bluuebunny/crossref_metadata_2025 huggingface dataset:
Human papillomavirus molecular biology and pathogenesis
Authors: Sanclemente G , Gill DK
Published: March 2003

Human papillomavirus (HPV) infection is the most common sexually transmitted disease in the world and accounts for an estimated 11% of the global cancer incidence in women. HPV‐16 is the most prevalent type detected in cervical cancer and along with types 18, 31, 33 and 45 has been classified as a class I carcinogen. In addition to cervical cancer, HPVs are also associated with the malignant transformation of other mucosal and skin cancers. Thus, the combination of the malignant potential of HPV and its high prevalence of infection confers to it an importance of generalized clinical and virological significance. The natural history of HPV infection with or without treatment varies from spontaneous regression to persistence. The most important mechanism for wart regression appears to be cell‐mediated immunity. Cytokines released by keratinocytes or cells of the immune system may play a part in the induction of an effective immune response against HPV infection and the subsequent regression of lesions. This review discusses the molecular biology, pathogenesis and immunology of HPV infections.
Terbinafine: efficacy and tolerability in young children with tinea capitis due to Microsporum canis
Authors: Silm H , Karelson M
Published: March 2003

Aims  We carried out an open, prospective, uncontrolled study to evaluate the efficacy and tolerability of terbinafine in the treatment of young children with tinea capitis due to Microsporum canis.

Methods  A total of 83 healthy, immunocompetent children (age range 2–13 years) were enrolled in eight centres in Estonia, Latvia and Lithuania. Patients received oral terbinafine in dosages based on weight, 62.5 mg for those weighing 10–20 kg, 125 mg for 20–40 kg, plus application of topical 1% terbinafine cream twice daily to affected areas. Treatment lasted for 4 weeks, followed by an 8‐week observation (treatment‐free) period. All the subjects were assessed for efficacy and tolerability at 12 weeks.

Results  Eighty‐one subjects were available for assessment at 12 weeks: 32 had completely recovered, with no evidence of relapse during the observation period, and 21 showed mycological cure, but presented residual physical signs of infection. Thus the effective cure rate was 65.4% in an infection known to be more difficult to cure than other causes of tinea capitis. Terbinafine was well tolerated by these children.

Conclusions  This study showed effective cure of two‐thirds of 81 cases of tinea capitis caused by M. canis with a 4‐week course of treatment. As one‐third of the cases did not respond to treatment, we suggest using combined oral and topical treatment with terbinafine in children with tinea capitis caused by M. canis.
Reedbed selection and colony size of breeding Purple Herons Ardea purpurea in southern France
Authors: Barbraud Christophe , Lepley Michel , Mathevet Raphael , Mauchamp Andre
Published: March 2003

Reedbeds of Phragmites australis have declined in Europe in recent decades. Moreover, in some European countries the remaining reedbeds are intensively managed for industrial reed cutting, hunting or grazing. Several species of conservation concern, such as herons and pelicans, use reedbeds as their principal breeding habitat. At the same time, data on habitat use and colony size of these species in relation to reedbed management practices are scarce. We investigated habitat characteristics of 71 reedbeds occupied or unoccupied by breeding Purple Herons Ardea purpurea in the Rhône delta (Camargue) and in other Mediterranean coastal marshes in southern France. In addition, data on colony size in occupied reedbeds were collected from aerial surveys. Reedbeds occupied by breeding Purple Herons were unharvested, or only partially harvested, in winter and had higher water levels in spring compared with unoccupied reedbeds. A logistic regression model with reed harvesting intensity and water levels in mid‐April as independent variables correctly classified reedbed use for 94.7% of the reedbeds in the study. A model with water levels in mid‐April alone was only 90.9% accurate, suggesting that low water level in spring is the most important factor limiting reedbed occupation by breeding Purple Herons. A general linear model indicated significant effects of harvesting intensity and reedbed surface area on colony size. Within occupied reedbeds there was a strong tendency for colony size to increase with increasing reedbed surface area. Given the recent developments in reed harvesting and wetland management in southern France and elsewhere in Europe, these results provide the first information on potential effects of these practices on reed nesting herons, and suggest that Purple Heron conservation is likely to be favoured by maintaining large uncut reedbeds with relatively high water levels in spring. The possible effect of changes in habitat on the Purple Heron population in southern France is discussed.
Starvation mortality and body condition of Goshawks Accipiter gentilis along a latitudinal gradient in Norway
Authors: Sunde Peter
Published: March 2003

Relative starvation risk and body condition were investigated in 599 Goshawks that had died in collision accidents or of starvation. Specimens were collected by the public along a 1300‐km north–south (58°N–71°N) gradient in Norway, representing the northernmost geographical range of the species. The probability of a Goshawk’s death being caused by starvation as opposed to by a collision accident increased with latitude with juvenile males at a disproportionately higher risk than others. Of birds killed in accidents, females generally were in better condition than males, and adults in better condition than juveniles. A season‐by‐latitude interaction indicated that males from northern latitudes were in poorer condition during winter and spring than males from southern parts of the country. This could also be modelled as a curvilinear relationship with daylength. There were no significant relationships between weather factors in the weeks prior to the deaths of the birds and the relative starvation probability or the condition of trauma victims. The results suggest that food limitation plays a relatively higher role in northern populations, affecting young males especially. This was also supported by the fact that the sex ratio of accidentally killed birds was increasingly female biased with increasing latitudes. It is suggested that the relatively higher mortality risk of males is due to their smaller average body size, and that selection for starvation resistance during winter is the reason behind the clinal increase of body size in Goshawks towards the northern and eastern parts of Europe.
Individual dispersal among colonies of Little EgretsEgretta garzetta
Authors: Fasola Mauro , Hafner Heinz , Kayser Yves , Bennetts Robert E. , Cezilly Frank
Published: March 2003

Colonial waterbirds are unusual in that competition for nest‐sites or mates may occur at a scale of a few metres, whereas thousands of birds may overlap in their foraging range at a larger scale. Dispersal has been evaluated for only a few such species, and its adaptive significance remains unclear. We studied Little Egret dispersal among all the colonies within the Camargue, southern France. The overall probability of dispersal between successive years was 0.45. The probability of dispersal was unaffected by a bird’s age, or by any density‐dependent effect of colony size. Juveniles dispersed at distances that would be expected if colony selection were random, while adults tended to remain within 10 km of their previous colony. We found no obvious environmental ‘trigger’ for an individual to disperse. Although our evidence is inconclusive, the short dispersal distances of adults are not consistent with foraging conditions as the primary trigger for dispersal. Little Egrets generally forage within 8 km of their colony, so birds dispersing less than 10 km would gain little advantage in response to unfavourable foraging conditions. Our data, with 75% of dispersing birds coming from decreasing colonies and 72% joining increasing colonies, suggest that individual dispersal depended on colony dynamics as a whole, i.e. (1) a social component of dispersal at the individual level, or (2) a simultaneous colony response to unfavourable environmental conditions or (3) both. Further investigation at a higher social level may be necessary to understand dispersal of this colonial nesting species.
Nesting area fidelity and survival of female Common Goldeneyes Bucephala clangula: are they density‐dependent?
Authors: Ludwichowski Ingo , Barker Richard , Bräger Stefan
Published: March 2003

The breeding histories of 218 female Common Goldeneyes Bucephala clangula were recorded between 1971 and 2000 in a study area in Schleswig‐Holstein, northern Germany. Females were first recorded breeding at a median age of 2 years usually in their area of hatching (philopatry). One hundred and two of 140 females (73%) re‐nested only in one of the 13 nesting areas (clusters of nestboxes) for all their known life of up to 13 breeding seasons. The remaining 38 individuals moved between different nesting areas at least once between breeding attempts. The two oldest females were still breeding at a minimum age of 15 years (i.e. 13 years between first and last recorded breeding attempt). Temporal variations in annual survival rates of adult females could best be explained by a model with annual survival rate varying independently and randomly about a mean of 0.830 (se = ±0.023) with an estimated sd of ±0.092 (95% CI = 0.064, 0.138). No trend in the annual survival rate was detected over the study period of 30 years, although the presence of a moderate trend could not be ruled out. The absence of any discernible trend in survival at a time when the population size increased substantially indicates little, if any, density‐dependence in survival of female Goldeneyes during this study.
On the taxonomic status of the Indian Spotted EagleAquila hastata
Authors: Parry S. J. , Clark W. S. , Prakash V.
Published: March 2003

We review the status of the two currently recognized subspecies of Lesser Spotted EagleAquila p. pomarina(western Eurasia) andA. p. hastata(Indian subcontinent) on the basis of museum diagnosis and field observations. We present differences between these two allopatric taxa which demonstrate that they should be treated as distinct species. Specifically, we present evidence of differences in plumage (both for adults and juveniles), external morphology, osteology, clutch size and behaviour. Particular emphasis is placed on differences in gape size and general cranial structure.
Strained energy budget of winter floaters in the Willow Tit as indicated by ptilochronology
Authors: Hogstad Olav
Published: March 2003

Most Willow Tits Parus montanus live within flock territories during the non‐breeding season, but many juveniles roam around or switch between several flocks. Such floaters behave submissively and spend time watching other flock members in addition to scanning for predators. During September–December 1989–2000, I studied individually colour‐ringed Willow Tits living in a subalpine forest area in central Norway. When among flock members, the floaters foraged less in favourable parts of trees and were more vigilant than the lowest‐ranked juvenile flock members. The nutritional condition of the birds was assessed by examining the growth bar widths of their tail feathers. Birds in better condition have wider growth bars than those in poorer condition. The daily growth bars of induced feathers of male and female floaters, laid down under winter conditions, were significantly narrower than those of the lowest ranked flock members. These results suggest that juvenile floater Willow Tits maintain a poorer nutritional status than low‐ranking juvenile flock members during winter.
Stress Concentration Factors for a Circular Hole in Curved Beams Under Bending Loads
Authors: Paloto J. C. , Santos R. D. , Domínguez P.
Published: March 2003

Abstract: As a contribution to the field of stress concentration studies, the case of circular hole in curved bar elements under bending is hereby studied. Trend values of stress concentration factors (SCF) are presented based on selected variables of the problem for two critical hole locations. The results will help to identify an SCF law for practical use by applying the statistical method of regression analysis. Two approximations obtained by means of computational methods are compared with those obtained by photoelastic experimental method.
Spatially resolved polarization properties for in vitro corneas
Authors: Bueno Juan M. , Jaronski Jaroslaw
Published: March 2003

Spatially resolved polarization properties of in vitro mammalian corneas have been studied by using a Mueller‐matrix imaging polarimeter in transmission mode. Sixteen images corresponding to independent combinations of polarization states in the illumination and analyzing pathways are recorded. Spatially resolved Mueller matrices of the samples are calculated from them. Results show that the birefringence of the cornea is almost linear. Although the magnitude of retardation depends on the sample, it is approximately constant at the center and increases towards the periphery. Dichroism and polarizing power are negligible. Maps of the degree of polarization indicate that the cornea basically does not depolarize the totally polarized incident light.
Do tinted lenses or filters improve visual performance in low vision? A review of the literature
Authors: Eperjesi Frank , Fowler Colin W. , Evans Bruce J. W.
Published: March 2003

This is a review of studies that have investigated the proposed rehabilitative benefit of tinted lenses and filters for people with low vision. Currently, eye care practitioners have to rely on marketing literature and anecdotal reports from users when making recommendations for tinted lens or filter use in low vision. Our main aim was to locate a prescribing protocol that was scientifically based and could assist low vision specialists with tinted lens prescribing decisions. We also wanted to determine if previous work had found any tinted lens/task or tinted lens/ocular condition relationships, i.e. were certain tints or filters of use for specific tasks or for specific eye conditions. Another aim was to provide a review of previous research in order to stimulate new work using modern experimental designs. Past studies of tinted lenses and low vision have assessed effects on visual acuity (VA), grating acuity, contrast sensitivity (CS), visual field, adaptation time, glare, photophobia and TV viewing. Objective and subjective outcome measures have been used. However, very little objective evidence has been provided to support anecdotal reports of improvements in visual performance. Many studies are flawed in that they lack controls for investigator bias, and placebo, learning and fatigue effects. Therefore, the use of tinted lenses in low vision remains controversial and eye care practitioners will have to continue to rely on anecdotal evidence to assist them in their prescribing decisions. Suggestions for future research, avoiding some of these experimental shortcomings, are made.
A retrospective pilot study to assess the impact of strabismus surgery on the corneal endothelium in children
Authors: Müller Andreas , Doughty Michael J. , Watson Lesley
Published: March 2003

Purpose: To investigate if strabismus surgery has an impact on the corneal endothelium in children.

Methods: Fourteen children who had undergone uncomplicated strabismus surgery an average of 41 months previously (range 24–73 months) were compared with a group of age‐matched (range 5–12 years) and refractive error (RE)‐matched (range –4.74 to +4.25 D) children. Following non‐contact specular microscopy, areas of at least 100 cells were measured, the number of sides for each cell recorded, and endothelial cell density (ECD) calculated from the area measures. Corneal diameter was measured with a clinical rule, corneal curvature with a manual keratometer, central corneal thickness (CCT) by ultrasound pachometry, and IOP by non‐contact tonometry.

Results: The average ECD (±S.D.) in the post‐surgery group was 4467 ± 627 cells mm–2, which was significantly higher (p < 0.02) than in the control group (3781 ± 452 cells mm–2). This was because the average endothelial cell area in the surgery group was significantly smaller than in the control group (p < 0.005; 252 ± 25 μm2 vs 296 ± 29 μm2). Differences in cell areas were slightly greater for smaller cells (–15.7% for five‐sided cells, –15.6% for six‐sided cells, –14.3% for seven‐sided cells and –13.8% for eight‐sided cells). The cell differences appear to be related to both a slightly smaller corneal diameter (11.00 ± 0.52 mm vs. 11.21 ± 0.58 mm) and a slightly higher CCT (0.528 ± 0.033 mm vs. 0.515 ± 0.032 mm) in the post‐operative group.

Conclusion: The endothelial mosaic in children after strabismus surgery can show a higher than expected ECD value and slight cell pleomorphism. These signs indicate that there might be differences in eye growth and endothelial inflammatory stress associated with uneventful strabismus surgery.
Coloured overlays in schools: orthoptic and optometric findings
Authors: Scott Lorna , McWhinnie Hazel , Taylor Lynette , Stevenson Nicola , Irons Peter , Lewis Elizabeth , Evans Marylyn , Evans Bruce , Wilkins Arnold
Published: March 2003

In two studies, the first in a school in Peterborough and the second in a school in Norwich, more than 233 children aged 8–12 years received either an orthoptic examination, or an optometric examination, together with an examination using coloured overlays and a test of reading fluency. In both studies more than one‐third of the children reported visual symptoms. More than one‐third of the children chose to use an overlay, and they read more quickly with it than without. The colour of the overlay chosen was weakly related to the binocular amplitude of accommodation: overlays reflecting greater energy at long wavelengths were chosen more frequently by children with a higher amplitude of accommodation. Although the visual symptoms were strongly related to the use of an overlay, in neither study was the benefit from an overlay strongly related to the orthoptic or optometric findings. Nevertheless, children who used an overlay had slightly, but significantly, reduced mean binocular amplitude of accommodation and fusional reserves. On average, children with `sensory' or `motor' instability of the nonius strips of the Mallett unit read more slowly than others, as did those with poor stereopsis. However, 60% of those demonstrating sustained overlay use gave a normal response on the Mallett aligning prism test, compared with 80% of those who did not use an overlay for a sustained period. Another indicator of decompensated heterophoria, Sheard's criterion, did not differentiate subjects who used overlays from those who did not. Although binocular and accommodative anomalies do not appear to be the underlying mechanism for the benefit from coloured filters in most cases, there may be some individuals who respond to coloured filters and in whom these ocular motor factors require treatment. Children with visually precipitated symptoms and/or reading difficulties need both a careful evaluation of their accommodative and binocular status, and an investigation of the effect of coloured filters.
Image quality in wearers of a centre distance concentric design bifocal contact lens
Authors: Gispets J. , Arjona M. , Pujol J.
Published: March 2003

The optical performance of eyes wearing bifocal concentric contact lens was studied using the double‐pass technique. Retinal image quality was measured for four subjects wearing CIBA Bisoft contact lenses presenting the central zone for correcting distance vision. Lenses with two different central optic zone diameter (COZD), 3.2 and 3.8 mm, were studied and the influence of pupil diameter and viewing distance were analysed. Results show that the best optical performance is obtained for far vision conditions when no lens is worn even if the pupil coverage by the COZD is complete. For near vision conditions, the optical performance when the lens is worn is, in general, better than when no lens is worn. When the lens is worn the best optical performance corresponds to a pupil diameter of 3 mm and far vision conditions. For this pupil diameter, variations in the situations analysed can be explained by changes in the percentage of pupil coverage corresponding to the far or the near vision zone of the lens. For a pupil diameter of 5 mm, the retinal image quality is more similar in all situations studied and pupil coverage alone cannot explain the results obtained and the influence of other parameters related to the design or contact lens fitting characteristics must be considered.
Remediation of refractive amblyopia by optical correction alone
Authors: Moseley Merrick J. , Neufeld Meir , McCarry Bernadette , Charnock Avril , McNamara Rowena , Rice Tricia , Fielder Alistair
Published: March 2003

Amblyopia – the commonest vision abnormality of childhood – is characterized by a loss of visual acuity usually of one eye only. Treatment aims to promote function of the amblyopic eye and does this by restricting, usually through occlusion, the competitive advantage of the fellow eye. Recent experimental evidence demonstrates that the recovery of vision following early deprivation is facilitated by increasing visually evoked activity. An analogous approach in humans is to minimise image blur by correcting refractive error prior to treatment – a practice which may account for the poorly quantified improvements in visual acuity sometimes attributed to `spectacle adaptation'. Here we describe clinically significant gains in visual acuity obtained over a period of 4–24 weeks in a group of amblyopic children arising solely in response to the correction of refractive error. Consequences for the clinical management of refractive amblyopia are discussed.
The contrast sensitivity function for detection and resolution of blue‐on‐yellow gratings in foveal and peripheral vision
Authors: Anderson R. S. , Zlatkova M. B. , Beirne R. O.
Published: March 2003

Abstract Previous studies using polychromatic gratings have shown that the peripheral grating contrast sensitivity function is significantly different when the task is resolution rather than detection. Specifically, in the middle frequency range, while resolution acuity drops suddenly to zero, detection performance continues up to much higher frequencies, accompanied by observations of aliasing. We wanted to determine if the same holds true for blue‐cone isolating gratings in either foveal or peripheral vision. Contrast sensitivity function (CSFs) were measured at the fovea and 20 degrees eccentricity in the temporal retina under conditions of short‐wavelength‐sensitive (SWS)‐cone pathway isolation using a two‐alternative forced choice paradigm. The detection and resolution CSF were identical at the low frequency end but at higher frequencies resolution sensitivity falls abruptly while contrast detection remained possible till higher frequencies [cut‐off frequencies: fovea detection 6.0 cycles (degree)−1, resolution 4.6 cycles (degree)−1; periphery detection 1.6 cycles (degree)−1, resolution 1.05 cycles (degree)−1]. Aliasing was observable when spatial frequency exceeded the resolution limit. Medium/high contrast blue‐cone‐mediated resolution acuity is sampling limited in both the fovea and periphery. Previous studies of blue‐cone contrast sensitivity which employed a detection task do not reflect the true resolution limit.
Modified attentional fields in ageing
Authors: Cunningham I. , Knox P. C. , Rowe F.
Published: March 2003

Purpose:  Clinical vision testing tends to underestimate age‐related visual decline. We have modified an automated perimeter by adding a second task at fixation and have investigated visual fields in conditions of focused (FA) and divided attention (DA).

Methods:  Two lasers were mounted on a Humphrey Visual Field Analyzer (Carl Zeiss, Jena, Germany). They projected red targets 2 mm either side of the standard fixation target. Fifteen young (mean age: 20 ± 1.4 years; range: 18–23) and 15 healthy old subjects (72 ± 5.1 years; range: 65–80) were assessed under FA using Fastpac 30–2 program (sequence 1). Subjects then repeated the test twice under DA (sequences 2 and 3), in which they were instructed to press a second handheld button in response to an asynchronously presented central laser target. They also responded to continuing laser targets after the threshold program finished.

Results:  For old subjects under DA, the mean threshold increased by 2.87 cd m−2 (sequence 2) and 0.8 cd m−2 (sequence 3) compared with FA (sequence 1). By comparison young subjects increased by 0.03 cd m−2 (sequence 2) and decreased by 0.55 cd m−2 (sequence 3). Compared with young subjects, mean threshold for old subjects was 8.44 cd m−2 (sequence 2) and 6.89 cd m−2 (sequence 3) greater. Mean reaction times for the fixation task alone were comparable (young: 353 ± 46 ms vs old: 352 ± 52 ms). However, when combined with the threshold field task, reaction times increased by much more in the old group (e.g. 497 ± 46 ms vs 557 ± 50 ms sequence 2).

Conclusion:  The visual fields of old subjects were only slightly reduced in DA conditions although the reduction was clearly greater than for the young group. There were marked increases in the reaction times of the older group to targets presented at fixation. Continuing studies will assess impact of DA on patients with ocular and cerebral disease.
Digital imaging system for assessing posterior capsular opacification: a preliminary report
Authors: Al‐Farhan H. , Hull C. C. , Hameed R. , Horgan S. E. , Woodward E. G.
Published: March 2003

Purpose:  Posterior capsular opacification (PCO) is the commonest complication of cataract surgery. The aim of this work is to develop a system that could be used by primary care practitioners to monitor the progression of PCO using familiar equipment.

Methods:  A Kodak DCS 100 (Eastman Kodak, Rochester, NY, USA) digital data back, which uses a Nikon F3 body, was connected to the camera port of a Nikon FS‐2 photo slit‐lamp. A fixation stimulus was developed and systematic studies carried out to determine optimum exposure and slit‐lamp settings using patients recruited from the YAG laser capsulotomy clinic at the Royal Eye Unit, Kingston Hospital. In all cases conventional illumination was used. Inter and intraobserver trials were then carried out using observers ranging from a non‐clinician to an experienced ophthalmologist. All images were analysed using ImagePro Plus image processing software prior to statistical analysis.

Results:  Optimum slit‐lamp parameters were found to be a 45° slit beam angle, 3 mm slit width and 25× magnification. The flash intensity was set to 2. The optimum camera and digital storage unit speed settings were both ISO 200 for fibrotic PCO but 800 and 1600, respectively, for Elschnig pearl type PCO. Intra‐observer repeatability gave ±0.375 mm (95% confidence) variation in fixation. However, initial results from interobserver trials showed significant variability.

Conclusions:  The current digital assessment system uses a standard piece of consulting room equipment coupled to a digital 35 mm camera. Initial results indicate that it should be suitable for use in monitoring PCO although a more exact measurement protocol is required to reduce interobserver variability. Work is currently underway to complete validation trials and to find suitable image statistics.
Computer colour tests for the major causes of blindness using an inexpensive PC system
Authors: Arden G. B. , Wood N. , Fiori B. , Wolf J. E. , Hogg C. H. , Berninger T. , Perry S. , Perry L.
Published: March 2003

Background:  Computer‐graphics methods of assessing acquired losses of colour vision are superior in many ways to all others. They can employ briefly flashed stimuli, that can be presented in the retinal periphery; any luminance signal can also be masked by dynamic random luminance noise; and chromaticity can be varied very precisely. We have devised a program that is designed to detect and quantify disturbances in the three major blinding conditions (glaucoma, ARM and diabetes).

Methods:  The tests can be performed very rapidly, using standard PCs.

Results:  Normal results from age‐matched groups prove prominent tritan losses in all 3 three conditions. In diabetes, relatively large abnormalities can be detected before the appearance of mild background retinopathy, and worsen with the appearance of microaneurysms. In suspected glaucoma, abnormalities can be detected when conventional perimetry is ambiguous. There is a good correlation with minor changes on the Heidelberg Retinal Tomograph (HRT). The loss is related to IOP. In ARM, even with normal visual acuity, very large losses of tritan contrast sensitivity can be seen. Although patients can see the colours on the monitor screen, the targets (small optotypes) cannot be recognised, apparently because of the presence of very small tritan scotomas, which can be demonstrated when the target is flashed briefly.

Conclusions:  Colour vision testing permits rapid screening of patients at risk of developing sight‐threatening disorders, and thus is potentially of considerable use in health‐care programmes.
Relative letter legibility of Punjabi optotypes
Authors: Sailoganathan A. , Siderov J. , Osuobeni E.
Published: March 2003

Purpose:  To investigate relative letter legibility of Punjabi optotypes.

Methods:  In experiment 1, the influence of font type on letter legibility was studied on nine subjects optically defocused using a +1.00 DS lens in front of one eye. Two Punjabi font types used in widely read Punjabi language newspapers and magazines were selected. Legibility was determined according to the method of Strong and Woo (1985). In experiment 2, a single Punjabi font (selected from experiment 1) was used to investigate relative letter legibility in 10 subjects who were optically defocused with a +1.00 DS, +2.00 DC, axis 180 and 90. The Punjabi letters were modified to fit into a 5 × 5‐grid using Coral draw and presented on a standard PC monitor at high contrast using Powerpoint. The method of Strong and Woo (1985) was used to determine relative letter legibility.

Results:  The results of experiment 1 showed no effect of font type on letter legibility (anova, p > 0.05). The results of experiment 2 were analysed in two ways. Firstly, anova revealed an interaction between blur condition (sphere, cyl axis 90, cyl axis 180) and letter legibility (p < 0.05). Post‐hoc analysis (analysis of main effects and Tukey HSD test) showed a significant effect of letter legibility only under the +2.00 DC axis 90 blur condition (p < 0.05). Secondly, the percentage difference in relative legibility under cylinder blur (axes 180 and 90) was plotted against the legibility under spherical blur. We selected 11 letters of equal legibility on the basis of a difference in relative legibility for each cyl condition of no more than 10% of the value of the spherical blur condition.

Conclusion:  Relative legibility of Punjabi letters was determined resulting in the selection of 11 letters. These letters will form the basis of a new, standardised vision chart in Punjabi.
Accuracy of wavefront measurement and the potential effect of erroneous custom corneal correction on the modulation transfer function
Authors: Diaz‐Santana L. , Davies N. , Lara‐Saucedo D.
Published: March 2003

Purpose:  To assess the accuracy of repeated measurements of ocular aberrations using wavefront sensing in a small group of observers and to assess the potential effect of measurement error on custom corneal correction.

Methods:  A Shack–Hartmann wavefront sensor was used to measure the ocular wavefront in nine eyes. Head position was stabilised using a dental bite bar and the pupil centred using a CRT monitor and circular grating. Twenty Shack–Hartmann images were collected for each measurement. Each observer had three sets of measurements taken; the first and the second after careful alignment and the final after regrasping the bite bar in the same position as for the second measurement, but without pupil realignment. The modulation transfer functions for each set were calculated and the effect of ideal custom treatments on the modulation transfer function (MTF) was estimated.

Results:  There were highly statistically significant differences in a large number of Zernike modes between the three sets of measurements. The MTFs calculated for the residual wavefronts following ideal custom treatment were below the diffraction limit. The RMS wavefront errors were consistently better for the residual wavefronts obtained using the realigned data than using data taken without pupil realignment.

Conclusions:  Sequential measurement of ocular aberrations shows statistically significant differences in a large number of Zernike modes. If aberrations determined by a single measurement are to be used in a custom correction the resulting modulation transfer function is likely to remain below the diffraction limit. Pupil realignment is critical in reduction of the residual root mean square wavefront values to a minimum.
Valerian: A Practical Review for Clinicians
Authors: Caron Michael F. , Riedlinger June E.
Published: March 2003

Abstract Valerian is a natural preparation of the root and rhizome of the perennial herb, Valeriana officinalis L. It has sedative and calming effects and is utilized primarily in the treatment of insomnia and sleep disturbances. Several compounds have been identified in valerian, and although pharmacological activity has not been attributed to a specific constituent, this herb's mechanism of action is thought to be related to its ability to interact with the inhibitory neurotransmitter gamma‐aminobutyric acid. This thorough review highlights significant valerian research to date. Valerian has been generally well tolerated in clinical trials; however, long‐term administration has been associated with occasional side effects of headache, excitability, uneasiness, and cardiac disturbances. Due to the limitations of small sample size, variation in formulation, and inconsistent results in currently published clinical trials, further research is needed to clarify the efficacy and side effect profile of valerian, especially in regard to long‐term therapy.
Dietary Supplements for Peri‐ and Early Postmenopausal Women: A Quantitative Proposal Based on Disparities Between Recommendations and Dietary Intakes
Authors: Booth Sarah L. , Nelson Miriam E. , Mason Joel B. , Angelo Giana , Meydani Simin Nikbin
Published: March 2003

Dietary supplement use is increasingly more popular in the United States. Although dietary supplements are not intended to replace intakes from foods, many formulations contain multiple nutrients at levels equivalent to or greater than their corresponding dietary recommendations. Nutrient doses are often justified by expected benefits. Women in the peri‐ and early postmenopausal stages are becoming the most frequent users of dietary supplements, so consideration of reported dietary intakes by women in this age range (45–60 years) is important for determining appropriate levels of supplementation. Dietary intakes at the 5th percentile among women in this age group meet 20–80% of the recommended intakes for individual nutrients. Therefore, for most nutrients, the difference between recommended dietary intakes and actual intakes reported by the 5th percentile represents an adequate level of supplementation. Exceptions to this strategy exist, which relate to evidence of deficiency in the US, the bioavailability of certain nutrients, and putative health benefits not considered in existing dietary recommendations. For some nutrients, there is an overall lack of scientific evidence that supplementation is required at all.
Nutrition Support for the Patient with Chronic Obstructive Pulmonary Disease
Authors: Paiva Sergio A.R. , Campana Alvaro O. , Godoy Irma
Published: March 2003

Rates of malnutrition among patients with chronic obstructive pulmonary disease range from 20 to 50%, depending on disease severity. Malnutrition and its associated weight loss have been related to a weakening of respiratory and peripheral muscles, impaired exercise performance, and increased susceptibility to lung infection. Although no single cause of malnutrition has been identified, contributing factors include altered basal metabolism, the presence of inflammatory mediators, and metabolic alterations produced by disease treatment and exacerbations. Each of these elements should be explored during a thorough assessment. Patients who are malnourished or losing weight and those with acute exacerbations of the disease should be considered for nutrition support. Patients can be given supplemental oral feedings when tolerated, but may require enteral or parenteral feeding if intakes are consistently inadequate. The goals of nutrition support are to achieve weight gain, preferentially as muscle mass, and to improve lung and respiratory muscle function, exercise performance, and well being scores.
Ginsengs: A Review of Safety and Efficacy
Authors: Mahady Gail B. , Gyllenhaal Charlotte , Fong Harry H.S. , Farnsworth Norman R.
Published: March 2003

Both Korean and Siberian ginseng are used extensively for the enhancement of mental and physical performance. However, results from recent randomized, controlled clinical trials do not substantiate the purported ergogenic effects of ginseng in healthy individuals. Nevertheless, there is some evidence (both human and animal studies) to suggest that Korean and Siberian ginseng may have health promoting effects by stimulating the immune response. The recommended daily dose for Korean ginseng is 0.5 to 2 g per day of dried root or 100 to 300 mg per day of a standardized extract containing 1.5 to 7% ginsenosides and, for Siberian ginseng, 2 to 3 g per day of dried root or equivalent preparations. Patients should be cautioned not to exceed these dosages, as adverse reactions such as hypertension, diarrhea, nervousness, and insomnia are associated with excessive ingestion. For Korean ginseng, drug interactions have been reported with both phenelzine and warfarin. There is a single case report of an interaction between Siberian ginseng and digoxin; however, the clinical significance has not been established. The use of ginseng is contraindicated for children and women who are pregnant or lactating, while Siberian ginseng should also be avoided by those patients with cardiovascular disease or hypertension (BP>180/90 mmHg).
Oral Health and Nutrition in the Elderly
Authors: Henshaw Michelle M. , Calabrese Joseph M.
Published: March 2003

There is a multidirectional association between nutrition and oral health. Oral diseases such as dental caries (tooth decay), periodontal disease, tooth loss, and oral cancer compromise the condition of teeth and supporting tissues, which, in turn, impacts food choice, nutritional intake, and quality of life. Conversely, nutritional status affects the development and progression of oral diseases. The cyclical nature of this interaction is particularly important in older adults, because elders are at increased risk for both poor nutritional status and oral health problems. Still, an oral health assessment is not a routine component of periodic examinations or nutrition counseling for older adults. To include this oft‐overlooked component of systemic health, health care providers must understand the link between nutrition and oral health and learn how to conduct simple oral health assessments. The knowledge gained from an oral health assessment will help clinicians provide more appropriate nutritional counseling and enable them to screen for and make appropriate referrals for oral health problems that may adversely affect their patients' nutritional status. Simple oral health assessments can be easily administered by health professionals, can be completed in less than five minutes, and may have the potential to improve patients' oral health, nutrition, overall health, and, ultimately, the quality of their lives.
Nutrition and Cognitive Function
Authors: Nicolas Anne‐Sophie , Nourhashemi L. Fati , Lanzmann‐Petithory Dominique , Vellas Bruno
Published: March 2003

Abstract Cognitive impairment is a major problem in elderly persons. The possible role of nutrition in the development of cognitive disorders and dementia is a current theme of investigation. This paper discusses a number of possible associations between nutrition and cognitive function, especially hypotheses concerning deficiencies of B vitamins and homocysteine and damage caused by free radicals, along with the potential role of antioxidants in preventing such damage. We present putative mechanisms through which diet could modulate cellular life in the brain, along with practical advice for clinicians.
Echinacea: Recommendations for its Use in Prophylaxis and Treatment of Respiratory Tract Infections
Authors: Mahady Gail B. , Qato Dima M. , Gyllenhaal Charlotte , Chadwick Luke , Fong Harry H.S.
Published: March 2003

Abstract Products containing Echinacea are some of the best selling and most widely used botanical dietary supplements in the United States. Commercial Echinacea extracts are manufactured primarily from 3 Echinacea species, namely Echinacea purpurea (herb, roots, or seeds), E. angustifolia (roots), and E. pallida (roots). Current recommendations for use of these products include oral administration for the prophylaxis and treatment of the common cold, bronchitis, influenza, and bacterial and viral infections of the respiratory tract.

Unfortunately, much of the clinical data published prior to 1991 suffered from poor methodology and, therefore, was difficult to assess. However, more recent controlled clinical trials have suggested that while Echinacea may not be effective for the prophylaxis of upper respiratory tract infections, these products may be useful in decreasing the symptoms and duration of illness.

In vitro and in vivo studies indicate that the therapeutic effects of Echinacea are due to a stimulation of cellular immune response. The major adverse events reported are allergic reactions, ranging from contact dermatitis to anaphylaxis. Patients with an allergy to plants in the daisy family (Asteraceae) should be instructed not to use products containing Echinacea. No drug interactions have been reported, however, the extracts have been shown to inhibit the activity of cytochrome P450 and, therefore, have the potential to influence drug metabolism. Echinacea‐containing dietary supplements may be used safely in conjunction with antibiotics or sulfa drugs. According to the German Commission E, patients with autoimmune disorders, AIDS, HIV infection, or tuberculosis should not use Echinacea, however, there is little scientific data to substantiate these contraindications.

Recommendations for oral dosage and dosage forms are difficult due to the wide variety of preparations and doses used in the clinical trials. However, based on existing data products containing pressed juice or hydroalcoholic extracts, Echinacea purpurea (leaf juice and roots) and E. pallida (roots) have the most convincing data supporting their use.
Subcutaneous tissue fibroblasts transfected with muscle and nonmuscle actins: A good in vitro model to study fibroblastic cell plasticity
Authors: Mounier Nicole , Desmoulière Alexis , Gabbiani Giulio
Published: March 2003

Cultured fibroblasts develop several biochemical and morphological properties of smooth muscle cells, particularly the expression of α‐smooth muscle actin, the actin isoform typical of vascular smooth muscle cells. They resemble modified fibroblasts or myofibroblasts observed in granulation tissue during wound repair and in fibrotic situations. We have analysed by immunolabeling the fate of exogenous epitope‐tagged actin isoforms by transfection of the corresponding cDNAs into fibroblasts cultured from rat subcutaneous tissue. Tagged muscle actins were efficiently integrated into stress fibers and did not produce obvious changes in cell shape of transfected cells. Transfected nonmuscle actins in contrast changed the morphology and were not or poorly incorporated into stress fibers. These cultured subcutaneous fibroblasts behave similarly to smooth muscle cells when transfected with the same actin encoding cDNAs, indicating another common characteristic of these two cell types in sorting and targeting actin isoforms. Subcutaneous fibroblasts transfected with muscle and nonmuscle actin isoforms provide a good in vitro model to analyze the intracellular sorting of isoactins and to improve our knowledge of myofibroblast characterization and differentiation during tissue repair as well as to understand the relationships between modifications of actin cytoskeleton, adhesion and extracellular matrix proteins. (WOUND REP REG 1999;7:45–52)
Transforming growth factor‐β: crossroad of glucocorticoid and bleomycin regulation of collagen synthesis in lung fibroblasts
Authors: Shukla Arti , Meisler Natalie , Cutroneo Kenneth R
Published: March 2003

Fibrosis is a consequence of injury which is characterized by accumulation of excess collagen and other extracellular matrix components, resulting in the destruction of normal tissue architecture and function. Transforming growth factor‐β, a potent wound healing agent, has also been shown to be an agent that can produce fibrosis because it is a potent stimulator of collagen synthesis. Both glucocorticoids and bleomycin have recently been shown to affect collagen synthesis in opposite directions, by utilizing a common pathway of involving transforming growth factor‐β activator protein binding to the transforming growth factor‐β element. This article presents a mechanistic overview of collagen synthesis regulation by glucocorticoids and bleomycin through the transforming growth factor‐β pathway.
An economic assessment of Apligraf® (Graftskin) for the treatment of hard‐to‐heal venous leg ulcers
Authors: Schonfeld Warren H , Villa Kathleen F , Fastenau John M , Mazonson Peter D , Falanga Vincent
Published: March 2003

Several recent advances in wound care may offer promise for the treatment of hard‐to‐heal venous leg ulcers. One such treatment is Apligraf® (Graftskin), a bilayered, living human skin construct. To assess the economic impact of Graftskin, a model was constructed to compare the annual medical costs and cost‐effectiveness of treating hard‐to‐heal venous leg ulcers with Graftskin vs. compression therapy using Unna's boot. A semi‐Markov model was used to describe the pattern of ulcer treatment, healing, and recurrence among patients with venous leg ulcers. Patients received 1 of 2 treatment regimens, Graftskin or Unna's boot, and were followed in the model for a 12‐month period. The analysis was done from the perspective of a commercial health plan; therefore, only direct medical costs were included. Health care resource use included the primary therapeutic intervention, additional compression dressings, physician office visits, home health visits, laboratory tests and procedures, management of adverse events, and hospitalizations. The model estimated the annual medical cost of managing patients with hard‐to‐heal venous leg ulcers to be $20,041 for those treated with Graftskin and $27,493 for those treated with Unna's boot. In addition, treatment with Graftskin led to approximately 3 more months in the healed state per person per year than did treatment with Unna's boot. Because patients treated with Graftskin experienced improved healing compared with those treated with compression therapy using Unna's boot, they required fewer months of treatment for unhealed ulcers. As a result, the use of Graftskin for treating hard‐to‐heal venous leg ulcers resulted in lower overall treatment costs.