bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling geometric uncertainties in radiation therapy
Authors: Craig Tim
Published: September 2003

Patient repositioning and organ motion lead to uncertainty in targeting the tumor in radiation therapy. This decreases the dose to the tumor and increases the dose to healthy tissues. Ultimately, tumor control is reduced and complications are increased. This work investigates the hypothesis that modeling geometric uncertainties can accurately estimate the dose distribution delivered when uncertainties are present. These modeling results provide a more accurate representation of the delivered dose distribution than present approaches. These uncertainties are conventionally addressed by adding a margin to the clinical target volume to define a planning target volume (PTV). Despite widespread use, some PTV implementation details have not been addressed. A mathematical model is developed to investigate these details and leads to recommendations for clinical implementation. However, limitations remain when using a PTV. A superior method of accounting for geometric uncertainties incorporates their effect into the dose calculation. This can be achieved by convolution of the planned dose distribution with a probability density function describing the uncertainty. Two assumptions in this model are that the dose distribution is shift invariant and that treatment extends over an infinite number of fractions. The errors resulting from each assumption are quantified. Assuming shift invariance leads to large errors near the patient surface. A “Corrected Convolution” method that reduces these errors was developed. Errors due to finite fractionation are large for very few fractions (hypofractionation), but are unlikely to impact treatment plan evaluation. The impact of geometric uncertainties for hypofractionated prostate cancer treatment is further explored. Hypofractionated treatments were simulated to quantify the impact of geometric uncertainties. The results suggest geometric uncertainties will not limit the clinical effectiveness of prostate hypofractionation. Convolution can assess the sensitivity of different techniques to geometric uncertainties. Simplified intensity modulated arc therapy plans were compared to conventional techniques. The magnitude of the change caused by geometric uncertainties varied by technique. Contrary to common assumptions, geometric uncertainties do not always result in a worse treatment than planned. In conclusion, existing methods to account for geometric uncertainties are limited. Modeling geometric uncertainties with convolution has the potential to improve clinical treatment decisions .
Visualization and Spectroscopy of a Metal-Molecule-Metal Bridge
Authors: Nazin G. V. , Qiu X. H. , Ho W.
Published: September 2003

Artificial nanostructures, each composed of a copper(II) phthalocyanine (CuPc) molecule bonded to two gold atomic chains with a controlled gap, were assembled on a NiAl(110) surface by manipulation of individual gold atoms and CuPc molecules with a scanning tunneling microscope. The electronic densities of states of these hybrid structures were measured by spatially resolved electronic spectroscopy and systematically tuned by varying the number of gold atoms in the chains one by one. The present approach provides structural images and electronic characterization of the metal-molecule-metal junction, thereby elucidating the nature of the contacts between the molecule and metal in this junction.
Neutralization of Measles Virus Infectivity and Antibody-Dependent Cell-Mediated Cytotoxicity Activity against an Epstein-Barr Virus-Infected Cell Line by Intravenous Administration of Immunoglobulin G
Authors: Colomar MariCarmen , Puga Irene , López Maite , Massot Marta , Jorquera Juan I. , Reina Manuel , Vilaró Senen , Espel Enric
Published: September 2003

Patients with antibody deficiency disorders are highly susceptible to microbial infections. Intravenous (i.v.) immunoglobulin concentrates were originally developed as replacement therapy for such patients. The present study assesses the measles virus neutralizing antibody titers and the antibody-dependent cell-mediated cytotoxicity (ADCC) capacities against Epstein-Barr virus (EBV)-infected cells of immunoglobulin G (IgG) preparations produced for i.v. use (i.v. IgG). The level of neutralizing antibodies against measles virus was determined by a syncytium neutralization test with Vero cells as targets. The measles virus neutralizing antibody titers of the i.v. IgG preparations were >3 × 10
2
and were an average of 1.0 log higher than the titers in pooled plasma from healthy subjects. The two IgG preparations tested showed similar ADCC activities against EBV-infected Raji cells, being active at concentrations of 3 mg/ml or higher. i.v. IgG bound to Raji cells but not to the EBV-negative Ramos cells, as evaluated by flow cytometry. Our in vitro findings may provide further support for the use of i.v. IgG for the prevention and treatment of infections caused by specific viral pathogens.
Detection of West Nile Virus (WNV)-Specific Immunoglobulin M in a Reference Laboratory Setting during the 2002 WNV Season in the United States
Authors: Prince Harry E. , Hogrefe Wayne R.
Published: September 2003

Between 1 June and 31 December 2002, 30,677 serum samples and 4,554 cerebrospinal fluid (CSF) samples were tested for West Nile virus (WNV)-specific immunoglobulin M (IgM) by an in-house enzyme-linked immunosorbent assay (ELISA); 1,481 serum samples (4.8%) and 345 CSF samples (7.6%) were positive for WNV IgM. Positive samples were forwarded to public health service laboratories (PHSLs) for further testing. PHSLs supplied results from their WNV IgM ELISAs for 654 samples; 633 (97%) were positive. PHSLs supplied WNV plaque reduction neutralization test results for 128 samples; 123 (96%) were positive. WNV IgM seroconversion and seroreversion trends were evaluated for 749 patients who each provided two serum samples that were tested during the study period. Of 574 patients whose first serum sample was IgM negative, 41 (7%) seroconverted (the second serum sample was IgM positive); of 175 patients whose first serum sample was IgM positive, 22 (13%) seroreverted (the second serum sample was IgM negative). The seroreversion rate was directly proportional to the time between serum sample collection; whereas only 1% of patients whose sera were collected <20 days apart showed seroreversion, 54% of patients whose sera were collected >60 days apart showed seroreversion. Conversion and reversion trends for CSF were evaluated for 68 patients. Of 54 patients whose first CSF specimen was IgM negative, 9 (17%) converted; none of 14 patients whose first CSF specimen was IgM positive reverted. Concomitant detection of WNV IgM in serum and CSF was assessed for 1,188 patients for whom paired serum and CSF specimens were available; for all 130 patients for whom IgM was detectable in CSF, IgM was also detectable in serum. These findings show that an in-house WNV IgM ELISA accurately identifies patients with WNV infection, document WNV IgM conversion and reversion trends, and demonstrate that WNV IgM detection in CSF is accompanied by WNV IgM detection in serum.
Monitoring Proteinase 3 Antineutrophil Cytoplasmic Antibodies for Detection of Relapses in Small Vessel Vasculitis
Authors: Segelmark Mårten , Phillips Brian D. , Hogan Susan L. , Falk Ronald J. , Jennette J. Charles
Published: September 2003

The clinical usefulness of antineutrophil cytoplasmic antibodies (ANCAs) in the monitoring of patients treated for small vessel vasculitis is debated. A capture enzyme-linked immunosorbent assay (ELISA) based on anti-proteinase 3 (anti-PR3) monoclonal antibody 4A3 has previously been proven to be superior to indirect immunofluorescence (IIF) and standard ELISA for the diagnosis of vasculitis. The present study compared the effectiveness of the capture ELISA for the detection of disease relapse. Samples from patients with relapses and remissions (relapse and remission samples, respectively) were identified through the database of the Glomerular Disease Collaborate Network. Twenty-one relapse samples and 49 remission samples were analyzed by the capture PR3-ANCA ELISA from Wieslab AB, the standard PR3-ANCA ELISA from Inova, and IIF. A Medline search was performed to identify published data on ANCA status at relapse. The capture ELISA was positive for 21 instances of relapses in 14 patients, while the standard ELISA and IIF each failed to detect 2 relapses (Pwas not significant). By using a higher cutoff value, the capture ELISA correctly categorized 84% of the remission samples and 81% of the relapse samples. Similar degrees of discrimination could be achieved by IIF but not by the standard ELISA. In previously published series, the median proportions of patients positive at relapse were 100% by IIF (range, 75 to 100%) and 86% by standard ELISA (range, 38 to 100%). The corresponding values for a rise that accompanied or preceded a relapse were 75% (range, 20 to 100%) for IIF and 50% (range, 25 to 81%) for ELISA. The capture PR3-ANCA ELISA is a sensitive tool for the detection of relapses. Larger studies are needed to detect differences between methods. Negative results by tests for ANCAs are rare during relapses.
Development and Evaluation of a Western Blot Kit for Diagnosis of Human Trichinellosis
Authors: Yera Hélène , Andiva Shakir , Perret Catherine , Limonne Denis , Boireau Pascal , Dupouy-Camet Jean
Published: September 2003

We evaluated industrially prepared Western blot strips designed to avoid the cross-reactions observed with indirect immunofluorescence and enzyme-linked immunosorbent assays used for the serodiagnosis of trichinellosis. The antigen preparations were crude extracts of
Trichinella spiralis
. The Western blot profile characteristic of trichinellosis was characterized by comparing 60 sera from patients infected by
Trichinella
to 11 sera from healthy subjects, 51 sera from patients with other proven parasitic diseases (cysticercosis, schistosomiasis, strongyloidosis, fascioliasis, toxocariasis, liver amebiasis, anisakiasis, filariasis, toxoplasmosis, hydatidosis, or malaria), and 23 sera from patients with autoantibodies. Specific 43- to 44-kDa and 64-kDa bands were obtained with all of the sera from 51 patients with acute trichinellosis, in 4 out of 9 patients at the early stages of the disease, and in only 1 control patient, who had suspected anisakiasis and in whom trichinellosis could not be ruled out by muscle biopsy.
Negative Immunodiffusion Test Results Obtained with Sera of Paracoccidioidomycosis Patients May Be Related to Low-Avidity Immunoglobulin G2 Antibodies Directed against Carbohydrate Epitopes
Authors: Neves Andréia R. , Mamoni Ronei L. , Rossi Cláudio L. , de Camargo Zoilo P. , Blotta Maria Heloísa S. L.
Published: September 2003

Immunodiffusion (ID) is the serologic test most frequently used for the diagnosis and posttherapy follow-up of patients with paracoccidioidomycosis (PCM). The ID test is highly specific (100%), but its sensitivity is relatively low (90%), leading to false-negative results. The aim of this study was to determine the profiles of antibodies in sera from patients with proven PCM and with negative results in the ID test (IDneg) versus positive results in the ID test (IDpos). We analyzed 46 sera from patients with active PCM for total immunoglobulin G (IgG) and IgG subclass responses toParacoccidioides brasiliensisgp43 antigen (treated or not treated with sodium metaperiodate) by enzyme-linked immunosorbent assay and immunoblotting. Immunoblotting showed that both IDnegand IDpossera recognized predominantly the gp43 fraction of theP.brasiliensisantigen used in the ID test. IDnegsera contain low-avidity antibodies, low levels of specific IgG (total) and IgG1, and high levels of IgG2 compared with IDpossera. The antibodies present in IDnegsera were predominantly directed against carbohydrate epitopes, since treatment with sodium metaperiodate resulted in a significant decrease in antibody reactivity. These data suggest that the lack of reactivity of sera from PCM patients in the ID test may be related to the production of low-avidity IgG2 antibodies directed against carbohydrate epitopes.
Molecular Inflammatory Responses Measured in Blood of Patients with Severe Community-Acquired Pneumonia
Authors: Fernández-Serrano Silvia , Dorca Jordi , Coromines Mercè , Carratalà Jordi , Gudiol Francesc , Manresa Frederic
Published: September 2003

In order to analyze the characteristics of the inflammatory response occurring in blood during pneumonia, we studied 38 patients with severe community-acquired pneumonia. Venous and arterial blood samples were collected at study entry and on days 1, 2, 3, 5, and 7 after inclusion. The concentrations of proinflammatory (tumor necrosis factor alpha [TNF-α], interleukin 1β [IL-1β], IL-6, and IL-8) and anti-inflammatory (IL-10) cytokines were determined in order to detect differences related to the origin of the sample, the causative organism, the clinical variables, and the final outcome of the episode.Legionellapneumonia infections showed higher concentrations of TNF-α, IL-6, IL-8, and IL-10. After 24 h, plasma IL-6, IL-8, and IL-10 concentrations in pneumococcal episodes increased, whereas in the same time interval, cytokine concentrations inLegionellaepisodes markedly decreased. The characteristics of the inflammatory response in bacteremic pneumococcal episodes were different from those in nonbacteremic episodes, as indicated by the higher plasma cytokine concentrations in the former group. Finally, our analysis of cytokine concentrations with regard to the outcome—in terms of the need for intensive care unit admittance and/or mechanical ventilation as well as mortality—suggests that there is a direct relationship between the intensity of the inflammatory response measured in blood and the severity of the episode.
Contribution of Serum Immunoglobulin Transudate to the Antibody Immune Status of Murine Intestinal Secretions: Influence of Different Sampling Procedures
Authors: Meckelein Barbara , Externest Dörthe , Schmidt M. Alexander , Frey Andreas
Published: September 2003

Serum immunoglobulin transudation into the murine gut after intragastric immunization with the model antigen ovalbumin and cholera toxin adjuvant was investigated with regard to the mucosal sampling technique applied. The levels of serum-derived immunoglobulin A (IgA) turned out to be lowest in feces, intermediate in gut lavage fluid specimens, and highest in filter wick-collected samples. However, these levels did not exceed 2% of total and specific IgA in any mucosal sample type, except after the administration of very high antigen doses (≥1 mg of antigen per g of body weight), when transudation rates of up to 31% could be measured in filter wick-collected samples from individual animals. Luminal IgG was plasma transudate and/or bile borne and appeared to be reabsorbed at the mucosa to some extent.
Systemic and Cutaneous Mucus Antibody Responses of Channel Catfish Immunized against the Protozoan ParasiteIchthyophthirius multifiliis
Authors: Maki Joanne L. , Dickerson Harry W.
Published: September 2003

Fish acquire protective immunity against the ciliated protozoan parasiteIchthyophthirius multifiliisfollowing sublethal infection or inoculation withI. multifiliisimmobilization antigens (i-antigens). In both cases, parasite-immobilizing antibodies have been identified in sera and mucosal secretions. To investigate the kinetics of this immune response, antibody levels were determined by enzyme-linked immunosorbent assay (ELISA) in the sera and cutaneous mucus of channel catfish (Ictalurus punctatus) that were either infected with parasites or given a single injection of purified i-antigen (5.0 μg/fish) in Freund's incomplete adjuvant. At 5 weeks, infected and inoculated fish had a mean serum (1:80 dilution) antibody absorbance (A405) value of 0.54 ± 0.17 and 0.35 ± 0.03, respectively, which were significantly higher (α = 0.05) than the pretreatment serum (1:80 dilution) antibody absorbance value of 0.24 ± 0.05. At 14 weeks, mean serum (1:80 dilution) ELISA absorbance values in the teo groups of fish increased to 0.79 ± 0.30 and 0.71 ± 0.24, respectively. In both groups of fish, antibody levels in cutaneous mucus (undiluted) were much lower than those in sera. Infected fish had detectable mucus (undiluted) antibody levels from 3 to 9 weeks, with the highest mean value (0.30 ± 0.07) occurring at 7 weeks. Although individual inoculated fish produced serum antibody absorbance values comparable to those seen in infected fish, the mean mucus antibody values in this group did not rise above pretreatment levels.I. multifiliisinfection induced a transient mucosal antibody response that coincided with the resolution of infection. Whether elicited by infection or intraperitoneal injection of i-antigen, the serum and mucus antibody responses of channel catfish immunized againstI. multifiliisdid not occur synchronously.
Periodontitis Is Associated with a Low Concentration of Vitamin C in Plasma
Authors: Pussinen Pirkko J. , Laatikainen Tiina , Alfthan Georg , Asikainen Sirkka , Jousilahti Pekka
Published: September 2003

This study aimed to clarify how concentrations of vitamin C in plasma relate to the serology of periodontitis. The random sample used comprised 431 men, 194 from Finland and 237 from Russia. The plasma vitamin C concentration was determined byo-phtaldialdehyde-fluorometry, and serum immunoglobulin G antibodies toActinobacillus actinomycetemcomitansandPorphyromonas gingivaliswere determined by a multiserotype enzyme-linked immunosorbent assay (ELISA). The mean plasma vitamin C concentration was higher (P< 0.001) in Finnish subjects (mean ± standard deviation, 4.5 ± 2.8 mg/liter) than in Russian subjects (1.4 ± 1.8 mg/liter). Mean antibody levels to bothA. actinomycetemcomitans(4.7 ± 3.6 versus 5.2 ± 3.1 ELISA units [P= 0.05]) andP. gingivalis(5.7 ± 2.5 versus 7.6 ± 2.9 ELISA units [P< 0.001]) were lower in Finnish men than in Russian men. In the combined Finnish and Russian population, the antibody levels toP. gingivaliswere negatively correlated with vitamin C concentrations (r= −0.22;P< 0.001); this association remained statistically significant (P= 0.010) in a linear regression model after adjustment for confounding factors. The proportion ofP. gingivalis-seropositive subjects decreased with increasing vitamin C concentrations (Pfor trend, <0.01), but no trend was seen amongA. actinomycetemcomitans-seropositive subjects. In conclusion,P. gingivalisinfection is associated with low concentrations of vitamin C in plasma, which may increase colonization ofP. gingivalisor disturb the healing of the infected periodontium.
Monoclonal Antibodies Reactive with Immunorecessive Epitopes of Glucuronoxylomannan, the Major Capsular Polysaccharide ofCryptococcus neoformans
Authors: Brandt Suzanne , Thorkildson Peter , Kozel Thomas R.
Published: September 2003

Cryptococcus neoformansis surrounded by an antiphagocytic capsule whose primary constituent is glucuronoxylomannan (GXM). An epitope shared by GXM serotypes A, B, C, and D is immunodominant when mice are immunized with serotype A GXM. In contrast, an epitope shared only by serotypes A and D is immunodominant when mice are immunized with serotype D. Hybridomas secreting antibodies reactive with subdominant epitopes were identified through a positive-negative screening procedure in which antibody-secreting colonies were characterized by reactivity with both the immunizing polysaccharide and GXMs from each of the four major serotypes. In this manner, a monoclonal antibody (MAb) that was reactive with an epitope shared only by serotypes A and B was identified and designated F10F5. Such an epitope has not been described previously. Immunization of mice with de-O-acetylated serotype A GXM generated a hybridoma that secreted an antibody, designated F12D2, that was reactive with all four serotypes. Unlike previously described monoclonal and polyclonal panspecific antibodies, the reactivity of MAb F12D2 was not altered by de-O-acetylation of GXM. These results indicate that there are at least two panspecific GXM epitopes; one epitope is dependent on O acetylation for antibody reactivity, and the other is independent of O acetylation. This study identifies strategies for production of MAbs that are reactive with subdominant or cryptic GXM epitopes and provides new information regarding the antigenic makeup and the humoral immune response to GXM, an essential virulence factor that is a target for active and passive immunization.
Development of a Polyclonal Competitive Enzyme-Linked Immunosorbent Assay for Detection of Antibodies to
Ehrlichia ruminantium
Authors: Sumption Keith J. , Paxton Edith A. , Bell-Sakyi Lesley
Published: September 2003

A polyclonal competitive enzyme-linked immunosorbent assay (PC-ELISA) is described for detection of antibodies to
Ehrlichia
(
Cowdria
)
ruminantium
by using a soluble extract of endothelial cell culture-derived
E. ruminantium
as the antigen and biotin-labeled polyclonal goat immunoglobulins as the competitor. For goats, the diagnostic sensitivity and specificity were both 100% with a cutoff of 80% inhibition (80 PI), with detection of antibodies for 550 days postinfection. For cattle, diagnostic sensitivity and specificity were 86 and 100%, respectively, with a cutoff of 50 PI and 79 and 100% with a cutoff of 70 PI. Cross-reactions with high-titer experimental or field antisera to other
Ehrlichia
and
Anaplasma
species were observed at up to 68 PI in cattle and up to 85 PI in sheep, and therefore to exclude these cross-reactions, cutoffs of 70 PI for bovine serology and 85 PI for small-ruminant serology were selected. Application of the PC-ELISA to bovine field sera from South Africa gave a higher proportion of positive results than application of the murine macrophage immunofluorescent antibody test or indirect ELISA, suggesting a better sensitivity for detection of recovered cattle, and results with bovine field sera from Malawi were consistent with the observed endemic state of heartwater and the level of tick control practiced at the sample sites. Reproducibility was high, with average standard deviations intraplate of 1.2 PI and interplate of 0.6 PI. The test format is simple, and the test is economical to perform and has a level of sensitivity for detection of low-titer positive bovine sera that may prove to be of value in epidemiological studies on heartwater.
Lipoteichoic Acid and Peptidoglycan fromStaphylococcus aureusSynergistically Induce Neutrophil Influx into the Lungs of Mice
Authors: Leemans Jaklien C. , Heikens Mirjam , van Kessel Kok P. M. , Florquin Sandrine , van der Poll Tom
Published: September 2003

Staphylococcus aureusis an important pathogen in nosocomial pneumonia. Lipoteichoic acid (LTA) and peptidoglycan (PepG) are part of the staphylococcal cell wall. Here we show that LTA and PepG act in synergy to cause polymorphonuclear cell recruitment in the pulmonary compartment duringS.aureuspneumonia.
RNA Binding Protein Sex-Lethal (Sxl) and Control of
Drosophila
Sex Determination and Dosage Compensation
Authors: Penalva Luiz O. F. , Sánchez Lucas
Published: September 2003

In the past two decades, scientists have elucidated the molecular
mechanisms
behind
Drosophila
sex determination and dosage compensation. These two processes are controlled essentially by two different sets of genes, which have in common a master regulatory gene,
Sex-lethal (Sxl). Sxl
encodes one of the best-characterized members of the family of RNA binding proteins. The analysis of different mechanisms involved in the regulation of the three identified Sxl target genes (
Sex-lethal
itself,
transformer, and male specific lethal-2)
has contributed to a better understanding of translation repression, as well as constitutive and alternative splicing. Studies using the
Drosophila
system have identified the features of the protein that contribute to its target specificity and regulatory functions. In this article, we review the existing data concerning Sxl protein, its biological functions, and the regulation of its target genes.
Repetitive Elements in Genomes of Parasitic Protozoa
Authors: Wickstead Bill , Ersfeld Klaus , Gull Keith
Published: September 2003

Repetitive DNA elements have been a part of the genomic fauna of eukaryotes perhaps since their very beginnings. Millions of years of coevolution have given repeats central roles in chromosome maintenance and genetic modulation. Here we review the genomes of parasitic protozoa in the context of the current understanding of repetitive elements. Particular reference is made to repeats in five medically important species with ongoing or completed genome sequencing projects:Plasmodium falciparum,Leishmania major,Trypanosoma brucei,Trypanosoma cruzi, andGiardia lamblia. These organisms are used to illustrate five thematic classes of repeats with different structures and genomic locations. We discuss how these repeat classes may interact with parasitic life-style and also how they can be used as experimental tools. The story which emerges is one of opportunism and upheaval which have been employed to add genetic diversity and genomic flexibility.
Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis
Authors: Bunn F , Collier T , Frost C , Ker K , Roberts I , Wentz R
Published: September 2003

Objective:To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries.

Design:Systematic review and meta-analysis.

Data sources:Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked.

Inclusion criteria:Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads.

Methods:Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model.

Findings:Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries.

Conclusion:Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries.
Injury and frequency of use of playground equipment in public schools and parks in Brisbane, Australia
Authors: Nixon J W , Acton C H C , Wallis B , Ballesteros M F , Battistutta D
Published: September 2003

Objective:The purpose of this study was to determine the frequency of use of play equipment in public schools and parks in Brisbane, Australia, and to estimate an annual rate of injury per use of equipment, overall and for particular types of equipment.

Methods:Injury data on all children injured from playground equipment and seeking medical attention at the emergency department of either of the two children’s hospitals in the City of Brisbane were obtained for the years 1996 and 1997. Children were observed at play on five different pieces of play equipment in a random sample of 16 parks and 16 schools in the City of Brisbane. Children injured in the 16 parks and schools were counted, and rates of injury and use were calculated.

Results:The ranked order for equipment use in the 16 schools was climbing equipment (3762 uses), horizontal ladders (2309 uses), and slides (856 uses). Each horizontal ladder was used 2.6 times more often than each piece of climbing equipment. Each horizontal ladder was used 7.8 times more than each piece of climbing equipment in the sample of public parks. Slides were used 4.6 times more than climbing equipment in parks and 1.2 times more in public schools.

The annual injury rate for the 16 schools and 16 parks under observation was 0.59/100 000 and 0.26/100 000 uses of equipment, respectively.

Conclusions:This study shows that annual number of injuries per standardized number of uses could be used to determine the relative risk of particular pieces of playground equipment. The low overall rate of injuries/100 000 uses of equipment in this study suggests that the benefit of further reduction of injury in this community may be marginal and outweigh the economic costs in addition to reducing challenging play opportunities.
Evaluation of North Carolina child care safety regulations
Authors: Kotch J B , Hussey J M , Carter A
Published: September 2003

Introduction:The goal of this study was to track any changes in injuries and injury hazards during the first 3.5 years of implementation of the North Carolina Child Care Commission’s 1996 playground safety regulations.

Methods:All reports (n=5402) of medically attended injuries in regulated child care settings in North Carolina during the period 1 January 1997 through 30 June 2000 were reviewed and analyzed. A total of 294 playground safety inspections were conducted in November and December 1998 in randomly selected North Carolina child care centers, and the playground safety inspections were repeated in 76 child care centers in August 2000. Finally, in 1999 a 1992 child care center director self assessment of safety features in classrooms was sent to the directors of 291 of the 294 centers.

Results:The annual rate of reported, medically attended injuries occurring in regulated child care facilities in North Carolina declined by 22% from 1997 to 1999. The playground safety inspections in the year 2000 revealed that, for nine of 10 playground concerns and 12 of 18 playground safety hazards, average ratings were equal to or better than those of 1998. Finally, the director surveys revealed no dramatic changes in classroom safety hazards since 1992.

Discussion:This study represents the first time that the authors are aware of that a significant decline in state-wide child care injury rates has been associated with improved regulation of playground safety in the US.
Identification of risk factors for non-fatal child injury in a rural area: Keokuk County Rural Health Study
Authors: Nordstrom D L , Zwerling C , Stromquist A M , Burmeister L F , Merchant J A
Published: September 2003

Objective:To identify risk factors for non-fatal injury among rural children.

Design:Cross sectional health interview survey, 1994–98.

Setting:A rural Iowa county, not adjacent to a metropolitan area.

Subjects:Stratified, random sample of households, including all resident children and adults.

Main outcome measures:Injury episodes in the past 12 months among children aged 0–17 years and the parental and child characteristics associated with these episodes.

Results:Of the 621 children in participating households, 137 or 22.1% were injured during the past 12 months. Children age 5–17 on a sports team were 1.88 times (95% confidence interval (CI) 1.07 to 3.31) more likely than other children to be injured. Children age 12–17 who binge drink were 3.50 times (95% CI 1.31 to 9.50) more likely than other children to be injured. Compared with children not on sports teams, girls on teams were 2.26 times (95% CI 1.02 to 5.13) more likely while boys on teams were 1.60 times (95% CI 0.71 to 3.68) more likely to have an injury episode. Compared with children who did not binge drink, girls binge drinking were 8.11 times (95% CI 1.52 to 43.33) more likely while boys binge drinking were 2.19 times (95% CI 0.70 to 6.84) more likely to have an injury episode.

Conclusions:Local studies such as this can provide useful clues regarding the etiology of injury. Some known and some new potential risk factors including behavioral aspects for childhood non-fatal injury in a very rural area were investigated. It is planned to address these cross sectional findings in future longitudinal follow up of this population.
Development of a multidisciplinary method to determine risk factors for arm fracture in falls from playground equipment
Authors: Sherker S , Ozanne-Smith J , Rechnitzer G , Grzebieta R
Published: September 2003

Objectives:To present the development of a novel multidisciplinary method to investigate physical risk factors for playground related arm fracture.

Rationale:Previous playground injury research has been limited in its ability to determine risk factors for arm fractures, despite their common and costly occurrence. Biomechanical studies have focused exclusively on head injury. Few epidemiological studies have quantified surface impact attenuation and none have investigated specific injury outcomes such as arm fracture.

Design:An unmatched case-control study design was developed. An instrumented child dummy and rig were designed to simulate real playground falls in situ. Validated output from the dummy was used to quantify arm load. Other field measurements included equipment height, fall height, surface depth, headform deceleration, and head injury criterion.

Discussion:Validated methods of biomechanics and epidemiology were combined in a robust design. The principle strength of this method was the use of a multidisciplinary approach to identify and quantify risk and protective factors for arm fracture in falls from playground equipment. Application of this method will enable countermeasures for prevention of playground related arm fracture to be developed.
Press coverage of public expenditure of Master Settlement Agreement funds: how are non-tobacco control related expenditures represented?: Table 1
Authors: Clegg Smith K M , Wakefield M A , Nichter M
Published: September 2003

Objective:To examine newspaper reports of Master Settlement Agreement (MSA) allocation decisions outside of tobacco control, focusing on the arguments being put forth in favour of competing claims on MSA funds. The major aims were to identify newsworthy non-tobacco control areas for which MSA funds have been applied and to examine how non-tobacco control spending has been presented through the US press.

Design:A qualitative textual analysis was performed on 94 articles taken from a sample of 322 newspapers over a 12 month period (October 2000 through September 2001) that related to the allocation of MSA funds to non-tobacco control causes. Articles were coded for general content areas of MSA allocation as well as for rhetorical and framing devices employed to explain and justify allocation decisions.

Main outcome measures:(1) Areas of non-tobacco control allocation; (2) rhetorical devices and framing techniques employed in the articles to discuss the allocation.

Results:The analysis identified a wide variety of issues for which MSA funds were being appropriated. Three main frames emerged in relation to justifying or appealing for particular spending decisions: (1) funds should be allocated to the needy and/or the deserving; (2) funds should be spent on state development; (3) funds should be put towards helping the state weather a crisis. Claims for each such issue were made using strategies such as presenting the MSA funds as a “windfall”, focusing coverage on the merits of the cause rather than the issue of resource allocation, and stressing links between the particular claim and the stated objectives of the MSA.

Conclusions:Press coverage of MSA non-tobacco control spending suggests that the funds have been quickly formulated as fodder for state spending, rather than to support tobacco control efforts. Thus, caution is required in pursuing settlements with the industry where the objective is better funding for tobacco control efforts, particularly in light of the possibility that press coverage of MSA allocation may actually serve as positive publicity for the tobacco industry.
British Columbia capital regional district 100% smokefree bylaw: a successful public health campaign despite industry opposition: Table 1
Authors: Drope J , Glantz S
Published: September 2003

Objective:To describe how the British Columbia Capital Regional District successfully passed, implemented, and enforced a 100% smokefree bylaw in all public places, including restaurants and bars, despite an aggressive campaign by the tobacco industry (acting through the hospitality industry) to stop it.

Methods:Information was obtained from news reports, internal tobacco industry documents, reports, public documents, and interviews with key players. Tobacco industry documents were accessed between February and April 2002. This project was approved by the University of California San Francisco committee on human research.

Results:As in the USA and elsewhere in the world, the tobacco industry in British Columbia, Canada, recruited and created hospitality associations to fight against the district smokefree bylaw. They used the classic industry rhetoric of individual rights and freedoms, economic devastation, and ventilation as a solution. Public health authorities were able to counter industry strategies with a strong education campaign, well written bylaws, and persistent enforcement.

Conclusion:It is possible to overcome serious opposition orchestrated by the tobacco industry and develop and implement a 100% smokefree bylaw in Canada. Doing so requires attention to detail in drafting the bylaw, as well as a public education campaign on the health dangers of secondhand smoke and active enforcement to overcome organised resistance to the bylaw. Jurisdictions considering smokefree bylaws should anticipate this opposition when developing and implementing their bylaws.
Perceived importance of being thin and smoking initiation among young girls
Authors: Honjo K , Siegel M
Published: September 2003

Background:Smoking among adolescents remains unacceptably high and the difference in potential risk factors for smoking initiation between male and female adolescents has been explored. Although the association between smoking initiation and dieting behaviour has been observed among girls, the mechanism of the association is unknown.

Objective:To examine prospectively the association between perceived importance of being thin at baseline and smoking initiation among girls.

Design:A four year prospective cohort survey including perceived importance of being thin at baseline and smoking behaviour, conducted in 1993 and 1996.

Setting and participants:273 Massachusetts female adolescents aged 12–15 years at baseline who reported having smoked no more than one cigarette by the time of the baseline survey, drawn from households sampled by random digit dialling.

Main outcome measure:Progression to established smoking, defined as having smoked 100 or more cigarettes in their lifetime.

Results:After adjusting for age, smoking status at baseline, and race/ethnicity, girls who valued thinness most strongly and somewhat strongly were both more likely to have become established smokers, compared to the girls who valued thinness least strongly. The odds ratios are 4.5 (95% confidence interval (CI), 1.4 to 16.7) and 3.4 (95% CI 1.04 to 10.9), respectively.

Conclusions:The level of perceived importance of being thin among young female adolescents predicts future smoking initiation. Smoking prevention programmes designed for female adolescents may therefore benefit from the inclusion of content related to importance of being thin.
The St-Louis du Parc Heart Health Project: a critical analysis of the reverse effects on smoking
Authors: Renaud L , O’Loughlin J , Déry V
Published: September 2003

Objectives:Although some school based smoking prevention programmes have shown positive impacts, others have had only short term effects, no effects, and in some cases reverse effects. The St-Louis du Parc Heart Health Project was a five year heart health promotion programme targeting children in eight elementary schools aged 9–12 years in disadvantaged multiethnic neighbourhoods in Montreal. In a controlled, longitudinal evaluation, the programme produced reverse effects on smoking—children exposed to the programme were more likely to initiate and to continue smoking than control children. This article explores hypotheses to explain the reverse effects.

Design:Following work by an in-house committee, a consensus workshop with international experts was conducted to develop hypotheses to explain the reverse effects. This was complemented by an analysis of the programme’s concordance with the standard guidelines on the school based prevention of tobacco use, and discussions with experts at the Centers for Disease Control and Prevention.

Results:The programme respected most standard guidelines for smoking prevention programmes with respect to content and mode of delivery. Hypotheses to explain the reverse effects include: an unfavourable environment characterised by strong pro-smoking models and resistance to environmental interventions; heightened sensitivity to smoking among children most exposed to the programme; defence mechanisms among children stimulated by cognitive dissonance or anxiety; unanticipated effects associated with the health educator who delivered the programme; inadequate attention in programme development to the diverse cultural origins of the population targeted; and intervention content inappropriately targeted to children’s stages of cognitive development.

Conclusion:Elementary school based interventions should aim to develop a clear and coherent social norm about the non-use of tobacco, as a precursor to or in close conjunction with having children as their primary target. Programme design should take key student characteristics into consideration and ensure that the modes of communication are adapted to the targeted group’s characteristics. Neighbourhood level interventions should be orchestrated to complement regional, provincial, and national programmes.
Tobacco specific nitrosamines and potential reduced exposure products for smokers: a preliminary evaluation of Advance™
Authors: Breland A B , Acosta M C , Eissenberg T
Published: September 2003

Objective:To develop a method for evaluating the carcinogen delivery of potential reduced exposure products (PREPs) like Advance™, a PREP marketed to reduce smokers’ exposure to one tobacco specific nitrosamine (TSN), NNK, a potent lung carcinogen.

Design, setting, and participants:Latin square ordered, three condition, outpatient, crossover design with 12 smokers of light or ultra-light cigarettes (15 or more cigarettes/day). In each five day condition, participants either smoked own brand, Advance™, or no cigarettes. Also, on the first and last day of each condition, participants smoked one cigarette in the laboratory.

Main outcome measures:Subject rated measures of tobacco/nicotine withdrawal, expired air carbon monoxide, urine concentrations of cotinine and NNAL (one TSN biomarker), puff volume, duration, number, and interpuff interval.

Results:Relative to own brand, Advance™ produced similar withdrawal suppression, slightly lower carbon monoxide, equivalent cotinine, and 51% lower NNAL concentrations. The lowest cotinine and NNAL concentrations were observed in the no cigarette condition. Participants took fewer puffs when smoking Advance™.

Conclusions:Past experience with PREPs that failed to reduce smoking’s harm demonstrates the need for clinical methods in PREP evaluation. This study shows how assessing PREP induced changes in withdrawal and exposure to carbon monoxide, nicotine, and carcinogens may help predict PREP harm reduction potential. Adequate withdrawal suppression, slightly lower concentrations of carbon monoxide, and reduction of one TSN biomarker were observed for Advance™. In the future, clinical methods like those described here may be valuable for evaluating PREPs before they are marketed publicly.
Arbuscular mycorrhizal responsiveness of in vitro tomato root lines is not related to growth and nutrient uptake rates
Authors: Labour Karine , Jolicoeur Mario , St-Arnaud Marc
Published: September 2003

Variability in growth and nutritional dynamics of in vitro tomato hairy root lines and their relationship with responsiveness to mycorrhizal colonization were studied. Four tomato cultivars were transformed with three Agrobacterium rhizogenes strains to obtain several hairy root lines, which were compared for growth and receptivity to Glomus intraradices. Four transformed hairy root lines were further characterized and compared with excised roots of the nontransformed tomato cultivar 'Cobra' and with Ri-T-DNA carrot hairy roots. Lines were compared during 4 months on minimal medium in terms of growth, nutrient uptake, and mycorrhizal colonization. In a subexperiment, the cultures were grown on a modified minimal medium to assess the contribution of initial inorganic phosphate concentration in mycorrhizal susceptibility of the three initially nonreceptive lines. On minimal medium, growth and nutrient uptake rates were highly correlated, but both were unrelated to mycorrhizal receptiveness. All the lines successfully established the symbiosis when the initial phosphate concentration was significantly reduced. No association was found between the origin of lines from the different tomato cultivar  bacterial strain combinations and the absence of symbiosis establishment on minimal medium. Decrease of inorganic phosphate concentration at the beginning of the culture was a key factor involved in precolonization steps of mycorrhizal symbiosis.Key words: Glomus intraradices, hairy roots, Lycopersicon esculentum, mycorrhizal responsiveness, root nutrition, inorganic phosphate.
Changes in forest floor bryophyte (moss and liverwort) communities 4 years after forest harvest
Authors: Fenton Nicole J , Frego Katherine A , Sims Mary R
Published: September 2003

Forest harvest presents a potential threat to forest floor bryophyte communities primarily through alteration of the microclimate and disturbance of substrates on the forest floor. Management, including harvest, applied at the landscape scale creates patches of disturbance of differing severities at the spatial scale experienced by bryophytes. Presumably, bryophyte diversity in managed landscapes is best conserved by forest harvest techniques that minimize community change, thereby allowing disturbed communities to reassemble to approach predisturbance composition. We monitored bryophyte community reassembly by sampling quadrats established in a 54-ha management block of Acadian forest in New Brunswick, before and after harvest. Quadrats were either in unharvested areas, or experienced a range of disturbance severities from removal of some or all canopy, to forest floor disturbance with complete canopy removal. Bryophyte communities showed compositional change over 4 years, even in areas that were not harvested. Although species richness was maintained or recovered 4 years after harvest, changes in species composition were significant in all disturbance classes with greatest change related to forest floor disturbance. In particular, liverworts were lost in areas with forest floor disturbance. We suggest that the simplest method to reduce immediate species loss, and presumably promote conservation of bryophyte communities within managed forest landscapes, is to utilize techniques that reduce the area of forest floor and associated substrates that are physically disrupted.Key words: bryophyte, community change, disturbance, forest harvest, monitoring.