bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical mobility limitations in adults with intellectual disabilities: a systematic review
Authors: Cleaver S. , Hunter D. , Ouellette‐Kuntz H.
Published: December 2008

Background  Mobility limitations increase with age in the general population. Despite a growing population of older adults with intellectual disabilities (ID), mobility is rarely studied in the ID literature. The specific aim of this study was to identify and summarise primary literature investigating mobility limitations in adults with ID.

Methods  This study was a systematic review of the epidemiological literature (incidence and prevalence) of mobility limitations among adults with ID. Four electronic databases were searched from January 1980 to May 2007 for publications according to predefined inclusion/exclusion criteria. Additional sources were consulted. Two reviewers extracted data from each of the included articles.

Results  Thirty‐two publications representing 31 studies were ultimately included. In general, studies did not focus on mobility but were conducted for other purposes. All studies were conducted in industrialised countries. Only one study used a longitudinal design; the remainders were cross‐sectional. Few investigators reported on the representativeness of the sample or the validity of the measurement tool. Study samples differed substantially and investigators used numerous definitions of mobility limiting comparability between studies.

Conclusions  There is a need for increased research on mobility limitations among adults with ID, particularly longitudinal research. Researchers investigating mobility limitations should use validated measurement tools and offer detailed descriptions of the study sample and how it compares with an identifiable population.
Differences in the clinical presentation of Trisomy 21 with and without autism
Authors: Molloy C. A. , Murray D. S. , Kinsman A. , Castillo H. , Mitchell T. , Hickey F. J. , Patterson B.
Published: December 2008

Background  Autism occurs 10 times more often in children with Down syndrome than in the general population, but diagnosing co‐occurring autism in Down syndrome with severe intellectual disability is challenging. The objective of this case–control study was to identify characteristics differentiating children with trisomy 21 with and without autism and to determine the extent to which severe cognitive impairment affects the measures of autism symptomatology.

Method  Twenty children with trisomy 21 and autism (cases) were compared with children with trisomy 21 without autism (controls) matched on chronologic age, race and gender. Communication, cognitive and adaptive behaviour skills were assessed with standardized instruments. Medical history was reviewed and medical records were examined for early head growth. Scores on the diagnostic algorithm of the Autism Diagnostic Interview – Revised (ADI‐R) were compared after adjusting for cognitive ability as measured by the Stanford‐Binet (Fifth Edition) non‐verbal change‐sensitive score.

Results  Cases performed significantly more poorly on all assessments. Mean case–control differences for matched pairs were all significant at P < 0.0001 for receptive and expressive language skills, cognitive skills and adaptive skills. Seven cases had a history of seizures compared with one control (P = 0.01). After adjusting for cognitive ability, the mean scores on the Reciprocal Social Interaction, Communication, and Restricted, Repetitive and Stereotyped Behaviours domains of the ADI‐R diagnostic algorithm remained significantly higher in cases compared with controls (P < 0.0001). All participants had decreased head size consistent with Down syndrome, with no case–control differences.

Conclusion  Children with trisomy 21 and autism have significantly more impaired brain function than children with trisomy 21 without autism. However, the deficits in the core domains of social reciprocity and communication, and the restricted and repetitive interests are not entirely explained by the more severe cognitive impairment. This autism phenotype in children with trisomy 21 which includes an increased risk for seizures may indicate a widespread loss of functional connectivity in the brain.
Sleep patterns and daytime sleepiness in adolescents and young adults with Williams syndrome
Authors: Goldman S. E. , Malow B. A. , Newman K. D. , Roof E. , Dykens E. M.
Published: December 2008

Background  Sleep disorders are common in individuals with neurodevelopmental disorders and may adversely affect daytime functioning. Children with Williams syndrome have been reported to have disturbed sleep; however, no studies have been performed to determine if these problems continue into adolescence and adulthood.

Methods  This study examined overnight sleep patterns and daytime sleepiness in 23 adolescents and adults with Williams syndrome age 25.5 (8.0) years [mean (SD)]. Interviewer‐administered sleep questionnaires were used to evaluate nighttime sleep behaviours and daytime sleepiness. Wrist actigraphy was used to evaluate sleep patterns.

Results  Although individuals in our sample averaged 9 h in bed at night, daytime sleepiness and measures of sleep disruption were common and comparable to those of other populations with neurodevelopmental disorders. These measures included reduced sleep efficiency [74.4 (7.0)%] with prolonged sleep latency [37.7 (37.3) min], increased wake time after sleep onset [56.1 (17.6) min], and an elevated movement and fragmentation index [14.3 (4.6)].

Conclusion  Adolescents and young adults with Williams syndrome were found to be sleepy despite averaging 9 h in bed at night. Implications are discussed for associated causes of sleep disruption and future polysomnographic evaluation.
Characterization of bradykinin‐induced endothelium‐independent contraction in equine basilar artery
Authors: UENO D. , YABUKI A. , OBI T. , SHIRAISHI M. , NISHIO A. , MIYAMOTO A.
Published: December 2008

We investigated the effect of bradykinin (BK) on isolated equine basilar arterial rings with and without endothelium. BK induced concentration‐dependent contraction of resting arterial rings and no relaxation when the rings were precontracted by prostaglandin F2α. The maximal response and pD2 value were 161.2 ± 28.1% (to 60 mm KCl‐induced contraction) and 8.24 ± 0.25 respectively. The cumulative concentration–response curve for BK was not shifted to the right by des‐Arg9‐[Leu8]‐BK (a B1‐receptor antagonist), HOE140 (a B2‐receptor antagonist) or NPC567 (another B2‐receptor antagonist). In four of six basilar arteries, NPC567 induced concentration‐dependent contraction. Indomethacin (a cyclooxygenase inhibitor), nordihydroguaiaretic acid (a lipoxygenase inhibitor), quinacrine (a phospholipase A2 inhibitor), tetrodotoxin (a selective blocker of Na+ channels), guanethidine (a nor‐adrenergic neuron blocking drug), phentolamine (an α‐adrenoceptor antagonist), Nω‐nitro‐l‐arginine (l‐NNA, a nitric oxide (NO) synthase inhibitor) and endothelial denudation did not affect the BK‐induced contraction. l‐NNA and indomethacin induced contraction and relaxation under resting vascular tone respectively. These results suggest that endothelial cells are not involved in BK‐induced contraction and that the contraction is not mediated via activation of known B1 and B2 receptors. Arachidonic acid metabolites and neurotransmitters like norepinephrine and NO might not play a role in BK‐induced contraction in equine basilar artery.
Safety and tolerability of 3‐week and 6‐month dosing of Deramaxx® (Deracoxib) chewable tablets in dogs
Authors: ROBERTS E. S. , VAN LARE K. A. , MARABLE B. R. , SALMINEN W. F.
Published: December 2008

Although non‐steroidal anti‐inflammatory drugs (NSAIDs) are effective in reducing pain and inflammation, these agents have adverse effects. Selective inhibitors of COX‐2 are an alternative to traditional NSAIDs. Deramaxx® [Novartis Animal Health US, Inc. (NAH), Greensboro, NC, USA] contains the selective COX‐2 inhibitor, deracoxib, and is approved for the relief of pain and inflammation associated with orthopedic surgery and osteoarthritis in dogs. The safety of Deramaxx was evaluated in two target animal safety studies: 40 dogs (four dogs/sex/group) received 0, 4, 6, 8, or 10 mg/kg/day deracoxib once daily for 21 days; and 60 dogs (five dogs/sex/group) received 0, 2, 4, 6, 8, or 10 mg/kg/day deracoxib once daily for 6 months. There was a dose‐dependent trend towards increased blood urea nitrogen (BUN) in treated dogs, however mean BUN values remained within the reference range at the labeled doses. In both trials, histopathology revealed focal renal tubular degeneration/regeneration in some dogs receiving ≥6 mg/kg/day deracoxib. Focal renal papillary necrosis was seen in one dog treated with 8 mg/kg/day and in three dogs receiving 10 mg/kg/day deracoxib on the 6‐month study. No other parameters of renal function were adversely affected for either study. Results show that Deramaxx is safe and well‐tolerated in dogs when administered as directed.
Induction of chemokines, MCP‐1, and KC in the mutant huntingtin expressing neuronal cells because of proteasomal dysfunction
Authors: Godavarthi Swetha K. , Narender Doronala , Mishra Amit , Goswami Anand , Rao Sudheendra N. R. , Nukina Nobuyuki , Jana Nihar Ranjan
Published: December 2008

Huntington’s disease is a hereditary neurodegenerative disorder caused by an aberrant polyglutamine expansion in the amino terminus of the huntingtin protein. The resultant mutant huntingtin form aggregates in neurons and causes neuronal dysfunction and degeneration in many ways including transcriptional dysregulation. Here, we report that the expression of mutant huntingtin in the mouse neuroblastoma cell results in massive transcriptional induction of several chemokines including monocyte chemoattractant protein‐1 (MCP‐1) and murine chemokine (KC). The mutant huntingtin expressing cells also exhibit proteasomal dysfunction and down‐regulation of NF‐κB activity in a time‐dependent manner and both these phenomena regulate the expression of MCP‐1 and KC. The expression of MCP‐1 and KC are increased in the mutant huntingtin expressing cells in response to mild proteasome inhibition. However, the expression of MCP‐1 and KC and proteasome activity are not altered and inflammation is rarely observed in the brain of 12‐week‐old Huntington’s disease transgenic mice in comparison with their age‐matched controls. Our result suggests that the mutant huntingtin‐induced proteasomal dysfunction can up‐regulate the expression of MCP‐1 and KC in the neuronal cells and therefore might trigger the inflammation process.
Prospects for Reconciling the Conflict between Economic Growth and Biodiversity Conservation with Technological Progress
Authors: CZECH BRIAN
Published: December 2008

Abstract: The conflict between economic growth and biodiversity conservation is understood in portions of academia and sometimes acknowledged in political circles. Nevertheless, there is not a unified response. In political and policy circles, the environmental Kuznets curve (EKC) is posited to solve the conflict between economic growth and environmental protection. In academia, however, the EKC has been deemed fallacious in macroeconomic scenarios and largely irrelevant to biodiversity. A more compelling response to the conflict is that it may be resolved with technological progress. Herein I review the conflict between economic growth and biodiversity conservation in the absence of technological progress, explore the prospects for technological progress to reconcile that conflict, and provide linguistic suggestions for describing the relationships among economic growth, technological progress, and biodiversity conservation. The conflict between economic growth and biodiversity conservation is based on the first two laws of thermodynamics and principles of ecology such as trophic levels and competitive exclusion. In this biophysical context, the human economy grows at the competitive exclusion of nonhuman species in the aggregate. Reconciling the conflict via technological progress has not occurred and is infeasible because of the tight linkage between technological progress and economic growth at current levels of technology. Surplus production in existing economic sectors is required for conducting the research and development necessary for bringing new technologies to market. Technological regimes also reflect macroeconomic goals, and if the goal is economic growth, reconciliatory technologies are less likely to be developed. As the economy grows, the loss of biodiversity may be partly mitigated with end‐use innovation that increases technical efficiency, but this type of technological progress requires policies that are unlikely if the conflict between economic growth and biodiversity conservation (and other aspects of environmental protection) is not acknowledged.
The Role of Prices in Conserving Critical Natural Capital
Authors: FARLEY JOSHUA
Published: December 2008

Abstract: Until recent decades, economic decision makers have largely ignored the nonmarket benefits provided by nature, resulting in unprecedented threats to ecological life‐support functions. The economic challenge today is to decide how much ecosystem structure can be converted to economic production and how much must be conserved to provide essential ecosystem services. Many economists and a growing number of life scientists hope to address this challenge by estimating the marginal value of environmental benefits and then using this information to make economic decisions. I assessed this approach first by examining the role and effectiveness of the price mechanism in a well‐functioning market economy, second by identifying the issues that prevent markets from pricing many ecological benefits, and third by focusing on problems inherent to valuing services generated by complex and poorly understood ecosystems subject to irreversible change. I then focus on critical natural capital (CNC), which generates benefits that are essential to human welfare and have few if any substitutes. When imminent ecological thresholds threaten CNC, conservation is essential and marginal valuation becomes inappropriate. Once conservation needs have been met, remaining ecosystem structure is potentially available for economic production. Demand for this available supply will determine prices. In other words, conservation needs should be price determining, not price determined. Conservation science must help identify CNC and the quantity and quality of ecosystem structure required to ensure its sustained provision.
Late‐onset periodic asystolia during vagus nerve stimulation
Authors: Iriarte Jorge , Urrestarazu Elena , Alegre Manuel , Macías Alfonso , Gómez Asier , Amaro Paola , Artieda Julio , Viteri Cesar
Published: December 2008

Cardiac changes may occasionally occur during vagus nerve stimulation (VNS) used in epileptic patients. As they can be potentially life‐threatening, it is important to detect them, and this is why an intraoperative test is performed during the implantation. Few cases of asystole during this test have been described. Only one patient with late‐onset bradyarrythmia caused by VNS has been reported. This patient had been implanted 2 years and 4 months before the episode. We present another case of late asystole in a patient whose VNS had been implanted 9 years before the arrhythmia onset. In our patient, each run of stimulation produced bradyarrhythmias and very often severe asystolia due to atrium‐ventricular block.
Do Off‐Label Drug Practices Argue Against FDA Efficacy Requirements? A Critical Analysis of Physicians' Argumentation for Initial Efficacy Requirements
Authors: Klein Daniel B. , Tabarrok Alexander
Published: December 2008

Abstract

The amended Food, Drug and Cosmetics Act requires efficacy certification for a drug's initial uses (“on‐label”), but does not require certification before physicians may prescribe the drug for subsequent uses (“off‐label”). Does it make sense to require FDA efficacy certification for new drugs but not for new uses of old drugs? Using a sequential online survey, we carried on a “virtual conversation” with some 500 physicians. The survey asked whether efficacy requirements should be imposed on off‐label uses; almost all physicians said no. It asked whether the efficacy requirements for initial uses should be dropped, and most physicians said no. We then asked respondents whether opposing efficacy requirements in one case but not the other involved an inconsistency. In response, we received hundreds of written commentaries. We organize and discuss these commentaries with an eye to understanding how the medical market certifies off‐label drug uses and how this compares to FDA certification. Does off‐label medicine use suggest that efficacy requirements should be placed on new uses of old drugs? Does it suggest that efficacy requirements on new drugs should be lifted? We explore these questions, and ask whether the response of many of the doctors exhibits the familiar behavior bias toward the status quo.
Business Groups in 20th‐Century Swedish Political Economy: A Sociological Perspective
Authors: Smångs Mattias
Published: December 2008

Abstract

Since the interwar period, the Swedish economy has been dominated by a few business groups that control practically all Swedish industry of any importance. This article provides a sociologically informed account of the existence and lasting dominance of business groups in Sweden. In challenging efficiency‐based accounts of business groups in Sweden offered by transaction‐cost economists, I adopt a historical and dynamic approach that understands economic institutions not as efficient responses to external circumstances, such as market conditions, but as “social constructions.” This approach emphasizes the role of contingency as well as agency in the formation and reproduction of institutions. The article demonstrates the historical contingencies of the emergence of the business groups—in the form of economic crises in the interwar period—and how the groups became institutionalized in the postwar period through a process of social exchange among the key actors in the Swedish political economy: the business elite, the trade unions, and the state.
Consistency of the initial cell acquisition procedure is critical to the standardization of CD34+ cell enumeration by flow cytometry: results of a pairwise analysis of umbilical cord blood units and cryopreserved aliquots
Authors: Flores Ana I. , McKenna David H. , Montalbán M. Angeles , De la Cruz Javier , Wagner John E. , Bornstein Rafael
Published: December 2008

BACKGROUND: The CD34+ cell content is a predictive factor for engraftment and survival after umbilical cord blood (UCB) transplantation. The high variability in the CD34 assay results in different recommended cell doses for infusion across transplant centers and also limits the clinical utility of the CD34+ cell counts provided by cord blood banks (CBBs). This bi‐institutional study was intended to understand the sources of this variability.

STUDY DESIGN AND METHODS: The level of CD34 agreement between the University of Minnesota (UM) and the Madrid CBB (MCBB) was evaluated on 50 UCB units before and after cryopreservation. Two cryopreserved vials per unit were thawed and processed at both laboratories. Dual‐platform ISHAGE‐based flow cytometry was used for CD34 enumeration.

RESULTS: Postthaw nucleated cell recoveries were similar. However, whereas CD34+ cell enumeration before freezing was 0.35 ± 0.22 percent, the results after thawing were 0.98 ± 0.65 and 0.57 ± 0.39 percent at UM and MCBB, respectively. Bland‐Altman plots analysis ruled out the interchangeability of MCBB and UM CD34 values. Differences in the initial cell acquisition settings accounted for most of the CD34 discrepancy, which was no longer present after normalization of the forward scatter threshold for cell acquisition.

CONCLUSIONS: The standardization of CD34+ cell enumeration by flow cytometry is strongly reliant on a consistent initial cell acquisition procedure. The interlaboratory variation can be minimized by using frozen cell aliquots as reference samples. Both requisites should be considered for CD34 testing and UCB unit selection by regulatory institutions involved with cord blood banking and transplantation.
Primary sex cord‐like variant of endometrioid adenocarcinoma arising from endometriosis
Authors: KAUPPILA SAILA , ALTINÖRS MEHMET , VÄRE PÄIVI , LIAKKA ANNIKKI , KNUUTI EILA , NISSI RITVA
Published: December 2008

Endometriosis, a relatively common disease generally affecting women in the reproductive age group, is mostly found in the pelvic organs. Although endometriosis is a benign disease, some malignant tumors have been reported to develop in endometriotic lesions, most commonly in the ovary. The relationship between endometriosis and malignancy is not well known, but the majority of endometriosis‐associated ovarian malignancies are usually endometrioid adenocarcinomas and clear cell carcinomas. The sex cord‐like variant of endometrioid adenocarcinoma is a rare tumor that histologically closely resembles the sex cord‐stromal tumor. Despite its rarity, the correct histological diagnosis of the sex cord‐like variant of endometrioid adenocarcinoma is crucial to avoid misdiagnosis of a less aggressive tumor. We here report a 53‐year‐old woman who was diagnosed as having this very rare subtype of endometroid adenocarcinoma curiously arising from an endometriotic lesion at the site of previous salpingo‐oophorectomy. The tumor was diagnosed based on light microscopy and immunohistochemistry.
Beta‐catenin expression and mutation in adult and pediatric Wilms' tumors
Authors: SU MIN‐CHENG , HUANG WAN‐CHEN , LIEN HUANG‐CHUN
Published: December 2008

Wilms' tumor is the most common pediatric renal neoplasm, but its occurrence in adults is very rare. In contrast to pediatric Wilms' tumor (PWT), very little is known about the pathogenesis of adult Wilms' tumor (AWT). Despite there currently being no morphological difference between AWT and PWT, a cytogenetic study has suggested that the pathogenesis of AWT might be different from that of PWT. Although dysregulation of the Wnt pathway has been implicated in PWT, its role in AWT has never been investigated. To investigate the role of dysregulation of the Wnt pathway in AWT, tumor samples from 4 AWTs and 19 PWTs were surveyed for subcellular localization of β‐catenin by immunohistochemistry and potential mutation of the β‐catenin gene by sequencing. Nuclear translocation of β‐catenin was found in one out of four cases of AWT, but none of them carried mutation of the β‐catenin gene. By comparison, nuclear translocation for β‐catenin and mutation of the β‐catenin gene were present in 53% (10/19) and 15.8% (3/19) of PWTs, respectively. Of the three mutations identified, we found a novel mutation combining a silent mutation (TCT to TCC, Ser37Ser) and an in‐frame six‐base‐pair deletion (del GGTGCC, del Gly38Ala39). This report suggests that dysregulation of the Wnt pathway might also play a role in the pathogenesis of AWT.
ORIGINAL ARTICLE: Treatment with Adalimumab (Humira®) and Intravenous Immunoglobulin Improves Pregnancy Rates in Women Undergoing IVF*
Authors: Winger Edward E. , Reed Jane L. , Ashoush Sherif , Ahuja Sapna , El‐Toukhy Tarek , Taranissi Mohamed
Published: December 2008

Problem  The purpose of this study was to investigate whether treatment with TNF‐α inhibitors and/or intravenous immunoglobulin (IVIG) increases in vitro fertilization (IVF) success rates among young (<38 years) women with infertility and T helper 1/T helper 2 cytokine elevation.

Method of study  Seventy‐five sub‐fertile women with Th1/Th2 cytokine elevation were divided into four groups: Group I: Forty‐one patients using both IVIG and Adalimumab (Humira®), Group II: Twenty‐three patients using IVIG, Group III: Six patients using Humira®, and Group IV: Five patients using no IVIG or Humira®.

Results  The implantation rate (number of gestational sacs per embryo transferred, with an average of two embryos transferred by cycle) was 59% (50/85), 47% (21/45), 31% (4/13) and 0% (0/9) for groups I, II, III and IV respectively. The clinical pregnancy rate (fetal heart activity per IVF cycle started) was 80% (33/41), 57% (13/23), 50% (3/6) and 0% (0/5) and the live birth rate was 73% (30/41), 52% (12/23), 50% (3/6) and 0% (0/5) respectively. There was a significant improvement in implantation, clinical pregnancy and live birth rates for group I versus group IV (P = 0.0007, 0.0009, and 0.003, respectively) and for group II versus group IV (P = 0.009, 0.04 and 0.05, respectively).

Conclusion  The use of a TNF‐α inhibitor and IVIG significantly improves IVF outcome in young infertile women with Th1/Th2 cytokine elevation.
Trends in body mass in Swedish adolescents between 2001 and 2007
Authors: Ekblom Örjan B , Bak Elin AM Ekblom , Ekblom Björn T
Published: December 2008

Aim: (1) Compare BMI standard deviation scores (BMIsds) in 16‐year olds in 2001 and 2007 to assess trends. (2) Describe tracking of BMIsds between ages 10 and 16 years, in a longitudinal 6‐year follow‐up. (3) Identify possible predictors in 2001 for high BMIsds in 2007 and increase in BMIsds between 2001 and 2007.

Methods: A six‐year follow‐up study on 296 subjects, aged 10 years at baseline and a panel study among 16‐year olds. BMIsds was used as the main outcome.

Results. No difference in BMIsds in 16‐year‐old adolescents was found between 2001 and 2007. Strong tracking (r = 0.80, 95% CI: 0.75–0.84) was found for BMIsds between ages 10 and 16 years. Low aerobic capacity and high BMIsds at age 10 years predicted overweight at age 16 years. High BMIsds in 2001 predicted a decline in BMIsds (OR: 0.58, 95% CI: 0.43–0.76) and high level of self‐reported moderate‐to‐vigorous physical activity predicted an increased BMIsds (OR: 1.38, 95% CI: 1.13–1.67).

Conclusion: There was no difference in prevalence of overweight plus obesity between the 2001 and 2007 samples. Normal weight and good aerobic fitness in 10‐year‐old children seems to decrease the risk of elevated relative BMI in 16‐year olds.
The Precision of Fit of Milled Titanium Implant Frameworks (I‐Bridge®) in the Edentulous Jaw
Authors: Eliasson Alf , Wennerberg Ann , Johansson Anders , Örtorp Anders , Jemt Torsten
Published: December 2008

Background: New computer numeric controlled (CNC)–milled frameworks for implant‐supported prostheses have been introduced. However, no data are available on the precision of fit of these new frameworks.

Purpose: The purpose of this study is to evaluate the precision of fit of a new CNC‐milled framework technique (I‐Bridge®, Biomain AB, Helsingborg, Sweden) using Brånemark System® (Nobel Biocare AB, Göteborg, Sweden) and NobelReplace™ (Nobel Biocare AB) system implants.

Materials and Methods: Ten test frameworks were fabricated for one master model for each implant system. Five additional frameworks were fabricated for five different models simulating clinical cases as controls (Brånemark System). The distortion of implant center point positions was measured in x‐, y‐, and z‐axes and in three dimensions by using a contact‐type coordinate measuring machine and a computer program developed specifically for this purpose. Mann–Whitney U‐test was used to compare differences of distortion within and between the groups.

Results: The maximal distortion in arch width (x‐axis) and curvature (y‐axis) was within 71 and 55 µm for all frameworks, respectively. The mean distortion in absolute figures in x‐, y‐, z‐axes and three dimensions was for “clinical control” frameworks 23, 26, 4, and 34 µm as compared with less than 12, 12, 2, and 17 µm for Brånemark and NobelReplace frameworks, respectively. Control frameworks showed significantly (p < .05) greater mean and range of distortions in x‐ and y‐axes and in three dimensions compared with test frameworks.

Conclusion: All measured frameworks presented signs of misfit, indicating that no framework had a “passive fit.” Frameworks produced in a more routine clinical environment seem to present greater levels of distortion as compared with frameworks produced in a strict test situation. However, all measured frameworks presented levels of precision of fit within limits considered to be clinically acceptable in earlier studies of frameworks placed on abutments.
Cardiovascular Effects of Phosphodiesterase Type 5 Inhibitors
Authors: Vlachopoulos Charalambos , Ioakeimidis Nikolaos , Rokkas Konstantinos , Stefanadis Christodoulos
Published: December 2008

Introduction

Phosphodiesterase type 5 (PDE5) inhibitors are widely used as first-line therapy for erectile dysfunction (ED). Their efficacy and safety combined with an increasing understanding of cyclic guanosine monophosphate (cGMP)-regulated mechanisms have triggered a number of attempts to determine their effects on the cardiovascular system and their potential benefits in cardiovascular conditions.

Aim

To review and discuss recent findings regarding the cardiovascular effects of PDE5 inhibitors and to highlight current and future clinical applications beyond ED.

Main Outcome Measures

Results of preclinical and clinical studies evaluating the cardiovascular effects of PDE5 inhibitors are analyzed and critically put into perspective.

Methods

Extensive PubMed literature search reviewing relevant data on effects and mechanisms of PDE5 inhibitors on the cardiovascular system.

Results

In recent years, extensive but very heterogeneous preclinical and clinical evidence has been reported. PDE5 inhibition has proven collateral benefits for a multitude of risk factors or diseases associated with or accompanying ED. However, these agents appear to have the potential of expanding their indications. To date, PDE5 inhibition has been shown to be effective for the treatment of idiopathic pulmonary artery hypertension, and sildenafil is approved for this indication. Importantly, accumulating data show that the therapeutic potential extends to the myocardium, the coronary and peripheral arteries, subliclinical inflammation, oxidative stress, thrombosis, neurological recovery, and pathways of fibrosis. Thus, the spectrum of patients who may benefit has expanded to include, for instance, patients with heart failure or coronary artery disease.

Conclusions

PDE5 inhibitors are an exciting class of drugs with pleiotropic effects. Current or future PDE5 inhibitors are a conceptually attractive therapeutic strategy with potential clinical applications in a variety of cardiovascular conditions.
Efficacy and Safety of Combined Oral Therapy with Tadalafil and Alfuzosin: An Integrated Approach to the Management of Patients with Lower Urinary Tract Symptoms and Erectile Dysfunction. Preliminary Report
Authors: Liguori Giovanni , Trombetta Carlo , De Giorgi Gioacchino , Pomara Giorgio , Maio Giuseppe , Vecchio Daniele , Ocello Giuseppe , Ollandini Giangiacomo , Bucci Stefano , Belgrano Emanuele
Published: December 2008

Introduction

Alpha1-blockers (AB) are the first-line monotherapy for lower urinary tract symptoms (LUTS). Phosphodiesterase type 5 (PDE5) inhibitors are the first-line treatment for erectile dysfunction (ED). Numerous studies have supposed a significant association between ED and LUTS, but a causal relationship cannot be established.

Aim

The aim was to evaluate the efficacy of a combined therapy with an AB (alfuzosin) and PDE5 inhibitors (tadalafil) in patients with LUTS and ED.

Methods

This was a randomized, open-label, three-arm study. A total of 66 men complaining of ED and LUTS were included in the study. Patients were assessed at baseline and after 12 weeks of study treatment, and then underwent randomized allocation to either alfuzosin 10 mg once a day (22 patients) or tadalafil 20 mg on alternative days (21 patients), or a combination of both (23 patients).

Main Outcome Measures

All participants completed the erectile function domain of the International Index of Erectile Function (IIEF-EF) and the International Prostatic Symptom Score (IPSS). Other efficacy variables included maximum urinary flow rate (Qmax) and medium urinary flow rate (Qave).

Results

IIEF-EF tended to improve with alfuzosin alone (+15%), while it was clearly improved with tadalafil alone (+36.3%). The greatest improvement was experienced with the combination therapy (+37.6%). Improvement in Qmax was observed in all groups, but patients receiving combination therapy had greater improvement (29.6%) than patients receiving either only alfuzosin (21.7%) or only tadalafil (9.5%). IPSS was significantly improved in alfuzosin group (27.2%), was more marked with the combination therapy (41.6%), and a small increase, although not significant, was also observed with tadalafil (8.4%).

Conclusions

Combined therapy improved ED and LUTS as demonstrated by the significant improvement in uroflowmetry measures and in IPSS and IIEF-EF scores. A significant improvement was also observed in quality of life assessments. The beneficial effects of tadalafil on LUTS similar to the benefits of alfuzosin on ED, although present, were smaller.
Persistent Genital Arousal Disorder in 18 Dutch Women: Part II—A Syndrome Clustered with Restless Legs and Overactive Bladder
Authors: Waldinger Marcel D. , Schweitzer Dave H.
Published: December 2008

Introduction

A systematic study in women with persistent genital arousal disorder (PGAD) is urgently needed to develop its clinical management.

Aim

To investigate the features, possible causes, and treatment of PGAD.

Methods

Eighteen women who fulfilled the five criteria for PGAD were included in the study. In-depth interviews were combined with laboratory and imaging studies as reported in Part I of the study. Clinical responses were observed with drugs exerting activity against a number of different neuro-regulatory mechanisms.

Main Outcome Measures

Detailed descriptions and clustering of some well established clinical syndromes.

Results

The majority of women experienced PGAD during early menopause without pre-existing psychiatric disorders and laboratory abnormalities. Most women had difficulties in describing the quality of the genital sensations. These were described in various terms and were diagnosed as dysesthesias and paresthesias. Their intensity was most severe during sitting. A few women reported PGAD during pregnancy and premenstrual. The majority of women also reported preexistent or coexistent restless legs syndrome (RLS) and overactive bladder syndrome (OBS). These strongly associated morbidities point into the direction of a clinical cluster, which harbors PGAD or PGAD plus these typical other disorders. Notably, as in RLS and OBS, it appeared that daily treatment with clonazepam 0.5–1.5 mg was effective in 56% of PGAD women. Also, oxazepam 10 mg and tramadol 50 mg elicited PGAD-reducing effect.

Conclusions

PGAD seems to belong to a highly associated disease cluster including morbidities, which share an imperative urge to suppress dysesthesias and paresthesias by firm manipulative actions. PGAD—or as proposed by our group, restless genital syndrome (RGS) in the context of its strong association with restless legs—is probably the expression of a nonsexually driven hyperexcitability of the genitals and subsequent attempts to overcome it by genital manipulations.
UV‐B‐induced Oxidative Damage and Protective Role of Exopolysaccharides in Desert Cyanobacterium Microcoleus vaginatus
Authors: Chen Lan‐Zhou , Wang Gao‐Hong , Hong Song , Liu An , Li Cheng , Liu Yong‐Ding
Published: December 2008

UV‐B‐induced oxidative damage and the protective effect of exopolysaccharides (EPS) in Microcoleus vaginatus, a cyanobacterium isolated from desert crust, were investigated. After being irradiated with UV‐B radiation, photosynthetic activity (Fv/Fm), cellular total carbohydrates, EPS and sucrose production of irradiated cells decreased, while reducing sugars, reactive oxygen species (ROS) generation, malondialdehyde (MDA) production and DNA strand breaks increased significantly. However, when pretreated with 100 mg/L exogenous EPS, EPS production in the culture medium of UV‐B stressed cells decreased significantly; Fv/Fm, cellular total carbohydrates, reducing sugars and sucrose synthase (SS) activity of irradiated cells increased significantly, while ROS generation, MDA production and DNA strand breaks of irradiated cells decreased significantly. The results suggested that EPS exhibited a significant protective effect on DNA strand breaks and lipid peroxidation by effectively eliminating ROS induced by UV‐B radiation in M. vaginatus.
Inhibitory Effect of Eleutherine americana Merr. Extract on Staphylococcus aureus Isolated from Food
Authors: Ifesan B.O.T. , Hamtasin C. , Mahabusarakam W. , Voravuthikunchai S.P.
Published: December 2008

ABSTRACT:  About 106 samples of ready‐to‐eat foods were purchased over a period of 3 mo out of which 76 (71.69%) were contaminated with Staphylococcus aureus. S. aureus isolated from the food samples were characterized phenotypically using traditional biochemical methods. Ninety‐four percent of the isolates were mannitol fermenters, 86% positive for coagulase test, while 80% produced lipase enzyme. Antibiotic susceptibility test revealed that 21% and 63% of the food isolates were resistant to oxacillin and penicillin, respectively. The antibacterial activity of the bulb of Eleutherine americana used in Thai cuisine was investigated by agar disc diffusion using 2.5 mg of the crude extract and produced inhibition zone between 14.5 and 15.7 mm, while the minimum inhibitory concentration (MIC) value ranged from 0.06 to 1.00 mg/mL on both food isolates and reference strains. Growth curve in the presence of the crude ethanol extract at 4 MIC showed bacteriostatic effect by 5 log reduction relative to the control. Partially purified fractions tentatively identified by column chromatography were suspected to be responsible for the antibacterial property. This study suggests that E. americana bulb has potential for application as a natural preservative in foods.
Technological and Functional Applications of Low‐Calorie Sweeteners from Lactic Acid Bacteria
Authors: Patra F. , Tomar S.K. , Arora S.
Published: December 2008

ABSTRACT:  Lactic acid bacteria (LAB) have been extensively used for centuries as starter cultures to carry out food fermentations and are looked upon as burgeoning “cell factories” for production of host of functional biomolecules and food ingredients. Low‐calorie sugars have been a recent addition and have attracted a great deal of interest of researchers, manufacturers, and consumers for varied reasons. These sweeteners also getting popularized as low‐carb sugars have been granted generally recommended as safe (GRAS) status by the U.S. Federal Drug Administration (USFDA) and include both sugars and sugar alcohols (polyols) which in addition to their technological attributes (sugar replacer, bulking agent, texturiser, humectant, cryoprotectant) have been observed to exert a number of health benefits (low calories, low glycemic index, anticariogenic, osmotic diuretics, obesity control, prebiotic). Some of these sweeteners successfully produced by lactic acid bacteria include mannitol, sorbitol, tagatose, and trehalose and there is a potential to further enhance their production with the help of metabolic engineering. These safe sweeteners can be exploited as vital food ingredients for development of low‐calorie foods with added functional values especially for children, diabetic patients, and weight watchers.
Immunomagnetic detection of micrometastatic cells in bone marrow in uveal melanoma patients
Authors: Eide Nils , Faye Ragnar S. , Høifødt Hanne K. , Øvergaard Ralf , Jebsen Peter , Kvalheim Gunnar , Fodstad Øystein
Published: December 2008

Purpose:  Our objective was to introduce immunomagnetic separation (IMS) in ocular research by evaluating the possibility of detecting tumour cells in bone marrow (BM) and peripheral blood (PB) samples and validating the captured cells as melanocytic cells.

Methods:  Mononuclear cell (MNC) fractions isolated from BM and PB in uveal melanoma patients were examined for tumour cells using our IMS method. Sheep‐anti‐mouse IgG antibody‐coated super paramagnetic particles were conjugated to an anti‐melanoma antibody. Microscopy of the magnetic fraction isolated from MNCs was performed to identify and count the number of bead‐rosetted cells. The finding of at least two rosettes with coated beads in a 20‐μl fraction of a sample was registered as a positive test. The melanocytic nature of the tumour cells was ascertained with a double labelling procedure using fluorescent microparticles.

Results:  Using IMS in a study of 328 patients, tumour cells were at initial diagnosis found in BM and PB in 29.9% and 1.6% of cases, respectively. In positive samples, a median of 56 tumour cells (range 2–500) were identified. The captured cells were documented to be of melanocytic origin by the simultaneous binding of fluorescent beads coated with another melanoma‐associated antibody.

Conclusions:  The IMS method was sensitive and efficient in the detection of occult melanoma tumour cells in BM. The validity of the immunomagnetic technique was strengthened by verifying the melanocytic characteristics of the isolated cells. The IMS procedure identifies intact, vital tumour cells, permitting further molecular characterization, an advantage which makes this method attractive for extended use. The clinical relevance of the findings will be further investigated in follow‐up studies with repeated sampling and characterization of the isolated tumour cells.
Communicating quality: a unified model of disclosure and signalling
Authors: Daughety Andrew F. , Reinganum Jennifer F.
Published: December 2008

Firms communicate product quality to consumers through a variety of channels. Economic models of such communication take two alternative forms when quality is exogenous: (i) disclosure of quality through a credible direct claim; or (ii) signalling of quality via producer actions that influence buyers' beliefs about quality. In general, these two literatures have ignored one another. We argue that firms should be viewed as choosing which means of communication they will employ. We show that integration of these two alternatives leads to new implications about disclosure, signalling, firm preferences over type, and the social efficiency of the channel of communication employed.
Static and Dynamic Characteristics of Oil Lubricated Beveled-Step Herringbone-Grooved Journal Bearings
Authors: Nemat-Alla M. M. , Gad A. M. , Khalil A. A. , Nasr A. M.
Published: December 2008

Recently, herringbone-grooved journal bearings (HGJBs) have important applications in high-speed rotating machinery. The groove action in pumping the lubricating fluid inward generates supporting stiffness and improves the stability of the bearing when operating concentrically. Several researchers have investigated the static and dynamic characteristics of HGJBs and grooved thrust bearings. Most of these investigations were theoretical and concentrated on HGJBs with rectangular-profile grooves. In the present work, the static and dynamic characteristics of the beveled-step HGJBs are experimentally investigated. The bearing attitude angle, pressure distribution, and bearing friction torque were measured on a hydrodynamic lubrication unit, and then the static and dynamic characteristics were determined. The obtained experimental results are compared to the obtained experimental results for plain journal bearing. The merits as well as the demerits of the groove profile were discussed through comparisons with plain journal bearings.
Influence of Manufacturing Process and Alloying Element Content on the Tribomechanical Properties of Cobalt-Based Alloys
Authors: Yu H. , Ahmed R. , Lovelock H. de Villiers , Davies S.
Published: December 2008

Manufacturing process routes of materials can be adapted to manipulate their microstructure and hence their tribological performance. As industrial demands push the applications of tribological materials to harsher environments of higher stress, starved lubrication, and improved life performance, manufacturing processes can be tailored to optimize their use in particular engineering applications. The aim of this paper was therefore to comprehend the structure-property relationships of a wear resistant cobalt-based alloy (Stellite 6) produced from two different processing routes of powder consolidated hot isostatic pressing (HIPing) and casting. This alloy had a nominal wt % composition of Co–28Cr–4.5W–1C, which is commonly used in wear related applications in harsh tribological environments. However, the coarse carbide structure of the cast alloy results in higher brittleness and lower toughness. Hence this research was conducted to comprehend if carbide refinement, caused by changing the processing route to HIPing, could improve the tribomechanical performance of this alloy. Microstructural and tribomechanical evaluations, which involved hardness, impact toughness, abrasive wear, sliding wear, and contact fatigue performance tests, indicated that despite the similar abrasive and sliding wear resistance of both alloys, the HIPed alloy exhibited an improved contact fatigue and impact toughness performance in comparison to the cast counterpart. This difference in behavior is discussed in terms of the structure-property relationships. Results of this research indicated that the HIPing process could provide additional impact and fatigue resistance to this alloy without compromising the hardness and the abrasive/sliding wear resistance, which makes the HIPed alloy suitable for relatively higher stress applications. Results are also compared with a previously reported investigation of the Stellite 20 alloy, which had a much higher carbide content in comparison to the Stellite 6 alloy, caused by the variation in the content of alloying elements. These results indicated that the fatigue resistance did not follow the expected trend of the improvement in impact toughness. In terms of the design process, the combination of hardness, toughness, and carbide content show a complex interdependency, where a 40% reduction in the average hardness and 60% reduction in carbide content had a more dominating effect on the contact fatigue resistance when compared with an order of magnitude improvement in the impact toughness of the HIPed Stellite 6 alloy.
Friction and Wear Behavior of Graphite-Carbon Short Fiber Reinforced Al–17%Si Alloy Hybrid Composites
Authors: Ramesh C. S. , Prasad T. B.
Published: December 2008

Graphite and carbon short fiber (copper coated) reinforced (2 wt %) hypereutectic Al–17%Si alloy composites were prepared by liquid metallurgy route. Room temperature friction and wear properties of as-cast hypereutectic Al–Si alloy reinforced with copper coated graphite and short carbon fibers were investigated. Friction and wear tests were conducted using a pin-on-disk machine under dry sliding conditions. The loads (contact pressure) and sliding velocities have been varied from 10 N to 50 N (contact pressure of 0.12–0.60 MPa) and 0.3 m/s to 1.2 m/s, respectively. The results reveal that the coefficient of friction and the wear rate of the hybrid composite are lower than that of the matrix alloy. The coefficient of friction of the matrix alloy and its hybrid composite decreased with increased load of up to 30 N and increased beyond this load. The wear rates of both the matrix alloy and its hybrid composite increased with the increasing load. However, at all the loads and sliding velocities studied, the developed hybrid composite exhibited a lower coefficient of friction and wear rates when compared with the matrix alloy.