bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of lipid‐lowering drug therapy on cardiovascular responsiveness in type 2 diabetic patients
Authors: Howes Laurence Guy
Published: December 2005

Type 2 diabetes is associated with a high prevalence of dyslipidaemia and a high incidence of cardiovascular disease. Lipid lowering therapy with HMG Co‐A reductase inhibitors (statins) reduce the risk of cardiovascular events in type 2 diabetic and non‐diabetic patients, effects which are believed to be partly due to improvements in vascular function. The aetiology of abnormal vascular function in type 2 diabetics is likely to be multifactorial and the pattern of vascular dysfunction in type 2 diabetes may differ from that which occurs in non‐diabetic patients with dyslipidaemia. Abnormalities in endothelium derived hyperpolarising factor (EDHF) mediated vasodilation in resistance vessels may be more prominent in both type 1 and type 2 diabetes than in non‐diabetic patients with endothelial dysfunction. The effects of lipid lowering therapy on vascular responsiveness may differ in type 2 diabetic patients from those found in non‐diabetic patients. Statin therapy does not appear to improve responses to endothelial dependent vasodilators in type 2 diabetics, but may alter the ratio between nitric oxide (NO) and EDHF mediated responses. Fibrate therapy improves flow mediated dilation of brachial arteries in type 2 diabetic patients, but only appears to improve endothelium dependant vasodilator responses in resistance vessels when given in conjunction with co‐enzyme Q.
Insulin status differentially affects energy transduction in cardiac mitochondria from male and female rats
Authors: Billimoria Framroze R. , Katyare Surendra S. , Patel Samir P.
Published: December 2005

Aim:  The incidence of coronary heart diseases (CHD), congestive heart failure (CHF) and myocardial infarction is higher in diabetic patients than in non‐diabetic groups, with these incidences being more in women than in the men. Hence, we examined involvement of mitochondrial energy transduction functions.

Methods:  Mitochondrial energy metabolism in cardiomyopathy was studied using streptozotocin (STZ)‐diabetic male and female rats as the model system. Effects of insulin treatment were also evaluated.

Results:  The body and heart weights decreased in both male and female diabetic rats. Insulin treatments resulted in significant increase in the body and heart weights in the female rats. Mitochondrial respiration rates with all the substrates tested decreased in diabetic condition in both males and females. Treatment with two dose‐regimens of insulin had differential restorative effect on mitochondrial substrate oxidation in the males but caused hyper‐stimulation in the females. Diabetic state brought about 19% decrease in the cytochrome aa3 content in the female rats. Treatment with 0.6 units of insulin significantly increased the cytochrome contents in general in both the sexes whereas higher dose (1.0 unit) caused decrease in the cytochromes content in the females. Diabetic state resulted in decreased dehydrogenases activities; insulin treatments had differential effect on the dehydrogenase activity in the males and the females. The results suggest that insulin treatment‐induced hyper‐stimulation of respiration in female rats may lead to increased production of reactive oxygen species. Besides, increased formation of advanced glycosylated end products may further lead to increased risk of CHF and CHD.

Conclusions:  The results suggest that differential effects of STZ‐diabetes and insulin treatments in the female rats than in males may be the underlying cause for increased incidence of diabetic cardiomypathies in the females.
Pioglitazone and reductions in post‐challenge glucose levels in patients with type 2 diabetes
Authors: Khan M. , Murray F. T. , Karunaratne M. , Perez A.
Published: December 2005

Aim:  Pioglitazone (PIO) has been shown to decrease insulin resistance in patients with type 2 diabetes, resulting in lowered blood glucose concentrations, lowered plasma insulin levels and lowered haemoglobin A1C (A1C) values. Postprandial glucose control has been recently recognized as an important target for reducing overall glycemic burden in patients with type 2 diabetes. Some authors assert that reductions in postprandial glucose levels may lead to a decrease in cardiovascular risk, one of the major complications associated with diabetes.

Methods:  Data were analysed from a 26‐week PIO monotherapy study of 88 patients who underwent a 3‐h oral glucose tolerance test (75 g dose) at baseline and last measurement. Change from baseline in area under the curve (AUC) values and hourly glucose concentrations were calculated and analysed at both time points for four medication groups: placebo group and PIO 15, 30 and 45 mg groups. Changes from baseline in fasting plasma glucose (FPG) and A1C also were reported.

Results:  Glucose AUC was significantly (p < 0.05) different from baseline at 15, 30 and 45 mg doses of PIO. In addition, when compared to placebo, PIO (15, 30 and 45 mg) significantly decreased post‐challenge blood glucose AUC (p < 0.05). The mean hourly blood glucose levels at last measurement for PIO 15, 30 and 45 mg all were significantly lower (p < 0.05) than placebo at all four time points. In addition, PIO significantly (p < 0.05) reduced FPG and A1C from baseline to last measurement in a dose‐related fashion.

Conclusions:  PIO significantly reduced post‐challenge glucose levels following an oral glucose challenge, leading to improvements in overall glycemic control. Postprandial glucose lowering is one of several metabolic effects of PIO in addition to decreasing insulin resistance and improving some lipids components. Whether these combined metabolic effects can lead to cardiovascular risk reductions may be confirmed by the pending results of cardiovascular outcomes studies with PIO.
Biphasic insulin aspart 30 plus metformin: an effective combination in type 2 diabetes
Authors: Kvapil M. , Swatko A. , Hilberg C. , Shestakova M.
Published: December 2005

Aim:  This study compared glycaemic control achieved with biphasic insulin aspart 30 (BIAsp 30) monotherapy, BIAsp 30 plus metformin and glibenclamide plus metformin in patients with type 2 diabetes not adequately controlled with metformin.

Methods:  In this multinational, open‐labelled, parallel group, 16‐week trial, 341 patients (patients not adequately controlled with metformin for at least 1 month) with type 2 diabetes were studied. Patients were randomized to receive BIAsp 30, twice daily (n = 107 exposed to treatment), or BIAsp 30, twice daily, plus metformin (n = 108) or glibenclamide plus metformin (n = 114). The primary endpoint was HbA1c at end of trial; adverse events, hypoglycaemia episodes, blood lipids and weight were also monitored.

Results:  In the total population (HbA1c 7.5–13.0% at screening), end‐of‐trial HbA1c levels were lower in patients receiving BIAsp 30 plus metformin compared with those receiving BIAsp 30 only [mean treatment difference (±s.e.m), 0.39 ± 0.15%, p = 0.007]. In a subpopulation (HbA1c ≥ 9.0% at baseline, n = 193), patients receiving BIAsp 30 plus metformin had significantly lower HbA1c levels at the end of the trial compared with those receiving glibenclamide plus metformin (treatment difference, 0.46 ± 0.21%, p = 0.027). Mean body weight (±s.d) at the end of the trial was significantly lower in patients receiving glibenclamide plus metformin compared with those receiving BIAsp 30 only (84.3 ± 13.3 kg vs. 88.9 ± 16.9 kg, p < 0.001). No major hypoglycaemic episodes were recorded during the trial, and incidence rates for minor and symptoms‐only hypoglycaemia were low and similar between treatment groups (0.03–0.04 events/patient/week).

Conclusion:  BIAsp 30 added to metformin could be an appropriate therapeutic option for achieving good glycaemic control, compared with the addition of a second oral agent, particularly where HbA1c ≥ 9%.
Continuity and Change in Mergers and Acquisitions: A Social Identity Case Study of a German Industrial Merger*
Authors: Ullrich Johannes , Wieseke Jan , Dick Rolf Van
Published: December 2005

abstract  It is crucial from an employee's point of view to perceive some degree of stability even in times of major organizational change. This paper examines the role of a sense of continuity for organizational identification after an organizational merger. We argue that mergers and acquisitions so often end in failures partly because the change is designed in discontinuous ways and employees do not feel they are doing the same job after the merger as before. Such discontinuous change engenders a critical tension between positive and negative effects of identification that has not yet been fully understood. To deepen the understanding of this tension, in‐depth interviews were conducted in a recently merged German industrial company. Based on these qualitative data we demonstrate how features of the post‐merger company structure and the way it was implemented may have eroded organizational identification. Finally, we propose a parsimonious model to be tested by future research, in which the sense of continuity is consisting of both observable as well as projected continuity.
The Impact of Gender Similarity on Employee Satisfaction at Work: A Review and Re‐Evaluation*
Authors: Peccei Riccardo , Lee Hyun‐Jung
Published: December 2005

abstract  We used data from the British 1998 Workplace Employee Relations Survey (WERS98) to examine key unanswered questions about the impact of gender similarity on employee satisfaction at work. The study sample consisted of 11,848 men and 11,278 women from over 1700 workplaces across Britain. In line with gender‐specific compositional arguments, the effects of gender similarity were found to be asymmetrical for men and women, with similarity tending to have a greater positive impact on men than on women. The effects involved were primarily linear in nature. Net of the potentially confounding influence of other factors, they were also found to be quite weak, weaker than has commonly been suggested in the literature.
When is Contracting Preferable to Employment? An Exploration of Management and Worker Perspectives
Authors: Peel Simon , Boxall Peter
Published: December 2005

abstract  Managers make choices regarding the types of employment structures that meet the needs of the firm, and workers make choices regarding the types of arrangement that meet their needs. Various streams of literature offer perspectives on why employment or contracting might be preferred but it is often the perspective of the firm that dominates the analysis. This kind of one‐sidedness weakens our understanding of employment as a relationship. It lacks recognition of the importance of mutuality: of matching the needs of the worker with the needs of the business. This paper reports research investigating management decisions to use self‐employed contractors or employees for particular jobs, and workers’ decisions to seek or accept organizational employment or self‐employment. Some 80 in‐depth interviews were conducted with managers and workers across two industries (energy supply and engineering consultancy) with the intent of studying two groups of workers differing dramatically in skill levels. While largely confirming existing theory on the management conditions relevant to the contracting‐out of work, the study identifies factors that make a contracting relationship more mutually beneficial, thus suggesting propositions for further research on worker preferences.
Urogynaecology: Urethral retro‐resistance pressure and urodynamic diagnoses in women with lower urinary tract symptoms
Authors: Alessandro Digesu G , Athanasiou Stavros , Chaliha Charlotte , Michalas Stylianos , Salvatore Stefano , Selvaggi Luigi , Khullar Vik
Published: December 2005

Objective  This study determines whether the retrograde urethral retro‐resistance pressure (URP) measurement discriminates between urodynamic diagnoses in a group of women.

Design  A prospective observational study.

Setting  Urogynaecology units of three tertiary referral teaching hospitals.

Population  Women with lower urinary tract symptoms.

Methods  Consecutive women attending the urodynamic clinics of three tertiary referral teaching hospitals were studied using a validated urinary symptom questionnaire, URP measurement and urodynamic evaluation between February and July 2004. The URP mean values were compared with urinary symptoms and urodynamic diagnoses, using the independent t test correction for multiple measurements.

Main outcome measures  Retrograde URP, urodynamic diagnoses and urinary symptoms.

Results  One hundred and eighty‐five women were recruited. Women with urodynamic stress incontinence (USI) have significantly lower URP than women with competent urethral sphincters (P < 0.05, independent t test). Women with mixed urodynamic incontinence had values of URP intermediate between women with detrusor overactivity (DOA) and those with USI. In the mixed group, URP mean values were not significantly different from those with DOA and competent sphincters or USI (P > 0.05, independent t test). There was no significant difference between mean URP values and different urinary symptoms (P > 0.05, independent t test).

Conclusions  There are significantly different URP measurements between women with DOA and those with USI. However, the URP is not a diagnostic tool.
Short communication: A longitudinal study of serum adiponectin during normal pregnancy
Authors: Fuglsang Jens , Skjærbæk Christian , Frystyk Jan , Flyvbjerg Allan , Ovesen Per
Published: December 2005

Adiponectin is secreted from adipose tissue. Serum adiponectin levels are inversely correlated with body mass index (BMI) and also insulin resistance, independent of the BMI. A role for adiponectin in the development of insulin resistance has been implied in pregnancy. However, no studies have been performed to describe the individual longitudinal course of adiponectin in normal pregnancies. Therefore, we measured serum adiponectin during and after normal pregnancy in 11 healthy women. Serum levels peaked in midpregnancy and the lowest levels were seen in late pregnancy. An inverse association with maternal BMI was observed.
General obstetrics: Vaginal birth after caesarean section versus elective repeat caesarean section: assessment of maternal downstream health outcomes
Authors: Paré Emmanuelle , Quiñones Joanne N , Macones George A
Published: December 2005

Objective  To compare the maternal implications of strategies of vaginal birth after caesarean section (VBAC) attempt versus elective repeat caesarean section in women with one previous lower segment caesarean section.

Design  Decision model.

Population  Women with one prior low transverse caesarean section who are eligible for trial of labour.

Methods  Two decision models were built: the first one applying to women planning only one more pregnancy, the second one applying to women planning two more pregnancies. Probability estimates for VBAC success rate and risks of uterine rupture, placenta praevia, placenta accreta and hysterectomy were extracted from the available literature.

Main outcome measures  Hysterectomy for uterine rupture, placenta accreta or other indications.

Results  In the first model VBAC attempt led to a higher hysterectomy rate (267/100,000) compared with repeat caesarean section (187/100,000). However, in the second model a policy of elective repeat caesarean section led to higher cumulative hysterectomy rate: 1465/100,000 versus 907/100,000 for VBAC. The first model was robust to all but one variable in sensitivity analyses. The second model was robust to all variables in sensitivity analyses.

Conclusions  These results indicate that long term reproductive consequences of multiple caesarean sections should be considered when making policy decisions regarding the risk–benefit ratio of VBAC.
General obstetrics: Does size matter? A population‐based study of birth in lower volume maternity hospitals for low risk women
Authors: Tracy Sally K , Sullivan Elizabeth , Dahlen Hannah , Black Deborah , Wang Yueping Alex , Tracy Mark B
Published: December 2005

Objective  To study the association between volume of hospital births per annum and birth outcome for low risk women.

Design  Population‐based study using the National Perinatal Data Collection (NPDC).

Setting  Australia.

Participants  Of 750,491 women who gave birth during 1999–2001, there were 331,147 (47.14%) medically ‘low risk’ including 132,696 (40.07%) primiparae and 198,451 (59.93%) multiparae.

Methods  The frequency of each birth and infant outcome was described according to the size of the hospital where birth took place. We investigated whether unit size (defined by volume) was an independent risk factor for each outcome factor using public hospitals with greater than 2000 births per annum as a reference point.

Main outcome measures  Rates of intervention at birth and neonatal mortality for low risk women in relation to hospitals with <100, 100–500, 501–1000, 1001–2000 and >2001 births per annum.

Results  Neonatal death was less likely in hospitals with less than 2000 births per annum regardless of parity. For multiparous low risk women in hospitals of 100 and 500 births per annum compared with hospitals of >2000 births per annum the adjusted odds of neonatal mortality [adjusted odds ratio (AOR) 0.36; 99% confidence interval (CI) 0.14–0.93]. For low risk primiparous women in hospitals with less than 100 births per annum, there were lower rates of induction of labour (AOR 0.62; 99% CI 0.54–0.73); intrathecal analgesia/anaesthesia (AOR 0.34; 99% CI 0.28–0.42); instrumental birth (AOR 0.80; 99% CI 0.69–0.93); caesarean section after labour (AOR 0.59; 99% CI 0.49–0.72) and admission to a neonatal unit (AOR 0.15; 99% CI 0.10–0.22) and for low risk multiparous women in hospitals with less than 100 births per annum: induction (AOR 0.69; 99% CI 0.62–0.76); intrathecal analgesia/anaesthesia (AOR 0.32; 99% CI 0.29–0.36); instrumental birth (AOR 0.52; 99% CI 0.41–0.67); caesarean section after labour (AOR 0.41; 99% CI 0.33–0.52); and admission to a neonatal unit (AOR 0.09; 99% CI 0.07–0.12).

Conclusions  In Australia, lower hospital volume is not associated with adverse outcomes for low risk women.
Systematic review: Hormone therapy and cardiovascular disease: a systematic review and meta‐analysis
Authors: Magliano Dianna J , Rogers Sophie L , Abramson Michael J , Tonkin Andrew M
Published: December 2005

Background  Despite decades of evidence from observational studies, the use of hormone therapy for the prevention of cardiovascular disease (CVD) among postmenopausal women is controversial. The recent completion of several randomised clinical trials examining the effects of hormone therapy on CVD presents an opportunity to provide a more precise estimate of the cardiovascular risks of hormone therapy.

Objective  To summarise the effects of hormone therapy on CVD in postmenopausal women.

Search strategy  MEDLINE, EMBASE, the Cochrane Library, DARE and CENTRAL were searched for clinical trials reporting mortality and/or CVD outcomes in association with hormone therapy. Bibliographies and editorials were also reviewed. All studies were reviewed and rated for quality independently by two reviewers.

Selection criteria  High quality, randomised placebo‐controlled clinical trials of hormone therapy (duration greater than one year) in non‐hospitalised postmenopausal women were included.

Data collection and analysis  Summary relative risks were estimated for all‐cause mortality, coronary heart disease (CHD) mortality, non‐fatal acute myocardial infarction (AMI) and all stroke.

Main results  Seven randomised clinical trials met the inclusion criteria. The use of hormone therapy had no significant effect on all‐cause mortality, non‐fatal AMI or CHD mortality, with relative risks of 1.02 [95% confidence interval (CI) 0.93–1.13], 1.00 (0.88–1.14) and 0.99 (0.82–1.21), respectively. For all stroke, the summary relative risk was 1.29 (1.13–1.48).

Author's conclusions  This systematic review, incorporating the latest available trial data, shows that hormone therapy does not significantly change the risk of all‐cause morality, CHD death or non‐fatal AMI but increases the risk of stroke in postmenopausal women.
Urogynaecology: Effect of tension‐free vaginal tape in women with a urodynamic diagnosis of idiopathic detrusor overactivity and stress incontinence
Authors: Duckett Jonathan RA , Tamilselvi Arjunan
Published: December 2005

Objective  To determine the effect of tension‐free vaginal tape (TVT) in women with idiopathic detrusor overactivity (DO) and urodynamic stress incontinence (USI) and to propose appropriate pre‐operative counselling based on this information.

Design  Retrospective cohort study.

Setting  Urogynaecology Unit, District General Hospital, Kent.

Population  Fifty‐one women (from a total of 344 women undergoing TVT) with urodynamic evidence of both DO and USI who underwent TVT insertion between November 1999 and March 2003.

Methods  Women with more than six‐month follow up were assessed objectively with cystometry. Subjective results were assessed using structured interview and condition specific Kings Quality of Life Questionnaire.

Main outcome measures  Objective resolution of DO and subjective absence of urge syndrome after TVT. Cure of USI was the secondary outcome measure analysed. The effect of drug therapy on residual urge symptoms was assessed.

Results  Objective cure of DO was demonstrated in 47% and subjective cure of urge symptoms in 63%. In women with persistent urge symptoms, the addition of anticholinergic medication resulted in resolution of urge incontinence in a further 22% of women. USI was objectively cured in 92%.

Conclusions  More than 60% of women diagnosed urodynamically with DO and USI experience complete resolution of urge symptoms following TVT. Further symptom improvement can be achieved with additional anticholinergic medication.
Antiaging – a scientific topic or just a social trend?
Authors: Kreyden Oliver P
Published: December 2005

The number of nonsurgical anti‐aging procedures have increased in recent years. Reasons for this trend are various: The World Wide Web distributes an immense amount of information throughout the world within seconds, which in turn generates a great demand on information. Active and aggressive medias, which were almost absent 50 years ago, have made our society ambitious; the perception of which is attractive, desirable, and sexy gets globalized. In addition, our lifestyle has changed with the fast‐growing offer of leisure activities. Wrinkles, fat deposits, and sun‐damaged skin do not fit into our neat society. The increasing demand for aesthetic treatments has prompted many physicians without any knowledge in aesthetic medicine to offer various nonsurgical aesthetic treatments with the danger that aesthetic dermatology stands to lose its scientific relevance. Evidence‐based medicine should be applied not only in medical procedures but also in aesthetic dermatology.
A pilot study evaluating the efficacy of topically applied niacin derivatives for treatment of female pattern alopecia
Authors: Draelos Zoe Diana , Jacobson Elaine L. , Kim Hyuntae , Kim Moonsun , Jacobson Myron K
Published: December 2005

Background  Female pattern alopecia is a common dermatologic condition that manifests after puberty. The only approved drug treatment for this condition is 2% minoxidil for topical application.

Aims  This pilot study examined the effect of topical application of two niacin derivatives, octyl nicotinate and tetradecyl nicotinate, on hair fullness in female alopecia.

Patients/methods  Sixty female subjects with Ludwig types I–III female pattern hair loss were evaluated in a double‐blinded, placebo‐controlled (40 active, 20 placebo) design using standardized 35‐mm photographic analyses for assessment of efficacy after 6 months of application.

Results  The niacin derivatives demonstrated a statistically significant increase in hair fullness (P = 0.04 compared to the placebo).

Conclusion  Whereas evaluation of hair growth in women is challenging, this 6‐month pilot study demonstrated statistically significant increase in hair fullness on blinded 35‐mm photographic analysis. Long‐term topical application of nicotinic acid derivatives offers promise for providing benefit in female alopecia and warrants further study.
Nitrous oxide as an adjunct in tumescent liposuction
Authors: Bird Garrett , Albert Clifford
Published: December 2005

Background  Nitrous oxide (N2O) has been used as an anesthetic for over 300 years. It is safe, easy to use, and effective. In this article we will document N2O use as an adjunct to tumescent liposuction. The history, mechanism of action, use, and safety in ambulatory surgery of N2O are reviewed.

Objective  The authors intend to review the history of both tumescent liposuction and N2O in surgery, discuss the possible adverse reactions, and present guidelines for the use of N2O during tumescent liposuction.

Methods  A Medline review of articles, 1966–2004, related to N2O was performed, using the search terms nitrous, oxide, safety, toxicity, mechanism, anesthetic, surgery, risks, and delivery. Articles that were cited by the authors of this subset of original articles were also used when appropriate. Articles were rated and included based on date of publication, level of evidence, and applicability to tumescent liposuction.

Results and conclusions  Nitrous oxide is safe, easily administered, inexpensive, and is an effective adjunct to tumescent liposuction. It provides a high level of pain control, and is patient controlled, while not putting the patient at risk of full anesthesia. When used correctly, with proper equipment, it poses little risk to either patients or healthcare workers.
Botulinum toxin – an update on its use in facial rejuvenation
Authors: Lehrer Michael S , Benedetto Anthony V
Published: December 2005

The role of botulinum toxin in facial rejuvenation has been greatly expanded in the last several years. In this article, we first review the traditional approach to botulinum toxin therapy in the forehead and glabella. For the advanced reader, we then discuss both the literature and our personal approaches to treatments of the periocular region, mid face, lower face, and neck. Throughout the discussion, attempts are made to include a description of relevant anatomy, the physiologic result of specific muscle activity and denervation, and perhaps most importantly, precise directions for patient treatment.
Nonablative skin rejuvenation
Authors: Nikolaou Vasiliki A , Stratigos Alexander J , Dover Jeffrey S
Published: December 2005

Laser resurfacing of photodamaged or scarred skin has traditionally involved the use of ablative lasers with their associated limitations and side effects. Nonablative skin rejuvenation is a relatively new concept in facial rejuvenation, which aims to induce dermal remodeling without visible epidermal disruption. A number of laser devices and light sources, emitting at various wavelengths, have been shown to effectively enhance the appearance of facial skin through nonablative mechanisms. Among the conditions that can be treated with this novel modality are erythema, telangiectasia, pigmentation, lentigines, and textural imperfections ranging from fine and moderate rhytides to other surface irregularities such as acne scarring. A major attraction of nonablative laser therapy is the very limited downtime after each treatment, making it an ideal method for patients seeking a minimally invasive procedure with an excellent safety profile.
Light/laser therapy in the treatment of acne vulgaris
Authors: Nouri Keyvan , Villafradez‐Diaz L Magaly
Published: December 2005

Acne vulgaris is one of the most prevalent skin diseases known. As common as this condition is, the social and psychological consequences are limitless. Although current treatments are available and include topical or oral antibiotics, it is crucial to develop a less risky and more effective therapy such as light/laser therapy. This article focuses specifically on the benefits of the light/laser treatment on acne vulgaris.

Porphyrins accumulated in the bacteria, Propionibacterium acnes, one of the etiologic factors involved in the pathogenesis, allows phototherapy to be a successful modality. They have specific absorption peaks at which lasers have optimal effects. The longer the wavelength of the light is, the deeper its penetration and thus the greater its damage to the sebaceous glands. Although blue light is best for the activation of porphyrins, red light is best for deeper penetration and an anti‐inflammatory effect. Ultraviolet (UV) light, although it may have initial an anti‐inflammatory effects, has been proven to be potentially carcinogenic and have adverse effects such as aging (by UV‐A) and burning (by UV‐B).

Previous studies indicate successful long‐term intervention and selective damage of the sebaceous glands by using a diode laser with indocyanine green (ICG) dye. Mid‐infrared lasers have been found to decrease lesion counts while also reducing the oiliness of skin and the scarring process. Nonablative laser treatment of acne scars using the Er:YAG laser with a short‐pulsed mode has been successful in reducing the appearance of scars by stimulating neocollagenesis.

The light/laser therapy has started to be explored with promising results in highly selected patients that require further investigation in greater populations and well‐designed protocols.
The state of mental health in old‐age across the ‘old’ European Union – a systematic review
Authors: Riedel‐Heller S. G. , Busse A. , Angermeyer M. C.
Published: December 2005

Objective:  The paper provides the first syllabus on the prevalence of mental disorders in old‐age focusing on surveys conducted in the 15 countries, which comprised the ‘old’ European Union.

Method:  A systematic search of the literature published from 1990 onwards was conducted.

Results:  Mental disorders in old‐age are common. The most serious threats to mental health in old‐age are posed by dementia and depression. It is a clear cut finding that dementia exponentially increases with age. The basic issue of whether depression increases or decreases with age remains unsolved. Databases on substance use, mild cognitive impairment, psychotic syndromes, anxiety, and somatoform disorders in old‐age are much smaller, making conclusions difficult to draw.

Conclusion:  Numerous questions in the field remain to be answered. Concerted action is needed to produce comparable data across Europe.
Differences in resting energy expenditure and body composition between patients with schizophrenia and healthy controls
Authors: Nilsson B. M. , Forslund A. H. , Olsson R. M. , Hambraeus L. , Wiesel F.‐A.
Published: December 2005

Objective:  A lowered energy metabolism in schizophrenia was reported already in the 1920s. However, these early investigations were case studies without control groups or statistical analysis. In this study the resting energy expenditure (REE) and relevant body composition variables were measured in patients with schizophrenia and healthy controls.

Method:  REE was determined in 30 patients and 17 controls. The difference between the measured and the expected level for each individual was calculated as ΔREE. Body composition was assessed with bioelectrical impedance and calliper measurements.

Results:  ΔREE was significantly lower in the patients than in the controls. A decrease was also seen in the non‐medicated patients. The patients showed significantly lower percentages of water in fat free‐mass and intracellular water.

Conclusion:  The lowering of REE and body water fractions may suggest a homeostatic aberration in schizophrenia that may be of importance for the understanding of metabolic disturbances observed in the disease.
Melatonin prevents apoptosis induced by UV‐B treatment in U937 cell line
Authors: Luchetti Francesca , Canonico Barbara , Curci Rosa , Battistelli Michela , Mannello Ferdinando , Papa Stefano , Tarzia Giorgio , Falcieri Elisabetta
Published: December 2005

Abstract:  Melatonin influences circadian rhythms and acts as antioxidant and free radical scavenger. UV irradiation triggers multiple cellular events which lead to cell death, in particular to apoptosis; this process involves reactive oxygen species. Apoptotic machinery involves several pathways, in which mitochondria play crucial roles. In this work we have evaluated by means of cytometric, biochemical and ultrastructural approaches, if incubation of U937 promonocytic leukemia cells with melatonin may affect apoptotic behavior induced by UV‐B. The cell line was treated with 1 mm melatonin before and after UV‐B exposure. Melatonin pretreatment significantly reduced the number of apoptotic cells, as revealed by FITC Annexin‐V and propidium iodide assays (P < 0.005), as well as attenuated mitochondria alterations, as shown by ultrastructural morphology, Mito Tracker and JC‐1 staining, and cytochrome c (cyt c) release (P < 0.005). On the contrary, incubation with melatonin after UV‐B exposure significantly protect U937 cells from UV‐B induced alterations, showing a possible delay of the apoptotic machinery (as revealed by the presence of earlier stages of apoptosis and significant cyt c release). Our results suggest that, in our experimental model, melatonin may play a role as noncytotoxic anti‐apoptotic compound and, at least in part, may protect U937 cells from UV‐B induced mitochondria dysfunction/damage.
In Situ Biotransformation of BTEX Compounds Under Methanogenic Conditions
Authors: Reinhard Martin , Hopkins Gary D. , Steinle‐Darling Eva , LeBron Carmen A.
Published: December 2005

In situ biotransformation of BTEX (benzene, toluene, ethylbenzene, o‐, m‐, and p‐xylenes) was investigated for a gasoline spill at Seal Beach Naval Weapons Station (Schroeder 1991) under methanogenic conditions in three controlled‐release push‐pull experiments. To create methanogenic conditions, anaerobic ground water (710 to 1365 L) was extracted from the anaerobic test zone, treated by deionization to remove nitrate and sulfate, and helium‐purged to remove any traces of oxygen. Prior to release through the multiport injection/extraction well, the injection water was amended with BTEX compounds (160 to 367 μg/L) and bromide tracer. Contaminant transformation was observed in three consecutive experiments by withdrawing samples at regular intervals for periods of 73 to 159 d. BTEX removal rates were rapid for toluene and o‐ and m‐xylenes (<30 d), and slow for benzene, ethylbenzene, and p‐xylene degrading (50% removal in 60 to 90 d). Methane was formed in all cases, and the levels of soluble iron, sulfate, and nitrate were too low to account for the levels of BTEX transformation observed. The data confirm that the presence of electron acceptors (oxygen, nitrate, iron, sulfate) is not a precondition for natural attenuation to occur.
Evaluation of an Inexpensive Small‐Diameter Temperature Logger for Documenting Ground Water–River Interactions
Authors: Johnson Adam N. , Boer Brian R. , Woessner William W. , Stanford Jack A. , Poole Geoffrey C. , Thomas Steven A. , O'Daniel Scott J.
Published: December 2005

Increasing numbers of studies are recording detailed temperature data for characterization of ground water–stream exchange. We examined laboratory and field operation of a small‐diameter, stand‐alone and inexpensive temperature logger capable of investigating stream–ground water exchange was examined. The Thermochron iButton is a 17.35‐mm‐diameter by 6‐mm‐thick instrument that costs <$10 when ordered in quantity. Testing of the loggers in a controlled temperature bath revealed a precision of ±0.4°C and an accuracy of ±0.5°C for a group of 201. More than 500 loggers have been installed in channels and in subchannel and floodplain ground water environments in two gravel‐bedded rivers in the western United States. Loggers were placed as single devices and in vertical arrays in monitoring wells with diameters of 10.16, 5.08, 2.54, and 1.9 cm. We determined that the loggers have four principal advantages over more commonly used wired and currently available stand‐alone logging devices: (1) the wireless nature does not require the instrument location to be associated with a control‐recording system; (2) the small size allows for installation in small hand‐driven or direct‐push monitoring wells and thus intimate contact of the instruments with the hydrologic environment; (3) multiple loggers are easily suspended in a single fully perforated monitoring well, allowing for the collection of high‐resolution temperature profile data; and (4) the low cost of the loggers allows for the deployment of large numbers, thus improving spatial resolution in shallow ground water floodplain scale studies.
Toward a Standard Thermistor Calibration Method: Data Correction Spreadsheets
Authors: Alexander Matthew D. , MacQuarrie Kerry T.B.
Published: December 2005

Temperature is one of the most frequently measured physical phenomena in environmental research. Many laboratory and field investigations of temperature use commercially available temperature loggers that come from the manufacturer precalibrated. After‐market calibration of temperature loggers provides more confidence in measured data. This paper proposes a general method for calibrating temperature loggers in order to obtain consistent, high‐quality data. A procedure and derivation of equations for performing logger calibration is presented. Spreadsheets are described for calculating correction coefficients and adjusting proxy data to a reference temperature. A temperature logger calibration example demonstrates the importance of instrument calibration and the improvement in accuracy. The procedure and spreadsheets presented here can be used for calibration and correction of data from any type of thermistor.
Full‐Scale Removal of DNAPL Constituents Using Steam‐Enhanced Extraction and Electrical Resistance Heating
Authors: Heron Gorm , Carroll Steven , Nielsen Steffen G.
Published: December 2005

In 2003, the United States Department of Energy completed a full‐scale non–aqueous phase liquid (NAPL) remediation of Area A of the Northeast Site at the Young‐Rainey STAR Center, Largo, Florida. Area A covered an area of 930 m2 (10,000 square feet) and extended to a depth of 10.7 m (35 feet), representing a total cleanup volume of 9930 m3 (12,960 cubic yards). The site was contaminated with ∼2500 kg (5500 lb) of NAPL constituents such as trichloroethylene, cis‐1,2‐dichloroethylene, methylene chloride, toluene, and petroleum hydrocarbons. The site consists of a fine‐grained sand aquifer underlain by a Hawthorn clay at 9 m (30 feet) depth. The upper 1.5 m (5 feet) of this clay formed part of the remediation volume, as dense non–aqueous phase liquid was present in this layer. The site was remediated using a combination of steam‐enhanced extraction and electrical resistance heating. Operations lasted 4.5 months. The site was heated to the target temperatures within 6 weeks, at which time the mass removal rate increased more than 1000‐fold. After the target volume had been heated to or near boiling temperatures, pressure cycles were used to increase the mass removal rates, until a final phase of diminishing returns was reached. Postoperational sampling of soil and ground water at randomly selected locations showed the concentrations of all contaminants of concern (COC) to be well below the remedial goals. The majority of the ground water samples were below maximum contaminant level (MCL) for all the COC. The estimate of volatile organic contaminant (VOC) mass removed from the site (1130 kg = 2500 lb) agreed well with the estimate of VOC present before operation (1170 kg = 2580 lb). The postoperational sampling showed that ∼0.5 kg (1 pound) of VOCs remained in the remedial volume, and showed remedial efficiencies of between 99.85% and 99.99% for the four chemicals of concern. Since the postoperational sampling shows all concentrations to be below or close to ground water MCLs, the thermal remedy may be satisfactory for site closure without a polishing phase.
The power of the projected self: a case study in self artistry: Figure 1
Authors: Rapport N
Published: December 2005

The “projected self” is an individual engaged in a life project. The power that enables an individual to formulate, to embark on, and to effect a life project is of an “existential”, embodied kind: something fuelled metabolically within the body of the individual, and conceived of by way of his or her ongoing, individual acts of interpretation. In this article the life of the English artist Stanley Spencer is looked to as a case study through which to flesh out and apply the above conceptual terms and their argument. To what extent can there be said to be a relationship between the “work of art” that Spencer created in and as his life, and his influence over those forces and those others that might otherwise have claimed a hold over his life? Spencer’s construction of a beautiful, involved, and extensive worldview, the article argues, does translate into him exercising a conscious control over the course of his life and enjoying a wellbeing of identity.
Some body wants to be normal: an account of an HIV narrative
Authors: Mooney A
Published: December 2005

Narrative accounts of illness often focus on the sociological construction of illness and neglect the body. This paper explores themes of seeing and being seen in the narrative of an HIV positive man to show the importance of uncovering the psychological and corporeal experience of HIV. Such accounts complement and enhance conventional medical accounts of illness. Poignantly, it is a story of how he understands others as reading his body and writing on it. Further, his story is not one that is in circulation. Accounts of positive heterosexual males are few. This paper seeks to add at least one account to the public record so that others may have narrative resources to draw upon. Narrative analysis provides new perspectives on the lived experience of HIV, which are crucial to appreciate how it might be possible to live a positive life.
They stole my baby’s soul: narratives of embodiment and loss
Authors: Campbell A V , Willis M
Published: December 2005

The controversy over retained organs, arising from the Bristol and Alder Hey findings about postmortem uses of body parts, has revealed a gulf between medical and lay understandings of the human body and its relationship with the human person. There is a clear utility in having a “doctor’s story”, which is different from the way patients and their families understand the significance of the body, since this enables medical diagnosis and treatment to be effective. When, however, the medical narrative intrudes uncritically into areas where the key issue is the integration of the body with the person, experienced or remembered, things go badly wrong with communications in medicine. For the lay person disrespectful treatment of the body of a loved one represents a personal attack. In this respect, strong emotion, seen as irrelevant or distracting by scientific medicine, is a central aspect of the narrative concerned with loss of a loved person. For doctor and lay person alike, a narrative of the self which pays proper attention to the embodiment of the self, offers the possibility of a genuinely humane medicine.
The experience of stroke and the life of the Spirit
Authors: de la Mare Ben
Published: December 2005

In this paper, I have tried in the first instance to describe the experience of stroke, and to set my own story in the context of more general observations on strokes and on the appropriate care of stroke patients. The paper makes clear that the stroke brought my active working life to an abrupt end, but I am keen to stress that in my case at least the thinking must go on. The production of this paper offers a test case of this last proposition. The paper does not attempt to survey my whole working life (mainly as a Church of England parish priest) and its interaction with my faith, but it does try to explore some of the consequences for faith, and for prayer, prompted by the stroke.

There is a personal story of sometimes bewildering complexity behind every stroke. “But why is stroke any different from other serious illness?” This paper seeks to identify some of the distinctive characteristics of strokes; but I leave it to others to answer the question more adequately. It only needs to be stated here that all strokes, in some measure, affectmentalprocesses, sometimes profoundly; and we easily underestimate the extent to which our performance is affected by our states of mind.
PARTY POLARIZATION IN AMERICAN POLITICS: Characteristics, Causes, and Consequences
Authors: Layman Geoffrey C. , Carsey Thomas M. , Horowitz Juliana Menasce
Published: December 2005

▪ Abstract  Recent commentary points to clear increases in ideological polarization between the major American political parties. We review the theoretical and empirical literature on party polarization and partisan change. We begin by comparing the current period both to earlier political eras and to theories of partisan change. We argue that in the current period the parties have grown increasingly divided on all the major policy dimensions in American politics—a process that we term conflict extension. We discuss various perspectives on increases in polarization between the parties in government, the parties in the electorate, and the parties' activists, and we consider the causal links between polarization at each of these levels. We consider whether American society itself, and not just the parties and their identifiers, has become increasingly polarized. Finally, we discuss the consequences of growing party polarization for American political life.
Pharmacokinetic Study of Intravesical Gemcitabine in Carcinoma in situ of the Bladder Refractory to Bacillus Calmette-Guérin Therapy
Authors: Bassi P. , De Marco V. , Tavolini I.M. , Longo F. , Pinto F. , Zucchetti M. , Crucitta E. , Marini L. , dal Moro F.
Published: December 2005

Introduction: Gemcitabine, a chemotherapeutic agent, has been shown to be active against transitional cell cancer of the bladder. The aim of the study was to determine the pharmacokinetic profile of gemcitabine, administered intravesically in patients with carcinoma in situ(CIS). Material and Methods: Nine patients with CIS refractory to intravesical bacillus Calmette-Guérin (BCG) therapy were enrolled. Gemcitabine was given in 50 ml 0.9% NaCl by catheterization and held in the bladder for 1 h, once weekly for 6 consecutive weeks. The pharmacokinetics for gemcitabine metabolites were performed in plasma and serum. Dose levels were: 1,000, 1,250, and 1,500 mg. Clinical evaluation was repeated 4 weeks after therapy and thereafter every 6 months. Results: Grade-1 neutropenia was observed only in 1 patient. Grade-1 urinary frequency and hematuria were observed in 1 and 3 patients, respectively. No grade 2–4 toxicity or clinically relevant myelosuppression were observed. Gemcitabine was detectable in serum, but with an irrelevant pharmacological effect, in only 1 patient treated with 1,500 mg of gemcitabine. With regard to activity, after 6 instillations of this drug, 4 complete responses were observed. Conclusion: Intravesical gemcitabine is well tolerated and safe. No systemic absorption with a clinical or pharmacological effect was detected and only slightly irritative bladder symptoms were observed. These results warrant further investigation in phase-II trials.