68 CD (11.7%) versus 3/60 controls (5%); aortic insufficiency, 3/68 CD (4.4%) versus none in the control group; and decreased left ventricle ejection fraction, 5/68 CD (7.3%) versus none in the control group. Pericardial effusion was found to be related to CD activity (r = 0.375; P = 0.002) as well as decreased ejection fraction (r = 0.358; P = 0.003). No correlation with age, sex, duration, therapy or localization of disease was found.

Conclusions:  These findings suggest that CD frequently determines cardiac involvement, although it is usually subclinical. The alteration of cytokine network, especially the elevated levels of tumor necrosis factor‐α, could be implicated in the cardiac alterations because it was observed, as for raised oxidative stress, in other heart diseases.
Mice lacking L1 cell adhesion molecule have deficits in locomotion and exhibit enhanced corticospinal tract sprouting following mild contusion injury to the spinal cord
Authors: Jakeman Lyn B. , Chen Ying , Lucin Kurt M. , McTigue Dana M.
Published: April 2006

L1 is a member of the immunoglobulin superfamily of cell adhesion molecules that is associated with axonal growth, including formation of the corticospinal tract (CST). The present study describes the effects of L1 deletion on hindlimb function in locomotion, and examines the role of L1 in recovery and remodeling after contusive spinal cord injury (SCI) in mice. Uninjured adult L1 knockout (Y/–) mice had impaired performance on locomotor tests compared with their wild‐type littermates (Y/+). Anterograde tracing demonstrated that CST axons project to thoracic, but not lumbar, levels of the spinal cord of Y/– mice, and revealed a diversion of these fibers from their position in the base of the dorsal columns. Retrograde tracing also revealed reduced numbers of descending projections from paraventricular hypothalamus and red nuclei to the lumbar spinal cord in Y/– mice. SCI at the mid‐thoracic level produced a lesion encompassing the center of the spinal cord, including the site of the dorsal CST and surrounding gray matter (GM). The injury caused lasting deficits in fine aspects of locomotion. There was no effect of genotype on final lesion size or the growth of axons into the lesion area. However, injured Y/– mice demonstrated a robust expansion of CST projections throughout the GM of the cervical and thoracic spinal cord rostral to the lesion compared with Y/+ littermates. Thus, L1 is important for the development of multiple spinal projections and also contributes to the restriction of CST sprouting rostral to the site of a SCI in adults.
l‐Glutamate activates RhoA GTPase leading to suppression of astrocyte stellation
Authors: Chen Chun‐Jung , Ou Yen‐Chuan , Lin Shih‐Yi , Liao Su‐Lan , Huang Yong‐San , Chiang An‐Na
Published: April 2006

The actin cytoskeleton is known to support cellular morphological changes. Rho family small GTPases function as switching molecules to promote the convergence of both extracellular and intracellular signals in regulating cytoskeletal organization. Evidence indicates that l‐glutamate suppresses morphological changes of astrocytes over a broad spectrum. To test the possibility that l‐glutamate affects cytoskeletal reorganization, we investigated its effect on morphological changes induced by manganese exposure. l‐Glutamate concentration‐dependently prevented and reversed manganese‐induced astrocyte stellation and cytoskeletal disruption. The suppressive effect of l‐glutamate on manganese‐induced stellation was mediated by the activation of the glutamate transporter rather than ionotropic or metabotropic glutamate receptors. Pharmacological and biochemical approaches revealed the involvement of Ras homolog gene family, member A (RhoA) activation in l‐glutamate‐mediated suppression of manganese‐induced stellation. The activation of RhoA by l‐glutamate was partly through the up‐regulation of guanine nucleotide exchange factor phosphorylation and was abrogated by competitive nonsubstrate inhibitors. Furthermore, the hyperphosphorylation of myosin light chain and cofilin through the activation of RhoA following l‐glutamate treatment synergistically stabilized actin stress fibres. These results suggest that manganese‐induced stellation is suppressed by a mechanism involving glutamate transporters. Our in vitro findings also strongly indicate that astrocyte morphological plasticity is under the control of RhoA and that manganese and l‐glutamate regulate astrocyte morphology by modulating this switching molecule under culture conditions.
Nitric oxide regulation of calcitonin gene‐related peptide gene expression in rat trigeminal ganglia neurons
Authors: Bellamy Jamie , Bowen Elizabeth J. , Russo Andrew F. , Durham Paul L.
Published: April 2006

Calcitonin gene‐related peptide (CGRP) and nitric oxide are involved in the underlying pathophysiology of migraine and other diseases involving neurogenic inflammation. We have tested the hypothesis that nitric oxide might trigger signaling mechanisms within the trigeminal ganglia neurons that would coordinately stimulate CGRP synthesis and release. Treatment of primary trigeminal ganglia cultures with nitric oxide donors caused a greater than four‐fold increase in CGRP release compared with unstimulated cultures. Similarly, CGRP promoter activity was also stimulated by nitric oxide donors and overexpression of inducible nitric oxide synthase (iNOS). Cotreatment with the antimigraine drug sumatriptan greatly repressed nitric oxide stimulation of CGRP promoter activity and secretion. Somewhat surprisingly, the mechanisms of nitric oxide stimulation of CGRP secretion did not require cGMP or PI3‐kinase signaling pathways, but rather, nitric oxide action required extracellular calcium and likely involves T‐type calcium channels. Furthermore, nitric oxide was shown to increase expression of the active forms of the mitogen‐activated protein kinases Jun amino‐terminal kinase and p38 but not extracellular signal‐related kinase in trigeminal neurons. In summary, our results provide new insight into the cellular mechanisms by which nitric oxide induces CGRP synthesis and secretion from trigeminal neurons.
Neural progenitor cells engineered to secrete GDNF show enhanced survival, neuronal differentiation and improve cognitive function following traumatic brain injury
Authors: Bakshi Asha , Shimizu Saori , Keck Carrie A. , Cho Sean , LeBold David G. , Morales Diego , Arenas Ernest , Snyder Evan Y. , Watson Deborah J. , McIntosh Tracy K.
Published: April 2006

We sought to evaluate the potential of C17.2 neural progenitor cells (NPCs) engineered to secrete glial cell line‐derived neurotrophic factor (GDNF) to survive, differentiate and promote functional recovery following engraftment into the brains of adult male Sprague–Dawley rats subjected to lateral fluid percussion brain injury. First, we demonstrated continued cortical expression of GDNF receptor components (GFRα‐1, c‐Ret), suggesting that GDNF could have a physiological effect in the immediate post‐traumatic period. Second, we demonstrated that GDNF over‐expression reduced apoptotic NPC death in vitro. Finally, we demonstrated that GDNF over‐expression improved survival, promoted neuronal differentiation of GDNF‐NPCs at 6 weeks, as compared with untransduced (MT) C17.2 cells, following transplantation into the perilesional cortex of rats at 24 h post‐injury, and that brain‐injured animals receiving GDNF‐C17.2 transplants showed improved learning compared with those receiving vehicle or MT‐C17.2 cells. Our results suggest that transplantation of GDNF‐expressing NPCs in the acute post‐traumatic period promotes graft survival, migration, neuronal differentiation and improves cognitive outcome following traumatic brain injury.
Clinical characteristics of bladder cancer in patients previously treated with radiation for prostate cancer
Authors: SANDHU JASPREET S. , VICKERS ANDREW J. , BOCHNER BERNARD , DONAT S. MACHELE , HERR HARRY W. , DALBAGNI GUIDO
Published: April 2006

OBJECTIVE

To determine if bladder cancer diagnosed after prostatic radiation therapy (RT) differs in behaviour from bladder cancer diagnosed after prostate cancer not treated with RT, as such bladder cancer is thought to be more aggressive than de novo bladder cancer, and epidemiological studies show a higher rate of bladder cancer in patients after irradiation.

PATIENTS AND METHODS

We reviewed our records to identify patients who had a diagnosis of bladder cancer with a previous diagnosis of prostate cancer. Patient age, date of diagnosis of prostate cancer, date of diagnosis of bladder cancer, symptoms, clinical stage, initial pathology, definitive therapy, definitive pathological stage, and disease status were recorded.

RESULTS

In all, 100 patients were identified who had a diagnosis of bladder cancer after a diagnosis of prostate cancer between January 1992 and August 2003; 58 had had RT for prostate cancer. The mean time between a diagnosis of bladder cancer and prostate cancer was 62 months in the RT group and 34 months in the unirradiated group (P = 0.002) At diagnosis of bladder cancer, 56 (97%) of the patients who received RT had high‐grade urothelial carcinoma, vs 27 (64%) of those not irradiated (P < 0.001). Thirty (52%) of the patients with RT had muscle‐invasive bladder cancer, vs 17 (40%) of those not irradiated (P = 0.3). The survival rate was similar for both groups.

CONCLUSIONS

Bladder cancer is diagnosed later, and is of higher grade, in patients who are irradiated for prostate cancer than in those treated with other methods. Patients with prostate cancer who are treated with RT should be monitored closely for the presence of bladder cancer.
Income Aspirations, Television and Happiness: Evidence from the World Values Survey
Authors: Bruni Luigino , Stanca Luca
Published: April 2006

This paper investigates the role of television in producing higher material aspirations, by enhancing both adaptation and positional effects. Using a large sample of individuals from the World Values Survey, we find that the effect of income on both life and financial satisfaction is significantly smaller for heavy television viewers than for occasional viewers. This finding is robust to a number of specification checks and alternative interpretations. The results suggest an additional explanation for the income‐happiness paradox: the pervasive and increasing role of television viewing in contemporary society, by raising material aspirations, contributes to offset the effect of higher income on individual happiness.
Glycaemic index effects on fuel partitioning in humans
Authors: Díaz E. O. , Galgani J. E. , Aguirre C. A.
Published: April 2006

The purpose of this review was to examine the role of glycaemic index in fuel partitioning and body composition with emphasis on fat oxidation/storage in humans. This relationship is based on the hypothesis postulating that a higher serum glucose and insulin response induced by high‐glycaemic carbohydrates promotes lower fat oxidation and higher fat storage in comparison with low‐glycaemic carbohydrates. Thus, high‐glycaemic index meals could contribute to the maintenance of excess weight in obese individuals and/or predispose obesity‐prone subjects to weight gain. Several studies comparing the effects of meals with contrasting glycaemic carbohydrates for hours, days or weeks have failed to demonstrate any differential effect on fuel partitioning when either substrate oxidation or body composition measurements were performed. Apparently, the glycaemic index‐induced serum insulin differences are not sufficient in magnitude and/or duration to modify fuel oxidation.
The Political Economy of US Aid to Pakistan
Authors: Anwar Mumtaz , Michaelowa Katharina
Published: April 2006

Variations of bilateral aid flows are difficult to explain on the basis of official development objectives or recipient need. Based on the example of US aid to Pakistan, this paper suggests alternative political economic explanations, notably the relevance of ethnic lobbying and the relevance of US business interests. Time series regressions for the period from 1980 to 2002 and logistic regressions based on votes for the Pressler and the Brown Amendment confirm the significance of these political economic determinants. While in case of the Pressler Amendment, the direct influence of population groups of Indian and Pakistani origins seems to have played a predominant role, the role of ethnic business lobbies appears to have dominated in the context of the Brown Amendment. Time series analysis also provides some evidence for the impact of US business interests based on FDI and exports, but these effects appear to be comparatively small.
Shortcuts and Signals: An Analysis of the Micro‐level Determinants of Aid Allocation, with Case Study Evidence from Brazil
Authors: Reinhardt Gina Yannitell
Published: April 2006

Does the distribution of foreign development assistance depend on the organizational capacity of the recipient organization? I argue that employees at donor agencies seek signals of which recipients will implement aid most effectively, and use these signals to determine the destination of foreign aid on the micro level. Qualitative evidence gathered in the US and Brazil indicates the types of signals donors seek and recipients strive to transmit: signals of a recipient's professionalism, reputation, and sustainability. After developing a signaling game to derive the conditions under which these signals might be credible indicators of implementation effectiveness, I present quantitative evidence of aid recipient organizations in Brazil and score them on the three signals. Statistical tests confirm that organizations with higher levels of these signals are more likely to receive funding, suggesting that donors use these signals to determine the destination of development assistance.
The role of P300 in the recovery of post‐stroke global aphasia
Authors: Nolfe G. , Cobianchi A. , Mossuto‐Agatiello L. , Giaquinto S.
Published: April 2006

Seventeen right‐handed patients suffering from global aphasia caused by a recent stroke in the left‐hemisphere were studied. Passive P300 auditory event related potential paradigm was applied every months for 6 months. Aachen subtests were used for evaluating comprehension. Only a minority of the patients displayed the P300 at the baseline. Those patients had the best outcome at the Aachen comprehension subtest. Latency and amplitude changed over time in an unpredictable way. The number of patients presenting with the P300 also fluctuated, since some patients could regain the potential, whereas some other patients could lose that from month to month. Passive P300 is a monitor of recovery following global aphasia. A single passive P300 recording is useful for prognostic purposes. Repairing mechanisms in the first 6 months have a non‐linear trend.
Skin biopsy findings and results of neuropsychological testing in the first confirmed cases of CADASIL in Norway
Authors: Rein Gustavsen W. , Reinholt F. P. , Schlosser A.
Published: April 2006

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is characterized by mutations in the notch3 gene. The mutation can be demonstrated by a gene test. The first group of Norwegian patients with CADASIL confirmed by gene testing was recently described. The present study includes six of the original nine patients with demonstrated notch3 mutation plus one patient with symptoms, who had been unwilling to go through gene testing. These seven patients underwent skin biopsy for electron microscopy. One patient was cognitively too impaired, but six went through neuropsychological testing. By electron microscopy characteristic granular osmiophilic material (GOM) was detected in all skin biopsies. The material is seen as granular deposits in the basal lamina of the smooth muscle layer, often making impressions upon adjacent smooth muscle cells. It seems important that blood vessels over a certain size (diameter >20 μm) are examined. A varying extent of cognitive decline was noted amongst all by neuropsychological testing. In cases with multiple infarctions reduction of perceptual speed, visuospatial skills and working memory could be demonstrated. Four patients showed executive dysfunction.
Plus Ça Change? ‘Correcting’ Inuit Inmates in Nunavut, Canada
Authors: LANDAU TAMMY C.
Published: April 2006

Abstract: Criminal justice reform in the context of indigenous peoples in Canada has been motivated by both their over‐representation at each stage of the administration of justice and their extreme cultural, social and political dislocation. The extent to which reforms can overcome institutionalised colonial practices is challenged by the experiences of Inuit inmates in Nunavut. It is argued that the correctional response to indigenous people in Canada is largely rhetorical and has led to few meaningful changes to the lives of Inuit inmates.