bluuebunny/crossref_metadata_2025 huggingface dataset:
An integral index for measuring aversion to large‐scale risks
Authors: Eisenhauer Joseph G.
Published: October 2006

Purpose

Conventional measures of risk aversion based on first and second derivatives of utility are strictly local instruments, valid only for infinitesimally small changes in wealth. This paper to develop a global index suitable for assessing attitudes toward large‐scale risks.

Design/methodology/approach

Integral calculus is used to measure the geometric area between an individual's actual utility function and a linear function displaying risk neutrality, over the entire range of potential wealth outcomes for a given risk. The area is then converted to an index number.

Findings

Local and global measures of risk aversion yield similar interpersonal comparisons only for small risks; with larger risks, local measures distort interpersonal differences. The analysis also shows that individuals having exponential utility functions evaluate risk exclusively on the basis of wealth dispersion, whereas those with logarithmic or square‐root utilities consider both the mean and variance of wealth.

Research/limitations/implications

The global index is quantifiable if the functional form of utility is known; further research is needed to approximate the index when information about utility is limited.

Practical implications

The most important risks encountered in practice, such as the possibility of unemployment or disability, involve variations in wealth far larger than differential calculus is designed to accommodate. The integral index therefore provides a more appropriate basis for measuring and comparing risk preferences.

Originality/value

The paper provides an innovative geometric interpretation of global risk aversion, and in contrast to local measures, the integral index captures differences in the intensity of an individual's aversion toward risks of various magnitudes.
Genetic search for redundancy optimization in complex systems
Authors: Agarwal Manju , Gupta Rashika
Published: October 2006

Purpose

Conceiving reliable systems is a strategic issue for any industrial society for its economical and technical development. This paper aims to focus on solving highly constrained redundancy optimization problems in complex systems.

Design/methodology/approach

Genetic algorithms (GAs), one of the metaheuristic techniques, have been used and a dynamic adaptive penalty strategy is proposed, which makes use of feedback obtained during the search along with a dynamic distance metric and helps the algorithm to search efficiently for final, optimal or near optimal solution.

Findings

The effectiveness of the adaptive penalty function is studied and shown graphically on the solution quality as well as the speed of evolution convergence for several highly constrained problems. The investigations show that this approach can be powerful and robust for problems with large search space, even of size 1017, and difficult‐to‐satisfy constraints.

Practical implications

The results obtained in this paper would be applicable on designing highly reliable systems meeting the requirement of today's society. Moreover, an important advantage of applying GA is that it generates several good solutions (mostly optimal or near optimal) providing a lot of flexibility to decision makers. As such, the paper would be of interest and importance to the system designers, reliability practitioners, as well as to the researchers in academia, business and industry. The paper would have wide applications in the fields of electronics design, telecommunications, computer systems, power systems etc.

Originality/value

Genetic algorithms have been recently used in combinatorial optimization approaches to reliable design, mainly for series‐parallel systems. This paper presents a GA for parallel redundancy optimization problem in complex systems.
Broadband penetration and broadband competition: evidence and analysis in the EU market
Authors: Polykalas Spyros E. , Vlachos Kyriakos G.
Published: October 2006

Purpose

To examine broadband competition and broadband penetration in a set of countries that employ the same regulation framework. To define the policy and strategy required to promote broadband in weak markets that do not employ alternative infrastructures.

Design/methodology/approach

Study penetration and competition level statistics from 2002 to 2005 in a set of countries with different infrastructures deployed, services provided as well as in their social‐economic structures but employing the same regulation framework. Measure the level of inter‐platform and intra‐platform competition as well as the availability of bitstream access versus the incumbents' shares.

Findings

The paper concludes that a mature broadband market is the one that exhibits a high penetration ratio in combination with a high competition level. Bitstream access can counterbalance the inexistence of alternative broadband infrastructures, especially in weak markets. In particular the availability of numerous bitstream access types in combination with the proper price differentiation can fuel broadband adoption in relatively weak broadband markets.

Originality/value

The paper challenges the general rule that only platform (also known as facility) based competition guarantees long‐term growth of the broadband market. Bitstream and resale access do not lag local loop unbundling and can be used in weak markets that do not employ alternative infrastructures to fuel competition in the relevant markets. Different policies and strategies must be followed, in that case, on behalf of the local NRA.
A cost‐benefit analysis of real‐money trade in the products of synthetic economies
Authors: Castronova Edward
Published: October 2006

Purpose

Macro goals: To alert the telecommunications policy community to the emergence of persistent online worlds as a communications and policy issue. Also to provide game industry decisionmakers with solid economic research on which to base policy decisions. Third, to connect these two communities to each other, for mutual benefit. Micro goals: to conduct a solid cost‐benefit analysis of a knotty problem in game economics: what to do about people who break the rules and use real money to buy game items (swords, wands, gold pieces, etc.)

Design/methodology/approach

Traditional cost‐benefit analysis. Consumer surplus analysis of externality effects, with a parameterized estimate of effects sizes.

Findings

Real‐money trading acts as a negative externality on the game subscription market. Seems likely to amount to several million dollars per 100,000 users per year.

Research limitations/implications

The effects sizes are simulated only. More data from the game industry are needed before one can put a solid dollar estimate on them. Also, much of the material in the paper had to be really elementary in order for the results to make sense for both policy economists and game industry analysts.

Practical implications

The analysis indicates a prima facie case for public policy intervention to help shield synthetic worlds from the deleterious effects of the global gold farming industry.

Originality/value

Interest in real‐money trade in gaming is growing, as indicated by the extent of online discussion by gaming scholars. Despite this, the literature on the economic and policy issues raised by the topic is limited. The article is an original piece of work that takes understanding forward.
The evolution of the exchange‐traded fund: is active management on the horizon?
Authors: Rosella Michael R. , Pugliese Domenick
Published: October 2006

Purpose

To discuss how product innovations in exchange‐traded funds (ETFs) have blurred the line between passive and active management, and to explore the legal ramifications of these developments.

Design/methodology/approach

Describes how ETFs operate and how the ETF marketplace has grown; discusses the use of broad‐based indexes for most ETFs until recently; describes newer ETFs that provide targeted exposure to narrow market segments; and discusses underlying indexes that are based on performance‐based characteristics rather than market segments, along with possible difficulties in making performance‐based criteria widely available to investors.

Findings

Historically the SEC has expressed skepticism over actively managed ETFs because of uncertainty as to whether they can provide the same portfolio transparency and arbitrage opportunity that traditional ETFs can. As “Rule Sets,” or criteria for including companies in performance indexes, become more involved and less objective, the challenge will be to ensure that sufficient arbitrage opportunities exist to ensure pricing efficiency. If that challenge can be met, it may serve as a model for a truly actively managed ETF.

Originality/value

Explains how the new generation of ETFs is coming closer to the line of active management and the legal issues that must be surmounted before truly actively managed ETFs are offered.
The downside of side letters
Authors: Levin Ian , Scanlan Kevin
Published: October 2006

Purpose

To discuss possible disadvantages and other implications for private investment fund managers of issuing side letters to certain investors.

Design/methodology/approach

Discusses the relatively common practice of issuing side letters; issues surrounding side letters that relate to private equity funds and hedge funds; recent SEC pronouncements regarding side letters; industry practices, including disclosure issues and corporate‐related issues; and ERISA consequences.

Findings

Side letters (i.e. agreements that afford investors of a private investment fund with rights and/or benefits that are different, and often superior, to those granted to such investors under the governing documents of the fund) have been utilized for years by sponsors of private investment funds. In fact, in many cases, it has been impossible for sponsors of private investment funds to close on subscriptions from large and/or strategic investors unless they agree to provide such investors with side letters. In light of the recent focus of the US Securities and Exchange Commission (the “SEC”) on the use of side letters by hedge fund managers, fund managers should consider what affect certain side letter provisions may have on the fund and its investors, in particular, the consequences such side letters will have under the Employee Retirement Income Security Act of 1974 (“ERISA”).

Originality/value

Useful reference for fund managers that describes the potential issues related to side letters.
Hedge fund marketing overview
Authors: Johnson Ethan W.
Published: October 2006

Purpose

To provide a brief overview of US securities laws that apply to the marketing of hedge funds.

Design/methodology/approach

Summarizes US securities offering rules, including Regulation S and Regulation D at the federal level, state securities laws, antifraud standards, and broker‐dealer regulation.

Findings

All securities offered and sold in the USA must be registered with the SEC unless an exemption is available under the Securities Act. Offerings offshore under Regulation S and private placements in the USA under Regulation D offer two such exemptions. Most states have private placement exemptions similar to Regulation D. While certain state‐level regulation over the registration of securities has been preempted by federal law, a level of state regulation continues to exist. All US offers and sales of securities are subject to general antifraud standards under both US federal and state laws. Funds and their employees, investment managers and their employees, and any placement agents may not contact any US investor in the USA or any non‐US investor from the USA without registering as broker‐dealers.

Originality/value

Provides a concise overview of laws and regulations that apply to the marketing of hedge funds.
Melan‐A/Mart‐1 expression in various melanocytic lesions and in non‐melanocytic soft tissue tumours
Authors: Orosz Z
Published: October 2006

Aims

The purpose of this study was to test different malignant non‐melanocytic tumours with the commercially available antibody Melan‐A to examine its diagnostic specificity and to compare the S100, Melan‐A and HMB‐45 reactivity in various melanocytic lesions.

Methods and results

Seventy‐three benign and malignant melanocytic lesions and 31 cases of non‐melanocytic tumours, sarcomas, carcinomas and carcinoids, were selected. Immunohistochemical staining of paraffin sections, following a high temperature antigen unmasking technique, was performed. Melan‐A stains junctional and dermal melanocytes in all benign melanocytic lesions with the exception of neuro‐naevoid areas. The epithelioid and the spindle cells in malignant melanomas did not show considerable difference in their Melan‐A reactivity. The predominantly spindle cell type mucosal melanomas contained more Melan‐A‐positive cells than HMB‐45‐positive cells and similar results were observed in metastatic malignant melanomas. In desmoplastic melanomas the positivity of Melan‐A was not consistent. None of the sarcomas, carcinomas and carcinoids expressed Melan‐A. Almost all soft tissue tumours, except for two malignant gastrointestinal stromal tumours, were unreactive for HMB‐45. These two cases did not react with Melan‐A antibody.

Conclusions

Melan‐A is a useful additional marker to differentiate non‐melanocytic tumours from primary or metastatic melanoma. In melanocytic lesions the Melan‐A staining pattern is similar to S100, but seems to be more specific. In desmoplastic melanomas, however, the variable Melan‐A staining further necessitated detailed histological examination and the use of the S100 reaction.
The role of IL‐4, IL‐13 and IL‐4Rα in the development of protective and pathological responses to Trichinella spiralis
Authors: SCALES H. E. , IERNA M. X. , LAWRENCE C. E.
Published: October 2006

T helper type 2 (Th2) responses have been shown to be important in protective responses to gastrointestinal (GI) helminth infections and in the development of the intestinal pathology accompanying expulsion of the parasite. Different inbred mouse strains have been shown to develop different cytokine profiles following infection with GI helminths with increased resistance observed in those strains where Th2 cytokines predominate. The aim of this study was to determine the role of IL‐4, IL‐13 and IL‐4Rα and the impact of host background on the development of the protective and pathological responses induced by infection with the gastrointestinal helminth Trichinella spiralis. IL‐4, IL‐13 and IL‐4Rα were required for the generation of Th2 responses to T. spiralis; however, the role these responses play in the development of protection and enteropathy was less clear. IL‐4Rα‐deficiency mice resulted in substantially reduced parasite expulsion, intestinal pathology and Th2 responses. Similarly, lack of IL‐13 resulted in inhibited expulsion and the development of enteropathy. Although Th2 responses were reduced in BALB/c IL‐4–/– mice, neither expulsion nor enteropathy were different from wild‐type mice. In contrast, C57BL/6 IL‐4–/– exhibited delayed expulsion and reduced pathology, suggesting that host genetics are important in the function of individual cytokines. Thus, differences in background genotype may be an important component in the development host protection and the development of intestinal pathology accompanying the loss of GI helminths.
Immunomodulation of the hepatic egg granuloma in Schistosoma japonicum‐infected pigs
Authors: HURST M. H. , LOLA S. G. , LINDBERG R.
Published: October 2006

Immunomodulation of perioval granulomas is a well‐known phenomenon in schistosome‐infected mice, but only little is known about granuloma modulation in other animal models of human schistosomiasis. In the present study, we explored immunomodulation of egg granulomas in the liver in a pig model of schistosomiasis japonica. Granuloma size was measured and T cells, B cells and IgG+ plasma cells in granulomas were quantified in pigs at 9, 12 and 21 weeks post infection (wpi) with Schistosoma japonicum. Granulomas were largest at 9 wpi, had decreased significantly in size at 12 wpi and remained small at 21 wpi (9 vs. 12 and 21 wpi: P < 0·05). The size of granulomas containing mature and immature eggs, respectively, did not differ significantly. The density of T (CD3ɛ+) cells and IgG+ plasma cells in granulomas was the same, irrespective of granuloma size and time points. B (CD79α+) cells were rare in granulomas. The results indicate that in pigs, S. japonicum egg granulomas in the liver are immunomodulated at an early stage of infection, and that not only mature but also immature eggs induce a marked granulomatous reaction in this species.
The evolution of trade‐offs: where are we?
Authors: ROFF D. A. , FAIRBAIRN D. J.
Published: October 2006

Trade‐offs are a core component of many evolutionary models, particularly those dealing with the evolution of life histories. In the present paper, we identify four topics of key importance for studies of the evolutionary biology of trade‐offs. First, we consider the underlying concept of ‘constraint’. We conclude that this term is typically used too vaguely and suggest that ‘constraint’ in the sense of a bias should be clearly distinguished from ‘constraint’ in the sense of proscribed combinations of traits or evolutionary trajectories. Secondly, we address the utility of the acquisition–allocation model (the ‘Y‐model’). We find that, whereas this model and its derivatives have provided new insights, a misunderstanding of the pivotal equation has led to incorrect predictions and faulty tests. Thirdly, we ask how trade‐offs are expected to evolve under directional selection. A quantitative genetic model predicts that, under weak or short‐term selection, the intercept will change but the slope will remain constant. Two empirical tests support this prediction but these are based on comparisons of geographic populations: more direct tests will come from artificial selection experiments. Finally, we discuss what maintains variation in trade‐offs noting that at present little attention has been given to this question. We distinguish between phenotypic and genetic variation and suggest that the latter is most in need of explanation. We suggest that four factors deserving investigation are mutation‐selection balance, antagonistic pleiotropy, correlational selection and spatio‐temporal variation, but as in the other areas of research on trade‐offs, empirical generalizations are impeded by lack of data. Although this lack is discouraging, we suggest that it provides a rich ground for further study and the integration of many disciplines, including the emerging field of genomics.
Partnerships in specialty care: Exploring rural haemophilia provider resource needs
Authors: Pritchard Andrea M. , Reimer Marlene , Simonson Kari , Oberle Kathleen
Published: October 2006

Objective:  The purpose of this study was to determine whether rural providers have adequate preparation for safe and effective haemophilia care.

Design:  This qualitative study proceeded in two phases: focus group (phase I) and telephone (phase II) interviews.

Setting:  Five Canadian rural hospitals served by one urban haemophilia treatment centre and providing service to at least one haemophilia family.

Participants:  Phase I: focus groups of rural health professionals (site 1: n = 5; site 2: n = 6), including nursing, medicine and lab technology. Phase II: telephone interviews with nine participants from nursing, medicine, lab technology, social work and physiotherapy across three sites.

Main outcome measures:  Qualitative content analysis yielded categorical themes for specialty care resource requirements in a rural context.

Results:  Resource needs reflected five main categories: communication network, subjective knowledge, team roles, objective knowledge and partnerships (C‐STOP).

Conclusions:  The five C‐STOP categories require resources and alignment of urban specialist, rural provider and family expertise. Specialty clinic efforts promoting self‐care are incomplete without matched resources for rural providers.

Key Terms:

• Haemophilia (A and B) refers to a deficiency in factor VIII or IX, with associated bleeding of post‐traumatic or spontaneous origin as potentially life or limb threatening1

• Rural refers to those communities beyond a 30‐min commuting distance2 to the tertiary‐based haemophilia treatment centre.
Motorcycle deployment and rider characteristics on Victorian farms
Authors: Day Lesley , Stathakis Voula , O’Hare Mary
Published: October 2006

Objective:  To describe the motorcycle fleet and rider characteristics on Victorian farms.

Design:  Cross‐sectional postal survey.

Setting:  Victorian agricultural industries.

Participants:  A total of 1382 randomly selected farmers in 2001.

Main outcome measures:  Farm motorcycle characteristics, use and maintenance schedule; motorcycle rider characteristics, respondent demographics and property characteristics.

Results:  A total of 70% of farms had motorcycles, with an average of 1.7 per property. A total of 49% were four‐wheel, and 44% were two‐wheel. The average engine size and age were 255 cc and 8.8 years, respectively. The milk cattle sector owned the largest share of the motorcycle fleet and cereal/grain farms the smallest share. Four‐wheel motorcycles were often used across the entire spectrum of agricultural tasks. Two‐wheel motorcycle use was concentrated more on mustering and transport. A total of 61% of farms performed motorcycle maintenance every 1–6 months. Fifteen per cent of riders were under 15 years of age, and the majority (71%) rode four‐wheel motorcycles. A total of 29% of all riders had received some form of motorcycle training.

Conclusions:  This study provides useful information on state‐level patterns of farm motorcycle use, as well as the key safety behaviours of rider training and motorcycle maintenance. This information might serve as baseline data for future monitoring and surveillance, and might assist with planning of prevention programs.
Small‐area estimates of general practice workforce shortage in rural and remote Western Australia
Authors: Scott Jessica , Larson Ann , Jefferies Felicity , Veenendaal Bert
Published: October 2006

Objective:  To trial a measure of rural and remote GP access for small areas.

Design:  A cross‐sectional study using geographical information systems software to calculate GP to population rates with a floating catchment of 100 km radius around census collection districts (CCDs).

Setting:  Non‐metropolitan Western Australia.

Participants:  The locations and full‐time equivalents of GPs and other primary‐care doctors were identified through a GP workforce survey.

Main outcome measures:  GP to population ratios for each CCD were classified as being above or below a benchmark of adequate GP access. CCDs with no GP sessions reported within 100 km were identified separately. These categories were investigated by divisions of general practice and by indigenous status, age and employment characteristics of the population.

Results:  Small‐area estimates detected greater variation in access than depicted by conventional methods. Sixty‐four per cent of the non‐metropolitan population live in CCDs with adequate GP access. Forty‐five per cent of indigenous people and 52% of people working in rural industries live in CCDs with access below the benchmark.

Conclusions:  The floating catchment method is a powerful tool to identify small areas of inadequate service. It can be applied to measure access to other professionals, medical equipment or facilities.
Clinical evaluation using Custom Control Software technology in coaxial phacoemulsification
Authors: Yao Ke , Ye Panpan , Tang Xiajing , Chen Peiqing , Shen‐Tu Xingchao
Published: October 2006

Abstract

Purpose:  The aim of this study was to evaluate the clinical outcomes of the Custom Control Software technology in coaxial phacoemulsification.

Methods:  This prospective, randomized, double‐masked clinical trial was conducted at the Eye Center, Affiliated Second Hospital, College of Medicine, Zhejiang University. The patients were grouped according to nuclear sclerosis and randomly assigned to undergo conventional phacoemulsification or phacoemulsification using Millennium Custom Control Software (CCS). All surgeries were performed by a single surgeon. The phaco time and average power of phacoemulsification were recorded and then calculated as absolute phaco time (APT). Visual acuity, pachymetry, endothelial cell density and anterior chamber flare count of both groups were noted at preoperatively day 1 and 3 months after surgery.

Results:  The APT of the CCS group was statistically lower than Conventional group in grades II, III and IV (P < 0.05) nuclear sclerosis, but the two groups had no statistically significant differences in the grade I group. At day 1 post surgery, there were significant differences in the thickened pachymetry (P = 0.047) and anterior chamber flare counts (P = 0.008) between two groups. At 3 months post surgery, the endothelial cell loss ratio showed statistical difference (P = 0.032) between two groups.

Conclusions:  Using CCS technology in coaxial phacoemulsification can provide lower APT and better power efficiency. This new power modulation may make the surgery safer and more effective than Conventional phacoemulsification.
Bilateral angle closure glaucoma induced by sulphonamide‐derived medications
Authors: Lee Grace C , Tam Christina P , Danesh‐Meyer Helen V , Myers Jonathan S , Katz L Jay
Published: October 2006

Abstract

Background:  Sulphonamide‐derived medications are widely used, although not always recognized as such. We report the occurrence of bilateral angle closure glaucoma with sulphonamide‐derived medications and highlight features of the presentation and treatment to assist in early diagnosis and management.

Methods:  The clinical records of three cases with bilateral angle closure glaucoma induced by three sulphonamide‐derived medications, sulfasalazine, oral acetazolamide, and hydrochlorothiazide, were reviewed.

Results:  All three cases identified presented with bilateral angle closure glaucoma and persistent elevated intraocular pressure despite patent iridotomy. Patients may be pseudophakic (2) or phakic (1).Cessation of the suspected medication is necessary to reverse the mechanism.

Conclusions:  The proposed mechanism of angle closure glaucoma induced by sulphonamide medication involves an idiosyncratic reaction in the uveal tissues to these systemic drugs that is associated with expansion of the extracellular tissue of the ciliary body and choroid. Management identification of sulphonamide‐derived medications and immediate cessation of suspected sulphonamide‐derived medication, refraction and ultrasound B scan or ultrasound biomicroscopy may aid in the proper diagnosis and can also be helpful for confirmation.
Optical coherence tomography analysis of bilateral end‐stage choroidal neovascularization where one eye is treated with photodynamic therapy
Authors: Sahni Jayashree , Stanga Paulo , Wong David , Lenfestey Pauline , Kent David , Harding Simon
Published: October 2006

Abstract

Background:  To compare retinal thickness and subretinal hyper‐reflectivity using Stratus optical coherence tomography (OCT3) between the eyes of patients with bilateral end‐stage exudative age‐related macular degeneration (AMD), where one eye has been treated with photodynamic therapy (PDT).

Methods:  Patients with PDT‐treated stable choroidal neovascularization (CNV), defined as a fibrotic lesion not requiring treatment for 6 months, in one eye and an untreated end‐stage CNV (disciform) scar in their fellow eye, underwent refraction protocol logMAR visual acuity (VA) in letters, slit‐lamp biomicroscopy, fluorescein angiography and OCT3 scan. Subretinal scar thickness was measured as Outer High Reflectivity Band Thickness (OHRBT) and retinal thickness as neuroretinal foveal thickness (NFT) on OCT3.

Results:  Thirty‐two eyes of 16 patients were studied. Mean OHRBT was 255.62 µm in treated eyes and 350.8 µm in untreated eyes (P = 0.001). Mean NFT was 130.3 µm in the treated eye and 79.9 µm in the untreated eye (P = 0.017). Mean VA was 42 letters in treated eyes and 15 letters in untreated eyes (P < 0.005).

Conclusion:  Based on OCT3 findings, eyes with AMD treated with PDT have a thinner fibrous scar and better preserved retinal thickness when compared with untreated fellow eyes with end‐stage fibrotic scarring.
A Country Split in Two? Contemporary Italy and Its Usable and Unusable Pasts
Authors: Bosworth R. J. B.
Published: October 2006

In this article, Richard Bosworth examines the state of the recent Italian past in the light of the April 2006 elections, so narrowly contested between coalitions of Left and Right. In doing so, he utilises Tony Judt's recent commentary about the place of history in general, and the history of the Second World War in particular, arguing that Italy may helpfully be compared in its historiographical tensions with the ex‐communist countries of Eastern Europe. Bosworth concludes optimistically that, if the perverse figure of Silvio Berlusconi can finally be extracted from the Italian body politic, now may be the moment for a more subtle and comprehensive understanding of Italy's ‘long Second World War’ and so of the meaning of its Fascist dictatorship.
Increased expression of Ob‐Rb and its relationship with the overexpression of TGF‐β1 and the stage of fibrosis in patients with nonalcoholic steatohepatitis
Authors: Cayón A. , Crespo Javier , Mayorga M. , Guerra A. , Pons‐Romero F.
Published: October 2006

Abstract: Aims: The main aim of this study was to examine the relationship of the leptin system in steatosis and nonalcoholic steatohepatitis (NASH). The study also analysed the pathogenic role of the leptin system in the development of hepatic fibrosis and its relation with the TGF‐β1 system.

Materials and methods: The study included 90 subjects, 55 with NASH and 35 with simple steatosis. Gene expression of leptin, leptin receptor and TGF‐β mRNA was analysed by real‐time PCR on liver tissue. Leptin serum levels were determined by RIA. Leptin receptor expression was also assessed by immunohistochemistry.

Results: Increased expression was found for leptin receptor mRNA (P=0.0016) and its protein (P<0.05) in patients with NASH, especially those with fibrosis. There was a marked increase in gene expression of TGF‐β1 in patients with NASH (P=0.0002). A strong correlation was demonstrated between leptin receptor gene expression and TGF‐β1 gene expression (P=0.023). No leptin expression was found in the liver tissue. All patients showed a marked hyperleptinemia, which was closely related to the anthropometric characteristics analysed and independent of development or not of NASH.

Conclusions: The results of the study demonstrate for the first time increased leptin receptor expression in liver tissue and its relationship with overexpression of TGF‐β1 and the degree of hepatic fibrosis.
Anti‐Golgi complex antibodies during pegylated‐interferon therapy for hepatitis C
Authors: Paraná Raymundo , Schinoni Maria Isabel , De Freitas Luiz A. R. , Codes Liana , Cruz Marla , Andrade Zilton , Trepo Christian
Published: October 2006

Abstract: Background/Aim:Pegylated interferon (Peg‐IFN) plus ribavirin is the standard therapy for hepatitis C. Peg‐IFN has several antiviral mechanisms, but its role in hepatitis C treatment seems to be related to its immunomodulatory effect. Ribavirin, an antiviral agent, potentiates IFN activity when added to it. Both drugs are associated with adverse reactions of different magnitudes. Autoimmune phenomena have been reported with this treatment. In this paper, we describe cases of ALT/GGT flares during Peg‐IFN plus ribavirin treatment, which related to the appearance of anti‐Golgi antibody and disease progress.

Methods:We investigated three patients with hepatitis C and severe ALT/GGT flares during Peg‐IFN and ribavirin treatment coinciding with anti‐Golgi complex antibody as the only marker of autoimmunity. We then reviewed the medical files and tested anti‐Golgi antibody in stored sera from 25 patients treated with conventional IFN and in 14 patients treated with Peg‐IFN.

Results:The three patients were male, over 45 years of age; all were relapsers and non‐responders. Anti‐Golgi antibody was positive during treatment coinciding with ALT/GGT flares but with hepatitis C virus (HCV)‐RNA negativity, disappearing after stopping treatment, with normalization of ALT/AST levels. One patient had progression of fibrosis from F2 to F3 despite negativity of HCV‐RNA. In the last group, only two patients treated with Peg‐IFN experienced ALT/GGT flares but without anti‐Golgi antibody

Conclusions:The presence of anti‐Golgi complex antibody could be a marker of a temporary autoimmune phenomenon and progressive disease.
Racial and ethnic variations in the epidemiology of intrahepatic cholangiocarcinoma in the United States
Authors: McLean Luciana , Patel Tushar
Published: October 2006

Abstract: Background/aims: Despite the global increase in the incidence of intrahepatic cholangiocarcinoma, regional variations occur. To assess the potential contribution of racial/ethnic factors, we assessed the epidemiology of these cancers in different racial and ethnic groups in the United States.

Methods: Disease prevalence, mortality and survival rates for different racial and ethnic groups were obtained from the surveillance, epidemiology and end results survey database.

Results: The age‐adjusted prevalence was highest for Hispanics (1.22 per 100 000) and lowest for Blacks (0.3 per 100 000). Age‐adjusted mortality rates were higher for American Indian/Alaska Natives and Asian/Pacific Islanders compared with other groups. However, mortality rates increased by greater than 3.5% annual for all racial or ethnic groups except for American Indian/Pacific Islanders in whom mortality rates decreased by 0.2% annually. The increase in mortality rates was greatest for Hispanic women aged between 40 and 49 years. Prevalence and survival were significantly higher in Hispanic women in contrast to gender differences observed in other groups.

Conclusions: Significant racial and ethnic variations occur in the epidemiology of intrahepatic cholangiocarcinoma within geographically defined regions in the United States These may reflect genetic, socioeconomic or cultural predispositions to cancer.
Differential expression genes analyzed by cDNA array in the regulation of rat hepatic fibrogenesis
Authors: Qiang Hui , Lin Yong , Zhang Xin , Zeng Xin , Shi Jian , Chen Yue‐Xiang , Yang Miao‐Fang , Han Ze‐Guang , Xie Wei‐Fen
Published: October 2006

Abstract: Purpose: To analyze the gene expression pattern in rat hepatic fibrogenesis and further assess the role of some key genes during the pathological process.

Methods: Hepatic fibrosis was induced by intraperitoneal injection of dimethylnitrosamine or carbon tetrachloride (CCl4) injection subcutaneously in rats, and identification of the hepatic fibrosis related genes with cDNA microarray was performed. After some key genes up‐regulated during the development of hepatic fibrosis were screened and confirmed, their effects on the function of the activated rat hepatic stellate cells (HSC) were assessed using the small interfering RNA (siRNA) technique.

Results: Using an Atlas rat cDNA array, a number of differentially expressed genes in fibrotic liver tissues were identified compared with non‐diseased control. A total of 15 genes predominantly associated with the mitogen‐activated protein kinase (MAPK) signal transduction pathway were upregulated in the fibrotic liver. Immunohistochemical study revealed that the expressions of both extracellular signal‐regulated kinases (ERK) and ribosomal protein S6 kinase (RSK), two of the key genes in the MAPK pathway, were remarkably induced, which was closely correlated to that of collagen types I and III during the development of hepatic fibrosis. Transfection of siRNA targeting ERK1 mRNA (siERK1) into HSC led to a 66% and 72% reduction of ERK1 mRNA and protein expression, respectively. Furthermore, siERK1 exerted the inhibition of the proliferation of HSC, accompanied by the induction of HSC apoptosis and reduction of collagen types I and III. In addition, siERK1 abolished the effect of platelet‐derived growth factor‐BB on the proliferation of HSC.

Conclusions: The present study provided strong evidence for the participation of the MAPK pathway in the pathogenesis of hepatic fibrosis. Selective targeting of ERK1 inhibitors to HSC might present as a novel strategy for the treatment of hepatic fibrosis.
Anemia associated with antiviral therapy in chronic hepatitis C: incidence, risk factors, and impact on treatment response
Authors: Hung Chao‐Hung , Lee Chuan‐Mo , Lu Sheng‐Nan , Wang Jing‐Houng , Chen Chien‐Hung , Hu Tsung‐Hui , Kee Kwong‐Ming , Chang Kuo‐Chin , Tseng Po‐Lin , Yen Yi‐Hao , Changchien Chi‐Sin
Published: October 2006

Abstract: Background:One major side effect of combination antiviral therapy is the development of anemia, which is more severe among the Asian population. We conducted this large‐scaled study to explore the incidence, risk factors, and impact on treatment response of anemia in chronic hepatitis C patients receiving combination antiviral therapy.

Methods:Four hundred and sixty‐six chronic hepatitis C patients were treated with interferon‐α‐2b (IFN‐α‐2b) three or five million units thrice weekly, or pegylated‐IFN‐α‐2b 1–1.5 μg/kg weekly plus ribavirin (1000–1200 mg/day) for 24 weeks. Severe anemia was defined as hemoglobin concentration <10 g/dl.

Results:The mean decrease of hemoglobin was 3.9±1.3 g/dl. Thirty‐nine percent of patients had developed severe anemia during therapy. Stepwise logistic regression analysis revealed that old age (≥50 years) (odds ratio [OR]=1.935,P=0.001) and baseline hemoglobin level (≥14 g/dl) (OR=2.975,P<0.001) were significantly correlated with maximal decreases in hemoglobin. Using Cox's regression analysis, pretreatment platelet counts (<150 000/mm3) (OR=1.821,P<0.001), old age (≥50 years) (OR=1.789,P=0.001), female gender (OR=1.739,P<0.001), and low body weight (<65 kg) (OR=1.493,P=0.027) were independent factors contributing to severe anemia. There was a significant linear correlation between the sustained virological response (SVR) rate and the time of severe anemia during therapy (r=0.774,P=0.003), especially among genotype 1 patients (r=0.960,P<0.001).

Conclusion:Careful monitoring of hemoglobin level is necessary in patients who are old, female and have low body weight and platelet counts. Development of severe anemia was significantly correlated with the SVR.
Strength training effects of whole‐body vibration?
Authors: Nordlund M. M. , Thorstensson A.
Published: October 2006

Whole‐body vibration (WBV) has been suggested to have a beneficial effect on muscle strength. Manufacturers of vibration platforms promote WBV as an effective alternative or complement to resistance training. This study aimed to review systematically the current (August 2005) scientific support for effects of WBV on muscle strength and jump performance. MEDLINE and SPORT DISCUS were searched for the word vibration in combination with strength or training. Twelve articles were included in the final analysis. In four of the five studies that used an adequate design with a control group performing the same exercises as the WBV group, no difference in performance improvement was found between groups, suggesting no or only minor additional effects of WBV as such. Proposed neural mechanisms are discussed.
Homocysteine and Stroke Prevention: Have the Trials Settled the Issue?
Authors: Spence J. David
Published: October 2006

Recent publicity surrounding disappointing results of clinical trials of homocysteine lowering has led to the claim that ‘homocysteine is dead’. However, there is strong evidence that elevated plasma total homocysteine is an important independent risk factor, and the highly plausible biological rationale is the following: total homocysteine increases coagulation, impairs endothelial function, increases oxidative stress and low density lipoprotein oxidation, and treatment with vitamins reverses these effects and halts progression of carotid plaque. Some studies have shown clinical benefit of vitamin therapy in coronary angioplasty and peripheral vascular disease. It has recently become apparent that vitamin B12 absorption is impaired in the elderly, and that metabolic B12 deficiency is much commoner than would be appreciated by statistical definitions of ‘normal’ serum B12; higher doses of B12 and perhaps other therapies such as betaine and thiols may be needed to achieve adequate reductions of total homocysteine. It remains likely that effective lowering of total homocysteine will reduce stroke and other vascular events.
Glyceryl Trinitrate vs. Control, and Continuing vs. Stopping Temporarily Prior Antihypertensive Therapy, in Acute Stroke: Rationale and Design of the Efficacy of Nitric Oxide in Stroke (ENOS) Trial (ISRCTN99414122)
Authors:   The ENOS Trial Investigators
Published: October 2006

High blood pressure (BP) is common in acute stroke and is independently associated with a poor outcome. Many patients with acute stroke are taking antihypertensive medications. To test the safety and efficacy of 7 days of transdermal glyceryl trinitrate (GTN, 5 mg/day) vs. no GTN in patients with acute stroke; patients taking antihypertensive therapy immediately before their stroke are also randomised to continue vs. stop this temporarily. ENOS is a prospective international multicentre single-blind randomised-controlled trial in 5000 patients with acute (< 48 h of onset) ischaemic or haemorrhagic stroke. The primary outcome is combined death and dependency (modified Rankin scale > 2) at 90 days measured by blinded central telephone follow-up. Secondary outcomes include: BP over the 7 days of treatment; death, impairment (Scandinavian stroke scale), recurrence, and neuroimaging at 7 days; discharge disposition, disability (Barthel index), cognition (mini-mental status examination) and quality of life (EuroQoL). The sample size will allow an absolute difference in death/dependency of 5% to be detected with 90% power at 5% significance for GTN versus no GTN. Randomisation and data collection are performed over a secure Internet site with real-time data validation. Neuroimaging and serious adverse events are adjudicated blinded to treatment.
Measurement of Intima-Media Thickness vs. Carotid Plaque: Uses in Patient Care, Genetic Research and Evaluation of New Therapies
Authors: Spence J. David
Published: October 2006

Intima-media thickness (IMT) has been measured for over 20 years, and is widely regarded as a surrogate for atherosclerosis. However, in the carotid arteries atherosclerosis is focal, manifesting as plaques. IMT is often measured deliberately where no plaque exists, or multiple measurements may be averaged, including only one or two that intersect plaque. IMT and plaque are biologically and genetically distinct, so they can be expected to respond differentially to therapies for atherosclerosis. Furthermore, because plaques grow along the carotid arteries 2·4 times faster than they thicken, progression or regression of total plaque area is more sensitive to effects of therapy than IMT. Because plaques also grow and regress circumferentially, three-dimensional (3-D) plaque volume is two orders of magnitude more sensitive to effects of therapy than is IMT. While 3-D ultrasound requires special equipment, total plaque area can be measured using the same equipment as IMT. Because plaque and IMT are biologically and genetically distinct entities, representing different phenotypes of atherosclerosis, both should be measured in any situation where IMT is measured, with the exception of studies in children too young for the occurrence of plaque. IMT should not be called ‘atherosclerosis’: the phenotype being assessed should be specified.
Subtotal scapulectomy as the treatment for scapular tumour in the dog: a report of six cases
Authors: Norton C , Drenen CM , Emms SG
Published: October 2006

The medical records of six dogs treated by sub‐total scapulectomy for tumours involving the scapula were reviewed. The mean age of dogs in this study was 8 years and 4 months. Clinical signs on presentation included lameness of the affected forelimb and a palpable mass over the scapular area on physical examination. Pre‐operative chest and affected forelimb radiographs were taken in most cases in addition to a biopsy. Subtotal scapulectomy was performed, ensuring margins clear of neoplastic tissue of at least 2 cm, preservation of the glenoid cavity and thus retention of the scapulo‐humeral joint. On histopathological examination the tumours where diagnosed as chondrosarcoma (one), haemangiosarcoma (two), anaplastic malignant neoplasia (one) and osteosarcoma (one). Limb function was found to be good in all cases postoperatively. Prognosis was related to histopathological diagnosis of the tumour, favourable with chondrosarcoma and poor with the other tumour types.
Assessment of producer conducted antemortem inspection of market pigs in Australia
Authors: Jackowiak J , Kiermeier A , Kolega V , Missen G , Reiser D , Pointon AM
Published: October 2006

Objective  A field trial was conducted to evaluate the effectiveness of on‐farm antemortem inspection performed by Australian pig producers in terms of proficiency in detecting unhealthy animals (suspects), the impact on food safety and animal welfare outcomes.

Animals  A total of 64 trial groups of market pigs (n= 10,703) were dispatched from 20 herds to three abattoirs in three states.

Procedure  All producers and abattoir antemortem inspectors were trained in antemortem inspection prior to the trial using a standardised set of antemortem criteria. Study 1 consisted of three comparisons: on‐farm versus abattoir antemortem inspections on the same pigs, transport effects in suspect and normal pigs, and meat rejection and carcase disposition in suspect and normal pigs. Study 2 compared Salmonella spp status of suspect and normal pigs. Studies 3 and 4 were conducted to assist the interpretation of the results of on‐farm versus abattoir inspection. Antemortem inspection results of three producers and one abattoir antemortem inspector were compared with those of a reference inspector (Gold Standard).

Results  Of the pigs examined, 2.12% (95% CI: 1.84%, 2.42%) were classified as suspect at on‐farm antemortem inspection compared to only 0.14% at abattoir antemortem inspection. Forty one percent of pigs classified as suspect on‐farm had locomotor problems (arthritis, lameness and foot abscess). Compared to normal pigs, suspect pigs had a relative risk of 67.7 (P < 0.0001) of suffering transport injuries. Meat rejection amounted to the equivalent of 9.68% of suspect carcases, compared to the equivalent of 0.35% of normal carcases. The isolation of Salmonella species from caecal content from 20.9% of 67 suspect pigs and 18.8% of 133 control pigs (two matched healthy pigs from the same batch for each suspect pig) were not significantly different. When compared with the reference inspector on‐farm, three producers classified abnormalities in 2,495 pigs with high specificity (0.98), acceptable sensitivity (0.82) and kappa (0.57).

Conclusions  With training, producer sensitivity in antemortem inspection may be high and more proficient than abattoir antemortem inspection. Use of producer inspections may have benefits for animal welfare and chain efficiency, but not food safety.
CONSTRAIN INTERGALACTIC MEDIUM FROM THE SZ EFFECT MAP
Authors: CAO LIANG , ZUO WEI , CHU YAO-QUAN
Published: October 2006

In this paper, we try to detect the SZ effect in the 2MASS DWT clusters and less bound objects in order to constrain the warm-hot intergalactic medium distribution on large scales by cross-correlation analysis. The results of both observed WMAP and mock SZ effect map indicate that the hot gas distributes from inside as well as outside of the high density regions of galaxy clusters, which is consistent with the results of both observation and hydro simulation. Therefore, the DWT measurement of the cross-correlation would be a powerful tool to probe the missing of baryons in the universe.