bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of light or dark phase testing on behavioural and cognitive performance in DBA mice
Authors: Roedel Angelika , Storch Corinna , Holsboer Florian , Ohl Frauke
Published: September 2006

Behavioural experiments in mice are often carried out during the resting phase of these nocturnal animals. Ignoring the fact that mice are more active during the dark period, results from resting-phase testing has also been used to characterize these animals. Since the influence of the light/dark cycle on testing is likely to be a relevant factor for the analysis of behavioural results, the aim of this study was to evaluate the effects of the relative time of the day as well as light conditions during testing on behavioural and cognitive performance in inbred mice. Naïve DBA/2N (DBA) mice were tested in the modified hole board (mHB) either during the dark phase under red light or during the light phase under white light. Different behavioural dimensions and cognitive functions were evaluated in parallel. Depending on the testing conditions, the results showed significant differences in behavioural activity, with DBA mice being less inhibited during dark phase. The same experimental group made fewer memory errors in a visuo-spatial task and showed a faster habituation compared with the group tested during the dark phase. From the results we conclude that testing during the light phase induces a pronounced behavioural inhibition as well as a cognitive disruption in DBA mice, which should be taken into account when cognitively testing these animals.
The feasibility of detecting motor and sensory potentials in a sheep model
Authors: Vialle Raphaël , Loureiro Maria-Carolina , Ilharreborde Brice , Liu Song , Lozeron Pierre , Tadié Marc
Published: September 2006

To investigate the characteristics of motor, sensory and sensory-evoked potentials (SEPs) of thoracic and lumbar roots, and demonstrate the feasibility of assessing axonal regrowth after the neurotization procedure in a sheep model. Six adult sheep were anaesthetized and placed in a sternal position. The thoracic and lumbar roots from T11 to L5 were identified at their emergence from the vertebral foramen and stimulated. Motor and sensory responses were monitored. Thoracic and lumbar roots were easily identified in all cases. Motor potentials were detected for each stimulated nerve without difficulty. The amplitudes were quite variable, ranging from 100 to 5300 μV. Sensory and SEPs were satisfactorily recorded in only three of the six animals. Sensory amplitudes also varied greatly, ranging from 25 to 120 μV. In three cases, SEPs could not be identified due to motor artefacts. The motor pathway after axonal regrowth in neurotized lumbar roots might easily be explored by proximal electric stimulation of the root, close to the sutured area. Detection of sensory and spinal cord evoked potentials might be improved by the use of curve summation techniques. Specific axonal tracing holds promise of being a useful technique for examining sensory and motor pathway recovery after neurotization in the sheep model.
Effect of restraint and injection methods on heart rate and body temperature in mice
Authors: Meijer M K , Spruijt B M , van Zutphen L F M , Baumans V
Published: September 2006

Routine procedures in the laboratory, inducing acute stress, will have an impact on the animals and might thereby influence scientific results. In an attempt to gain more insight into quantifying this acute stress by means of the parameters heart rate (HR) and body temperature (BT), we subjected mice to different restraint and injection methods. We first compared the treatment response of HR and BT, measured by means of radiotelemetry, with the treatment response of plasma corticosterone (pCORT), a common and well-validated parameter for measuring acute stress responses. It was found that HR, and to a lesser extent also BT, parallels pCORT values after subjecting the animals to different methods of restraint. Secondly, the acute stress response caused by different injection methods was evaluated. Again, HR was found to be a more sensitive parameter than BT. We found that, in case of sham injections, the acute stress response after an intraperitoneal (i.p.) injection was more pronounced than after intramuscular (i.m.) or subcutaneous (s.c.) injections, but this difference was found to be inconsistent when saline was used as injection fluid. In a third experiment we investigated if the level of experience of the animal technician influenced the stress response after s.c. injections, but no differences were found. Overall, the results have indicated that HR might be considered as a useful parameter for measuring acute stress responses to routine procedures, but the value of BT seems to be of limited value in this respect.
Behaviour of laboratory mice in different housing conditions when allowed to self-administer an anxiolytic
Authors: Olsson I Anna S , Sherwin Chris M
Published: September 2006

Standard cages prevent mice from performing several natural behaviours for which they are motivated. As a consequence, abnormal behaviours sometimes develop and mice often spend long periods inactive. To improve welfare, cages are sometimes furnished with items such as nesting material, shelters and running wheels. We have previously reported that when allowed to self-administer an anxiolytic, mice in furnished cages consume less anxiolytic than mice in standard cages. This paper presents the results of behaviour studies of the mice in the same experiment. Female C57BL/6J mice (3 per cage) were housed in Standard ( n = 10), Unpredictable ( n = 10) or Furnished ( n = 6) cages. Unpredictable cages were identical to Standard cages, but were exposed to unpredictable events two to three times a week. Furnished cages were double the size of Standard cages and contained nesting material, nest box, tubes, chew blocks and a running wheel. During three consecutive periods, mice had access to only water (control), water or an anxiolytic solution on a daily alternating schedule (forced consumption), and finally, both water and anxiolytic (self-administration). Behaviour was analysed from video recordings taken during the dark phase. The housing type affected behaviour both under the control and the self-administration conditions. Overall, mice in Furnished cages spent less time resting and performing bar-related behaviours and more time on exploratory/locomotory behaviours. Mice in Furnished cages also performed less bar-circling stereotypies than mice in Standard cages. The Unpredictable treatment did not significantly affect behaviour compared to mice in the Standard conditions. There was an overall effect of anxiolytic availability on rest-related behaviours and on exploration–locomotion behaviours, in that mice rested more and spent less time on exploration and locomotion when they were able to self-administer the anxiolytic.
Effects of an individually ventilated cage system on the airway integrity of rats (Rattus norvegicus) in a laboratory in Brazil
Authors: Teixeira M A , Chaguri L C A G , Carissimi A S , Souza N L , Mori C M C , Saldiva P H N , Lemos M , Macchione M , Guimarães E T , King M , Merusse J L B
Published: September 2006

The ventilation method used in the management of laboratory rats is important in maintaining their health. Rats kept under general diluting ventilation (GDV) are exposed to high levels of pollutants present in the environment (dust, airborne bacteria, etc.) or those pollutants produced by animal metabolism and excretion inside the boxes (e.g. ammonia and carbon dioxide). These pollutants may contribute to respiratory pathologies. An alternative experimental ventilation system for laboratory animal housing using intracage ventilation technology (individually ventilated cage system, IVC) was developed. In this system, ammonia levels decreased and rats exhibited better reproductive performance and a lower incidence of pneumonia than rats maintained under GDV. Using two different levels of air speed (0.03–0.26 m/s: IVC1; 0.27–0.80 m/s: IVC2), the effects of IVC were compared with GDV (control) in Wistar rats in terms of respiratory mucus properties, on the nasal epithelium (as measured by quantitative morphometry) and on the lungs (as determined by the cellular composition obtained by bronchoalveolar lavage). Mucus of the respiratory system was evaluated using the following techniques: rheology (viscoelasticity) by microrheometer, in vitro mucociliary transportability (frog palate) and contact angle (an indicator of adhesivity). Also, membrane transepithelial potential difference was measured as a biomarker of airway integrity. After bedding was changed, ammonia concentrations inside the cages on day 3 were significantly higher for GDV than for IVC1 and IVC2. The potential-difference values for IVC1, IVC2 and GDV in the epiglottis and in the trachea also showed differences. Although some significant differences were observed across the three groups in counts of some cell types, the intragroup results were highly variable among individuals and inconsistent between sexes. No significant differences in the other parameters were found across groups. These results establish that rats maintained under GDV in relatively unregulated conditions are exposed to factors that can lead to deleterious effects on the ciliated epithelium of the airways, and that these effects can be prevented by the use of IVC.
Refined anaesthesia for implantation of engineered experimental aortic valves in the pulmonary artery using a right heart bypass in sheep
Authors: Schauvliege S , Narine K , Bouchez S , Desmet D , Van Parys V , Van Nooten G , Gasthuys F
Published: September 2006

The feasibility of an anaesthetic protocol developed for surgery during right heart bypass in sheep is reported. Seven female Suffolk sheep, weighing 25–35 kg, were selected for the study. Premedication consisted of midazolam and methadone (both 0.1 mg kg−1 intravenously). Anaesthesia was induced with propofol (2–4 mg kg−1) and maintained with isoflurane in oxygen and continuous rate infusions of propofol (5–7 mg kg−1 h−1) and fentanyl (5 μg kg−1 bolus, 5 μg kg−1 h−1). Cisatracurium (0.2 mg kg−1) provided muscle relaxation. A standard roller pump was used for the extracorporeal circulation. Drugs administered to maintain blood pressure and heart rate within acceptable levels included phenylephrine (3–4 μg kg−1), ephedrine (0.1–0.2 mg kg−1), nitroglycerine (50–150 μg kg−1 h−1) and metoprolol succinate (30–80 μg kg−1). Electrolytes were infused as needed. Postoperative analgesia was provided by an intercostal block (15 mL 0.5% bupivacaine + epinephrine), carprofen (4 mg kg−1) and an opioid (methadone 0.1 mg kg−1 or buprenorphine 0.01 mg kg−1). One sheep became hypoxic during the bypass (PaO2 47.7 mmHg). Irregularities of the electrocardiogram were observed during manipulation of the heart in all animals. During the initial phase of the bypass, blood pressure decreased in all sheep, accompanied by dilatation of the heart and large intrathoracic veins in five sheep. With appropriate treatment, blood pressure was restored and easily maintained until the end of the bypass. Weaning from the bypass, using an infusion of nitrates, was smooth. One sheep required a blood transfusion because of severe blood loss and another sheep died postoperatively from respiratory complications. Minor irregularities of the electrocardiogram observed during manipulation of the heart were not life threatening and required no treatment. Decreases in blood pressure at the beginning of the bypass can be expected and require treatment. Nitrates are useful in avoiding volume overload during weaning. The anaesthetic protocol is acceptable for surgery under right heart bypass in sheep.
Preference for bedding material in Syrian hamsters
Authors: Lanteigne M , Reebs S G
Published: September 2006

This study aimed to determine whether Syrian (golden) hamsters, Mesocricetus auratus, prefer certain bedding materials and whether bedding material can affect paw condition, body weight gain and wheel-running activity. In a first experiment, 26 male hamsters had access to two connected cages, each cage containing a different bedding material (either pine shavings, aspen shavings, corn cob or wood pellets). In a second experiment, 14 male hamsters had access to four connected cages that contained the different bedding materials and also a piece of paper towel to serve as nest material. In a third experiment, 30 male hamsters were each placed in a single cage, 10 of them with pine shavings, 10 with aspen shavings and 10 with corn cob, and they were monitored for 50 days. Significant preferences in the first experiment were: pine shavings over aspen shavings, corn cob over wood pellets, pine shavings over corn cob and aspen shavings over wood pellets (aspen shavings versus corn cob was not tested). However, there was no significant preference expressed in the second experiment, suggesting that the general preference for shavings in the first experiment was based on bedding material suitability as a nesting material. No significant effect of bedding material on paw condition, body weight gain and wheel-running activity was detected. None of the four bedding materials tested in this study can be judged to be inappropriate in the short term if nesting material is added to the cage and if the litter is changed regularly.
Detection of antibodies to Streptobacillus moniliformis in rats by an immunoblot procedure
Authors: Boot R , Van de Berg L , Vlemminx M J
Published: September 2006

An immunoblot (IB) technique for detecting antibodies to Streptobacillus moniliformis in rat sera was evaluated. Immune sera to three S. moniliformis strains showed a similar reactivity pattern with both autologous and homologous antigens in the 18–87 kDa range. Using a rat S. moniliformis strain as the antigen, a similar reactivity pattern was found with sera from rats infected experimentally with S. moniliformis and sentinels. Two to five proteins were detected in the 32–55 kDa range. Over a period of 2.5 years, 27/133 rat serum panels submitted for routine monitoring yielded one or more S. moniliformis enzyme-linked immunosorbent assay (ELISA)-positive samples. In one of these 27 panels, sera showed an IB reactivity pattern resembling that observed with immune sera and with sera from infected and exposed rats. S. moniliformis was confirmed in the colony by both culture and polymerase chain reaction (PCR). Sera from the remaining 26 ELISA-positive serum panels frequently showed activity to a 57 kDa antigen but not more than one antigen was detected in the 32–55 kDa range. We conclude that the IB can be used as a confirmatory test for the detection of S. moniliformis infection in ELISA-positive rats.
Guidelines for health and welfare monitoring of fish used in research
Authors: Johansen R , Needham J R , Colquhoun D J , Poppe T T , Smith A J
Published: September 2006

The aim of this paper is to provide background material necessary for the development of international guidelines for the health and welfare monitoring of fish used in research. It provides an overview of present guidelines and discusses why more detailed and species-specific guidelines are needed. A major issue within fish research is to document the situation today and point out areas where improvements are needed.
Long-term effects of cage-cleaning frequency and bedding type on laboratory rat health, welfare, and handleability: a cross-laboratory study
Authors: Burn Charlotte C , Peters Alan , Day Michael J , Mason Georgia J
Published: September 2006

Cage-cleaning is necessary for a hygienic environment, but since rats communicate using scent, they might suffer if their cages are cleaned too frequently. Male rats (Sprague–Dawley and Wistar) were kept for five months across four animal units. Their cages were cleaned twice-weekly, weekly, or every two weeks, and contained either aspen woodchips or absorbent paper bedding. Aggression, injuries and general health, weight gain, chromodacryorrhoea (a stress-related Harderian gland secretion), handleability, and lung pathology were monitored, as was in-cage ammonia. Cleaning frequency had no clear impact on rat welfare, although frequent cleaning decreased ammonia concentrations and handleability, and non-aggressive skirmishing was highest in weekly cleaned rats. Surprisingly, bedding type did not affect ammonia, but all ammonia readings were unexpectedly low. However, rats kept on aspen had greater sneezing rates and lung pathology than those on paper bedding, but also had higher body weights. The results raise concerns about aspen bedding, which is relatively inert compared with other wood beddings, but nevertheless more harmful than paper. Animal unit significantly affected eight of the 11 variables tested, having interactive effects on five of them. The study also demonstrates the interactive effects of different animal units, casting doubt on the feasibility of standardization. We explored multiple variables of interest, so all findings require confirmation through further work. Nevertheless, cage-cleaning rates seem to affect socially housed male rats little, while bedding type has important effects on rat health.
Intraoral cheek fistulae: a refined technique
Authors: Hintiryan Houri , Hayes Unja L , Chambers Kathleen C
Published: September 2006

Taste reactivity testing (TRT), which entails infusing a solution into the oral cavity of subjects, is used across a wide range of studies. For laboratories inexperienced in the conventional technique of implanting cheek fistulae, the surgery can be problematic for both the subjects and the experimenter. We have proposed a refined method for fistulae implantation that is less invasive, thereby reducing the pain and distress of the animals. Using this refined technique, we were able to replicate the findings of previous TRT studies, namely that a high dose of lithium chloride produces an increase in aversive and a decrease in ingestive orofacial and somatic responses. Using indices of health, we demonstrate that unlike animals with the conventional method of fistulae implantation, subjects that receive the refined technique regain their pre-surgery body weights rapidly and show no physical signs of discomfort. Additional advantages of the refined technique are discussed.
Islet-like cell clusters: viability, cell types, and subretinal transplantation in pancreatectomized cats
Authors: Maeno Takatoshi , Inoue Makoto , Embabi Sherif N , Miki Daijiro , Hatchell Diane L
Published: September 2006

We investigated a method for isolating sufficient feline islets of Langerhans to restore normoglycaemia following transplantation into the subretinal space of pancreatectomized cats. Collagenase digestate of feline pancreas was maintained in serum-free tissue culture medium for 1–9 days. Viability of islet-like cell clusters (ICC) was assessed with ethidium bromide and fluorescein diacetate staining; cell types were identified immunohistochemically. After nine days, the ICC were transplanted. We estimated viable ICC in tissue culture at nine days as 3800 ± 2000 (mean ± SD) per pancreas. While numbers of β cells decreased over time in culture, ductal cells increased. Bromodeoxyuridine labelling showed no proliferation of β cells but extensive proliferation of ductal cells. Subretinal transplants of cultured ICC in the diabetic cats maintained normoglycaemia for up to 12 days, while they provoked massive lymphocyte infiltration indicating rejection. Islet transplantation into the feline subretinal space temporarily restored normoglycaemia. Our current method of culture achieved sufficient reduction of acinar cells but an insufficient yield of insulin-producing cells.
What is 'continuity of care'?
Authors: Gulliford Martin , Naithani Smriti , Morgan Myfanwy
Published: September 2006

Continuity of care is concerned with the quality of care over time. There are two important perspectives on this. Traditionally, continuity of care is idealized in the patient's experience of a 'continuous caring relationship' with an identified health care professional. For providers in vertically integrated systems of care, the contrasting ideal is the delivery of a 'seamless service' through integration, coordination and the sharing of information between different providers. As patients' health care needs can now only rarely be met by a single professional, multidimensional models of continuity have had to be developed to accommodate the possibility of achieving both ideals simultaneously. Continuity of care may, therefore, be viewed from the perspective of either patient or provider.

Continuity in the experience of care relates conceptually to patients' satisfaction with both the interpersonal aspects of care and the coordination of that care. Experienced continuity may be valued in its own right. In contrast, continuity in the delivery of care cannot be evaluated solely through patients' experiences, and is related to important aspects of services such as 'case-management' and 'multidisciplinary team working'. From a provider perspective, the focus is on new models of service delivery and improved patient outcomes. A full consideration of continuity of care should therefore cover both of these distinct perspectives, exploring how these come together to enhance the patient-centredness of care.
Is self-care a cost-effective use of resources? Evidence from a randomized trial in inflammatory bowel disease
Authors: Richardson Gerald , Sculpher Mark , Kennedy Anne , Nelson Elizabeth , Reeves David , Roberts Chris , Robinson Andrew , Rogers Anne , Thompson David
Published: September 2006

Objectives: To determine if a whole-system approach to self-management in inflammatory bowel disease (IBD), using a guidebook developed with patients and physicians trained in patient-centred care, leads to cost-effective use of health system resources.

Methods: Cost-effectiveness analysis over a one-year time horizon comparing the whole systems self-management approach to treatment with usual treatment. Nineteen hospitals in the northwest England were randomized to the intervention or to be controls; 651 patients (285 at intervention sites and 366 at control sites) with established IBD were included. The economic evaluation related differential health service costs, from a UK NHS perspective, to differences in quality-adjusted life years (QALYs) based on patients' responses to the EQ-5D.

Results: The intervention was associated with a mean reduction in costs of £148 per patient and a small mean reduction in QALYs of 0.00022 per patient compared with the control group. This resulted in an incremental cost per QALY gained of £676,417 for treatment as usual and a probability of around 63% that the whole-system approach to self-management is cost-effective, assuming a willingness to pay up to £30,000 for an additional QALY.

Conclusions: Although there is uncertainty associated with these estimates, more widespread use of this method in chronic disease management seems likely to reduce health care costs without evidence of adverse effect on patient outcomes.
Exploring the determinants of NHS performance ratings: lessons for performance assessment systems
Authors: Jacobs Rowena , Martin Stephen , Goddard Maria , Gravelle Hugh , Smith Peter
Published: September 2006

Objectives: A basic tenet of effective performance management is that decision makers should be held responsible only for aspects of performance over which they have control. We examine the degree to which variations in the performance of health care organizations are explained by a range of factors that are subject to differing degrees of managerial control.

Methods: We use multiple regression methods and data on 304 National Health Service (NHS) Primary Care Trusts (PCTs) in England for 2002/03 to analyse the relationship between their performance, as measured by 'star ratings' and nine key performance targets, and a large number of explanatory variables. We classify the explanatory variables into five groups along a spectrum from 'no managerial control' to 'total managerial control'. We also analyse the relationship between PCTs that are service purchasers and their main providers to assess the degree to which their performance is linked.

Results: For all of the key performance targets, most of the variation in performance is unexplained, although variables in groups 1, 2 and 3 (less managerial control) explain the largest proportion of variation. We find some evidence that socioeconomic and geographic factors have an impact on performance. We also find a positive relationship between the performances of purchaser and provider organizations.

Conclusions: The star ratings did not allow for the different environmental circumstances within which PCTs operate and which affect their performance. Policy-makers should exercise caution in using such performance indicators to regulate health care organizations.
A systematic review of evidence about extended roles for allied health professionals
Authors: McPherson Kathryn , Kersten Paula , George Steve , Lattimer Val , Breton Alice , Ellis Bridget , Kaur Dawn , Frampton Geoff
Published: September 2006

Objective: Extending the role of allied health professionals has been promoted as a key component of developing a flexible health workforce. This review aimed to synthesize the evidence about the impact of these roles.

Methods: A systematic review of extended scope of practice in five groups: paramedics, physiotherapists, occupational therapists, radiographers, and speech and language therapists. The nature and effect of these roles on patients, health professionals and health services were examined. An inclusive approach to searching was used to maximize potential sources of interest including multiple databases, 'grey' literature and subject area experts. An expanded Cochrane Collaboration method was used in view of the anticipated lack of randomized controlled trials and heterogeneity of designs. Papers were only excluded after the search stage for lack of relevance.

Results: A total of 355 papers was identified as meeting relevance criteria and 21 studies progressed to full review and data extraction. The primary reason for exclusion from data extraction was that the study included neither qualitative nor quantitative data or because methodological flaws compromised data quality. It was not possible to evaluate any pooled effects as patient health outcomes were rarely considered.

Conclusions: A range of extended practice roles for allied health professionals have been promoted and are being undertaken, but their health outcomes have rarely been evaluated. There is also little evidence as to how best to introduce such roles, or how best to educate, support and mentor these practitioners.
A comparison of formal consensus methods used for developing clinical guidelines
Authors: Hutchings Andrew , Raine Rosalind , Sanderson Colin , Black Nick
Published: September 2006

Objectives: To compare two consensus development methods commonly used for developing clinical guidelines in terms of the judgments produced, closeness of consensus, amount of change between rounds, concordance with research evidence and reliability.

Methods: In all, 213 general practitioners and mental health professionals from England participated in four Delphi and four nominal groups. They rated the appropriateness of four treatments (cognitive behavioural therapy [CBT], behavioural therapy [BT], brief psychodynamic interpersonal therapy [BPIT] and antidepressants) for three conditions. First, participants rated the appropriateness of interventions independently, using a postal questionnaire. For nominal groups, the ratings were fed back and discussed at a meeting, and then group members privately completed the questionnaire again. For Delphi groups, there was feedback but no discussion, and the entire process was conducted by postal questionnaire.

Results: The effect of consensus method on final ratings varied with therapeutic intervention, with nominal groups rating CBT and antidepressants more favourably than Delphi groups. Consensus was closer in the nominal than in the Delphi groups in both rounds. There was no overall difference between groups in their concordance with research evidence (odds ratio 1.13, 95% confidence interval 0.79–1.61). In this study, the Delphi method was more reliable ( κ coefficients 0.88 and 0.89 compared with 0.41 and 0.65 for nominal groups).

Conclusions: The advantages of nominal groups (more consensus; greater understanding of reasons for disagreement) could be combined with the greater reliability of the Delphi approach by developing a hybrid method.
Does continuity of care with a family physician reduce hospitalizations among older adults?
Authors: Menec Verena H , Sirski Monica , Attawar Dhiwya , Katz Alan
Published: September 2006

Objective: To examine the relation between continuity of primary care and hospitalizations.

Methods: Survey data from a representative sample of older adults aged 67 or over living in the province of Manitoba ( n = 1863) were linked to administrative data, which provide complete records of physician visits and hospitalizations. A visit-based measure of continuity of care was derived using a majority-of-care definition, whereby individuals who made 75% of all their visits to family physicians (FPs) to the same FP were classified as having high continuity of care, and those with less than 75% of their visits to the same FP as having low continuity of care. Whether individuals were hospitalized (for either ambulatory care-sensitive conditions or all conditions) was also determined from administrative records.

Results: High continuity of care was associated with reduced odds of ambulatory care-sensitive hospitalizations (adjusted odds ratio = 0.67, confidence interval 0.51–0.90) controlling for demographic and self-reported, health-related measures. It was not related to hospitalizations for all conditions, however.

Conclusions: The study highlights the importance of continuity of primary care in reducing potentially avoidable hospitalizations.
Gathering data for health care regulation: learning from experience in England and Wales
Authors: Attride-Stirling Jennifer , Humphrey Charlotte , Tennison Barry , Cornwell Jocelyn
Published: September 2006

Objectives: Between 2000 and 2004, the Commission for Health Improvement (CHI) undertook a comprehensive programme of reviews of progress with clinical governance in National Health Service trusts (provider organizations) in England and Wales. An internal retrospective evaluation of the main instruments and processes used to gather evidence for these reviews was undertaken to identify lessons for the future development of health care regulation methods.

Methods: A multimethod retrospective study involving review of data-gathering tools previously undertaken by CHI, an intranet-based survey and confidential interviews with CHI staff. The study reviewed 11 instruments and processes used to gather information about trusts from routine data-sets, internal documents, staff, patients and the public, local statutory bodies, and community and voluntary stake-holders. Analysis focused on inputs required (skills and resources required to use the approaches effectively and challenges associated with their use) and value obtained (relevance and quality of the information obtained and its contribution to clinical governance review conclusions).

Results/conclusions: Most of the instruments and processes evaluated had the potential to elicit worthwhile information for clinical governance reviews, but in practice their value varied considerably. A range of factors, within and beyond CHI, was found to affect the quality of the data obtained. Based on this learning, lessons are identified whose implementation would help optimize the quality of data gathering for health care regulation.
Better the devil you know than the doctor you don't: is advertising drugs to doctors more harmful than advertising to patients?
Authors: Vaithianathan Rhema
Published: September 2006

Most countries ban the advertising of prescription medication directly to consumers, yet allow drug companies to promote drugs to doctors intensively. Such a differential treatment of promotion cannot be justified on economic grounds, but is a result of paternalism in health care regulation, which portrays patients as gullible and doctors as perfect agents. Instead, there should be a complete deregulation of direct-to-consumer (DTC) advertising and doctors ought to be required to reveal their relationships with drug companies. This is particularly apt, given the calls for similar transparency rules to address the potential conflict of interest between drug companies and researchers.
Might how you look influence how well you are looked after? A study which demonstrates that GPs perceive socio-economic gradients in attractiveness
Authors: O'Reilly Dermot , Steele Keith , Patterson Chris , Milsom Penny , Harte Pat
Published: September 2006

Objective: To test the hypothesis that more disadvantaged patients are perceived by general practitioners (GPs) as being less attractive than their more affluent peers.

Design: Three hundred and twenty five consecutive ambulant patients attending 15 GPs' surgeries in Northern Ireland, UK, had three digital photographs taken; two of their face (smiling and non-smiling) and one of their face and upper trunk. Photographs were assessed by 30 GPs from practices other than those used to select the patients. Patients were subdivided into 'more affluent', 'average' and 'more deprived' groups based on their household tenure, level of educational attainment and car availability. The age and sex of the GP-assessors was recorded along with the average deprivation score for their own practice population. The relationship between patient, GP and practice characteristics was explored using multilevel modelling to take account of the hierarchical nature of the dataset. The main outcome measure was the perceived attractiveness score of the patient as rated by the GP.

Results: Of those invited, 301 (92%) participated in the study. The mean age of patients was 49.6 (standard deviation 6.1) years and 59% were female. GPs rated younger patients more attractive than older patients; each additional 10 years reduced the attractiveness scores by an average of 2.7 points (95% confidence intervals 1.4–3.9, P < 0.001). Patients from higher socio-economic backgrounds were assessed as more attractive than their less affluent peers, the mean difference being 7.8 points (5.8–9.9, P < 0.001). The difference in attractiveness scores between affluent and deprived patients was greatest when the GP assessor came from a practice serving predominantly deprived patients.

Conclusion: The perceived difference in the average attractiveness scores between affluent and deprived patients is large and, though this study does not prove it, there is sufficient circumstantial evidence to indicate that it might play a significant role in modifying the medical encounter.
An Identification Method with Direct Acquisition of Reduced Order Model from a Step like Response
Authors: Kosaka Manabu
Published: September 2006

This paper describe a discrete time off-line identification method performed by using input and output data having a constant steady state output response such as a step response. A step input causes noise or vibration from a mechanical system only at the moment when it is applied but they are attenuated asymptotically. The method can directly acquire any order of reduced model without knowing the real order of the plant. The effectiveness of the method is verified by applying it to a two-mass mechanical system.
A New Method for Wind-Induced Response Analysis of Long Span Roofs
Authors: Bo Chen , Yue Wu , Shizhao Shen
Published: September 2006

Long span roofs are usually characterised by their dense distribution of natural frequencies and remarkable coupling effects among different natural modes. Those traditional methods, such as modal superposition method, are not suitable for analyzing wind-induced response of these structures. In this paper, a new method named as Ritz-POD method is proposed to analyse wind-induced response of long span roofs in frequency domain, which synthesises proper orthogonal decomposition (POD) technique and direct superposition method with Ritz vectors. The eigenvectors of fluctuating wind load with POD technique are regarded as spatial distributions of this load to generate Ritz vectors, and wind-induced response is analysed by direct superposition method with Ritz vectors. Therefore, it can take into account multimode buffeting response automatically, even the case that structures vibrate in high order modes. According to this method, the wind-induced response of a single layer reticular shell is analysed, and compared to the results achieved with modal superposition method. It shows that Ritz-POD method is more accurate and efficient with fewer Ritz vectors.
Optimization for Maximum Buckling Load of a Lattice Space Frame with Nonlinear Sensitivity Analysis
Authors: Chen Pei-Shan , Kawaguchi Mamoru
Published: September 2006

The paper presents an optimization analysis method to find the optimum shape of a lattice space frame with maximum buckling load. The buckling load of the lattice space frame is determined by a geometrically nonlinear analysis. The mathematic analysis of the optimization is based on Generalised Reduced Gradient method (GRG) [1], in which the slope of the objective function (the load parameter at buckling point) with respect to the design parameters is required. In order to determine the slope, the authors introduced a so-called Stiffness Sensitivity Tensor in the nonlinear structural analysis, such that the sensitivity analysis can be carried out simultaneously with the incremental iteration of the geometrically nonlinear structural analysis. A single layer lattice dome is taken as a numerical example, and the results show that the buckling load parameter for full area loading case increases 32.75% compared to that for the initial shape.
Use of Routinely Collected Amniotic Fluid for Whole-Genome Expression Analysis of Polygenic Disorders
Authors: Nagy Gyula Richárd , Gyõrffy Balázs , Galamb Orsolya , Molnár Béla , Nagy Bálint , Papp Zoltán
Published: September 2006

Background: Neural tube defects related to polygenic disorders are the second most common birth defects in the world, but no molecular biologic tests are available to analyze the genes involved in the pathomechanism of these disorders. We explored the use of routinely collected amniotic fluid to characterize the differential gene expression profiles of polygenic disorders.

Methods: We used oligonucleotide microarrays to analyze amniotic fluid samples obtained from pregnant women carrying fetuses with neural tube defects diagnosed during ultrasound examination. The control samples were obtained from pregnant women who underwent routine genetic amniocentesis because of advanced maternal age (>35 years). We also investigated specific folate-related genes because maternal periconceptional folic acid supplementation has been found to have a protective effect with respect to neural tube defects.

Results: Fetal mRNA from amniocytes was successfully isolated, amplified, labeled, and hybridized to whole-genome transcript arrays. We detected differential gene expression profiles between cases and controls. Highlighted genes such as SLA, LST1, and BENE might be important in the development of neural tube defects. None of the specific folate-related genes were in the top 100 associated transcripts.

Conclusions: This pilot study demonstrated that a routinely collected amount of amniotic fluid (as small as 6 mL) can provide sufficient RNA to successfully hybridize to expression arrays. Analysis of the differences in fetal gene expressions might help us decipher the complex genetic background of polygenic disorders.
Endocrine differentiation of fetal ovaries and testes of the spotted hyena (Crocuta crocuta): timing of androgen-independent versus androgen-driven genital development
Authors: Browne P , Place N J , Vidal J D , Moore I T , Cunha G R , Glickman S E , Conley A J
Published: September 2006

Female spotted hyenas (Crocuta crocuta) have an erectile peniform clitoris and a pseudoscrotum but no external vagina, all established by day 35 of a 110-day gestation. Recent studies indicate that these events are androgen-independent, although androgen secretion by fetal ovaries and testis was hypothesized previously to induce phallic development in both sexes. We present the first data relating to the capacity of the ovaries and testes of the spotted hyena to synthesize androgens at different stages of fetal life. Specifically, spotted hyena fetal gonads were examined by immunohistochemistry at GD 30, 45, 48, 65, and 95 for androgen-synthesizing enzymes, as related to the morphological development. Enzymes included 17α-hydroxylase/17,20-lyase cytochrome P450 (P450c17), cytochrome b5, 3β-hydroxysteroid dehydrogenase (3βHSD), and cholesterol side-chain cleavage cytochrome P450 (P450scc). Anti-Müllerian-hormone (AMH) expression was also examined. AMH was strongly expressed in fetal Sertoli cells from GD 30 and after. P450c17 expression was detected in Leydig cells of developing testes and surprisingly in Müllerian duct epithelium. Fetal ovaries began to organize and differentiate by GD 45, and medullary cells expressed P450c17, cytochrome b5, 3βHSD, and P450scc. The findings support the hypothesis that external genital morphology is probably androgen-independent initially, but that fetal testicular androgens modify the secondary, male-specific phallic form and accessory organs. Fetal ovaries appear to develop substantial androgen-synthesizing capacity but not until phallic differentiation is complete, i.e. after GD 45 based on circulating androstenedione concentrations. During late gestation, fetal ovaries and testes synthesize androgens, possibly organizing the neural substrates of aggressive behaviors observed at birth in spotted hyenas. These data provide an endocrine rationale for sexual dimorphisms in phallic structure and reveal a potential source of androgenic support for neonatal aggression in female and male C. crocuta.
Diploid porcine parthenotes produced by inhibition of first polar body extrusion during in vitro maturation of follicular oocytes
Authors: Somfai Tamás , Ozawa Manabu , Noguchi Junko , Kaneko Hiroyuki , Ohnuma Katsuhiko , Karja Ni Wayan Kurniani , Fahrudin Mokhamad , Maedomari Naoki , Dinnyés András , Nagai Takashi , Kikuchi Kazuhiro
Published: September 2006

We investigated nuclear progression and in vitro embryonic development after parthenogenetic activation of porcine oocytes exposed to cytochalasin B (CB) during in vitro maturation (IVM). Nuclear progression was similar in control oocytes and oocytes matured in the presence of 1 μg/ml CB (IVM-CB group) by 37 h IVM; at this time the proportion of oocytes that had reached or passed through the anaphase-I stage did not differ significantly between the IVM-CB and the control groups (61.3 and 69.9% respectively; P < 0.05). After IVM for 37 h, no polar body extrusion was observed in the IVM-CB group. In these oocytes, the two lumps of homologous chromosomes remained in the ooplasm after their segregation and turned into two irregular sets of condensed chromosomes. By 41 h IVM, the double sets of chromosomes had reunited in 89.5% IVM-CB oocytes and formed a single large metaphase plate, whereas 68.8% of the control oocytes had reached the metaphase-II stage by this time. When IVM-CB oocytes cultured for 46 h were stimulated with an electrical pulse and subsequently cultured for 8 h without CB, 39.0% of them extruded a polar body and 82.9% of them had a female pronucleus. Chromosome analysis revealed that the majority of oocytes that extruded a polar body were diploid in both the control and the IVM-CB groups. However, the incidence of polyploidy in the IVM-CB group was higher than that in the control group (P < 0.05). In vitro development of diploid parthenotes in the control and the IVM-CB groups was similar in terms of blastocyst formation rates (45.8 and 42.8% respectively), number of blastomeres (39.9 and 44.4 respectively), the percentage of dead cells (4.3 and 2.9% respectively), and the frequency of apoptotic cells (7.3 and 6.3% respectively). Tetraploid embryos had a lower blastocyst formation rate (25.5%) and number of cells (26.2); however, the proportion of apoptotic nuclei (7.0%) was similar to that in diploid parthenotes. These results suggest that the proportion of homozygous and heterozygous genes does not affect in vitro embryo development to the blastocyst stage.
Spatial Modeling to Project Southern Appalachian Trout Distribution in a Warmer Climate
Authors: Flebbe Patricia A. , Roghair Laura D. , Bruggink Jennifer L.
Published: September 2006

In the southern Appalachian Mountains, the distributions of native brook trout Salvelinus fontinalis and introduced rainbow trout Oncorhynchus mykiss and brown trout Salmo trutta are presently limited by temperature and are expected to be limited further by a warmer climate. To estimate trout habitat in a future, warmer climate, we produced a regional map of wild trout habitat based on information from stream samples, expert knowledge, and suitable land cover. We then developed a quantile regression model of the elevation–latitude boundary for the present distribution of trout; this constitutes a more direct, spatially explicit approach to modeling trout distribution than the use of thermal limits. In combination with a lapse rate model, the boundary model was used to project future wild trout distributions over a range of higher temperatures. If the predictions of the Hadley Centre global circulation model (GCM) are assumed, about 53% of trout habitat would be lost; if the more extreme Canadian Centre GCM is used, 97% would be lost. With increasing temperature, fragmentation would increase, leaving populations in small, isolated patches vulnerable to extirpation because of the decreased likelihood of recolonization. The regional trout habitat map and the models produced here were useful for making these predictions, and the map could be used for assessing the impacts of other regional stressors.
Chlamydia trachomatis and Neisseria gonorrhoeae Infections Among Men and Women Entering California Prisons
Authors: Bernstein Kyle T. , Chow Joan M. , Ruiz Juan , Schachter Julius , Horowitz Evalyn , Bunnell Rebecca , Bolan Gail
Published: September 2006

Objective. We estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection among newly arriving inmates at 6 California prisons.

Methods. In this cross-sectional study in 1999, urine specimens collected from 698 men aged 18 to 25 years and 572 women aged 18 years or older were tested at intake for C trachomatis and N gonorrhoeae using ligase chain reaction. An analysis of demographic and arrest-related correlates of C trachomatis and N gonorrhoeae infection was performed.

Results. The overall C trachomatis prevalence was 9.9% (95% CI=7.8%, 12.3%) among men aged 18 to 25 years, 8.9% (95% CI = 2.9%, 22.1%) among women aged 18 to 25 years, and 3.3% (95% CI=2.0%, 5.1%) among women overall. Three N gonorrhoeae cases were detected with an overall prevalence of 0.24% (95% CI=0.05%, 0.69%).

Conclusions. The prevalence of C trachomatis infection at entry to California prisons, especially among young female and male inmates, was high, which supports routine screening at entry into prison. In addition, screening in a jail setting where most detainees are incarcerated before entry into the prison setting may provide an excellent earlier opportunity to identify these infections and treat disease to prevent complications and burden of infection in this high-risk population.