bluuebunny/crossref_metadata_2025 huggingface dataset:
Conservation of Species in Dynamic Landscapes: Divergent Fates ofSilene tataricaPopulations in Riparian Habitats
Authors: JÄKÄLÄNIEMI ANNE , TUOMI JUHA , SIIKAMÄKI PIRKKO
Published: February 2006

Abstract: In transient environments, where local extinctions occur as a result of destruction or deterioration of the local habitat, the long‐term persistence of a species requires successful colonizations at new, suitable sites. This kind of habitat tracking should be associated with the asynchronous dynamics of local populations, and it can be especially important for the conservation of rare plant species in riparian habitats. We determined spatiotemporal variation in the demography of the perennialSilene tatarica(L.) Pers. in 15 populations (1998–2003) located in periodically disturbed riparian habitats. The habitats differed according to their morphology (flat shores, slopes) and the amount of bare ground (open, intermediate, closed) along a successional gradient. We used elasticity and life‐table response analyses and stochastic simulations to study the variation in population demography. Finite population growth rate was higher in intermediate habitats than in open and closed habitats. In stochastic simulations population size increased in most cases, but four populations were projected to become extinct within 12–70 years. The viability of local populations depended most on the survival and growth of juvenile individuals and on the fecundity of large fertile individuals. On a regional scale, the persistence of this species will require a viable network of local populations as protection against local extinctions caused by natural disturbances and succession. Accordingly, the long‐term persistence of riparian species may depend on habitat changes; thus, their conservation requires maintenance of natural disturbance dynamics. Along regulated rivers, management activities such as the creation of open habitats for new colonization should be implemented. Similarly, these activities can be rather general requirements for the conservation of endangered species dependent on transient habitats along successional gradients.
Modeling the Effect of Population Dynamics on the Impact of Rabbit Hemorrhagic Disease
Authors: CALVETE CARLOS
Published: February 2006

Abstract: The European wild rabbit (Oryctolagus cuniculus) is a staple prey species in Mediterranean ecosystems. The arrival and subsequent spread of rabbit hemorrhagic disease throughout southwestern Europe, however, has caused a decline in rabbit numbers, leading to considerable efforts to enhance wild rabbit populations, especially through habitat management. Because rabbit population dynamics depend on habitat suitability and changes in habitat structure and composition subsequent to habitat management, I evaluated the effects of population dynamics on the long‐term impact of rabbit hemorrhagic disease on rabbit populations. I used an age‐structured model with varying degrees of population productivity and turnover and different habitat carrying capacities, and I assumed the existence of a unique, highly pathogenic virus. My results suggest that disease impact may be highly dependent on habitat carrying capacity and rabbit population dynamics, and the model provided some insight into the current abundance of wild rabbits in different locations in southwestern Europe. The highest disease impact was estimated for populations located in habitats with low to medium carrying capacity. In contrast, disease impact was lower in high‐density populations in habitats with high carrying capacity, corresponding to a lower mean age of rabbit infection and a resulting lower mortality from rabbit hemorrhagic disease. The outcomes of the model suggest that management strategies to help rabbit populations recover should be based on improving habitats to their maximum carrying capacity and increasing rabbit population productivity. In contrast, the use of strategies based on temporary increases in rabbit density, including vaccination campaigns, translocations, and temporal habitat improvements at medium carrying capacities, may increase disease impact, resulting in short‐term decreases in rabbit population density.
Implementation of peripheral blood CD34 analyses to initiate leukapheresis: marked reduction in resource utilization
Authors: Meehan Kenneth R. , Hill John M. , Patchett Linda , Webber Susan M. , Wu Jillian , Ely Pamela , Szczepiorkowski Zbigniew M.
Published: February 2006

BACKGROUND:  Analysis of the peripheral blood (PB) C34 value may determine the optimal time to initiate leukapheresis.

STUDY DESIGN AND METHODS:  After selecting a threshold PB CD34 value of five CD34 + cells per µL to initiate leukapheresis procedure, a prospective analysis of 50 consecutive patients was initiated to identify the optimal time to initiate leukapheresis and its impact on costs and resource utilization. Clinical decisions were made to commence or to postpone leukapheresis with this PB CD34 threshold number. Based on PB CD34 values for each patient, the number of leukapheresis procedures, postponed or canceled, the number of CD34+ cells per kg, and the total number of cells collected were identified. Costs of mobilization were obtained from the hospital cost accounting system.

RESULTS:  In 13 months, 50 patients with a hematologic disorder underwent mobilization. There were 34 cancellations or postponements of collections due to a low PB CD34 value in 13 patients. By use of our identified costs per initial collection, this resulted in a savings of $67,660.

CONCLUSIONS:  This prospective study defines how the implementation of the PB CD34 value results in costs savings. A low PB CD34 value canceled or postponed a significant number of leukapheresis procedures, resulting in a substantial cost savings. Use of the PB CD34 value should be the standard of care during mobilization and peripheral blood progenitor cell collection.
A Sequential Stratification Method for Estimating the Effect of a Time‐Dependent Experimental Treatment in Observational Studies
Authors: Schaubel Douglas E. , Wolfe Robert A. , Port Friedrich K.
Published: February 2006

SummarySurvival analysis is often used to compare experimental and conventional treatments. In observational studies, the therapy may change during follow‐up and such crossovers can be summarized by time‐dependent covariates. Given the ever‐increasing donor organ shortage, higher‐risk kidneys from expanded criterion donors (ECD) are being transplanted. Transplant candidates can choose whether to accept an ECD organ (experimental therapy), or to remain on dialysis and wait for a possible non‐ECD transplant later (conventional therapy). A three‐group time‐dependent analysis of such data involves estimating parameters corresponding to two time‐dependent indicator covariates representing ECD transplant and non‐ECD transplant, each compared to remaining on dialysis on the waitlist. However, the ECD hazard ratio estimated by this time‐dependent analysis fails to account for the fact that patients who forego an ECD transplant are not destined to remain on dialysis forever, but could subsequently receive a non‐ECD transplant. We propose a novel method of estimating the survival benefit of ECD transplantation relative to conventional therapy (waitlist with possible subsequent non‐ECD transplant). Compared to the time‐dependent analysis, the proposed method more accurately characterizes the data structure and yields a more direct estimate of the relative outcome with an ECD transplant.
The Politics of Vulnerability: Constructing Local Performance Regimes for Homeland Security
Authors: Clarke Susan E. , Chenoweth Erica
Published: February 2006

Paradoxically, the greater the national security threats, the more important the role of local policy in the United States. In this article we examine homeland security initiatives—particularly the tension between risk and vulnerability—and the governance dilemmas they pose for local communities. In contrast to the usual emphasis on coordination and capacity, we argue for conceptualizing local imperatives attendant to homeland security as collective action problems requiring the construction of local performance regimes. Performance regimes must engage three challenges: (1) to enlist diverse stakeholders around a collective local security goal despite varying perceptions of its immediacy; (2) to persuade participants to sustain their involvement in the face of competing demands, and (3) to create a durable coalition around performance goals necessary for reducing local vulnerability. Using these analytic categories casts local homeland security issues in strategic terms; it also encourages comparisons of local governance arrangements to respond to risk and vulnerability.
Assessing Instrument Mixes through Program‐ and Agency‐Level Data: Methodological Issues in Contemporary Implementation Research
Authors: Howlett Michael , Kim Jonathan , Weaver Paul
Published: February 2006

Theories of policy instrument choice have gone through several “generations” as theorists have moved from the analysis of individual instruments to comparative studies of instrument selection and the development of theories of instrument choice within implementation “mixes” or “governance strategies.” Current “next generation” theory on policy instruments centers on the question of the optimality of instrument choices. However, empirically assessing the nature of instrument mixes is quite a complex affair, involving considerable methodological difficulties and conceptual ambiguities related to the definition and measurement of policy sector and instruments and their interrelationships. Using materials generated by Canadian governments, this article examines the practical utility and drawbacks of three techniques used in the literature to inventory instruments and identify instrument ecologies and mixes: the conventional “policy domain” approach suggested byBurstein (1991); the “program” approach developed byRose (1988a); and the “legislative” approach used byHosseus and Pal (1997). This article suggests that all three approaches must be used in order to develop even a modest inventory of policy instruments, but that additional problems exist with availability and accessibility of data, both in general and in terms of reconciling materials developed using these different approaches, which makes the analysis of instrument mixes a time‐consuming and expensive affair.
Area Poverty Effects on Local Health Care Costs: An Analysis of Mississippi
Authors: Roberts Brandon
Published: February 2006

This article examines the relationship of area medical costs and poverty in Mississippi. Using a fixed‐effects model and Medicare expenditures, the results indicate that an addition of one percentage point in area poverty increases expected per enrollee expenditures by 0.90%. These figures imply that successful poverty amelioration efforts could yield substantial reductions in medical costs over time. The estimates suggest that a one‐percentage‐point reduction in poverty could accrue to a statewide savings of $510 million in medical costs over a 5‐year time period.
Considering Knowledge Uptake within a Cycle of Transforming Data, Information, and Knowledge
Authors: Michaels Sarah , Goucher Nancy P. , McCarthy Dan
Published: February 2006

Knowledge uptake, having decision makers assimilate the ideas of experts, is recognized as an important stimulus to bringing about policy change. This is particularly true in the realm of environmental policymaking, which is characterized by knowledge intensity, complexity, and multifaceted concerns. Using examples from an innovative watershed management organization, this article presents a heuristic for understanding how knowledge uptake occurs within a cycle of organizational reasoning. This cycle is driven by activities that transform data, information, and knowledge and that link specialists with decision makers. The heuristic can be used as a diagnostic tool to identify breaks in the transformation process that impede mandate fulfillment and impair capacity building. Lack of appreciation of the dynamic relationship between data, information and knowledge leads to mistimed and ineffective policy interventions that do not result in the hoped for progress in science intended to underpin policy advances.
Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation
Authors: Raslan Nabih , Wetzel Willi‐Eckhard
Published: February 2006

Abstract –  The aim of this study was to compare the pulpal reactions after exposure due to trauma and/or caries and to suggest the appropriate treatment options for the management of pulp, in the light of the histological findings in the primary teeth. Fifteen primary maxillary incisors with pulpal exposure were examined with light microscope in a blind study. After the histological evaluation, teeth were divided into three groups for the etiological factors due to the exposure according to the patient's files: trauma group, caries group and caries and trauma group. The inflammatory infiltration was diminished from the pulp chamber towards the apical third of the root canal in all of the examined teeth. Teeth in the trauma group presented fewer inflammatory cells in the root canal in comparison with other groups. It was concluded that the teeth with traumatic pulp exposure were considered as more likely to respond positively to pulpotomy technique. Pulpectomy or extraction seemed to be indicated for the decayed or decayed and traumatically injured teeth.
Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA
Authors: Andreasen Jens Ove , Munksgaard Erik Christian , Bakland Leif K.
Published: February 2006

Abstract –  Thirty immature sheep incisor teeth were tested for their fracture resistance after various treatment modalities using calcium hydroxide (CH) or a mineral trioxide aggregate material (MTA®) as a root filling. The incisors, having approximately 80% of their root growth completed, were removed from jaws of slaughtered sheep and divided into four experimental groups. The pulps were extirpated from all the teeth through the open apexes. (a) Saline group: the teeth were preserved in saline for 100 days at 6°C. (b) CH group: the root canals were filled with CH and sealed apically with IRM® and stored as above. (c) MTA® group: the canals were filled with MTA® and stored as above. (d) CH + MTA® group: the canals were filled with CH and sealed with IRM®. After 30 days, the CH was replaced with MTA® and stored as above. At the end of the 100‐day storage period, all teeth were embedded in plaster of Paris and tested for fracture strength at the cervical area in an Instron® testing machine. The results showed a decrease in fracture resistance (a) of the incisors with CH in the root canals after 100 days of storage, compared to (b) teeth stored in intracanal saline and (c) teeth with 30 days of CH and then filled with MTA®, and (d) those filled with MTA in the canals. In conclusion, when CH was kept in the canals of immature sheep teeth for only 30 days followed by root filling with MTA® there was no significant decrease in strength of the root within an observation period of 100 days. This finding may be of importance in the decision of treatment plans for teeth with pulp necrosis and immature root formation.
Dissecting Damages: An Empirical Exploration of Sexual Harassment Awards
Authors: Sharkey Catherine M.
Published: February 2006

My empirical study first replicates and then extends a prior preliminary empirical study by Cass Sunstein and Judy Shih of sexual harassment damages awards. It covers a comprehensive set of 232 cases in which plaintiffs won some positive amount of compensatory damages from state and federal, trial and appellate court decisions from 1982–2004 (published either in official reporters or solely on Westlaw). Contrary to Sunstein and Shih's finding, my analysis of these data reveals a consistent, and statistically significant, positive relationship between punitive and compensatory damages (at least in cases where punitive damages are awarded). My new empirical study then employs dependent variables that, in my view, are more theoretically and statistically sound than those employed by Sunstein and Shih and others who have focused exclusively on the relationship between punitive and compensatory damages: total combined damages (i.e., all compensatory and punitive damages), and what I term “outrage” damages, or combined noneconomic compensatory and punitive damages. My empirical results, using these new dependent variables, essentially confirm Sunstein and Shih's conclusions regarding the irrelevance of variables pertaining to the nature and severity of harassment. What my study reveals as crucial predictive factors, by contrast, are factors pertaining to damages limitations. My study highlights that these factors—including the effect of the 1991 Civil Rights Act, and whether plaintiffs append state civil rights and tort claims to their Title VII claims—are critical to a fuller understanding of damages determinations in sexual harassment cases.
Surgical Technique to Maintain Penile Length After Insertion of an Inflatable Penile Prosthesis via Infrapubic Approach
Authors: Borges Fernando , Hakim Lawrence , Kline Cliff
Published: February 2006

Introduction

The aim of this study was to provide an overview of the principal author's experience in maintaining penile length after implantation of a three-piece inflatable penile prosthesis (IPP). For many patients with erectile dysfunction, who choose surgical treatment, loss of penile length after implantation of an IPP is a common concern. In the principal author's experience, release of the suspensory ligament during IPP implant surgery can maintain penile length, alleviating this concern.

Methods

After implantation with an IPP, the principal author released the patient's suspensory ligament.

Main Outcome Measures

The main outcome measure was patient satisfaction with penile length after IPP surgery. A second outcome measure was a substudy measuring the patient's penile length after IPP implantation both before and after suspensory ligament release.

Results

From August 1997 through September 2002, the principal author implanted a total of 303 Alpha 1 IPPs into men who suffered from erectile dysfunction (ED). All had their suspensory ligament released. Postoperative complications were minimal and for the most part transitory. Ninety-three percent reported satisfaction with IPP performance, penile length, and willingness to undergo the IPP surgery again. None of the patients reported penile shortening, with some of them reporting an increase in penile length, as compared with preoperative measurements.

Conclusion

Release of the suspensory ligament appears to maintain or even increase penile length, with a minimum of complications, and a high degree of patient satisfaction.
Differences Between Candesartan and Hydralazine in the Protection of Penile Structures in Spontaneously Hypertensive Rats
Authors: Mazza Osvaldo Néstor , Angerosa Margarita , Becher Edgardo , Toblli Jorge Eduardo
Published: February 2006

Introduction

Previous studies indicate that angiotensin type I receptor antagonists present a beneficial effect on penile structures in hypertensive rats. However, at present there is no substantial information concerning the functional aspect of this class of antihypertensive drugs.

Aim

To determine, by in vitro studies, functional effects of Candesartan in comparison with a traditional vasodilating agent, Hydralazine, on penile structures in a rat model of arterial hypertension.

Methods

During 4 months, three groups of male spontaneously hypertensive rats (SHR) and one of Wistar–Kyoto (WKY) rats, as control group, were studied: SHR without treatment; SHR with Candesartan cilexetil 7.5 mg/kg/day; SHR with Hydralazine 50 mg/kg/day; and WKY rats without treatment. Cavernous smooth muscle strips were mounted in an organ bath system for in vitro studies. In addition, cavernous smooth muscle and vascular smooth muscle from cavernous arteries, cavernous tissue fibrosis, and collagen type III were also evaluated by immunohistochemistry.

Results

After 4 months, SHR with Candesartan and Hydralazine showed similar reduction in blood pressure compared with untreated SHR. However, in vitro studies revealed that SHR with Candesartan displayed a better relaxation response to acetylcholine than SHR and SHR with Hydralazine (P < 0.01). Immunostaining indicates that only SHR with Candesartan and control WKY rats showed significantly lower values of: (i) cavernous smooth muscle (P < 0.01); (ii) vascular smooth muscle (P < 0.01); and (iii) collagen type III (P < 0.01) when compared with untreated SHR or SHR with Hydralazine. Additionally, SHR with Candesartan presented a higher endothelial nitric oxide synthase expression in sinusoidal endothelium in comparison with SHR, and SHR with Hydralazine (P < 0.01).

Conclusion

Candesartan presented equivalent blood pressure control compared with Hydralazine. However, only Candesartan showed a significant better response to acetylcholine, in in vitro studies, with a protective role against structural changes in vessels as well as in cavernous spaces of the erectile tissue.
Chocolate and Women's Sexual Health: An Intriguing Correlation
Authors: Salonia Andrea , Fabbri Fabio , Zanni Giuseppe , Scavini Marina , Fantini Gemma Viola , Briganti Alberto , Naspro Richard , Parazzini Fabio , Gori Enzo , Rigatti Patrizio , Montorsi Francesco
Published: February 2006

Introduction

Historically chocolate has been reported to exert several effects on human sexuality, mainly acting as an effective aphrodisiac, increasing sexual desire, and improving sexual pleasure.

Aim

The aim of our study was to assess whether there is an association between daily chocolate intake and sexual function in a convenience sample of Northern Italian women.

Methods

A convenience sample of 163 women (mean ± SD age: 35.3 ± 9.2 years; body mass index [BMI]: 22.5 ± 3.5 kg/m2), recruited through advertising, completed an anonymous semistructured interview on recreational habits and questionnaires to assess sexual function (Female Sexual Function Index [FSFI]), sexual distress (Female Sexual Distress Scale), and depression (Beck Depression Inventory and Center for Epidemiological Survey Depression Scale).

Results

Complete data were available for 153/163 (93.8%) women. Participants who reported daily chocolate intake (Group 1: 120 women) were significantly younger than those (Group 2: 33 women) who did not report to eat chocolate (33.9 ± 0.8 years vs. 40.4 ± 1.6 years, respectively) (P = 0.0003), despite a similar BMI. Participants in Group 1 had significantly higher total (P = 0.002) and desire domain (P = 0.01) FSFI scores than participants in Group 2. No differences between the two groups were observed concerning sexual arousal and satisfaction, sexual distress and depression. Our data also confirm that aging has a high statistically significant impact on women's sexual function.

Conclusions

It is alluring to hypothesize that chocolate can have either a psychological or a biological positive impact on women's sexuality. In our sample women reporting chocolate consumption have higher FSFI scores than women who do not eat chocolate. However, when data are adjusted for age FSFI scores are similar, regardless of chocolate consumption.
Transverse colon rupture in a young footballer: Figure 1
Authors: Dutson S C M
Published: February 2006

The case is reported of a 16 year old footballer who sustained a blunt abdominal injury resulting in traumatic rupture of the transverse colon and transverse process of L1.
Influence of intermittent anaerobic exercise on mouse physical endurance and antioxidant components
Authors: Qiao D , Hou L , Liu X
Published: February 2006

Objective:To determine the effect of intermittent anaerobic exercise on physical endurance, antioxidant capacity, and lipid peroxidation of brain, heart, and skeletal muscles in mice.

Methods:Mice were made to perform intermittent (with short or long rest intervals) anaerobic swimming on six consecutive days. Body weight was monitored. Tissue total antioxidant capacity (T-AOC), superoxide dismutase (SOD), and thiobarbituric acid reaction substance (TBARS) were determined on the 2nd, 4th, and 6th day. Physical endurance was determined on day 7 by using an exhaustive swimming test and a static grasping test.

Results:The intermittent anaerobic exercise resulted in decreased growth rate and physical endurance capacity, as indicated by less weight gain and shorter time to exhaustion during the exhaustive swimming and static grasping test (p<0.05). It also led to a higher T-AOC in muscle, heart, and brain, higher SOD activity in muscle and heart, and higher TBARS content in muscle (p<0.05). This type of exercise had no effect on brain SOD and TBARS. The changes in T-AOC in brain, muscle, and heart were all more pronounced the longer the experiment continued (p<0.05).

Conclusion:Intermittent anaerobic exercise reduced growth and physical endurance and increased tissue antioxidant capacity and lipid peroxidation.
Rapid recovery from acute transverse myelitis in an elite female swimmer
Authors: Dubnov G , Constantini N W
Published: February 2006

Rubella is now an uncommon disease, and its neurological complications are rarely encountered. One complication, acute transverse myelitis, has been described in a few case reports and usually has an unfavourable outcome. The case is presented of an elite swimmer who developed transverse myelitis after rubella, which was treated with methylprednisolone. The recovery was so rapid and complete that two months after the acute event she broke a national swimming record.
Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold
Authors: Škof B , Strojnik V
Published: February 2006

Objective:The aim of this study was to determine the influence of intensive aerobic running on some muscle contractile characteristics and the dynamics of their recovery during a 2 hour period afterwards.

Methods:Seven well trained runners performed a 6 km run at anaerobic threshold (VOBLA). Knee torque during single twitch, low and high frequency electrical stimulation (ES), maximum voluntary knee extension, and muscle activation level test of the quadriceps femoris muscles were measured before and immediately after the run, and at several time points during a 120 minute interval that followed the run.

Results:After exercise, the mean (SE) maximum twitch torque (TTW) and torque at ES with 20 Hz (low frequency ES; TF20) dropped by 14.1 (5.1)% (p<0.05) and 20.6 (7.9)% (p<0.05) respectively, while torque at stimulation with 100 Hz (high frequency ES; TF100), maximum isometric knee extension torque (maximum voluntary contraction torque; TMVC), and activation level did not change significantly. Twitch contraction time was shortened by 8 (2)% (p<0.05). Ten minutes after the run, TTWwas 40% higher than immediately after the run and 10% (p<0.05) higher than before the run. TF20, TF100, and TMVCremained lower for 60 minutes (p<0.05) than before the run.

Conclusions:A 6 km continuous run at VOBLAcaused peripheral fatigue by impairing excitation–contraction coupling. Twitch torque recovered very quickly. However, the process of torque restoration at maximum isometric knee extension torque and at high and low frequency ES took much longer.
Aprotinin in the management of Achilles tendinopathy: a randomised controlled trial
Authors: Brown R , Orchard J , Kinchington M , Hooper A , Nalder G
Published: February 2006

Background:Achilles tendinopathy is a common condition, which can become chronic and interfere with athletic performance. The proteinase inhibitor aprotinin (as injection) has been found to improve recovery in patellar tendinopathy1 (evidence level 1b2) and Achilles tendinopathy.3 Internationally this therapy is being used based on this limited knowledge base.

Aim:To evaluate whether aprotinin injections decrease time to recovery in Achilles tendinopathy.

Method:A prospective, randomised, double blind, placebo controlled trial was performed comparing saline (0.9%) plus local anaesthetic injections and eccentric exercises with aprotinin (30 000 kIU) plus local anaesthetic injection and eccentric exercise. Three injections were given, each a week apart. In total, 26 patients, with 33 affected tendons, were enrolled for this study.

Results:At no follow up point (2, 4, 12, or 52 weeks) was there any statistically significant difference between the treatment group and placebo. This included VISA-A scores4 and secondary outcome measures. However, a trend for improvement over placebo was noted.

Conclusion:In this study on Achilles tendinopathy, aprotinin was not shown to offer any statistically significant benefit over placebo. Larger multicentre trials are needed to evaluate the efficacy of aprotinin in Achilles tendinopathy.
Sodium supplementation is not required to maintain serum sodium concentrations during an Ironman triathlon
Authors: Hew-Butler T D , Sharwood K , Collins M , Speedy D , Noakes T
Published: February 2006

Context:Critical assessment of recommendations that athletes consume additional sodium during athletic events.

Objective:To evaluate if sodium supplementation is necessary to maintain serum sodium concentrations during prolonged endurance activity and prevent the development of hyponatraemia.

Design:Prospective randomised trial of athletes receiving sodium (620 mg table salt), placebo (596 mg starch), or no supplementation during a triathlon. The sodium and placebo tablets were taken ad libitum, with the suggested range of 1–4 per hour.

Setting:The 2001 Cape Town Ironman triathlon (3.8 km swim, 180 km cycle, 42.2 km run).

Subjects:A total of 413 triathletes completing the Ironman race.

Main outcome measures:Sodium supplementation was not necessary to maintain serum sodium concentrations in athletes completing an Ironman triathlon nor required to prevent hyponatraemia from occurring in athletes who did not ingest supplemental sodium during the race.

Results:Subjects in the sodium supplementation group ingested an additional 3.6 (2.0) g (156 (88) mmol) sodium during the race (all values are mean (SD)). There were no significant differences between the sodium, placebo, and no supplementation groups with regard to age, finishing time, serum sodium concentration before and after the race, weight before the race, weight change during the race, and rectal temperature, systolic and diastolic blood pressure after the race. The sodium supplementation group consumed 14.7 (8.3) tablets, and the placebo group took 15.8 (10.1) tablets (p  =  0.55; NS).

Conclusions:Ad libitum sodium supplementation was not necessary to preserve serum sodium concentrations in athletes competing for about 12 hours in an Ironman triathlon. The Institute of Medicine’s recommended daily adequate intake of sodium (1.5 g/65 mmol) seems sufficient for a healthy person without further need to supplement during athletic activity.
Effectiveness of post-match recovery strategies in rugby players: Figure 1
Authors: Gill N D , Beaven C M , Cook C
Published: February 2006

Objectives:To examine the effectiveness of four interventions on the rate and magnitude of muscle damage recovery, as measured by creatine kinase (CK).

Methods:23 elite male rugby players were monitored transdermally before, immediately after, 36 hours after, and 84 hours after competitive rugby matches. Players were randomly assigned to complete one of four post-match strategies: contrast water therapy (CWT), compression garment (GAR), low intensity active exercise (ACT), and passive recovery (PAS).

Results:Significant increases in CK activity in transdermal exudate were observed as a result of the rugby match (p<0.01). The magnitude of recovery in the PAS intervention was significantly worse than in the ACT, CWT, and GAR interventions at the 36 and 84 hour time points (p<0.05).

Conclusions:An enhanced rate and magnitude of recovery was observed in the ACT, CWT, and GAR treatment groups when compared with the PAS group. Low impact exercise immediately post-competition, wearing compression garments, or carrying out contrast water therapy enhanced CK clearance more than passive recovery in young male athletes.
Video analysis of falls experienced by paediatric iceskaters and roller/inline skaters
Authors: Knox C L , Comstock R D
Published: February 2006

Objectives:To evaluate differences in the way iceskaters and roller/inline skaters fall.

Methods:Children’s falls related to skating were videotaped and categorised based on type of skating activity, child’s estimated age, direction of fall, whether the child attempted to break the fall, and whether the head struck the skating surface.

Results:In total, 216 iceskating and 201 roller/inline skating falls were captured on videotape. In both iceskating and roller/inline skating, the majority of falls were forward in direction. The skaters attempted to break the falls with their arms or hands in over 90% of falls in both iceskating (93.1%) and roller/inline skating (94.5%). A greater proportion of falls in iceskating resulted in the head striking the skating surface (13.0%) than did those in roller/inline skating (3.0%) (odds ratio = 4.8; 95% confidence interval 1.9 to 13.3; p<0.001).

Conclusions:This study found that paediatric iceskaters and roller/inline skaters fall similarly and that both types of skaters try to break their falls with their arms or hands; however, because iceskating takes place on a low friction surface, attempts to break falls with the arms or hands are often unsuccessful, leading to head and face injuries. The development of a new type of protective gear, a wrist guard with a non-slip palm, should stop iceskaters from striking the head, protect against upper extremity fractures, and unlike a bulky helmet, should not discourage children from skating.
Detection ofSimkania negevensisby culture, PCR, and serology in respiratory tract infection in Cornwall, UK
Authors: Friedman M G , Kahane S , Dvoskin B , Hartley J W
Published: February 2006

Respiratory tract infections are often treated empirically without investigation to detect the aetiological agent, which may be a virus or a bacterium, including atypical pathogens such asChlamydophila pneumoniaeorMycoplasma pneumoniae. Recently, several typesChlamydia-like intracellular bacteria have been detected in environmental samples and clinical specimens. Little is known of their geographical distribution and potential pathogenicity. We describe the detection, by PCR and isolation in cell culture, ofSimkania negevensisin nasopharyngeal aspirates of paediatric patients with bronchiolitis in Cornwall, UK. We also present serological evidence of exposure to the organism in 62% of adult patients and 46% of a sample of pregnant women. Empirical treatment of serious respiratory tract infection should consider the possible contribution of these organisms.
Prognosis and morphometrical features of non-bronchioloalveolar cell adenocarcinoma: an assessment of the non-alveolar replacing area and high grade atypical area
Authors: Tajiri M , Kameda Y , Nakayama H , Sakamoto K
Published: February 2006

Aim:It has become obvious that the prognosis of bronchioloalveolar cell carcinoma (BAC) in small peripheral adenocarcinoma of the lung is good, but most cases actually treated as pulmonary adenocarcinoma in hospitals tend to be non-bronchioloalveolar cell carcinoma (non-BAC). The prognoses of non-BAC are greatly varied. We studied the relationships between the morphometrical features and the prognoses of non-BAC.

Methods:In total, 69 cases of non-BAC measuring ⩽20 mm in diameter across their greatest dimension were evaluated. We considered that the non-alveolar replacing area and the high grade atypical area were related to the prognosis, and therefore defined the ratio of both areas to the total area at the maximum face of the tumours as the non-alveolar replacing area ratio (NAAR) and the high grade atypical area ratio (HAAR), respectively. We thereafter analysed the relationships between both ratios and the prognosis.

Results:The NAAR and HAAR were significantly higher in the recurrent cases than in the recurrence free cases. We divided the non-BAC cases at the centre of both ratios into two groups, high and low. The 5 year survival rate of the high NAAR and high HAAR group was 48.3%, while that of the low NAAR and low HAAR group was 72.2%. The groups showing high rates for both ratios had significantly worse prognoses. A multivariate analysis indicated that the HAAR contributes most to the prognosis.

Conclusions:These results suggest that the NAAR and HAAR are closely associated with the prognosis of non-BAC.
An unusual case of systemic mastocytosis associated with chronic lymphocytic leukaemia (SM-CLL)
Authors: Horny H-P , Sotlar K , Stellmacher F , Valent P , Grabbe J
Published: February 2006

Aims:Whereas focal accumulations of reactive lymphocytes around mast cell (MC) infiltrates are often seen in indolent systemic mastocytosis (ISM) involving the bone marrow, an association of systemic mastocytosis (SM) with malignant lymphoma/lymphatic leukaemia is very rare. This report contributes to the differential diagnosis of ISM by demonstrating that such lymphocytic aggregates may be neoplastic.

Methods:Biopsy specimens (bone marrow and gastrointestinal mucosa) of a 69 year old woman with mild blood lymphocytosis and a history of urticaria pigmentosa-like skin lesions that had disappeared a few years earlier, were investigated immunohistochemically using antibodies against CD3, CD5, CD20, CD23, CD25, CD34, CD117, chymase, and tryptase. Rearrangements of theIgHandTCRygenes were studied by seminested PCR. Mutation analysis of c-kitwas performed by melting point analysis of nested PCR using amplified DNA from pooled microdissected single cells (MC and B cells) of both sites.

Results:The histomorphological features of the bone marrow corresponded to that of ISM with multifocal accumulations of MC surrounded by clusters of lymphocytes of mature appearance. However, these lymphocytes revealed an aberrant immunophenotype with coexpression of CD5, CD20, and CD23, thus enabling the final diagnosis of SM with an associated clonal haematological non-MC lineage disease, in particular SM with associated B cell chronic lymphocytic leukaemia (SM-CLL). Monoclonality for both ISM and B-CLL could be confirmed by demonstrating the typical activatingc-kitpoint mutation D816V in bone marrow MC, and a monoclonal IgH rearrangement in bone marrow B cells.

Conclusions:Usually, focal accumulations of lymphocytes around MC infiltrates in the bone marrow of patients with SM are reactive in nature (lymphocytosis). However, a low grade malignant lymphoma should also be included in the differential diagnosis. We describe here the first case, to our knowledge, with synchronous diagnosis of SM and associated B-CLL. This diagnosis could only be established by application of appropriate immunohistochemical and molecular techniques, as the bone marrow histology on first investigation resembled that of typical ISM.
Overexpression of Pim-1 during progression of prostatic adenocarcinoma
Authors: Cibull T L , Jones T D , Li L , Eble J N , Ann Baldridge L , Malott S R , Luo Y , Cheng L
Published: February 2006

Aims:Pim-1 is a serine/threonine kinase that has been shown to play an integral role in the development of a number of human cancers, such as haematolymphoid malignancies. Recently, evidence has shown Pim-1 to be important in prostatic carcinogenesis. In order to further our understanding of its role in prostate cancer, we investigated Pim-1 expression in normal, premalignant, and malignant prostate tissue.

Methods:Using immunohistochemistry, Pim-1 expression was analysed in prostate tissue from 120 radical prostatectomy specimens. In each case, Pim-1 staining was evaluated in benign prostatic epithelium, high grade prostatic intraepithelial neoplasia (PIN), and prostatic adenocarcinoma. The number of positively staining cells was estimated, and the intensity of staining was scored on a scale of 0 to 3+.

Results:Pim-1 immunoreactivity was identified in 120 cases (100%) of adenocarcinoma, 120 cases (100%) of high grade PIN, and 62 cases (52%) of benign glands. The number of cells staining in benign epithelium (mean 34%) was much lower than that in high grade PIN (mean 80%; p<0.0001) or adenocarcinoma (mean, 84%; p<0.0001). There was no significant difference between high grade PIN and adenocarcinoma in the percentage of cells staining positively for Pim-1 (p = 0.34). The staining intensity for Pim-1 was significantly lower in benign prostatic epithelium than in PIN and adenocarcinoma (p<0.001). There was no statistically significant correlation between the level of Pim-1 expression and Gleason score, patient age, tumour stage, lymph node metastasis, perineural invasion, vascular invasion, surgical margin status, extraprostatic extension, or seminal vesicle invasion.

Conclusions:Pim-1 expression is elevated in PIN and prostatic adenocarcinoma compared with benign prostatic epithelium. This finding suggests that upregulation of Pim-1 may play a role in prostatic neoplasia.
An evaluation of molecular markers for improved detection of breast cancer metastases in sentinel nodes
Authors: Abdul-Rasool S , Kidson S H , Panieri E , Dent D , Pillay K , Hanekom G S
Published: February 2006

Background and objectives:In patients with breast cancer (BC), the sentinel node (SN) is the first node in the axillary basin that receives the primary lymphatic flow and can be used to accurately assess the axillary nodal status without removal of the axillary contents. Currently, histology and/or immunohistochemistry are the routine methods of SN analysis. The primary objective of this study was to develop a reproducible reverse transcription (RT) PCR assay, with emphasis on achieving high specificity for accurate detection of BC micrometastases in the SN. To correct for the heterogeneity of BC cells, a multimarker approach was followed, with the further aim of improving the detection rate of the assay.

Methods:In total, 73 markers were evaluated, of which 7 were breast epithelial markers and 66 were either cancer testis or tumour associated antigens. Twelve BC cell lines and 30 SNs (from 30 patients) were analysed using RT-PCR to determine the in vitro and in vivo detection rates for each of the markers. In addition, 20 axillary nodes obtained from a patient with brain death were used as controls to optimise the PCR cycle numbers for all the markers.

Results:Of the 30 SNs, 37% (11/30) were positive on haematoxylin and eosin analysis. Extensive immunohistochemical (IHC) analyses of the haematoxylin and eosin negative nodes confirmed the presence of very small numbers of BC cells in an additional 40% (12/30) of SNs. Molecular analysis with the hMAM-A alone identified metastases in 70% (21/30) of SNs. Using MAGE-A3 in combination with hMAM-A identified metastases in 90% (27/30) of patients. Seven SNs (23%) were negative for micrometastases (with haematoxylin and eosin and IHC) but RT-PCR positive for either hMAM-A or MAGE-A3.

Conclusions:As IHC analysis resulted in a 77% detection rate compared with 37% for haematoxylin and eosin analysis, we consider that IHC is essential in order not to miss SN micrometastases. Molecular analysis with hMAM-A and MAGE-A3 allows detection of BC micrometastases with a 90% detection rate. However, the clinical value of histologically negative but RT-PCR positive SNs can only be determined with long term follow up.
Rosai-Dorfman disease of the testis: an unusual entity that mimics testicular malignancy
Authors: Fernandopulle S M , Hwang J S G , Kuick C H , Lui J , Tan P H , Siow W-Y , Wong M
Published: February 2006

A 47 year old Chinese man with diabetes mellitus and previously treated pulmonary tuberculosis presented with painless right testicular enlargement of 1 month’s duration. He underwent an orchidectomy for presumed testicular neoplasm corroborated clinicoradiologically. Histological examination of the testicular mass revealed an inflammatory lesion comprising lymphocytes, plasma cells and sheets of pale staining histiocytes, some containing lymphocytes within their ample cytoplasm, suggestive of emperipolesis. S100 immunohistochemistry stained the histiocytes, while ultrastructural examination confirmed emperipolesis. A diagnosis of Rosai-Dorfman disease was made, an exceedingly rare testicular lesion. Clinicoradiological findings mimicked a neoplasm, while the inflammatory histological appearances with occasionally discerned multinucleated cells raised the possibility of xanthogranulomatous orchitis. Tuberculous orchitis was excluded through negative Ziehl-Neelsen stains and PCR for mycobacterium, while seminoma, which sometimes features a predominant inflammatory component obscuring neoplastic cells, was excluded by absent immunostaining for placental alkaline phosphatase and CD117.
Immunohistological characterisation of tumour infiltrating lymphocytes in melanocytic skin lesions
Authors: Hussein M R , Elsers D A H , Fadel S A , Omar A-E M
Published: February 2006

Background:Although the presence of tumour infiltrating lymphocytes (TIL) is a constant feature in melanomas, their immunophenotypic characterisation is still incomplete. We hypothesise that the transition from normal skin to benign naevi (BN) to melanocytic dysplastic naevi (MDN) to radial growth phase cutaneous malignant melanoma (RGP-CMM) to vertical growth phase cutaneous malignant melanoma (VGP-CMM) is associated with alterations in TIL. This study attempted to test this hypothesis and to characterise TIL in the melanocytic skin lesions.

Methods:In total, 74 lesions (12 BN, 12 MDN, 13 RGP-CMM, 26 VGP-CMM, and 11 metastatic melanomas) were examined using immunoperoxidase staining methods and antibodies targeting leukocyte common antigen (LCA+), T (CD3+) and B (CD20+) lymphocytes, and resting cytotoxic T cells (TIA-1+).

Results:Histologically, the transitions from normal skin to BN to MDN to RGP-CMM to VGP-CMM was associated with a gradual increase in the numbers of TIL (total, parenchymal, stromal, perivascular, and epidermal TIL, as well as TIL at the base of the lesions). The numbers of TIL were higher at the stroma than at the parenchyma. Similarly, immunostaining revealed that these transitions were associated with a gradual increase in the staining values (staining intensity, percentage of positive cells, and immunoreactivity score) for LCA+, CD20+, CD3+, and TIA-1+cells. The number of CD3+ cells was higher than that of CD20+ cells. All these differences between the normal skin and the lesional ones reached statistical significance (p<0.01). The majority of CD3+ cells were TIA-1+ T cells with cytotoxic potential. Compared with primary melanomas, there was a decrease in TIL in metastatic melanomas.

Conclusions:The gradual increase in TIL during melanoma tumorigenesis may reflect increased antigenicity of the tumour cells. Although both humoral and cell mediated immunity are involved in melanomagenesis, the latter seems to have the major role. The immune profile of MDN suggests their intermediacy between BN and CMM.
MASSLESS PARTICLES IN WARPED THREE SPACES
Authors: BARROS MANUEL , CABALLERO MAGDALENA , ORTEGA MIGUEL
Published: February 2006

The model governed by an action measuring the total proper acceleration of trajectories provides a nice framework one to describe the dynamics of massless relativistic particles. In high rigidity cases, metrics with constant curvature, the model is consistent only in spherical three spaces and in three-dimensional anti de Sitter backgrounds, according to a Riemannian or a Lorentzian context, respectively. In contrast to flat gravitational fields, the existence of nontrivial trajectories are shown in a family of three spaces whose metrics admit a certain degree of symmetry. Such trajectories are included in regions with real presence of matter. An algorithm to obtain them is also designed.